氯化钾缓释片对充血性心力衰竭104例的保钾疗效

充血性心力衰竭患者１０４例（正在使用地高辛加排钾利尿剂）随机均分为氯化钾缓释片（Ｓｌｏｗ－Ｋ）及普通氯化钾片（ＲＫＣｌ）２组进行保钾治疗２ｗｋ,而后改换进入另１组作自身对照。结果：Ｓｌｏｗ－Ｋ组治疗１ｗｋ末血钾即显著增加,服药承受性较好;ＲＫＣｌ组治疗２ｗｋ末血钾才显著增加,且服药承受性较差,不良反应高达２６．９％。＊Ｐ＜０．０１。±２８９ｍｇ／ｄ）。在验证过程中所用利尿剂剂量不变。３观察项目服药前测血钾（Ｋ）、钠（Ｎａ）、氯（Ｃｌ）、肌酐（Ｃｒ）、尿素氮（ＢＵＮ）和心电图。服药后每１ｗｋ复查Ｋ,Ｎａ,Ｃｌ和心电图,每２ｗｋ加复查Ｃｒ和ＢＵＮ。结果Ｓｌｏｗ－Ｋ组１０４例患者全部完成研究。ＲＫＣｌ组在研究过程中共脱落１３例（其中坚持出院者３例,心衰严重救治无效而死亡３例,因胃肠道不良反应难以耐受而改服Ｓｌｏｗ－Ｋ导致研究中断者７例）,故能完成统计分析者为９１例。血清电解质治疗前后的变化２组治疗前的血Ｋ＋参数总体看来尚属正常范围,可能是由于在住院后短时间内测定血Ｋ＋,．所用排Ｋ＋利尿剂时间不长的关系。其中只有５例的血Ｋ＋在２－３ｍｍｏｌ／Ｌ的低水平。加服Ｓｌｏｗ－Ｋ片或ＲＫＣｌ片后,均能有效地使患者的血Ｋ＋提升?     

Cannabis laws: an analysis of costs

There is evidence that the use of cannabis is increasing in Australia, with stable black-market prices, despite the 9-year National Campaign Against Drug Abuse, increasing expenditure to enforce the laws against cannabis use, and the seizure of large plantations of cannabis plants. Recent government data are used to estimate the conservative cost of drug-law enforcement against cannabis use as being $329m in 1991-92. Alternatives to the existing regime are examined, including expiation, decriminalization, and legalization.     

The development of guidelines for drug and alcohol dependence treatment: affecting policy and practice

The rationale and methodology behind the Australian Quality Assurance Project is described. The Project aimed to develop guidelines for treatment content based on three sources of information: research findings, current practice and expert opinion. The issue of the gap between research and practice is discussed, as well as the role of dissemination in altering clinician behaviour.     

Harnessing harm reduction in Australia: an interview with the Hon. Neal Blewett. Interview by Steve Allsop

The National Campaign Against Drug Abuse (NCADA) was established in April 1985. Aiming to provide a national framework to minimize the harmful consequences of drug use, the original 3-year programme was extended to 1997. A key figure in the NCADA, Dr Neal Blewett, was interviewed to gain his perspective on the development and implementation of the Campaign over its first 10 years.     

The Pulmonary Absorption of Aerosolized and Intratracheally Instilled rhG-CSF and monoPEGylated rhG-CSF

