定志丸对东莨菪碱诱发大鼠被动回避反应的影响

唐·孙思邈《备急千金要方》的定志丸在防治记忆障碍作用上较《太平惠民和剂局方》记载的定志丸为佳。茯苓、远志、石菖蒲有协同人参之作用。《和剂局方》中的朱砂未见有改善学习记忆障碍的作用,故无组成方剂意义。     

Improvements in retention rates and changes in client group with methadone maintenance streaming

This study evaluated changes in client population and in retention rates following the introduction of a system of methadone maintenance streaming. A low intervention and low supervision stream was combined with two abstinence-orientated streams. Privileges of take-home doses and local pharmacy dose collection were contingent on successful participation in the abstinence-orientated streams. The clinic also modified policy to allow clients greater control over dose levels. The case notes of the first 100 clients entering the programme in the year prior to the changes (1991) and in the year following the changes (1993) were compared. The results showed a significant increase in retention rates. The demographic and heroin using histories did not change, but the newer programme attracted a greater proportion of clients with no previous history of methadone maintenance treatment. Mean clinic dose increased from 45 mg to 63 mg when clients were allowed to exert control over dose. These findings reveal improved outcomes in a public methadone maintenance programme as a result of policy changes designed to give clients greater control of their treatment.     

Anti-social personality disorder and response to methadone maintenance treatment

A sample of 183 current methadone maintenance patients were interviewed on their drug use history, criminal history, current drug use, and symptoms of Anti-social Personality Disorder (ASPD). Thirty-nine percent of patients met the DSM-III-R criteria for a diagnosis of ASPD. ASPD patients had an earlier onset of drug use, drug injecting, heroin use, had wider polydrug using histories and had been arrested earlier and more frequently than other patients. Despite the different pretreatment histories of ASPD and other patients, there were no differences between the two groups in retention in treatment, methadone dosage or heroin use. It is concluded that heroin-dependent ASPD patients can be successfully retained in methadone treatment, on similar methadone doses and with similar in-treatment drug use patterns as those of non-ASPD heroin dependent patients.     

Comparative study on the cardio-respiratory change during prostaglandin E1-induced hypotension in the patients in the supine and prone position

Prostaglandin E₁-induced hypotension (25% reduction from the preadministration level in mean arterial pressure) was applied to thirteen patients. Eight patients among them were operated in the supine position (group I) and other five in the prone position (group II). The maintenance dose of PGE₁ was considerably lower in group II than in group I (0.067µg·kg^–1·min^–1 vs. 0.119µg·kg^–1·min^–1). In group I, there was a significant increase in CI, with a significant decrease in SVRI and PVRI during PGE₁-induced hypotension. Such a high dose of PGE₁ (0.119µg·kg^–1·min^–1) was considered to have a direct dilating action on the systemic resistance bed as well as on the pulmonary vasculature. It was considered that the suppression of hypoxic pulmonary vasoconstriction could be a mechanism to increase venous admixture during PGE₁-induced hypotension. In group II, there was no significant increase in CI, and no significant decrease in SVRI and PVRI. PGE₁-induced hypotension can be safely applied to the anesthetized patients, but we should be careful to apply it to the patients in the prone position, because lower dose of PGE₁ can induce severe hypotension, which is not accompanied by the increase in CI as occures in the patients in the supine position.(Hirose M, Yoda K, Sakai K, et al.: Comparative Study on the cardio-respiratory change during prostaglandin E₁-induced hypotention in the patients in the supine and prone position. J Anesth 5: 30–35, 1991)     

The ONG capsular lens,report of 100 implantations

This Capsular Lens (ONG, type IV, to be called O.C.L.) has been developed for routinely performed extracapsular cataract extraction with lens implantation. The fundamental surgical procedure was based on continuing experience with the bimanual aspiration-irrigation technique and system developed by the author in 1971. The biomechanical properties of the asymmetric partly flexible, haptic loops are designed to give tensionfree fixation in two capsular pockets. The plano-anterior position of the lens ensures well-defined irido-lenticular clearance and proper alignment of the convex side with the posterior capsule. Consequently no iridectomy or iridotomy is needed for proper aqueous flow.     

