戒烟门诊220例戒烟求助者问卷调查分析

目的分析220例戒烟求助者的人口学特征及其吸烟习惯等,为戒烟门诊服务工作提供依据。方法采用统一问卷,用自我填表的形式对220名来戒烟门诊寻求帮助的戒烟者进行基线调查。收集个人资料、有关吸烟习惯、尼古丁的依赖程度、戒烟的阶段、吸烟危害的认知和态度、戒烟成功的信心、困难程度等资料。以SPSS软件统计分析各参数的构成比。结果戒烟者的平均年龄为41岁,绝大多数（96%）为男性,（73%）多数是已婚,21~40岁占56%,大专以上文化水平的占54%,在职人员占75%。吸烟开始的平均年龄为20岁,16~19岁占48%。74%为中重度尼古丁依赖者,79%曾试过戒烟,46%试过2~5次。35%处于戒烟行动阶段,51%处于考虑戒烟阶段。过去6个月内有向医生求诊的经历,71%表示未有接受过任何戒烟忠告。结论需进一步加强吸烟有害健康的宣传,并且普及医务人员规范的戒烟服务的培训,提高医务人员戒烟服务水平。促进更多的戒烟求助者戒烟。     

LC-MS/MS测定人血浆中对乙酰氨基酚及其人体药动学和生物等效性研究

目的 建立一种快速、灵敏的高效液相色谱-串联质谱（HPLC-MS/MS）方法以测定人血浆中对乙酰氨基酚浓度,并应用于两种对乙酰氨基酚制剂的人体药代动力学和生物等效性研究。方法 以替硝唑为内标,200μL血浆样品经5倍于其体积的乙酸乙酯液液萃取,再经Waters XBridge? C18柱等度洗脱分离后导入串联质谱,以正离子多反应监测模式进行定量分析,对乙酰氨基酚和内标的选择性反应离子对分别是m/z 152→110和248→121。方法经验证后应用于19名健康受试者单剂量空腹口服两种对乙酰氨基酚制剂500mg后药代动力学和生物等效性的研究。结果 血浆中对乙酰氨基酚在0.1～8.0 μg·mL-1范围内线性良好（r2 > 0.99）,最低检测限为 0.1 μg·mL-1,提取回收率为91.0%～98.7%,日内和日间准确度分别为98.8%～111.3% （精密度：CV ? 9.03%）和94.9%～102.6% （精密度：CV ? 10.68%）。生物等效性试验中,受试制剂与参比制剂的主要药代动力学参数Cmax、AUC0-t和AUC0-∞ 几何均值比的90%置信区间分别为83.50%～105.79%,94.25%～101.54%和93.24%～101.02%,均落在生物等效可接受标准80.00%～125.00%范围内。结论 所建立测定人血浆中对乙酰氨基酚浓度的HPLC-MS/MS法具有快速灵敏、回收率高、选择性好的特点,适用于对乙酰氨基酚片人体药代动力学和生物等效性研究。受试制剂与参比制剂在人体内吸收速度和程度相似,两种制剂生物等效。     

Psoriasis in childhood and adolescence: evaluation of demographic and clinical features

BACKGROUND: The present study was aimed to define the gender ratio, familial occurrence, age of onset, precipitating factors, clinical types, nail and joint involvement of psoriasis in childhood and adolescence in Turkey. METHODS: A total of 61 children with psoriasis under 18 years old were evaluated retrospectively, for age, gender, age of disease onset, family history, concomitant disease, the clinical type of psoriasis, clinical localization, nail and joint involvement and treatment modalities. RESULTS: Of the patients, 23 (37.70%) were boys and 38 (62.30%) were girls. Mean age was 9.28 +/- 4.02 years in girls and 11.18 +/- 3.85 years in boys (9.96 +/- 4.03 years in all children). Mean age at the onset of the disease was 6.81 +/- 4.11 years in girls and 7.03 +/- 4.28 years in boys (6.89 +/- 4.14 years in all patients). In 14 (23%) cases, a positive family history was detected. The most frequent probable triggering factors were upper respiratory tract infections (14.8%) and positive throat culture for A group ss-hemolytic streptococcus (21.3%). Frequency of emotional stress and psychiatric morbidity were 54% and 9.8%, respectively. The most frequent localizations at onset were trunk (44.3%), extremities (54.0%), and scalp (36.0%). Three children (4.9%) had a history of dissemination from psoriatic diaper rash. In total, 51 (83.6%) patients presented with psoriasis vulgaris, eight (13.1%) with generalized pustular psoriasis, and the remaining two (3.3%) with erythrodermic psoriasis. CONCLUSION: The incidence of psoriasis among dermatological patients in childhood and adolescence was 3.8%. The disease tends to appear earlier in girls than boys. The authors suggested that stress and upper respiratory infections are the most important triggering factors in childhood and adolescence psoriasis.     

