牡丹根药理作用的研究

目的：通过对牡丹根药效学和毒性的研究,为牡丹根的综合利用提供药理学依据。方法;采用比浊法,玻片法,观察牡丹根的凝血作用,耳肿法,足跖肿胀法和士的宁惊厥法,分别判断其抗炎及抗惊厥作用;同时对其降压作用和毒性进行测定。结果;大剂量１５ｇ／ｋｇ牡丹根在促进血小板聚集,抗炎,降压及抗惊厥方面均有显著的作用,与丹皮比较,无显著性差异。     

Models of exogenous and endogenous sleep perturbation as diagnostic and therapeutic predictors in depression

In a group of 60 samples divided into three subgroups: a) healthy, b) exogenic (non-psychotic) and c) endogenic (psychotic) depressives, nocturnal sleep (10 p.m. to 6 a.m.) was registered according to accepted standards. 130 parameters (variables) of hypnograms were exposed to exact statistical testing. Mathematical modes were formed through satisfactory conditions of N-distribution by the method of discriminative analysis ("step by step"). These models were called "The Discriminative Profile of Sleep" (DPS). The Model of Exogenic Perturbation of Sleep is characteristic of exogenic (reactive) depressive disturbances. The dominant discriminative factors of this model are: increased number of nocturnal awakenings (NAW) and fragmentation of nocturnal sleep. The Model of Endogenic Perturbation of Sleep is formed by: shortened REM-latency, reduction of delta-sleep, increase of the Index of Endogenic Periodicity/Perturbation (IEP). These models contribute not only to the problem of correct differential diagnosis, but also to the accurate choice of therapy, the appraisal of therapeutic sensitivity-insensitivity following the course of illness, and a more precise final result. According to these models, depression in relation to the structure of nocturnal sleep is defined as: hypnofragmentic exogenic (reactive) depression, and hypnodisrrhythmic endogenic depression (or where endogenic perturbation developed during the illness).     

Periodontal health and HIV infection

Despite a large amount of research of periodontal health seen in HIV infection, much remains to be learned. Very few large controlled studies of infected people at settings not self-selected for oral disease have been reported, and few have investigated the necrotising periodontal diseases described in HIV infection. In this paper we present a brief review of three approaches to identify periodontal changes associated with HIV infection and identify possible aetiological factors for them. First, we summarise the methods and findings of a controlled blinded study of the periodontal health of homosexual men attending a genito-urinary medicine clinic. Second, we précis a case-control study of gingival ulceration among patients at a dedicated dental clinic. Finally, we outline how the validity of diagnostic criteria for HIV-associated periodontal changes were tested against the data collected in the controlled study.     

Severe oral ulceration in patients with HIV infection: A case series

OBJECTIVE: Oral ulceration occurs in an estimated 2–4% of patients with HIV infection. This retrospective observational study describes the aetiology and characteristics of 94 HIV-positive patients with either severe and/or recurrent oral ulceration presenting at a dedicated HIV dental unit over a 4-year period. METHODS: Case records were reviewed for diagnosis investigations, CD4 count, CDC stage and treatment modality. RESULTS: Of the 94 patients 50% had an AIDS diagnosis. In patients with asymptomatic HIV disease minor recurrent oral ulceration was the commonest diagnosis whilst large non-specific neutropenic ulcers were more frequently seen in patients with symptomatic disease with low CD4 counts. A variety of treatment modalities were used including thalidomide. An algorithm is presented for the management of patients with severe oral ulceration.     

Design of the Dutch Obesity Intervention in Teenagers (NRG-DOiT): systematic development, implementation and evaluation of a school-based intervention aimed at the prevention of excessive weight gain in adolescents

Background

Immigrants to the U.S. are required to undergo overseas screening for tuberculosis (TB), but the value of evaluation and treatment following entry to the U.S. is not well understood. We determined the cost-effectiveness of domestic follow-up of immigrants identified as tuberculosis suspects through overseas screening.

