Valves replacement operation in treatment of electrical storm induced by rheumatic valves disease

Objective： To present a case of electrical storm （ES） in a female patient with rheumatic valve disease. Methods： A female patient with severe rheumatic valve disease suffered an unexpected ES. She received more than 50 electrical shocks for repeated cardiac arrests due to ES over 16 hours. Then she received beta-blocking agent treatment and had an operation of double valves replacement. Results： ES was suppressed by sympathetic blockade with beta-receptor blocker and finally disappeared after the double pathological valves had been replaced. Conclusion： Increased sympathetic activity plays an important role in the genesis of electrical storm and sympathetic blockade may effectively suppress ES. However, the most important thing in the treatment of ES is to identify and eliminate the underlying cause of ES.     

老年糖尿病低血糖昏迷原因及治疗分析

目的探讨老年糖尿病低血糖昏迷的原因。方法采用回顾性分析46例老年糖尿病低血糖昏迷并行相应对症处理的方法。结果自行加大治疗前药物剂量，进食减少或未及时进食及急性感染是产生低血糖昏迷的主要原因，经抢救处理45例血糖逐渐回升至正常，神志较清，1例死于乳酸酸中毒。结论老年人对血糖调节功能低下，药物过量和进食不当均已导致低血糖，甚至昏迷，治疗过程中应定期监测血糖，指导饮食与治疗。     

万辉化痰止咳露镇咳效果临床评价

目的··：考察万辉化痰止咳露的临床镇咳效果及不良反应。方法··：应用万辉化痰止咳露与佩夫人止咳露进行对照试验,用于治疗急性支气管炎或慢性支气管炎急性发作伴有中度以上咳嗽患者各３０例。用药方法均为每次１０ｍｌ,每日３次,口服,用药周期３－７ｄ。结果··：万辉化痰止咳露临床总有效率为７６．７％,与佩夫人止咳露比较,其疗效差异无显著性。其不良反应主要有头晕、思睡、便秘等,发生率很低,表现轻微,与对照组比较差异无显著性。结论··：万辉化痰止咳露具有确切的镇咳作用、良好的祛痰化痰效果及可靠的安全性。     

我国喹诺酮类抗感染药物的研究进展

对我国近几年喹诺酮类药物研究开发概况、新合成路线与工艺改进、结构改造与构效关系研究进行了简要的述评。     

Effect of linolenic acid/ethanol or limonene/ethanol and iontophoresis on the in vitro percutaneous absorption of LHRH and ultrastructure of human epidermis

The effect of enhancer(s) (e.g. ethanol (EtOH), 5% linolenic acid/EtOH, and 5% limonene/EtOH) and iontophoresis was investigated on the in vitro percutaneous absorption of luteinizing hormone releasing hormone (LHRH) and ultrastructure of human epidermis by transmission electron microscopy (TEM). 5% linolenic acid/EtOH or 5% limonene/EtOH significantly enhanced (P<0.05) the passive flux of LHRH through human epidermis in comparison to the control (no enhancer treated epidermis). Iontophoresis further increased the flux of LHRH through enhancer(s) treated epidermis. Iontophoretic flux of LHRH through 5% linolenic acid/EtOH and 5% limonene/EtOH treated epidermis was significantly (P<0.05) enhanced in comparison to iontophoretic flux through the control epidermis. TEM is the most efficient way to visualize the ultrastructure of the stratum corneum (SC). TEM results reveal that iontophoresis in combination with enhancers (e.g. linolenic acid/EtOH or and limonene/EtOH) transformed the highly compact cells of the SC into a looser network of filaments, disrupted the keratin pattern, and resulted in swelling of SC cell layers of human epidermis. Thus, linolenic acid/EtOH or limonene/EtOH in combination with iontophoresis increased the flux of LHRH through human epidermis by disrupting keratin pattern as well as loosening and swelling of SC cell layers.     

