阿戈美拉汀联合米氮平治疗抑郁症的临床研究

目的 探究阿戈美拉汀片联合米氮平片治疗抑郁症的临床疗效。方法 选取2019年3月—2020年3月江汉油田总医院心理精神科收治100例抑郁患者,将所有患者按照随机数字表法分为对照组和治疗组,每组各50例。对照组睡前口服米氮平片,初始剂量为15 mg/d,1周后剂量增至30 mg/d。治疗组在对照组治疗的基础上睡前口服阿戈美拉汀片,初始剂量为25 mg/次,1次/d,若治疗两周后症状没有改善,可增加剂量至50 mg/次,1次/d。两组患者均持续治疗6个月。观察两组的临床疗效,比较两组的抑郁程度和去甲肾上腺素（NE）、脑源性神经营养因子（BDNF）、谷氨酸（Glu）和γ-氨基丁酸（GABA）水平。结果 治疗后,治疗组的总有效率为84.00%,明显高于对照组总有效率66.00%（P＜0.05）。治疗后,两组患者汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）评分均明显降低（P＜0.05）,治疗组患者HAMD、HAMA评分均明显低于对照组（P＜0.05）。治疗后,两组患者血清NE、BDNF、GABA水平均明显升高,Glu水平明显降低（P＜0.05）,且治疗组患者血清NE、BDNF、GABA水平高于对照组,Glu水平明显低于对照组（P＜0.05）。结论 阿戈美拉汀片联合米氮平片治疗抑郁症具有较好的疗效,能有效缓解患者的抑郁程度,降低Glu水平,提高NE、BDNF、GABA水平。     

乌灵胶囊联合左乙拉西坦治疗老年癫痫的临床研究

目的 探究乌灵胶囊联合左乙拉西坦治疗老年癫痫的临床疗效。方法 选取2018年3月-2019年5月中国人民解放军联勤保障部队第988医院收治的老年癫痫患者103例,随机分为对照组（51例）和治疗组（52例）。对照组口服左乙拉西坦片,初始剂量为5 mg/（kg·次）,2次/d,连续治疗1周,第2周增加至10 mg/（kg·次）,第3周增加至25 mg/（kg·次）,后维持该剂量。治疗组在对照组基础上口服乌灵胶囊,3粒/次,3次/d。两组患者均连续治疗12周。结果 治疗后,治疗组总有效率94.23%显著高于对照组80.39%,两组比较差异有统计学意义（P<0.05）。治疗后,两组阵挛发作频率、强直发作频率均较治疗前显著下降（P<0.05）,且治疗后治疗组癫痫发作频率显著低于对照组（P<0.05）。治疗后,两组MMSE评分均较治疗前显著升高（P<0.05）,治疗后治疗组MMSE评分显著高于对照组（P<0.05）。治疗后,两组血尿酸较治疗前均显著升高,但胱抑素C（Cystatin C）水平较治疗前显著下降（P<0.05）;治疗后,治疗组血尿酸高于对照组,而Cystatin C低于对照组（P<0.05）。治疗后,两组同型半胱氨酸（Hcy）、不对称二甲基精氨酸（ADMA）水平均较治疗前显著升高（P<0.05）;但治疗后Hcy、ADMA水平组间比较差异无统计学意义。结论 乌灵胶囊联合左乙拉西坦治疗老年癫痫具有较好的临床疗效,改善患者认知功能,但对降低Hcy、ADMA水平无明显作用,具有一定的临床推广应用价值。     

