伊曲康唑PVP微丸制备及体外溶出实验

目的：运用微丸技术提高难溶性药物伊曲康唑的溶解度及体外溶出速率.方法：采用固体分散技术,将药物与聚乙烯吡咯烷酮（PVPK30）的混合有机液喷包于微晶纤维素（MCC）空白丸心上形成膜衣骨架型供沉淀物结构制备伊曲康唑微丸,考察伊曲康唑微丸的溶出特性.结果：体外溶出结果表明微丸能显著增加药物在水及人工胃液中的溶解度及体外溶出度（45 min1∶2微丸体外溶出度为伊曲康唑的13.1倍.在0.1 mol/ml HCl中溶解度是伊曲康唑的36.8倍）.结论：伊曲康唑微丸能明显提高伊曲康唑的溶解度及体外溶出速率.     

原发性甲状旁腺机能亢进症(附15例报告)

本文报告15例原发性甲状旁腺机能亢进症。患者都以骨病就诊,平均血钙在2.82mmol/L以上,作者提出,凡血钙在2.62～2.74mmol/L以上、有典型的临床表现者,可为手术探查指征。本组病例均经手术治疗,13例为甲状旁腺腺瘤,2例为甲状旁腺增生。术后除1例仍有高血钙和甲状旁腺机能亢进的表现外,其余各例均恢复健康。     

Higher dose of warfarin for patients with pulmonary embolism complicated by obstructive sleep apnea hypopnea syndrome

Background

The concomitant prevalence of obstructive sleep apnea hypopnea syndrome (OSAHS) and pulmonary embolism (PE) is strikingly high, and therefore we studied the patients with PE to determine whether those who had OSHAS required greater warfarin doses to achieve a therapeutic international normalized ratio (INR).

Methods

By using computer tomographic pulmonary angiography or pulmonary angiography, we identified and recruited 97 patients with PE and all underwent polysomnography. Warfarin was initiated at a dose of 3 mg/day and modified to adjust the INR to the range of 2.0–3.0.

Results

OSAHS patients (n = 32) required a significantly higher dose of warfarin than their non-OSAHS counterparts (5.01 mg vs 3.61 mg, P < .001). This difference still existed between the two groups after adjusting for covariates (achieved INR value and weight). Logistic analysis suggested that OSAHS was an independent risk factor for high dose warfarin (OR 5.715, P < .001). On admission, OSAHS patients had a lower mean value of INR and prothrombin time but higher plasminogen (PLG) activity compared to non-OSAHS patients. Other coagulation indices were not significantly different between the two groups. Except for the PLG activity (r = .273, P = .026), the correlation between the warfarin dose and the baseline coagulating indices wasn't significant.

Conclusions

Our findings indicate that factors associated with OSAHS, such as hypercoagulation, may explain the need for higher doses of warfarin in treating patients with PE.     

国人椎体的测量与分析

目的：提供骨性脊柱的解剖学形态基础。方法：用游标卡尺等,对成都地区１２５套成人干燥椎骨的椎体进行测量。结果：椎体矢径除Ｃ７和Ｌ５外,其他由上而下矢径依次增大;椎体横径大于同一椎体的矢径;椎体高度为Ｃ３～Ｃ６逐渐减小、Ｃ７～Ｌ５依次增大。结论：椎体矢径、横径及高度的变化,符合脊柱运动及依次从上至下负重递增的要求。