脑活素改善血管性痴呆患者智能状况的临床研究

目的:探索脑活素对血管性痴呆患者智能状况的改善效果。方法:将29例符合血管性痴呆标准的患者分为对照组和治疗组。对照组用血塞通0.4g,治疗组在对照组的基础上加用脑活素20mL,10d为1个疗程,3年共6个疗程,其后分别采用中文版简易智能状态检查(MMSE)量表进行积分,用中国人修订韦氏成人量表(WAIS-RC)进行智力测验比较。结果:根据WAIS-RC测验结果,两组3年后知识(11.32±1.76比9.23±1.78)、领悟(13.19±1.85比11.24±2.12)、算术(10.18±1.32比8.63±1.25)、相似(9.46±0.68比7.56±0.98)、数字广度(10.12±0.69比8.68±0.97)、词汇(31.25±0.78比27.32±1.02)、数字符号(31.35±1.20比25.35±0.78)、填图(9.78±0.98比7.45±0.65)、图片排列(19.16±0.74比15.23±1.52)等项目比较,治疗组积分明显高于对照组(t=1.96～5.21,P<0.05或0.01)。治疗组治疗前后上述项目自身对照积分亦有显著提高(t=1.96～5.21,P<0.05或0.01)。结论:脑活素能有效抑制神经细胞的凋亡,减少脑功能的受累,治疗血管性痴呆,对老年群体的康复有一定的治疗作用。     

Treatment of AL Amyloidosis: Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) Consensus Statement 2020 Update

Immunoglobulin light chain (AL) amyloidosis is a clonal plasma cell disorder leading to progressive and life-threatening organ failure. The heart and the kidneys are the most commonly involved organs, but almost any organ can be involved. Because of the nonspecific presentation, diagnosis delay is common, and many patients are diagnosed with advanced organ failure. In the era of effective therapies and improved outcomes for patients with AL amyloidosis, the importance of early recognition is further enhanced as the ability to reverse organ dysfunction is limited in those with a profound organ failure. As AL amyloidosis is an uncommon disorder and given patients’ frailty and high early death rate, management of this complex condition is challenging. The treatment of AL amyloidosis is based on various anti–plasma cell therapies. These therapies are borrowed and customized from the treatment of multiple myeloma, a more common disorder. However, a growing number of phase 2/3 studies dedicated to the AL amyloidosis population are being performed, making treatment decisions more evidence-based. Supportive care is an integral part of management of AL amyloidosis because of the inherent organ dysfunction, limiting the delivery of effective therapy. This extensive review brings an updated summary on the management of AL amyloidosis, sectioned into the 3 pillars for survival improvement: early disease recognition, anti–plasma cell therapy, and supportive care.     

Subchronic toxicity evaluation of aloesin

Aloesin, an aromatic chromone present in various Aloe species, shows potential beneficial effects on indices related to pre-diabetic states, including metabolic syndrome. Aloesin may have utility as a functional food ingredient. As part of a program to assess its safety, aloesin was administered by oral gavage at doses of 250, 500, and 1000 mg/kg body weight/day to groups of 10 male and 10 female Sprague-Dawley rats for 90 days. Treatment was not associated with mortality and appeared to be well tolerated. There were no toxicologically or statistically significant changes in body weight gain or in feed and water consumption. A few statistically significant changes in serum biochemistry and hematology parameters were noted, but all were mild in nature, were confined to one sex, and/or did not show dose–response relationships. Urinalysis revealed dose-dependent increases in urinary ketones. This result was due to the presence of aloesin, which possesses ketone functionalities, in the urine and not due to a systemic effect. There was no effect of treatment on organ weights or on the results of the histopathological examinations. The no-observed-adverse-effect level was considered to be 1000 mg/kg body weight/day, the highest dose tested. The results support potential use of aloesin as a functional food ingredient.     

药品生产质量管理规范在外用药制剂生产管理中的应用

目的探讨药品生产质量管理规范在外用药制剂生产管理中的应用。方法从药品生产企业的外用药制剂生产现状和实际情况出发,以外用药市场上最常见的乳膏制剂为例,在调研的基础上,总结外用药制剂生产的质量管理现状分析及存在问题。结果运用先进的产品质量管理模式,提升外用药产品的生产管理水平,可提高产品市场占有率,减少企业因质量造成的损失成本。结论完善药品生产质量管理体系,才能保证整个药品生产和使用过程安全有效。     

Gray matter morphology and the level of functioning in one-year follow-up of first-episode schizophrenia patients

Schizophrenia is a condition with a highly variable course that is hard to predict. The aim of the present study was to investigate if local gray matter volume (GMV) can differentiate poor (PF) and good (GF) functioning patients using voxel-wise analysis in a group of first-episode schizophrenia subjects (FES).     

