住院病人抗生素的合理使用回顾与前瞻

本文报告我院抗生素的用药情况,发现抗生素使用面广,应用中存在问题较多,因此,我们采用“药历表”调查病历中抗生素的使用情况,并在提倡“围术期”预防用抗生素等方面做了一些工作。随机抽查1988年7月～1990年4月已出院病历710份,对使用过抗生素的病历进行了回顾性调查,发现抗生素使用率达到85％左右。前瞻性检查方式:参加对严重感染或混合感染病人的会诊用药,并追踪观察抗生素的使用效果;实地检查抗生素所用溶媒、给药间隔、给药方法、配伍变化及联合用药,并对其安全性、合理性进行了讲评,逐步改变目前带普遍性不合理使用的现象和预防性使用抗生素是否合理的问题。     

Vegetables,fruit, and cancer. II. Mechanisms

The epidemiologic literature on the relationship between vegetable and fruit consumption and human cancer at a variety of sites was reviewed systematically in Part I.¹ It was concluded that consumption of higher levels of vegetables and fruit is associated consistently, although not universally, with a reduced risk of cancer at most sites, and particularly with epithelial cancers of the alimentary and respiratory tracts. Possible mechanisms by which vegetable and fruit intake might alter risk of cancer are addressed here. A large number of potentially anticarcinogenic agents are found in these food sources, including carotenoids, vitamins C and E, selenium, dietary fiber, dithiolthiones, glucosinolates and indoles, isothiocyanates, flavonoids, phenols, protease inhibitors, plant sterols, allium compounds, and limonene. These agents have both complementary and overlapping mechanisms of action, including the induction of detoxification enzymes, inhibition of nitrosamine formation, provision of substrate for formation of antineoplastic agents, dilution and binding of carcinogens in the digestive tract, alteration of hormone metabolism, antioxidant effects, and others. It appears extremely unlikely that any one substance is responsible for all the associations seen. Possible adverse effects of vegetable and fruit consumption are also examined. One way to consider the relationships reviewed here is to hypothesize that humans are adapted to a high intake of plant foods that supply substances crucial to the maintenance of the organism, but only some of which are currently called essential nutrients. Cancer may be the result of reducing the level of intake of foods that are metabolically necessary—it may be a disease of maladaptation.Authors are with the Division of Epidemiology, School of Public Health, University of Minnesota, 1-210 Moos Tower, 515 Delaware Street SE, Minneapolis, MN 55455, USA. Address correspondence to Dr Potter. This work was supported by NIH Grants CA 50305, CA 46618, and CA 09607.     

Human nonspecific suppressive lymphokines

Since the term lymphokine first appeared in print over 20 years ago, a tremendous number of these soluble mediators of the immune system have been described. Within the past few years, many human nonspecific suppressive lymphokines have been identified. This review discusses the historical basis of immunologic suppression and suppressor factors. Later reports describing suppressive human lymphokines are then grouped into four categories: primarily stimulatory lymphokines that also mediate certain suppressive activities, suppressive lymphokines produced during altered states of immunity, suppressive lymphokines produced by exogenously stimulated lymphocytes, and suppressive lymphokines produced by unstimulated lymphocytes. Recent work I have been involved in focusing on the human suppressive lymphokine soluble suppressor factor (SSF) is also discussed.     

Augmentation with sulpiride for a schizophrenic patient partially responsive to clozapine

OBJECTIVE: Schizophrenic patients who are only partially responsive to clozapine pose a therapeutic challenge. In these circumstances some clinicians would consider adding in a second antipsychotic. We present a case report and review evidence for the efficacy of such augmentation strategies. METHOD: Single case report and literature review. RESULTS: The total number of patients in studies and case reports of combining clozapine with other antipsychotics is small. There has been only one randomized controlled trial. This found the addition of sulpiride to clozapine resulted in clinical improvement in some patients. CONCLUSION: Further randomized controlled studies of augmentation of clozapine therapy are needed to provide scientific justification for this clinical practice.     

黄芪注射液临床应用进展

目的：对黄芪注射液临床应用及其疗效进行综述。方法：通过查阅近期国内部分期刊杂志，对黄芪注射液在肺心病、老年肺结核、脑中风、冠心病、流行性出血热、病毒性心肌炎、甲亢、肝病及肾病等临床应用新进展进行综述。结果：黄芪注射液辅助治疗上述疾病疗效满意。结论：黄芪注射液是治疗心脑血管疾病、肾病、肝病等的有效药物。     

针灸治疗单纯性肥胖症及机理研究探讨

单纯性肥胖症是当今社会常见病、多发病之一。近年来 ,针灸治疗单纯性肥胖症无论在临床方面还是在实验机理研究方面 ,均取得较大进展。但针灸减肥的机理研究大多局限在中枢神经核团神经递质含量的研究 ,没有新的突破 ,在临床方面有待于更多、更科学、更规范的临床研究报道。     

针灸治疗胆汁返流性胃炎近况

系统回顾及总结了近几年来有关针灸治疗胆汁返流性胃炎(BRG)的文献，认为针灸防治BRG具有肯定的临床疗效和优势，并为进一步探索提供思路。     

中医药治疗间质性肺病的研究概况

通过对近10年来相关文献的整理和分析，显示中医药对间质性肺病（ILD）防治的研究进展。目前中医学对ILD病症、病因病机以及临床治疗的认识和研究都有了显著的提高，无率是单味中药还是组方用药，其疗效优于单用西药。在延长生存期、改善生存质量、缓解临床症状等方面效果尤为明显。     

植物聚戊烯醇的研究进展

综述了国内外植物聚戊烯醇的研究近况，对其化学结构和含量分布、纯化和分析方法、应用及其药物开发等方面进行阐述，为国内聚戊烯醇的药物开发和应用提供了新思路。     

维生素B12工业生产技术的进展

介绍了维生素B12生产过程中菌株的选育和工艺的优化进展，包括二步发酵工艺和膜反应器的应用与改进。通过菌株选育和工艺改进大大提高了产量，推进了生产。特别是膜技术和其他分离技术的联用弥补了单一膜反应器中原料利用率低的缺点，具有良好的生产应用价值。