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    特约稿
  • 特约稿
    Clinical Manifestations, Pharmacotherapy and Prognosis of 46 Patients with Severe Acute Respiratory Syndrome (SARS)
    YUAN Jing;LUO Ziyi;HU Yiwen;ZHOU Boping;WANG Zhaoqin;LIU Yan;LI Wei
    2003, 22(12): 832-834.
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    Objective:To study the clinical features of patients with SARS. Methods:Clinical manifestations, treatment and prognosis of 46 patients with confirmed diagnosis of SARS in the Shenzhen District were submitted to analysis. Results:①The ratio of male to female was 1.3 to 1, the mean age, 30.5 years. Childhood cases of the disease were relatively few and did not turn to be severe in general. Pregnant women and people over 45 years of age suffering from the disease were liable to develop severe consequences. ②High infectivity and aggregated invasion in families and organizations were some of the epidemiological characteristics. ③Fever, mostly remittent, was present in all cases, lasting (9.07±4.23) days in average, and was frequently associated with symptoms of the respiratory tract. Roentgenogtrams showed that pneumonia used to appear 3 to 4 days after the onset of fever, lasting in average (16.7±10.3) days. Disorders of the liver function were usually detected. A striking decrease in the CD＋4/CD＋8 cell count, with an average of (17.9±5.6)%/(24.2±6.5)% could be demonstrated on admission. ④In comparison with the conventional cases, severe cases of SARS were of more advanced age. Besides, severe cases had longer sustained fever, higher incidence of bilateral pneumonia of longer duration, higher rate and degree of sorum ALT elevation and greater extent of decrease in CD＋4 cell count on admission(P＜0.05). ⑤47.3% of the conventional cases turned to be severe ones. The case fatality rate was 4.3%. Patients were prone to develop type Ⅰrespiratory failure(15.2%) and pulmonary fibrosis (17.4%). ⑥The incidence of pulmonary fibrosis was related to age, state of illness of the patient and application of thymosinα1 as well as shortterm administration of adrenocortical hormone. Conclusion:The advanced age of the patient, the protracted course of fever, the presence of bilateral pneumonia of prolonged duration, evidences of liver function disorders and striking decrease in CD＋4 cell count may serve as early signs for the prediction that the patient is likely to develop serious consequences. The incidence of pulmonary fibrosis was lowered if thymosinα1 and shortterm adrenocortical hormone had been administered.
    • 药物研究
  • 药物研究
    The Effect of Allicin on Apoptosis of the Lymphocyte and the Expression of Its Regulatory Proteins in an Experimental Model of Ulcerative Colitis in the Rat
    XU Ximing;YU Jieping;HE Xiaofei;LI Junhua;YU Liangliang
    2003, 22(12): 835-837.
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    Objective:To survey the effect of allicin on apoptosis of the lymphocyte and the expression of its regulatory proteins bc12 and Bax in an experimental rat model of ulcerative colitis and to probe into the protective action of allicin on the intestinal mucosa of the animal as well as its underlying mechanisms.Methods:48 SD rats were randomly divided into 4 equal groups, with 12 animals in each group: group(1): blank control; group(2): TNBS (trinitrobenzenesulfonic acid) treated; group(3): TNBC＋0.9% NaCl solution; group(4): TNBS＋allicin. The rat model of ulcerative colitis was brought about by an enema of 150 mg•kg1 of TNBS. Beginning from the 2nd day, gastrogavage was used to administer 4 ml of 0.9% NaCl solution to each animal of group3 (TNBS＋NS) and 30 mg•kg1 of allicin to each rodent of group(4) (TNBS＋allicin)q.d.. The rats were sacrificed 3 weeks later. Apoptosis of the lymphocyte was detected with the technique of TUNEL (Tdtmediated dUTP nick end labeling) while bcl2 and Bax protein expressions were assayed with immunohistochemical staining. Besides, the macroscopic and histologic changes in the intestinal tract were also kept under observation.Results:As compared with changes in animals of group(2) (TNBS treated) and group(3) (TNBS＋NS), apoptosis of lymphocytes was increased(P＜0.01) while lymphocytes expressing bcl2 protein were decreased (P＜0.01) in animals of group(4)(TNBS＋allicin). The index of injury in this group was significantly decreased(P＜0.01).Conclusion:Allicin was shown to exert a protective effect on the intestinal mucosa in a rat model of ulcerative colitis possibly by promoting apoptosis of lymphocytes in lamina propria.
