半夏白术天麻汤加减治疗美尼埃病48例

美尼埃病是由内耳膜迷路积水引起，以发作性眩晕、耳鸣、听力逐渐减退为主要表现的一种耳源性眩晕病。笔者运用半夏白术天麻汤加减治疗本病48例，取得较好疗效，报道如下。     

Effect of berberine on the pharmacokinetics of substrates of CYP3A and P‐gp

The in vivo effects of berberine (BBR), the widely used bioactive herbal ingredient from many traditional Chinese medicinal herbs, on the pharmacokinetics of carbamazepine (CBZ, a substrate of CYP3A) and its metabolite carbamazepine 10,11‐epoxide (ECBZ), digoxin (DIG, a substrate of P‐gp) and cyclosporine A (CsA, a dual substrate of CYP3A and P‐gp) were evaluated in rats. After a 2‐week pretreatment with BBR, the pharmacokinetic parameters of i.g. administered CBZ and ECBZ were not significantly altered. The pharmacokinetics of i.v. administered DIG was not modified by single and 2‐week pretreatments with BBR, but a dose‐dependent increase in AUC and C_max was observed in the i.g. administered DIG parameters in rats. The AUCs of DIG with BBR (30 mg/kg, 100 mg/kg) were 133%, 170% (single) and 123%, 169% (2‐week) of control, respectively. The AUC and C_max of i.g. administered CsA with a 2‐week pretreatment with BBR increased by 62% and 43% (BBR 30 mg/kg, p < 0.05), 96% and 60% (BBR 100 mg/kg, p < 0.01), compared with the control. In conclusion, berberine produced a dose‐dependent increased bioavailability of digoxin and cyclosporine A by inhibition of intestinal P‐gp. No significant changes in CYP3A activity by berberine were observed. Copyright © 2009 John Wiley & Sons, Ltd.     

子宫体三角形切除术的临床应用

目的:探讨子宫体三角形切除术的临床价值。 方法 :对子宫体三角形切除术组、子宫次全切除术组各6 4例进行回顾性分析。结果:两组的手术时间、出血量、术后排气时间等比较 ,差异无统计学意义 (P >0 .0 5 ) ,但子宫体三角形切除术组术后有少量月经。两组在性生活质量及更年期症状方面差异有统计学意义 (P <0 .0 1)。子宫体三角形切除术组的血清性激素水平手术前 FSH(7.0 5± 1.10 ) IU/ L、E2 (5 6 .4 0± 1.12 ) pm ol/ L,手术后 FSH(6 .88± 1.12 ) IU/ L、E2 (5 6 .2 8± 1.15 ) pm ol/ L,手术前后比较差异无统计学意义 (P >0 .0 5 )。子宫次全切除术组血清性激素水平手术前 FSH(5 .98± 1.15 ) IU/ L、E2 (5 6 .2 2± 1.10 ) pmol/ L,手术后 FSH(10 .6 6± 1.18) IU/ L、E2(47.4 5± 1.2 0 ) pmol/ L,手术前后比较差异有统计学意义 (P<0 .0 5 )。 结论:子宫体三角形切除术术式具有操作简单、易于掌握、不影响卵巢功能、术后恢复快等优点 ,能满足患者既去除疾病又保留子宫的生理和心理需要     

A randomized, double-blind, crossover comparison of risperidone and haloperidol in Korean dementia patients with behavioral disturbances.

OBJECTIVE: Behavioral disturbances in dementia are extremely prominent and distressful, and often result in serious physical, social, and economic consequences. The authors compared the efficacy and tolerability of risperidone and haloperidol in the treatment of behavioral and psychological symptoms of dementia (BPSD) in institutionalized elderly Korean patients with Alzheimer disease, vascular dementia, or mixed dementia. METHODS: This was an 18-week double-blind, crossover study involving 120 patients who were randomly assigned to receive flexible doses (0.5-1.5 mg/day) of risperidone or haloperidol. BPSD were assessed using the Korean version of the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD-K), the Korean version of the Cohen-Mansfield Agitation Inventory (CMAI-K), and the Clinical Global Impression of Change scale (CGI-C). Safety and tolerability assessments included the Extrapyramidal Symptom Rating Scale and the incidence of adverse events. RESULTS: Both risperidone and haloperidol were efficacious in alleviating BPSD. However, when receiving risperidone, patients showed significantly greater improvement than when receiving haloperidol in the total and subscale scores of the BEHAVE-AD-K, the total and subscale scores of the CMAI-K, and the scores on the CGI-C scale. Also, risperidone had an additional benefit on aggressiveness and anxieties/phobias. The risk of antipsychotic-induced parkinsonism throughout this study was significantly lower with risperidone than with haloperidol. CONCLUSION: Risperidone had a favorable efficacy and tolerability profile compared with haloperidol in the treatment of BPSD in this patient population.     

CT在诊断胸部结节病中的意义

结节病(sarcoidosis)是一种原因不明的疾病,全身多个器官均可受累,90%以上有肺的改变犤1犦,以病变处非干酪样上皮细胞肉芽肿形成为特征犤2犦。临床多无特异性症状,常规胸片为其基本诊断方法。随着螺旋CT、高分辨CT在临床中的     

单独肝尾状叶血管瘤切除术

肝尾状叶由于解剖位置特殊,位置深,难以显露,手术难度大,是肝脏外科领域手术操作的难点与研究热点.随着肝血流控制技术的发展、肝实质离断技术的提高,肝尾状叶肿瘤切除率明显提高[1].2006年4月至2008年10月,我科完成单独肝尾状叶血管瘤切除术9例,现将手术技巧与疗效报道如下.     

不开胸食管剥脱术在颈段食管癌中的治疗价值

目的探讨不开胸食管剥脱术治疗颈段食管癌的效果。方法自1995年7月至2004年12月对21例颈段食管癌患者行不开胸食管剥脱术并Ⅰ期行胃咽吻合或胃食管端侧吻合术。结果本组病人的手术切除率100%。手术后发生各类并发症8例,其中吻合口瘘3例,肺部感染3例,伤口裂开1例,气胸1例。18例患者术后有不同程度的胃液反流。1例住院期间因胃大出血死亡。除2例失访外其余患者获得随访27个月～12年,13例存活超过1年,6例存活超过3年,3例存活超过5年。结论不开胸食管剥脱术手术简单,效果满意,适用于颈段食管癌。食管剥脱术后行胃代食管者胃液反流严重,手术方式有待进一步改善。     

上腔静脉综合征的外科治疗

目的报告５例上腔静脉综合征外科治疗经验及体会。方法２例行颈内静脉－大隐静脉转流术，３例行颈外静脉－大隐静脉转流术。结果无术后并发症及手术死亡。术后近期疗效满意５例，远期疗效满意２例。结论外科手术治疗上腔静脉综合征能明显改善患者的预后；但由于上腔静脉综合征病因、梗阻部位和范围不同，手术方法应有所选择。     

芜湖市社区高血压病人现况调查

目的　了解高血压病人的基本情况 ,为寻找社区人群高血压的防治对策提供依据。方法　应用单纯随机抽样调查某街道 5 0 1名≥ 30岁居民中的高血压病人 ,用SPSS统计软件进行分析。结果　高血压患者的知晓率为 80 .0 %,服药率为 6 8.7%,采取非药物治疗的 6 3.5 %,使血压能控制在正常范围的占 18.0 %。结论　知晓率、服药率、控制率比 1991年全国抽样调查的结果有明显提高 ,在社区广泛开展健康教育和健康促进 ,对社区高血压患者实施防治结合是很有必要的。