罗格列酮对2型糖尿病患者冠脉支架内再狭窄的预防作用

目的 探讨罗格列酮对2型糖尿病患者行冠脉成形及支架植入术后支架内再狭窄的预防作用。方法 选择行冠脉成形及支架植入术的2型糖尿病患者60例。在原有降糖药物治疗的基础上，研究组(n=31)加服罗格列酮；对照组(n=29)用药方案不变。术后随访6mo，观察患者死亡、急性心肌梗死及再次血管重建术等心血管事件的发生情况，在随访结束时行活动平板检查，结果 阳性的再次行选择性冠脉造影术。结果2组患者随访期间均无死亡、急性心肌梗死等心血管事件发生。6mo内研究组9例再次心绞痛发作，5例活动平板试验阳性，其中5例(16．1％)冠脉支架内再狭窄；而对照组18例再次心绞痛发作，其中15例活动平板阳性，15例(48．4％)冠脉造影术证实支架内再狭窄，2组再狭窄对比有显著差异(P=0．013)。结论 对于2型糖尿病合并冠心病行冠脉成形及支架植入术患者，罗格列酮能有效降低支架内再狭窄。     

Misuse of zopiclone and convulsions during withdrawal.

It has been documented that benzodiazepines have the potential to cause dependence and withdrawal reactions, including convulsions. However, the available data concerning zopiclone, a nonbenzodiazepine hypnotic, are insufficient. The present study describes the case of a 36-year-old man who repeatedly misused zopiclone, in daily doses of 60-90 mg. Furthermore, the patient suffered from convulsion on two occasions following abrupt withdrawal of zopiclone. The concomitant use of alcohol, trimipramine, and promazine may have contributed to the development of convulsions. It is concluded that zopiclone may cause problems associated with misuse and withdrawal reactions similar to those of benzodiazepines.     

Development of glutamate neurotoxicity in cortical cultures: induction of vulnerability by insulin.

The effect of insulin on the development of excitotoxic vulnerability in primary cultures of the rat cerebral cortex was examined. Cells were maintained for two weeks in serum-supplemented culture media, in the presence or absence of increasing insulin concentrations. Excitotoxic cell death was induced by 1 mM glutamate. The vulnerability of cells was evaluated by phase contrast microscopy and by the measurement of lactate dehydrogenase (LDH) release due to cytotoxic injury. In addition to a moderate (less than 50%) stimulation of protein and DNA synthesis, insulin produced more than a twofold increase in the excitotoxic vulnerability of cells. The effect of insulin was specific, concentration-dependent and required an intact molecular structure of insulin. Our findings indicate that insulin induces significant changes in cerebral neurons by increasing the lethal vulnerability of cortical cells to excitatory amino acids (EAAs).     

Mitochondrial function and mitochondrial DNA in a series of 64 patients suspected of having mitochondrial myopathy

Biochemical results concerning 64 patients suspected of mitochondrial myopathies are presented. Four clinical groups were studied including 21 encephalomyopathies, 42 ocular myopathies, 8 isolated myopathies and 3 cardiomyopathies. In 26 cases, the coexistence of a normal mitochondrial DNA and a mutated mitochondrial DNA (heteroplasmy) was found (19 simple deletions, 4 multiple deletions and 3 punctual mutations) and all cases presented with ocular disorders (excepted 2 cases with MERRF). Furthermore, 1 complex I deficiency (1 ocular myopathy), 1 complex IV deficiency (1 adult encephalomyopathy type Leigh), 3 complexes I + IV deficiencies (2 cases with a cardiomyopathy and 1 familial MELAS) and 2 pyruvate (1 adult from of Leigh's encephalomyopathy) dehydrogenase deficiencies (clinically and genetically different) did not show evidence of mitochondrial DNA mutation.     

四种口服头孢菌素的体外抗菌活性的比较研究

本文报道口服Cefixime对900株需氧菌和厌氧菌的体外抗菌作用,并与其它口服的头孢克罗、头孢羟氨苄和头孢氨苄进行了比较。Cefixime对链球菌具较强作用,但对葡萄球菌的作用较差;对肠球菌无效。对肠杆菌科细菌的抗菌活性四者之中以Cefixime最强。Cefixime对头孢氨苄耐药株仍具高度活性,其MIC均值可降低60～1200倍以上。绿脓杆菌、硝酸盐阴性杆菌、鲁氏不动杆菌和产碱杆菌对Cefixime和其它3种头孢菌素的敏感性均较差。四者对厌氧菌的作用除厌氧球菌外其抗菌活性都很弱。Cefixime对β-内酰胺酶稳定,口服吸收良好,抗菌作用强,是一个值得进行临床研究的口服头孢菌素。     

Bilateral absolute phakolytic glaucoma. A clinical and ultrasonographic case study

We describe an unusual case of absolute bilateral phakolytic glaucoma. On admission for cataract surgery the 75-year-old patient was found to be totally blind, no light perception in either eye. The ocular tensions were about 75 mmHg in both eyes, corneas hazy, the fundi could not be seen. The swollen lens of the right eye had slightly subluxated downwards. In the left eye the ultrasound showed a luxated swollen lens in the vitreous space. The ultrasound also revealed totally excavated optic discs. This patient had been on the waiting list for 8 months. Information of the stage of the cataracts of patients on the waiting lists for operation is of paramount importance in the prevention of lens induced problems which may lead to irreversible visual deterioration.     

Mortality and lead exposure: a retrospective cohort study of Swedish smelter workers

The study is based on the work histories and mortality data for 3832 male workers first employed before 1967 at a copper smelter in northern Sweden and followed up from 1950 to 1981. From the 3832 workers a lead cohort consisting of 437 workers employed for at least three years at sites with considerable lead exposure during 1950-74 was selected. These workers had regularly had blood lead measurements performed since 1950. Based on the cumulative blood lead dose 1950-74 and peak blood lead values, the cohort was subdivided into high mean, low mean, high peak, and low peak groups. Standardised mortality ratios (SMR) were calculated for the six groups using general and local reference populations. The original cohort of 3832 workers showed considerable excess of deaths for total mortality, malignant neoplasms especially lung and stomach cancer, ischaemic heart diseases, and cerebrovascular diseases when compared with the general population. In the lead cohort where the workers had been subjected to a considerable lead exposure only the raised SMR for lung cancer was sustained (SMR = 162; not significant). No significant differences were found between high lead and low lead exposed smelter workers.