右美沙芬缓释混悬液治疗慢性咽炎所致咳嗽90例的临床观察

目的：研究右美沙芬缓释混悬液治疗成人慢性咽炎所致咳嗽的临床效果。方法：将90例慢性咽炎咳嗽患者随机分为3组,对照组给予万应胶囊治疗,治疗组l给予万应胶囊联合右美沙芬缓释混悬液治疗,治疗组2给予万应胶囊联合右关沙芬缓释混悬液及抗组胺药治疗,疗程均为14d。结果：治疗组1及治疗组2在7d、14d时疗效均优于对照组,差异有统计学意义（P〈O．01）;治疗组2在7d时疗效优于治疗组1,差异有统计学意义（P〈O．01）。结论：右美沙芬缓释混悬液用于成人慢性咽炎所致咳嗽临床效果良好,右关沙芬缓释混悬液联合抗组胺药对成人慢性咽炎所致咳嗽的临床疗效更快、更好。     

Microbiological infections in HIV positive Bahraini patients with low CD4+ T-lymphocyte count

The correlation of CD4+ T-lymphocyte count and the distribution of pathogenic or opportunistic microbial infection most commonly found in HIV positive individuals differ from one area to the other. The present study reports such findings in 67 HIV positive Bahraini patients in the period May 1997 to Nov. 1998. CD4+ T-lymphocyte count was measured using flow cytometry. Bacterial and fungal cultures were performed. Serological diagnosis was performed when indicated. Viral study was done serologically. The distribution of CD4+ T-lymphocyte count in the studied group was: 21 patients (31.3%) less than 100 cells/microl, 5 patients (7.5%) 100-200 cells/microl, 25 patients (37.3%) 201-500 cells/microl and 16 patients (23.9%) with count more than 500 cells/microl. Among patients with low CD4 count (less than 100 cells/microl) (n=21), microbial infections varied from fungal infections 66%, bacterial infections 57% and viral infections 4.8%. Bacterial infections included Salmonellosis (14.3%), Staphylococcus epidermidis (14.3%), Pseudomonas aeruginosa (9.5%), H. influenzae (9.5%), Legionellosis (4.8%) and E. coli (4.8%). Fungal infection included Candida albicans (52.4%), Pneumocystis carinii (9.5%), Cryptococcus neoformans (4.8%). Viral infection included H. simplex to (4.8%). Fungal infections were the highest common infection in thus study. The most common microbial infection was Candida albicans. P. carinii and Cryptococcus neoformans were less common than found in other studies world wide.     

Usefulness of transesophageal three-dimensional echocardiography in the identification of individual segment/scallop prolapse of the mitral valve

We evaluated the potential usefulness of three-dimensional (3D) transesophageal echocardiography (TEE) in assessing individual scallop/segment prolapse in 36 adult patients with mitral valve prolapse (MVP) undergoing surgical correction. Intraoperative 3D TEE correctly identified the location of scallop/segment prolapse in 34 of 36 patients (94%). However, in 6 of these patients 3D TEE images revealed more scallops or segments with prolapse than the surgeon noted intraoperatively. Prolapse of these areas was less prominent and this could possibly explain the lack of correlation with the surgical findings in these patients. In another 2 patients areas of prolapse seen by the surgeon were missed by 3D TEE because some of those scallops/segments could not be well imaged due to image "drop out" and artifacts. Thus, perfect correlation between 3D TEE and surgery was noted in 28 of 36 (78%) patients. Noncoaptation of the MV was also identified in 2 patients. The prolapsed area of posterior (n = 28 observations) and anterior (n = 9 observations) MV leaflets ranged from 1 cm2 to 9 cm2 (mean 3.50 cm2+/- 2.14) and 1.20 cm2 to 5.99 cm2 (mean 3.21 cm2+/- 1.33), respectively. Interobserver and intraobserver agreement for location and area of MVP was excellent (r = 0.97 and r = 0.99, respectively; all P values are <0.0001). In conclusion, 3D TEE is useful in identifying the location of MVP. It may also be potentially useful in assessing the extent of individual scallop/segment prolapse and identifying sites of MV noncoaptation. This information could aid the surgeon in deciding the extent of MV resection.     

胰高血糖素样肽1及其类似物的脑保护作用

胰高血糖样肽1是一种肠促胰岛素,它通过促进胰岛素的释放,抑制胰高血糖素分泌、胰岛β细胞增殖、延缓胃排空等多种途径发挥降糖作用。在临床上胰高血糖素样肽1及其类似物已用于2型糖尿病的治疗。近年来,研究发现胰高血糖样肽1受体不仅分布于胰腺中,在人和动物的脑中也有广泛分布,胰高血糖样肽1及其类似物具有脑保护作用,预示着他们有可能成为治疗中枢神经系统疾病的新型药物。     

