滥用药物与生命质量退化的伦理思考

本文从生命质量的内涵入手,分析了滥用药物的直接和间接、近期和远期的危害,通过论证得出了滥用药物必将引起人类生命质量退化的结论.以期从一个新的认识度唤起人们对滥用药物问题的重视、并由此引出了一些对医学目的以及滥用药物控制措施的思考.     

Antitumor activity of five new platinum complexes having a glycolate leaving ligand.

In an attempt to develop a new anticancer platinum complex with greater or equivalent antitumor activity but reduced side effects compared with cisplatin (CDDP), a series of new platinum complexes having a glycolate leaving ligand was synthesized. Among them, five complexes were selected for further development on the basis of adequate water solubility, low nephrotoxicity and high antitumor activity in a murine system. The chemosensitivity of these five complexes was examined in MTT assay against two human pulmonary adenocarcinoma cell lines, PC-9 and PC-14, and two human stomach adenocarcinoma cell lines, MKN-45 and KATO III. Their IC50 and relative antitumor activity (RAA) values were compared with those of CDDP and 254-S, a second-generation platinum complex with a glycolate leaving ligand under phase III clinical trial. The lowest mean IC50 value was observed in CDDP, followed by SKI 2034R and SKI 2033R. In this study, the antitumor activity was evaluated in terms of RAA values and SKI 2034R showed the highest RAA value. The order of RAA values was SKI 2034R > CDDP > SKI 2032R > SKI 2033R > SKI 2030R > SKI 2029R > 254-S. Based on the RAA order, we have recommended SKI 2034R as the most promising candidate for further development of a clinically useful platinum complex.     

环丙沙星与氧氟沙星注射液治疗细菌性感染的疗效观察

以乳酸环丙沙星（ＣＰＬＸ）注射液和氧氟沙星（ＯＦＬＸ）注射液随机分组治疗各种细菌性感染４０例及４２例，并以注射用头孢噻肟钠（ＣＴＸ）治疗４９例作对照。三组平均年龄、体重、疗程及病情程度相比无显著性差异，具可比性。病种分布以消化道感染最多，共８１例，占总数的６１．８％。三组１３１例病人细菌阳性率为９４．７％。一疗程ＣＰＬＸ组、ＯＦＬＸ组、ＣＴＸ组治愈率分别为８７．２％、８３．３％、７１．４％，有效率     

赖型钩体flaB2与VR1012中的CpG基序分析

目的：对问号赖型钩端螺旋体（赖型钩体）DNA疫苗[包括内鞭毛蛋白基因（flaB2)和质粒DNA表达载体（VR1012）]的CpG基序（CpG motifs)进行分析，为DNA疫苗免疫机制的阐明和提高DNA疫苗的效能奠定基础。方法：以flaB2与VR1012构建重组DNA的免疫原，对flaB2及VR1012全核苷酸序列进行计算机分析（分类、计数和定位）。结果：CpG的“C”的侧翼为两个嘌呤，“G”的侧翼为两个嘧啶，在flaB2中共3个，分别为GACGCT，GACGTC和GACGCC；在VR1012中共11个，分别为GACGTC1个，GACGCT2个，GACGCC1个，GACGTT1个，GGCGTT2个，GGCGCT2个，GGCGCC1个，AACGCT1个，其中特别重要的TGACGTCA4个和TAACGCCA有1个，位于5'端456－463；509－516；592－599；778－785和486－493；4个TGACGTCA和1个TAACGCCA均位于5'端且相对集中。结论：赖型钩体flaB2与VR1012构成的DNA疫苗含有TGACGTCA等CpG，这些基序又称免疫刺激序列，构成了DNA疫苗中的佐剂。     

血清前－S_2蛋白检测的临床意义

采用ＥＬＩＳＡ法检测１０４例各类型乙型肝炎（乙肝）患者的血清前－Ｓ２抗原（Ｐｒｅ－Ｓ２Ａｇ）及其抗体（Ｐｒｅ－Ｓ２Ａｂ），结果表明，Ｐｒｅ－Ｓ２Ａｇ的出现与ＨＢｓＡｇ、ＨＢｅＡｇ、ＨＢｃＡｂ呈显著相关性（Ｐ值均＜０．００５），主要见于乙肝急性期及慢性乙肝患者，说明病毒复制活跃、传染性强。而Ｐｒｅ－Ｓ２Ａｂ阳性仅见于急性乙肝恢复期。     

Induction of metallothionein synthesis by menadione or carbon tetrachloride is independent of free radical production.

The relationship between induction of hepatic metallothionein (MT) synthesis and lipid peroxidation by free radical production following an injection of menadione or carbon tetrachloride (CCl4) in mice was studied. The hepatic concentration of MT was increased by menadione significantly at 25 mg/kg or higher. A significant increase in thiobarbituric acid (TBA) value, indicative of lipid peroxidation, was observed in the liver at menadione doses of 62.5 mg/kg or higher. Both the MT and the TBA value in the liver were significantly increased at the low dose of CCl4. The concentration of MT was increased significantly 4-8 hr after administrations of these compounds. The increase of TBA value over time was similar to that of MT concentration after administration of CCl4, but not after administration of menadione. The MT concentration in the menadione group was higher than that in the CCl4 group, and the TBA level in the menadione group was lower than that in the CCl4 group. Pretreatment with vitamin E caused a significant reduction in the TBA value, but did not affect the MT level in the liver. The concentration of MT did not significantly correlate with the TBA value in either the menadione or the CCl4 group. Pretreatment with phenobarbital, which promotes free radical production, did not influence induction of MT synthesis following an injection of menadione or CCl4. Neither L-buthionine sulfoximine nor 2-cyclo-hexen-1-one, which decreases hepatic glutathione, influenced the induction of MT by menadione. These data suggest that induction of MT synthesis by menadione or CCl4 is independent of free radical production in the liver.     

医用低值材料采供管理的探讨

医疗消耗材料是医疗工作开展的基础，本文从医用低值消耗材料的计划制定、材料采购、库房库存结构、材料供应、成本核算等多方面探讨了如何对医疗消耗材料进行科学管理，这对医院的医疗发展和管理建设有着重要意义。     

8～12岁单纯性肥胖儿童心功能研究

利用多导生理仪，同步记录心电图、心音图、颈动脉搏动图和心阻抗微分图，测试８～１２岁肥胖儿童９４名，对照组儿童７６名，分析比较有关心功能数据。结果显示肥胖儿童收缩压、舒张压、平均动脉压、左室射血时间和心搏出量高于对照组儿童，心输出量与对照组比较差异无显著性，心功能指数低于对照组儿童。提示肥胖儿童由于回心血量增加，血压增高，而使心脏前、后负荷加重，心肌收缩力代偿性增强，单位体表面积心输出量下降，部分心功能指标已受到影响。