Efficacy in intra-oesophageal acid suppression may decrease after 2-year continuous treatment with proton pump inhibitors

BACKGROUND: Long-term intra-oesophageal acid suppression with proton pump inhibitors represents a management option for Barrett's oesophagus and severe reflux oesophagitis, but its stability over time has not been adequately assessed. AIM: Our aim was to evaluate prospectively the efficacy of proton pump inhibitors in suppressing intra-oesophageal acidity after 2-year continuous treatment. METHODS: Forty-five patients with Barrett's oesophagus or severe reflux oesophagitis on a proton pump inhibitor regimen (once or twice daily) that normalised the total percentage acid exposure time were re-evaluated by means of 24-h oesophageal pH-monitoring after 2-year of continuous unmodified treatment. RESULTS: A significant rise in the total percentage acid exposure time was observed at 2-year follow-up (P=0.029), owing to an increased value in 27 (60%) cases (9 on a twice daily regimen), higher than normal in 10 of them (22% of the whole group) (3 on a twice daily regimen). In 18 patients (40%) the total percentage acid exposure time was stable or decreased. Heartburn remained efficiently suppressed in all patients. CONCLUSIONS: The efficacy of proton pump inhibitors in suppressing intra-oesophageal acidity during continuous treatment may decrease over time, up to abnormal levels of oesophageal acid exposure in a minority of cases. This may occur without heartburn recurrence and with both once and twice daily regimens.     

火把花根片对哮喘豚鼠气道炎症抑制作用的实验研究

目的 研究火把花根片对哮喘豚鼠气道炎症的作用。方法 建立哮喘豚鼠动物模型。豚鼠17只随机分为2组，即对照组(8只)和火把花根组(9只)。测定支气管肺泡灌洗液(BAIF)细胞总数、嗜酸性粒细胞、淋巴细胞、中性粒细胞数量及蛋白浓度，图像分析软件测定气道壁厚度及腺体厚度。结果 火把花根组BAIF细胞总数、嗜酸性较细胞为主的炎性细胞数量及蛋白浓度均低于对照组(P＜0．01)，图像分析表明火把花根组气道壁厚度及腺体厚度均较对照组减低(P＜0．01)。结论 火把花根片可抑制哮喘豚鼠的气道慢性炎症，对支气管哮喘有治疗作用。     

原料药粒径对盐酸普萘洛尔渗透泵片释药行为的影响

目的:研究原料药粒径等对盐酸普萘洛尔渗透泵片释药行为的影响。方法:取不同批号盐酸普萘洛尔及同批号重结晶前、后的原料药均按相同处方制备成渗透泵片,考察药物体外释放情况及释药24h后衣膜形态;并对上述不同原料药的粒径分别以光学显微镜和激光粒度分析仪进行证实。结果:以原料药粒径较小的渗透泵片释放完毕后衣膜变形,且不能维持零级释放,原料药粒径较大的渗透泵片结果与之相反。不同原料药经仪器证实粒径确有差异。结论:原料药的粒径可影响制备的渗透泵片的释放行为,提示性状稳定的原料药的合理选择在制剂过程中不可忽视。     

苏云金芽孢杆菌以色列变种发泡块剂灭白纹伊蚊幼虫的效果研究

目的：比较苏云金芽孢杆菌Bti－951发泡块剂（由本所研制）和Bti－Ft发泡块剂（德国提供）灭白纹伊蚊效果。方法：模拟现场试验和现场试验。结果：室内生物测定，Bti－951发泡块剂LD50为0.2365μg／ml；Bti－Ft发泡块剂LD50为0．0903μg／ml。在3．4～3．7m2现场水池中，两种发泡块剂使用剂量为0．5、1．0、1．5g／m2，制剂24小时灭蚊效果均达100％；当剂量为1．5g／m2时，Bti-951发泡块剂持效15天，Bti－Ft可达20天。结论：该剂型运用于小型水体，便于贮存、携带和使用，比乳剂、粉剂持效更长。     

预防肝硬化上消化道出血的临床研究

目的　探讨普萘洛尔和低剂量兰索拉唑长期维持治疗对预防肝硬化门脉高压消化道出血的疗效。方法　1 1 9例肝硬化门脉高压患者随机分为 3组 :Ⅰ组 :给予口服普萘洛尔加上护肝治疗。Ⅱ组 :联合给予低剂量兰索拉唑和普萘洛尔。Ⅲ组 :仅给予护肝治疗。兰索拉唑维持服药 6个月 ,普萘洛尔及一般对症治疗维持 1年。观察治疗前后各组患者所伴发溃疡、门脉高压性胃病 (PHG)、急性胃黏膜病变 (AGML)情况 (发生率 ) ,各组消化道出血的复发率、门静脉直径 (PVD)、脾静脉直径 (SVD)的变化。结果　经 1年观察 ,结果显示 ,普萘洛尔组、联合治疗组、对照组出血的复发率分别为 1 5 0 %、2 2 %、48 5 % ,组Ⅰ、组Ⅱ复发率显著低于组Ⅲ ,同时 ,组Ⅰ与组Ⅱ间的差异有显著性意义。治疗可见组Ⅰ、组Ⅱ患者所伴发的溃疡、PHG、AGML明显改善 ,PVD、SVD缩小。结论　普萘洛尔组联合抑制酸维持治疗 ,可预防引起消化道出血多种病因 ,较单用普萘洛尔的疗效好     

