丁胺卡那、左氧氟沙星治疗耐多药肺结核临床观察

目的观察丁胺卡那，左氧氟沙星在耐多药肺结核（MDR-TB）治疗中的疗效。方法68例耐多药肺结核患者随机分为治疗组36例和对照组32例。治疗组采用3DZThVA／15DThV，对照组采用3DZThES／15DThE方案治疗。结果疗程结束后，治疗组痰菌阴转率，病灶吸收好转率分别为86．11％，88．39％，而对照组分别为59．38％，59．38％，两组比较，差异有显著性。结论对耐多药肺结核采用含丁胺卡那、左氧氟沙星的方案治疗MDR-TB效果肯定。     

甲硝唑阿米卡星清洗液对预防阑尾炎术后切口感染的研究

目的 观察甲硝唑阿米卡星清洗液预防阑尾炎术后切口感染的临床疗效.方法 选取化脓性、坏疽性及穿孔性阑尾炎患者290例,随机分为治疗组和对照组,每组145例.在术前准备、手术方式和术后治疗方式均相同的前提下,缝合腹膜后,治疗组使用甲硝唑阿米卡星清洗手术切口,对照组常规使用碘伏生理盐水清洗手术切口.结果 治疗组感染3例（2.10％）对照组感染10例（6.90％）,治疗组感染率低于对照组,差异有统计学意义（P＜0.05）;坏疽性及穿孔性阑尾炎,治疗组感染2例（2.90％）,对照组感染8例（11.76％）,两组比较差异有统计学意义（P＜0.05）;化脓性阑尾炎,治疗组感染1例,对照组感染2例,两组比较差异无统计学意义（P＞0.05）.结论 甲硝唑阿米卡星清洗液能够有效预防阑尾炎术后切口感染,特别是对感染严重的重症阑尾炎的效果更为显著.     

Effects of Pentoxifylline on Amikacin-Induced Nephrotoxicity in Rats

The nephrotoxicity of amikacin (AK) was prevented with pentoxifylline (PTX) in a rat model. Rats were received a single injection of AK (1.2 g/kg, i.p.) with or without PTX pretreatment (25 mg/kg, orally). Renal morphology was investigated by light microscopy. Tissue samples and trunk blood were also obtained to determine renal malondialdehyde (MDA), blood urea nitrogen (BUN), and creatinine (Cr) levels. MDA production was found to be higher in AK group. PTX administration caused a significant decrease in MDA production. Morphological damage in rats given AK was severe in the kidney, whereas in rats given AK plus PTX, no histological changes occurred. It is concluded that PTX could be useful for reducing the nephrotoxic effects of AK.     

探讨药物对EDTA依赖性血小板聚集的抑制和解离作用

目的:探讨丁胺卡那霉素、氟化钠在体外对EDTA依赖性血小板聚集的抑制和解离作用,为临床EDTA依赖性假性血小板减少症患者提供更好的解决方案。方法:应用血液分析仪检测添加了氟化钠或不加药物的EDTA抗凝血中血小板的数目,对比它们在不同时段的变化。结果:即时或1h内加入药物,2种药物对EDTA依赖性血小板聚集抑制作用效果相近,均能显著地抑制或解离EDTA依赖性血小板聚集;但1h后加入药物,2种药物对EDTA依赖性血小板聚集的解离作用微弱。结论:1h内加入丁胺卡那霉素、氟化钠对EDTA依赖性血小板聚集有很好的抑制或解离作用,1h后加入丁胺卡那霉素、氟化钠对EDTA依赖性血小板聚集的解离作用不佳。     

紫外分光光度法测定注射液中硫酸阿米卡星的含量

目的：采用紫外分光光度计测定硫酸阿米卡星在注射液中的含量。方法：茚三酮与硫酸阿米卡星在一定的pH和加热条件下发生络合反应生成紫色络合物，采用比色法进行测定，测定波长为568nm。结果：线性范围15～27μg／ml，r=O．9996(n=6)。平均回收率为99．56％，RSD=0．83％。结论：本法简便、快速、准确、适用于阿米卡星有关制剂的质量控制。     

