维生素K1致过敏性休克1例

患者男，50岁，因肝癌入院。遵医嘱给予维生素K120mg，止血敏500mg加入5％葡萄糖500mL内静滴。5min后患者出现胸闷、出冷汗、意识丧失、小便失禁、血压测不到。立即停药，吸氧，静注地塞美松10mg，葡萄糖酸钙10mL和生理盐水20mL等处理，10min后症状缓解，意识恢复正常。15日后遵医嘱给予维生素K140mg和生理盐水20mL静脉注射，速度缓慢，约5min患者再次出现胸闷、出冷汗、血压测不到。     

药品包装材料对液体药剂质量的影响

目的:探讨药品包装材料与用药安全的关系。方法:参考有关文献并结合我国实际情况进行分析。结果:药品包装材料质量对人体能产生一定的危害,对药品质量也产生一定的影响。结论:应按药品的理化性质选用合适的药品包装材料,药品包装材料生产企业也要按专业标准化生产药品包装材料,以适应各种药品包装的需求。     

Bard补片和普理灵疝装置在老年腹股沟疝无张力修补术中的应用

目的总结Bard充填式网塞及成型补片和普理灵疝装置(PHS)治疗老年腹股沟疝的手术经验。方法回顾性分析1999年1月~2004年10月应用无张力疝修补术治疗老年腹股沟疝540例的临床资料,其中采用Bard充填式网塞及成型补片462例,PHS 78例。结果全部患者治愈出院。手术时间30~140 m in,平均45 m in。平均住院5 d。术后伤口均一期愈合,无一例切口感染。术后疼痛轻微,仅7例应用止痛药物。术后并发尿潴留11例,切口脂肪液化2例,皮下及阴囊血肿、浆液肿8例。随访时间3~82个月,复发2例。结论无张力疝修补术对腹股沟疝的解剖缺陷具有针对性,符合生理,创伤小,修补可靠,恢复快,并发症少,复发率低。两种修补材料各有特点,针对性选用能更好地发挥其疗效。     

药用丁基橡胶塞包装药品的临床使用情况调查分析

目的从临床实际工作出发,提高和细化卤化丁基橡胶塞质量标准,减少穿刺落屑.方法对临床科室使用卤化丁基橡胶塞包装药品情况进行回顾性调查及询问现场考察分析.结论丁基胶塞经临床穿刺使用普遍存在脱屑现象.     

心脏介入性治疗并发急性和亚急性心脏压塞的早期识别和急诊处理

回顾性总结8例心脏介入治疗并发急性和亚急性心脏压塞患者的临床资料。8例年龄9～85岁，于介入性治疗术中出现急性心脏压塞3例，在术后延迟出现亚急性心脏压塞5例。其中行起搏器植入术2例，临时心脏起搏2例，冠状动脉介入治疗3例，右心室造影1例。均行心包穿刺及留置引流导管治疗，抢救成功7例，死亡1例。提示心脏介入性治疗合并急性和亚急性心脏压塞多与操作不当有关，应加强防范意识，改进操作技巧；心脏压塞的早期识别和果断处理是成功抢救患者的关键。     

心塞通口服液对心肌缺血再灌注损伤的保护作用

目的观察心塞通口服液对家兔心肌缺血再灌注损伤的疗效并探讨其机制,寻找保护再灌注损伤的药物。方法以家兔开胸冠状动脉左室支结扎/开放心肌缺血再灌注模型,将家兔分为空白对照组、模型对照组、人参皂甙对照组、心塞通口服液低、中、高剂量组。测血清心肌酶、ΣST段观察心肌受损程度;选择超氧化物岐化酶、丙二醛、一氧化氮、内皮素等反映心肌缺血再灌注损伤的标志物,以及左心室缺血区心肌组织光镜下病理检查等主要观察指标进行观察。结果心塞通口服液能使抬高的心电图ST段明显下降;心律失常发生减少;心肌酶活性明显降低;保护超氧化物岐化酶活性,减少丙二醛的形成;对抗内皮素的产生及释放,增加一氧化氮水平;同时使缺血再灌注心肌细胞结构损伤明显减轻。结论心塞通口服液可以全面对抗心肌缺血再灌注造成的心肌损伤。     

