雾化疗法应用于小儿支气管肺炎的临床应用价值分析

目的探讨雾化疗法应用于小儿支气管肺炎的临床应用价值分析。方法选取2013年1月至2014年1月,到我院就诊的小儿支气管肺炎患者101例,随机分为试验组(51例)与对照组(50例),两组患者均给予相同的对症治疗,对照组使用氨溴索静脉滴注,试验组采用对照组的基础上使用布地奈德雾化吸入,观察两组患者呼吸频率以及氧饱和度等指标的改变。结果治疗后试验组呼吸频率以及氧饱和度指标优于对照组,差异有统计学意义(P<0.05)。结论使用雾化疗法治疗小儿支气管肺炎临床效果显著,值得在临床推广。     

氧驱动雾化吸入盐酸氨溴索联合布地奈德治疗小儿支气管肺炎78例疗效分析

目的：探讨临床上对小儿支气管肺炎患儿采用布地奈德联合盐酸氨溴索氧驱动雾化吸入治疗方案的疗效性以及安全性。方法156例支气管肺炎患儿,随机分为对照组和治疗组,每组78例,两组患儿在入院后均给予临床常规的支气管肺炎治疗,对照组在此基础上氧驱动雾化吸入布地奈德,治疗组在对照组基础上给予盐酸氨溴索,对比分析两组患儿临床主要症状改善、消失时间、住院时间以及不良反应等。结果治疗组总有效率97.44%明显优于对照组83.33%,差异具有统计学意义(P<0.05);临床症状改善、消失时间以及住院时间相比于对照组患儿明显缩短,差异均具有统计学意义(P<0.05);两组患者在治疗期间均无不良反应发生(P>0.05)。结论氧驱动雾化吸入布地奈德治疗以及氧驱动雾化吸入布地奈德联合盐酸氨溴索治疗小儿支气管肺炎安全性高均较高,联合疗法更加有效的改善各指标,值得广泛应用于临床。     

氨溴索雾化吸入佐治小儿支气管肺炎临床疗效回顾

目的:回顾盐酸氨溴索注射液雾化吸入佐治小儿支气管肺炎的临床疗效。方法:将96例肺炎患儿随机分为治疗组(氨溴索组)和对照组。结果:治疗组有效率97.92%,对照组有效率81.25%,两组比较有显著差异(P<0.05)。结论:回顾既往小儿肺炎治疗时加用氨溴索雾化吸入治疗临床效果明显,简单易行,值得基层医院临床推广使用。     

布地奈德雾化吸入联合氨溴索在小儿支气管肺炎辅助治疗中的临床应用

目的探讨布地奈德雾化吸入联合氨溴索在小儿支气管肺炎辅助治疗中的临床应用价值。方法将140例确诊为小儿支气管肺炎的患儿随机分为治疗组(67例)和对照组(73例)。两组患儿均入院后都给予相同的对症支持治疗。对照组给予口服必嗽平片祛痰;治疗组静脉注射氨溴索同时给予雾化吸入布地奈德。对比两组患儿的临床疗效,呼吸频率以及氧饱和度等指标的改变。结果治疗后,治疗组氧饱和度为(98.3±1.2)%,对照组为(90.2±1.7)%,两组比较具有显著的统计学差异(P<0.05);治疗组呼吸频率为(23±2)次/min,对照组为(35±2)/min,两组比较具有显著的统计学差异(P<0.05);治疗组总有效率为100%,对照组为90%,两组比较具有显著的统计学差异(P<0.05)。结论布地奈德雾化吸入联合氨溴索在小儿支气管肺炎的治疗中较必嗽平片具有更好的祛痰效果,能有效提高小儿支气管肺炎的治愈率,值得临床应用。     

超声雾化吸入野菊花注射液佐治婴幼儿支气管肺炎疗效观察

目的:探讨超声雾化吸入野菊花注射液佐治婴幼儿支气管肺炎的临床疗效。方法:将137例婴幼儿支气管肺炎患儿随机分为治疗组69例和对照组68例,两组均给予常规综合治疗,治疗组在常规综合治疗基础上超声雾化吸入野菊花注射液,对照组在常规综合治疗基础上超声雾化吸入灭菌蒸馏水。治疗过程中观察患儿发热、咳嗽、喘息、气促及肺部干湿啰音消失情况,治疗前及治疗后第3天监测血常规和CRP水平。结果:治疗组患儿发热、咳嗽、喘息及肺部体征消失时间均早于对照组(P<0.05),平均住院时间少于对照组[(13.7±3.7)d vs(16.2±4.5)d,P<0.05],白细胞计数及CRP水平均较治疗前降低(P<0.05),且均低于对照组(P<0.05),总有效率高于对照组(89.9%vs 67.6%,P<0.05)。结论:超声雾化吸入野菊花注射液佐治婴幼儿支气管肺炎具有明显疗效。     