局部应用氨甲环酸及阿米卡星预防扁桃体切除术后出血

目的 :观察局部应用氨甲环酸及阿米卡星预防扁桃体切除术后出血的效果。方法 :对照组1 5 3例 (男性 78例 ,女性 75例 ,年龄 2 6a±s 3a)用2 %利多卡因 1 0mL加入氯化钠注射液 2 0mL及0 .1 %肾上腺素 3滴作扁桃体周围浸润麻醉。 2 2 9例 (男性 97例 ,女性 1 3 2例 ,年龄 2 8a± 4a)为观察组 ,用药在对照组基础上加氨甲环酸 0 .2g及阿米卡星 0 .2 g。结果 :观察组术后出血 4例 ,出血率 1 .7% ;对照组出血 1 2例 ,出血率 7.8% ,2组病人术后出血率差异有非常显著意义 (P <0 .0 1 )。结论 :局麻药中加入氨甲环酸及阿米卡星可以明显降低扁桃体切除术后出血的发生     

A RANDOMISED TRIAL OF EMPIRICAL ANTIBIOTIC THERAPY IN FEBRILE NEUTROPENIC PATIENTS WITH HEMATOLOGICAL DISORDERS: CEFTAZIDIME VERSUS AZLOCILLIN PLUS AMIKACIN

One hundred and two patients with neutropenia (<1 × 10⁹/L) secondary to primary hematological disorders or chemotherapy for hematological malignancies were prospectively randomised, upon the development of fever or other signs of infection, to receive empirical antibiotic treatment with either ceftazidime (± flucloxacillin) (n = 52) or azlocillin plus amikacin (± flucloxacillin) (A&A, n = 50). The two groups were equivalent with respect to clinical and laboratory parameters prior to antibiotic therapy and flucloxacillin was added to approximately 25% of the patients in each group on the clinical suspicion of Gram positive infection. When assessed at 96 hours, the complete response rates were 59.6% for the ceftazidime treated patients and 44% for A&A treated patients. Partial response rates were 17% and 20% respectively. This difference was not statistically significant. Eight patients died whilst on the trial, three of those initially randomised to ceftazidime and five initially randomised to A&A. Moderate to severe hypokalemia was encountered significantly less often in the ceftazidime treated group (p< 0.01), whilst other parameters of toxicity were equivalent. No primary or acquired resistance to ceftazidime was encountered. Separate analysis of those patients who did not receive flucloxacillin yielded identical results. We conclude that ceftazidime (±flucloxacillin) is as efficacious as azlocillin plus amikacin (±flucloxacillin) in the empirical antibiotic management of such patients and is associated with a lower incidence of moderate to severe hypokalemia.     

Isolation of an amikacin-resistant Escherichia coli strain after tobramycin treatment of previous recurrent episodes of respiratory tract infections caused by Pseudomonas aeruginosa

Amikacin-resistant Escherichia coli strains are isolated rarely from clinical samples. In the present study, investigation of an amikacin-resistant clinical isolate of E. coli demonstrated the presence of two class 1 integrons carrying the aacA4 gene plus the aacA7 gene, and the dfrA17 gene plus the aadA5 gene, respectively. Resistance to amikacin in this E. coli isolate was related to the presence of both aacA4 and aacA7.     

催产素拮抗丁胺卡那霉素对离体外毛细胞耳毒性作用的研究

目的：研究催产素对丁胺卡那霉素耳毒性的拮抗作用。方法：以连续录像手段观察离体耳蜗外毛细胞运动；荧光测钙技术测定单个外毛细胞内游离钙浓度（以荧光比值表示）。结果：⑴催产素对正常离体耳蜗外毛细胞运动及胞内游离钙浓度的影响较弱。⑵３．２３ｍｇ·ｍｌ１的丁胺卡那霉素可迅速降低细胞内钙离子浓度；６．６７ｍｇ·ｍｌ１的丁胺卡那霉素可使外毛细胞胞膜皱缩内陷，局部直径变细。⑶丁胺卡那霉素作用后，再加０．９１ＩＵ·ｍｌ１催产素，在测定的３０ｓ内，细胞内钙离子浓度恢复不显著；但施加１．２５ＩＵ·ｍｌ１的催产素，２ｍｉｎ后外毛细胞形态恢复明显。若先加催产素，再加等量的丁胺卡那霉素，细胞内钙离子浓度下降程度减轻，外毛细胞变形也不明显。结论：催产素可以预防和降低丁胺卡那霉素对耳蜗外毛细胞的耳毒性作用。