多烯磷脂酰胆碱治疗抗结核药致肝损害40例临床观察

目的观察多烯磷脂酰胆碱注射液对抗结核药所致肝损害的临床疗效。方法将我院2008年8月~2013年2月收治应用抗结核药引起肝损害患者80例,随机分为观察组和对照组各40例,观察组给予多烯磷脂酰胆碱注射液697.5mg加入5%葡萄糖250ml中静滴,每天1次;对照组给予甘草酸二胺注射液150mg加入5%葡萄糖250ml静滴,每天1次。疗程结束观察两组患者肝功能变化情况,并进行比较分析。结果两组患者的肝功能指标比较差异具有统计学意义（P〈0.05）。结论多烯磷脂酰胆碱注射液对抗结核药所致的肝损害有较好疗效。     

黄芪注射液联合米力农治疗充血性心力衰竭的临床分析

目的:观察黄芪注射液联合米力农治疗充血性心力衰竭的临床疗效及安全性.方法:将76例充血性心力衰竭患者随机分成两组,其中治疗组38人,对照组38人.所有患者均采取使用利尿剂、口服血管紧张素转换酶抑制药等常规治疗,治疗组患者在常规治疗基础上采用米力农联合黄芪注射液治疗,对照组患者在常规治疗基础上采用米力农治疗,从临床疗效、心衰疗效计分、心率、心脏指数、心输出量及左心室射血分数指标进行评价.结果:治疗组的临床疗效、心衰疗效计分、心率、左心室射血分数与对照组相比,有统计学差异(P＜0.05).结论:黄芪注射液联合米力农治疗充血性心力衰竭的临床疗效优于单纯应用米力农.     

索拉非尼和沙利度胺对肝癌患者血清中VEGF-C、VEGF-D及微血管密度的影响

目的：探讨索拉非尼和沙利度胺这两种不同的化疗药物,对肝癌患者血清中VEGF-C、VEGF—D及微血管密度的影响。方法：将患者分成3组,每纽16例。对照组采用常规治疗并服用安慰剂;索拉非尼和沙利度胺这两个组患者中,前者服用索拉非尼400mg／次,2次／d,治疗6个月;后者服用沙利度胺每日服200mg,每周增加200mg／d,直至最大剂量每日600mg,至少服用4月。ELISA检测患者血清中VEGF-C、VEGF-D;免疫组织化学检测肝癌组织中微血管密度。结果：对照组患者血清中VEGF-C的水平为210ng／ml,索拉非尼组患者血清中VEGF—C的水平为132ng／ml,而沙利度胺组患者血清中VEGF—C的水平为186ng／ml。与对照组相比,索拉非尼组和沙利度胺组患者血清中VEGF—C的水平均降低。对照组患者血清中VEGF—D的水平为322ng／ml,索拉非尼组患者血清中VEGF—D的水平为217ng／ml,而沙利度胺组患者血清中VEGF—D的水平为256ng／ml。与对照组相比,索拉非尼组和沙利度胺组患者血清中VEGF—D的水平均降低。索拉非尼组患者血清中VEGF—D的水平明显低于沙利度胺高（P〈0．05）。对照组肝癌组织MVD为（44．32±5．16）个,索拉非尼组患者肝癌组织MVD为（21．75±1．49）个,而沙利度胺组患者肝癌组织MVD为（34．78±2．31）个。结论：多靶点化疗药物索拉非尼对肝癌患者血清中VEGF—C、VEGF—D及微血管密度的影响最大,深入探讨其作用机制．可为其肝癌患者提供新的化疗方案。     

酪酸梭菌活菌散治疗小儿病毒性腹泻疗效观察

目的观察和评价酪酸梭菌活菌散（商品名：宝乐安）治疗小儿轮状病毒性腹泻的临床疗效。方法将93例轮状病毒性腹泻患儿随机分为观察组和对照组,观察组46例,给予酪酸梭菌活菌散,0．5g/次,3次／d;对照组47例,给予利巴韦林15mg／（kg·d）,分2次肌内注射或加入10％GS250ml中静脉滴注。疗程均为3—7d,观察疗效和不良反应。结果观察组总有效率为95．7％,轮状病毒转阴率为89．2％;对照组总有效率为76．6％,轮状病毒转阴率为65．8％,差异有显著性（P〈0．05）。2组均未见不良反应。结论酪酸梭菌活菌散治疗小儿轮状病毒性腹泻疗效显著,且未见不良反应,值得临床推广应用。     

