人工心脏瓣膜置换术后PT-INR测定监测口服抗凝药的研究

人工心脏瓣膜置换术后患者口服抗凝治疗不当所致的出血与栓塞占远期并发症的首位。血浆凝血酶原时间（PT）是对人工心脏瓣膜置换术后患者口服抗凝药监测简便、敏感、快速、实用的实验室首选指标，其报告方式的标准化对临床医生有着非常重要的指导意义，国际标准化比率（PT-INR）作为一个较好的监测抗凝药物水平的表示方法，已被WHO推荐使用，但对于人工心脏瓣膜置换术后患者口服抗凝药治疗时PT-INR值的允许范围各地报告不一，为此，我们对我院收治的行人工心脏瓣膜置换术后患者口服华法令治疗时PT监测的情况进行了总结和研究，以探讨适合本地区人工心脏瓣膜置换术后患者口服抗凝药治疗监测中PT-INR的允许范围，为临床合理用药提供安全可靠的实验室监测指标。现报告如下。     

Avoidance therapy in reactive dye-induced occupational asthma: long-term follow-up.

BACKGROUND: Previous studies reported that early diagnosis and avoidance therapy are the most important factors for prevention of permanent lung impairment; however, few studies have evaluated the long-term prognosis of reactive dye-induced occupational asthma (RD-OA). OBJECTIVE: To evaluate the long-term outcomes of RD-OA. METHODS: Methacholine airway hyperresponsiveness (AHR) and lung functions were evaluated and compared in 26 patients with RD-OA at the time of diagnosis and after complete avoidance of the causative agents. Patients with continued (n = 13) or remitted (n = 6) AHR were further monitored for up to a mean +/- SD of 8.7 +/- 1.8 years. RESULTS: The AHR resolved in 10 (38%) of 26 patients a mean +/- SD of 2.2 +/- 1.3 years after complete avoidance of RDs; however, prebronchodilator forced expiratory volume in 1 second (FEV1) values were not different. Levels of IgE specific to the RD-human serum albumin complex were markedly decreased at first follow-up in 5 RD-atopic patients from whom paired serum samples were compared (P = .02). The AHR disappeared in an additional 5 patients and improved in 4 by the second follow-up. The FEV1 values also improved compared with diagnosis and first follow-up levels. Favorable prognosis was associated with early diagnosis of RD-OA and complete avoidance of the causative agent. No association was found with smoking history, latent periods, the presence of RD specific IgE, baseline provocation concentration that caused a decrease in FEV1 of 20%, or FEV1. CONCLUSIONS: Early diagnosis and avoidance therapy are the most important prognostic factors in RD-OA. The AHR and lung function of patients with RD-OA can sometimes be recovered steadily and slowly through avoidance measures.     

A six-week, parallel, randomized, double-blind study comparing the efficacy and safety of the 0.5% timolol/2.0% MK-507 combination b.i.d. to the concomitant administration of 0.5% timolol b.i.d. and 2.0% MK-507 b.i.d.

This was a 6-week, parallel, randomized, double-blind study comparing the efficacy and safety of the 0.5% timolol/2.0% MK-507 combination b.i.d. to the concomitant administration of 0.5% timolol b.i.d. and 2.0% MK-507 b.i.d. Patients with ocular hypertension or open-angle glaucoma from 21 to 85 years of age were enrolled in this study. Each of them should have intraocular pressure (IOP) of 20 mmHg or more in the study eye after they completed the wash-out period. The patients enrolled were randomly assigned to either combination (0.5% timolol/2.0% MK-507 b.i.d. and placebo b.i.d.) or concomitant (0.5% timolol b.i.d. and 2.0% MK-507 b.i.d.) treatment. During the study, no systemic or topical medication affecting IOP other than test drugs were allowed. A total of 20 randomized patients were included in the intention-to-treat population for analysis of data. The ten were assigned to the combination treatment and others were assigned to the concomitant treatment. There was no statistically significant difference between the two study treatments in terms of gender distribution, average age, and average IOP at the trough and the peak before starting the test medications. Mean reduction of the IOP from baseline to the final visit at the trough was 5.04 mmHg in the combination treatment and was 2.73 mmHg in the concomitant treatment. Mean reduction of the IOP at the peak was 2.19 mmHg in the combination treatment and was 2.53 mmHg in the concomitant treatment. There were no statistically significant differences in the above analyses between the two treatments. Safety evaluation was carried out, and number of adverse events in each treatment group did not differ substantially. Ocular signs and symptoms were evaluated in each visit, and all of the between-treatment values were not different significantly, either. Laboratory tests were performed, and showed no significant differences between pre- and post-treatment periods. None of these was found to be clinically serious, either. We concluded that the 0.5% timolol/2.0% MK-507 combination b.i.d. is equivalent in the efficacy of lowering IOP as well as safety compared to the concomitant administration of 0.5% timolol b.i.d. and 2.0% MK-507 b.i.d. in patients with ocular hypertension or open-angle glaucoma.     

