Pharmacokinetics of oral alminoprofen (Minalfen) in elderly patients with rheumatoid arthritis and spondylosis deformans]

The pharmacokinetics of oral Alminoprofen, a nonsteroidal anti-inflammatory drug, were studied in five elderly patients with rheumatoid arthritis and spondylosis deformans after 200 mg (three times a day) repeated dose for 5 days. The pharmacokinetic parameters after oral administration of Alminoprofen were analyzed by the one-compartment open model method. The maximum plasma concentrations (Cmax) were 16.1 +/- 2.5 micrograms/ml, after dosing on day 1, 25.2 +/- 1.6 micrograms/ml on day 3 and 21.6 +/- 2.7 micrograms/ml on day 5. The maximum time (Tmax) were about 2 hours after the medication in al cases. The area under the curve in drug concentration in plasma versus time (AUC) were 58.5 +/- 6.3 micrograms hr/ml on day 1, 58.5 +/- 3.1 micrograms hr/ml on day 3 and 58.1 +/- 8.5 micrograms hr/ml on day 5. The biological half-lives (t1/2) were 2.45 +/- 0.35, 2.09 +/- 0.82 and 2.49 +/- 0.63 hours, after dosing on day 1, day 3 and day 5, respectively. The analysis of moment in pharmacokinetics revealed that the mean residence time (MRT) on day 1, day 3 and day 5 observed were 2.31 +/- 0.03, 2.15 +/- 0.09 and 2.15 +/- 0.07 hours, respectively. The variance residence times (VRT) observed were 0.95 +/- 0.05 hour2 on day 1, 0.88 +/- 0.09 hour2 on day 3 and 1.06 +/- 0.07 hour2 on day 5. The ratios of accumulation calculated were 1.16 +/- 0.05 in both the morning medication on day 3 day 5, and it therefore appears that the steady-state equilibrium is established within 3 days after commencement of dosage.(ABSTRACT TRUNCATED AT 250 WORDS)     

Surgical repair of total anomalous pulmonary venous connection in neonates and infants--prevention for pulmonary venous obstruction at the site of anastomosis

From October, 1980, to June, 1987, thirty-eight infants less than one year old underwent correction for total anomalous pulmonary venous connection (TAPVC). Overall operative mortality and late mortality were 13% and 6%, respectively. Residual pulmonary hypertension was noted in 4 patients: three had pulmonary venous obstruction at the site of atrial anastomosis (PVOA) and one had supracardiac (Ia) lesion left after repair of mixed type (IV: Ia + III) of TAPVC. Two late deaths occurred in these with PVOA. Twenty-two patients with supracardiac (I) or infracardiac (III) TAPVC were divided into three groups according to the technical development in atrial anastomosis: the large anastomosis in which venous incision reached into at least one pulmonary vein beyond common pulmonary vein and the continuous running suture were used in 10 patients (group 1), the appropriate size of anastomosis in which venous incision limited within the common pulmonary vein and the continuous running suture used in 4 patients (group 2), and the appropriate size of anastomosis and the interrupted suture in 8 patients (group 3). PVOA were 3 (33%) in group 1, but 0 (0%) in group 2 and 3. Two late death occurred all in group 1 with PVOA. Cardiopulmonary bypass time and aortic clamp time in group 3 were 91 min and 74 min respectively, which did not become longer than those in both group 1 and group 2. Interrupted suture technique does not make operating time longer than continuous running suture one. PVOA is one of the important factors predicting late operative result.(ABSTRACT TRUNCATED AT 250 WORDS)     

Heterotopic heart transplantation: a radiographic review

Heterotopic heart transplantation can be performed in the presence of high pulmonary vascular resistance. The authors call attention to a rare, but potentially life-saving procedure.     

