雾化吸入博利康尼联合沐舒坦在慢支治疗中的作用

目的探讨博利康尼、沐舒坦在慢性支气管炎急性加重期治疗中的作用.方法慢支急性加重期患者142例,随机分为治疗组和对照组两大组.治疗组110例分为A、B、C三个方案组,用氧启动雾化吸入治疗.A组博利康尼雾化液2.5mg/ml;B组沐舒坦注射液7.5mg/ml;C组博利康尼雾化液2.5mg/ml+沐舒坦注射液7.5mg/ml.对照组32例给予α-糜蛋白酶400U/ml.结果在治疗组中A、B方案组的有效率分别为77.8%和80.6%,A、B两组疗效无显著差异(P＞0.05).C方案组的有效率为92.1%,与A、B方案组比较有显著差异(P＜0.05).对照组的有效率为75.0%,治疗组中C方案组与对照组比较,也有显著差异(P＜0.05).从达到临床缓解的时间比较,A、B方案组、对照组三者无显著差异(P＞0.05),但与C方案组比较却有显著差异(P＜0.05).结论在慢支急性加重期的治疗中,采用氧启动雾化联合吸入博利康尼、沐舒坦有助于病情缓解.     

湿度风速对风湿性心脏病病情加重的影响

目的:分析太原地区湿度风速对风湿性心脏病病情加重的影响。方法:将1999年～2 0 0 3年收治的太原地区2 6 9例风湿性心脏病患者作为研究对象,用率与构成比描述性分析季湿度风速对风湿性心脏病患者病情加重的影响,用特殊多元线性回归分析周湿度风速对风湿性心脏病病情加重的影响。结果:1999年～2 0 0 3年春、夏、秋、冬四季风湿性心脏病患者病情加重率分别为13.4 %、2 4 .5 %、31.1%、32 .0 % ,季湿度、季风速与风湿性心脏病病情加重间有部分关系;周湿度、周风速对风湿性心脏病病情加重关系不大。结论:季湿度和风速与风湿性心脏病病情加重有部分关系。     

慢性乙型肝炎重叠戊型肝炎病毒感染与肝炎重症化关系的临床观察

目的 探讨慢性乙型肝炎重叠戊肝病毒（HEV）感染与肝炎重症化的关系。方法 对771例慢性乙肝患进行酶联免疫吸附试验（ELISA），放射免疫试验（RIA）和斑点杂交试验检测甲、丙、丁、戊型肝炎病毒感染和肝功能检测。结果 经临床观察、对照和分析。发现重叠HEV感染的慢性乙肝患的重型肝炎发生率和慢性乙肝重度发生率高。结论 提示HBV/HEV重叠感染在肝炎重症化过程中起着重要的作用。     

Oxcarbazepine, not its active metabolite, potentiates GABAA activation and aggravates absence seizures

Purpose:   Studies in genetic absence epileptic rats from Strasbourg (GAERS) indicate that enhancement of γ aminobutyric acid (GABA_A) receptor activity is a critical mechanism in the aggravation of seizures by carbamazepine (CBZ). We examined whether structural analogs of CBZ, oxcarbazepine (OXC), and its active metabolite, monohydroxy derivative (MHD), also potentiate GABA_A receptor current and aggravate seizures.
Methods:   In vitro studies in Xenopus oocytes compared the three drugs' effect on GABA_A receptor currents. In vivo studies compared seizure activity in GAERS after intraperitoneal drug administration.
Results:   OXC potentiated GABA_A receptor current and aggravated seizures in GAERS, similarly to the effect of CBZ. Conversely, MHD showed only a minor potentiation of GABA_A receptor current and did not aggravate seizures.
Discussion:   A hydroxyl group at the C-10 position on the CBZ tricyclic structure in MHD reduces GABA_A receptor potentiation and seizure aggravation. Reports of the aggravation of absence seizures in patients taking OXC may result from circulating unmetabolized OXC rather than MHD.     

Aggravation of Focal Epileptic Seizures by Antiepileptic Drugs

Summary: Aggravation of focal epileptic seizures in adults is common after the antiepileptic drug (AED) therapy is initiated. Sometimes aggravation is mimicked by clustering of the seizures. Therefore, it is always necessary to analyze the patient's history and therapy carefully before drawing any conclusions. It is likely that a paradoxical aggravation of epileptic seizures can be attributed to the given AED and is sometimes, but only rarely, due to drug interactions.     

Effects of Kanlijian on exercise tolerance, quality of life, and frequency of heart failure aggravation in patients with chronic heart failure

Objective: To observe the effects of conventional therapy combined with Kanlijian (KLJ) on exercise tolerance, quality of life and frequency of heart failure aggravation in patients with chronic heart failure(CHF).Methods: Sixty CHF patients differentiated as sufferring from the syndrome of Xin-Shen Yang deficiency were included in the study and randomly assigned at the ratio of 2: 1 into the KLJ group (n = 39) and the control group(n = 21). All the patients were treated with conventional therapy of Western medicine, but to those in the KLJ group, KLJ was medicated additionally one dose daily with 24 wks as one therapeutic course. The efficacy on TCM syndrome and changes of scores on TCM syndrome were observed after treatment. The indexes, including 6-minute walking distance (6MWD), quality of life (QOL, accessed by LHFQ scoring), NYHA grade, hemodynamic indexes and reducing/withdrawal rate of diuretic and digoxin before and after treatment were recorded and compared. Also the frequency of re-admission due to aggravation of heart failure in one year’s time were observed.Results: (1) The efficacy on TCM syndrome, improvement on scores of TCM syndrome, therapeutic effects on 6MWD, QOL, and NYHA grade in the KLJ group were superior to those in the control group. (2) Hemodynamic indexes after treatment, left ventricular fractional shortening (LVFS) and E peak/A peak (E/A), between the two groups had no significant difference, while left ventricular ejection fraction (LVEF) was increased significantly in the KLJ group, but with no obvious change in the control group. (3) The reducing/withdrawal rate of diuretic and digoxin in the KLJ group was significantly higher than that in the control group. (4) The 1-year frequency of re-admission significantly decreased in the KLJ group.Conclusion: The adjuvant treatment of KLJ on the basis of Western conventional therapy can significantly improve CHF patients’ exercise tolerance, quality of life and cardiac function, reduce the dosage of diuretic and digoxin needed, and decrease the re-admission frequency due to aggravation of heart failure. Supported by the Item of Shanghai Municipal Ministry of Health on Standard for Quality Controling of Single Disease     

银杏达莫注射液对慢性肺心病急性加重期肺动脉高压及血液流变学的影响

[目的]观察银杏达莫注射液对慢性肺源性心脏病急性加重期的临床疗效及对肺动脉高压、血液流变学的影响。[方法]慢性肺源性心脏病急性加重期患者随机分为两组,均予西药常规治疗,治疗组加用银杏达莫注射液;比较两组临床疗效及治疗前后肺动脉压、动脉血气分析、血液流变学的变化。[结果]治疗组临床疗效明显优于对照组(P<0.05),对肺动脉压、动脉血气分析、血液流变学指标的改善优于对照组[。结论]银杏达莫注射液能有效降低慢性肺源性心脏病肺动脉压,降低血黏度,提高临床疗效。