丹参川芎嗪注射液治疗脑供血不足性眩晕30例疗效观察

我院神经内科应用丹参川芎嗪注射液(血通注射液)治疗30例脑供血不足性眩晕,取得良好的效果,现报道如下。1临床资料1·1一般资料60例眩晕患者,男36例,女24例,年龄58~76岁。全部行TCD、头颅CT、颈椎正侧片和血脂检查,结合病史及临床体征,确诊为脑供血不足性眩晕。将患者随机分为治疗组30例,对照组30例。并进行观察比较疗效。1·2治疗方法对照组:给予低分子右旋糖酐500 ml,每日1次静脉点滴。治疗组在对照组基础上给予血通注射液5ml加入5%葡萄糖250 ml中静滴,每日1次,10天为1个疗程。两组均应用抗血小板、降血脂、控制血压及控制血糖等治疗。1…     

醒脑静注射液治疗急性酒精中毒的疗效观察

应用醒脑静注射液治疗急性酒精中毒患者 2 0例 ,疗效满意 ,现报告如下。1　临床资料1 .1　一般资料　 2 0例均为急诊患者 ,年龄 1 8～ 50岁 ,平均 34岁。饮酒量约为 40 0～ 1 0 0 0 ml,多在酒醉 1～ 2 h内送医院救治。主要表现为面色潮红、恶心、呕吐 ,心率加快 ,共济失调 ,谵妄 ,嗜睡 ,惊厥甚至昏迷。其中 3例呈休克状态 ,2例合并吸入性肺炎。 2 0例患者入院时血、尿常规、电解质等均未见异常变化。1 .2　治疗方法　立即给予洗胃 ,清除残留酒精 ,阻止酒精进一步吸收。给予醒脑静注射液 (无锡健宏药业总公司生产 ) 40 ml加入 5%葡萄糖液 50 …     

硫普罗宁治疗脂肪肝的临床疗效分析

目的：观察硫普罗宁治疗脂肪肝的临床疗效。方法：治疗组采用硫普罗宁200mg加入5％葡萄糖250ml注射液中缓慢静脉滴注1次／日。对照组不加入硫普罗宁。治疗4周,治疗结束后评定疗效。结果：治疗组总有效率88.1％,对照组总有效率43．3％,两组比较有显著性差异P〈0,005,治疗组在ALT（丙氨酸氨基转移酶）下降的同时,TG（甘油三脂）、AKP（碱性磷酸酶）均有下降,与治疗前相比差异有显著性;治疗组在ALT、TG、AKP下降方面与对照组相比差异有显著性。结论：硫普罗宁治疗脂肪肝能有效的改善临床症状,明显降低谷丙转氨酶、碱性磷酸酶和血脂,且副作用少。     

疏血通注射液合低分子肝素钙治疗急性脑梗死的临床观察

目的对疏血通注射液与低分子肝素钙联合应用治疗急性脑梗死的疗效进行临床观察。方法采用随机对照方法,将60例急性脑梗死患者分成2组,每组30例。治疗组用疏血通注射液6ml,每日一次静点,共14天,低分子肝素钙0.4ml,每12小时腹部皮下注射1次,共用7天;对照组用参芎葡萄注射液200ml,奥扎格雷钠80mg加入液体中静脉滴注,1日1次,共14天。分别观察2组治疗前后临床疗效及血液学改变。结果经治疗,治疗组基本痊愈率40.0%,显效率43.3%;基本痊愈率及显效率均优于对照组(P<0.05)。治疗中未出现不良反应。结论疏血通注射液与低分子肝素钙联合应用治疗急性脑梗死,在改善临床症状及血液学指标方面均明显优于对照组。     

