Ertapenem versus piperacillin/tazobactam for the treatment of complicated infections: a meta-analysis of randomized controlled trials

Background  

Ertapenem, a new carbapenem with a favorable pharmacokinetic profile, has been approved for the treatment of complicated intra-abdominal Infections (cIAIs), acute pelvic infections (APIs) and complicated skin and skin-structure infections (cSSSIs). The aim of this study is to compare the efficacy and safety of ertapenem with piperacillin/tazobactam, which has been reported to possess good efficacy for the treatment of these complicated infections.     

介绍一种手术纱布定量清点盒

手术纱布清点作为术中护理工作的一个重要步骤,稍有不慎就可能给病人造成不良影响。对此进行了技术创新,设计了一种实用方便的医用手术纱布清点盒,保障了手术顺利、快速、安全进行。     

精神分裂症患者氯氮平维持治疗的治疗依从性、剂量及浓度研究

目的 探讨精神分裂症患者氯氮平维持治疗的治疗依从性、剂量及浓度与预防复发／恶化的关系。方法 对经氯氮平治疗后疗效达到明显好转而出院的102例精神分裂症患者随访1年。每月评定简明精神病评定量表（BPRS）,采用BPRS的核心条目（4、7、11、12和15）判定是否复发／恶化;每日评定服药依从性;每2个月采集出血。结果 复发／恶化率为32．4％（33／102）。复发／恶化者的服药依从性明显低于未复发者（P＜0．001）。经运筹特性曲线分析得出,未复发者氯氮平维持治疗的最佳有效剂量为137．5mg/d（灵敏度为100．0％,特异度为93．9％）,氯氮平最低有效血清浓度为132．0μg/L（灵敏度为100．0％,特异8度为93．9％）;氯氮平＋去甲氯氮平最低血清浓度为201．0μg/L（灵敏度为98．6％,特异度为97．0％）。结论 对于经氯氮平治疗后疗效达到明显好转以上的精神分裂症患者,维持治疗时需提高服药依从性。氯氮平维持治疗的剂量应不低于137．5mg/d,氯氮平或氯氮平＋去甲氯氮平的血清浓度应分别不低于132．0μg/L和201．0μg/L.     

Polymorphism of the angiotensin-converting enzyme gene in patients with cerebral infarction in koreans

The relationship between cerebrovascular disease and an insertion/deletion (I/D) polymorphism in the angiotensin-converting enzyme (ACE) gene is still being debated. The frequency of the DD genotype of the ACE gene was significantly higher in subjects with than those without cerebral infarction in Japan. The aim of the present study was to assess the relationship between ACE gene polymorphism and the development of cerebral infarction in a population from Korea. We examined its possible role as a risk factor in patients with cerebral infarction. The association between ACE gene polymorphism and cerebral infarction was examined in 106 patients with cerebral infarction and 498 controls without cerebral infarction. Frequencies of the genotypes and alleles of the ACE gene were investigated. The ACE genotype was analyzed by the polymerase chain reaction (PCR). The frequency of D allele was 37.7% in patients and 39.1% in controls (X ²=0.128, p=0.720). The frequencies of the genotypes of the ACE gene were II:39.6%, ID:45.3%, and DD:15.1% in patients, and II:37.1%, ID:47.6%, and DD:15.3% in controls (X ²=0.127, p=0.721). There was no significant difference in the frequency of the DD genotype of the ACE gene, and we did not find any association between ACE polymorphism and cerebral infarction. These results indicate that ACE polymorphism is not a risk factor for the development of cerebral infarction in a Korean population.     

中枢神经系统原发性血管炎的诊断与治疗

目的研究中枢神经系统原发性血管炎(PACNS)的诊断与治疗方法。方法对12例以占位性病变为突出表现的PACNS病人,回顾性分析其临床表现、影像特征及手术治疗结果。结果病变表现为低密度的CT、和长T     