鲁拉西酮联合舒必利治疗精神分裂症的临床研究

目的 探讨盐酸鲁拉西酮片联合舒必利片治疗精神分裂症的临床疗效。方法 选取2020年2月-2022年11月在上海市静安区精神卫生中心就诊的120例精神分裂症患者,按照计算机随机排列法分为对照组和治疗组,每组各60例。对照组患者口服舒必利片,首次剂量1片/次,3次/d,治疗7 d后增加至3片/次,3次/d。治疗组患者在对照组基础上口服盐酸鲁拉西酮片,1片/次,1次/d。两组患者连续治疗2个月。观察两组的临床疗效,比较两组的阳性与阴性症状量表(PANSS)评分、精神分裂症生活质量量表(SQLS)评分以及血清中催乳素(PRL)、白细胞介素-6(IL-6)、白细胞介素-17(IL-17)水平。结果 治疗后,治疗组的总有效率为91.67%,对照组的总有效率为78.33%,组间比较差异有统计学意义(P<0.05)。治疗后,两组的PANSS各项评分均显著降低(P<0.05),且治疗组PANSS各项评分较对照组更低(P<0.05)。治疗后,两组的SQLS各项评分显著降低(P<0.05),治疗组SQLS各项评分降低程度高于对照组(P<0.05)。治疗后,两组的血清PRL水平高于治疗前,血清IL-6、IL-17水平低于治疗前(P<0.05);治疗后,治疗组的血清IL-6、IL-17水平低于对照组(P<0.05)。结论 盐酸鲁拉西酮片联合舒必利片可提高精神分裂症的临床疗效,减轻患者精神症状,提高生活质量,减轻炎症反应,且药物安全性良好。     

癫痫宁片联合奥卡西平治疗癫痫的临床研究

目的 探讨癫痫宁片联合奥卡西平片治疗癫痫的临床疗效。方法 选取2021年1月-2022年1月在海南省老年病医院就诊的94例癫痫患者，按照计算机随机排列分为对照组和治疗组，各47例。对照组患者口服奥卡西平片，起始剂量1片/次，2次/d，每隔1周增加药物剂量，每次增加2片，分为2次口服，维持剂量2~8片/d。治疗组在对照组基础上口服癫痫宁片，4片/次，3次/d。两组连续治疗3个月。观察两组的临床疗效，比较两组的强直发作频率、阵挛发作频率、痫样放电数、累及导联数、棘波指数以及血清神经元特异性烯醇化酶（NSE）、白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）水平。结果 治疗后，治疗组的总有效率为91.49%，对照组的总有效率为74.47%，组间比较差异有统计学意义（P<0.05）。治疗后，两组强直发作频率、阵挛发作频率明显低于治疗前（P<0.05）；治疗后治疗组强直发作频率、阵挛发作频率明显低于对照组（P<0.05）。治疗后，两组的痫样放电数、累及导联数、棘波指数显著降低（P<0.05）；治疗后治疗组的痫样放电数、累及导联数、棘波指数低于对照组（P<0.05）。治疗后，两组的血清NSE、IL-1β、TNF-α水平低于治疗前（P<0.05），治疗组血清NSE、IL-1β、TNF-α水平较对照组更低（P<0.05）。结论 癫痫宁片联合奥卡西平片能显著提高癫痫的临床疗效，减轻癫痫症状、脑部异常放电和神经细胞的炎症损伤。     

