华蟾素配伍丝裂霉素体外抑瘤作用

目的：从体外药敏实验的角度观察华蟾素注射液配伍丝裂霉素对不同肝癌细胞抑瘤效果和对正常肝细胞的毒性反应。方法：通过四甲基偶氮唑盐比色法观察低浓度华蟾素注射液、丝裂霉素及两配伍使用时对人肝癌细胞系SMMC-721、BEL—7402细胞及正常肝细胞系L-02细胞的生长抑制作用。结果：对人肝癌细胞的生长抑制作用，华蟾素及丝裂霉素两配伍使用较两单独使用显增强；丝裂霉素对正常肝细胞具有一定生长抑制作用，而华蟾素注射液则无此作用，与单独使用丝裂霉素比较，两的配伍使用对正常肝细胞的生长抑制作用未见明显增加。结论：华蟾素和丝裂霉素配伍使用可显提高对人肝癌细胞的杀伤作用，同时未增加对正常肝细胞的生长抑制作用，提示华蟾素和丝裂霉素配伍使用在肝癌治疗中具有很好的临床应用前景。     

沃尼妙林注射液的研制

以含量测定为指标,通过均匀设计试验进行处方筛选,同时优化制备工艺;用高效液相色谱(HPLC)法对沃尼妙林注射液的含量进行检测;通过经典恒温加速试验,进行初步的稳定性试验研究.结果,优选得到的注射剂的工艺处方组成稳定.HPLC法的回收率为99.59%,检测限为0.030 4 μg/mL,定量限为0.085 2μg/mL,回归方程y=1E+06x-25 120,相关系数r2=0.999 7.结果表明,研发的沃尼妙林注射液较稳定,适合产业化生产.     

Death following injection sclerotherapy due to phenol toxicity

Prolapse rectum (PR) or protrusion of the rectum beyond the anus occurs frequently in populations at both extremes of age. In the pediatric population, in developed countries, the commonest cause for PR is thought to be cystic fibrosis (CF). Treatment options for CF include conservative management, surgical resection and fixation, suturing, and injection sclerotherapy (IS). The last is considered an attractive treatment option because it is minimally invasive. In this case report, the authors present the details about a 2-year-old female child, with PR and CF, who died after IS, using phenol as the sclerotherapeutic agent. Autopsy findings and toxicology tests performed to establish phenol toxicity are documented. The available literature is reviewed. This case report underscores the risks of using phenol for IS and emphasizes the point that the procedure is not innocuous and an adverse outcome including fatality is a possibility.     

Maximizing order or harm? Arrests among a social network of people who inject drugs in a large urban city

Encountering the criminal justice system at the first point of entry---an arrest---is associated with heightened HIV and Hepatitis risk behavior among people who inject drugs (PWIDS). Intervening structurally through the criminal justice system impacts public health; therefore, determining arrest patterns is an important tool for risk reduction. Among a sample of 740 PWIDs, and their social network members recruited from predominantly African-American neighborhoods in Baltimore City, a third were recently arrested in the previous six months, and of those, the arrests were disproportionately African-American persons and characterized as nonviolent, i.e., drug possession/attempt to purchase (38%) and loitering (29%). Poisson regression models were built adjusted for age, sex, race, education level, homelessness, and monthly income after exploring bivariable characteristics of arrests using chi-squared tests. Active drug use was associated with a recent arrest (adjusted prevalence ratio: aPR 2.38 95% CI 1.6, 3.6), in addition to participants who recently reported attending a syringe exchange program (aPR 1.45 95% CI 1.1, 2.0). Our findings are suggestive of recent media coverage and burgeoning research revealing the prioritization of policing resources toward both communities of color and neighborhoods of intensified drug trafficking. Further research is warranted to contextualize the operationalization of criminal justice resources and the impact on community health.     

Dr. Death? Professionalism,Virtue, and U.S. Physician Participation in the Death Penalty

In the United States at present, the death penalty is a possible sentence in 31 out of 50 states, as well as within the military and for federal cases. In the U.S., numbers of executions are declining, in part due to moratoriums in place and challenges to execution by lethal injection. Participation by physicians in lethal injection executions has been steadfastly viewed by professional medical organizations as contrary to their ethical standards. However, physicians have participated in lethal injection executions, and the morality of the death penalty itself is a matter of intense social and political debate. Medical ethics commentators and professional organizations have typically held that the prohibition on physician participation in the death penalty is independent of the ethical status of the death penalty itself. This article argues that this view is untenable, and that it is tied to a view of professional role virtue that is similarly untenable. At the same time, it argues that, given the morally uncertain status of the death penalty, it is plausible that virtuous physicians may either refuse or choose to participate in some aspects of the death penalty.     

