局部PUVA治疗儿童白癜风疗效及安全性观察

目的:观察局部光化学疗法(Psoralen plus UVA,PUVA)治疗儿童白癜风的临床疗效及安全性.方法:采用小型UVA灯(电压220V,电流0.34A,功率25.4w,主波峰长36 5nm,辐照度为1 070uw/cm2)治疗56例白癜风患儿,30次为一个疗程,共观察3个疗程.结果:第一疗程、第二疗程及第三疗程结束后临床显效率分别达39.29%、48.21%和5 5.36%,未发现明显不良反应,其中病程短、局限性及面颈部白癜风患儿疗效佳.结论:局部PUVA治疗儿童白癜风安全、有效、不良反应小,小型UVA灯具有疗效好、治疗方便的优点.     

Late side-effects with cosmetic relevance following soft X-ray therapy of cutaneous neoplasias

Background Cosmetic changes are to be expected after radiotherapy for skin tumours. Objectives This study aimed to answer the questions: How frequent are cosmetic changes after soft X‐ray therapy? Do treatment parameters, tumour thickness, localization and size of the irradiated field have a major influence? Were patients irritated by the visual appearance of the irradiated field? Methods In total, 2474 examinations of 1149 irradiated fields were performed. Results Hypopigmentation was found in 64.7% of examinations more than 90 days after therapy, teleangiectases in 43.1%, erythema in 24.8%, and hyperpigmentation in 16.8%. The frequency of hypopigmentation, teleangiectases and hyperpigmentation increased with time from X‐ray exposure; more than 4 years after therapy hypopigmentation was diagnosed in 91.8% and teleangiectases in 82.2% of examinations. Total dose, the time–dose–fractionation factor (TDF), field size and dose per fraction were significantly related to the frequency of cosmetic changes. Incidence rates of cosmetic changes differed by less than 15% if different treatment conditions were compared: thicker vs. thinner tumours, larger vs. smaller fields, higher vs. lower total doses, doses per fraction, and TDF. Frequencies of hypopigmentation, teleangiectases, erythema and hyperpigmentation differed by more than 15% between some localizations on the head. Women reported irritation by the visual appearance of the irradiated field in 12.6% of 1116 interviews, and men in 4.4% of 1284 interviews. Conclusions Cosmetic changes after soft X‐ray therapy are relatively frequent. Treatment parameters, tumour thickness and field size have only a minor influence. Few patients, but more women than men, were irritated by the visual appearance of the irradiated field.     

Laser photobioactivation mechanisms: in vitro studies using ascorbic acid uptake and hydroxyproline formation as biochemical markers of irradiation response

Clinical investigations of laser photobioactivation, or biostimulation, might be differently designed and more fruitful if knowledge of basic biochemical mechanisms were better understood. In this investigation, biochemical events identified as responses to 904 nm irradiation included increased ascorbic acid uptake by fibroblasts. These cells also showed increased hydroxyproline formation, and this was increased several-fold by the addition of proline to the medium. Maximum biochemical responses were observed at a pulse frequency of 67 Hz and a pulse width of 150 nsec with an energy density of approximately 7 mJ/cm2 per exposure. Elements in the mitochondrial cytochrome system are proposed as the radiation absorbing chromophore(s). Hypothetically, the energy generated is linked to ascorbic acid uptake, which in turn stimulates collagen synthesis.     

Analgesic and antipyretic effects of Ecballium elaterium (L.) A. Richard. Extract in rodents

The dried (elaterium) or fresh juice from Ecballium elaterium fruit is used in the treatment of various inflammatory conditions in popular medicine. In this study the elaterium is examined for its analgesic and antipyretic effects in several animal models. The elaterium exhibits both analgesic and antipyretic activities.     