Methods

Using a stochastic simulation for tuberculosis reactivation, transmission, and follow-up for a hypothetical cohort of 1000 individuals, we calculated the incremental cost-effectiveness of follow-up and evaluation interventions. We utilized published literature, California Reports of Verified Cases of Tuberculosis (RVCTs), demographic estimates from the California Department of Finance, Medicare reimbursement, and Medi-Cal reimbursement rates. Our target population was legal immigrants to the United States, our time horizon is twenty years, and our perspective was that of all domestic health-care payers. We examined the intervention to offer latent tuberculosis therapy to infected individuals, to increase the yield of domestic evaluation, and to increase the starting and completion rates of LTBI therapy with INH (isoniazid). Our outcome measures were the number of cases averted, the number of deaths averted, the incremental dollar cost (year 2004), and the number of quality-adjusted life-years saved.

Results

Domestic follow-up of B-notification patients, including LTBI treatment for latently infected individuals, is highly cost-effective, and at times, cost-saving. B-notification follow-up in California would reduce the number of new tuberculosis cases by about 6–26 per year (out of a total of approximately 3000). Sensitivity analysis revealed that domestic follow-up remains cost-effective when the hepatitis rates due to INH therapy are over fifteen times our best estimates, when at least 0.4 percent of patients have active disease and when hospitalization of cases detected through domestic follow-up is no less likely than hospitalization of passively detected cases.

Conclusion

While the current immigration screening program is unlikely to result in a large change in case rates, domestic follow-up of B-notification patients, including LTBI treatment, is highly cost-effective. If as many as three percent of screened individuals have active TB, and early detection reduces the rate of hospitalization, net savings may be expected.     

Risk factors for Peyronie's disease: a case-control study

OBJECTIVE: To test some hypotheses about risk factors for Peyronie's disease (PD). PATIENTS AND METHODS: In a case-control study, 82 patients with PD, consecutively diagnosed at the first author's institution, were compared with 246 men visiting the same institution for dermatological diseases. Univariate and multivariate logistic regression analyses were used to assess the data. RESULTS: From the multivariate logistic regression analysis the risk factors for PD were: a history of genital and/or perineal injuries, transurethral prostatectomy, cystoscopy, diabetes mellitus, hypertension, lipoma, propranolol in therapy, Dupuytren's contracture in the medical history, ever having smoked, alcohol consumption, fibromatous lesions of the genital tract of the partner, and surgical intervention on the genital tract of the partner. CONCLUSION: The results of the present study are in line with the hypothesis that, in addition to genetic predisposition, trauma of the penis and systemic vascular diseases are risk factors for PD. Smoking and alcohol consumption also seem to have some role in the development of the disease.     

Labyrinthine ossification: etiologies and CT findings

Ossification of the membranous labyrinth (labyrinthitis ossificans) develops as the final result of many inflammatory processes, for example, meningitis, blood-borne septic emboli, middle ear infection, and cholesteatoma. Labyrinthine ossification may also occur as a result of previous labyrinthectomy or secondary to trauma. Seven cases of labyrinthine ossification accompanied by severe vertigo and total hearing loss in the affected ear are discussed. The computed tomographic appearance of varying degrees of ossification, the clinical and surgical circumstances from which this disorder may develop, and the various approaches to labyrinthectomy are described.     

Phototherapy. Short and long-term complications

Use of phototherapy for hyperbilirubinaemia in 300 consecutively treated infants has shown that minor complications are common. With a knowledge of these complications and measures taken to minimize their effects, phototherapy appears to be safe in the short term. The long-term follow-up study showed that growth, and in particular head circumference, was not affected. There was, however, a higher incidence of squints and abnormal developmental performance in those infants treated with phototherapy. This may not have been due to phototherapy usage per se. However, because of these findings, it is suggested that phototherapy should not be used indiscriminately for hyperbilirubinaemia until the results of further long-term studies are available.