酵母样真菌感染的菌群临床分布与药敏分析

目的了解临床酵母样真菌的感染类型、分布及其对常用抗真菌药物的敏感性,为临床诊断治疗提供正确的用药依据。方法采用常规方法分离培养真菌,用法国生物梅里埃公司生产的ATB Expression微生物自动鉴定/药敏分析仪进行真菌鉴定和药敏分析。结果396株酵母样真菌中,白色假丝酵母菌检出率最高(72.3%),其次为热带假丝酵母菌(15.91%),光滑假丝酵母菌(6.82%)。酵母样真菌对5-氟胞嘧啶、两性菌素B、氟康唑、依曲康唑的敏感性分别为98.02%,98.43%,77.38%,77.76%。结论临床酵母样真菌感染以白色假丝酵母菌为主,对5-氟胞嘧啶、两性菌素B敏感性较高,对氟康唑、依曲康唑有不同程度的耐药,因此,药敏监测是非常必要的,临床医生应根据药敏结果合理使用抗真菌药物。     

2002—2004年深圳市慢病院抗结核病用药情况分析

目的掌握我院抗结核药物的用药现状及变化趋势。方法对我院2002—2004年抗结核药物的用药品种、金额进行分析和比较。结果我院抗结核药物的用药金额2002—2004年呈逐年上升趋势。结论抗结核药物的品种相对较少，价格较便宜．但抗结核病药物在我院防病、治病方面占有重要的地位，其用药数量、用药金额都在不断增长，抗结核病药物品种亟待进一步开发。     

自制无针粉末注射给药系统药物导入率的体外评价

目的 建立体外吸收评价方法，考察自制无针粉末注射给药系统的给药性能。方法 以人体皮肤为研究材料，荧光素钠作为模型药物，高效液相-荧光法检测，以透皮吸收率为指标，采用正交试验设计优选无针粉末注射的载药喷射参数。结果 建立的方法分析时间小于3min，在0．2304-9．216ng范围内呈线性关系，绝对回收率大于99．8％，RSD〈0．8％；自制无针粉末注射给药系统的最高透皮吸收率可达到40％，超过普通透皮途经400倍以上，与国外同类产品的药物导入效率（33％）相当；正交试验分析表明气源压力、喷管型号、药物剂量、药粉粒径均对无针粉末注射的效果有影响。结论 建立的研究方法简便、快速、准确、可靠，可用于无针粉末注射系统的体外研究；自制无针粉末注射给药系统的药物导入效率较高，值得进一步推广应用。     

慢性脑低灌注的病理生理学和药物治疗

慢性脑低灌注时,脑组织发生一系列病理生理学改变,临床主要表现为进行性认知功能减退,是血管性痴呆、Alzheimer病和Binswanger病等多种疾病发展过程中的一个共同的病理学过程。目前对慢性脑低灌注的临床治疗方法和手段极其有限。因此,研究其发病机制以及预防和治疗措施显得尤为重要。     

利福喷汀治疗耐利福平肺结核的疗效分析

目的分析增加利福喷汀的用药剂量对利福平耐药肺结核的疗效，以评价利福喷汀在治疗利福平耐药患者中的作用。方法根据药敏结果选取耐利福平肺结核患者101例，分为治疗1组（利福平低耐），治疗2组（利福平高耐），两组治疗方案中均含利福喷汀，对照组（利福平高耐）治疗方案中不合利福喷汀。观察治疗后3、18个月疗效。结果治疗1组在各阶段的痰菌阴转率、病灶吸收和空洞闭和情况明显优于治疗2组和对照组，两组差异有统计学意义；治疗2组的痰菌阴转率、病灶吸收和空洞闭和情况略优于对照组，两者差异无统计学意义。结论对利福平耐药的患者尤其在利福平低度耐药病例中，可以选择增加利福喷汀用药剂量的方案进行治疗，在利福平高度耐药病例中利福喷汀的作用不能确定。     

2002-2004年深圳市慢病院抗结核病用药情况分析

目的掌握我院抗结核药物的用药现状及变化趋势。方法对我院2002-2004年抗结核药物的用药品种、金额进行分析和比较。结果我院抗结核药物的用药金额2002-2004年呈逐年上升趋势。结论抗结核药物的品种相对较少,价格较便宜,但抗结核病药物在我院防病、治病方面占有重要的地位,其用药数量、用药金额都在不断增长,抗结核病药物品种亟待进一步开发。     

Bacterial ghosts (BGs)—Advanced antigen and drug delivery system

Bacterial ghosts (BGs) are empty bacterial envelopes of Gram-negative bacteria produced by controlled expression of cloned gene E, forming a lysis tunnel structure within the envelope of the living bacteria. BGs are devoid of cytoplasmic content and possess all bacterial bio-adhesive surface properties in their original state while not posing any infectious threat. BGs are ideally suited as an advanced drug delivery system (ADDS) for toxic substances in tumor therapy. The inner space of BGs can be loaded with either single components or combinations of peptides, drugs or DNA which provides an opportunity to design new types of (polyvalent) drug delivery vehicles. Uptake of BGs loaded with Doxorubicin (Dox) by CaCo2 cells led to effective Dox release from endo-lysosomal compartments and accumulation in the nucleus. Viability and proliferative capacity of the cells were significantly decreased (2–3 orders of magnitude) after internalization of Dox loaded BGs as compared to cells incubated with free Dox. The same effect was observed with leukemia cells. Melanoma cells also revealed a high capability to internalize BGs. These results indicate that BGs are able to target a range of types of cancer. BGs have also been investigated as DNA delivery vectors. Studies show DNA loaded BGs are efficiently phagocytosed and internalized by both professional APCs and tumor cells with up to 82% of cells expressing the plasmid-encoded reporter gene. Our studies with BGs as an ADDS system contribute (i) to optimize drug delivery for the treatment of cancer; (ii) define specific conditions for selection and preparation of BG formulations; (iii) and provide a background for the clinical application of BGs in cancer therapy.     

Individualized Mycophenolate Mofetil Dosing Based on Drug Exposure Significantly Improves Patient Outcomes After Renal Transplantation

Efficacy and safety of mycophenolate mofetil (MMF) may be optimized with individualized doses based on therapeutic monitoring of its active metabolite, mycophenolic acid (MPA). In this 12-month study, 137 renal allograft recipients from 11 French centers receiving basiliximab, cyclosporine A, MMF and corticosteroids were randomized to receive either concentration-controlled doses or fixed-dose MMF. A novel Bayesian estimator of MPA AUC based on three-point sampling was used to individualize doses on posttransplant days 7 and 14 and months 1, 3 and 6. The primary endpoint was treatment failure (death, graft loss, acute rejection and MMF discontinuation). Data from 65 patients/group were analyzed. At month 12, the concentration-controlled group had fewer treatment failures (p = 0.03) and acute rejection episodes (p = 0.01) with no differences in adverse event frequency. The MMF dose was higher in the concentration-controlled group at day 14 (p < 0.0001), month 1 (p < 0.0001) and month 3 (p < 0.01), as were median AUCs on day 14 (33.7 vs. 27.1 mg*h/L; p = 0.0001) and at month 1 (45.0 vs. 30.9 mg*h/L; p < 0.0001). Therapeutic MPA monitoring using a limited sampling strategy can reduce the risk of treatment failure and acute rejection in renal allograft recipients 12 months posttransplant with no increase in adverse events.