乌司他丁联合血必净治疗重症脓毒症的研究

目的：评估乌司他丁联合血必净注射液治疗重症脓毒症的临床疗效。方法：将符合入选标准的脓毒症患者40例,按照随机分组原则分为观察组和对照组,每组20例。所有患者给予常规抗感染治疗（根据培养结果给予敏感抗生素）和必要的对症支持治疗。观察组患者加用血必净注射液50ml静脉滴注,1次／12h,乌司他丁60万u静脉滴注,1次／12h,连用7d。记录治疗前后所有患者的体温、脉搏、呼吸、血白细胞（W33C）、降钙素原（PCT）、c反应蛋白（CRP）、急性生理学与慢性健康状况评分（APACHEII）、7天病死率。结果：疗程结束时观察组脉搏、呼吸、WBC、PCT、CRP、APACHEII评分、7天病死率均较治疗前明显下降,与对照组相比差异有统计学意义（P〈0．05）。结论：血必净注射液联合乌司他丁对重症脓毒症有明确疗效,改善临床症状,降低病死率。     

蕲蛇酶治疗不稳定型心绞痛的疗效

目的：观察蕲蛇酶治疗不稳定型心绞痛（ＵＡＰ）的疗效。方法选择同期入院的ＵＡＰ患者６０例,随机分为观察组３０例和对照组３０例。观察组给予蕲蛇酶１．５ｕ加５％葡萄糖液５００ｍｌ静滴,每天１次,１０天为１疗程;对照组给予低分子右旋糖酐５００ｍｌ加复方丹参注射液２０ｍｌ静滴,每天１次,１０天为１疗程,两组均给予常规治疗。结果观察组ＵＡ治疗总有效率９３．３％,对照组为６０％。观察组心电图总有效率８３．３％,     

Randomised,double blind,multicentre comparison of hydrochlorothiazide,atenolol, nitrendipine,and enalapril in antihypertensive treatment: results of the HANE study. HANE Trial Research Group.

OBJECTIVE: To compare the effectiveness and tolerability of hydrochlorothiazide, atenolol, nitrendipine, and enalapril in patients with mild to moderate hypertension. DESIGN: Randomised multicentre trial over 48 weeks with double blind comparison of treatments. SETTING: 48 centres in four countries. PATIENTS: 868 patients with essential hypertension (diastolic blood pressure 95-120 mm Hg) INTERVENTIONS: Initial treatment (step 1) consisted of 12.5 mg hydrochlorothiazide (n = 215), 25 mg atenolol (n = 215), 10 mg nitrendipine (n = 218), or 5 mg enalapril (n = 220) once daily. If diastolic blood pressure was not reduced to < 90 mm Hg within four weeks, doses were increased to 25 mg, 50 mg, 20 mg, 10 mg, respectively, once daily (step 2) and after two more weeks to twice daily (step 3). The eight week titration phase was followed by an additional 40 weeks for patients who had reached the target diastolic pressure. MAIN OUTCOME MEASURES: Blood pressure by means of an automatic device with repeated measurements. RESULTS: After eight weeks the response rate for atenolol (63.7%) was significantly higher than for enalapril (50.0%), hydrochlorothiazide (44.7%), or nitrendipine (44.5%). After one year atenolol was still more effective (48.0%) than hydrochlorothiazide (35.4%) and nitrendipine (32.9%), but not significantly better than enalapril (42.7%). The treatment related dropout rate was higher (P < 0.001) in the nitrendipine group (n = 28). CONCLUSIONS: There is no evidence of superiority for antihypertensive effectiveness or tolerability of the "new" classes of antihypertensives (calcium channel blockers and angiotensin converting enzyme inhibitors). As these drugs are now widely used as treatment of first choice, our results further emphasise the need for studies confirming that they also reduce morbidity and mortality, as has been shown for diuretics and beta blockers.     

Campylobacter susceptibility to ciprofloxacin and corresponding fluoroquinolone concentrations within the gastrointestinal tracts of chickens

