思瑞康与氯丙嗪治疗精神分裂症的对照研究

目的:比较思瑞康和氯丙嗪治疗精神分裂症的疗效和安全性。方法:将92例符合精神分裂症诊断标准(CCMD-3)的患者随机分为2组,每组46例,分别给予思瑞康和氯丙嗪治疗8wk,采用阳性症状与阴性症状量表(PANSS)、不良反应症状量表(TE_SS)评定疗效与不良反应。结果:思瑞康组与氯丙嗪组有效率分别为87.0%、91.3%(P>0.05)。思瑞康组嗜睡、头昏和体质量增加发生率更高(26.1%、23.9%、17.3%),氯丙嗪组锥体外副作用、心动过速和直立性虚脱发生率更高(60.9%、39.1%、32.6%)。结论:思瑞康与氯丙嗪治疗精神分裂症疗效相当,而前者不良反应相对较轻,安全性更好。     

Efficacy of diphenhydramine against cough in humans: a review

Aim To determine the efficacy of diphenhydramine against cough due to respiratory infection or irritation in patients/subjects without comorbidities. Method Two reviewers independently identified English language studies, searching on: clinical trials, randomized, diphenhydramine (OR dimenhydrinate), antitussive agents, cough (combine using AND). Sources were: Medline (1966–2005), Embase (1980–2005), Cochrane and references from retrieved articles. Two other reviewers, blinded to study origin selected studies, inclusion criteria being: diphenhydramine monotherapy against placebo, double-blinded, randomized, clinical trial, intention-to-treat, dropout information. The blinded reviewers evaluated the selected studies on a quality scale. Results Eleven articles were identified, 7 were rejected (4 not placebo controlled, 2 had no diphenhydramine, 1 not blinded), leaving 4 articles, that were included in the evaluation and scored 20, 21, 25 and 26 out of a maximum of 32. In these selected studies, a total of 162 people were examined, 65 on diphenhydramine, 63 on placebo and 34 in a crossover setting. There was a total of 13 dropouts. The crossover studies demonstrated significant effect; 27–56% reduction in 20 healthy volunteers and 21–26% reduction in 13 patients (originally 14, one outlier left out), whereas the active versus placebo studies did not. Conclusion In spite of the 60 years that the substance has been on the market, only few studies have properly evaluated the effect of diphenhydramine against cough. Presumptions about efficacy of diphenhydramine against cough in humans are not univocally substantiated in literature.     

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。     

Efficacy I: a new method for estimating relative efficacy of full agonists via a newly defined efficacy related parameter

A new method for estimating relative efficacies and relative intrinsic efficacies of agonists is described. Relative efficacy is estimated by employing a newly defined efficacy related parameter (e^ES) and it may be estimated without prior knowledge of efficacy values or the value of the equilibrium dissociation constants, K_A, of agonist-receptor complexes. The parameter e^ES is directly related to efficacy (e) and is defined as the ratio of maximal stimulus to maximal effect of an agonist. The value of e^ES indicates whether or not spare receptors are present for a particular agonist–effector system. The e^ES values of agonists are estimated by utilizing submaximal concentration–effect curves determined with fixed agonist-competitive antagonist concentration combinations and choosing a suitable reference (height of an agonistic concentration–effect curve) to which the height of the stimulus concentration–effect curves of the agonist may be compared. In addition to e^ES, other new agonist–effector parameters, namely S_Em/S_m and φ_min, were also defined.     

介入治疗移植肾动脉狭窄的疗效观察

目的　评价介入治疗移植肾动脉狭窄 (TRAS)的疗效。资料与方法　 2 0 0 0年 1月～ 2 0 0 2年 11月 ,采用经皮血管内成形术 (PTA)和 /或内支架治疗 2 0例TRAS患者 ,其中PTA治疗 14例次 ,内支架治疗 9例次。对治疗前后的血压、降压药物和血肌酐进行随访。结果　采用PTA治疗者 ,收缩压、舒张压、降压药物和血肌酐由术前的(15 7± 17)mmHg、(97± 7)mmHg、(1.5± 1.0 )种、(5 12± 2 96 ) μmol/L ,术后 1周降为 (137± 11)mmHg(P <0 .0 5 )、(86± 7)mmHg(P <0 .0 1)、(0 .9± 1.0 )种 (P >0 .0 5 )、(2 76± 2 2 6 ) μmol/L(P <0 .0 5 ) ,术后 6个月降为 (12 8±10 )mmHg(P <0 .0 1)、(83± 7)mmHg(P <0 .0 1)、(0 .8± 0 .9)种 (P >0 .0 5 )、(14 5± 5 5 ) μmol/L(P <0 .0 1)。采用内支架治疗者 ,收缩压、舒张压、降压药物和血肌酐由术前的 (15 4± 31)mmHg、(93± 12 )mmHg、(1.6± 1.0 )种、(338±14 2 ) μmol/L ,术后 1周降为 (134± 17)mmHg(P >0 .0 5 )、(82± 7)mmHg(P <0 .0 5 )、(0 .8± 1.0 )种 (P >0 .0 5 )、(197±76 ) μmol/L(P <0 .0 5 ) ,术后 6个月为 (132± 9)mmHg(P >0 .0 5 )、(83± 4 )mmHg(P <0 .0 5 )、(0 .5± 0 .8)种 (P >0 .0 5 )、(2 0 4± 16 9) μmol/L(P <0 .0 5 )。总     

