自体造血干细胞移植治疗恶性血液病

为探讨恶性血液病的有效治疗方法,应用自体骨髓移植(ABMT)38例,自体外周血造血干细胞移植(ABSCT)13例,自体外周血造血干细胞与自体骨髓联合移植15例。治疗白血病54例,恶性淋巴瘤11例,多发性骨髓瘤1例。外周血造血干细胞采用化疗加多抗甲素或C—CSF动员。移植物采用微波、阿克拉霉素净化处理。结果:两组动员方案均有良好动员效果。ABSCT组及联合移植组造血功能恢复比ABMT组快(P<0.05),合并症少。66例中,45例仍呈持续缓解(CCR),中位CCR时间32(5～98)个月,复发21例。3年无病生存率及复发率分别为68.5％及26.1％。结果表明:自体造血干细胞移植是根治恶性血液病的有效手段。ABSCT及联合移植具有造血功能恢复快,合并症少等优点。微波和阿克拉霉素体外净化移植物是一种简便、有效的净化方法。     

1995 National Clinical Pharmacy Services Study

To determine the extent of hospital-based clinical pharmacy services in 1995, we surveyed 1109 United States acute care, general, medical-surgical, and pediatric hospitals with 50 or more licensed beds. Fifteen clinical pharmacy services were assessed to determine pharmacists' specific patient care responsibilities. The percentage of hospitals offering services grew between 1992 and 1995: pharmacokinetic consultations (16% increase), drug therapy protocol management (15%), drug therapy monitoring (8%), drug counseling (13%), and parenteral-enteral nutrition team (6%). All other services increased 0–5%. Pharmacists conducted clinical research in 14% of hospitals, averaging 6.3 ± 22.1 protocols/department annually; total budget $96,219 ± $262,026. Patient-focused care predominated in 20% of hospitals, although most pharmacists reported to directors of pharmacy through traditional pharmacy department channels. Clinical pharmacy services continue to expand, with pharmacists providing higher-level direct patient care activities related to drug therapy management and monitoring.     

Practice Functions Necessary for the Delivery of Pharmaceutical Care

Pharmaceutical care is a concept outlining the responsibilities of individual pharmacists to individual patients. Although widely accepted on a philosophical basis, there is a lack of comprehensive information about the functions and responsibilities pharmacists undertake when providing pharmaceutical care. Pharmacy educators and practitioners at the faculty of pharmacy, University of Toronto, developed and informally tested a process that details the practice functions required of pharmacists when providing pharmaceutical care as originally defined.     

23例尿毒症及维持性血液透析患者外周血单核巨噬细胞产生白细胞介素Ⅰ浅析

采用ConA活化小鼠胸腺细胞法测定慢性肾衰尿毒症患者(10例)及维持性血液透析(血透)患者(13例)外周血单核—巨噬细胞产生白细胞介素I(IL—1),结果发现尿毒症患者及血透患者IL—1产生明显低于尿毒症患者,说明不论是尿毒症患者还是血透患者细胞免产疫功能均低下,尤以后者为甚。     

Comparison of Two Methods for INR Determination in a Pharmacist-Based Oral Anticoagulation Clinic

Warfarin is a commonly used oral anticoagulant that is usually initiated after the definitive diagnosis of a certain thromboembolic disorder or disease. Warfarin therapy will usually be prescribed for 6–12 weeks or more, and some patients may continue therapy throughout life, depending on the type of thromboembolic disorder. Major problems associated with warfarin therapy include adverse effects such as bleeding complications and drug-drug or drug-food interactions. In addition, thromboembolic complications may occur due to subtherapeutic dosages of warfarin. The laboratory reference standards for monitoring warfarin therapy are the prothrombin time (PT) and the International Normalized Ratio (INR). While both the PT or INR will reflect the clinical response in the patient, results reported as INR values have been shown to be more accurate than those reported as PT values. Thirty-two patients were enrolled in this study. Our objectives were to compare INR values measured by both the Coumatrak and conventional laboratory method, and to demonstrate the effects of pharmacist intervention on managing patients receiving warfarin therapy. Results from our study reveal that INR monitoring by Coumatrak is similar to the conventional laboratory method. In addition, our study indicates that patients receiving warfarin therapy can be monitored and managed effectively by pharmacists.     

抑菌防霉剂—噻苯哒唑的合成

本文介绍了噻苯哒唑的新用途和采用“一锅煮”工艺制备噻唑酸进而制得该防霉剂的合成方法。     

用蛋白Ⅷ在噬菌体表面展示抗体分子效果的观察

目的 观察抗体分子通过丝状噬菌体主要外壳蛋白Ⅷ（cpⅧ）和次要外壳蛋白Ⅲ（cpⅢ)在噬菌体表面呈现效果的差异。方法 分别构建通过cpⅢ或cpⅧ展示抗乙肝表面抗原（HBs)Fab,ScFv和抗角蛋白（Ker)Fab的表达载体，制备噬菌体抗体，比较其抗原结合活性和Fab呈现水平。用多种方法尝试提高cpⅧ介导的噬菌体展示效果。结果 cpⅧ对不同特异性抗体Fab段和不同形式的小分子抗体（Fab和ScFv)的展示效果均低于cpⅢ的展示，增加cpⅧ－Fab对野生型cpⅧ的表达比例，试用不同菌株，在Fab和cpⅧ之间插入间隔序列及换用控制更为严密的启动子等,匀未能改善cpⅧ介导的噬菌体展示。结论 以前所报道的通过cpⅧ多价展示Fab段不是普遍存在的现象，对有些抗体基因不能达到多价展示。     

神经移位治疗火器性肌皮神经和腋神经损伤

在观察和测量100个上肢解剖标本的基础上,我们设计了带血管的胸背神经和下肩胛下神经移位,一期修复一例火器性肌皮神经和腋神经损伤.术后8个月复查功能恢复甚为满意.     

骨水泥性能及其对人工关节柄固定强度的影响

本文研究了骨水泥三种不同临床使用方法所形成的内部气泡结构状态,测定了骨水泥的抗压强度、收缩率、疲劳强度、变形积累量等物理机械性能,以及关节固定强度,用气泡状态解释了不同临床使用方法对骨水泥性能及固定强度所带来的各种影响。     

Successful treatment of chronic idiopathic urticaria and angioedema with cimetidine alone

We have studied a 50-year-old white man with chronic urticaria and angioedema who has responded to treatment with cimetidine alone for over 2 yr. In a double-blind, placebo-controlled study, cimetidine alone was at least as effective as chlorpheniramine in relief of urticaria and angioedema. Additionally, cimetidine significantly inhibited (p less than 0.01) the wheal response to histamine when it was compared to placebo. The inhibition of wheal response to histamine by cimetidine was significantly higher (p less than 0.05) than chlorpheniramine. The presence of predominantly H2- rather than H1-histamine receptors in the cutaneous blood vessels may be responsible for the therapeutic effects of cimetidine in this patient.