类风湿性关节炎药物治疗的进展

近年来,随着类风湿性关节炎发病机制及某些致炎因子的发现,出现了一系列新药。环氧合酶-Ⅱ特异性抑制剂与传统的非甾体类抗炎药相比具有疗效好、副作用小的优点;早期联合使用改变病情性抗风湿药在近期内有较好的临床疗效。此外重组可溶性肿瘤坏死因子受体融合蛋白 (etanercept)、人体抗肿瘤坏死因子-α单克隆抗体(adalimumab)和阿那白滞素(anakinra)等生物学治疗及中药治疗均显示了新的治疗前景。     

我院抗骨质疏松药物应用情况分析

目的：通过对比分析我院抗骨质疏松（OP）药物在老年病门诊患者及全院的应用数据,为临床用药提供参考。方法：采用抗菌药物的用药频度（DDDs）、用药金额排序、限定日费用等药物经济学参数,对我院2010-2011年老年病门诊患者和全院抗OP药物处方进行回顾性分析。结果：与2010年比较,2011年抗OP药物总消费金额增长幅度（62.37%）远大于其他药品（7.90%）,双膦酸盐类药物和钙制剂临床用药量较为平稳,但所占份额均有所下降,维生素D及活性代谢物和降钙素类药物应用量增幅较为突出;老年病门诊患者抗OP用药消耗金额与DDDs数据同步性较好,患者治疗费用更合理,而全院消耗金额与DDDs数据同步性较差;全院及老年病门诊双膦酸盐类药物和活性维生素D类的DDDs及销售金额均最高;阿法骨化醇DDDs明显大于骨化三醇,患者长期应用过程中更具有药物经济学比较优势,有助于提高患者用药依从性。结论：抗OP药物的药物经济学分析和用药趋势调查,应针对临床实际,在进行相关疾病治疗药物分析时采集专业科室的数据更能反映其临床应用的合理性。     

妊娠期糖尿病用药的安全性和有效性评价

为妊娠期糖尿病患者提供合理的用药指导是临床药师的重要工作。笔者通过文献查阅和总结．对胰岛素和口服降糖药分别进行了阐述．以探讨治疗妊娠期糖尿病药物的有效性和安全性。胰岛素比口服降糖药更适用于妊娠期糖尿病。     

The Association Between Antihypertensive Drug Use and Hospitalization for Pneumonia in the General Population: A Case-Crossover Study Using the National Health Insurance Database of Korea

BackgroundPrevious studies have reported an association between pneumonia risk and the use of certain drugs. We investigated the relationship between antihypertensive drugs and pneumonia in the general population.MethodsThis case-crossover study utilized the nationwide data of South Korea. We included participants who were hospitalized for pneumonia. A single case period was defined as 30 days before pneumonia onset, and two control periods were established (90–120 and 150–180 days before pneumonia onset). Further, we performed sensitivity and subgroup analyses (according to the presence of diabetes, documented disability, and whether participants were aged ≥ 70 years). We used conditional logistic regression models adjusted for covariates, such as angiotensin-converting-enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), other antihypertensives, statins, antipsychotics, benzodiazepine, and the number of outpatient visits.ResultsIn total, 15,463 subjects were included in this study. ACE inhibitors (adjusted odds ratio [aOR], 0.660; 95% confidence interval [CI], 0.558–0.781), ARBs (aOR, 0.702; 95% CI, 0.640–0.770), and other antihypertensive drugs (aOR, 0.737; 95% CI, 0.665–0.816) were significantly associated with reduced pneumonia risk. Subgroup analyses according to the presence of diabetes mellitus, documented disability, and whether participants were aged ≥ 70 years consistently showed the association of antihypertensives with a reduced risk of hospitalization for pneumonia.ConclusionAll antihypertensive drug types were related to a lower risk of hospitalization for pneumonia in the general population. Our results implied that frequent medical service usage and protective immunity were primarily related to a reduced risk of pneumonia in the general population of South Korea.     

