A Bayesian dosing method for carboplatin given by continuous infusion for 120 h

Carboplatin (CBDCA), an analogue of cisplatin, exhibits reduced toxicity but wide interpatient variability of its pharmacokinetic parameters. Individualization of the CBDCA dose is therefore necessary. Although various formulas have been developed for this purpose, major side effects have been reported on CBDCA administration by short-term infusion (0.5 or 1h). We therefore propose a new schedule of CBDCA administration. Instead of a dosing method based on the estimation of renal function when a classic administration schedule is used, we propose a pharmacokinetic dosing method (Bayesian method), whereby CBDCA is given by continuous infusion for 120 h. First, CBDCA was given to 21 patients to determine the population pharmacokinetic parameters of carboplatin. Then, on the basis of total platinum plasma concentration measurements and Bayesian estimation of pharmacokinetic parameters, it was possible to individualize the CBDCA dose within the first 24 h of the infusion. This new protocol for CBDCA administration was evaluated in 36 new patients (60 courses). Three theoretical end points at the end of the infusion were considered. For a given theoretical end point, 20 courses were taken into account. The theoretical end points (i.e., 1, 1.5, and 1.8 mg/l) were compared with the concentrations measured at the end of the infusion, which were 0.99 ± 0.10, 1.41 ± 0.13, and 1.72 ± 0.20 mg/l, respectively. This Bayesian dosing method can easily be used in clinical practice, and the determination of predictive performances has shown that the method is precise and unbiased. With no more toxicity or practical difficulties than those produced by other methods, and with acceptable tolerance, it was possible to reach a median dose that was 20% higher than the usual dose (484 ± 190 mg/m² as compared with 400 mg/m²). In conclusion, this new schedule of CBDCA administration appears to be interesting in terms of tolerance. However, new studies are required to confirm that this new scheme leads to equal or better efficacy than the classic protocol. Received: 10 December 1995 / Accepted: 15 December 1996     

徐蔚霖治疗女童性早熟用药经验

儿童性早熟目前尚无理想的治疗方法。徐蔚霖认为，性早熟病在冲任，源在肝肾，治疗重在调理冲任和肝肾，尤应以疏肝理气为主，用药以入肝经药为先。对肾阴亏虚、相火亢盛患儿，加用滋阴补肾清火类药。对肝经湿热、气机郁滞患儿，酌加清热凉血、利湿化浊之品。用药当注意顾护脾胃，提出间歇服药这一特色方法     

去氢骆驼蓬碱注射用乳剂的凝聚动力学研究

采用电导法对去氢骆驼蓬注射用乳剂的凝聚动力学进行了研究，求出凝聚速度方程和25℃时半凝聚期，从而定量地预测了这一分散体系的物理稳定性。     

组织蛋白酶D表达对乳腺癌预后的意义

 用免疫组化法检57例乳腺癌患者的Cath-D在乳腺癌组织中间质细胞和癌细胞的表达情况。结果表明：间质细胞Cath—D的表达强度高于癌细胞（P＜0.01）；Cath—D阳性表达与乳腺癌的淋巴结转移呈正相关（P＜0.005）与五年生存期呈负相关（P＜O.0O5）；在无淋巴结和小于4个转移的病例中，间质Cath—D阳性表达与五年生存期呈负相关（P＜0.005），而癌细胞的阳性与淋巴结转移情况和五年生存期的关系无统计学意义。本研究提示乳腺癌间质Cath—D表达能作为预测乳腺癌预后因素之一。对选择高危人群进行针对性治疗有意义。     

利用"分层法"评价中药复杂体系药效时有关权重设立的讨论

本文讨论了以分层法进行中药药效评价时权重设立的问题，主要由以下几部分组成：1．建立递阶层次结构；2．构造两两比较判断矩阵；3．计算单一准则下元素的相对权重；4．计算各层元素的组合权重。由于中药作用具有多途径、多靶点的特性，因此评价过程中权重的设立就占有重要位置。它直接影响对被评价对象药效作用的评判。全面解决中药作用多途径、多靶点药效学评价的数学方法，客观量化的评价中药的综合药效，是中药现代化进程中一个值得研讨的命题。     

中国汉族196人红细胞谷胱甘肽硫转移酶的活性分布

目的采用分光光度法测定人RBC谷胱甘肽硫转移酶(GSTs)活性,研究196名(男101名,女95名)健康汉族人的GSTs活性分布。方法制备人RBC裂解后,参照Habdous等的方法测定GSTs活性。反应体系如下:0.1 mol.L-1磷酸钠缓冲液(pH 6.5)2.6 mL,RBC裂解液0.1 mL,30 mmol.L-1谷胱甘肽0.1 mL,10 mmol.L-11-氯-2,4-二硝基苯(CDNB)0.1 mL。结果方法的日内和日间精密度均<10%。RBC GSTs活性呈正偏态分布,196例健康汉族人的平均GSTs活性为(3.89±0.96)U.(gHb)-1。不同年龄组平均GSTs活性无差异,而女性的平均GSTs活性比男性的平均值高,但并不显著。结论确定了可供临床参考的健康汉族人GSTs活性分布范围。     

青钱柳嫩叶中多糖的含量测定

目的建立青钱柳叶中多糖含量的测定方法.方法采用苯酚-浓硫酸显色法,于490 nm处测吸光度.结果青钱柳嫩叶中多糖含量为0.65 32%;平均回收率99.03%;r=0.9991.结论方法简便、快速,结果准确、可靠,适合多糖的含量测定.     

Orem自理学说在脑卒中患者临床护理中的应用与探讨

目的:分析护理方式对脑卒中患者自护能力的影响.方法:采用随机分组的方法,观察组以 Orem自理学说为理论框 架,依据马斯洛的需要层次论,针对疾病作用于人体所引起的生理、心理、社会的反应,运用护理程序,围绕护理目 标、实施护理计划;与同期住院按分级护理标准,实施护理计划的对照组比较.结果:两组的并发症有高度显著性差 异( P<0.01)两组的后遗症有显著性差异 (P<0.05).结论:自我护理具有较强的针对性,有利于实现护患双方共同的目标,降低并发症和致残率.     

非虚假设非中心法及其临床应用

目的本文提出一种非虚假设非中心法,并说明其临床应用.方法以非虚假设取代虚假设将经典非中心法加以扩展,以Monte Carlo方法展示其行为.结果当最小临床承认差量取零时,它还原为经典方法.其观测功效与预定功效吻合.结论这种方法适用于以治疗-对照差临床意义研究或临床等效性为目的临床试验的设计.     

改良皮下埋藏缝线法重睑形成术

目的:探讨重睑形成术的手术方法和效果。方法:对15例(29眼)单睑者在皮下埋藏缝线法重睑形成的基本原理的基础上,在具体操作技术上用我们改良后的手术方法施行手术。结果:经5～10d和6～12mo的随访观察,除其中1例无力型因年龄大适应症选择不当0.5a后效果不佳;其余全部受术者,恢复后形成重睑皱褶自然,长短基本一致,重睑对称。受术者、施术者、第三者均较满意。结论:改良后的重睑形成术,手术操作简便,效果可靠。是一种具有应用价值的手术方式,值得推广使用。