控制性低温对大鼠肢体爆炸伤后继发肺损伤的作用

目的 观察早期全身和局部控制性低温对大鼠肢体爆炸伤后继发肺损伤的作用,探讨控制性低温在肢体爆炸伤后继发肺损伤防治中的临床应用价值.方法 采用大鼠肢体爆炸伤模型,动物按随机数字表法分为4组(每组8只):正常对照组(C)、单纯致伤组(Ⅰ:致伤)、全身低温组(Ⅱ:致伤 全身低温6 h)和局部低温组(Ⅲ:致伤 局部低温6 h);各组分别于致伤后6 h取标本.测定肺TNF-α、IL-6、IL-10和MDA浓度;观察肺脏病理学变化.结果 大鼠致伤6 h后肺TNF-α、IL-6、IL-10和MDA浓度显著升高(P＜0.01);肺脏充血水肿和炎细胞浸润明显;致伤大鼠经全身低温或局部低温处理6 h后肺、IL-6、IL-10及MDA浓度均明显降低(P＜0.05);肺脏充血水肿和炎细胞浸润程度明显减轻.结论 早期全身或局部控制性低温可明显抑制肢体爆炸伤大鼠肺脏的炎性损伤和氧化损伤,减轻肺脏充血水肿和炎细胞浸润程度,有利于减轻爆炸伤后继发性肺损伤.     

奥氮平与舒必利治疗急性脑血管疾病后妄想综合征比较

目的:观察奥氮平治疗急性脑血管疾病后妄想综合征的疗效.方法:急性脑血管疾病后妄想综合征病人100例,分为2组奥氮平组50例,男性28例,女性22例,年龄(60±S11)岁,给予奥氮平2.5mg/d逐渐加至5～10㎎mg/d、PO×4周;舒必利组50例,男性26例,女性24例,年龄(62±S13)岁,给予舒必利0.3g/d逐渐加至0.4～0.6g/d、PO×4周.结果:奥氮平组和舒必利组经过4WK的治疗后总有效率分别为88%和83%(P＞0.05)、两组在2周末有效率分别为78%和26%(P＜0.05).结论:奥氮平治疗急性脑血管疾病后妄想综合征与舒必利对比显效早、药物不良反应少且轻.     

复方甘草酸苷联合局部浸润治疗带状疱疹后神经痛及其对免疫功能的影响

目的探讨复方甘草酸苷注射液联合局部浸润治疗老年带状疱疹后神经痛(PHN)的临床效果及其对免疫功能的影响。方法老年PHN20例,静脉滴注复方甘草酸苷40mg(5%葡萄糖注射液250ml),1次/d,连续3周为1个疗程,同时口服复方甘草酸苷片50mg,3次/d;以0·2%布比卡因20ml(含加入醋酸泼尼松龙30mg、利巴韦林0·4g,弥可保1mg)在皮损疼痛区皮下浸润,2次/d。以VAS评分法评价治疗前后的临床效果;检测治疗前和治疗后7、14、21d外周血淋巴细胞亚群变化。结果治疗后VAS评分显著降低(P<0·01);治疗后CD3 、CD4 、CD4 /CD8显著回升(P<0·01),并接近正常水平。结论老年PHN免疫功能可受到不同程度抑制,采用复方甘草酸苷联合皮损区局部浸润对缓解PHN患者的神经病理性疼痛有显著效果,并有提高及调节免疫功能的作用。     

原发性蛛网膜下隙出血患者心电图和肌酸激酶（CK-MB）改变的研究

目的探讨蛛网膜下隙出血（SAH）后患者的心电活动、肌酸激酶（CK-MB）的变化,并比较不同预后患者的差别。方法回顾分析2005年1月~2008年10月入住我院的67例SAH患者出现ECG改变、CK-MB升高的相关临床资料。结果有38例出现ECG改变,发生率为56.71%,其中复极异常28例（73.68%）,传导异常4例（10.53%）,节律异常14例（36.84%）,病理性Q波2例（5.26%）。CK-MB升高的发生率为37.3l%,有ECG异常的SAH患者出现CK-MB升高的概率更高（P〈0.001）。GOS≤3分者EEG改变和CK-MB异常明显高于COS〉3分者。结论SAH后ECG改变以复极异常为主,预后差者ECG和CK-MB改变更明显。     

小切口皮下剥离联合打包治疗腋臭临床观察

目的观察小切口皮下剥离联合打包治疗腋臭的疗效及并发症。方法将68例腋臭患者随机分为联合治疗组和单纯皮下剥离组,观察两组的疗效和并发症。结果两组总有效率比较差异无统计学意义（P〉0.05）,联合治疗组并发症发生率明显低于单纯皮下剥离组（P〈0.05）。结论小切口皮下剥离联合打包治疗腋臭疗效确切,并发症发生率低,可在临床推广应用。     

SOCS对Th1/Th2平衡的调控及妊娠影响的研究概况

细胞因子信号转导抑制因子(suppressor of cytokine signaling ,SOCS)是近年来新发现的一类负向调节蛋白,可抑制多种细胞因子的信号通路,且大多数成员可被细胞因子和生长因子所诱导产生.     

