注射用益气复脉(冻干)与氯化丁基胶塞相容性研究中抗氧剂和硫化剂的含量测定

目的 建立注射用益气复脉（冻干）药品中氯化丁基橡胶塞用抗氧剂2,6-二叔丁基-4-甲基苯酚（BHT）和硫化剂对-特辛基苯酚的含量测定方法,并对其稳定性进行考察。方法 采用ACQUITY UPLC BEH C₁₈柱,以乙腈-0.2%甲酸水为流动相梯度洗脱,体积流量0.3 mL/min,柱温35℃,检测波长280 nm。结果 BHT和对特-辛基苯酚质量浓度在0.4～20μg/mL线性关系良好（r > 0.999）;准确度试验平均回收率分别为99.3%、101.9%,精密度及耐用性结果均符合要求;注射用益气复脉（冻干）稳定性考察样品中BHT和对-特辛基苯酚含量均小于限度值。结论 所建立的方法准确可靠,可用于注射用益气复脉（冻干）中BHT和对-特辛基苯酚的含量测定。     

女性会阴整形现状

综述国内外女性会阴整形的研究现状,对会阴部整形按照以功能重建、形态重塑与满足心理需求为目的进行分类,并对手术、微创与激光治疗方法进行了临床经验归纳。3种治疗方式各有适应证与禁忌证,手术方法包括阴道再造术、会阴成形术、小阴唇缩小术、处女膜修补术、阴道缩紧术、阴蒂肥大缩小整形术;微创技术方法包括激光、射频治疗阴道松弛和压力性尿失禁,以及应用自体脂肪组织、胶原蛋白、透明质酸、透明质酸联合PRP的注射填充治疗。会阴部整形因受传统文化的影响存在就诊、评价与整形治疗技术不规范,应尽快研究制订诊疗标准;激光和射频治疗因缺乏大样本研究,临床作用机制不详,应进行规范入组随机对照的临床观察;注射填充治疗多为非标签用药,未见文献报道对疾病的治疗作用,且存在后果严重的出血、栓塞等并发症的报道,因此应在伦理委员会的指导下谨慎实施。     

腰麻注药速度及部位对肠回纳术麻醉的影响

目的分析腰麻不同注药速度及部位对麻醉的影响。方法 150例ASAⅠ^Ⅱ级回结肠造瘘术后肠回纳患者,按注药速度10、15、20 s随机均分为A、B、C三组,每组50例;各组再按注药部位L2Ⅱ级回结肠造瘘术后肠回纳患者,按注药速度10、15、20 s随机均分为A、B、C三组,每组50例;各组再按注药部位L2³、L33、L3⁴不同均分为两亚组,各亚组25例。观察各组麻醉效果和不良反应。结果腰麻注射速度和部位不同,麻醉效果和不良反应随之而变(P<0.05)。结论肠回纳术患者,以L24不同均分为两亚组,各亚组25例。观察各组麻醉效果和不良反应。结果腰麻注射速度和部位不同,麻醉效果和不良反应随之而变(P<0.05)。结论肠回纳术患者,以L2³穿刺15 s注入0.5%左布比卡因2 m L安全优效,可控性好。     

心脉隆注射液对老年慢性心力衰竭患者脑钠肽前体及肌钙蛋白Ⅰ的影响

目的：探讨心脉隆注射液对老年慢性心力衰竭（ CHF ）患者脑钠肽前体（ proBNP ）及肌钙蛋白I （ CTnⅠ）的影响。方法收集医院70岁以上CHF住院患者92例,随机分为两组。对照组43例予CHF常规治疗;心脉隆组49例在CHF常规治疗基础上加用心脉隆注射液300 mg/d静脉滴注治疗14 d。治疗前后分别检测患者proBNP及CTnⅠ水平、6 min步行试验（6MWT ）距离。结果92例患者中,随着NYHA心功能分级增加,患者proBNP及CTnⅠ水平均上升,而6MWT距离下降;治疗14 d后,两组患者proBNP及CTnⅠ水平均较治疗前降低,6MWT距离较治疗前增加;治疗后心脉隆组患者较对照组患者proBNP更低[（410.97±74.56） pg/mL比（476.75±80.21）pg/mL, P=0.000],CTnⅠ亦更低[（0.06±0.03） ng/mL比（0.08±0.04） ng/mL,P=0.008],而6MWT距离[（431.78±42.58） m比（406.25±46.31）m,P=0.007]较对照组增高。结论心脉隆注射液能改善老年CHF患者的心功能。     

