原钒酸钠对四氧嘧啶诱导的糖尿病大鼠的糖耐量的影响

目的研究原钒酸钠对四氧嘧啶诱导的糖尿病大鼠的糖耐量的影响。方法建立四氧嘧啶诱导的糖尿病大鼠模型,对正常大鼠及糖尿病大鼠给予原钒酸钠治疗7天后,采用葡萄糖氧化酶法测定大鼠的血糖值、糖耐量,并以放射免疫法测定血清胰岛素值。结果原钒酸钠能显著对抗由四氧嘧啶诱导的大鼠血糖值升高,并改善糖耐量;对正常大鼠的血糖值和血清胰岛素值无影响。结论原钒酸钠对四氧嘧啶诱导的糖尿病大鼠有明显的改善糖耐量作用,且这种改善作用与血清胰岛素含量无关。     

Myocardial bridging increases the risk of coronary spasm

BACKGROUND: Myocardial bridging (MB) has been associated with cardiac events. Whether coronary spasm is one factor contributing to those events is unknown. HYPOTHESIS: This study investigated whether the likelihood of coronary spasm is increased in patients with MB. METHODS: A spasm-provocation test was performed by infusing acetylcholine into the left coronary artery in 114 Japanese patients with chest pain. The test result was defined as positive when the diameter of the coronary artery was reduced by > or = 50% and ST-segment changes were documented. Myocardial bridging was defined as a > 15% reduction in coronary arterial diameter during systole after intracoronary injection of nitroglycerin. RESULTS: Myocardial bridging was identified in 41 patients (36%) and was located in the mid-segment of the left anterior descending coronary artery (LAD) in all patients. Patients with MB experienced coronary spasm more frequently than patients without MB (MB+: 73%; MB-: 40%, p = 0.0006). Furthermore, among patients with a positive spasm-provocation test, coronary spasm occurred more frequently in the mid-segment of the LAD in patients with MB than in those without MB (MB+: 73%; MB-: 45%, p = 0.0259). Multivariate regression analysis demonstrated that MB was a predictor of coronary spasm (odds ratio: 3.478, p = 0.0088). CONCLUSIONS: These results suggest that MB increases the risk of coronary spasm and that coronary spasm may be the proximate etiology of cardiac events associated with MB.     

Antibiotic strategy after the empiric phase in patients treated for a hematological malignancy

 Empiric broad-spectrum antibiotic therapy has become a generally accepted strategy in the treatment of febrile neutropenic patients. Particularly in patients with prolonged neutropenia, subsequent adaptation of such a regimen will be the rule rather than exception. Since there are no uniformly accepted guidelines for the modification of antibiotic therapy during the post-empiric phase, we assessed the impact of a set of rules that evolved during the first randomized trials. Evaluation of the clinician's compliance with these rules in 1951 febrile neutropenic episodes was the subject of the present analysis. Treatment was modified in 761 (39%) cases, and these changes were made according to the rules in 76%. For 75% of the alterations in treatment during the evening and night shifts, no reasonable explanation was established, while 93% of the modifications during the normal working hours were made for objective reasons. The empiric regimen was more frequently changed in patients with a clinical focus of infection at the onset of fever than in patients who showed fever as the only symptom of a possible infection. The perceived need for modification amounted to 69% in pulmonary infections, to 51% in skin and soft-tissue infections, to 44% in patients with abdominal complaints, and to 37% in upper respiratory tract infections. Glycopeptides constituted 22% of modifications, particularly in patients with a central venous catheter, and systemically active antifungals were administered in 16% of cases. Especially inexperienced clinicians tend to adjust antibiotic therapy, in spite of the fact that persistence of fever alone seldom reflects inadequate treatment when the clinical condition of the patient is stable or improving. On the other hand, the development of subsequent infectious events emphasizes that a genuine need for modification does frequently exist. Received: 4 December 1995 / Accepted: 7 December 1995     

Combined Efficacy of Acamprosate and Disulfiram in the Treatment of Alcoholism: A Controlled Study

This study presents the results of a multicenter investigation of the efficacy of acamprosate in the treatment of patients with chronic or episodic alcohol dependence. One hundred eighteen patients were randomly assigned to either placebo or acamprosate, and both groups were stratified for concomitant voluntary use of disulfiram. Treatment lasted for 380 days, with an additional 360-day follow-up period. The primary efficacy parameters evaluated were: relapse rate and cumulative abstinence duration (CAD). Results were analyzed according to Intention-To-Treat principles using χ², t , and multiple regression analyses where appropriate. After 30 days on study medication, 40 of 55 (73%) acamprosate-treated patients were abstinent, compared with 26 of 55 (43%) placebo-treated patients ( p = 0.019). The treatment advantage remained throughout the study medication period and was statistically significant until day 270 ( p = 0.028). Twenty-seven percent of patients on acamprosate and 53% of patients on placebo had a first drink within the first 30 days of the study. The mean CAD was 137 days (40% abstinent days) for the patients treated with acamprosate and 75 days (21% abstinent days) for the placebo group ( p = 0.013). No adverse interaction between acamprosate and disulfiram occurred, and the subgroup who received both medications had a better outcome on CAD than the those on only one or no medication. Acamprosate was well tolerated. Diarrhea was the only significant treatment-induced effect. It was concluded that acamprosate was a useful and safe pharmacotherapy in the long-term treatment of alcoholism. Concomitant administration of disulfiram improved the effectiveness of acamprosate.     

Moderate Alcohol Consumption and Cardiovascular Disease: Is There Evidence for a Preventive Effect?