Circadian system response to night work in relation to the individual circadian phase position

Summary In 6 night nurses the daily course of body temperature and pulse rate was measured under strict resting conditions immediately after a 7 to 18-day period with night work as well as after a 10-day period of recovery under normal life conditions. Three of the subjects were morning types and three evening types according to the Horne-Östberg-Questionnaire as well as to the phase position of the body temperature cycle.In order to quantify the changes in amplitude, phase position, and frequency a flattening index, a circadian deformation index, and according to the calculated phase shift a corrected deformation index were used. While the evening types reacted with a flattening of their circadian amplitude and thus gained a greater tolerance, the morning types hyper reacted when exposed to the inverse life pattern, developing an increased amplitude and adding to the circadian deformation by ultradian periods. No significant differences could be detected in phase shift. Higher amounts of subjective complaints and deficit of sleep as well as differences in the additionally controlled vigilance functions demonstrated the lower tolerance of the morning types to night work.The discussion concerns the methological basis of a quantitative evaluation of disturbance of the circadian system, and shows off, that the greater tolerance of evening types to night work is based on a lower reagibility of the vegetative functions to changes in the outer environment.     

局部药代动力学的药物浓度时空方程初探

目的 建立局部植入给药的药物浓度时空方程。方法 将局部药物浓度时空方程构建为空间分布函数和时间分布函数(药物浓度经时方程)的积函数。并以加权平均及多元分析的数学手段予以证明及推导。结果 四维时空的局部植入给药的药物浓度时空方程的通式为：C(t，X，Y，Z)＝F(X，Y，Z)．C(t)，F(X，Y，Z)＝B0 B1X B2Y B3Z B4r3 B5r2 B6r,C(t)＝A1e^-Ket A2e^-Ket A3c^-Ket.。两维变量的简化的药物浓度时空方程为：C(t,ρ)＝F(ρ)．C(t)F(ρ)＝D0 D1ρ D2ρ2 D3ρ3，C(t)同上。结论 推导基本合理，并在初步的动物试验探索中得以验证。理论有较好科研价值，有助于揭示局部给药的药代动力学规律。     

左旋卡尼汀治疗维持性血液透析患者卡尼汀缺乏症的临床研究

目的:评价左旋卡尼汀对慢性维持性血液透析患者卡尼汀缺乏症的临床疗效及其药物不良反应。方法:用多中心、随机、对照、单盲方法选择维持性血液透析患者147名,分为试验组、对照组。试验组用Demo公司的左旋卡尼汀,对照组用Sigma-Tau公司的左旋卡尼汀,均每次iv 1g,疗程12周。结果:iv两种左旋卡尼汀均可以显著提高血浆游离卡尼汀水平(P<0.01);同时使患者体力增加,食欲、透析后虚弱感、肌肉痉挛及透析中低血压明显减轻或缓解,两组间比较无显著性差异;在改善血脂代谢、改善患者对r-HuEPO的低反应性方面可能有一定作用。常见药物不良反应为胃肠道反应,可随治疗时间延长减轻或停药后消失。总的药物不良反应发生率两组间比较无显著性差异。结论:左旋卡尼汀能安全有效地治疗维持性血液透析患者卡尼汀缺乏症。     

风行水上 自然成文——简论《红楼梦》诗词曲在全书的地位和作用

《红楼梦》里的诗词曲“如辐辏毂” ,是全书的有机构成。它不仅是浑然天成的画卷 ,还拨动着人物心灵的琴弦。     

Permanent Postoperative Anosmia: A Serious Complication of Neurovascular Decompression in the Sitting Position

Summary  In posterior fossa surgery, the sitting position offers a number of advantages believed to outweigh complications such as air embolism and pneumatocephalus. For this reason, the sitting position is frequently used in neurovascular decompression for trigeminal neuralgia. Two years ago we reported on a previously undescribed complication: permanent postoperative anosmia. Following the recent occurrence of a second case, we conducted a nationwide survey to determine the frequency of this complication. Permanent postoperative anosmia following surgical procedures in the sitting position has been observed in 3 other institutions. In addition, the survey revealed that only 40% of German neurosurgeons still favor the sitting position for surgery of the posterior cranial fossa.  Considering that permanent anosmia severely reduces quality of life, and that it can be avoided by using another position, the sitting position for surgical procedures in the posterior fossa should be restricted to special cases (e.g., brain stem tumors).