参加临床药师规范化培训的学习体会

目的:总结参加临床药师培训的收获与感想,为学员参加临床药师培训提供参考。方法:结合笔者亲身实践,介绍参加临床药师培训的经验及体会。结果:通过一年培训,笔者加强学习与实践,培养了临床思维与药学思维,完成了普通药师向临床药师的转变。结论:临床药师培训可以提高学员的综合素质,是培养临床药师的重要过程。     

心血管专业临床药师培训方法探讨

目的:探索心血管专业临床药师完成临床培训阶段的切实可行的培训方法。方法:通过笔者亲身实践,结合培训单位的要求和自己的体会进行分析总结。结果:临床药师培训可以从明确培训目标、帮助药师掌握临床基本技能和知识以及培养其与医护人员、患者交流能力3方面着手。结论:掌握一种好的培训方法,有利于心血管专业临床药师尽快适应临床工作,尽早成为临床治疗团队中的一员。     

卫生部临床药师培训基地带教模式的探索与实践

目的:为规范临床药师培训工作提供参考。方法:根据卫生部临床药师培训工作要求,结合我院工作实践,对现阶段临床药师的培训工作模式进行分析总结,探索并建立一套切实可行的临床药师培训工作标准操作规程。结果与结论:我院带教老师在带教工作中不断探索,加强组织管理,突出临床实践,优化培训方案,并严把考核关,形成了一套临床药师培训工作标准操作规程,可用于规范临床药师培训工作。     

我院临床药师培训基地带教模式浅析

目的:为建立规范化的临床药师带教模式提供参考。方法:结合原卫生部发布的关于临床药师培训基地的培训要求,回顾分析我院临床药师培训的带教过程,总结经验心得。结果与结论:我院在严格执行原卫生部关于临床药师培训基地培训要求的基础上,进一步规范组织管理、细化培训流程,制订了详细的理论与实践的教学计划,初步形成了较为规范的临床药师带教模式。该模式不仅培养了学生理论与实践的衔接能力,还能做到"教学相长"。     

基于临床问题的Seminar教学法在临床药师培训中的应用

摘 要 探讨Seminar教学法在临床药师培训中的应用。提出能够显示临床药师培养的重点和难点,对于临床技能培养有引导作用的40个临床问题,与国际规范的Seminar教学法相融合,进行实践总结。旨在推进我国临床药师培训国际化进程,提升临床药师教育水平和工作胜任能力。     

临床药师带教师资培训的实践与体会

目的:探索临床药师带教师资培训的模式与具体方法。方法:结合医院开展临床药师师资培训的经验,总结师资培训的目的、模式、步骤及体会。结果:临床药师师资培训与临床药师培训有所不同,应明确师资带教的目的,由医院有关部门负责统筹安排,多科室协作,药学部具体实施,以临床实践为基础,制订适合于师资培养的带教方案与内容。结论:根据实际工作所得到的师资培训工作经验行之有效,但仍有待完善。     

上海市中医临床药师规范化培训模式探索和实践

目的： 适应上海市医政工作新形势和临床药学学科发展新需求,探索和实践上海市中医临床药师规范化培训模式。方法： 参考上海市西医通科临床药师在职规范化培训模式,制定上海市中医临床药师规范化培训方案,组织开展培训工作。培训工作结束后,对培训基地和学员进行了调研,参考调研结果对培训方案进行调整。部分基地在完成培训大纲要求外,对培训内容和形式进行了拓展与实践。结果： 培训工作主要由师资培训、基地遴选、学员培训、调研和改进四部分组成,其中学员培训包括集中理论知识培训、门诊抄方、审方实践和临床实践。首期遴选出4家医院作为首批中医临床药师培训基地,第一、二期分别有31名和40名学员通过考核取得培训合格证书。参考调研结果,增加了门诊审方、门诊抄方和临床实践时间,门诊审方增加了中药饮片处方点评内容。曙光医院基地通过课堂授课、知识手册学习以及参观实践,加强对学员理论知识和实践技能的培训。结论： 上海市中医临床药师规范化培训模式是可行的,为本市二、三级医院培养了一批中医临床药师,加强了医疗机构临床药师队伍建设,使临床药学服务体系更加完善。     

卫生部临床药师培训模式及带教经验

临床药师是临床药学工作的主体,为探索有效的临床药师培养模式,为药学工作提供借鉴。该文从卫生部临床药师培训基地具体实践着眼,对卫生部临床药师培训模式、目标、标准以及基地带教经验作一探讨。     

药剂师向临床药师转型的体会与思考

结合临床工作经历从普通药剂师向临床药师转型的体会及思考, 探索我国临床药师培训的有效路径, 促进临床药学发展. 学习、实践及自我准确定位的结合, 可使药师成为适应临床需要的合格临床药师.     

我院住院药师药物咨询培训的实践与探索

目的:建立住院药师药物咨询培训体系,培养具备药物咨询能力的住院药师。方法:对我院住院药师进行药物咨询培训,培训内容包括药物咨询工作流程、药物咨询常用查询工具、沟通技巧、专业技能实践、突发事件的处理和文献检索方法等。结果与结论:经过药物咨询教学培训的住院药师已基本具备药物咨询的专业实践能力,实现了药学基础理论与临床实践的结合。     

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.