CGRP免疫反应神经纤维在大鼠胆总管与十二指肠连接处的分布

用免疫组织化学ＡＢＣ法，研究了降钙素基因相关肽（ＣＧＲＰ）免疫反应神经纤维在大鼠胆总管末端与十二指肠连接处的分布。大鼠的胆总管末端有较丰富的ＣＧＲＰ免疫反应神经纤维，它们多呈串珠（膨体）状，少数为无膨体的细长纤维。ＣＧＲＰ－ＩＲ纤维主要分布肌层及血管周围，在神经纤维的附近可见到含ＣＧＲＰ－ＩＲ阳性颗粒的肥大细胞。本实验为神经免疫调节机制的研究提供了形态学依据。     

Respiratory symptoms and cigarette smoking in 3,197 pulmonologist-based asthmatic patients with a highly prevalent use of inhaled corticosteroid.

The relation between smoking and risk of asthma has been well-examined; however little attention has been paid to the correlation between smoking and asthma symptoms. The aims of this study were to examine respiratory symptoms in asthmatics with a highly prevalent use of inhaled corticosteroid (ICS) and to assess the effects of smoking and its cessation. A cross-sectional study of pulmonologist-based 3197 asthmatics (men 45.2%, ages 20-97) was performed using a questionnaire about smoking habits, the incidence and frequency of symptoms (sputum, cough and wheezing, night symptoms, and shortness of breath), physical activity interference, and medication. Although 81.4% of the patients used ICS according to the international guideline, 14.9% had activity interference, and daily symptoms remained in 43.3%. At the time of the questionnaire, 21.6% were current and 25.1% were ex-smokers. In multiple logistic regression analysis, the factors of significance (p < 0.0001) were (1) smoking; for all four symptoms, (2) age and duration of asthma; for shortness of breath. Current smokers were at a risk of sputum (age-adjusted odds ratio 2.32 [95% confidence interval 1.73-3.11]; 2.09 [1.57-2.79]), of cough and wheezing (2.38 [1.81-3.14]; 1.78 [1.35-2.36]), of night symptoms (1.95 [1.41-2.60]; 1.47 [1.09-1.98]), and of shortness of breath (1.70 [1.26-2.28]; 1.30 [0.97-1.75]) in men and women, respectively. These ratios in ex-smokers decreased to the level similar to nonsmokers. Although 81.4% of asthmatic patients used ICS, 43.3% complained of daily respiratory symptoms, especially sputum. It is suggested that the effects of ICS on asthma symptoms may be interfered with by smoking and therefore more emphasis should be placed on cessation of smoking.     

新生儿手术体位的摆放

目的 探讨新生儿手术体位的摆放方法，利于术野的暴露和手术的顺利完成。方法 自制新生儿手术体位摆放辅助物品，用于46例出生2h至28d需仰卧位、侧俯卧位、截石卧位及侧卧位手术患儿的体位摆放。结果 术野暴露充分，术中患儿呼吸、循环正常，关节、神经功能完好，皮肤无擦伤，均顺利完成手术。结论 针对新生儿特点，合理摆放体位，有利于确保手术成功。     

A preliminary study of the relationship between antibiotic administration and changes in bacteriological profile of wound infection in a burn unit

Objective:To investigate the relationship between antibiotic administration and the changes in bacteriological profile in a burn unit. Methods: The data of consumption of different kinds of antibiotics, including total antibiotic consumption [expressed as the number of defined daily doses (DDD)] as well as pathogen identification, were collected in a 8-year period. The constituent ratios of different kinds of antibiotics in total antibiotic consumption to isolation rates of various species of bacteria were calculated, and their correlation was analyzed. Results: Within this period, it was found that the aminoglycosides and first generation cephalosporins were used less frequently, while the polypeptides, carbopenem and macrolides were used proportionally more. At the same time, the isolation rates of Staphylococcus aureus, Acinetobacter sp, Enterobacter cloacae, Klebsiella pneumoniae and methicillin-resistant Staphylococcus aureus were gradually increased. The constituent ratios of predominant pathogens were correlated to the different kinds of antibiotics consumption in the burn unit. Conclusion: The results suggested that the consumption of different antibiotics was closely related to the trends of emergence of bacterial isolates from infected burn wounds. The result might imply that to regulate the administration of certain antibiotics might help decrease the emergence of certain pathogenic bacteria in burn infections.