重组人脑利钠肽治疗老年患者急性心力衰竭的临床疗效

目的 探究重组人脑利钠肽治疗老年患者急性心力衰竭的临床疗效和安全性。方法 将2013年1月-12月入住天津市胸科医院的88例急性心力衰竭（AHF）患者随机分为治疗组和对照组,每组44例。两组患者入院后均常规进行抗心力衰竭药物治疗,对照组在常规治疗基础上加用硝酸甘油注射液,起始剂量为10 μg/min,匀速静脉泵入,以5 μg/min的速度递增直到血压稳定为止。治疗组在常规治疗基础上加用冻干重组人脑利钠肽,以冲击量2.0 μg/kg持续1 h后以0.01 μg/(kg·min)的滴速维持静脉泵注。两组患者均持续治疗1周。治疗结束后,观察两组的临床疗效,同时比较两组患者给药前后收缩压、舒张压、心率、Na⁺、K⁺、肌酐（Cr）的变化。结果 治疗后,治疗组和对照组的总有效率分别为88.63%、72.73%,两组比较差异有统计学意义（P<0.05）。治疗后,治疗组的心率、舒张压、收缩压均较治疗前有所下降,治疗前后差异有统计学意义（P<0.05）。对照组的舒张压和收缩压较治疗前有所下降,差异有统计学意义（P<0.05）。治疗后,治疗组心率、收缩压均明显低于对照组,两组比较差异有统计学意义（P<0.05）,同时治疗组K⁺水平高于对照组,两组比较差异有统计学意义（P<0.05）。结论 重组人脑利钠肽能明显改善老年急性心力衰竭患者的临床症状,对此类患者有较好的临床疗效和安全性,值得推广应用。     

环磷腺苷联合辛伐他汀治疗慢性心力衰竭的临床研究

目的 探讨环磷腺苷联合辛伐他汀治疗慢性心力衰竭的临床疗效。方法 将天津市北辰医院心血管内科2012年9月—2014年9月收治的慢性心力衰竭患者120例,随机分为治疗组和对照组,每组各60例。对照组在常规治疗的基础上口服辛伐他汀片,10 mg/次,3次/d。治疗组患者在对照组的基础上静脉滴注环磷腺苷葡胺注射液120 mg,1次/d。两组均治疗2周。比较两组的临床疗效,心功能指标左室射血分数(LVEF)、最大血流速度比(E/A)、左室短轴缩短率(FS),血清因子脑钠肽(BNP)、超敏C反应蛋白(hs-CRP)、血尿酸(UA)、白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α),以及血脂水平三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)。结果 治疗组总有效率(93.33%)明显高于对照组(80.00%),两组比较差异具有统计学意义(P< 0.05);治疗后,两组患者的LVEF、E/A、FS均较同组治疗前明显升高,且治疗后治疗组的相关指标均高于同期对照组,比较差异有统计学意义(P< 0.05);两组患者的BNP、hs-CRP、UA、IL-6、TNF-α均显著低于同组治疗前(P< 0.05);治疗后治疗组的BNP、hs-CRP、UA、IL-6、TNF-α均低于同期对照组,比较差异有统计学意义(P< 0.05);治疗后,两组患者的TC、TG、LDL-C均较同组治疗前显著降低,HDL-C较同组治疗前显著升高(P< 0.05)。治疗后,两组患者的TC、TG、HDL-C、LDL-C比较差异无统计学意义。结论 环磷腺苷联合辛伐他汀治疗慢性心力衰竭具有较好的临床疗效,改善患者的心功能,同时改善各种相关的血清因子指标。     

Applications of research evidence during processes to acquire approvals for syringe services program implementation in rural counties in Kentucky

IntroductionDespite decades of empirical research in the US and internationally documenting the benefits of implementing syringe services programs (SSPs), their implementation may be controversial in many jurisdictions. Better understanding how research evidence is applied during SSP implementation processes may enable the public health workforce to advocate for program scale up. This study explores applications of research evidence during processes to acquire approvals for SSP implementation in rural counties in Kentucky.MethodsIn-depth interviews were conducted among eighteen stakeholders (e.g. health department directors, SSP operators) involved in SSP implementation in rural Kentucky counties. Stakeholders were asked to describe the contexts surrounding SSP implementation processes. Interviews were transcribed and analysed for applications of research evidence. Research evidence-related quotes were subsequently categorised based on the typologies for applications of research evidence developed by Weiss et al. (instrumental, conceptual, and symbolic) and a fourth category for instances when research evidence was not used.ResultsInstrumental applications of research evidence occurred at the intrapersonal and interpersonal levels to dispel concerns about SSPs and formed the basis for implementation support. SSP proponents used research evidence in a conceptual manner to address underlying attitudes and beliefs that were not evidence-based. Participants reported symbolic research evidence applications to justify pre-existing attitudes and beliefs about meeting the public health needs of people who inject drugs. Lastly, in some instances, research evidence was met with scepticism and an unwillingness to consider its merits.ConclusionApplications of research evidence during SSP implementation approval processes in rural Kentucky counties were heterogeneous in nature. Better understanding the diversity of ways in which research evidence may be employed during SSP implementation processes may support efforts to improve the public health of people who inject drugs.

Key messages

1. Applications of research evidence during SSP implementation approval processes in rural Kentucky counties were heterogeneous in nature.
2. Instrumental applications of research evidence occurred at the intrapersonal and interpersonal levels to dispel concerns about SSPs and formed the basis for implementation support.
3. SSP proponents used research evidence in a conceptual manner to address underlying attitudes and beliefs that were not evidence-based.