数理方法筛查影响Ⅱ类错(牙合)功能矫治的因素

目的:通过比较功能矫治前后和自然生长前后颅(牙合)面的变化,排除自然生长的因素干扰,找到影响Ⅱ类错(牙合)患者功能矫治疗效的主要因素.方法:应用数理统计原理,逐步筛查出影响功能矫治疗效的主要指标.结果:排除自然生长的因素后, U1-NA(mm)、U1-NA、APDI、Ls-EP为判断Ⅱ类错(牙合)矫治疗效的4项主要指标.     

关于开办“国家中医药管理局中医农村适宜技术推广专栏”的函

各有关单位:为了落实国家中医药管理局《关于实施中医临床适宜技术推广计划的通知》(国中医药函[2006]58号)和《关于加强中医临床诊疗技术推广工作的通知》(国中医药函[2005]131号)文件精神,进一步做好中医农村适宜技术的推广工作,充分发挥中医药的特色和优势,提高农村中医药服务水平,我“中心”在《中国乡村医药》杂志开设了“国家中医药管理局中医农村适宜技术推广专栏”,我们将有计划的分期分批刊登中医农村适宜技术相关内容以及应用过程中的成功经验和体会,同时将开展多种形式的技术继续教育培训。希望各有关单位积极配合我们做好此项工…     

学分证书通知

"农村中医适宜技术专栏学分考试试题"及答题卡已在2013年第9期杂志上刊登。"农村中医适宜技术讲座"(国家I类学分12分),学员学习经考试合格,可申请全国继续医学教育学分证书,有关事项如下:1.请挂号寄来准确的以下个人信息,不可缺项(这是办证必备的要求):①姓名,②身份证号,③职称,④专     

潍坊市农村消费者购药决策影响因素分析

该文对农村消费者购药决策影响因素进行调查分析，结果表明，影响农村消费者购药决策的因素中，重要性顺序为疗效、价格、医生/店员推荐、促销、品牌、广告、相关群体。剂型与疗效认识存在偏差，疗效与价格存在不对等；经济状况对药品价格、文化程度对品牌选择无统计学意义，药价仍需下降，促销提升销量；信任品牌药品；医生店员推荐成功率高。建议医药企业生产传统剂型、规格成本低的药品投放农村市场；开展符合农村市场的品牌宣传活动；重视与基层医疗机构、药店合作。     

以病定技术中医适宜技术在石岩街道社区应用效果评价

目的研究以病定技术中医适宜技术在石岩街道社区应用效果。方法抽取石岩街道社区2015年6~8月选取以病定技术中医适宜技术分别为耳穴疗法治疗失眠、中药雾化治疗慢性咽炎、封包疗法治疗风湿性关节炎、艾灸治疗慢性结肠炎200例患者作为观察组,另选取单纯使用常规治疗方案进行治疗的200例患者作为对照组,比较两组临床疗效、满意度和费用。结果观察组患者总满意人数为180例,总满意率为90%,对照组患者总满意人数为132例,总满意率为66%,观察组患者社区中医适宜技术应用的满意度明显高于使用常规治疗方案患者,差异具有统计学意义(P0.05);观察组患者总有效率为92%,对照组总有效率为为73%,两组比较差异有统计学意义(P0.05);观察组患者平均医疗费用(358.5±58.4)元,对照组患者平均医疗费用(386.8±109.4)元,两组患者医疗费用比较差异无统计学意义(t=1.282,P0.05)。结论以病定技术中医适宜技术逐渐在社区家庭病床患者的治疗中得到应用,能够提高病人的满意率,提高临床疗效,可以大范围推广。     

学分证书通知

"农村中医适宜技术专栏学分考试试题"及答题卡已在2013年第9期杂志上刊登。"农村中医适宜技术讲座"(国家I类学分12分),学员学习经考试合格,可申请全国继续医学教育学分证书,有关事项如下:1.请挂号寄来准确的以下个人信息,不可缺项(这是办证必备的要求):①姓名,②身份证号,③职称,④专业,⑤学历,⑥通信地址,⑦邮编,⑧单位名称,⑨联系电话。     

上海市社区中医药适宜技术应用效果评价研究

目的:评价上海市社区中医药适宜技术的应用效果,为中医药适宜技术在社区卫生服务中心推广应用提供技术支撑。方法:采用回顾性调查、现况调查和小组访谈的方法,对开展中医药适宜技术的社区卫生服务中心进行调查,重点了解上海市7项适宜技术开展情况,系统评价中医适宜技术项目实施的技术和效果。结果:7项中医药适宜技术服务具有有效率高(84.21%)、中医药服务量增高(44.90%),患者满意度高(82.11%)的优势,但亦有部分中医药适宜技术项目存在适应病例较少(50.00%)、收费混乱(33.52%)、经费紧缺(24.18%)的问题。结论:上海市在社区卫生服务中心开展中医药适宜技术取得了良好的效果,为在上海市和其他地区推广应用提供了经验。     

关于申请2015年度全国继续医学教育学分证书的通知

“农村中医适宜技术专栏学分考试试题”及答题卡将在2015年第9期杂志上刊登。本次继续教育项目名称:“中医临床诊疗技术培训班”,学员学习经考试合格,可申请全国继续医学教育学分证书(国家I类学分10分),有关事项如下:1.请挂号寄来准确的以下个人信息,不可缺项(这是办证必备的要求):1姓名,2身份证号,3职称,4专业,     

药物性肝损伤的临床特点及其预后评估

目的 总结药物性肝损伤(DILI) 的临床特点,探讨评估DILI预后的因素.方法 回顾性分析近5年安徽医科大学第一附属医院消化内科DILI的106例临床资料,运用Logistic回归分析筛选影响预后的指标.结果 DILI病人女性较多(61例,57.5%) ,平均年龄(51.9±16.9)岁,用药以中药、抗菌类及解热镇痛类为主.肝细胞型DILI多见(86例,81.1%),严重程度分级中以中度居多(58例,54.7%),97例(91.5%)病人预后良好.不同严重程度肝细胞型DILI间Hy′s 法则符合率不同(P<0.05),符合此法则的肝细胞型DILI病人肝衰竭的发生率为22.9%(11/48).多因素回归分析显示:影响预后的指标为丙氨酸氨基转移酶(ALT)(OR=1.672,P<0.05)、国际标准化比值(INR)(OR=8.852,P<0.05).结论 DILI病人大部分预后较好.发病时ALT及INR是预测DILI预后的独立指标.     

农村适宜技术

在国家农村卫生工作的总体部署精神指导下,为充分发挥中医药的优势和特色,不断满足广大农民对中医药的需求,使农村中医药服务功能进一步完善,提高农村中医药服务水平,由国家中医药管理局(包括解放军总后卫生部)组织专家筛选确定,疗效确切,适合农村基层医生学习和便于操作的医疗技术。农村适宜技术栏目是针对基层医疗机构进行继续教育的专栏。内容包括:技术特色、适应证诊断、优势病种的介绍、技术应用的禁忌、治疗方法介绍、技术要领、注意事项等内容。     

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。     

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.     

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.     

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.     

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。