布地奈德联合盐酸氨溴索雾化吸入治疗小儿支气管肺炎的疗效评价

目的探讨布地奈德联合盐酸氨溴索雾化吸入治疗小儿支气管肺炎的临床疗效。方法选取我院收治的124例小儿支气管肺炎患者,随机分为观察组(布地奈德+盐酸氨溴索)和对照组(盐酸氨溴索)各62例。对比两组临床疗效。结果观察组总有效率95.16%显著高于对照组75.81%(P<0.05)。观察组症状改善时间和住院时间均显著短于对照组(P<0.05)。结论小儿支气管肺炎应用布地奈德联合盐酸氨溴索雾化吸入效果显著,能够有效改善患儿临床症状和体征,值得临床推广。     

盐酸氨溴索与普米克令舒联合雾化吸入治疗小儿支气管肺炎效果及安全性评价

目的 探讨盐酸氨溴索与普米克令舒联合雾化吸入治疗小儿支气管肺炎的效果及安全性.方法 收集我院2015年1月至2015年11月入院的160例支气管肺炎患儿随机分为两组,对照组患儿给予传统常规治疗,实验组患儿加用盐酸氨溴索与普米克令舒联合雾化吸入治疗,比较两组患儿总体治疗效果评价、呼吸频率与血氧饱和度水平、相关临床指标与安全性等.结果 实验组患儿治疗总有效率明显高于对照组,差异有统计学意义(P＜0.05);实验组患儿治疗后呼吸频率显著低于对照组,血氧饱和度显著高于对照组,差异有统计学意义(P＜0.01);实验组患儿退热时间、湿啰音消失时间与住院时间显著短于对照组,差异有统计学意义(P＜0.01);两组患儿不良反应与并发症发生率不存在统计学差异(P＞0.05).结论 盐酸氨溴索与普米克令舒联合雾化吸入治疗小儿支气管肺炎效果显著,且安全性较高,具有借鉴性.     

氨溴索治疗小儿支气管肺炎49例疗效分析

目的探讨氨溴索雾化吸入治疗小儿支气管肺炎的临床疗效。方法将99例小儿支气管肺炎患儿随机分为2组,对照组50例在常规治疗的基础上给予α-糜蛋白酶1000U高频雾化吸入;治疗组加用氨溴索注射液雾化吸入,均每天2次,疗程7d。疗程结束后观察2组疗效。结果治疗组总有效率为95.9%明显高于对照组的78.0%,差异有统计学意义(P<0.05)。结论氨溴索雾化吸入治疗小儿支气管肺炎疗效较满意,安全性好,值得推广应用。     

盐酸氨溴索雾化治疗小儿支气管肺炎疗效分析

目的：观察盐酸氨溴索雾化吸入法治疗小儿支气管肺炎的疗效。方法：将116例小儿支气管肺炎患儿随机分为治疗组和对照组,均给予常规抗感染及对症等治疗,治疗组增用氧驱动泵雾化吸人盐酸氨溴索注射液,对照组给予氧驱动泵雾化吸入糜蛋白酶治疗。结果：治疗组总有效率为92.0%,对照组总有效率为77.3%,两组比较差异有显著性（P〈0.05）,治疗组疗效明显好于对照组。结论：盐酸氨溴索雾化吸入治疗小儿支气管肺炎疗效较好。     

痰热清注射液联合盐酸氨溴索佐治小儿支气管肺炎38例

目的 观察痰热清注射液联合盐酸氨溴索佐治小儿支气管肺炎的临床疗效,探讨护理对策。方法 将76例小儿支气管肺炎患儿随机分为治疗组和对照组,各38例。两组均给予抗感染、止咳化痰、降温等综合治疗及常规护理,治疗组加用痰热清注射液静脉滴注和雾化吸入盐酸氨溴索,并给予综合护理干预,7 d为1个疗程。比较两组患儿的临床疗效和主要症状及体征消失、体温复常时间、住院时间,调查护理满意度。结果 治疗组的总有效率为94.74%,明显高于对照组的81.58%(P<0.05);观察组主要观察指标及护理满意度均优于对照组(P<0.05)。结论 痰热清注射液联合盐酸氨溴索并结合综合护理干预治疗小儿支气管肺炎,可缩短病程,提高疗效及护理满意度,值得临床推广。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

基层医院护士在临床合理用药中的作用

目的充分利用护士在医师和患者间的特殊地位和作用,促进基层临床合理用药。方法从护士的工作性质出发,论述护士参与促进合理用药的方便和优势。结果通过实践,护士在促进合理用药中的作用得到有效发挥,基层合理用药环境得到极大改善。结论充分利用护士与医师和患者间的特殊桥梁作用,在基层医院促进合理用药,规范医师用药行为,防止药物滥用,引导患者安全用药,降低药源性疾病。