Myelography with a dimeric (iodixanol) and a monomeric (iohexol) contrast medium: a clinical multicentre comparative study

The purpose of this study was to evaluate and compare the radiographic efficacy and safety of iodixanol (Visipaque; 270 and 320 mg I/ml) and iohexol (Omnipaque; 300 mg I/ml) in myelography. The study was randomized, double-blind and comparative including 398 patients from five European university clinics. The radiographic visualisation was evaluated as poor, good or excellent. Adverse events were recorded by interviewing the patients after the myelography, and each patient was given a questionnaire to be returned after 1 week. In cervical myelography with cervical puncture more films with excellent quality was obtained after iodixanol 320 mgI/ml compared with iohexol 300 mgI/ml (p = 0.009). Also in lumbar myelography iodixanol 320 mgI/ml compared favourably with iohexol 300 mgI/ml (p = 0.006). The most frequent adverse event was headache, which occurred in 5–35 % of patients during the first 24 h and in 19–61 % within the first 7 days, depending on the centre. There was no difference in frequency and severity of the adverse effects between the contrast media. Received 13 March 1997; Revision received 29 December 1997; Accepted 5 January 1997     

Safety and efficacy of combined upper blepharoplasties and open Coronal Browlift: A consecutive series of 600 patients

Surgical rejuvenation of the upper face involves the correction of excess and lax forehead, eyelid, and periorbital skin. Improving the appearance by correcting the effects of aging involves a combination of blepharoplasty and open coronal foreheadplasty. Many surgeons and several reports question the safety of both procedures being performed concomitantly. The difficulty arises in precisely balancing the skin excision from the frontal forehead and upper eyelid areas. Over-resection of skin may result in incomplete closure of the eyelid and dry-eye syndrome, while an inadequate resection may produce a poor aesthetic result. There is no large series that documents the safety and effectiveness of these two procedures being performed concomitantly. Furthermore, with the recent and rapid development of complex multiplanar endoscopic facial rejuvenation techniques, the basic open forehead-plasty has become increasingly overlooked as a legitimate, efficacious technique for rejuvenation of the upper face. The technique utilized in this series is presented in detail. The consistently excellent results obtained satisfy the aesthetic goals of patients as well as the goals of surgeons, and suggest a renewed interest in the technique based upon its simplicity and easily reproducible results.     

儿童原发性夜间遗尿症生理心理治疗的疗效及随访评估

目的应用生理心理治疗观察儿童原发性夜间遗尿症(PNE)的临床远期疗效,并探讨其治疗机制。方法对2004年9月至2006年1月在上海交通大学医学院附属上海儿童医学中心发育行为儿科应用生理心理治疗PNE患儿的资料进行回顾性分析,治疗中2周随访1次(随访观察6个月),治疗结束后1个月随访1次,家长每日记录患儿遗尿频率和夜间自行起床排尿次数。B超测定治疗前和治疗结束时最大憋尿状态下的膀胱容量。统计分析生理心理治疗的远期疗效,遗尿频率、膀胱容量以及夜间自行起床排尿次数的变化情况,采用Logistic回归分析影响生理心理治疗远期疗效的危险因素。结果研究期间应用生理心理治疗的68例PNE患儿远期疗效为:治愈43例(63.2%),显效18例(26.5%),部分有效5例(7.4%),无效2例(2.9%)。治疗前平均遗尿频率为每周(6.12±1.32)次,停止治疗6个月后遗尿频率为每周(1.23±0.18)次(t=2.65,P=0.011)。治疗前平均夜间自行起床排尿次数为每周(0.72±0.15)次,停止治疗6个月后平均夜间自行起床排尿次数为每周(6.83±1.16)次(t=2.25,P=0.026)。治疗前患儿平均膀胱容量/...     