A phosphate binding assay for sevelamer hydrochloride by ion chromatography

Sevelamer hydrochloride is a cross-linked polymeric amine; it is the active ingredient of Renagel® capsules. Renagel® is indicated for the control of hyperphosphatemia in patients with end-stage renal disease. An in vitro phosphate-binding assay is required to measure the drug’s efficacy. The assay developed for this purpose involves mixing the drug (polymer) with a solution of known phosphate concentration, filtering off the polymer–phosphate complex, and quantitating the unbound phosphate concentration by ion chromatography. The binding capacity, reported as mmol of phosphate bound g of polymer⁻¹, is calculated from the calculated amount of bound phosphate and the weight of polymer used. The method has been validated for accuracy, precision, linearity, range, and ruggedness.     

Effects of perioperative cimetidine administration on natural killer cells in patients with gastrointestinal cancer

Cimetidine(CIM)isahistaminetype2receptorantagonistwidelyusedtotreatpepticulcers.Italsohasimportanteffectsontheimmunesystem.TheadministrationofCIMhasbeenfoundtopreserve,tosomedegree,patient'sperioperativeimmunecapability."]However,whethertheuseofCIMca...     

Gemcitabine Hydrochloride-Loaded Functionalised Carbon Nanotubes as Potential Carriers for Tumour Targeting

The objective of the present work was to formulate gemcitabine hydrochloride loaded functionalised carbon nanotubes to achieve tumour targeted drug release and thereby reducing gemcitabine hydrochloride toxicity. Multiwalled carbon nanotubes were functionalised using 1,2-distearoylphosphatidyl ethanolamine-methyl polyethylene glycol conjugate 2000. Optimised ratio 1:2 of carbon nanotubes:1,2-distearoylphosphatidyl ethanolamine-methyl polyethylene glycol conjugate 2000 was taken for loading of gemcitabine hydrochloride. The formulation was evaluated for different parameters. The results showed that maximum drug loading efficiency achieved was 41.59% with an average particle size of 188.7 nm and zeta potential of −10−1 mV. Scanning electron microscopy and transmission electron microscopy images confirmed the tubular structure of the formulation. The carbon nanotubes were able to release gemcitabine hydrochloride faster in acidic pH than at neutral pH indicating its potential for tumour targeting. Gemcitabine hydrochloride release from carbon nanotubes was found to follow Korsmeyer-Peppas kinetic model with non-Fickian diffusion pattern. Cytotoxic activity of formulation on A549 cells was found to be higher in comparison to free gemcitabine hydrochloride. Stability studies indicated that lyophilised samples of the formulation were more stable for 3 months under refrigerated condition than at room temperature. Thus carbon nanotubes can be promising carrier for the anticancer drug gemcitabine hydrochloride.     

山东省收治汶川地震伤员的损伤特点及诊治体会

目的 总结分析在山东省住院治疗的396例"5.12"汶川地震伤员的损伤特点及诊治经验.方法 汶川地震伤员396例,于2008年5月22日转至山东省住院治疗.山东省卫生厅及医学会成立了专家巡诊组,自5月22日至6月24日,对全部伤员逐个进行巡诊检查,统一阅读影像学资料,统一规范诊断,制定治疗方案.对伤员性别、年龄、损伤部位、骨折部位、手术情况、二次手术情况、截肢情况、伤口感染情况以及治疗结果进行调查分析.结果 本组病例在年龄分布、受伤部位、受伤特点等方面不同于交通伤.特点为多发伤常见,下肢截肢及伤口感染者较多,脊柱及骨盆骨折以稳定性骨折为主.手术治疗220例,其中转入前已经手术142例,转入后手术78例,有12例需要对转入前的手术进行二次手术调整内固定或治疗深部感染.至6月24日,已经治愈出院219例,无死亡病例,无医原性并发症出现.结论 按伤害控制理论,根据伤员的损伤特点、损伤程度制定转运及治疗方案,前线以抢救生命为主,早期清创.骨折的治疗原则是对不具备内固定条件者采用临时性外固定,复杂内固定手术留待转院后进行,可以提高救治效率,减少并发症,获得更好的综合疗效.