脑康泰胶囊联合普拉克索治疗早期帕金森病的临床研究

目的 探讨脑康泰胶囊联合普拉克索治疗早期帕金森病的临床效果。方法 选取2019年4月—2021年10月北京市和平里医院收治的136例早期帕金森病患者,采用随机数字表法将所有患者平均分为对照组和治疗组,每组各68例。对照组口服盐酸普拉克索片,起始剂量0.125 mg/次,3次/d,随后根据患者耐受情况逐渐增加剂量,每周加量1次,每次日剂量增加0.375 mg,有效剂量为0.50～0.75 mg/次,3次/d,最大日剂量为4.5 mg。治疗组在对照组基础上口服脑康泰胶囊,3粒/次,3次/d。两组疗程均为12周。观察两组的临床疗效,比较治疗前后两组国际运动障碍学会帕金森病综合评定量表（MDS-UPDRS）中各部分（Ⅰ、Ⅱ、Ⅲ、Ⅳ）评分及其总分、帕金森病睡眠评估量表中文版（PDSS-CV）总分、39项帕金森病生活质量问卷（PDQ-39）总分及血清白细胞介素（IL）-1β、IL-17、超氧化物歧化酶（SOD）、谷氨酸（Glu）和γ氨基丁酸（GABA）水平。并统计两组不良反应情况。结果 治疗后,治疗组有效率是94.12%,较对照组82.35%显著提高（P＜0.05）。治疗后,两组MDS-UPDRS中各部分（Ⅰ、Ⅱ、Ⅲ、Ⅳ）评分及其总分比治疗前均显著降低（P＜0.05）;且均以治疗组下降更显著（P＜0.05）。治疗后,两组PDSS-CV总分比治疗前均显著升高,PDQ-39总分比治疗前均显著降低（P＜0.05）;且均以治疗组改善更显著（P＜0.05）。治疗后,两组血清IL-1β、IL-17水平均显著低于治疗前,血清SOD、Glu和GABA水平均显著高于治疗前（P＜0.05）;且治疗后,治疗组血清IL-1β、IL-17水平比对照组均显著更低,血清SOD、Glu和GABA水平比对照组均显著更高（P＜0.05）。治疗后,治疗组患者不良反应发生率是14.71%,比对照组29.41%显著降低（P＜0.05）。结论 脑康泰胶囊联合普拉克索治疗早期帕金森病的整体疗效满意,可安全有效地改善患者睡眠状况,并能进一步抑制血清IL-1β和IL-17表达水平、增强体内SOD活性及提高血清Glu、GABA水平,从而对患者生活质量及病情的改善具有重要作用。     

不同剂量利培酮治疗首发精神分裂症的疗效观察

目的 探讨不同剂量利培酮片治疗首发精神分裂症的临床疗效及其安全性评价。方法 选择2012年4月—2014年4月北京市房山区精神卫生保健院接受诊治的首发精神分裂症患者127例,随机分为大剂量组(n＝62)和小剂量组(n＝65)。大剂量组患者给予利培酮片起始剂量为0.5～1 mg/d,第2～3天根据患者病情和不良反应逐渐增加剂量为6 mg/d,维持量为6 mg/d。小剂量组患者给予利培酮片起始剂量为0.5～1 mg/d,第2～3天根据患者病情和不良反应逐渐增加剂量为3 mg/d,维持量为3 mg/d。两组均连续治疗8周。比较两组的临床疗效,并对比分析两组PANSS量表评分、锥体外系反应(EPS)发生情况及副反应量表(TESS)评分。结果 小剂量组患者总有效率为93.85%,大剂量组患者总有效率为82.26%,两组比较差异具有统计学意义(P< 0.05)。治疗后,两组患者阴性症状量表分、阳性症状量表分、精神病理量表分和PANSS总分均显著降低(P< 0.05);小剂量组阴性症状量表分、阳性症状量表分、精神病理量表分及PANSS总分治疗4、8周后均显著低于同期大剂量组,且差异具有统计学意义(P< 0.05)。小剂量组EPS发生率显著低于大剂量组,且差异具有统计学意义(P< 0.05)。小剂量组治疗4、8周TESS评分均显著低于大剂量组,差异具有统计学意义(P< 0.05)。结论 小剂量利培酮片治疗首发精神分裂症小剂量可明显提高疗效、减低PANSS评分、EPS发生少、不良反应少,明显优于大剂量利培酮片。     

