固定剂量复合剂在省结核病防治规划中应用的研究

目的 研究固定剂量复合剂在省结核病防治规划中应用的可行性.方法 将初治涂阳肺结核病人按登记序号单双分入研究组和对照组.用对照研究方法对两组的完成治疗率、治疗效果、治疗依从性和不良反应等情况进行分析.结果 研究组和对照组在性别、年龄、体重、完成治疗率、督导管理方式和治疗依从性等方面差异无显著性（P值均＞0.05）.研究组的2、3个月未痰菌阴转率和治愈率分别为87.0%、93.5%和93.5%,对照组的2、3个月未痰菌阴转率和治愈率分别为89.4%、93.5%和87.0%,两组间的疗效差异无显著性（P值均＞0.05）.除因链霉素引起的耳鸣（精确概率法P=0.024）外,两组其他不良反应症状出现的比例都无显著性差异（P值均＞0.05）.结论 在结核病防治规划中推广应用固定剂量复合剂是可行的.     

固定剂量复合剂治疗肺结核患者依从性调查与分析

Objective To survey and analyse the treatment compliance of fixed-dose combination （FDC）,so as to provide evidences for expending use FDC nationwide. Methods Nine hundred and sixty-six primary smear positive pulmonary tuberculosis cases registered in 17 counties TB institutions from 4 provinces were randomly divid- ed into experiment and control groups. Compared compliance difference with uniform questionnaires, and analysed compliance changes with time throughout the treatment. Results Nine hundred and sixty-one cases were surveyed at the beginning, 899（93.5% ）preferred receiving treatment. There was significant difference on the percentage who prefer had drugs per day between experiment（86.8% ）and control group（42.1% ）（ P 〈 0.01 ）.At the end of intensive phase, 261（28.3 % ）cases perceived difficulty with the treatment ;213 （23.1% ）cases thought that were the doctors who lead to the insist of treatment.At the end of treatment,only 138 cases（15.5% ）thought that were the doctom who lead to the insist of treatment. Conclusion The compliance of FDC was better than control group. It might increase the compliance when decreasing the number of tablets and should expend used on TB control. The ef- fect of TB doctors decreased through the treatment. More intention should be paid in intense phase.     

青霉烷砜对氨苄青霉素的增效作用

观察加用青霉烷砜后氨苄青霉素对痢疾杆菌的体外杀菌效果。结果表明,加用青霉烷砜后对69株痢疾杆菌的杀菌效果,从单纯氨苄青霉素的杀菌率59.4％(41/69)提高到98.6％(68/69),有显著增效作用(P<0.005)。各株痢疾杆菌对国产和墨西哥产氨苄青霉素的敏感性无差异。证明青霉烷砜对氨苄青霉素有增效作用,对原耐氨苄青霉素痢疾杆菌的杀菌率达96.4％(27/28)。对耐药痢疾杆菌治疗药物的选择提供了有益的参考。     

中药“金黄羔”敷治疗小儿颌下部急性外淋巴腺炎

报道采用局部外敷“金黄羔”治疗小儿颌下部急性淋巴腺炎4例,平均7天治愈,不留瘢痕,既经济又方便病人。     

The SIMULTEST approach for testing mutagens in the Salmonella microtitre fluctuation assay

The concept of combining several histidine-dependent Salmonella strains in a single test, the SIMULTEST, has been applied to the microtitre fluctuation test. The activity of five mutagens was determined in strains TA97, TA98, TA100, and TA102 individually as well as in a SIMULTEST mixture. All five compounds were mutagenic in the SIMULTEST, demonstrating the utility of this time and labour-saving approach of combining strains for testing with this method. The microtitre fluctuation SIMULTEST results were quantitatively comparable to those of the SIMULTEST Salmonella/microsome plate test. The microtitre fluctuation test compared with the plate incorporation assay generally showed more favourable "sensitivity" and "quantity" indices in that four of the five chemicals tested in the fluctuation test were mutagenic at lower doses than in the plate test.     

Amikacin and ceftazidime as empirical antibiotic therapy in severely neutropenic patients: analysis of prognostic factors

This study aimed to evaluate the efficacy of amikacine and ceftazidime as an empirical antibiotic therapy for neutropenic patients affected by haematological neoplasms and to investigate the presence of prognostic features suggesting a poor outcome with this antibiotic combination at the onset of infection. This could allow the identification of subgroups of patients with a low rate of response to amikacin/ceftazidime therapy; in these patients different initial empirical therapy may be indicated. The study population comprised 166 severely neutropenic (absolute neutrophil count below 500/l) oncohaematological patients with fever or clinical signs of infection. Multivariate analysis confirmed four negative prognostic factors: 3 or more days of hospitalization at the onset of an infectious episode, a diagnosis of acute myeloid leukaemia, a haematological disease status different from complete remission, the presence of pneumonia. Depending on how many factors are present, cases can be stratified into three groups, of significantly different prognosis: favourable (0 or 1 factor) 76% success; intermediate (2 factors) 52% success; unfavourable (3 or 4 factors) 19% success. At the onset of an infectious episode a subgroup of patients with a very low response rate to empirical amikacin/ceftazidime antibiotic therapy is identifiable, for whom a different therapy is indicated. Because of the high rate of proven or probable fungal infections in this group, the immediate administration of a systemic antifungal therapy, in addition to antibacterial agents, could be considered in these high-risk patients. Studies should be specifically addressed to evaluating a stratification of empirical antibiotic therapy according to risk factors present at the onset of infection.     