  • 药物研究
    The Effect of Yangxuezhiyang Tablets on Allergic Contact Dermatitis Induced by DNFB in Mice
    LI Weiying;XIE Wenping;DENG Shigui;XUAN Guowei
    2003, 22(12): 838-840.
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    Objective:To probe into the effect of Yangxuezhiyang tablets (YXZYT) on type IV allergic reaction induced by 2,4dinitrofluorobenzene (DNFB) in mice.Methods:30 female NIH mice served as the subjects of the study. An area of round 3 cm2 on the abdomen of each mouse was dipilated and smeared with 25 μL of 0.25% DNFB for sensitization. 5 days later, the dorsal surface of the left ear of each mouse was smeared with 25 μL of 0.25% DNFB to induce dermatitis, which was the model of DNFB allergic contact dermatitis in the mouse. The animals were then divided into 3 equal groups. Mice of group(1) were given each(3.0 g•kg1) of YXZYT, those of group(2) were given each (24.0 mg•kg1) of prednisone acetate and those of group(3) were given each 20 mL•kg1 of normal saline. All drugs were given by gastrogavage, b.i.d., for 5 consecutive days. The weight difference between the right ear and left ear and the histopathologic changes in the affected ear of each mouse were examined.Results:As compared with changes in animals of group(3) treated with NS, the inflammatory response in the affected ears of mice treated with YXZYT ［group(1)］ and predicone acetate ［group(2)］ was dramatically inhibited. There was a sharp decrease in the numbers of monoclear and polymorphonuclear cells (P＜0.05), signifying a definite alleviation of pathologic changes. Conclusion:YXZYT was shown to exert a distinct inhibitory effect on the type IV allergic reaction in mice induced by DNFB. It seems to be one of the underlying mechanisms of the effect of YXZYT in the treatment of eczema.
  • 药物研究
    An Experimental Study of the Antiinflammatory and Analgesic Effects of Xiaozhitang
    DU Liuhu;LI Younian;ZHOU Liguo;ZENG Fanbo
    2003, 22(12): 840-842.
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    Objective:To survey the antiinflammatory and analgesic effects of xiaozhitang, a decoction for the treatment of hemorrhoids. Methods:The antiinflammtory effect of the drug given by gastrogavage was tested by assessing its action against the inflammatory edema of the mouse ear induced by local smearing of dimethylbenzene. The analgesic effect of xiaozhitang, administered by gastrogavage as well, was assayed with the writhing and hotplate methods in mice. Results:The inhibition rate of the inflammatory edema of the mouse ear induced by dimethylbozene was 37.39%,57.96% when the dose of xiaozhitang was between 8.8,17.6 g•kg1•d1. The inhibition rate of the pain caused by acetic acid in the mouse was 47.24%,74.87%. The pain threshold of the mouse was significantly elevated 1－6 h after the administration of the drug, as shown by the hotplate method. Conclusion:Xiaozhitang was shown to have antiinflammtory and analgesic effects.
    • 感染性疾病用药专栏
  • 感染性疾病用药专栏
    The Drug Treatment of Opportunistic Infections in 14 Patients with AIDS
    LUO Mingqi;GAO Shicheng;DAI Yongan;ZHANG Yongxi
    2003, 22(12): 843-844.