AIMS: This study evaluated the relationship between Campylobacter susceptibility and enteric fluoroquinolone concentrations in chickens treated with different doses of enrofloxacin. METHODS AND RESULTS: All chickens were challenged with seven fluoroquinolone sensitive Campylobacter jejuni (6.6 x 10(6) CFU per bird) at 2 weeks posthatch. At 26 days of age chickens were treated with 0 (n = 29 birds), 25 mg ml(-1) enrofloxacin (Baytril, Bayer Corp., Shawnee Mission, KS, USA) for 3 days (n = 45 birds) or 50 mg ml(-1) enrofloxacin for 7 days (n = 65 birds) in the drinking water. The crop, upper ileum, lower ileum, ceca and colon contents were collected from both enrofloxacin treatment groups (n = 5 birds per day per treatment group) and nonmedicated controls. The minimum inhibitory concentration (MIC) of ciprofloxacin for Campylobacter increased for isolates from both treatment groups within the first day of dosing and the daily average ranged from 1.4 to 6.5 microg ml(-1) throughout the study. Although enteric fluoroquinolone concentrations were higher (P < 0.05) in birds dosed with 50 mg ml(-1)vs 25 mg ml(-1) enrofloxacin, there were no differences between the isolates collected from these groups for MIC values. CONCLUSION: These data indicate, for the doses used, differences in gut fluoroquinolone concentrations do not produce isolates of Campylobacter with differing susceptibility to ciprofloxacin. SIGNIFICANCE AND IMPACT OF THE STUDY: Using the manufacturers lowest, shortest duration dose vs the highest, longest duration dose of enrofloxacin did not change Campylobacter susceptibility to ciprofloxacin. However, ciprofloxacin MIC values for Campylobacter determined in this study were lower than previously reported.     

步长稳心颗粒治疗功能性早搏60例疗效分析

目的:观察步长稳心颗粒(简称稳心颗粒)治疗功能性早搏的临床疗效及安全性。方法:选择功能性早搏60例病人,随机分为治疗组及对照组,每组各30例。治疗组给予稳心颗粒一包(9克),每日三次,温开水冲服;对照组给予倍他乐克25毫克,每日二次口服,一个月为一疗程。结果:四周后治疗组显效11例,有效16例,总有效率90%。对照组显效8例,有效18例,总有效率86.7%,p>0.05,两组比较无显著性差异。对血压、心率影响方面稳心颗粒明显优于倍他乐克结论:稳心颗粒治疗功能性早搏疗效显著,且效果稳定,安全无明显不良反应,值得临床推广应用。     

Verapamil versus hydrochlorothiazide in the treatment of hypertension: results of long term double blind comparative trial. Verapamil versus Diuretic (VERDI) Trial Research Group.

OBJECTIVE--To compare the efficacy and tolerability of hydrochlorothiazide, sustained release verapamil, and their combination in patients with mild to moderate hypertension. DESIGN--Randomised multicentre trial of 48 weeks'' duration with a double blind comparison of hydrochlorothiazide and verapamil followed by an open trial of combined treatment for patients not achieving the target diastolic blood pressure (less than 90 mm Hg) during treatment with a single drug. SETTING--Outpatient departments in 10 clinics and 10 private practices of general practitioners or internists. PATIENTS--369 Hypertensive patients with a diastolic blood pressure of 95-120 mm Hg during a placebo run in period of two weeks. INTERVENTIONS--Initial treatment consisted of 12.5 mg hydrochlorothiazide (n = 187) or 120 mg sustained release verapamil (n = 182) once daily (regimen I). If the target diastolic blood pressure of less than 90 mm Hg was not achieved within four weeks doses were increased to 25 mg hydrochlorothiazide or 240 mg verapamil once (regimen II) and twice daily (regimen III). Patients not achieving target blood pressure were given the combination of hydrochlorothiazide and verapamil--that is, 25 and 240 mg once (regimen IV) and twice daily (regimen V). MAIN OUTCOME MEASURE--Blood pressure determined with a device permitting automatic repeated measurements with printouts. RESULTS--After eight weeks of treatment with a single drug 76 out of 178 (43%) and 101 out of 175 (58%) patients achieved the target blood pressure with hydrochlorothiazide and verapamil, respectively. During follow up until 48 weeks patients treated with verapamil reached the target blood pressure more often and at lower doses and were less likely to switch to combination treatment than patients randomised to hydrochlorothiazide treatment. Adding verapamil to hydrochlorothiazide was more effective than the addition of hydrochlorothiazide to verapamil. At the end of the study 42 out of 169 (25%) and 73 out of 163 (45%) patients initially randomised to hydrochlorothiazide and verapamil, respectively, were at target blood pressure without combination treatment. After adding verapamil to hydrochlorothiazide or hydrochlorothiazide to verapamil an additional 58 (34%) and 29 (18%) patients reached the target blood pressure, respectively. Altogether 92 out of 332 (28%) patients failed to achieve target blood pressure with regimen V. There were four, 10, seven, and seven withdrawals due to possible adverse effects to treatment with hydrochlorothiazide, verapamil, combining verapamil with hydrochlorothiazide, and combining hydrochlorothiazide with verapamil, respectively. CONCLUSIONS--In doses currently used in antihypertensive treatment verapamil was more effective than hydrochlorothiazide as a single agent and in combination in mild to moderate hypertension, whereas withdrawal rates caused by side effects possibly related to treatment were similar.     

