诺氟沙星静脉滴注致三叉神经痛样疼痛

1名31岁男性,因患急性胃肠炎,给予诺氟沙星0.4g静脉滴注。滴注约40min后,患者左侧面部先有麻木感,然后出现发作性触电样剧痛。疼痛每次持续约10s,5min左右发作1次。立即停止输液,给予对症支持治疗。第2天改用阿米卡星静脉滴注,患者疼痛发作的次数和程度有所减轻。继续治疗3d后,其症状消失。     

Effects of Simvastatin and Metformin on Inflammation and Insulin Resistance in Individuals with Mild Metabolic Syndrome

BACKGROUND: In addition to lipid-lowering and insulin-sensitizing actions, statins (HMG-CoA reductase inhibitors) and metformin may have pleiotropic effects. OBJECTIVE: To study the effect of simvastatin and metformin on insulin sensitivity and inflammatory markers. METHODS: Forty-one subjects with body mass index (BMI) 25-39.9 kg/m(2) and impaired glucose tolerance were randomized to receive simvastatin or metformin for 16 weeks. Blood samples were obtained for measurement of metabolic and inflammatory parameters before and after each treatment. RESULTS: As expected, when compared with simvastatin, metformin therapy resulted in significant reductions in mean BMI, fasting plasma glucose, and homeostasis model assessment-insulin resistance (HOMA-IR), whereas simvastatin treatment resulted in significantly reduced total cholesterol, low-density lipoprotein-cholesterol (LDL-C), and apolipoprotein B levels. Independently of the medication used, significant decreases in C-reactive protein (CRP) and interleukin (IL)-6 were detected from baseline to treatment end. CRP showed a mean reduction of 0.12 +/- 0.04 mg/dL (p = 0.002) over the 16-week intervention period and IL-6 a mean reduction was 0.35 +/- 0.17 pg/mL (p = 0.046). No change was observed in the tumor necrosis factor-alpha levels. Baseline values of CRP and IL-6 and their percentage declines were correlated (r = 0.71 and r = 0.67, respectively; p < 0.001). In simvastatin recipients, no correlation was detected between reductions in CRP or IL-6 and lipids, whereas in metformin recipients, reductions in inflammatory markers were not correlated to BMI and HOMA-IR. CONCLUSION: Our findings suggest that both metformin and simvastatin have similar beneficial effects on low-grade inflammation, in addition to their classical effects on glucose and lipid metabolism. Moreover, they confirm the importance of treating at-risk individuals even before the precipitation of overt diabetes mellitus or full-blown metabolic syndrome.     

环孢素A治疗难治性特发性血小板减性紫癜疗效观察

目的探讨环孢素A治疗难治性特发性血小板减少性紫癜的疗效、毒副反应和患者对药物的耐受性。方法19例难治性特发性血小板减少性紫癜患者口服环孢素A,剂量为3mg·kg-1·d-1。定期复查血常规、肝肾功能,并观察药物的副作用。结果良效14例(73.7%),显效4例(21.1%),无效1例(5.2%)。使用环孢菌素后18～74天(43.7±13.5天)血小板计数开始上升。14例良效患者血小板升为正常的时间为36～105天(68.6±19.4天),4例显效患者血小板达到最高的时间为57～95天(71±17.3天)。3例良效患者停药后复发,复用环孢素A仍然有效。复发患者及3例显效患者用小剂量环孢素A维持。部分患者出现轻微副反应。结论环孢素A治疗难治性特发性血小板减少性紫癜效果良好,毒副反应轻微,患者耐受性好。     

藏药翼首草的研究与应用

翼首草为藏医广泛应用,具有清热解毒、祛风湿、止痛等作用,本文根据国内外有关文献研究,对藏药翼首草的研究进展与应用情况进行了综述,结果发现现代药理学研究结论与文献记载该药的功能主治相一致,这为该药的研究与应用奠定了良好的基础,可以预见随着研究的深入,该药应用前景广阔。     

大柴胡汤对胆汁淤积大鼠肝功能的影响

目的:观察大柴胡汤对胆汁淤积大鼠肝功能的影响.方法:用胆总管结扎方法复制大鼠胆汁淤积模型,观测大鼠肝功能变化及大柴胡汤干预的作用.结果:大柴胡汤组TBil、TBA含量及ALP活性均降低.结论:大柴胡汤能够改善胆汁淤积大鼠的肝功能.     

复方甘草甜素联合西替利嗪及多虑平治疗荨麻疹

目的:分析复方甘草甜素片联合西替利嗪及多虑平治疗慢性荨麻疹的疗效和可行性.方法:将296例慢性荨麻疹患者随机分为两组,对照组144例,西替利嗪10 mg,p0.qd,多虑平25 mg,po tid;治疗组152例,在对照组的基础上加服复方甘草甜素片75 mg,tid,两组均连用4周.结果:治疗组和对照组有效率分别为82.89%、61.11%,两组比较差异有统计学意义(P<0.01).结论:复方甘草甜素片联合西替利嗪及多虑平治疗慢性荨麻疹的疗效满意,值得临床选择应用.     

胃肠道肿瘤细胞周期素A的表达及其与化疗药物敏感性的关系

目的探讨胃肠道肿瘤细胞细胞周期素A（Cyclin A）的表达及其与肿瘤化疗敏感性之间的相关性。方法用流式细胞术双参数标记法对45例临床胃肠道肿瘤标本Cyclin A的表达进行检测，同时用四甲基偶氮唑盐显色法（MTT法）检测该肿瘤标本对几种常用化疗药物单药和联合用药方案的敏感程度。结果Cyclin A阳性表达的肿瘤细胞中对5-氟尿嘧啶（5-FU）、顺铂（DDP）、5-FU＋丝裂霉素（MMC）敏感的标本比例分别为76.9%、73.1%和84.6%；Cyclin A阴性表达的肿瘤细胞中相应的比例分别为15.8%、15.8%和10.5%，Cyclin A的表达与5-FU、DDP、5-FU＋MMC的药物敏感性之间具有相关性（均P〈0.01）。Cyclin A的表达与泰素（Taxol）、替尼泊苷（VM-26）、MMC、5-FU＋Taxol、5-FU＋DDP药物敏感性未发现有相关性（均P〉0.05）。结论Cyclin A的表达与某些肿瘤术后化疗方案的敏感程度显著相关，检测该指标对术后化疗药物和联合化疗方案选择可起到一定指导作用。     

慢性缩窄性心包炎的影像学特征分析

目的:提高对慢性缩窄性心包炎的临床及影像学特征的认识能力,降低误诊率.方法:分析41例慢性缩窄性心包炎的临床表现,影像学特征.结果:临床表现为不同程度的呼吸困难、心悸、浅静脉充盈,心尖搏动减弱、奇脉、脉压差小.影像学表现:超声心动图检查:心室舒张末径缩小者33例,24例于M型超声心动图上见左室后壁在舒张中晚期运动停止呈平直外形.X线检查:心影轻中度扩大者32例,25例出现心包钙化,26例出现肺淤血,肺部有结核病灶者23例.CT可明确显示心包增厚及钙化.结论:慢性缩窄性心包炎的影像学特征是一侧或两侧心缘僵直,搏动减弱,心包膜增厚、钙化,心室缩小,小心室大静脉.