The potential of a 2Tone Trainer to help patients use their metered-dose inhalers

BACKGROUND: Many patients have problems using the correct inhalation technique when they use their metered-dose inhalers (MDIs). We have investigated whether a training aid (2Tone Trainer [2T]; Canday Medical Ltd; Newmarket, UK) helps to maintain the correct inhaler technique after patients leave the clinic METHODS: Ethics committee approval was obtained, and patients gave consent. Asthmatic patients who had been prescribed an MDI had their inhalation technique assessed. Their peak inhalation flow (PIF) when using their MDI, FEV(1), and the Juniper asthma quality of life questionnaire (AQLQ) score were measured. Those patients using the recommended MDI technique were the good-technique (GT) group. The remainder were randomized to receive verbal training (VT) or VT plus the 2T to improve their MDI technique. All patients returned 6 weeks later. RESULTS: There were 36, 35, and 36 asthmatic patients, respectively, who completed the GT, VT, and 2T procedures. FEV1 did not change within all groups between visit 1 and 2. PIF and AQLQ score did not change in the GT group. In the VT and 2T groups, the AQLQ score increased by mean differences of 0.33 (95% confidence interval [CI], 0.14 to 0.53; p < 0.001) and 0.74 (95% CI, 0.62 to 0.86; p < 0.001). At visit 1, all patients in the VT and 2T groups inhaled > 90 L/min decreasing to 12 patients and 1 patient, respectively, at visit 2 (p < 0.001 both groups). The overall changes in the 2T group for PIF and AQLQ score, between visits 1 and 2, were significantly (p < 0.001) greater than the corresponding changes in the VT group. CONCLUSION: The 2T helps patients to maintain the recommended MDI technique posttraining with improvements in AQLQ score.     

血红蛋白电泳和G6PD联合检测在诊断贫血中的价值

目的探讨血红蛋白电泳和G6PD缺乏联合检测在婚前、产前检查的意义和新生儿地中海贫血和G6PD缺乏发病率。方法收集3326例孕妇产前血样标本和276例新生儿溶血患者血样标本。采用琼脂糖凝胶电泳检测血红蛋白、比值检测G6PD。结果3326例孕妇产前血样标本检测中,地中海贫血HBA2〈2．5％有335例、检出率占10．07％,HBA2〉3．5％有258例、占7．76％,HBA2〉H4．0％有167例、占5．02％,异常血蛋白17例。G6PD缺乏89例、占2．7％。276例新生儿溶血患者血样标本有Hb Bart’s带79例、占28．62％。G6PD缺乏22例占7．91％。结论地中海贫血和G6PD缺乏联合检测在产前检查中有较高的阳性率,引起新生儿溶血的比例较高。因此两种方法在婚前、产前检查中可以相互补充,避免了单项检测时可能造成的遗漏现象,而且操作方法简单值得推广。     

药物导致双硫醒样不良反应分析

目的探讨双硫醒不良反应发生的原因,预防救治措施。方法对本院3例不良反应报告进行分析总结。结果全部治愈。结论医务人员、患者提高认知度,双硫醒不良反应可以预防治疗。     

遗传毒性试验的质量保证与现场检查

遗传毒性试验在毒理学试验中属于短期、小型试验,但因其测试终点的多样性及统计分析的复杂性,在药品非临床研究质量管理规范（GLP）和质量保证（QA）方面有其特殊性。文中从实验室资质的确认、研究过程的核查、原始资料和报告的审核、现场检查等4个方面介绍遗传毒性试验质量保证的程序、要求和注意事项。     

微波配合良好护理治疗慢性宫颈炎的疗效观察

目的探讨微波配合良好护理治疗各型慢性宫颈炎的临床疗效观察。方法对我科100例不同类型宫颈炎患者采用微波治疗并配合良好的护理。结果在良好护理条件下用微波治疗慢性宫颈炎疗效显著,轻度宫颈糜烂、宫颈息肉、纳氏囊肿治愈率达100％．中度宫颈糜烂治愈率达93．3％,重度宫颈糜烂治愈率达71．4％,总治愈率达91％,且无明显不良反应。结论微波治疗具有操作简单、手术时间短、止血效果好、治愈率高、无明显不良反应等优点,微波配合良好护理是一种操作简单、安全性高、疗效好、副作用少的慢性宫颈炎治疗方法,值得临床推广应用.