2例丙肝患者伴发获得性大疱性表皮松解症

作者报道2例确诊的慢性丙肝病毒感染患者合并获得性大疱性表皮松解症（EBA）。两例患者临床上均表现为典型EBA，包括皮肤脆性增加及自发和继发于外伤后发生皮肤水疱，继而以粟丘疹和瘢痕愈合。EBA常常是一种免疫状态改变或低下的疾病。还需进一步研究在这两例患者中和一般情况下丙肝病毒是否诱发EBA。     

Prolonged cardioselective blockade of beta-1 adrenoreceptors in combination with increased diuresis as a method of choice in the treatment of hypertension]

The clinical effects of Tenoric, a long-acting combined drug (atenolol and chlorthalidone in a tablet), were studied in 31 patients with Stages I and II hypertensive disease, by using echocardiography, daily automatic blood pressure monitoring, bicycle ergometry, measurements of plasma renin and aldosterone. The drug was found to be highly clinically effective in labile and sustained hypertension. When given once or twice a day, it makes it possible to reliably monitor blood pressure, improve hemodynamic parameters, as reflected by lower cardiac output and decreased peripheral vascular resistance, reduce the estimated mass of the left myocardium, alleviate a pressor response to exercise and enhance its tolerance, lower plasma renin levels. The side effects of the drug are minimal and include moderate bradycardia. Peripheral vasospasm and systemic weakness were observed in single cases. There were no atherogenic changes in lipid spectrum and disturbed glucose and uric acid metabolism during the drug therapy.     

血清低密度脂蛋白胆固醇直接测定与Friedewald公式计算结果比较

采用聚乙烯硫酸（ＰＶＳ）沉淀法测定血清低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）值，同时应用Ｆｒｉｅｄｅｗａｌｄ公式计算ＬＤＬ－Ｃ含量，并对两法结果进行比较分析，提出当甘油三脂（ＴＧ）＜４．５２ｍｍｏｌ／Ｌ时，Ｆ公式计算法可代替ＰＶＳ法，当ＴＧ＞４．５２ｍｍｏｌ／Ｌ时，不宜用Ｆ公式计算ＬＤＬ－Ｃ的值。     

Dose-Response Characteristics of Spinal Bupivacaine in Volunteers: Clinical Implications for Ambulatory Anesthesia

Background: Small doses of bupivacaine may be a reasonable choice for spinal anesthesia for patients having ambulatory surgery. However, few dose-response data are available to guide the selection of reasonable doses of bupivacaine for different ambulatory procedures.

Methods: Eight volunteers per group were randomized to receive 3.75, 7.5, or 11.25 mg of 0.75% bupivacaine with 8.25% dextrose in a double-blind manner. Sensory block was assessed with pinprick, transcutaneous electrical stimulation equivalent to surgical incision at the ankle, knee, pubis, and umbilicus, and with duration of tolerance to pneumatic thigh tourniquet. Motor block at the quadriceps and gastrocnemius muscles was assessed with isometric force dynamometry. Times until recovery from spinal anesthesia were recorded. Dose-response relationships were determined by linear regressions. Mean (95% confidence intervals) for durations of sensory and motor block per milligram of bupivacaine administered were calculated from linear regressions.

Results: Significant dose-response relationships (P < 0.006) were determined for sensory block, motor block, and time until recovery (R from 0.6 to 0.9). Within the range of doses studied, each additional milligram of bupivacaine was associated with an increase in duration of tolerance to transcutaneous electrical stimulation of 10 (7 to 13) min, an increase in tolerance to tourniquet of 7 (2 to 11) min, an increase in duration of motor block of 8 (5 to 12) min, and an increase in time until recovery of 21 (17 to 25) min.     

The effect of various anaesthetics on the spatial tuning of two major wave peaks in the transient pattern electroretinogram of the cat: evidence for pattern and luminance components

The main PERG component of the transient contrast reversal pattern electroretinogram (PERG) in cats was a negative wave (3.5 microV average, SD 1.7 microV) peaking at about 130 msec (N130) with a spatial resolution above 5.5 c/deg, close to behavioural estimates. The early positivity (P35) was more variable, smaller and had lower spatial resolution. Different anaesthetic protocols affected both the waveform and the amplitude by spatial frequency functions. Responses of urethane anaesthetised cats were like those reported previously for decerebrate cats or cats paralysed and ventilated with N2O/O2/CO2 (75%/24%/1%). P35 was evoked only by coarse stimuli and N130 amplitude decreased linearly as spatial frequency increased. When the luminance response amplitude, predicted from the optical transfer function of the eye, was subtracted, spatial tuning appeared. An anaesthetic mixture of ketamine hydrochloride and xylazine depressed both P35 and N130 at low spatial frequencies while enhancing them at high frequencies. In paralysed animals ventilated with N2O/O2 (67%/33%) P35 was larger and recordable to 1.6 c/deg. Peak times were reduced and the inter-peak time halved. Other anaesthetics depressed the ERGs. These effects suggest that cats are a good model for studying N130 in isolation or its interaction with P35 and that both PERG peaks include luminance and pattern components.     

世界生物技术药品市场的现状及展望

生物技术的迅速发展将导致一场新的药物革命。预计2000年世界生物技术药品的销售额将达500亿美元。美国、日本和西方工业化国家的制药公司对生物技术药品的开发非常重视。目前,人生长激素、红细胞生长素和人胰岛素在医药市场中占有重要位置,毫无疑问,二十一世纪的医药市场将是生物技术药品的时代。     

雷公藤生物碱的分离鉴定

我们从雷公藤（ＴｒｉｐｔｅｒｙｇｉｕｍＷｉｌｆｏｒｄｉｉＨｏｏｋ．ｆ．）中按常法分离得到总碱后经ＨＰＬＣ分析出现８个峰，经硅胶柱层析及硅胶ＲＰ－１８反相中压柱层析分离得到５个生物碱，由化学方法和光谱分析证明为雷公藤吉碱（Ｗｉｌｆｏｒｇｉｎｅ２０）．雷公藤次碱（Ｗｉｌｆｏｒｉｎｅ２１），雷公藤春碱（Ｗｉｌｆｏｒｔｒｉｎｅ２２），雷公藤碱戊（Ｗｉｌｆｏｒｉｄｉｎｅ２３），呋喃南蛇碱（Ｃｅｌａｆｕｒｉｎｅ１６）。ＨＰＬＣ分析指出含量最高为雷公藤吉碱，其次为呋喃南蛇碱。     

中药饮片加工炮炙在临床中的意义

本文简述了中药炮炙的根据、原理、方法以及各种不同辅料和炮炙方法对饮片药性与作用的影响。说明不同的炮炙方法可以直接影响和改变中药的药性和作用,影响到临床疗效,因此,必须重视中药饮片的炮炙工作。以确保临床安全有效的用药。     

Routine hysteroscopy for patients with a high risk of uterine malignancy

Summary. Seventy patients with abnormal vaginal bleeding were examined with a Storz hysteroscope. The examination took an average of only 5 min. Sixty patients had the examination under general anaesthesia, five under paracervical block and five had no form of anaesthesia. All tolerated the procedure well. There were no complications directly related to the hysteroscopic examination. There was complete correlation between the histology of the endometrium obtained at subsequent curettage and the hysteroscopic findings.