Effects of Different Over – the - Counter Whitening Products on the Microhardness,Surface Roughness,Color and Shear Bond Strength of Enamel

ObjectiveThe purpose of this in vitro study was to evaluate the effects of four over-the-counter (OTC) whitening products on the microhardness, surface roughness, color, shear bond strength (SBS) and surface charecteristics of human enamel compared with a product used for dentist-supervised home whitening.Materials and methodsSeventy eight enamel specimens allocated into 6 groups (n=13): 1-Opalescence PF 10% (OP) dentist prescribed home whitening product, 2-Opalescence Go prefilled tray (PT), 3-Opalescence Whitening Toothpaste (WT), 4-Listerine Healthy White whitening mouth rinse (WMR), 5-Cavex Bite&White whitening pen (WP) and 6- no treatment (Con). The microhardness (VHN), surface roughness (Ra) and color of the specimens were measured (T₀). The specimens were then subjected to whitening protocols for 14 days (T₁.) followed by artificial saliva storage for 14 days (T₂). The measurements were repeated at T₁ and T₂. The SBS test was done after the application of 35% phosphoric acid (Scotchbond Universal Etchant), followed by a universal adhesive (G-Premio Bond) and a micro hybrid/universal resin composite (Essentia) into a Teflon tube attached to the enamel surface (p<0.05). Surface morphologies of the enamel surfaces were examined by SEM. p value was set at 0.05ResultsApplication of OP, PT and WP decrased the microhardness of enamel specimens (p<0.05) whereas, no significant changes were seen in the microhardness of enamel specimens treated with WT and WMR (p>0.05). Ra values of enamel specimens increased with the application of OP, PT and WT (p<0.05); whereas no changes were observed after the applications of WMR and WP (p>0.05). OP, PT, WMR, and WP changed the color of the enamel(p<0.05). There were not any significant differences among the SBSs groups, apart from OP applied enamel specimens. OP showed the least SBS values (p=0.001). SEM observations revealed smooth enamel surfaces.ConclusionsThe whitening products affected the microhardness, surface roughness, color of enamel differently. Only OP decreased the SBS of the enamel.     

Becoming Cognitive Science

Cognitive science continues to make a compelling case for having a coherent, unique, and fundamental subject of inquiry: What is the nature of minds, where do they come from, and how do they work? Central to this inquiry is the notion of agents that have goals, one of which is their own persistence, who use dynamically constructed knowledge to act in the world to achieve those goals. An agentive perspective explains why a special class of systems have a cluster of co‐occurring capacities that enable them to exhibit adaptive behavior in a complex environment: perception, attention, memory, representation, planning, and communication. As an intellectual endeavor, cognitive science may not have achieved a hard core of uncontested assumptions that Lakatos (1978) identifies as emblematic of a successful research program, but there are alternative conceptions according to which cognitive science has been successful. First, challenges of the early, core tenet of “Mind as Computation” have helped put cognitive science on a stronger foundation—one that incorporates relations between minds and their environments. Second, even if a full cross‐disciplinary theoretic consensus is elusive, cognitive science can inspire distant, deep, and transformative connections between pairs of fields. To be intellectually vital, cognitive science need not resemble a traditional discipline with its associated insularity and unchallenged assumptions. Instead, there is strength and resilience in the diverse perspectives and methods that cognitive science assembles together. This interdisciplinary enterprise is fragile and perhaps inherently unstable, as the looming absorption of cognitive science into psychology shows. Still, for many researchers, the excitement and benefits of triangulating on the nature of minds by integrating diverse cases cannot be secured by a stable discipline with an uncontested core of assumptions.     

How to tackle complications in radial procedures: Tip and tricks

Transradial interventions (TRI) are becoming increasingly popular because of accumulating recent evidence suggesting improved survival and reduced morbidity. Complications, though rare, do occur, especially for operators on their learning curve. The complications are best prevented by utilization of proper technique. Forearm hematoma are preventable and easy to treat, but a delay in detecting and managing them can lead to disastrous consequences compartment syndrome being the most dreaded one. This review deals with tips and tricks to prevent as also treat the common and rare complications.     

缺血预处理介导神经保护的分子机制

大量动物实验证实,缺血预处理可产生强大的器官保护作用,但动物实验向临床试验转化的进展和结果不尽如人意.对缺血预处理介导的神经保护的分子机制进行研究,寻找可转化到临床的安全且有效的预处理诱导方式,对于提高卒中和手术患者神经组织对缺血缺氧的耐受力,实现安全和有效的神经保护具有重要意义.文章从预处理活化受体、线粒体、转录因子和蛋白激酶等方面对缺血预处理介导神经保护的分子机制进行了综述.