疾病以及配伍对人参皂苷在大鼠体内的药动学影响

目的 建立SD大鼠血浆中人参皂苷Rb1、Rb2和Rg1的HPLC分析方法,对比分析配伍白术挥发油前后,人参皂苷在慢性萎缩性胃炎模型大鼠体内药动学特征。方法 SD大鼠分为4组,其中单用正常组和单用模型组均给药人参总皂苷292 mg·kg^-1,配伍正常组和配伍模型组均给药人参总皂苷292 mg·kg^-1和白术挥发油0.1 mL·kg^-1。于给药前和给药后不同时间点进行眼眶取血,采用HPLC测定各成分的血药浓度,并采用Winnolin 6.3软件计算其药动学参数。结果 与单用正常大鼠比较,单用模型组大鼠体内人参皂苷Rb1的C_max和AUC值降低,T_max、T_1/2以及MRT增加,人参皂苷Rb2和Rg1则呈现出AUC增加的变化;而配伍正常组大鼠体内人参皂苷Rb1、Rb2和Rg1的C_max和AUC值均增加,T_max、T_1/2以及MRT值均缩短。与单用模型组大鼠比较,配伍模型组大鼠体内人参皂苷Rb1和Rg1的C_max和AUC值均增加,T_max、T_1/2以及MRT值均降低。结论 在相同给药剂量下,疾病状态机体对人参皂苷的吸收和代谢呈现缓慢趋势,而配伍后能促进皂苷成分在体内的吸收,同时加快代谢消除,为人参的临床用药提供参考依据。     

磁共振T2-Mapping成像对呼吸衰竭患者心肌损害的临床应用价值

目的　探讨磁共振T2-Mapping成像对呼吸衰竭患者心肌损害的临床应用价值。 方法　选择2016年8月到2018年12月本院内科诊治的呼吸衰竭患者122例作为研究组,同期无呼吸衰竭病史的78例内科患者作为对照组。所有患者给予超声心动图与磁共振T2-Mapping成像,记录成像参数并进行相关性分析。 结果　衰竭组的DT值高于对照组（P<0.05）;两组E/A与Pulmonary S/D ratio值对比无统计学差异（P>0.05）;两组心磁共振图像质量Ⅲ级与Ⅳ级分别占比80.3%、9.8%和76.9%和12.8%,对比均无统计学差异（P>0.05）;衰竭组短轴位与长轴位的左心室前壁、后壁T2值均大于对照组（P<0.05）;衰竭组患者中,Pearson相关性分析显示短轴位、长轴位的左室前壁、后壁T2值与DT值均呈正相关性（P<0.05）。 结论　磁共振T2-Mapping成像能反映呼吸衰竭患者心肌损害情况,通过定量评估心肌T2值可有效评估左心室心肌功能,对指导临床治疗方案的抉择和预后判断具有重要作用。     

MRU对肾移植术后原自体无功能肾、输尿管移行细胞癌的诊断价值(附21例报告)

目的：探讨磁共振水成像(Magnetic resistance urography,MRU)在肾移植术后对原自体无功能性肾、输尿管移行细胞癌的诊断价值。方法：对21例肾移植术后临床诊断为肾盂或输尿管移行细胞癌患者进行MRU检查,同时行逆行肾盂输尿管造影;11例行输尿管镜及病理学检查,并行MRU诊断。16例行经尿道输尿管口环形切开、腰部一处切口的肾输尿管全长切除术。结果：术前21例MRU检查均提示肾盂、输尿管有占位性病变,11例配合输尿管镜得出组织学诊断,术前诊断与手术结果一致。21例中,16例采用肾输尿管全长切除术均获得成功。结论：MRU对肾移植术后IVU不显影的原无功能性肾、输尿管移行细胞癌具有重要的临床诊断价值;输尿管口切除、肾输尿管全长切除术对移植肾同侧原肾发生肾盂输尿管癌一样有效。     

间接型药物性肝损伤:新类型与新挑战

间接型药物性肝损伤是由药物的治疗作用所引起的肝损伤,而不是因为药物固有的肝毒性或免疫原性所导致的一类新型药物性肝损伤(DILI)。目前临床常见的间接型DILI主要有3种临床表型,即免疫检测点抑制剂相关肝损伤、药物引起肝炎病毒再激活和药物影响肝细胞代谢所致的脂肪肝或原有脂肪肝加重。由于间接型DILI是一类新型DILI,临床对其认识不足,诊治经验缺乏。尤其是随着免疫检测点抑制剂在临床快速推广应用,间接型DILI迅速增加,给临床诊断和治疗带来更大的挑战。因此,对间接型DILI常见类型的临床特点、发病机制及诊断治疗等研究进展等进行综述,具有重要的临床意义。     

Satisfaction with and adherence to warfarin treatment: A cross-sectional study among Sudanese patients

Background

Satisfaction with and adherence to oral anticoagulant treatment are important measures that decrease morbidity and mortality. Higher satisfaction and adherence to warfarin therapy was found to be associated among other factors with good International Normalized Ratio (INR) control.