Current concepts in the pathophysiology and management of diabetic ketoacidosis

Recent studies indicate that for the development of diabetic ketoacidosis glucagon excess is essential in addition to a deficiency of insulin. Glucagon activates the carnitine acyl transferase I leading to ketonemia. Low dose continuous infusion of insulin appears to be the ideal mode of therapy for the correction of hyperglycemia. The use of sodium bicarbonate and phosphate as adjuvants in management is discussed in the light of recent observations.     

探讨低剂量索他洛尔与普罗帕酮治疗心律不齐的效果

目的 探讨低剂量索他洛尔与普罗帕酮治疗心律不齐的效果.方法 选取2017年4月至2019年8月于本院治疗的60例心律不齐患者为研究对象,随机分为对照组和观察组,各30例.对照组使用普罗帕酮进行治疗,观察组使用低剂量索他洛尔进行治疗.比较两组治疗效果,检测治疗前后QT离散度数据,记录治疗期间药物不良反应发生情况.结果 观...     

锥形束CT在鼻泪管阻塞性疾病辅助诊断中的应用价值

目的 探讨锥形束CT(CBCT)在鼻泪管阻塞性疾病辅助诊断中的应用价值.方法 选取2018年1月至2020年8月在中国人民解放军总医院眼科门诊就诊的鼻泪管阻塞性疾病患者104例,按随机数字表法分为观察组及对照组,各52例,观察组患者采用CBCT检查鼻泪管,对照组采用CT泪道造影检查鼻泪管.观察并比较两组患者鼻泪管的影像...     

L-454,560, a potent and selective PDE4 inhibitor with in vivo efficacy in animal models of asthma and cognition

Type 4 phosphodiesterases (PDE4) inhibitors are emerging therapeutics in the treatment of a number of chronic disorders including asthma, chronic obstructive pulmonary disease (COPD) and cognitive disorders. This study delineates the preclinical profile of L-454,560, which is a potent, competitive and preferential inhibitor of PDE4A, 4B, and 4D with IC50 values of 1.6, 0.5 and 1.2 nM, respectively. In contrast to the exclusive binding of cilomilast and the preferential binding of roflumilast to the PDE4 holoenzyme state (Mg2+-bound form), L-454,560 binds to both the apo-(Mg2+-free) and holoenzyme states of PDE4. The intrinsic enzyme potency for PDE4 inhibition by L-454,560 also results in an effective blockade of LPS-induced TNFalpha formation in whole blood (IC50 = 161 nM) and is comparable to the human whole blood potency of roflumilast. The cytokine profile of inhibition of L-454,560 is mainly a Th1 profile with significant inhibition of IFNgamma and no detectable inhibition of IL-13 formation up to 1 microM. L-454,560 was also found to be efficacious in two models of airway hyper-reactivity, the ovalbumin (OVA) sensitized and challenged guinea pig and the ascaris sensitized sheep model. Furthermore, L-454560 was also effective in improving performance in the delayed matching to position (DMTP) version of the Morris watermaze, at a dose removed from that associated with potential emesis. Therefore, L-454,560 is a novel PDE4 inhibitor with an overall in vivo efficacy profile at least comparable to roflumilast and clearly superior to cilomilast.     

黄芪当归合剂肾脏保护作用的有效部位筛选

目的:以肾间质纤维化模型大鼠的肾功能及肾小管间质损伤指数改善为药理活性指标,对黄芪当归合剂(AA)进行分离和筛选,获得其肾脏保护作用的药物有效部位。方法:应用溶剂法和色谱法逐级对AA进行追踪分离,分别获得11个不同部位。同时将Wistar大鼠随机分为假手术组、单侧输尿管梗阻(UUO)模型组、AA组及不同部位治疗组。灌胃给药后观察AA各部位对UUO大鼠肾损伤的疗效。治疗10 d后经腹主动脉取血检测血清肌酐(Scr)和尿素(Urea)水平;同时观察梗阻侧肾脏的病理变化,并对肾间质细胞浸润、肾小管萎缩和肾间质纤维化等病理损伤的程度(PI-Ⅰ)进行半定量评分,以PI-Ⅰ改善作为主要疗效、肾功能改善作为次要疗效,筛选获得具有最佳药理活性的有效部位。结果:在溶剂法分离获得的7个不同极性部位中,组分I和IC均具有改善肾功能、减轻肾小管间质损伤的疗效,其肾脏保护作用与AA疗效相近;而色谱法分离IC得到的4个部位对Scr,Urea及PI-I均无改善作用。结论:在UUO大鼠模型中,源自复方中药AA的组分I和IC具有与原方剂相似,具有抑制肾间质纤维化的作用,可确认为AA肾脏保护作用的有效部位。     

Polycystic ovary syndrome (PCOS)

Polycystic ovaries syndrome (PCOS) is one of the most common female hormonal disorders. Its multiple components--reproductive, metabolic, neoplasic and cardiovascular--have a major impact on the public health. Androgen excess and resistance to insulin, probably from genetic origin, are responsible for most of the clinical symptomatology. Resistance to insulin seems to be accompanied by a greater risk of glucose intolerance, type 2 diabetes, lipidic anomalies and can involve the development of cardiovascular diseases. In addition, sleep apnea syndrome is more progressively described in PCOS. Infertility, menses disorders and hirsutism often push these patients to consult their physician. A better understanding of the physiopathological mechanisms led to the emergence of new therapeutic options increasing the sensitivity to insulin. Besides the pregnancy wishes, cares aim to attenuate the marks of the hyper-androgenism (hormonal treatment and cosmetic) and to correct cardiovascular, respiratory and gynaecological risk factors. In case of infertility by anovulation, cares must be performed by trained experts to minimize the risk of ovarian hyper-stimulation syndrome and multiple pregnancies. A gradation from loose weight to clomiphene citrate ovulation induction, ovarian drilling, low dose gonadotropin, in vitro fertilisation, or in vitro maturation of oocytes should bring back good reproduction potential.     

2008年天津市部分介入放射工作人员个人剂量的监测与评价

目的了解天津市从事介入放射医疗工作人员职业性外照射的个人剂量情况。方法选取天津市4所医院的放射工作者72人,采用热释光监测方法,结合相关标准进行评价分析。结果4所医院的介入放射工作人员中,人均年剂量分别为2.08、3.73、0.65和0.64mSv。全体人均年剂量为2.30mSv。其中61人低于5mSv,占总数的84.7%;9人高于5mSv而低于10mSv,占总数的12.5%;2人高于10mSv而低于20mSv,占总数的2.8%。全部72人均不超过20mSv。结论部分放射工作人员的个人剂量监测结果超过了标准规定的限值。需要加强对天津市的介入放射学工作人员的放射防护管理,降低个人剂量水平。     

放射治疗射野任意点剂量自动计算的实现

本文介绍了放射治疗射野任意点剂量自动计算的实现方法。此方法完成模拟定位机下对患者治疗野图像的识别与任意点剂量的计算。     

腕管综合征的MRI诊断

研究腕管综合征（CTS）的MRI特征及应用价值。材料和方法：经临床及手术证实的CTS12例，行MRI检查，以横断面为主。结果：12例CTS的MRI表现为：正中神经进入腕管时肿胀增粗12例，正中神经肿胀率（MNSR）为2．25：1。正中神经腕管内受压变扁12冽，正中神经扁平率（MNFR）为3．4。腕横韧带向掌侧膨隆10例，腕横韧带膨隆率（BR）为15．8％。T2WI像正中神经信号增高12例。结论：MRI对CTS的诊断、治疗方式的选择及疗效观察有重要的价值。