剖宫产不合理使用抗生素146例临床分析

目的了解我院剖宫产抗生素的使用情况,以指导临床合理应用抗生素。方法抽取我院2007年1月1日至2008年12月31日住院行剖宫产的所有病例共927例,以2004年卫生部颁布的《抗菌药物临床应用指导原则》为标准,将抗生素不合理使用情况分为10类进行分析,包括是否使用抗生素、预防用药指征、联合用药指征、药物选择、给药途径及方法、剂量及疗程、药敏试验、病程记录、围手术期用药及分级使用。结果 927例中全部使用抗生素,使用率为100%,其中预防性用药589例,占63.5%,治疗性用药272例,占29.3%,混合性用药66例,占7.2%。以《抗菌药物临床应用指导原则》为标准评估,927例中146例属于不合理用药,占15.7%。结论制定剖宫产抗生素应用细则,加强临床药学监管与服务的力度,使剖宫产抗生素应用更为合理。     

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??OBJECTIVE To establish an HPLC method to determine the related substances of vortioxetine hydrobromide and identify the degradation products of vortioxetine hydrobromide by HPLC-MS. METHODS An HPLC method was developed by using a CN column(Agilent Zorbax SB-CN,4.6 mm??250 mm, 5 ??m),the mobile phase consisted of CH₃CN-HCOONH₄(50??50, pH adjusted to 5.0 with phosphoric acid),the flow rate was 1.0 mL??min^-1, and the detection wavelength was set at 228 nm. The column temperature was maintained at 25 ??, and the injection volume was 20 ??L. RESULTS Vortioxetine hydrobromide was well separated from the related substances. The detection sensitivity of vortioxetine hydrobromide and its related substances met the determination requirements. The calibration curves of vortioxetine hydrobromide and related substances had good linearity. The repeatability of the method was good(RSD=6.89%, n=6). The average recoveries of the sample were all within 95%-105%. The degradation product produced by oxidation was identified by mass spectrometry as related substance D. CONCLUSION The developed method proves to be simple,accurate,specific and reliable. It can be applied to the determination of vortioxetine hydrobromide and its related substances.     

Purification design and practice for pertactin,the third component of acellular pertussis vaccine,from Bordetella pertussis

Development of acellular pertussis vaccine (aPV) requires purification of several components from Bordetella pertussis. While the components pertussis toxin (PT) and filamentous hemagglutinin (FHA) have been successfully purified, the third component, pertactin, proves to be a difficult target due to its very low concentration. In order to solve its purification problem, we performed the surface potential analysis with GRASP2 program. The results demonstrated that there are two major charge patches, one negative and one positive, which are located separately on this linear protein. For this special feature, we designed a dual ion exchange chromatography strategy including an anionic exchange and a cationic exchange process for separation of pertactin from the heat extract of B. pertussis. The initial anionic exchange chromatography concentrated the product from 1.7% to 14.6%, with recovery of 80%. The second cationic exchange chromatography increased the purity to 33%, with recovery of 83%. The final purification was accomplished by hydrophobic interaction chromatography, yielding a purity of 96%. The total recovery of the three columns was 61%. Characterization of the purified antigen was performed with CD, intrinsic fluorescence, HP-SEC and western-blot, showing that the purified protein kept its natural conformation and immune-reactivity. The rationally designed process proved to be feasible, and it is suitable for large-scale preparation of the third aPV component pertactin.     

磷酸卡维地洛缓释微丸的制备及其在比格犬体内的药动学

目的:评价自制磷酸卡维地洛缓释微丸在Beagle犬中的等效性。方法:〗流化床包衣法制备磷酸卡维地洛缓释微丸;试验采用两周期交叉试验设计,将6条Beagle犬,雌雄各半,分为两组,分服试验制剂磷酸卡维地洛或参比制剂磷酸卡维地洛;采用HPLC-FD法比较给药后原研和自研制剂在Beagle犬体内不同时间点的血药浓度。计算药动学参数并根据试验制剂和参比制剂AUC计算相对生物利用度。同时对主要药动学参数进行方差分析、双单侧t检验和[1-2α]置信区间分析,评价试验制剂和参比制剂的生物等效性。结果:磷酸卡维地洛在1~300 ng·mL^-1范围内线性关系良好(r=0.999 3),定量下限为1ng·mL^-1。提取回收率均高于50%,日内、日间RSD均小于12%,专属性良好,在本实验涉及的条件下样品稳定。磷酸卡维地洛缓释微丸试验制剂和参比制剂主要药动学参数t_1/2、t_max、C_max、AUC_0-t、AUC_0-∞无明显差异,与参比制剂相比较试验制剂相对生物利用度为(96.8±8.7)%。结论:自研制剂与原研制剂在Beagle犬体内生物等效。     

矿物药白石英优质矿产资源筛选及XRD Fourier指纹图谱研究

目的 分析不同产地白石英样品中矿物成分及含量,评价不同产地白石英样品的质量,筛选白石英优质矿产资源,并建立白石英X射线衍射（XRD）Fourier特征指纹图谱。方法 通过偏光显微及XRD分析不同样品矿物成分及其含量,以结晶度和石英含量作为评价指标。采用粉末XRD对白石英样品进行分析,建立中药白石英XRD Fourier特征指纹图谱,并进行模糊聚类分析、主成分分析和相似性评价。结果 偏光显微分析结果显示,不同产地白石英样品在结晶度上有明显不同。物相分析结果显示白石英样品主要成分为石英和正长石,且大多数样品含有钠长石。不同产地白石英中石英质量分数为91.2%~99.4%,其中浙江省安吉县章村镇和安徽省绩溪县扬溪镇白石英中石英质量分数最高,均为99.4%,浙江安吉县杭垓镇产白石英中石英质量分数为91.2%。建立了以12个共有峰为特征指纹信息的白石英XRD Fourier指纹图谱分析方法,其XRD Fourier指纹图谱的相似度为0.993～1.000。结论 在所采集的样品中,白石英药材品质总体较好,石英质量分数均在90.0%以上,其中浙江省安吉县章村镇和安徽省绩溪县扬溪镇所产白石英品质最好,其次为福建永安小陶镇和江苏新沂阿湖镇产白石英。偏光显微特征观察和XRD Fourier指纹图谱分析法可用于白石英的鉴定与分析。     