单片机自动灌流系统设计及其医学应用

介绍一种用单片机构成的自动灌流控制系统。它以灌流压为控制指标，以ＬＤＢ－Ｍ电子蠕动泵作为执行机构，构成闭环控制系统，能实现用户设定的各种液流压曲线。系统内采用了ＥＥＰＲＯＭ存储器，可对用户设定的多达１０条灌流曲线进行长期保存。     

Pharmacokinetics of Controlled Release and Immediate Release Morphine Sulphate Tablets after a Single Dose and Multiple Doses in Chinese Volunteers

健康志愿者１０名，随机交叉口服硫酸吗啡控释片（ＣＲＭＳ）３０ｍｇ（３０ｍｇ×１）和硫酸吗啡普通片（ＩＲＭＳ）２０ｍｇ（１０ｍｇ×２），分别于服药前后各时点取静脉血，用ＧＣＭＳ测定血浆中吗啡含量。以药代软件程序处理，分别求得ＣＲＭＳ和ＩＲＭＳ的Ｃｍａｘ为１９．３８±３．８０和２１．２７±６．２１ｎｇ／ｍｌ；ｔｍａｘ为２．３６±０．３７ｈ和０．５５±０．１６ｈ；ｔ１／２β为３．５３±０．８７ｈ和３．０３±０．７４ｈ，曲线下面积ＡＵＣ为１４５．１５±１７．６５和９３．０８±１６．６５ｎｇ·ｈ／ｍｌ。癌症病人多次口服硫酸吗啡至稳态，ＣＲＭＳ和ＩＲＭＳ的峰浓度分别为２７．４３±０．３３ｎｇ／ｍｌ，２２．６８±０．１６ｎｇ／ｍｌ；谷浓度分别为１９．４５±１．４４ｎｇ／ｍｌ；１８．１４±０．４９ｎｇ／ｍｌ。     

Osmotic mini-pumps: A convenient program for weight-adjusted filling concentrations

A BASIC computer program is described which is useful for calculating filling concentrations for ALZET osmotic mini-pumps employed in studies of chronic drug and hormone administration. After the user has entered the required daily dose, the pump parameters and the animals' weights, the program gives the following information: The total quantity of the drug or hormone required for the experiment; the minimum volume and concentration of solution, allowing a 10% margin for error, to serve as a standard that, when diluted, will fill all pumps in the experiment; individual volumes of this solution that, when diluted to a constant volume will yield the required concentrations to fill each of the respective pumps. Use of this program will ensure reliably accurate and very rapid preparations of solutions for mini-pump use.     

Development and Initial Testing of a Permanently Implantable Centrifugal Pump

Abstract: To be able to salvage heart failure patients, the need for an economical permanent ventricular assist device is increasing. To meet this increasing demand, a miniaturized centrifugal blood pump has been developed as a permanently implantable device. The Gyro permanently implantable model (PI-601) incorporates a sealless design with a blood stagnation free structure. The pump impeller is magnetically coupled to the driver magnet in a sealless manner. This pump is atraumatic and antithrombogenic and incorporates a double pivot bearing system. A miniaturized actuator was utilized in this system in collaboration with the University of Vienna. The priming volume of this pump is 20 ml. The overall size of the pump actuator package is 53 mm in height and 65 mm in diameter, 145 ml of displacement volume, and 305 g in weight. Testing to date has included in vitro hydraulic performance and hemolysis. This pump can provide 5 L/min against a 110 mm Hg total pressure head at 2,000 rpm and 8 Limin against 150 mm Hg at 2,500 rpm. The normalized index of hemo-lysis (NIH) value of this pump was 0.0028 g/100 L at 5 Limin against 100 mm Hg. A preliminary anatomical study revealed the possibility of the implantability of 2 such systems in biventricular bypass at a preperitoneal location. This system is feasible for use as a permanently implantable biventricular assist device.     

胰岛素泵治疗与2型糖尿病第一时相分泌的研究进展

随着对糖尿病机理研究的深入，发现胰岛β细胞第一时相分泌，对糖尿病的发生、发展有重要影响，新诊断2型糖尿病患者早期予胰岛素泵治疗，模拟生理性胰岛素分泌方式，可改善第一时相分泌，促进胰岛β细胞功能的修复，利于糖尿病的治疗及预后。