罗替高汀贴片联合多巴丝肼治疗帕金森病的临床研究

目的 探讨罗替高汀贴片联合多巴丝肼片治疗帕金森病的临床疗效。方法 选取2018年9月-2020年12月在郑州市第九人民医院就诊的108例帕金森病患者作为研究对象,按照随机数字表法将所有患者分为对照组和治疗组,每组各54例。对照组患者口服多巴丝肼片,3次/d,首次剂量0.125 g/次,每周增加剂量0.125 g,维持剂量3次/d,0.25 g/次。治疗组患者在对照组基础上联合罗替高汀贴片,1次/d,首次剂量4.5 mg/10 cm²,每周增加剂量4.5 mg/10 cm²,维持剂量每次13.5 mg/30 cm²。两组患者连续治疗3个月。观察两组患者的临床疗效,比较两组患者的生活质量、新版世界运动障碍病学会帕金森病综合评价量表(MDS-UPDRS)评分和血清因子水平。结果 治疗后,治疗组的总有效率为94.44%,对照组的总有效率为81.48%,组间比较有明显差异(P<0.05)。治疗后,两组的帕金森调查表(PDQ-39)评分显著降低(P<0.05);且治疗后治疗组PDQ-39评分低于对照组(P<0.05)。治疗后,两组的非运动症状评分、运动症状评分、运动功能检查评分、运动并发症评分均显著降低(P<0.05);治疗组的非运动症状评分、运动症状评分、运动功能检查评分、运动并发症评分明显低于对照组(P<0.05)。治疗后,两组的血清淀粉样蛋白A(SAA)、白细胞介素-12(IL-12)水平显著降低,载脂蛋白A1水平显著升高(P<0.05);治疗组SAA、IL-12水平比对照组低,载脂蛋白A1比对照组高,差异有统计学意义(P<0.05)。结论 罗替高汀贴片联合多巴丝肼片治疗帕金森病的疗效确切,能有效改善患者生活质量,减轻临床症状,减轻炎症反应。     

吡仑帕奈治疗难治性癫痫部分发作的Meta分析

目的 系统评价吡仑帕奈治疗难治性癫痫部分发作的有效性与安全性。方法 计算机检索PubMed、EBSCO、EMbase、Cochrane Library、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、中文科技期刊全文数据库（VIP）和万方数据库,收集吡仑帕奈治疗难治性癫痫部分发作的随机对照试验,检索时限从建库至2017年2月,采用RevMan 5.0软件对各效应指标进行Meta分析。结果 共纳入5项研究,计1 500例患者。Meta分析结果显示：吡仑帕奈组癫痫完全不发作率[OR=3.75,95%CI （1.77,7.93）,P=0.000 6]、发作频率减少≥ 50%的患者百分率[OR=2.08,95%CI （1.69,2.56）,P<0.001]均高于安慰剂组,差异有统计学意义;吡仑帕奈主要不良反应有眩晕、困倦、头痛、共济失调、鼻咽炎等;吡仑帕奈8 mg和12 mg组总不良反应发生率高于安慰剂组,差异有统计学意义（P<0.05）。结论 吡仑帕奈治疗难治性癫痫部分发作能有效减少癫痫发作频率,且不良反应较轻,患者基本耐受。     

天麻头痛片联合佐米曲普坦治疗偏头痛的临床研究

目的 研究天麻头痛片联合佐米曲普坦治疗偏头痛的临床效果。方法 选取2021年6月—2022年6月郑州市第三人民医院收治的偏头痛患者共80例为研究对象,按照随机数字表法将所有患者分为对照组和治疗组,每组各40例。对照组患者口服佐米曲普坦片,2.5 mg/次,1次/d。如首次服药后头痛症状持续,可于2 h后再服2.5 mg,每日最大剂量不超过15 mg。治疗组在对照组基础上口服天麻头痛片,4片/次,3次/d。如症状改善不佳,可增1片/次,每次口服剂量不超过6片,每日不超过18片。两组均连续服药3个月。观察两组的临床疗效,比较两组症状改善情况和血清因子变化情况。结果 治疗后,治疗组总有效率是95.00%,显著高于对照组的77.50%（P＜0.05）。治疗后,两组偏头痛发作次数、持续时间及视觉模拟（VAS）评分均较治疗前显著降低（P＜0.05）;且治疗后,治疗组偏头痛发作次数、持续时间及VAS评分均低于对照组（P＜0.05）。治疗后,两组血清载脂蛋白（LPA）、肿瘤坏死因子-α（TNF-α）、血清内皮素-1（ET-1）及一氧化氮（NO）水平均较治疗前显著降低,而5-羟色胺（5-HT）水平显著升高（P＜0.05）;治疗后,治疗组患者LPA、TNF-α、ET-1、NO水平低于对照组,5-HT高于对照组（P＜0.05）。结论 天麻头痛片联合佐米曲普坦能够显著改善偏头痛患者的临床症状,调节血清因子水平,且不增加不良反应发生率,具有一定的临床推广应用价值。     

