头孢地嗪治疗社区获得性下呼吸道感染患者的临床效果分析

目的:探究头孢地嗪治疗社区获得性下呼吸道感染患者的临床效果,总结临床经验。方法:以2014年12月23日~2016年12月23日在某院就治的146例社区获得性下呼吸道感染患者作为观察对象,随机数字表法分组。对照组73例患者应用常规治疗,观察组73例患者在常规治疗的基础上应用头孢地嗪治疗,研究对比两组患者的临床疗效、症状改善时间、痰培养转阴时间及不良反应发生率。结果:观察组治疗的总有效率为95.89%,相比对照组(78.08%)明显更高,P0.05;观察组患者治疗后的咳痰、发热、呼吸困难、肺部音、痰培养转阴时间分别为(2.24±1.30)d、(2.30±1.26)d、(2.54±1.16)d、(3.24±1.34)d、(3.84±1.05)d,相比对照组明显更短,P0.05;观察组73例患者的不良反应发生率为5.48%,和对照组(2.74%)无明显区别,P0.05。结论:对社区获得性下呼吸道感染患者采取头孢地嗪进行治疗,能显著缓解患者的临床症状,改善患者预后,且副作用较小,使用安全。     

老年患者下呼吸道感染3种治疗方案的成本-效果分析

目的分析3种不同治疗方案对老年患者下呼吸道感染所产生的疗效及经济效果。方法将98例住院患者随机分成3组,分别给予头孢地嗪(A组)、甲磺酸帕珠沙星(B组)、哌拉西林舒巴坦(C组)治疗10 d,运用最小成本法进行经济学评价。结果 A组、B组、C组总有效率分别为85.29%,87.50%,81.25%,成本-效果比分别为14.26,13.23,17.43。结论甲磺酸帕珠沙星治疗老年患者下呼吸道感染是较佳方案。     

分析莫西沙星治疗老年呼吸道感染的有效性与安全性

目的研究莫西沙星治疗老年呼吸道感染的有效性与安全性。方法选择我院2017年5月至2018年5月收治的呼吸道感染老年患者72例,按照随机分组方式分为莫西沙星组(莫西沙星治疗)及头孢组(头孢治疗),对比两组患者治疗后的治疗效果、症状消失时间和不良反应发生概率。结果进行治疗后,莫西沙星组的治疗效果、症状消失时间明显优于头孢组,不良反应发生率明显低于头孢组,结果均具有显著差异(P <0.05)。结论使用莫西沙星对老年呼吸道感染患者进行治疗,可以有效提高其治疗效果,且不良反应发生情况少,安全性较高,值得临床相关医务工作者进行推广应用。     

橘红痰咳液联合拉氧头孢钠治疗小儿下呼吸道感染的临床研究

目的:探讨橘红痰咳液联合拉氧头孢钠治疗小儿下呼吸道感染的临床疗效。方法:选择2017年1月~2019年7月我院治疗的71例下呼吸道感染患儿,应用随机数表法分为观察组(36例)、对照组(35例)。对照组接受拉氧头孢钠治疗,观察组则加用橘红痰咳液治疗。对比两组临床疗效、症状消失时间及不良反应。结果:观察组总有效率(94.44%)高于对照组(74.29%),差异有统计学意义(P<0.05);观察组咳嗽消失时间(4.29±0.86)d、气喘消失时间(3.46±0.76)d、发热消失时间(3.21±0.92)d、肺啰音消失时间(5.16±1.13)d,短于对照组的(5.58±1.27)d、(5.24±0.97)d、(4.30±1.01)d、(6.74±1.52)d,差异有统计学意义(P<0.05);观察组与对照组不良反应发生率相比(5.56%VS 2.86%),差异无统计学意义(P>0.05)。结论:下呼吸道感染患儿接受橘红痰咳液、拉氧头孢钠联合治疗安全性高且疗效好,有利于加快症状缓解,消除肺部症状,改善病情。     

盐酸头孢吡肟治疗小儿下呼吸道感染87例疗效观察

目的评价头孢吡肟（Cefepim,FEP）治疗小儿下呼吸道感染的临床疗效。方法87例患者,分成治疗组46例和对照组41例,分别应用头孢吡肟和头孢地嗪,剂量均为50mg/（kg.d）,1次/12h,静脉滴注给药,疗程7～10d。结果头孢吡肟和头孢地嗪临床有效率分别为91.3%、87.8%,细菌清除率分别为91.0%、87.0%,不良反应发生率较低。结论头孢吡肟可作为治疗小儿下呼吸道感染有效和安全的抗生素。     