前列地尔注射液联合生脉注射液治疗 不稳定型心绞痛疗效观察

目的：探讨前列地尔注射液联合生脉注射液治疗不稳定心绞痛的疗效。方法：在于2004年12月至2005年12月期间住院的80例患者,随机分配为常规组和观察组各40例。常规组给予硝酸异山梨脂,阿司匹林和能量合剂等常规治疗,观察组在常规治疗的基础上给予前列地尔注射液（三精制药）200μg,ivgtt,qd,14d,同时给予生脉注射液（益盛药业）80ml,ivgtt,qd,14d。观察常规组和观察组在治疗前后的临床症状变化和心电图变化。结果：常规组和观察组的疗效有显著差异（p〈0．01）。结论：在常规治疗的基础上加用前列地尔注射液联合生脉注射液治疗不稳定型心绞痛,疗效显著。     

Test of ML23 as an antagonist to the effects of melatonin in the ram

In Exp. 1, four groups of 8 yearling Soay rams were housed under long days (16L:8D) to induce reproductive quiescence and were treated daily for 12 weeks with: (I) vehicle (2 or 4 ml 50% ethanol/water), (II) ML23 (2 mg), (III) melatonin (2 mg) and (IV) melatonin and ML23 (2 mg of each). All treatments were given orally in the mid-light phase. In the rams receiving melatonin (Group III) there was an earlier increase in the plasma concentrations of FSH and testosterone and regrowth of the testes compared to the controls (time to maximum testicular diameter: 10.0 +/- 0.5 and 15.3 +/- 1.2 weeks). These differences were reversed after the end of the 12-week treatments when rapid testicular regression occurred in melatonin-treated rams but not in the controls. In the group receiving ML23 and melatonin (Group IV), there was early reactivation and regression of the reproductive axis as in the melatonin group (testis max. 9.9 +/- 0.7 and 10.0 +/- 0.5 weeks) while in the group receiving ML23 alone (Group II) there was a slower redevelopment and regression as in the controls (testis max. 15.7 +/- 1.1 and 15.3 +/- 1.2 weeks). The comparison between the 4 groups in the changes in the blood concentrations of prolactin, voluntary food intake and total body weight also indicated that the treatment with ML23 failed to modify the effect of melatonin (combined treatment vs melatonin) or the effect of the long day photoperiod (ML23 vs vehicle).(ABSTRACT TRUNCATED AT 250 WORDS)     

Safety and tolerability of elubaquine (bulaquine, CDRI 80/53) for treatment of Plasmidium vivax malaria in Thailand

We conducted a study to compare the safety and tolerability of anti-relapse drugs elubaquine and primaquine against Plasmodium vivax malaria. After standard therapy with chloroquine, 30 mg/kg given over 3 days, 141 patients with P. vivax infection were randomized to receive primaquine or elubaquine. The 2 treatment regimens were primaquine 30 mg once daily for 7 days (group A, n = 71), and elubaquine 25 mg once daily for 7 days (group B, n = 70). All patients cleared parasitemia within 7 days after chloroquine treatment. Among patients treated with primaquine, one patient relapsed on day 26; no relapse occurred with elubaquine treatement. Both drugs were well tolerated. Adverse effects occurred only in patients with G6PD deficiency who were treated with primaquine (group A, n = 4), whose mean hematocrit fell significantly on days 7, 8 and 9 (P = 0.015, 0.027, and 0.048, respectively). No significant change in hematocrit was observed in patients with G6PD deficiency who were treated with elubaquine (group B, n = 3) or in patients with normal G6PD. In conclusion, elubaquine, as anti-relapse therapy for P. vivax malaria, was as safe and well tolerated as primaquine and did not cause clinically significant hemolysis.     