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    Objective:To study the status and method of drug treatment of opportunistic infections (OI) in patients with AIDS. Methods:OI were found to occur in 14 cases for 26 casetimes among 16 inpatients with AIDS. Patients with thrush (12 casetimes) were given each 100 mg of fluconazole PO. q.d. for 10－14 consecutive days. Patients with pneumonia (4 casetimes) were treated with antibacterial drugs (cephalosporin of the third generation) in combination with trimethoprimsulfamethoxazole (SMZTMP) in high doses (3.0 g•d1•case1) for 10－14 days. Patients with diarrhea (3 case times) were treated with SMZTMP in high doses (3.0 g•d1•case1) for 7 days. The patient with cryptococcal meningitis (1 casetime) was treated with amphotericin B for 2 weeks and fluconazole for 2 months. Results:In the 14 cases of OI treated, 8 showed improvement, 4 proved unaffected and 2 died. Conclusion:Opportunistic infections are frequently encountered in patients with AIDS. In the present study, only a portion of the cases of opportunistic infections responded to treatment with choice drugs.
  • 感染性疾病用药专栏
    The Effect of Lamivudine Alone or in Combination with Oxymatrine in the Treatment of Chronic Viral Hepatitis B
    ZHOU Helong;YANG Xiaoming;HE Shengsong;ZHU Huabin;HUANG Huafang
    2003, 22(12): 845-847.
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    Objective:To survey the therapeutic effect of lamivudine alone or in combination with oxymatrine in the treatment of chronic viral hepatitis B. Methods:76 patients with chronic viral hepatitis B were divided into 3 groups: A, B and C. Patients of group A (n＝35) were given each 100 mg of lamivudine PO, q.d. for 12 consecutive months. Patients of group B (n＝21) were subjected to lamivudine treatment as well at the same dosage as that of patients in group A. In the meantime, each of them was given 20 mg of oxymatrine PO, t.i.d.. The course of treatment lasted 6 months. Patients of group C (n＝20) were treated with conventional hepatinica and symptomatic therapeutic measures, serving as controls. Changes in serum HBV replication markers and liver functions were dynamically monitored. Results:①At the end of the 3rd, 6th and 12th months of treatment, the rates of sera to turn negative for HBVDNA were 62.9%, 80.0% and 77.1%, respectively, in patients of group A, and 76.2%, 90.5% and 76.2%, respectively, in patients of group B. In the same time series, the rates of sera to turn negative for HBeAg were 28.6,%.34.3% and 42.9%, respectively, in patients of group A, and 38.1%, 47.6% and 42.9%, respectively, in patients of group B. The rates of sera to turn negtive for HBVDNA and HBeAg, in patients of group A and group B were significantly higher than those in patients of group C(P＜0.05). However, differences of these rates between patients of group A and group B were insignificant(P＞0.05). ②At the end of the 3rd, 6th and 12th months, the rates for serum ALT to be normalized were 37.1%, 65.7% and 71.4%, respectively, in patients of group A, and 42.9%, 66.7% and 81.0%, respectively, in patients of group B. At the end of the 12th month only, the rates for serum ALT to be normalized in patients of group A and group B were significantly higher than that of patients in group C(P＜0.05). Conclusion:Lamivudine alone or in combination with oxymatrine was shown to exert a definite inhibotory effect on hepatitis B virus. Administration of the two drugs in combination was capable of improving the liver function and increasing the rates for serum HBVDNA and HBeAg to turn negative.
    • 药物与临床
  • 药物与临床
    A Study of the Stability of Phenobarbital in Serum Samples from Sick Children
    CHEN Yilu;LU Hui;DENG Li;YANG Tong;ZHUO Yi
    2003, 22(12): 856-858.
