妇科千金片联合莫西沙星治疗急性盆腔炎60例临床分析

目的：探讨妇科千金片联合莫西沙星治疗急性盆腔炎的临床效果。方法：将2009年2月至2011年2月收治的急性盆腔炎患者120例随机分为观察组和对照组各60例,观察组采用妇科千金片联合莫西沙星治疗,对照组采用头孢三嗪联合替硝唑治疗,比较两组临床效果。结果：观察组疗效明显优于对照组（P〈0．05）,两组不良反应发生率无显著性差异（P〉0．05）。结论：妇科千金片联合莫西沙星治疗急性盆腔炎的效果优于头孢三嗪联合替硝唑,且不良反应少,建议临床推广应用。     

Third International Conference on Shape Memory and Superelastic Technologies

Summary. More than 10 years after its clinical introduction, extracorporeal shock wave lithotripsy (ESWL) has proved to be the safest treatment modality for more than 90% of urinary stones. Absolute contraindications are untreated coagulopathy, urinary tract infection and pregnancy. After careful preparation, even patients with severe coagulopathy (haemophiliacs A/B, thrombocytopenia) can be treated successfully by ESWL. Shock wave lithotripsy for an increasing amount of small symptomatic renal calculi resulted in a stone-free rate of 50% and a complaint-free rate of 52%. A 50% chance of success justifies initial ESWL treatment for stones in caliceal diverticula. A stone-free rate of 70% was reported for stone-bearing horseshoe kidneys, but the recurrence rate was 29%. Therefore, percutaneous stone removal may become necessary in such cases.

The utilization of indwelling stents has contributed to the extension of indication for ESWL monotherapy, even for staghorn calculi, as acute morbidity is reduced. Double-J stents, however, do not improve the stone-free rate and special attention should be paid to double-J morbidity. Depending on stone localization, post-ESWL long-term stone-free rates are 58–84% with a recurrence rate of 6–11 % and despite persisting fragments, the infection rate is low.

The main features of third generation lithotripters are a combined localization system allowing interdisciplinary shock wave lithotripsy, a wide energy range of the shock wave source resulting in an efficacy similar to that of the Dornier HM3 and integration of the shock wave source and fluoroscopy unit in an endoscopic treatment table for multifunctional use. Finally, a modified version of the Clayman-Preminger efficacy quotient for clinical comparison of different lithotripters, is outlined.     

Fibrinogen concentrate – a potential universal hemostatic agent

Background: Human fibrinogen concentrates have been commercially available for decades for substitution therapy in hypofibrinogenemia, dysfibrinogenemia and afibrinogenemia. Accumulating new data suggest that fibrinogen plays a critical role in achieving and maintaining hemostasis, particularly in patients suffering from acquired fibrinogen deficiency during massive bleeding, where benefit from early intervention with fibrinogen concentrate appears to be important. Objective/methods: This work focuses on pasteurized fibrinogen concentrate, with special emphases on product characteristics, pharmacodynamics, pharmacokinetics, laboratory monitoring, dosing, clinical efficacy, safety and tolerability. Future clinical and laboratory perspectives on fibrinogen are discussed and outlined. Results/conclusion: Pasteurized fibrinogen concentrate is derived from human plasma. Its half life is 2.7 days in patients with congenital fibrinogen deficiency. For congenital and acquired deficiency in vivo recovery rates vary from 60% to 109%. Reportedly, administration of pasteurized fibrinogen in patients with congenital deficiency is efficacious. Acquired deficiency of fibrinogen appears to be an early event in seriously bleeding patients, preceding critical levels of platelets or other coagulation factors. Experimental animal studies, as well as clinical observations suggest a beneficial role of early substitution with fibrinogen in management of critical traumatic and surgical bleeds. Pasteurized fibrinogen concentrate is well tolerated and associated with a low incidence of adverse thrombo-embolic events.     

Integrated analysis of safety and efficacy of a plasma- and albumin-free recombinant factor VIII (rAHF-PFM) from six clinical studies in patients with hemophilia A

Background: Hemophilia A is an X-linked bleeding disorder that results from insufficient levels of factor VIII (FVIII) coagulant activity. Objective: To evaluate the efficacy and safety of ADVATE^® rAHF–PFM (Baxter Healthcare Corporation), a recombinant FVIII concentrate manufactured without human or bovine blood-derived additives, and to assess the effect of compliance with prophylactic use in preventing bleeding episodes (BEs). Methods: Clinical data were integrated from six prospective studies. Two hundred thirty-four hemophilia A subjects (FVIII levels ≤ 2%) (median age 14.7 (range: 0.02 – 72.7) years) were included. Results: BEs were managed with one or two infusions and nearly all (1953/1956) responded to treatment. Compliance with a prophylactic treatment regimen significantly reduced the incidence of BEs (p = 0.0061) and prevented non-traumatic joint BEs (median annualized BE rate was 0). One previously treated subject developed an inhibitor; no other safety concerns were observed. Conclusions: These results reinforce the efficacy and safety of rAHF-PFM and suggest that compliance is an essential contributor to the effectiveness of prophylaxis in the treatment of hemophilia A.     

Apelin receptor: its responsiveness to stretch mechanisms and its potential for cardiovascular therapy

It has recently been demonstrated that the apelin receptor (APJ) plays a significant role in mediating the stretch response within the heart in a G-protein-independent and β-arrestin-dependent fashion. This discovery adds to the consolidated literature describing the potential benefits of APJ agonists. In this review, the authors will examine the functional selectivity of APJ and stretch with respect to their ability to signal via both G-protein-dependent and G-protein-independent mechanisms, with a focus on the multifunctional protein, β-arrestin. The possibility of selecting or designing novel ligands that differentially activate only a subset of functions via a single receptor holds great promise for the treatment of diseases such as heart failure and hypertension. Finally, hypothetical approaches to target APJ, taking into account its downstream pathways, will be described.     

乳酸菌阴道胶囊联合抗真菌栓剂序贯给药治疗妊娠期外阴阴道假丝酵母菌病疗效及安全性的Meta分析

目的 用meta分析评价乳酸菌阴道胶囊联合抗真菌栓剂序贯给药治疗妊娠期外阴阴道假丝酵母菌病疗效及安全性。方法 计算机检索PubMed、EMbase、Cochrane Libraries、CNKI、万方和维普数据库（各数据库检索时间均从创建至2016年12月）,收集相关文献。根据纳入和排除标准筛选并提取资料,采用RevMan 5.2软件进行meta分析。结果 共纳入15项研究,2 522例患者。Meta分析结果显示：乳酸菌阴道胶囊联合抗真菌栓剂试验组的治愈率高于单用抗真菌栓剂对照组,2组相比总治愈率具有统计学差异（P<0.000 01）;乳酸菌阴道胶囊联合抗真菌栓剂试验组的复发率低于单用抗真菌栓对照组,2组相比总复发率具有统计学差异（P<0.000 01）;乳酸菌阴道胶囊联合抗真菌栓试验组的不良反应发生率和单用抗真菌栓剂对照组接近,2组相比总不良反应发生率不具有统计学差异（P=0.68）。结论 基于现有临床证据,乳酸菌阴道胶囊联合抗真菌栓剂治疗妊娠期外阴阴道假丝酵母菌病比单用抗真菌栓剂的疗效好,且复发率低,安全性好。