新辅助化疗联合间隔肿瘤细胞减灭术治疗晚期卵巢癌的临床观察

目的:观察新辅助化疗与间隔肿瘤细胞减灭术联合治疗晚期卵巢癌的临床疗效。方法:选取我院收治的晚期卵巢癌患者88例,采取分层随机法分成两组,对照组采取间隔肿瘤细胞减灭术治疗,将全子宫、大网膜、双附件、肿瘤转移灶、阑尾切除,根据手术中的情况,切除腹主动脉旁、盆腔淋巴结及受累的脏器,观察组在对照组基础上采取新辅助化疗,行2-3次化疗后进行手术,采取TP方案进行新辅助化疗,150 mg/m~2紫杉醇,行静脉滴注,持续滴注3小时,每天1次;0.06卡铂、200 m L 0.9%氯化钠注射液,行静脉滴注,每天1-3次;每个疗程间隔3周。比较两组的临床治疗总有效率、腹水量、术中出血量、病灶大小、手术时间、住院时间。结果:观察组的治疗总有效率(75.00%)显著高于对照组(54.55%)(P0.05),腹水量、术中出血量均明显少于对照组,病灶显著小于对照组(P0.05),手术时间、住院时间均明显短于对照组(P0.05)。结论:新辅助化疗联合间隔肿瘤细胞减灭术治疗晚期卵巢癌患者的临床效果明显优于单用间隔肿瘤细胞减灭术。     

CysC检测在阿托伐他汀治疗早期CRS中的意义

目的:观察血清胱抑素C(Cystatin C,Cys C)在阿托伐他汀治疗早期心肾综合征中的变化,探讨Cys C在阿托伐他汀治疗早期心肾综合征中的临床意义。方法:选择90例慢性心功能不全引起的早期心肾综合征患者,随机分为常规治疗组(A组)、阿托伐他汀20 mg组(B组)以及阿托伐他汀40 mg组(C组)各30例。常规治疗组给予常规抗心力衰竭药物治疗,阿托伐他汀组在常规抗心衰药物治疗基础上分别加用阿托伐他汀20 mg/d或者阿托伐他汀40 mg/d口服。分别测定其治疗3个月前后Scr、GFR、Cys C水平并进行组间比较。结果:治疗3个月后,A组、B组Scr及GFR分别与治疗前比较差异无显著性(P0.05),C组Scr及GFR与治疗前比较差异有显著性(P0.05);治疗3个月后,A组Cys C与治疗前比较差异无显著性(P0.05),B组、C组Cys C与治疗前比较差异有显著性(P0.01)。结论:在阿托伐他汀治疗早期心肾综合征疗效观察中,Cys C较Scr更能敏感反应早期肾功能变化情况。     

吉西他滨眼内应用抑制兔眼白内障术后 后囊膜混浊的实验研究

目的：研究眼内应用浓度为5mg／ml的吉西他滨（GEM）对于后囊膜混浊的抑制作用。方法：12只（24眼）实验动物随机分为A、B二组,A组为治疗组,B组为对照组。所有的实验动物均进行晶状体囊外摘除＋人工晶体植入术。A组术中应用5mg/ml吉西他滨溶液作水分离;B组术中应用平衡盐溶液作水分离。术后定期观察角膜水肿,评价PCO及进行角膜内皮细胞分析。结果：术后第1天,第3天,第7天两组角膜水肿的例数均无差异。术后第二周,两组后囊膜发现不同程度混浊,第四周后囊膜混浊程度分级,对照组中央后囊明显混浊;角膜内皮细胞分析显示两组的角膜内皮数量明显低于术前,比较两组的角膜内皮数量减少量无统计学意义。结论：实验显示眼内应用5mg／ml吉西他滨后囊膜混浊程度较对照组明显轻。尽管眼内应用有导致眼内组织毒性反应的可能性,但通过用药方法的改进和保护措施的加强是可以有效避免或减轻的,因此吉西他滨是一种有潜力的预防后发性白内障的侯选药物。