The influence of molecular structure on the affinity and efficacy of some β-adrenoceptor agonists

Summary The affinity and efficacy of a number of sympathomimetic amines structurally related to prenalterol and the selective ₁-adrenoceptor agonist RO 363 were determined using a combination of radioligand binding and organ bath techniques. Affinity of the molecules (pK _D) was calculated from their ability to displace the radioligand [¹²⁵I]iodocyanopindolol ([¹²⁵I]CYP) from -adrenoceptor sites in left atrial (₁) and uterine (₂) membrane homogenates. These pK _D values were used to calculate efficacy from the positive inotropic and uterine relaxant responses elicited by the drugs in organ bath experiments. The drugs studied were either arylethanolamines i.e., (–)-isoprenaline (ISO), p-hydroxyisoprenaline (pOH-ISO), compounds XIV and XVI or aryloxypropanolamine-derivatives, i.e., oxymethylene-isoprenaline (OM-ISO), prenalterol and Compound XI which possessed ap-phenol or catechol ring and an isopropyl or a homoveratryl amine substituent. Only ISO, OM-ISO, pOH-ISO and Compound XVI were active as agonists in both tissue preparations. These drugs were partial agonists which exhibited a wide range of pD₂ values and did not display any marked selectivity for either -adrenoceptor subtype. Compound XI and prenalterol were inactive as agonists and together with the partial agonists behaved as competitive antagonists to ISO in the two preparations. All drugs tested displaced [¹²⁵I]CYP from -adrenoceptor sites, however, there was also a wide range of potency amongst the drugs.Analysis of the structure-affinity and structure-efficacy relationships indicated that removal of the 3-hydroxyl group from the catechol ring reduces both affinity and efficacy without altering the selectivity of the drug for either -adrenoceptor subtype. While aryloxypropanolamine derivatives have generally higher affinities than arylethanol-amines, especially at -adrenoceptor sites, their efficacies are generally reduced at both -adrenoceptors. The presence of a homoveratryl group in aryloxypropanolamines enhances slightly the affinity for ₁- and reduces affinity for ₂-adrenoceptors. With this amine group, efficacy is markedly reduced at ₂- as opposed to ₂-adrenoceptor sites.Thus for prenalterol, the small degree of cardioselectivity can be attributed to the oxymethylene group whilst its lack of agonist activity (i.e., efficacy) reflects a combined action of this group and the absence of the 3-hydroxyl group on the phenyl ring. In RO363 it can be deduced that the oxymethylene group, together with the homoveratryl substituent are responsible for the observed selective affinity of the drug for ₁- as opposed to ₂-adrenoceptors.     

国产重组人促卵泡激素在辅助生殖技术控制性超促排卵的临床应用

目的评价国产重组人促卵泡激素(recombinant human follicle-stimulating hormone,rhFSH)用于辅助生殖技术(assisted reproductive technology,ART)控制性超促排卵(controlled ovarian hyperstimulation,COH)的有效性及安全性。方法本试验采用多中心、随机、双盲、阳性平行对照、非劣效研究方法,于2017年7月至2019年6月间选取6家生殖医学中心纳入卵巢储备正常的不孕女性进行ART的COH治疗。受试者随机分为试验组(国产rhFSH,n=134)和对照组(进口rhFSH,n=133),研究过程中因各种因素排除受试者共8例,试验组7例,对照组1例,最终依照研究方案完成试验的受试者试验组127例,对照组132例。比较两组受试者COH周期中获得的卵母细胞总数、rhFSH用药情况、卵母细胞受精率、优质胚胎数、临床妊娠率、活产率、新生儿情况及不良反应发生率等指标。结果试验组和对照组在COH周期中获得的卵母细胞总数分别为(13.0±5.8)枚和(12.9±5.7)枚,差异无统计学意义(P>0.05);在82例卵胞质内单精子显微注射(intracytoplasmic sperm injection,ICSI)受试者中,试验组(39例)获得MII卵母细胞数[(9.9±3.9)枚]显著高于对照组(43例)[(7.5±3.0)枚,P=0.003];卵母细胞受精率试验组[63.82%(1048/1642)]显著高于对照组[56.19%(958/1705),P<0.001]。rhFSH用药时间和总量、优质胚胎数、临床妊娠率、早产率、活产率、新生儿异常发生率、新生儿体质量、Apgar评分等两组间差异无统计学意义(P均>0.05);治疗期间卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)和其他不良反应发生率差异无统计学意义(P均>0.05),且均为进口rhFSH已知的不良反应。结论在卵巢储备正常的不孕女性中使用相同卵巢刺激治疗方案,国产rhFSH有效性及安全性与进口rhFSH相当。