Estimation of brain receptor occupancy for trazodone immediate release and once a day formulations

Trazodone is approved for the treatment of major depressive disorders, marketed as immediate release (IR), prolonged release, and once a day (OAD) formulation. The different formulations allow different administration schedules and may be useful to facilitate patients’ compliance to the antidepressant treatment. A previously verified physiologically‐based pharmacokinetic model based on in vitro and in vivo information on trazodone pharmacokinetics was applied, aiming at predicting brain receptor occupancy (RO) after single and repeated dosing of the IR formulation and repeated dosing of the OAD formulation in healthy subjects. Receptors included in the simulations were selected using static calculations of RO based on the maximum unbound brain concentration (C_max,brain,u) of trazodone for each formulation and dosing scheme, resulting in 16 receptors being simulated. Seven receptors were simulated for the IR low dose formulation (30 mg), with similar t _onset and duration of coverage (range: 0.09–0.25 h and 2.1–>24 h, respectively) as well as RO (range: 0.64–0.92) predicted between day 1 and day 7 of dosing. The 16 receptors evaluated for the OAD formulation (300 mg) showed high RO (range: 0.97–0.84 for the receptors also covered by the IR formulation and 0.73–0.48 for the remaining) correlating with affinity and similar duration of time above the target threshold to the IR formulation (range: 2–>24 h). The dose‐dependent receptor coverage supports the multimodal activity of trazodone, which may further contribute to its fast antidepressant action and effectiveness in controlling different symptoms in depressed patients.

Study Highlights

• WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC?

The antidepressant efficacy of trazodone has been shown to be significantly correlated to its steady‐state plasma levels, and previous work has shown some understanding of trazodone range of affinity for different receptors, at different doses, but without considering the different available formulations. Trazodone is commonly available as: immediate release (IR), prolonged release (PR), and once a day (OAD) tablets. The IR formulation has a rapid onset and short duration of action, whereas the PR formulation is characterized by an absorption boost as soon as it is administered and has a comparatively delayed maximum concentration (C_max). Conversely, the OAD formulation provides a controlled release of trazodone over 24 h without the early high peak plasma concentration seen with the IR and PR formulations.

• WHAT QUESTION DID THIS STUDY ADDRESS?

This work aims to identify the brain receptors reaching a threshold occupancy of 50% through static predictions and determine the occupancy versus time profile for those of interest following administration of short‐ and long‐acting trazodone formulations.

• WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE?

Brain receptor occupancy (RO) for key targets were predicted based on free drug concentrations, allowing for a physiologically relevant assessment of the different pathways affected by each formulation and dose.

• HOW MIGHT THIS CHANGE CLINICAL PHARMACOLOGY OR TRANSLATIONAL SCIENCE?

The presented physiologically‐based pharmacokinetic approach to assess RO can be used to guide formulation selection and dosing in clinical studies.     

Circulating coxsackievirus A16 identified as recombinant type A human enterovirus, China

To determine the relationship of coxsackievirus A16 (CA16) to prototype CA16-G10, we conducted a phylogenetic analysis of circulating CA16 strains in China. Complex recombinant forms of CA16-related viruses involving multiple human enteroviruses, subgroup A (CA4, CA16, and enterovirus 71), are prevalent among patients with hand, foot, and mouth disease.     

Protective effect of valerian extract capsule (VEC) on ethanol- and indomethacin-induced gastric mucosa injury and ameliorative effect of VEC on gastrointestinal motility disorder

ContextValerian extract capsule (VEC) is an effective Chinese patent medicine used for gastrointestinal (GI) diseases.ObjectiveTo investigate the detailed pharmacological activity for VEC clinical effects in GI diseases.Materials and methodsSprague-Dawley rats were divided into six groups: control, model, and drug-treated (VEC-L, VEC-M, VEC-H, and teprenone). Rats were orally administered VEC (124, 248, 496 mg/kg) and teprenone (21.43 mg/kg) for 3 consecutive days. After 1 h, the five groups (except the control group) were orally given ethanol (10 mL/kg) for 1 h or indomethacin (80 mg/kg) for 7 h. The spasmolytic activity of VEC (0.01–1 mg/mL) on ACh/BaCl₂-induced New Zealand rabbit smooth muscle contraction was performed. The C57BL/6 mice carbon propelling test evaluated the effects of VEC (248–992 mg/kg) on intestinal motility in normal and neostigmine/adrenaline-induced mice.ResultsCompared with the model group, VEC treatment reduced the gastric lesion index and mucosal damage. Further experiments showed that the pathological ameliorative effect of VEC was accompanied by augmentation of the enzymatic antioxidant system and cytoprotective marker (COX-1, p < 0.01; PGI2 p < 0.05;), along with the alleviation of the levels of MPO (ethanol: 15.56 ± 0.82 vs. 12.15 ± 2.60, p < 0.01; indomethacin: 9.65 ± 3.06 vs. 6.36 ± 2.43, p < 0.05), MDA (ethanol: 1.66 ± 0.44 vs. 0.81 ± 0.58, p < 0.01; indomethacin: 1.71 ± 0.87 vs. 1.09 ± 0.43, p < 0.05), and inflammatory mediators. VEC decreased the high tone induced by ACh/BaCl₂ and promoted intestinal transit in normal and neostigmine/adrenaline-induced mice.Discussion and conclusionsVEC showed a potential gastroprotective effect, suggesting that VEC is a promising phytomedicine for the treatment of GI diseases.     

有源植入式医疗器械标准研究

介绍了国内、国际有源植入物分技术委员会及有源植入式医疗器械标准的现状.结合日常检测和具体实例,对现行标准中标记要求、包装要求和混合医疗相关要求等进行了总结和论述,有助于正确理解标准要求,并为该类医疗器械的研发、检验和评审等提供了思路和参考,保障了医患的用械安全.