从专利分析视角浅析医学高职院校中医药知识产权现状

目的 “一带一路”背景下中医药文化迅速传播,中医药专利的价值低下不仅影响中医药在国际社会上的推广与认可,还会对我国中医药行业造成不可估量的经济损失。医学类高职院校作为中医药知识产权发明主体必需努力提升中医药专利的质量和价值。 方法 采用描述性统计分析法对2000年1月—2019年10月期间,我国高职院校申请的中医药相关专利进行统计分析。 结果 从专利申请数量看,高职院校累计申请中医药专利1 321项;从高职院校中医药专利申请内容看,排名前三的分别是中草药制剂配方专利、中药生产加工装置专利、中医药保健产品专利;从专利申请人类型看,各类高职院校都有中医药专利产生,其中数量最多的分别是综合类高职院校、理工类高职院校和农林类高职院校,医药类高职院校排第四;从专利失效数据看,截止到2017年的数据,中医药相关专利的失效率为41.52%,其中发明专利失效率为28.00%,实用新型专利失效率为52.08%。 结论 医学类高职院校在中医药知识产权的保护方面存在授权专利数量少、专利价值低、专利失效率高等突出问题。应从充分发挥高职院校在服务地方经济发展中的作用、充分利用高校图书馆的专利信息服务功能、及时调整专利奖励资助政策和激励机制、大力推进医学类高职院校校园中医药知识产权文化建设等方面入手,多管齐下,努力提升医学类高职院校中医药专利的质量和价值。      

Progression of quality of life in patients with grade 3 obesity after a 36 months care pathway with and without bariatric surgery

ObjectivesBeyond somatic consequences, excess weight affects quality of life. In the literature this has markedly improved in the first 6 months, but has decreased later. The originality of our work in that is based on the comparison of two groups of patients, surgical and non-surgical ones, monitored by a multi-professional team for 3 years.MethodsThe sample is comprised of 32 subjects divided into two groups: 17 subjects from the non-surgical pathway and 15 from the surgical one. The Quality of Life, Obesity, and Dietetics questionnaire (QOLOD), the Hospital Anxiety and Depression Scale (HADS) and the Dutch Eating Behaviour Questionnaire (DEBQ), age, BMI, and sex were recorded.ResultsAt baseline, age was significantly different between two groups (surgery vs. non-surgery). BMI and QOLOD improvement were significantly more important in surgical group (?13.6 kg [?19.2; ?10.8] vs. 0.0 kg [?2.8; 3.0] P < 0.001 and 16.9 [8.5; 32.2 vs. 2.1 [?9.4; 16.2], P = 0.004). The progression of the QOLOD score correlated negatively with the progression of BMI (r = ?0.5, P = 0.005)ConclusionThere is a link between post-surgery weight loss and improved quality of life at 36 months. We suggest a qualitative follow-up survey for surgical and non-surgical obese patients.     

浦口区社区居民中成药用药行为的调研分析

目的：通过调研社区居民使用中成药的用药行为,分析存在的问题并提出推进药学服务的对策。方法：随机对南京市浦口区643名社区居民进行中成药用药行为调查,并对结果进行统计分析。结果：被调查对象通过药师推荐和指导来选（服）用中成药的仅占3.9%,持续使用中成药时间达6个月以上的占50.7%,使用3种及以上中成药的占37.2%,中成药与化药联合应用占45.7%。社区居民用药以个人行为为主。结论：社区居民使用中成药存在诸多不规范行为,须推进基层中药师药学服务;加强基层中药师培养,利用现代互联网技术宣传中成药用药知识,促进公众安全合理用药,消除社区居民用药安全隐患。     

液相色谱-串联质谱检测鸡蛋中氟虫腈及其代谢物的残留量

目的建立一种检测鸡蛋中氟虫腈及其代谢物残留的液相色谱-串联质谱(LC-MS/MS)定量分析方法。方法优化检测条件:用乙腈进行样品提取,选择C18固相萃取小柱和无水硫酸镁对提取样品净化后进行液质联用检测。结果经过优化后液相条件:流动相由2mmol/L的甲酸铵水溶液和甲醇组成,采用梯度洗脱方式在C18反相色谱柱中进行分离,进样量为4μL。质谱条件:离子源采用ESI负离子,通过SRM模式对样品中氟虫腈及其代谢物进行定量检测。优化后,氟虫腈及其代谢物在0~20ng/mL质量浓度范围内线性关系良好,R2均>0.9993,检出限(S/N=3)和定量限(S/N=10)分别0.2~0.4μg/kg和0.66~1.32μg/kg。实际样品中添加4.0、20.0、40.0μg/kg 3个质量浓度水平下,平均回收率在76.60%~98.24%,相对标准偏差(RSD)为1.03%~3.41%,符合定量检测要求。结论该方法操作简便、灵敏度高,可满足鸡蛋中氟虫腈及其代谢物的检测要求。