不同比例黄连-吴茱萸配方颗粒/单/合煎对比分析

目的： 通过考察不同比例的黄连与吴茱萸药对,其配方颗粒与单煎液、合煎液的关键成分含量差异,探索药对配方颗粒与传统煎法的等效性。方法： 采用高效液相色谱法测定不同制法下6种生物碱含量,并利用SPSS18.0进行统计检验。结果： 与单煎相比,配方颗粒中4种黄连生物碱和吴茱萸次碱含量均与合煎中没有明显差异（小檗碱P=0.881;表小檗碱P=0.810;黄连碱P=0.961;巴马汀P=0.220;吴茱萸次碱P=0.137）,单煎中黄连生物碱含量平均值约为配方颗粒或合煎的2倍（P<0.01）,吴茱萸次碱单煎含量明显降低（配方颗粒/合煎平均值为单煎的3倍以上,P<0.01）,而吴茱萸碱在配方颗粒与单煎中的差异小（P=0.314）,平均值均在合煎液含量的40%以下（P<0.01）。另外,随着吴茱萸占比提高,合煎液中4种黄连生物碱、吴茱萸碱和吴茱萸次碱含量明显降低,但比例对配方颗粒和单煎影响不大。结论： 在黄连和吴茱萸药对中,黄连生物碱配方颗粒与合煎差异不显著,吴茱萸生物碱在配方颗粒中可能发生转变,导致与合煎有差异,而且配方颗粒并不能重现合煎中药对比例对成分含量的影响趋势。     

盐酸氨溴索片预防新生儿呼吸窘迫综合征临床研究

目的探讨母亲产前未用过激素的早产儿在生后12h内应用盐酸氨溴索片(商品名沐舒坦)预防新生儿呼吸窘迫综合征的效果。方法早产儿120例,按区组随机分为沐舒坦应用组和观察组各60例,观察两组新生儿呼吸窘迫综合征(RDS)及其并发症的发生率。 结果(1)沐舒坦组RDS发生率为25.0％,对照组为66.7％,两组有显著差异(P<0.01);(2)沐舒坦组RDS的严重程度较对照组轻,有显著差异(P<0.05);(3)沐舒坦组支气管肺发育不良、脑室内出血及获得性肺炎的发生低于对照组(P<0.01)。 结论对产前母亲未用过激素的早产儿生后立即静脉给沐舒坦可以降低早产儿RDS的发病率及其并发症的发生率。     

科学合理地使用高等医药院校学报

阐述了高等医药院校学报的特点及其作用，针对各高等医药院校普遍存在的对医药院校学报不够重视、利用率较低等问题，提出了如何最大限度地发挥高等医药院校学报的作用，合理利用高等医药院校学报的措施。     

上海市部分地区健康人群流行性腮腺炎抗体水平检测

为了解上海市部分地区健康人群流行性腮腺炎(腮腺炎)自然感染情况及腮腺炎IgG抗体分布情况,采用红血球凝集抑制试验检测腮腺炎IgG抗体.共检测了691人,其中市区342人,郊区349人,年龄从6月龄～20岁以上.结果表明腮腺炎IgG抗体总阳性率为51.52%,几何平均滴度(GMT)为1∶10.69.6～8月龄婴儿抗体阳性率最低,为2.85%.市区和郊区阳性率分别为56.14%、46.99%(χ2＝5.79、P＜0.05),其差异有显著的统计学意义;GMT分别为1∶14.91、1∶7.72(t＝4.76、P＜0.01),其差异有极显著的统计学意义.腮腺炎自然感染率市区(56.14%)高于郊区(46.99%).婴儿在≥6月龄时应考虑接种腮腺炎疫苗.     

浅论药学监护与药学教育的改革

“药学监护”是新世纪药学发展的必然趋势，其服务模式是以患者为中心。发达国家几乎先后都开展了这一工作，WHO也予以认可。该工作在我国还处于理论探讨和实践的探索阶段。制约其发展的主要原因是高素质药学人才匮乏，药学教育规模过小，教学内容和方法不能适应现代药学发展的需要。必须从药学教育的学制、教学模式、课程体系等方面进行改革。     

苯巴比妥预防新生儿重度窒息后脑损伤的临床观察

目的:对苯巴比妥预防新生儿重度窒息后颅脑损伤的作用进行对照研究。方法:1998年12月￣2003年12月,将60例在我院NICU住院的重度窒息患儿,随机分为对照组和治疗组,治疗组在生后6小时内静脉滴注苯巴比妥负荷量20mg/kg一次给予,12小时后给予维持量5mg/(kg·d),分2次,共用5天。对照组不用苯巴比妥,出现惊厥用安定镇静止惊,其他治疗与治疗组相同,两组均在出生后第四天应用头颅螺旋CT扫描。结果:治疗组脑损伤(HIE和ICH)发生率65%,对照组发生率90%,两组之间的差异有高度显著性(x2=7.17,P<0.01)。两组惊厥发生率,对照组55%,治疗组10%,差异有高度显著性(x2=16.26,P<0.01)。结论:苯巴比妥可显著降低新生儿窒息后颅脑损伤的发生率,同时有效预防和控制了窒息后惊厥的发生。     