环孢霉素A滴眼治疗角膜移植排斥反应

应用0.5％环孢霉素A(cyclosporin A,CsA)滴眼治疗穿透性角膜移植术后发生免疫排斥患者16例(16只眼),治愈9只眼,好转6只眼,无效1只眼。随访5～24个月,其中2只眼因停药复发,1只眼于拆线后复发,继续用药或增加给药次数后治愈。研究表明0.5％CsA滴眼剂治疗术前移植床条件较好,角膜移植术后发生免疫排斥的病例可得到良好疗效;而对术前移植床条件较差,角膜移植术后发生免疫排斥的病例有一定的疗效。作者对眼局部应用CsA治疗角膜移植排斥的疗效和作用机理进行了讨论。     

Antiepileptic drug toxicity: Definition and mechanism of action

A detailed review of the adverse reactions of anticonvulsants is given, focusing on the definitions of drug toxicity, sources of information, patterns of durg utilization, pharmacokinetic variables and different mechanisms of action. The information available in the literature provides a wide spectrum of drug toxicity with no attempt at a practical definition of the reported events. This favors uncertainty among practising physicians, who are led to use the individual items with different attitudes. Suggestions are given for the evaluation, prevention and treatment of anticonvulsant drug toxicity.

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Sommario La presente è una revisione critica dei diversi aspetti della tossicità dei farmaci antiepilettici. L'analisi della letteratura è condotta con particolare riferimento alle diverse fonti di informazione, ai pattern di utilizzo dei singoli principi attivi, ai dati farmacocinetici ed ai meccanismi di azione farmacologica sottostanti. L'ampio panorama che ne deriva non consente una definizione pratica degli effetti indesiderati degli anticonvulsivanti. Ciò determina incertezza e confusione nella pratica medica, con conseguente diversità di comportamenti. La rassegna si conclude con la presentazione di alcuni suggerimenti pratici per la valutazione, la prevenzione ed il trattamento della tossicità da anticonvulsivanti.

     

Segregation analysis of diastolic blood pressure in a large pedigree

Hypertension, a major risk factor for cardiovascular diseases, is thought to be inherited to some extent. However, the nature of its genetic component remains unresolved. In the present study, data from a single large kindred (the HGAR1 pedigree) were used to search for evidence of single gene and multifactorial effects on diastolic blood pressure. Commingling analyses found that a mixture of three distributions fit the data significantly better than a single normal distribution, suggesting a major effect influencing diastolic blood pressure levels. However, segregation analysis, using regressive models, indicated that the transmission probabilities were not consistent with Mendelian expectations. There was no evidence of either major gene or polygenic effects on diastolic blood pressure levels in this family. © 1993 Wiley-Liss, Inc.     

随机微分方程特征值期望的上界估计

利用变分原理,从不同角度,讨论了随机微分方程特征问题特征值的性质,给出了其期望值的两个上界估计式。     

A Single-Blind, Crossover Comparison of the Pharmacokinetics and Cognitive Effects of a New Diazepam Rectal Gel with Intravenous Diazepam

Summary: Purpose: The objective of this study was to compare the pharmacokinetics and cognitive effects of a new diazepam (DZP) rectal gel (Diastat®) with intravenously administered DZP.
Methods: Twenty healthy volunteers were enrolled in a single-blind, randomized, double-dummy, two-period, crossover study. Subjects received either 15 mg of DZP rectal gel or 7.5 mg of DZP by intravenous infusion. Blood samples for DZP and desmethyldiazepam analysis were obtained before the dose and from 3 min to 240 h after the dose. Heart rate and blood pressure were measured over the first 24-h period. Subjects also completed five repetitions of a neuropsychological test battery over the first 8-h period.
Results: Diazepam rapidly appeared in plasma after rectal administration, exceeding 200 ng/mL within 15 min and reaching an initial maximum of 373 ng/ml at 45 min and a second maximum of 447 ± 91.1 ng/ml at ∼70 min. The absolute bioavailability of DZP rectal gel was 90.4%. Subjects receiving intravenous DZP were less alert and performed less efficiently on the WAIS Digit Symbol test 6 min after the dose. Subjects receiving DZP rectal gel performed less well on the WAIS Digit Span test 1 h after the dose and required more time to complete the Letter Cancellation and Grooved Pegboard tests 1 and 2 h after drug administration.
Conclusions: Diastat® displayed rapid, consistent absorption and was well tolerated. Alterations in cognition were mild and dissipated within 4 h of drug administration. This new rectal drug-delivery system offers an easy, safe, and bioavailable method to administer DZP.