糖尿病合并忧郁症病人的护理

忧郁症是一种常见的精神病,女性发病率比男性高2-3倍.根据《精神障碍统计和诊断手册》第4版标准,其临床表现为持续2周以上情绪低落和兴趣缺失,同时伴随食欲减退或增加、失眠或嗜睡、敏感或运动迟钝、疲乏无力、无用感和负疚感、思维和注意力下降及反复出现的自杀等症状[1].周连华[2]等报道糖尿病患者中31.4%合并忧郁症,其中评分为60分及以上的重度忧郁症占14.3%,Thomas等[3]报道糖尿病人群中忧郁发生率36%,糖尿病患者易合并忧郁是肯定的,我院自2004年11月至今对住院糖尿病人200例患者用SDS量表进行忧郁症筛查,报告如下:     

牙隐裂患者发病情况的临床研究

目的 研究牙隐裂的病因和发病规律.方法 对40例患者共47颗患牙的临床表现及牙颌情况进行了研究.结果 牙隐裂多发生于中老年人的磨牙40颗(85.11%),尤其是上磨牙,35颗(74.47%),其次是前磨牙7颗(14.89%).患牙颌面多有异常磨损和高陡牙尖,颌面隐裂与发育沟吻合并延伸至边缘嵴.患牙有咬在某一特定部位疼痛或曾有硬物硌伤的病史.结论 牙齿结构的薄弱环节及创伤性颌力可能是牙隐裂发生的重要条件.     

解开"中国人起源之谜"的第三条线索

1987年三位美国遗传学家,根据对现生各大洲妇女胎盘线粒体DNA的研究,提出假说,主张各大洲的现代人都起源于大约20万年前生活在非洲的一位妇女,她的一些后人在大约13万年前走出非洲,散布到亚洲和欧洲,完全取代原来住在各该地区的人类.就中国而言,就是那些从非洲来的移民,才是现生中国人的祖先,而北京猿人的所有后代都被取代了.这个假说后来被称为"夏娃学说",一经提出在西方公众中便非常流行.[1]     

白内障,手术好还是药物好

白内障是由于各种原因如老化、遗传、局部营养障碍、免疫与代谢异常、外伤、中毒、辐射等,引起晶状体代谢紊乱,导致晶状体蛋白质变性而发生浑浊的一种老年人常见眼病,此时光线被混浊晶状体阴扰无法投射在视网膜上,就不能看清物体.     

山东省食品药品监督管理局关于对严重违法广告药品在全省范围内暂停销售的通告

近期,我局在药品广告发布情况监测中发现,部分药品广告宣传存在扩大功能主治或适应症,绝对化夸大疗效,或以专家、医生、患者的名义和形象证明疗效等违法行为,严重欺骗和误导消费者.     

别拿疫苗不当回事

早在宋朝,中国人就通过接种天花患者的脓液(即人痘)来预防天花.该方法于18世纪初期传入欧洲.英国医生金纳发现挤牛奶的女工不会得天花,因为她们感染了牛痘.于是,1796年,金纳医生首先进行了接种牛痘预防天花的研究.研究证明,只要预先接种牛痘病毒,就可以预防天花.由此开始,疫苗学与免疫学诞生了.     

生活中的辅助降压法

方法1:晒太阳降血压 《健康时报》曾经报道,北京天坛医院心内科主任杜凤和教授建议,高血压患者和高危人群应积极参加户外运动.因为在户外晒10分钟太阳,血压可下降6毫米汞柱.理由:太阳光的紫外线照射可使机体产生一种营养素——维生素D3,而维生素D3与钙相互影响又能够控制动脉血压,所以适当晒太阳能使血压下降.     

头孢哌酮/舒巴坦致过敏性休克1例

患者,女,70岁,因COPD合并感染入院,体格检查,T36.8℃,P 100次/分,R 26次/分,Bp 140/85 mmHg,神清,无紫绀,桶状胸,两肺叩呈高清音,两肺呼吸音低,满布哮鸣音,两肺低细湿罗音,心率100次/分,律齐,无病理性杂音,其他未见异常.追问病史,患者反复多次使用过多种抗生素,自述有时青霉素皮试阳性,1周前使用头孢哌酮/舒巴坦2.0加入0.9%氯化钠100 ml中静滴5 d.医嘱给予头孢哌酮/舒巴坦2.0加入0.9%氯化钠100 ml中静滴,未做皮试.静滴约10 min时,患者出现心慌、胸闷,继之紫绀、呼吸微弱,心音、脉搏消失,立即给予心、肺、脑复苏.复苏成功能,患者已康复出院.     

瘦素在妊娠及其并发症中的临床意义

1994年,Zhang等[1]成功克隆和测序了小鼠和人类的肥胖基因(obese gene,Ob),确定了其编码蛋白产物为瘦素(leptin).瘦素是分子量为16 000的蛋白质类激素,主要由白色脂肪细胞产生和分泌,在脂肪组织中表达最高,在胎盘,骨骼肌,胃,乳房和脑组织均有表达.     

宫颈上皮内瘤样病变与LEEP术的探讨

近年来,由于普遍开展了宫颈细胞学检查,使许多宫颈上皮内瘤样病变(cervical intraepithelial neoplasia,CIN)得以早期发现;而宫颈电圈环切除术(loop electrosurgical excision procedure,LEEP)是近年来治疗CIN的一种新技术,LEEP治疗简便、经济,且对患者损害小.本文介绍,经过详细采集病史,遵循细胞学、阴道镜与组织学活检三阶梯式诊断程序,对于112例CINⅠ～Ⅱ级的门诊患者行LEEP术.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.