食管手术病人头孢曲松两种给药方案比较

目的：比较头孢曲松两种给药方案的预防感染效果。方法：将159例食管手术病人随机分到单剂组（n=79)与4剂组（n＝80），分别给予单剂或4剂头孢曲松，观察术后感染率。结果：单剂组和4剂组术后感染率分别为4．1％与7．5％，两组无明显差异（P＞0．05）。结论：单剂头孢曲松是食管手术病人经济、有效的预防性给药方案。     

克疱乳膏和酞丁安搽剂治疗单纯疱疹的疗效

目的：观察克疱乳膏治疗单纯疱疹的疗效和安全性。方法：选择了４２例单纯疱疹患者，分别接受克疱乳膏（ｎ＝２５）和酞丁安搽剂（ｎ＝１７）局部治疗，ｑｉｄ，疗程１￣２周。结果：克疱乳膏治疗组和酞丁安搽剂治疗组的有效率分别为１００％和６４．７％（Ｐ〈０．０１），两组均未见明显的不良反应。结论：克疱乳膏治疗口唇疱疹和生殖器疱疹有很好的疗效。     

高效液相色谱法测定人血清中伊曲康唑浓度

目的：建立了ＨＰＬＣ法测定血清样品中伊曲康唑的定量分析方法。方法：色谱条件：以ＺＯＲＢＡＸＴＭＣ１８（５μｍ,４．６×１５０ｍｍ）为色谱柱;乙腈水（６７．５∶３２．５）为流动相,检测波长２６３ｎｍ;用正庚烷∶异戊醇（９８．５∶１．５）作为提取剂。结果：三种浓度４０,８０,３００ｎｇ·ｍｌ－１回收率分别为１０５．０５％,１００．５７％,９７．９１％（ｎ＝６）;日内、日间ＲＳＤ分别为３．８３％,４．０５％,３．０９％及６．００％,４．９０％,４．７２％（ｎ＝６）。血清中药物的最低检测浓度为５ｎｇ·ｍｌ－１,在５～６００ｎｇ·ｍｌ－１血药浓度范围内线性关系良好,ｒ＝０．９９９５。结论：方法灵敏、准确、结果满意     

复方葆春袋泡茶质量标准研究

目的：制订复方葆春袋泡茶质量标准。方法：双波长薄层扫描法测定了五味子乙素的量,对淫羊藿,五味子,女贞子进行了薄层色谱鉴别。结果;加样回收率平均为９７．１５％（ＲＳＤ＝１．２％,ｎ＝５）,标准曲线ｒ＝０．９９９１,重复性ＲＳＤ＝１．４％（ｎ＝６）精密度ＲＳＤ＝２．３％（ｎ＝６）,结论,方法稳定,可靠,可作为该制剂的质量控制方法之一。     

Effects of N-methyl berbamine on delayed outward potassium current in isolated rat hepatocytes

目的：研究Ｎ甲基小檗胺（ＮＭＢ）对大鼠肝细胞外向钾电流的影响．方法：应用膜片箝技术和全细胞记录方法，箝制电位－５０ｍＶ，指令电位＋３０至＋１４０ｍＶ，持续时间９００ｍｓ．结果：ＮＭＢ以浓度依赖方式降低外向钾电流．电流幅值在２０，５０，４００ｎｍｏｌ·Ｌ－１和５０μｍｏｌ·Ｌ－１时分别从４４±１０（ｎ＝４），２５±１８（ｎ＝４），５８±２１（ｎ＝５），４６±１３（ｎ＝６）ｎＡ降到３６±０４（Ｐ＞００５），２１±１６（Ｐ＞００５），３７±１６（Ｐ＜００５），２３±１３（Ｐ＜００１）ｎＡ．抑制率分别为１０％，１５％，３７％，５１％．结论：ＮＭＢ是一种钾通道阻断剂．     

A Dual Wavelength Differential First Derivative Spectrophotometric Method for Identification and Determination of Carbon Monoxide Generated During the Microsomal Metabolism of Xenobiotics in vitro