It is well-known that the intake of large quantities of alcohol is hazardous to the health. During the last few decades, moderate alcohol consumption has been claimed to have a protective effect in the cardiovascular system. For this study, literature search and review on moderate alcohol consumption and cardiovascular disease was performed. Data from ecological studies indicate that the consumption of wine, but not hard liquor or beer, are associated with a reduced mortality from cardiovascular diseases. Data from case-referent studies indicate no beneficial effect at all, whereas data from prospective cohort studies indicate a beneficial effect from all types of alcohol. There are several interpretational problems involved in this issue. No results from interventional studies are available. In the absence of such data, less valid conclusions are drawn from other types of studies. The soundness of conclusions based on comparisons of moderate drinkers and abstainers in case-referent and cohort studies has been questioned, because abstainers may have a higher than normal incidence of cardiovascular disease due to self-selection. Several possible modes of action have been proposed. However, provided that there is a protective effect of moderate alcohol consumption, there is no hard evidence that any of the proposed modes of action would be the sole one. Probably more than one mechanism is involved.     

Semantic organisation and handedness: Mixed-handedness is associated with more diffuse activation of ambiguous word associates

Research indicates that there are individual differences in the flexibility and ease with which one retrieves and uses concepts stored in memory. Based on prior research suggesting that mixed-handedness is associated with greater cognitive flexibility, it was hypothesised that mixed-handers have access to a relatively diffuse associative network, where link strengths for closely related and distantly related concepts are not as disparate as in the case of strong-handers. This idea was explored using ambiguous words for stimuli, as ambiguous words are known to have both strong (concepts related via dominant meaning) and weak associates (concepts related via subordinate meaning). Consistent with the prediction, mixed-handers showed equal ease in accessing both strongly and weakly related concepts. In Experiment 1 mixed-handers exhibited equivalent priming for dominant and subordinate associates, while strong-handers exhibited priming for dominant associates only. In Experiment 2 ratings of strength of association for dominant versus subordinate associates were examined. Mixed-handedness was associated with lesser disparity of dominant and subordinate association ratings.     

The single-word lexicon of a severely mentally handicapped child

Three criteria — phonetic form, semantic relevance and communicative saliency — are used to identify the single-word vocabulary of a young mentally handicapped child. The data are taken from video recordings made of the child playing at home and at school over a 12-month period. Inspection of the words reveals that the child exhibits phonological processes typical of younger, normally developing children and, when the complete vocabulary collected for this period is categorized following Nelson (1973), the proportion of word types used is comparable to those reported for normally developing children at the single-word stage. However. this child's use of single words is not restricted to the here-and-now but is used to transcend time and space.     

Preliminary assessment of the feasibility of using AB words to assess candidacy in adults

Background: Adult cochlear implant (CI) candidacy is assessed in part by the use of speech perception measures. In the United Kingdom the current cut-off point to fall within the CI candidacy range is a score of less than 50% on the BKB sentences presented in quiet (presented at 70?dBSPL).

Goal: The specific goal of this article was to review the benefit of adding the AB word test to the assessment test battery for candidacy.

Results: The AB word test scores showed good sensitivity and specificity when calculated based on both word and phoneme scores. The word score equivalent for 50% correct on the BKB sentences was 18.5% and it was 34.5% when the phoneme score was calculated; these scores are in line with those used in centres in Wales (15% AB word score).

Conclusion: The goal of the British Cochlear Implant Group (BCIG) service evaluation was to determine if the pre-implant assessment measures are appropriate and set at the correct level for determining candidacy, the future analyses will determine whether the speech perception cut-off point for candidacy should be adjusted and whether other more challenging measures should be used in the candidacy evaluation.     

大剂量云南白药治疗应激性胃溃疡的疗效观察及护理

目的观察大剂量云南白药治疗应激性胃溃疡的疗效及总结护理对策。方法将2000年9月～2001年12月收治的104例各种原因引起的应激性消化道出血病人作为对照组,选择2002年1月～2003年2月的92例各种原因引起的应激性消化道出血病人作为实验组。两组在常规止血药治疗基础下,实验组加用冰盐水、云南白药局部治疗,对照组加用冰盐水、去甲肾上腺素及凝血酶,观察两组治疗效果。结果实验组:显效62例,有效24例,无效6例,总有效率93.5%;对照组:显效24例,有效31例,无效49例,总有效率52.9%。两组疗效比较,字2=10.61,P<0.01,差异有统计学意义。结论云南白药直接作用于出血部位,能使血小板黏附、聚集,加速凝血酶生成等,从而缩短了凝血过程,保护胃黏膜促进溃疡愈合。     

Identifying and prioritizing industry-level competitiveness factors: evidence from pharmaceutical market

Background

Pharmaceutical industry is knowledge-intensive and highly globalized, in both developed and developing countries. On the other hand, if companies want to survive, they should be able to compete well in both domestic and international markets. The main purpose of this paper is therefore to develop and prioritize key factors affecting companies’ competitiveness in pharmaceutical industry. Based on an extensive literature review, a valid and reliable questionnaire was designed, which was later filled up by participants from the industry. To prioritize the key factors, we used the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS).

Results

The results revealed that human capital and macro-level policies were two key factors placed at the highest rank in respect of their effects on the competitiveness considering the industry-level in pharmaceutical area.

Conclusion

This study provides fundamental evidence for policymakers and managers in pharma context to enable them formulating better polices to be proactively competitive and responsive to the markets’ needs.