The use of oral sedatives in dental care

Oral administration of tranquillizing and anxiety-suppressing drugs has long been the commonest method of achieving light sedation. The benzodiazepines are the drugs of first choice. Benzodiazepines given orally may be indicated to avoid 'treatment stress', alleviate mild anxiety before dental treatment, and facilitate sleep on the night before the treatment. Furthermore, they could be used for the dental treatment of medically poor risk patients, particularly those with cardiovascular disease. The drug can be given either in a fractionated dose or a single dose. The recommended doses for diazepam vary from 0.1–0.8 mg/kg body weight, depending on age, with higher doses in children and lower doses in elderly patients. Few side effects are reported.     

渗透压微泵恒速给药丙戊酸在小鼠体内的时间药物动力学

以渗透压微泵植入小鼠皮下恒速给予丙戊酸钠，在达到理论稳态浓度时间后，血浆药浓呈昼夜变化，白昼高于夜间，峰值位于明期末。药动学研究揭示丙戊酸血药浓度的昼夜差异可能与其清除率及分布容积的昼夜变化有关。     

大学生自我和谐与社交焦虑的相关研究

目的探讨大学生的自我和谐与交往焦虑的特点和关系。方法采用自我和谐量表和交往焦虑量表对310名大学生进行调查。结果男生在自我灵活性和自我和谐上得分低于女生（P〈0．01），研究生在自我灵活性上得分低于本科生（P〈0．01），理科生在社交焦虑上得分低于文科生（P〈0．05）；高自我和谐组在社交焦虑上得分低于低自我和谐组（P〈0．05）；从总体上看，社交焦虑与自我与经验的不和谐、自我刻板性、总体的自我和谐均呈正相关（P〈0．01）。结论大学生的自我和谐和社交焦虑之间均存在相关，自我和谐对社交焦虑具有良好的预测作用。     

Using Queueing Theory to Increase the Effectiveness of Emergency Department Provider Staffing

Objectives: Significant variation in emergency department (ED) patient arrival rates necessitates the adjustment of staffing patterns to optimize the timely care of patients. This study evaluated the effectiveness of a queueing model in identifying provider staffing patterns to reduce the fraction of patients who leave without being seen. Methods: The authors collected detailed ED arrival data from an urban hospital and used a Lag SIPP queueing analysis to gain insights on how to change provider staffing to decrease the proportion of patients who leave without being seen. The authors then compared this proportion for the same 39‐week period before and after the resulting changes. Results: Despite an increase in arrival volume of 1,078 patients (6.3%), an average increase in provider hours of 12 hours per week (3.1%) resulted in 258 fewer patients who left without being seen. This represents a decrease in the proportion of patients who left without being seen by 22.9%. Restricting attention to a four‐day subset of the week during which there was no increase in total provider hours, a reallocation of providers based on the queueing model resulted in 161 fewer patients who left without being seen (21.7%), despite an additional 548 patients (5.5%) arriving in the second half of the study. Conclusions: Timely access to a provider is a critical dimension of ED quality performance. In an environment in which EDs are often understaffed, analyses of arrival patterns and the use of queueing models can be extremely useful in identifying the most effective allocation of staff.     

“分步给药”在低氧易感患者无痛苦胃镜检查中安全性的探讨

目的 探讨在低氧易感患者无痛苦胃镜检查中采用分步给药的安全性和镇静/镇痛效果.方法 接受胃镜检查的180例患者,其中有鼾症、或咳嗽、咳痰症状的患者120例单双号随机入选Ⅰ组(分步给药组)和Ⅱ组(普通组),60例无鼾症、咳嗽、咳痰症状的患者为Ⅲ组(常规给药组),Ⅰ组采用分步给药法,Ⅲ组采用常规给药法对患者实施胃镜检查前的镇静/镇痛术,Ⅱ组则进行普通胃镜检查,分析2种镇静法对SBP、DBP、SpO2、HR、清醒时间、患者反应、患者对检查过程的感受以及是否愿意再次接受检查的影响,评价分步给药法在低氧易感患者无痛苦胃镜检查中的安全性和镇静/镇痛效果.结果 Ⅰ组、Ⅲ组检查中SBP、DBP变化无明显差异(均P＞0.05),Ⅰ组检查前、中SpO2的变化小于Ⅲ组(均P＜0.01);Ⅰ组进镜时咽部受刺激产生的恶心咽吐、流涎、咳嗽、躁动反应多于Ⅲ组(均P＜0.01),但较Ⅱ组少(均P＜0.01);Ⅰ组对胃镜检查的评价与Ⅲ组无明显差异(P＞0.05),与Ⅱ组相比有明显差异(P＜0.01).结论 分步给药法是一种适用于低氧易感患者无痛胃镜检查的安全、有效的镇静/镇痛方法.     