神经干细胞移植对脑出血模型大鼠神经功能的影响☆

背景：外源性神经干细胞具有神经修复作用，可能对脑出血后的神经功能恢复起到一定的作用。 目的：观察胎鼠神经干细胞的体外生长、分化及移植到脑出血大鼠后的存活、迁徙、分化情况，探讨神经干细胞对脑出血模型大鼠受损神经功能的修复作用。 设计：完全随机分组设计，对照动物实验。 单位：复旦大学附属华山医院神经外科 材料：选用健康雄性成年SD大鼠18只为受体，体质量280~320 g，由中国科学院上海实验动物中心提供。实验用鼠抗BrdU为Neomarkers产品, 鼠抗胶质纤维酸性蛋白和兔抗微管相关蛋白2 为Chemicon产品。 方法：实验于2006-02/12在复旦大学附属上海医学院解剖组胚实验室完成。从胎龄14 d的胎鼠海马中分离、培养、鉴定神经干细胞。16只受体SD大鼠被随机分为3组：对照组，PBS组和移植神经干细胞组。均通过尾状核内注射自体动脉血制作大鼠脑出血模型。移植NSC组在造模后30 min在血肿腔周围四点分别移植浓度为2×1011 L-1神经干细胞悬液5μL；PBS组于相同时间点在脑内相同部位注射PBS；PBS和神经干细胞的移植方法同自体血的移植方法。对照组大鼠在造模后30 min只造成四点损伤，不注射任何物质。 主要观察指标：在造模后立即，1，3，5，14，21，28 d采用前肢评分和转身评分对大鼠神经功能进行评估。大鼠于造模后28 d麻醉后取脑，并通过双标胶质纤维酸性蛋白、微管相关蛋白2、BrdU免疫组化来检测移植入脑的神经干细胞在体内的分化情况。 结果：①神经功能评分：造模后5 d，各组差异无显著性意义（P > 0.05）。造模后14~28 d，干细胞移植组较其他3组明显改善（P < 0.05）。②脑组织切片双免疫组织学双标染色结果：干细胞移植组血肿周围凋亡细胞少于PBS组。受体大鼠脑组织切片显示有BrdU, 微管相关蛋白2,胶质纤维酸性蛋白阳性细胞，说明神经干细胞可以在宿主脑内存活、迁徙和分化，可以分化为神经元样细胞和神经胶质样细胞。 结论：神经干细胞移植可能通过分化为神经元样细胞和神经胶质细胞促进大鼠脑出血的神经功能恢复。     

老年脑肿瘤患者开颅术围术期的血液流变学变化分析

目的：探讨老年脑肿瘤患者开颅术围术期的血液流变学改变特点及临床意义。方法30例老年脑肿瘤患者术前1d及术后1、3、7d均进行血液流变学指标检测,包括红细胞聚集指数及血沉方程K值、血浆黏度、全血黏度（低切、中切及高切）、全血还原黏度（低切、中切及高切）。结果开颅术前1d、术后1、3、7d在红细胞聚集指数、血浆黏度及血沉方程K值、全血黏度（低切、中切及高切）、全血还原黏度（低切、中切及高切）呈先升高后降低的趋势,其中术后1d达到峰值;术后3d与术后1 d比较差异有统计学意义（P＜0.05）。结论老年脑肿瘤患者开颅术围术期血液流变学指标的变化特点为先升后降,常于术后1d达到峰值。     

Medical Histories of Control Subjects Influence the Biomarker Potential of Plasma Aβ in Alzheimer’s Disease: a Meta-analysis

Whether blood amyloid-β (Aβ) could be a peripheral biomarker of Alzheimer’s disease (AD) remains in dispute. In the present study, we conducted a meta-analysis with 19 citations searched from Embase, PubMed, and the Cochrane Library database. Weighted mean difference (WMD) with 95% confidence intervals (CIs) was used to estimate the effect size. We firstly analyzed the plasma Aβ40, Aβ42, and Aβ42/Aβ40 ratio in AD and control group subjects. However, only a lower level of plasma Aβ42 was figured out in AD group subjects with weak statistical significance (WMD 1.82; 95% CI 0.59, 3.06; P = 0.004; I2 = 84%). We considered that the medical histories of control subjects could influence the biomarker ability of plasma Aβ. Therefore, subgroup analyses were then carried out based on a new recruiting criterion for control subjects, defining as no afflictions of any Aβ-related diseases. Surprisingly, AD group subjects showed a significant decrease in plasma Aβ42/Aβ40 ratio with low heterogeneity among studies (WMD 0.02; 95% CI 0.02, 0.02; P < 0.00001; I2 = 0%). Moreover, not only the Aβ42/Aβ40 ratio but also Aβ42 and Aβ40 were indifferent between AD and pseudo-control subjects which might be afflicted with Aβ-related diseases. This meta-analysis demonstrated that medical histories of control subjects were interference factors impeding plasma Aβ to be a biomarker of AD.