药物降脂治疗在女性患者中的应用

背景：有几项临床研究评价了药物降脂治疗冠心病(coronary heart disease，CHD)的作用。但是许多研究没有包括足够数量的女性患者，无法进行性别校正分析，也没有单纯关于女性的相关结果。目的：对药物治疗女性高脂血症预防CHD事件的证据进行汇总和评估，对药物治疗对死亡率的影响进行汇总分析。资料来源：我们通过MEDLINE、Cochrane数据库和有效性综述摘要数据库(the Database of Abstracts of Reviews of Effectiveness)检索了1966年至2003年12月发表的相关文献，复习了文章的参考文献并请教了相关专家。研究选择和数据提取：入选标准为治疗至少1年以上、评价了降脂治疗对临床预后的影响、有性别分层结果的有关门诊患者的研究。评价的指标有总死亡率、CHD死亡率、非致死性心肌梗死(myocardial infarction，MI)、血运重建和总CHD事件。通过随机效应模型计算有心血管病史和无心血管病史患者治疗的相对危险度(relative risks，RR)。数据综合：共入选13项研究。6项研究包括了11435例无心血管病的女性，并对降脂治疗的效果进行了评价。降脂治疗并未减少总死亡率(RR，0．95；95％可信区间[confidence interval，CI]，0．62～1．46)、CHD死亡率(RR，1．07；95％CI，0．47～2．40)、非致死性MI(RR，0．61；95％CI，0．22～1．68)、血运重建(RR，0．87；95％CI，0．33～2．31)或CHD事件(RR，0．87；95％CI，0．69—1．09)。由于现有研究中CHD事件太少，使一些统计分析受到了限制。8项研究包含了8272例女性心血管病患者，并对降脂治疗效果进行了评价，结果显示降脂治疗并未降低女性心血管病患者的总死亡率(RR，1．00；95％CI，0．77～1．29)。然而，降脂治疗降低了这些患者的CHD死亡率(RR，0．74；95％CI，0．55～1．00)、非致死性MI(RR，0．71；95％CI，0．58～0．87)、血运重建(RR，0．70；95％CI，0．55～0．89)和CHD事件(RR，0．80；CI，0．71～0．91)。结论：对于没有心血管病的女性，降脂治疗对总死亡率和CHD死亡率没有影响。降脂治疗可能会减少CHD事件，但是现有证据还不足以证明这一点。对于有心血管病的女性患者，治疗高脂血症可以有效减少CHD事件、CHD死亡率、非致死性MI和血运重建，但对总死亡率无影响。     

脑炎

1 基础，定义：脑炎是指由于感染引起的脑实质的炎症。脑膜脑炎是大脑及脑膜的炎症。     

A NOTE ON THE FORCES OF MORTALITY AND THEIR CLASSIFICATION IN PEIPING

The development in this country of reporting and of classifying moit- ality has been previously described in detail (1 and 2). National regula- tions exist to provide routines whereby local and provincial authorities presumably report mortality statistics to the ceritral authoriticS. There are two ofhciallists oF classihcation of causes of death coritaining 27 and lU7 causes respectively (3). The latter is entirelyitnpractical. The forruer should be revised, on the basis of additional experience.     

瑞罗替克(Irinotecan CPT—11)加顺铂治疗非小细胞肺癌

瑞罗替克（CPT-11）是喜树碱的一种衍生物，通过干扰细胞核拓扑异构酶Ⅰ而发挥独特的细胞毒作用。至今CPT－11治疗非小细胞肺癌的临床研究大多是在日本进行的。Negoro等所做Ⅰ期临床试验，给17例进展期NSCLC病人CPT－1150～150mg／m2，每周一次，剂量限制毒性（DLT）为白细胞减少及腹泻，2例达PR，推荐最大耐受剂量（MTD）为每周100mg／m2。Fukuoka等用该剂量及方案对73例NSCLC进行Ⅱ期临床试验，其中多数为晚期。Ⅲ～Ⅳ级白细胞减少及腹泻发生率各为25％及21％，总有效率31．9％，在40例Ⅳ期病人中，有效率为32．5％，中位生存…     

AN EVALUATION OF VAR10US RESECTIONS IN THE SURGICAL TREATMENT OF LUNG CANCER

The indications and results of various resec- tions for lung cancer were evaluated, basing on the experience in 748 patients treated surgically from 1961 through 1982. Of this series there was an overall resectability rate of 80.3', a resection mortality rate of l.20l-f, and an overall 5.year survival rate of 42.0%. Regular lobectomy, currently the most common ly used or standard procedure for lung cancer was done in 445 (74.0%) cases, with an operative mor tality of l.1% and a 5-year survial rate of 42.2%. Ilronchoplastic lobectomy was performed in 67 (11.2%), with an operative mortality of l.5% and a 5-year survival rate of 54.1%. As a surgica'l pro ccdure for lung cancer it is highly evaluated. Pneu monectomy was done in only 74 (12.3%), with an operative mortality of l.4To and a 5.year survival rate of 35.3%, and was reserved almost exclusively for patients who have adequate cardiopulmonary function and in whom, for technical or oncologic reasons, radical eradication of the tumor could not be accomplished with a lesser extent of resection. Emphasis is made on the strict indications for each mode of resection, and on the principle of maximal cancer eradication and maximal conserva tion of functionall lung tissue.     

Calpain在噪声损害毛细胞中的角色

目的：了解Calpain在噪声损害耳蜗毛细胞中所扮演的角色。方法观察Calpain免疫细胞化学反应产物在噪声损害中的变化。结果正常对照耳蜗样品中未见Calpain活性显示，但噪声损害耳蜗样品中可见外毛细胞底部及其神经末梢区域出现大量的Calpain。结论噪声引起的耳蜗毛细胞破坏可能与Calpain的激活及其降解功能有关。     

THE OCCURRENCE OF LATE LACTOSE FERMENTING COLIFORM BACILLI IN DYSENTERY

Colon bacillus, a life-tong lodger of ntan and animal. finds its access into the body of the host soon after the birth of the latter. Although the significance of its presence is frequently questioned,it has generally been considered as being harmless in so far as it is con- fined to the proper places which nature asigns to it. However, if the balartce between the resistance of the host on one hand and the virulence of the parasite on the other is disturbed, disease may supervene.     

EFFECTS OF TYROSINE AND ITS ANALOGUES ON hCG-INDUCED PROGESTERONE PRODUCTION BY RAT CORPUS LUTEUM IN VITRO

Rat corpora lutea (CL) were utilized to examine a series of tyrosine analogues for their structure- activity relationships. CL were obtained from im mature rats pretreated with pregnant mare's serum gonadotropin (PMSG) and human chorionic gona- dotropin (hCG). The results indicated that hCG stimulated the production of progesterone and this effect was blocked by tyrosine. The effects of 17 analogues were compared with those of hCG and tyrosine in this system. It was shown that the essen tial functional groups necessary for progesterone antagonism production were the tyrosine a-amino and phenolhydroxyl groups, while the carboxyl group was seemingly essential for the antagonistic effect. Among the tyrosine analogues, tyrosine hy- drazide and glycyl-tyrosine were more potent than tyrosine.