本文研究了双波长差示一阶导数分光光度法运用于作为对照品的一氧化碳（ＣＯ）饱和水浓度标定及定性与定量测定微粒体代谢中生成的一氧化碳的方法。本法的优点在于能显著消除试样本底干扰，大大提高了定量准确性及灵敏度。在ＣＯ浓度２～１０μｍｏｌ·Ｌ１范围内与导数光谱峰（４１５ｎｍ）和谷（４２６ｎｍ）之间距离（Ｄ）呈良好线性关系，ｒ＝０．９９９９（ｎ＝５），回归方程Ｃ（ｍｍｏｌ·Ｌ１）＝１７．６Ｄ０．４。最低检测浓度低于０．１μｍｏｌ·Ｌ１ＣＯ。系统回收率和加样回收率（Ｘ±ＲＳＤ）分别为１０２．１±２．９％（ｎ＝７）和７９．７±６．８％（ｎ＝１２）；日内、日间精密度（ＲＳＤ）分别为４．４％（ｎ＝１８）和６．１％（ｎ＝１６）。将本法用于４个三卤苯胺和一个三卤苯的体外代谢测定，结果表明，仅２，４，５三氟苯胺在体外能被大鼠肝微粒体、ＮＡＤＰＨ和分子氧代谢生成一氧化碳。苯巴比妥和地塞米松等肝药酶诱导剂能显著提高一氧化碳的代谢转化速率，它们分别为空白对照组的３或８倍。     

薄层扫描法测定黄芪生脉颗粒中黄芪甲甙含量

目的：制订黄芪生脉颗粒中黄芪甲甙含量测定方法。方法：双波长薄层扫描法，经乙酰洗涤、正丁醇提取和Ｄ１０１大乳吸附树脂柱层析法制备样品，以氯仿－甲醇－水（１３：７：２）下层液为展开剂，检测波长为５１０ｎｍ，参比波长为７００ｎｍ。结果：加标回收率平均为９８．７％（ＲＳＤ＝２．０％，ｎ＝６），标准曲线ｒ＝０．９９６６，重复性ＲＳＤ＝１．４％（ｎ＝５），精密度ＲＳＤ＝２．０％（ｎ＝６）。结论：方法稳定、可靠     

离子对色谱法测定颠茄及莨菪制剂中的3种有效成分

本文以安宫黄体酮为内标，采用离子对色谱法测定莨菪烷类的３种有效成分（东莨菪碱、山莨菪碱、阿托品）的含量。仪器：ＬＣ－４Ａ，层析柱：ＯＤＳ４．６ｍｍ×１５ｃｍ；柱温：３５℃；流动相：乙腈─甲醇─冰乙酸─二乙胺─水（水含０．００５ｍｏｌ／Ｌ十二烷基磺酸钠，５０：２５：０．０７５：０．１２５：２５）。在２０７ｎｍ波长处检测，样品回收率：东莨菪碱，１００．３％，ｎ＝５，ＲＳＤ＝１．３％；山莨菪碱，９８．８％，ｎ＝５，ＲＳＤ＝１．２％；阿托品，９９．１％，ｎ＝５，ＲＳＤ＝０．９３％。     

血脂康和辛伐它丁对高胆固醇血症患者降脂作用比较

本文旨在研究血脂康的降血清胆固醇作用，并与辛伐它丁（舒降之）比较。２８例高胆固醇血症患者随机进入血脂康组（ｎ＝１５，１．２ｇ／ｄ晚顿服）和舒降之组（ｎ＝１３，１０ｍｇ／ｄ）晚顿服。服药前及服药后４周、８周分别采血（禁食１２小时）。结果表明：１．血脂康降低血清总胆固醇（ＴＣ）作用与舒和之相同。服药后４周、８周ＴＣ分别各自降低了２０．７％、２２．３％（血脂康）和２２．５％，２２％（舒降之）（Ｐ〈０．０     

HPLC法测定精制冠心口服液中丹参素的含量

建立了反相ＨＰＬＣ测定精制冠心口服液中的丹参素的含量测定方法。采用Ｃ１８柱,水－甲醇－二甲基甲酰胺－冰醋酸（９０：４：４：２）为流动相,检测波长２８１ｎｍ,线性范围为０．０２７２￣０．２２４８ｍｇ／ｍｌ（ｒ＝０．９９９９,ｎ＝５）,回收率为９８．４％,ＲＳＤ＝０．８％。     