COX-2 选择性抑制剂Celecoxib 治疗胶质瘤的体内实验研究

 目的 探讨选择性环氧化酶-2抑制剂Celecoxib(塞来昔布)对C6胶质瘤生长抑制的体内实验研究。方法 将成瘤小鼠分为对照组和治疗组，应用肿瘤HE染色法、肿瘤生长曲线、前列腺素E2(PGB)检测及电镜检查方法观察Celecoxib对小鼠移植瘤的作用。结果 HE染色和电镜可见治疗组血管破坏、细胞坏死和凋亡，PGE2检测及肿瘤生长曲线分析有统计学意义，P<0．05。结论 Celecoxib能够抑制COX-2活性。降低PGB合成，Celecoxib对C6胶质瘤生长具有抑制作用，对胶质瘤的治疗有重要意义。     

三七总皂苷治疗不稳定型心绞痛的临床观察

不稳定型心绞痛(UA)是心绞痛症状不稳定的统称，易导致急性心肌梗塞(AMI)或猝死，我科于2002年3月-2004年2月运用三七总皂苷(注射用血塞通)治疗60例不稳定型心绞痛患者，并与西医常规治疗进行比较，取得了较好的疗效，现报告如下：     

塞来昔布对人鼻咽癌CNE-2细胞生长抑制及放射增敏研究

Objective To investigate the growth inhibition and radiosensitization of Celecoxib in hu-man nasopharyngeal carcinoma cell line CNE-2. Methods CNE-2 growth inhibition by Celecoxib was eval-uated by MTT method. Apoptosis-related changes in morphology were observed by transmission electron mi-croscopy (TEM). Cell cycle distribution and apoptosis rate were measured by flowcytometry (FCM). The ex-pression of COX-2 protein was observed by SP method after the treatment of Celecoxib. Cells were randomly planted into four groups: irradiation control(Ci), drug group(Cd), irradiation group(R), and Celecoxib plus irradiation group(D+R). Single irradiation of 2,4,6,8,and 10 Gy were administered for colonogenic assay. Cell cycle distribution and apoptosis rate were analyzed at 6 Gy irradiation. Results The growth of CNE-2 cell was inhibited by celecoxib in a dose-and time-dependent manner, the IC50 was 80 μmol/L After the treatment, cell ratio of GO and G, phases was increased (47.03±2.76 vs 56.17±1.95, t=4.68, P= 0.010), whereas the ratio of S and G2/M phases was decreased (33.07±1.86 vs 24.87±1.76, t=5.54, P = 0.010; 19.30±0.53: 17.73±0.83, t=2.75, P=0.050), and the apoptosis rate was increased (1.57±0.47:10.47±0.31, t = 27.39, P = 0.000) in a dose-dependent manner. Apoptosis with nuclear chromatin condensation, fragmentation and cell shrinkage was found by TEM. SP method showed that Celeib decreased COX-2 expression (17.48±0.34 vs 12.82±0.51,t=13.20,P =0.00). The sensitivity ratio(D0) was 1.15. FCM showed that the percentage of cells in G2/M phase was significanty more in R and D+R groups than in Ci and Cd groups (68.00±1.65,54.27±5.74,17.60±0.80,14.86±1.23, t=47.70,P=0.000; t=11.63, P=0.000), and also significantly different between R group and D + R group (t=3.99, P= 0.020). The apoptosis rate was higher in R and D + R groups than Ci and Cd groups(4.83±0.97,9.50± 1.35,1.33±0.86 and 2.28±0.42,t=4.67,P=0.010;t=8.81, P=0.000), D + R group than R group(t =4.85,P=0.010). Conclusions Celecoxib can markedly inhibit the growth and induce apoptosis in CNE-2 cells,which may depend on COX-2 pathway. Celeeoxib potently enhances the radiosensitivity of CNE-2 cells,which may due to the repair inhibit of radiation-induced DNA damage, inhibit of cell proliferation,and enhancement of cell apoptosis after irradiation.     

丁基胶塞与注射用青霉素钠相容性实验考察

目的　根据国家关于以丁基胶塞替代天然胶塞的规定,考察丁基胶塞与注射用青霉素钠产品相容性情况。方法　依据中国药典2 0 0 0版药物稳定性指导原则和药物相溶性指导原则,标准要求,对注射用青霉素钠使用丁基胶塞后进行含量、水分、pH、澄清度与颜色项目的考察。结果　丁基胶塞的使用对注射用青霉素钠产品质量无显著影响。结论　对于注射用青霉素钠产品,以丁基胶塞替代天然胶塞不影响产品质量,可以保证患者用药的安全性