疏肝理气与祛痰化瘀法治疗子宫内膜异位症33例的的临床观察

为探讨疏肝理气、祛痰化瘀法对子宫内膜异位症(EMs)患者的临床疗效,将65例患者随机分为2 组,治疗组33例予内异消症方治疗,对照组32例予丹那唑治疗,比较2组临床疗效及治疗前后血清CA125值。结果:治疗组临床疗效优于对照组(P<0．05),其血清CA125治疗前后比较差异显著(P<0．05),对照组则无显著性差异(P>0．05)。提示疏肝理气与祛痰化瘀法对EMs疗效显著,为临床治疗EMs的有效途径之一。     

早期应用乌司他丁对严重烧伤患者脏器功能的保护

目的 探讨早期应用乌司他丁(UTI)对严重烧伤患者重要脏器功能的影响.方法 将收治的伤后24 h内入院、烧伤面积≥50%总体表面积的严重烧伤患者84例,分为UTI治疗组和常规治疗组,每组42例.UTI治疗组在常规治疗的基础上加用UTI 30万IU静脉滴注,3次/d,连续14 d.烧伤后1、3、7、14 d检测两组血常规和肝肾功能指标,并观察其临床效果.结果 UTI治疗组用药后能较好度过休克期、感染期和围手术期,病程相对平稳.UTI治疗组各项检测指标恢复较明显,患者28 d生存率为100%,死亡率为2.38%,与常规治疗组比较有显著性差异(P＜0.05).UTI治疗组伤后第7、14天全身炎症反应综合征、多器官功能障碍综合征的发生率明显低于对照组(P＜0.05).结论 早期应用UTI治疗严重烧伤患者,可以从多个环节抑制细胞的损伤,保护脏器,能显著减轻炎症反应程度,有效保护严重烧伤患者的脏器功能,具有良好的临床疗效.     

我国公立医院的岗位设置探讨

科学设岗是人事制度改革和医院可持续发展的需要。从梳理岗位设置相关政策出发,阐释科学设岗对人才结构优化和激励、医院可持续发展及人事制度改革的重要意义,并结合我国公立医院岗位设置的问题与现状,提出开展岗位设置过程中应首先注重培养全院员工的可持续发展观念,以此扎实开展岗位设置方案制定,加快科学设岗落实的配套措施跟进。     

烧伤病房铜绿假单胞菌耐药率及抗菌药使用变化

Objective To study changes in the drug-resistance of Pseudomonas aeruginosa (PA)and the use of antibiotics in burn wards so as to optimize the use of antibiotic in the future. Methods Bacteria were isolated from specimens of blood, venous catheter, stool, sputum, urine, wound tissue from 5717 patients hospitalized in our burn wards within the duration of January 2005 to December 2009. The number of specimens examined and positive rates of bacteria were calculated. Changes in constituent ratio of cocci and bacilli, spectrum of bacteria, the drug-resistance rate of PA, and the usage of antibiotics were analyzed. The number of specimens examined, constituent ratio of cocci and bacilli, drug-resistance rate were processed with chi-square test. Bivariate correlation analysis was performed between the usage of antibiotics and the drug-resistance rate. Results (1) The number of specimens examined showed no statistical difference during the five years ( with rates from 73.2% to 76.1% , x 2 = 5. 583, P ＞ 0.05 ) , while constituent ratio of cocci and bacilli showed statistical difference (with ratios from 105:134 to 169: 126, x 2 =14. 806, P ＜0.01 ). The positive rates of bacteria were increasing in the five years. (2) One thousand six hundred and seventy-five strains were identified during the five years from different kinds of specimens, with 29 from blood, 39 from venous catheter, 3 from stool, 157 from sputum, 13 from urine, and 1434 from wound tissue. Among them, Staphylococcus aureus accounted for 28% to 42% , PA accounted for 10% to 25% , Acinetobacter baumannii accounted for 10% to 19% , and they were the predominant strains. (3)The difference among drug-resistance rates of PA to each kind of 12 antibiotics during the five years were statistically significant (with x2 values from 47. 911 to 308. 095, P values all below 0.01 ). The drug-resistance rates of PA to some antibiotics showed downward trend in the former four years, including amikacin,ceftazidime, and imipenem/cilastatin, but it rebounded in the fifth year. (4) There was descending trend in usage of cefoperazone/sulbactam and levofloxacin, but vancomycin was always used widely. (5) Drug-resistance rates of PA to 7 antibiotics, including amikacin, imipenem/cilastatin, and ciprofloxacin, etc. , were positively correlated with usage of various antibiotics (with r values from 0. 879 to 0. 978, P ＜ 0. 05 or P ＜0. 01). Conclusions In our burn wards, drug-resistant PA was prevalent. Disinfection and isolation measures,appropriate use of antibiotics,etc. can reduce PA infection.