ACUPUNCTURE CHANNELS - MYTH OR REALITY GS Sekhon School of Surgery and Allied Sciences

Spurred by recent advances in the ancient science of acupuncture in China, world interest in the subject has renewed. While the benefits of acupuncture are evident, its. mode of action and the existence of channels and collaterals are major controversial subjects. Based on personal experience and that of some of their colleagues and patients, the authors believe that channels and collaterals exist. These channels not only play a role in the treatment of deep seated dis- eases and analgesia induction and probably a.lso moderate normal healthy perception. The ex- istence of channels and their collaterals has not been proved anatomically.     

Pharmacokinetics and comparative bioavailability of two vinpocetine tablet formulations in healthy volunteers by using the metabolite apovincaminic acid as pharmacokinetic parameter

The objective of this study was to evaluate the pharmacokinetics of apovincaminic acid, the main metabolite of vinpocetine ((3alpha, 16alpha) -eburnamenine-14-carboxylic acid ethyl ester, CAS 42971-09-5), and to assess the average bioequivalence of two immediate release formulations of 10 mg vinpocetine tablets in 24 healthy male volunteers. The relative bioavailability of the test (generic) product (Vimpocetina) with respect to the reference product was determined in a single dose, randomized, crossover study. A simple, rapid specific and reliable high performance liquid chromatographic method coupled with mass spectrometry detection has been developed and validated for vinpocetine and apovincaminic acid. However, only the concentrations of the metabolite could be used for bioequivalence determinations because the concentrations of the parent drug were too low to be accurately measured in the biological matrix. The compartmental analysis of the metabolite's appearance-disappearance in blood shows similarity with first-order kinetics of a drug extravascularly administered. The apparent pharmacokinetic constants were determined. The mean values for the Cmax were 49.5 (+/- 16) ng/ml for test and 51.4 (+/- 14) ng/ml for the reference product. The mean values for the AUC0-infinity were 95 (+/- 29) ng/ml x h for test and 96.9 (+/- 26) ng/ml x h for reference, respectively. The 90 % confidence intervals for test/reference mean ratios of the plasma pharmacokinetic variables Cmax and AUC0-infinity lie between 0.83-1.08 and 0.88-1.08, respectively, which is within the conventional bioequivalence range of 80-125 % (Schuirman test). The difference between Tmax of the test and reference products was statistically non-significant (Friedman test). The test product is therefore bioequivalent to the reference product with respect to the rate and extent of apovincaminic acid pharmacokinetics.     

Food-drug interactions: grapefruit juice

Food-drug interactions are increasingly recognized as important clinical events which may change significantly the bioavailability of oral administrated drugs. Grapefruit juice (GFJ) demonstrated multiple interactions with drugs leading to loss of the therapeutic effects or increased side-effects. GFJ decreases pre-systemic metabolism through a) competitive or mechanism-based inhibition of gut wall CYP3A4 isoenzymes and b) P-glycoprotein (P-gp), c) multidrug resistance protein-2 (MRP2) or d) organic anion-transporting polypeptide (OATP) inhibition. Although, GFJ presents high amounts of flavonoids (e.g. naringin, naringenin), furanocoumarins (e.g. 6',7'-dihydroxybergamottin, bergamottin) are the main chemicals involved in the pharmacokinetic interactions. As compounds of GFJ show additive or synergistic effects, all the major furanocoumarins are necessary for the maximal inhibitory effect. Also, related citrus fruits (sweeties, pummelo and sour orange) or various plants containing furanocoumarins may present pharmacological interactions, yet to be discovered.     

大剂量甘露醇治疗癌性颅内高压症1例

1 临床资料患者、女性、38岁、因右小细胞肺癌术后16 mo,间断性头痛10 mo,加重1 wk后于2003-01-01入院.在2002-02因枕部疼痛,行头颅CT示: 脑多发转移癌.行多次头颅局部X-刀、γ-刀加全脑预防性放疗和化疗,疗效达部分缓解.2002-12末头痛症状复发,约1.5 h发作1次,伴短暂意识丧失、喷射状呕吐和四肢抽搐.     

2009年成都市水性疾病及哨点监测结果分析

目的了解成都市介水传染病流行状况和特征,做好水性疾病预警,同时掌握其分布规律和流行趋势,探讨水性疾病的控制策略。方法收集成都市2009年经水传播的肠道传染病及哨点医院症状监测结果,数据用χ^2检验进行统计学分析。结果成都市水性疾病构成主要以其他感染性腹泻和细菌性痢疾为主,两者占总发病数的93.01%,除1～3月发病率较低外,其他月份发病率均较高,但无统计学差异（5～12月发病率P〉0.05）;发病人群以5岁以下散居儿童为主,哨点医院进行症状监测年发生率与成都市水性疾病年发生率相比无显著性差异（P〉0.05）。结论 5岁以下散居儿童为水性疾病的高危人群,水性疾病的控制可以其他感染性腹泻和细菌性痢疾为主进行相关性研究,而选择合适的医院门诊作为监测水性疾病的哨点,是一种切实可行的监测模式。     

Risk of gonadoblastoma in female patients with Y chromosome abnormalities and dysgenetic gonads

We report two female patients with gonadal dysgenesis and sex chromosome mosaicism involving the Y chromosome. Conventional karyotyping was supplemented with fluorescent in situ hybridisation techniques in order to confirm the presence of Y chromosomes. One patient is a phenotypic female with karyotype 45,X/46,X,idic(Y)(q11.2). She underwent a laparoscopic gonadectomy at which streak ovaries without evidence of gonadoblastoma were removed. The second patient presented as a virilised female with karyotype 45,X/47,XYY. At laparoscopy, she was found to have mixed gonadal dysgenesis with a gonadoblastoma in situ. We recommend early gonadectomy in female children presenting with gonadal dysgenesis and the presence of a Y chromosome although once the gonadoblastoma locus on Y chromosome gene has been cloned it may be possible to identify those patients who have a low risk of developing gonadoblastoma.     

胃癌雌激素受体的研究

自20世纪60年代发现雌激素受体以来,学者们开展了对各种不同器官肿瘤受体的研究,并形成了激素作用机制的3种模式(二步模式、核模式和平衡模式).目前已在众多的肿瘤中发现了性激素受体,如孕酮激素(PR)、雌激素(ER)和雄激素(AR).这些肿瘤包括激素依赖性器官和非依赖性器官的肿瘤.