Incidence of ABO haemolytic disease of the newborn in a group of Hong Kong babies with severe neonatal jaundice

Two methods were used to determine the incidence of ABO haemolytic disease of the newborn (ABO-HDN) among Hong Kong Chinese infants. The first method employed the Lui elution technique to elute anti-A,B from cord blood of Group A and B babies with a Group O mother, and set out to correlate the titration score of the eluate with the serum bilirubin of the neonates. This method proved to be a failure because of the poor correlation. The second method was mathematical. By comparing the 'expected' frequency of various mother-infant ABO combinations (based on the ABO distribution of our local population) with the 'observed' frequency of a cohort of infants with severe neonatal jaundice, it was found that only two combinations (O-A and O-B mother-infant pairs) were responsible for ABO-HDN, for which the incidence was 1 in 5 among infants with a serum bilirubin level of 300 mumols/L or more.     

香港高危青少年对滥用咳药水的信念

目的:探讨香港青少年对滥用咳药水的信念。方法:应用《滥用咳药水信念量表》(Beliefs about Cough Medicine Abuse Scale-BACMAS),了解160名滥用咳药水及65名非滥用咳药水的香港青少年,对滥用咳药水的信念。结果:研究显示,此量表有高的内在一致性信度及效度(包括同证效度及构念效度)。一般而言,参加者认为滥用咳药水并不会带来很多好处,而他们亦了解滥用咳药水的危害。不过,仍然有为数不少的参加者认为,长期滥用咳药水并不会上瘾,而他们亦认为跟滥用咳药水的朋友交往并不危险。结论:此量表具有可接受的心理测量特性。青少年对滥用咳药水的自相矛盾信念,对预防滥用咳药水的工作有重要的启示。     

HYPOTHALAMIC HYPOPITUITARISM FOLLOWING CRANIAL IRRADIATION FOR NASOPHARYNGEAL CARCINOMA

Eight patients, one male and seven females, with no pre-existing hypothalamic-pituitary disease, who developed symptoms of hypopituitarism following cranial irradiation for nasopharyngeal carcinoma were studied 5 years or more after radiotherapy. All were GH deficient. Four of the patients with no GH response during insulin tolerance tests (ITT) showed increased GH in response to synthetic human growth hormone releasing factor (GRF-44). Four patients had impaired cortisol responses to ITT, and gradual but diminished cortisol responses to ovine corticotrophin releasing factor (CRF-41). There was no significant difference between mean peak increments in response to ITT and those in response to CRF-41. TSH responses to TRH were delayed in five and absent in two patients; four of these had low free T4 index. Prolactin was raised in all seven women and increased further in response to TRH. Two patients had impaired gonadotrophin responses to LHRH. None of the patients had clinical or biochemical evidence of diabetes insipidus. These data suggest that post-irradiation hypopituitarism in these patients results from radiation damage to the hypothalamus leading to varying degrees of deficiency of the hypothalamic releasing or inhibitory factors.     

PREVENTION OF HYPOGLYCAEMIA IN A PATIENT WITH PANCREATIC MICROADENOMATOSIS BY A LONG-ACTING SOMATOSTATIN ANALOGUE SMS 201-995

Acute suppression of insulin secretion from pancreatic insulinomas by long-acting somatostatin analogue SMS 201-995 has been documented. We report the chronic use of the drug in a patient with persistent hypoglycaemia due to benign pancreatic microadenomatosis with satisfactory control of plasma glucose level and reduction of insulin production. There was no tachyphylaxis or untoward side-effect noted during the 6-month treatment period.     

Apixaban, an oral, direct and highly selective factor Xa inhibitor: in vitro, antithrombotic and antihemostatic studies

Summary. Background: Apixaban is an oral, direct and highly selective factor Xa (FXa) inhibitor in late‐stage clinical development for the prevention and treatment of thromboembolic diseases. Objective: We evaluated the in vitro properties of apixaban and its in vivo activities in rabbit models of thrombosis and hemostasis. Methods: Studies were conducted in arteriovenous‐shunt thrombosis (AVST), venous thrombosis (VT), electrically mediated carotid arterial thrombosis (ECAT) and cuticle bleeding time (BT) models. Results: In vitro, apixaban is potent and selective, with a K_i of 0.08 nm for human FXa. It exhibited species difference in FXa inhibition [FXa K_i (nm ): 0.16, rabbit; 1.3, rat; 1.7, dog] and anticoagulation [EC_2× (μm , concentration required to double the prothrombin time): 3.6, human; 2.3, rabbit; 7.9, rat; 6.7, dog]. Apixaban at 10 μm did not alter human and rabbit platelet aggregation to ADP, γ‐thrombin, and collagen. In vivo, the values for antithrombotic ED₅₀ (dose that reduced thrombus weight or increased blood flow by 50% of the control) in AVST, VT and ECAT and the values for BT ED_3× (dose that increased BT by 3‐fold) were 0.27 ± 0.03, 0.11 ± 0.03, 0.07 ± 0.02 and > 3 mg kg^?1 h^?1 i.v. for apixaban, 0.05 ± 0.01, 0.05 ± 0.01, 0.27 ± 0.08 and > 3 mg kg^?1 h^?1 i.v. for the indirect FXa inhibitor fondaparinux, and 0.53 ± 0.04, 0.27 ± 0.01, 0.08 ± 0.01 and 0.70 ± 0.07 mg kg^?1 day^?1 p.o. for the oral anticoagulant warfarin, respectively. Conclusions: In summary, apixaban was effective in the prevention of experimental thrombosis at doses that preserve hemostasis in rabbits.