肺、食管手术预防性应用头孢曲松的成本-效果分析

目的 :探讨一种经济、有效的肺、食管手术预防性应用抗生素方案。方法 :采用随机对照研究 ,比较短程头孢曲松方案与长程头孢曲松方案预防肺、食管手术后感染的效果和成本。结果 :单剂头孢曲松方案 (术后感染率5 62 % )与四剂头孢曲松方案 (术后感染率9 06% )预防肺、食管手术后感染的临床效果基本相同 (P>0 05) ,单剂方案的平均费用为 (1257 84±769 67)元 ,明显低于四剂方案的 (1786 69±652 83)元 ,具有显著性差异 (P<0 05)。结论 :短程头孢曲松方案是肺、食管手术经济、有效的预防性应用抗生素方案     

Cefuroxime versus ceftriaxone prophylaxis in cardiovascular surgery

In a randomized, prospective study a 2-day course of cefuroxime prophylaxis (Zinacef, 1.5g every 12 h) was compared with 2-day ceftriaxone prophylaxis (Rocephin, 2g i.v. plus 1g i.v. after 24 h). To date 512 patients undergoing cardiac (n = 418) and major vascular surgery (n = 94) entered the study: 258 in the cefuroxime and 254 in the ceftriaxone group. The one-month lethality rate was 1.0%. The total infection rate was 4.7% (12 patients in the cefuroxime and 12 in the cefuroxime group. Septicaemia occurred in 1-4% (cefuroxime n = 4; ceftriaxone n = 3); pneumonia in 2% (5 vs 5 patients). One patient developed diarrhoea due to Clostridium difficile. Plasma concentrations of ceftriaxone were measured (HPLC method) over the first 24 h in 110 patients undergoing cardiac surgery. Plasma concentrations 24 h post-injection were 25.4 +/- 12.7 micrograms/ml. Prophylaxis with either cefuroxime or ceftriaxone was highly effective. The mean plasma levels of ceftriaxone achieved are far in excess of the MICs for the microorganisms commonly associated with infection following cardiovascular surgery, with the exception of Bacteroides and Pseudomonas. A single dose of ceftriaxone should therefore provide adequate prophylaxis for most patients undergoing major cardiovascular surgery.     

Ceftriaxone/Amikacin vs Ceftazidime/Amikacin as Empirical Therapy for Fever in Patients with Haematological Malignancy and Severe Granulocytopenia: Clinical and Economic Outcomes

To assess the economic outcomes produced when a conventional antibiotic treatment regimen requiring three administrations per day was replaced with a treatment regimen requiring only one daily administration, the efficacy, tolerability and cost of ceftazidime was compared with that of ceftriaxone (both drugs in combination with amikacin) for the empirical treatment of febrile granulocytopenic patients with haematological malignancy. 102 febrile patient-episodes were randomly assigned to receive ceftazidime (6g in three divided doses) or ceftriaxone (2g as a single daily dose), both in combination with amikacin. The response was evaluable in 94 patients (47 in each group). 75 (80%) patients had an absolute granulocyte count lower than 100/mm(3) at the onset of fever or during the first week of antibiotic therapy. 61 (64.9%) were affected by acute leukaemia. Multiple daily ceftazidime plus amikacin was effective in 33 of 47 (70.2%) patients, and single daily ceftriaxone plus amikacin in 31 of 47 (66%) patients (p > 0.2). Among patients successfully treated, median time to defervescence was 3.3 days (range 1 to 11) for ceftazidime plus amikacin and 4.5 days for ceftriaxone plus amikacin (range 1 to 15) [p = 0.14]; study drugs were continued for 12 (range 7 to 26) and 12.3 days (range 7 to 28), respectively. Our study demonstrated that single daily administration of ceftriaxone was as effective and well tolerated as multiple daily administration of ceftazidime when both were administered in combination with amikacin. Cost analysis showed that compared with the thrice daily regimen, administration of single daily doses of ceftriaxone for a 12-day treatment period would result in a net cost saving of $US392 (626 940 Italian lire).     