复合维生素E,C,B组合物面膜治疗寻常痤疮117例的疗效和安全性(英文)

目的:了解维生素E,C,B组合物面膜治疗寻常痤疮的疗效及安全性。方法:117例13a以上、痤疮严重程度分级在2级以上且主要表现于脸部的病人,予维生素E,C,B组合物面膜治疗,每日1次,共8wk。观察治疗前后痤疮数量及性质,包括粉刺、丘疹、脓疱及囊肿之数目,并评估整体疗效。结果:治疗后,粉刺、丘疹、脓疱及囊肿数目下降了13±s13,10±12,5±7及3±3,均P<0.01。7例(6.0%)病人症状完全改善,44例(37.6%)中度改善,56例(47.9%)轻度改善,10例(8.6%)无改善。59例(50.4%)病人无红肿、搔痒、灼热及脱皮等现象发生。结论:维生素E,C,B组合物面膜治疗痤疮有效,超过半数的受试者无不良反应发生,可作为传统治疗寻常痤疮药物的替代。     

川芎嗪对P2X3受体介导的大鼠伤害性兴奋传入的作用

通过动物痛行为反应(缩足反射)确定局部和鞘内应用川芎嗪(TMP)对ATP等P2X受体激动剂所致大鼠足底急性伤害性行为反应的影响。P2X3受体拮抗剂TNP-ATP(0．3μmol／L)明显抑制P2X受体激动剂ATP(1μmol／L)或α，β-meATP(0．6μmol／L)引起的大鼠足底急性伤害性反应。大鼠足底局部应用TMP(0．1-10mmol／L)剂量依赖性地对ATP(1μmol／L)或α，β-meATP(0．6μmol／L)引起的伤害性反应具有抑制作用。鞘内应用TMP(50mmol／L)对ATP(1μmol／L)或α，β-meATP(0．6μmol／L)引起的伤害性反应具有抑制作用。结果表明，TMP可通过阻断P2X3受体介导的伤害性兴奋传入抑制P2X受体激动剂引起的大鼠足底急性伤害性反应。     

F wave studies after intrathecal methotrexate administration

Electrophysiological examinations were done on 20 patients aged 40–71 years with recently diagnosed high grade non-Hodgkin's lymphomas. General chemotherapy and intrathecal chemotherapy in order to prevent central nervous system (CNS) involvement were begun. On the first day of chemotherapeutic cycle patients received intrathecally methotrexate (ITMTX) and prednisolone. Electrophysiological study was carried out twice in each subject: before ITMTX injection and a day after injection. The study procedure included: a conventional nerve conduction examination (peripheral conduction velocity and compound muscle action potential amplitude), the F wave latency and amplitude measurement and F ratio (F-M-1/2M) calculation for peroneal and tibial nerve bilaterally. Results of the first and the second examinations were statistically compared by t-Student's test. No significant differences between values of estimated parameters were found. The study revealed no recent alterations in proximal, paraspinal motor conduction and motor neuron excitability due to antidromical activation after single ITMTX administration.     

Comparison of Simulated and in-Vivo Plasma Levels of Cilastatin Following Intravenous in-Line Drug Administration

The primary objective of this work was to establish a method to simulate the plasma levels of cilastatin, a model drug, following an intravenous in-line delivery scheme. In-vivo data in dogs obtained from this work were used to demonstrate the validity of the proposed approach. The in-line drug delivery system consists of a drug containing device which is placed between a large volume parenteral and a patient. Numerous advantages have been identified for this automatic in-line reconstitution delivery system. The numerical convolution integral algorithm was used in this work to perform plasma profile simulation. The results indicated that the simulated cilastatin plasma profile following in-line delivery closely agreed with the in-vivo data.