金水宝胶囊联合泼尼松治疗狼疮性肾炎的临床研究

目的 探讨金水宝胶囊联合泼尼松治疗狼疮性肾炎的临床效果。方法 选取2018年6月-2020年12月河南科技大学第一附属医院收治的80例狼疮性肾炎患者,使用随机数字表法分成对照组和治疗组,每组各40例。对照组患者口服醋酸泼尼松片,1 mg/(kg∙d),4~6周后逐步减量至最小维持量(<7.5mg/d)。在对照组基础上,治疗组口服金水宝胶囊,1.98 g/次,3次/d。两组连续治疗6个月。观察两组患者临床疗效,比较治疗前后两组患者肾功能指标24h尿蛋白定量(24h-Upro)、血清尿素氮(BUN)和肌酐(Cr)水平,系统性红斑狼疮疾病活动指数(SLEDAI)评分和36项健康调查简表(SF-36)总分,中性粒细胞与淋巴细胞比值(NLR),及血清高迁移率族蛋白B1(HMGB1)、白细胞介素-18(IL-18)和细胞间黏附分子-1(ICAM-1)水平。结果 治疗后,治疗组总有效率为92.5%,较对照组的75.0%显著提高(P<0.05)。治疗后,两组24 h-Upro和血清BUN、Cr水平均显著低于治疗前(P<0.05),且治疗组肾功能改善作用较对照组更明显(P<0.05)。治疗后,两组SLEDAI评分均显著降低,而SF-36总分则均显著升高(P<0.05),且治疗组SLEDAI和SF-36评分显著好于对照组(P<0.05)。治疗后,两组NLR和血清HMGB1、IL-18、ICAM-1水平显著低于治疗前(P<0.05),且治疗组明显低于对照组(P<0.05)。治疗期间,治疗组不良反应发生率明显低于对照组(12.5% vs 32.5%,P<0.05)。结论 金水宝胶囊联合泼尼松治疗狼疮性肾炎的整体疗效确切,是保护患者肾功能、降低疾病活动度及改善生活质量的安全有效途径。     

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。     

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。     

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.     

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。     

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.     

Chondroprotective Effects of Wogonin in Experimental Models of Osteoarthritis in vitro and in vivo

We evaluated the chondroprotective effects of wogonin by investigating its effects on the gene expression and production of matrix metalloproteinase-3 (MMP-3) in primary cultured rabbit articular chondrocytes, as well as on production of MMP-3 in the rat knee. Rabbit articular chondrocytes were cultured in a monolayer, and RT-PCR was used to measure interleukin-1β (IL-1β)-induced expression of MMP-3, MMP-1, MMP-13, a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4), and type II collagen. In rabbit articular chondrocytes, the effects of wogonin on IL-1β-induced production and proteolytic activity of MMP-3 were investigated using western blot analysis and casein zymography, respectively. The effect of wogonin on MMP-3 protein production was also examined in vivo. In rabbit articular chondrocytes, wogonin inhibited the expression of MMP-3, MMP-1, MMP-13, and ADAMTS-4, but increased expression of type II collagen. Furthermore, wogonin inhibited the production and proteolytic activity of MMP-3 in vitro, and inhibited production of MMP-3 protein in vivo. These results suggest that wogonin can regulate the gene expression and production of MMP-3, by directly acting on articular chondrocytes.