普胸手术预防性应用头孢呋辛随机对照研究

目的　评价预防性使用单剂头孢呋辛对普通胸外科手术后感染的预防效果。方法　通过随机对照试验 ,将 2 6 4例普胸手术患者随机分成单剂组 (n=134)和多剂组 (n=130 ) ,比较两组的术后感染率、平均住院时间和平均住院费用。结果　单剂组的术后感染率 (8.96 %)与多剂组的术后感染率 (7.6 9%)不具有显著性差异 (P>0 .0 5 ) ,两组的住院时间也无显著性差异 (P>0 .0 5 )。但是单剂组的平均住院费用比多剂组少1345 .90元 (P<0 .0 5 )。结论　单剂头孢呋辛是预防普胸手术后感染有效的抗生素方案。     

Cefotaxime therapy of lower respiratory tract infections in intensive-care patients

Cefotaxime is one of two third-generation cephalosporins (the other being ceftriaxone) that undergo significant metabolism and is the only third-generation cephalosporin for which an active metabolite has been identified. Cefotaxime was administered intravenously in doses of 6 g per day to 20 patients with serious infections of the lower respiratory tract due to organisms susceptible to cefotaxime (isolates of Enterobacteriaceae and of Pseudomonas aeruginosa). It was administered with gentamicin in some high-risk patients. Cefotaxime resulted in mean peak concentrations of 32 mu/ml (cv% = 53) and of 29.5 micrograms/ml (cv% = 65) respectively after the first and after the last dose of a regimen of 2 g every 8 hours. The half-life value averaged 1.8 h and 6.4 h for cefotaxime and its desacetyl metabolite respectively. The average value of the metabolite at the end of short infusion was 11.5 micrograms/ml (cv% = 31) after the initial dose and 15.5 micrograms/ml (cv% = 37) after the last administered dose. Overall results were 75% patients cured or improved; 83% of the patients with nosocomial pulmonary infections due to Enterobacteriaceae were cured; 50% of the patients with Pseudomonas aeruginosa infections were cured and 25% improved despite the pathogen not being eradicated. No serious toxicity was observed.     

Safety and efficacy of ximelagatran: meta-analysis of the controlled randomized trials for the prophylaxis or treatment of venous thromboembolism

BACKGROUND: Ximelagatran has been approved in Europe for VTE prophylaxis in orthopedic surgery at fixed doses and without laboratory monitoring. Aim of the study was to evaluate safety and efficacy of ximelagatran in a meta-analysis of prophylaxis and/or treatment randomized controlled trials. METHODS: Absolute risk of events for ximelagatran and OR for its comparison with LMWH and coumarins were calculated. Subgroup analysis was performed for ximelagatran regimen, comparator agent, type of surgery, starting time of prophylaxis. RESULTS: Twelve studies and 16,992 patients were meta-analysed. Ximelagatran showed an absolute risk of major VTE of 4.04% and 1.69% and of major bleedings of 1.68% and 1.03% in prophylaxis and treatment trials, respectively. In prophylaxis trials, a significant excess mortality (OR: 2.5; 95% CI: 1.02 - 6.13) and an excess in major bleedings (OR: 1.41; 95% CI: 0.93 - 2.14) was found in the whole ximelagatran group. No evidence of treatment effect for major VTE was seen in the comparison with LMWH (OR: 1.01; 95% CI: 0.52 - 1.97). The cohort of patients treated with 24 mg b.i.d. showed similar results. An increase in the absolute risk of bleeding (from 1.04% to 3.03%) was found between post and preoperative administration of ximelagatran. Major VTE risk was increased when ximelagatran was compared to b.i.d. LMWH. CONCLUSIONS: Ximelagatran can be considered for its potential advantages for prevention and treatment of VTE. Future efforts are needed by researchers to prospectively investigate the best postoperatively starting time and by clinicians to monitor overall mortality in prophylactic use.     