Purpose. The objective of this study was to highlight differences in the pulmonary absorption of a monoPEGylated rhG-CSF and rhG-CSF after intratracheal instillation and aerosol delivery. Methods. Male Sprague Dawley rats (250 g) were anesthetized and intratracheally instilled (IT) with protein solution or were endotracheally intubated and administered aerosol for 20 min via a Harvard small animal ventilator. A DeVilbiss Aerosonic nebulizer containing 5 ml of protein solution at 3 mg/ml was used to generate aerosol. The volume of protein solution deposited in the lung lobes was estimated to be 13 µl after delivery of Tc-99m HSA solutions. The PEGylated proteins consisted of a 6 kDa (P6) or 12 kDa PEG (PI2) linked to the N-terminus of rhG-CSF. rhG-CSF also was administered IT in buffers at pH 4 and pH 7 and in dosing volumes ranging from 100 to 400 µl. Blood samples were removed at intervals after dosing and the total white blood cell counts (WBC) were determined. Plasma was assayed for proteins by an enzyme immuno assay. Results. The plasma protein concentration v. time profiles were strikingly different for aerosol v. IT delivery. The C _max values for rhG-CSF and P12 after aerosol delivery were greater than found after IT (Aerosol: 598 ± 135 (ng/ml) rhG-CSF; 182 ± 14 P12 v. IT: 105 ± 12 rhG-CSF; 65.9 ± 5 P12). Similarly, T_max was reached much earlier after aerosol administration (Aerosol: 21.7 ± 4.8 (min) rhG-CSF; 168 ± 31 P12 v. IT: 100 ± 17 rhG-CSF; 310 ± 121 P12). Estimated bioavailabilities (F_lung %) were significantly greater via aerosol delivery than those obtained after IT (Aerosol: 66 ± 14 rhG-CSF; 12.3 ± 1.9 P12 v. IT: 11.9 ± 1.5 rhG-CSF; 1.6 ± 0.1 P12). An increase in circulating WBC counts was induced by all proteins delivered to the lungs. The rate and extent of absorption of rhG-CSF was not influenced by the pH employed nor the instilled volume. Conclusions. Estimates of bioavailability are dependent upon the technique employed to administer drug to the lungs. Aerosol administration provides a better estimate of the systemic absorption of macromolecules.     

Estimating the human immunodeficiency virus infection curve of intravenous drug users in Lombardia,Italy

We present a model to estimate the infection curve of the human immunodeficiency virus in intravenous drug users in Lombardia. We based estimates on AIDS incidence data, according to a backcalculation model accounting for therapy and changes in the surveillance definition of AIDS.     

妇科门诊患者生殖道支原体感染及耐药性分析

目的:了解妇科门诊患者生殖道支原体感染状况及支原体的耐药性。方法:采用法国BioMerieux 公司的Mycoplasma IST试剂盒,对妇科门诊患者的生殖道分泌物标本进行支原体培养和耐药性检测。结果:受检者中解脲脲原体( Uu)阳性率为60% ,人型支原体( Mh) 阳性率为26 % ;6 种抗生素的药敏试验显示,Uu 和Mh 对红霉素完全耐药,对氧氟沙星耐药在60% 以上,对交沙霉素和普那霉素最为敏感。结论:妇科门诊患者中存在较大比例的支原体感染和携带,且对常用抗生素已产生一定的耐药性,这种状况应引起临床医生的注意     

Modulation of sodium currents in rat CA1 neurons by carbamazepine and valproate after kindling epileptogenesis

PURPOSE: To determine the modulation of sodium currents in hippocampal CA1 neurons by carbamazepine (CBZ) and valproate (VPA), before and after kindling epileptogenesis. METHODS: Voltage-dependent sodium current was measured in isolated hippocampal CA1 neurons, by using the whole-cell voltage-clamp technique. CBZ (15-100 microM) or VPA (0.5-5 mM) was applied by bath perfusion. Cells from fully kindled rats were compared with controls, 1 day and 5 weeks after the tenth generalized seizure. RESULTS: CBZ did not affect sodium current activation but selectively shifted the voltage dependence of steady-state inactivation to more hyperpolarized potentials. One day after the last kindled generalized seizure, the shift induced by 15 microM CBZ was 2.1+/-0.5 mV (mean +/- SEM; n = 20) compared with 4.3+/-0.3 mV (n = 16; p<0.001) in matched controls. The EC50 of the concentration-effect relation was 57+/-6 microM compared with 34+/-2 microM (p<0.01) in controls. Five weeks after kindling, these values had recovered to a level not different from control. VPA induces at a relatively high concentration a similar but smaller shift in voltage dependence of inactivation than does CBZ. After kindling, the shift induced by 2 mM VPA (2.8+/-0.6 mV; n = 19) was not different from controls (3.0+/-0.5 mV; n = 22). The EC50 for VPA was 2.6+/-0.3 mM compared with 2.5+/-0.4 mM in controls. CONCLUSIONS: Both CBZ and VPA selectively modulate the voltage dependence of sodium current steady-state inactivation and as a consequence reduce cellular excitability. The effect of CBZ was reduced immediately after kindling epileptogenesis, apparently by a reduced affinity of its receptor. In contrast, the shift induced by VPA was not different at any stage after kindling epileptogenesis. The change in CBZ sensitivity after kindling is related to epileptic activity rather than to the epileptic state, because it almost completely recovers in a period without seizures.