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    Objective:To probe into the stability of phenobarbital (PB) in refrigerated serum samples from sick children.Methods:The serum concentration of PB in 30 sick children treated with the drug was analyzed with the fluorescence polarization immunoassay (FPIA). The concentrations of PB in sera harvested on the day of blood sampling (C1) were compared with those in the sera which had been refrigerated at 2～10℃ for 7 days(C7). Results:The blood concentration of PB C1 was positively correlated with that of C7 (P＜0.01), the formula of linear regression being C7＝1.054 5C1－1.275 8, r＝0.983 1. The average Re C7/C1, corresponding to the mean recovery rate of PB in sera of sick children, was (100.4±4.8)%, with an RSD of 4.70 (n＝30). Both the standard deviations ［(C7－C1)/C1］ were smaller than ±10%. Conclusion:The concentrations of PB in sera from sick children were shown to be kept stable after the sera had been refrigerated for 7 days. The results seem to be advantageous to routine therapeutic drug monitoring(TDM) for stored samples.
  • 药物与临床
    Treatment of Massive Hemorrhage from the Lower Gastrointestinal Tract with Octreotide in Combination with Reptilase
    XIAO Weiming;YANG Jianguo;WU Jian;LI Jiaju
    2003, 22(12): 858-859.
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    Objective:To survey the effects of octreotide in combination with reptilase in the treatment of massive hemorrhage from the lower gastrointestinal tract (LGIT).Methods:39 patients with massive hemorrhage from the LGIT were randomly divided into two groups, the treatment group (26 cases) and the control group (13 cases).On the basis of routine treatment with fluid replacement, blood transfusion and conventional hemostantic agents, patients of the treatment group were given each an IV injection of 1－2 kU of reptilase. Reptilase injection could be repeated if the bleeding continued. Besides, each of these patients was given an IV injection of 0.1 mg of octreotide as an initial dose, followed by continuous intravenous instillation of the drug in a dose of 0.2 μg•h1 until the hemorrhage had stopped for 24 hours. Patients of the control group were given each additionally 0.2 U•min1 of pituitrin administered by IV instillation. After the bleeding had stopped, the dose of the drug was reduced to 0.1 U•min1 for 24 hours. Results:The effective rate of the treatment group(80.8%) was significantly higher than that of the control group(46.2%)(P＜0.05).Conclusion:Octreotide in combination with reptilase was shown to be fairly effective in the treatment of massive hemorrhage from the LGIT. No adverse reactions were encountered.
  • 药物与临床
    A Contrasted Study of the Effect of Diclofenac Sodium Sustained Release Capsules and Ibuprofen Sustained Release Capsules in the Treatment of Rheumatoid Arthritis
    REN Xiaoming
    2003, 22(12): 860-861.
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    Objective:To make a contrasted study of the curative effect and safety rate of diclofenac sodium sustained release capsules and ibuprofen sustained release capsules in the treatment of rheumatoid arthritis(RA). Methods:168 patients with RA were randomly divided into two groups. Patients of the treatment group(n＝86) were given each 50 mg of diclofenac sodium in sustained release capsules, PO b.i.d., while those of the control group (n＝82) were given each 300 mg of ibuprofen in sustained release capsules, PO b.i.d.. The course of treatment in both groups lasted 2 weeks. Patients of both groups were subjected to 2 courses of treatment. Results:Both diclofenac sodium sustained release capsules and ibuprofen sustained release capsules were shown to dramatically ameliorate the symptoms of RA at the termination of the treatment. The overall effective rates were 76.74% and 63.41% in the treatment group and control group, respectively (P＞0.05). However, the rates of excellent therapeutic effect were 56.98% and 37.80% in the treatment group and control group, respectively(P＜0.05).Conclusion:The curative effect and safety rate of diclofenac sodium sustained release capsules were found to be better than those of ibuprofen sustained release capsules.
    • 药物制剂
  • 药物制剂
    Influence of pH on the Stability of Sulfadiazine Silver Cream
    WANG Jing;YANG Tianyan
    2003, 22(12): 876-877.
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    Objective:To survey the influence of different pH on the stability of sulfadiazine silver cream.Methods:Changes in the outward appearance of sulfadiazine silver creams dispensed with stearic acid by different factories, as well as changes in outward appearance of sulfadiazine silver creams with different pH were kept under observation.Results:It was shown that sulfadiazine silver cream with a pH value of 8 would have a fairly good stability.Conclusion:pH of sulfadiazine silver cream should be checked.