Double β-lactam regimen compared to an aminoglycoside/β-lactam regimen as empiric antibiotic therapy for febrile granulocytopenic cancer patients

In a prospective, randomized trial, 205 febrile episodes in granulocytopenic cancer patients were treated with ceftazidime with or without tobramycin (C±T), both agents being administered only if the initial granulocyte count was below 200/l, or ceftazidime plus piperacillin (C+P). The overall response rate was 71% (39 of 60 for C±T and 45 of 58 for C+P). Logistic regression analyses documented no evidence of a significant difference between the two regimens in overall treatment effect after accounting for the linear effects of potentially important variables, such as infection type and granulocyte count. Although the response rates for the subgroup of patients with bacteremias was better with the C+P regimen (P=0.06), there was no difference in response for patients with bacteremia and profound (<100/gml) sustained granulocytopenia. The double -lactam combination demonstrated in vitro synergism in 73%; antagonism was not seen. Both regimens produced execllent serum bactericidal levels (C±T geometric mean peak 1:170; C+P peak 1:137) against gram-negative but not gram-positive pathogens (1:4; 1:7 respectively) that had caused bacteremia. Emergence of resistance and significant coagulopathy and/or bleeding did not occur during therapy. Antibiotic-related nephrotoxicity was noted in 7 of 95 trials in the C+P and in 6 of 89 trials in the C±T group (P=0.19). The incidence of secondary infections in patients with profound (<100/l) sustained granulocytopenia was lower in the C±T group (P=0.04). Alimentary canal anaerobic flora preservation with C±T, and suppression with C+P, was demonstrated. These results suggest that these regimens are of similar effectiveness and neigher is associated with major toxicity.     

复方盐酸二甲双胍片治疗2型糖尿病的随机双盲多中心临床研究

目的 通过临床观察评价国产四类新药复方盐酸二甲双胍片治疗2型糖尿病的临床疗效和安全性.方法 采用随机、双盲、双模拟、平行对照、多中心研究设计,用药观察周期为12周.试验组(A)72例服用复方盐酸二甲双胍片加模拟格列苯脲片;对照组(B)72例服用盐酸二甲双胍片加格列苯 脲片.结果 降血糖效果:试验组和对照组治疗2周、4周、8周、12周后各时点空腹血糖都较治疗前有显著降低,但两组间下降率比较在2周、4周、8周无统计学差异,仅在12周时,有统计学差异,对照组下降率比试验组低.在治疗12周后,两组餐后2小时血糖、糖化血红蛋白(HbA1c)、都较用药前显著下降,但组间比较无统计学差异.空腹胰岛素、空腹C肽、餐后2小时胰岛素、餐后2小时C肽仅试验组餐后2小时C肽较用药前明显升高,其余指标两组与用药前比较无统计学意义,组间比较也无差异.两组病人用药后疗效分析,有效率和显效率相近,无统计学差异.安全性观察:两组不良反应共7例,两组不良反应发生率比较无显著性意义.结论 对糖尿病患者而言,复方二甲双胍是一种安全有效的降糖药物,可予临床推广使用.     

固定剂量复合剂治疗肺结核不良反应对照研究

目的 研究抗结核药物固定剂量复合剂治疗肺结核不良反应发生情况，为全国结核病防治规划推广应用提供依据。方法 在全国4省17县结核病防治规划实施中，对登记的初治涂阳肺结核患者，以县为单位采用简单随机分组方法，使用固定剂量符合剂与抗结核病组合药进行对照研究，观察患者治疗过程中不良反应的发生情况。结果 在发生不良反应的病例中，37例因重症药物不良反应停药，其中研究组10例，占研究组观察例数的2．1％，对照组27例，占对照组观察例数的5．5％。重症药物不良反应停药率对照组高于研究组（P〈0．01）。研究组某些不良反应的开始时间晚于对照组，结束时间早于对照组，持续时间短于对照组，累积时间少于对照组。65岁一组不良反应总发生率高于其他年龄组，女性某些不良反应发生率高于男性。对照组体重40〈公斤患者关节痛的发生率高于其他体重患者。结论 固定剂量复合剂重症药物不良反应导致患者停药率低于抗结核板式组合药，减少了患者中断治疗率，对提高患者规律服药率和治愈率，降低耐药率具有十分重要的意义。     

In-vitro activity of ceftriaxone combined with newer agents against MRSA

In this study, in vitro synergism in combinations of agents as ceftriaxone/dalbavancin, ceftriaxone/linezolid and ceftriaxone/daptomycin against MRSA strains were investigated. Thirty clinical MRSA strains were tested. The minimum inhibitory concentrations of all antibiotics were determined using reference broth microdilution method. In-vitro activities of antibiotics combined against the strains were tested using two-dimensional checkerboard microdilution method. Results were interpreted as follows: synergy = FICI ≤0.5; ‘no interaction’ effect = FICI ?0.5-≤4; antagonism = FICI ?4. The MIC₅₀, MIC₉₀ and MIC_range of ceftriaxone, daptomycin, dalbavancin and linezolid were found as 128, 1024 and 16-2048 mg/L; 1, 1 and 0.5–1 mg/L; 0.12, 0.12 and 0.03–0.12 mg/L; and 1, 2 and 1–2 mg/L, respectively. Our results showed that the frequency of synergistic effects (FICI: ≤0.5) of three combinations were all at the same rate of 77% (23/30). No in vitro antagonism (FICI >4) was observed.