13家医疗机构儿科常用中成药说明书信息及标注情况分析

目的:通过调查13家医疗机构儿科门急诊常用中成药说明书及信息标注情况,分析儿科常用中成药说明书中存在的问题,并提出相关建议.方法:根据13家医疗机构儿科常用的340种中成药信息,对功能主治、剂型、辅料、含毒性药物、儿童用法用量等项目进行统计分析.结果:340种中成药中,31.76％为儿童专用药.以清热、化痰、止咳平喘类中药使用最多,且以口服剂型居多.明确标注辅料信息的中成药构成比为46.18％;含毒性成分中成药为34.12％.用法用量按儿童年龄段明确标注的占31.76％.结论:儿科常用中成药说明书存在儿童用药及安全性信息标注不全的情况,为确保中成药在儿科临床应用的有效性和安全性,应充分考虑儿童群体的特殊性.     

《中国药典》收载儿科用中成药临床应用现状分析

目的:剖析我国儿科用中成药临床应用的现状及其相关问题,为我国中成药在儿科的合理应用提出建议。方法:统计2010年版《中国药典》收录的176个儿科用中成药的功能主治、剂型和剂量,与国家公布的非处方药目录比较,并查阅相关近期的临床研究报道,统计、分析临床应用的情况。结果与结论:此次统计范围中,共有104个儿科用中成药被遴选为非处方药,存在治疗病症比较集中、部分品种未公布处方药味剂量、有1/2的儿科用中成药未见临床应用研究报道等问题。应深入儿科用中成药临床应用研究,建立安全性、必要性再评价机制,为儿科用中成药合理使用提供参考,并加强药品标准建设,淘汰临床不适宜品种。     

儿科中成药用药交代服务策略的优化

中成药在我国儿科药物治疗中有着独特的实践经验和治疗优势。为了彰显中医药在儿科健康服务中的特色优势,应针 对儿科中成药的特点在用药指导方面给出清晰合理的交代,探索符合中医药特色的用药交代模式。本文基于儿科中成药使用 现状和青岛妇女儿童医院常用品种目录,立足于药师用药交代的工作需求,针对当前儿科中成药用法用量不精准、说明书和指 南参照标准不全、含毒性饮片品种的忽视、中西医证型不匹配等诸多难点进行思考并提出建议。以聚焦中成药的证候禁忌、配 伍禁忌、饮食禁忌、服药时间和特殊成分等基本信息为重点构架,建立并优化儿科中成药用药交代的系统模式。希望有助于拓 宽药学服务的广度和深度,促进儿科中药临床应用的高质量发展     

福州市第一医院2011年儿科门诊中成药使用分析

目的:了解福建医科大学附属福州市第一医院儿科门诊中成药使用情况,以提高中成药合理使用水平,保障儿童用药安全。方法:收集2011年该院儿科门诊处方48 076张,对其中的3 164张中成药处方进行回顾性分类归纳和统计分析。结果:该院儿科门诊中成药处方占儿科门诊处方的6.58%,儿科门诊中成药销售金额占儿科门诊销售金额的4.73%,所占比例均较低;儿科中成药不合理使用主要表现为辨证不足(44.07%)、用法用量不当(20.69%)。结论:该院儿科中成药临床应用基本合理,但存在辨证不足、用法用量不当现象,应加强中医的辨证施治,规范中成药的临床使用,提高合理用药水平。     

基于循证医学的《儿童中成药研发目录建议清单》研究

目的 制定《儿童中成药研发目录建议清单》，为促进儿童中药创新研发提供参考依据。方法 以儿科领域临床优势病种为切入点，以儿童中成药“未满足的临床需求”为导向，通过文献计量法、专家问卷调查法和专家论证会等循证医学方法，立足国家中药研发制度，系统梳理儿童中成药应用现状，儿科临床疾病诊疗需求及现有人用经验等，形成清单证据体。结果 制定了涉及10个系统包含22个优势病种的《儿童中成药研发目录建议清单》。整体上明确了儿童中成药新药的两大研发思路：一是老药新用，增加完善儿童用法用量；二是进行新药研发。结论 《儿童中成药研发目录建议清单》的制定为儿童用药不足的关键问题提出方向性的解决策略，有力地推动儿童中成药新药的研发上市。     

儿科医院中成药的应用状况

目的 对本院儿科门诊最近几年中成药应用的情况进行调查,为规范儿科用药及临床用药提供相关的参考依据。方法 借助计算机对儿科2012年-2013年应用的中成药进行统计,对所有中成药品种、出库数量、金额依据剂量类型、作用进行系统分类。结果 本院2012-2013年共计中成药87种,其中儿科中成药53种,占60.92%;分析显示,在这87类中成药中,适合婴幼儿用药且不会产生明显抗拒性的中成药类别共有71种,占81.60%,其中有53种完全符合儿童用药的中成药,占60.92%;依据中成药作用类别划分发现,本院中成药品种类型最多的几种依次为清热解毒剂、祛痰止咳剂、补益剂等,其所占比例依次为17.24%、14.24%、11.49%,而完全适合儿科用药在三类中所占比例分别为60.0%、69.2%和50.0%。结论 本院2012-2013年儿科中成药的临床应用针对性较强,大部分中成药都是依据儿童用药使用,不适合儿童用药较少,符合儿童专科医院的本质。     

我院儿科急诊应用中成药现状分析

目的:分析我院儿科急诊应用中成药的现状,为儿科合理应用中成药提供参考.方法:整理2018年我院使用的中成药药品说明书,随机抽取2018年8-10月的急诊儿科处方1180张,根据药品说明书对中成药的使用情况进行统计分析.结果:2018年我院儿科急诊使用了13种中成药,其中5种(38.47％)药品说明书中无儿童用法用量信息,7种(53.85％)不良反应"尚不明确",10种(76.92％)禁忌"尚不明确";13种中成药均合多种药味成分,其中超过5种药味成分的品种占61.54％(8/13).抽查处方中,42.20％(498/1180)开具中成药(均由西医师开具),16.95％ (200/1180)存在中成药联用.结论:儿科急诊应用中成药存在诸多局限,联用中成药时,成分重复的现象明显,应引起重视.     

胃复春综合评价研究

目的:以临床常用药物胃复春为例,探索中成药综合评价的内容和方法,为中成药的临床合理使用、中成药价值的研究开发以及药品相关决策提供依据,推动合理用药.方法:基于系统检索文献和药品生产企业获得的研究资料,利用循证医学和药物经济学等卫生技术评估基本方法,从药学特性、安全性、有效性、经济性、适宜性、可及性和创新性等方面对胃复春...     

我院儿科门诊中成药应用情况分析

目的：调查我院儿科门诊中成药应用情况,为临床合理用药提供参考依据。方法：对4299张儿科中成药处方,中药物剂型、疾病类别、总销售金额、用药频度、日均费用进行统计、分析。结果：销售金额较高的剂型为口服液、合剂与颗粒剂;中成药在儿科呼吸系统、消化系统及耳鼻喉疾病方面的应用频率较多;用药频度排名前3位的中成药分别为金振口服液、四君子合剂和醒脾养儿颗粒。结论：我院儿科门诊中成药应用基本合理。     

FDA对儿科医疗器械的上市前评价

目的介绍FDA对以儿科为对象的医疗器械上市前评价。方法明确了保证医疗器械（预期用于儿科群体）安全性、有效性需要的信息类型,还为针对儿科对象的医疗器械临床试验提供了指导原则和保护原则。结果与结论 FDA在儿科医疗器械上市前的评价中有特殊的关注点,以确保用于儿科群体的医疗器械安全有效。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.