    • 药品质量控制
  • 药品质量控制
    Determination of Puerarin in Niuge Oral Liquid with RPHPLC
    YE Dongmei;LU Mei;JING Shuhan;PAN Hongping
    2003, 22(12): 882-883.
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    Objective:To set up a method for the determination of puerarin in niuge oral liquid with highperfomance liquid chromatography (HPLC). Methods:A NovaPak C18 chromatographic column(3.9 mm×150.0 mm, 4 μm) served as the stationary phase, while a mixture of methanolH2O＝25∶75(V/V), as the mobile phase. The flow rate was 0.7 mL•min1 and the wavelength for detection was 250 nm.Results:A good linear correlation was shown when the concentration of puerarin lay within a range of 0.404－2.020 μg, r＝0.999 9. The average rate of recovery was 99.23%, RSD＝1.29%; and the RSD value of precision for continuous sample mountings was 0.26%. Conclusion:Interference of other components could eliminated by this method, which was shown to be accurate, reliable, simple and convenient with good reproducibility.
  • 药品质量控制
    Determination of the Content of Bacterial Endotoxin in Saline Injection of Ligustrazine Phosphate with Kinetic Turbidimetry
    FANG Jianguo;LI Yongjin;DING Shuiping
    2003, 22(12): 883-886.
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    Objective:To set up a method for the determination of the content of bacterial endotoxin in saline injection of ligustrazine phosphate. Methods:A 16fold dilution of the saline injection of ligustrazine phosphate was prepared. The content of bacterial endotoxin in saline injection of ligustrazine phosphate was determined with kinetic turbidimetry after interference test and verification test had been completed. Results:The 16fold dilution of the saline injection of ligustrazine phosphate was shown to be effective in eliminating the interference with the limulus test. The average rate of recovery was with the range of 92.80%～109.92%. Conclusion:The kinetic turbidimetric limulus test was shown to be highly effective for the quantitative determination of bacterial endotoxin in saline injection of ligustrazine phosphate.
    • 用药指南
  • 用药指南
    An Analysis of the Serum Digoxin Concentration Monitoring in 951 Patients with Cardiac Insufficiency
    XIE Shouxia;ZHANG Wanfan;DONG Chun;WANG Daguo
    2003, 22(12): 890-892.
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    Objective:To understand the state of serum digoxin monitoring. Methods:An investigation was made into the data of serum digoxin monitoring in 951 patients with cardiac insufficiency carried out in the People’s Hospital of Shenzhen City within 3 years from 1998～2000, with an emphasis upon the influence of age on the serum concentration of digoxin. Results:There was a year by year increase in the percentage of serum digoxin concentrations within the effective range (0.8～2.0 μg•mL1). The percentage of serum digoxin concentrations lower than the therapeutic range (＜0.8 μg•mL1) was relatively large while that higher than the therapeutic range, relatively small. The incidence of digoxin intoxication in patients with serum digoxin concentrations higher than the therapeutic range was 53.6%(52/97), while that in patients with serum digoxin concentrations within the therapeutic range was 1.3%(6/470). Serum digoxin concentrations in patients over 70 years of age were significantly higher than those in patients of other age groups. No apparent correlation was shown between age and the percentage of serum digoxin concentrations exceeding the therapeutic range. The major clinical manifestations of digoxin intoxication were cardiac arrhythmias(54.2%) and gastrointestinal reactions (34.7%). The causes of digoxin intoxication included increase in serum creatinine, hyperkalemia, hypokalemia and concomitant infections. Conclusion:Serum digoxin concentration monitoring was shown to cast fairly good reflections of the clinical therapeutic effects of digoxin. The possibility of digoxin intoxication could not be ruled out by normal serum digoxin concentrations. Stress should be laid on aged patients in the clinical monitoring.
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