颅内疾病的心电图改变

目的 :探讨颅内疾病的心电图改变及对预后的影响。 方法 :将我院 1999年以来的 10 2例颅内疾病患者的心电图资料按病因分为 4组 ,所有患者均于发病 1～ 2d内入院 ,常规描记 12导联心电图 ,住院期间定期复查。结果 :心电图改变主要为复极障碍 (ST段下移 ,T波倒置、低平或双向以及Q T间期延长 ) ,其次为心律失常。 4 0例重型颅脑外伤及蛛网膜下腔出血者中心电图异常 36例 ,正常 4例 ,死亡组心电图异常率及程度均重于存活组。结论 :“脑型心电图改变”主要表现为ST T改变和冲动起源异常的心律失常是暂时的应激反应。发生急性颅内病变时要及时识别 ,积极予以处理 ,以减轻脑损伤所致的心脏损害。     

非胰岛素依赖型糖尿病人缺锌对部分免疫功能的影响

对３４例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者在用一般降糖治疗后血糖稳定时加用锌剂，检测补锌前后免疫功能和血清锌含量的改变。结果发现：糖尿病红细胞受体花环（ＲＢＣ＿Ｃ３ｂＲＲ），Ｔ淋巴细胞亚群（ＣＤ３，ＣＤ４，ＣＤ４／ＣＤ８）及血清锌均低于正常对照组，而ＣＤ８及红细胞免疫复合物花环（ＲＢＣ－ＩＣＲ）高于对照组，经补锌治疗一月后，糖尿病组血清锌，ＲＢＣ－Ｃ３ｂＲＲ，ＲＢＣ－ＩＣＲ，ＣＤ３，ＣＤ４诼Ｃ     

黄氏病毒灭滴眼液治疗单疱病毒性角膜炎的疗效观察

目的：观察中药制剂黄氏病毒灭滴眼液对单疱病毒性角膜炎的临床效果。方法：以无环鸟苷治疗本病为对照组，对７４例８６眼单疱病毒性角膜炎进行了临床疗效对比观察。结果：黄氏病毒灭滴眼液具有较好的治疗单疱病毒性角膜炎的作用，临床有效率达９５％，平均治愈日为１１．０６日。该药无毒副作用及过敏反应，与其他抗病毒药物无交叉耐药。结论：该药可作为治疗单疱病毒性角膜炎有效而又简便的方法之一。     

成人原发性肾病综合征患者尿视黄醇结合蛋白的测定及意义

采用酶联免疫法检测１００例正常人及７９例成人原发性肾病综合征治疗前后尿视内醇结合蛋白的变化。追踪随访２年，发现经治疗后病理类型为ＥＣＰＧＮ，ＭＣＮ，ＩｇＡ ＧＮ者，尿蛋白及ＲＢＰ均明显减少，其肾功能不全的发生率较低，而ＭＧＮ，ＦＳＧＳ，ＳＧＮ者，尿蛋白及ＲＢＰ无明显减少，肾功能不全的发生率较高，ＭｓＰＧＮ因其增生程度的不同，治疗效果及预后有所不同，轻度增生者治疗效果及预后较好，中，重度增生者，基     

费氏艾美尔球虫（E.ferrisi）某些生物学特性的研究

采用从自然感染球虫的小鼠粪便中分离的单卵囊接种小鼠获得成功，观察了此种球虫的卵囊形态，孢子化时间，潜隐期和寄生部位等，确定此球虫为费氏艾美尔球虫。为进行费氏艾美尔球虫病的流行病学调查和防治提供了依据。     

高脂饲料加重大鼠阿霉素肾病的实验病理学研究

探讨高脂饲料加剧阿霉素肾病大鼠高脂血症及肾组织形态学改变的作用。用ＡＤＲ静脉注射建立大鼠肾病模型，饲喂含１．５％胆固醇、５％猪油的高脂饲料，观察大鼠尿蛋白排泄量，测定血肖中脂质有关指标以及检查肾组织形态学改变。饲喂高脂饲料的ＡＤＲ肾病大鼠，血清脂质水平在整个试验过程中均明显高于饲喂基础饲料的ＡＤＲ肾病大鼠，肾小球病变也显著加重，饲喂高脂饲料所致高脂血症是导致大鼠ＡＤＲ肾病进行性进展的重要因素之一。     

大,巨型垂体腺瘤的手术入路选择

自１９９０年以来收治直径在２－５．６ｃｍ的大、巨型垂体腺瘤３３例。依肿瘤生长形态与扩展范围将其简略分为三种类型。Ａ型：瘤体位于鞍内或侵入蝶窦；Ｂ型；瘤体呈椭圆形或哑铃向鞍上扩展，三脑室明显移位抬高；Ｃ型：瘤体巨大侵入三脑室阻塞室间孔或明显的鞍周扩展。