盐酸氨溴索用于下呼吸道感染50例的临床评价

目的观察盐酸氨溴索治疗下呼吸道感染的临床疗效和安全性。方法选择2011年1月至2012年6月医院收治的下呼吸道感染患者100例,随机分成两组,各50例。对照组给予β-内酰胺类抗生素(头孢唑林、头孢噻肟、头孢曲松等)持续静脉滴注。治疗组加用盐酸氨溴索注射液30 mg静脉滴注,每天2次,5 d为1个疗程。观察两组患者疗效、临床症状缓解时间及不良反应发生情况。结果临床总有效率对照组为82.00%,治疗组为96.00%,差异有统计学意义(P<0.05);治疗组咳嗽、咳痰、肺部罗音缓解时间明显短于对照组(P<0.05);两组患者治疗期间均无不良反应发生。结论盐酸氨溴索治疗下呼吸道感染的有效率高,能快速止咳、化痰,缩短病程,且无不良反应,疗效理想,值得临床推广。     

探究头孢呋辛钠、头孢曲松钠在下呼吸道感染治疗中的临床应用效果

目的探究头孢呋辛钠、头孢曲松钠在下呼吸道感染治疗中的临床应用效果。方法100例下呼吸道感染患者,按随机盲选法分为对照组和观察组,每组50例。对照组患者在常规治疗基础上给予头孢呋辛钠治疗,观察组患者则在常规治疗基础上给予头孢曲松钠治疗。比较两组患者临床疗效、临床指标以及用药不良反应发生情况(皮肤瘙痒、胃肠道反应)。结果观察组治疗总有效率96.00%高于对照组的84.00%,差异具有统计学意义(P<0.05)。观察组患者体温恢复正常时间(4.70±0.72)d、止咳时间(6.31±1.120)d、治疗时间(5.36±1.05)d均短于对照组的(6.03±1.15)、(8.74±1.58)、(7.26±1.52)d,差异均具有统计学意义(t=6.931、8.872、7.272,P<0.05)。观察组中发生皮肤瘙痒1例、胃肠道反应1例,不良反应发生率为4.00%;对照组中出现皮肤瘙痒1例、胃肠道反应2例,不良反应发生率为6.00%。两组不良反应发生率比较,差异无统计学意义(χ^2=0.211,P>0.05)。结论在下呼吸道感染治疗中,不同抗生素有着不同效果,与头孢呋辛钠相比,头孢曲松钠的疗效更高,因此可择优选择使用,进一步提高患者临床医治疗效。     

头孢曲松与头孢克肟序贯治疗下呼吸道感染的临床疗效分析

目的分析在为下呼吸道感染患者实施治疗过程中,头孢曲松与头孢克肟序贯治疗的临床效果。方法参加此次研究对象均选自我院2016年2月至2017年2月呼吸科收治的下呼吸道感染患者,共计128例,根据患者治疗药物选择不同分为两组,采用头孢曲松与头孢克肟序贯治疗的64例为联合组,采用头孢曲松治疗的64例为单一组。结果联合组患者与单一组患者临床治疗效果分别为92.2%、89.1%,两组统计学比较无意义(P>0.05);联合组患者不良反应发生率低于单一组,治疗总费用明显少于单一组,比较结果具有统计学意义(P<0.05)。结论下呼吸道感染临床病例中发现联合运用头孢曲松与头孢克肟序贯治疗效果较好,且患者不良反应发生率较低,在治疗费用上相对更加低廉,值得予以广泛的临床推广。     

头孢呋辛联合阿奇霉素治疗儿童呼吸道感染的疗效评价

目的研究头孢呋辛联合阿奇霉素治疗儿童呼吸道感染的疗效。方法选择2016年2月至2017年2月某医院收治的儿童呼吸道感染患儿148例,分为对照组和观察组,每组患儿74例。对照组患儿单独使用阿奇霉素治疗,观察组患儿使用头孢呋辛联合阿奇霉素治疗。对比两组患儿的治疗效果,治疗期间的不良反应,以及症状消退时间。结果观察组患儿治疗总有效率为94.59%,对照组患儿治疗总有效率为78.38%,二者相比有显著差异(P <0.05)。观察组患儿不良反应发生率为6.76%,对照组患儿不良反应发生率为9.46%,二者相比无显著差异(P> 0.05)。观察组患儿发热消退时间(2.14±1.32)d、咳嗽消退时间(4.55±0.85)d,对照组患儿发热消退时间(4.32±1.17)d,咳嗽消退时间(8.19±0.97)d,二者相比有显著差异(P <0.05)。结论在儿童呼吸道感染的治疗中,采用头孢呋辛联合阿奇霉素的方法治疗,能够提高治疗总有效率,缩短患儿症状消退时间,同时不增加不良反应,临床疗效和安全性都比较理想。     

头孢美唑钠治疗老年人下呼吸道感染34例疗效分析

目的:评价头孢美唑钠治疗老年人下呼吸道感染的临床疗效.方法:用头孢美唑钠治疗34例下呼吸道感染的老年患者,2 g·d-1,疗程7-14 d.结果:临床有效率为88.2%(30/34),细菌清除率为81.0%(17/21),无明显不良反应.结论:头孢美唑钠治疗老年人下呼吸道感染安全、有效.     

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。     

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.     

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。