论我国注射死刑的平等适用

目前,我国在执行注射死刑时存在不能完全平等适用的问题。这种不平等适用体现为不同身份的死刑犯适用不平等、不同地区的死刑犯适用不平等、不同罪行的死刑犯适用不平等等方面。注射死刑不平等适用违反了法律面前人人平等原则,引起社会的诸多质疑。而注射死刑未平等适用的原因较为复杂,既因立法上存在漏洞,又受到注射成本过高,地方司法机关推动力度不够,民众报应观念较强等因素制约。     

香丹注射液治疗心肌缺血血瘀证32例

目的：观察香丹注射液治疗心肌缺血（血瘀证）的临床疗效。方法：68例心电图提示心肌缺血且中医辨证属血瘀证患者随机分为西药对照组（简称对照组）30例和香丹注射液治疗组（简称治疗组）38例,对照组予消心痛5－10g,每日3次,或鲁南欣康10－20mg,每日2次;治疗组在对照组治疗基础上,用香丹注射液20ml加入50g/L葡萄糖溶液200ml中静滴,疗程均为14d。结果：治疗组总有效率达94．74％,对照组为76．67％,两组比较差异显著（P＜0．05）;治疗组胸闷,心绞痛,舌紫暗等症状,体征消减率均高于对照组（P＜0．05或P＜0．01）;心电图及血液流变性各项指标的改善均较对照组明显（P＜0．05或P＜0．01）。结论：香丹注射液对血瘀证的多种心脏病所致心肌缺血有较好疗效。     

丹参注射液对格列喹酮在糖尿病大鼠体内药物代谢动力学参数和肠吸收特性的影响

目的考察丹参注射液对格列喹酮在糖尿病大鼠体内药物代谢动力学参数的影响,为两药的临床合用提供依据。方法链脲佐菌素腹腔注射建立糖尿病大鼠模型,考察丹参注射液对格列喹酮药物代谢动力学参数的影响;建立原位在体肠循环模型,研究丹参注射液对格列喹酮肠吸收特性的影响。结果糖尿病大鼠的药物代谢动力学研究结果表明,两药合用能够显著缩短格列喹酮的达峰时间,增加最大药物浓度、药时曲线下面积,并且可以显著减少清除率。肠吸收特性实验结果显示,丹参注射液可以显著增加格列喹酮在糖尿病大鼠体内吸收速率和表观渗透系数。结论丹参注射液和格列喹酮合用可以显著提高糖尿病大鼠格列喹酮的血药浓度和生物利用度,其原因可能与丹参注射液促进格列喹酮的小肠吸收相关。     

中药胃管注入治疗肠梗阻临床观察

目的观察中药胃管注入治疗肠梗阻的临床疗效。方法将114例肠梗阻患者随机分为研究组和对照组,每组57例。对照组仅给予外科基础治疗,研究组在对照组疗法基础上辨证给予具有行气活血通腑、活血解毒通腑、健脾润肠功效的中药经胃管注入治疗。治疗结束后观察两组临床疗效和中转手术率。结果研究组临床疗效显著优于对照组(P0.05),中转手术率显著低于对照组(P0.05)。结论在外科基础治疗之上,经胃管辨证给予具有行气、活血、解毒、通腑、健脾、润肠功效的中药能提高肠梗阻的临床疗效,降低中转手术率。     

关节腔注射、运动疗法联合中药熏洗治疗粘连期肩周炎的临床观察

目的 探讨关节腔注射、运动疗法联合中药熏洗治疗粘连期肩周炎的临床疗效。方法 将90例粘连期肩周炎患者随机分为对照组和治疗组,每组45例。对照组采取关节腔注射联合运动疗法治疗,治疗组在此基础上加用中药熏洗治疗,疗程为2周。治疗前后采用视觉模拟量表（visual analogue scale,VAS）评价肩关节疼痛程度,采用肩关节功能Melle评分量表及肩关节活动度评价肩关节活动度和功能,并观察两组临床疗效。结果 治疗后两组患者VAS评分、Melle评分均较治疗前降低（P＜0.05）;两组Melle评分差值比较,差异有统计学意义（P＜0.05）。治疗后两组患者的肩关节外展、内旋、外旋活动度均较治疗前增加（P＜0.05）;治疗组患者肩关节外展、内旋、外旋活动度升高值均显著高于对照组（P＜0.05）。两组临床疗效分布比较,差异有统计学意义（P＜0.05）。结论 两种治疗方案均能减轻肩关节疼痛,改善肩关节功能,关节腔注射、运动疗法联合中药熏洗对粘连期肩周炎的疗效优于关节腔注射联合运动疗法,能更好地改善肩关节功能和活动度。