Ceftriaxone. A reappraisal of its antibacterial activity and pharmacokinetic properties, and an update on its therapeutic use with particular reference to once-daily administration

Since ceftriaxone was first reviewed in the Journal, further studies have confirmed its broad antibacterial spectrum in vitro and extended its clinical documentation in comparative studies with other widely used drugs in infections of the urinary and lower respiratory tract, meningitis in infants and children, uncomplicated gonorrhoea, perioperative prophylaxis in patients undergoing surgery, and in several other types of infection. As in earlier studies, which primarily used a twice-daily dosage regimen, few significant differences were found between therapeutic groups in comparative studies and results have demonstrated the efficacy of once-daily ceftriaxone in all but the most serious infections, such as sole antibiotic therapy in pseudomonal infections. Wider clinical experience has established that ceftriaxone is generally well tolerated. Thus, ceftriaxone now has a well-defined place as an appropriate alternative for the parenteral treatment of a variety of infections due to susceptible organisms, as well as for perioperative prophylaxis of surgery, and may offer advantages of greater convenience over other parenteral antibiotics which are administered more frequently.     

糖尿病人择期胆囊切除术中抗生素的预防应用

目的探讨能有效地预防糖尿病病人行择期胆囊切除术后切口感染的用药方法。方法实验组21例在麻醉诱导期单剂量静脉滴注头孢三嗪2g ;对照组63例术后继续用头孢三嗪2g和甲硝唑1.0g ,共3天。结果实验组和对照组切口感染率分别为4.76 %和6.35% ,实验组较对照组差异无显著意义。结论麻醉诱导期单剂量静脉滴注头孢三嗪2g能有效预防糖尿病病人择期胆囊切除术后切口感染的发生。     

Comparison of single-dose moxalactam and a three-dose regimen of cefoxitin for prophylaxis in vaginal hysterectomy

In patients undergoing vaginal hysterectomy, prophylactic use of a single dose of moxalactam was compared with use of a standard three-dose regimen of cefoxitin for efficacy and for rate of postoperative colonization of the vaginal cuff with resistant bacteria. In a prospective, randomized study, patients hospitalized for vaginal hysterectomy received either cefoxitin sodium 2 g intramuscularly on call to the operating room followed by 2 g intravenously every six hours for two additional doses or a single dose of moxalactam disodium 2 g intramuscularly on call. Cultures of the meatal area and of urine were obtained preoperatively; postoperatively, cultures of urine, of the vaginal cuff, and of any site or fluid presumed to be infected were obtained. Data were evaluated for 38 patients in the moxalactam group and 40 patients in the cefoxitin group. There was no significant difference in the incidence of infectious morbidity (7.5% of cefoxitin-treated patients and 10.5% of moxalactam-treated patients). Infectious morbidity was not related to age, length of surgery, or estimated blood loss. The incidence of febrile morbidity was not significantly different (7.5% of the cefoxitin group and 13.2% of the moxalactam group). Colonization of the vaginal cuff with resistant organisms occurred in 70% of cefoxitin patients and 71% of moxalactam patients and was a poor predictor of infectious morbidity. In these 78 women undergoing vaginal hysterectomy, single-dose moxalactam and a three-dose regimen of cefoxitin were equally effective for surgical prophylaxis.     

低剂量甲基强的松龙预防下肢长骨骨折患者创伤后肺脂肪栓塞的临床研究

目的：研究低剂量甲基强的松龙对预防下肢长骨骨折患者创伤后肺脂肪栓塞的作用。方法：选择我院2014年1月～2015年6月骨科收治的胫骨及股骨骨折患者96例,采用随机数字表法分为三组,每组32例,分别给予低剂量甲基强的松龙、大剂量甲基强的松龙及生理盐水,三组患者年龄、性别、骨折部位及严重程度均进行均衡性对比,观察三组肺脂肪栓塞发生情况。结果：治疗3d、5d、7d低剂量甲基强的松龙组、大剂量甲基强的松龙组FES评分较治疗前无明显变化（P＞0.05）。对照组治疗3d、5d、7dFES评分明显升高（P＜0.05）,与低剂量甲基强的松龙组、大剂量甲基强的松龙组比较差异有统计学意义（P＜0.05）。三组共发生FES5例,其中低剂量甲基强的松龙组1例（3.13%）,大剂量甲基强的松龙组0例（0.0%）,对照组4例（12.5%）,对照组FES发生率明显高于低剂量甲基强的松龙组、大剂量甲基强的松龙组（P＜0.05）。低剂量甲基强的松龙组、大剂量甲基强的松龙组FES发生率比较差异无统计学意义（P＞0.05）。结论：低剂量甲基强的松龙可预防下肢长骨骨折患者创伤后肺脂肪栓塞。