电子申请单在医院使用中的体会

阐述了医院电子申请单实施时的重点及值得注意的地方,电子申请单在各个检查科室的应用改变了病人的检查流程,解决了病人做检查过程中的多次排队现象,缩短了病人的检查时间,真正实现了无纸化的操作。     

肺癌三维适形放疗与常规放疗剂量学优势的比较

目的:比较肺癌三维适形放射治疗与常规放射治疗时的肿瘤靶区、正常组织和器官的剂量分布优势。方法:选择三维适形放射治疗进行根治性治疗的10例肺癌,先在适形放射治疗体位下在模拟机下常规定位,标出其射野范围后进行CT模拟扫描。非小细胞肺癌在DT40Gy时行第2次CT扫描调整CTV,常规照射设野避开脊髓加量。采用三维适形治疗计划系统评价常规照射和三维适形照射对肿瘤靶区、正常组织和器官的剂量分布。结果:三维适形放射治疗比常规放射治疗,从剂量分布对肿瘤靶区有更好的适形度,95%CTV达到的平均剂量高出11·5Gy(5~20Gy),平均高出医生给予剂量CTV体积的38%(10%~59%)。在正常组织中,除健侧肺的V20和V30比常规放疗稍高外(1·1%和1·7%),脊髓的最大剂量平均低4Gy(-4~12Gy),心脏V35低24·3%(-4%~75%),双肺V20和V30分别低7%(-5%~20%)与7·4%(-6%~20%),患侧肺的V20和V30分别低13%(-7%~45%)和15%(-8%~40%)。结论:三维适形放疗治疗肺癌比常规放射治疗有一定的优势,对肿瘤靶区有更好的适形度和剂量均匀性,并且能更好的减少正常组织脊髓、心脏和肺的照射体积和剂量,特别是高剂量的照射体积。     

儿童鼻窦低剂量CT扫描的临床应用研究

目的：探讨儿童(1~12岁)鼻窦低剂量CT扫描的临床应用价值。方法300例行鼻窦CT检查的儿童(1~12岁)随机分为三组,分别行低剂量[(100 kV,40 mA)、(100 kV,25 mA)]和常规剂量(100 kV,100 mA)扫描,比较三组的剂量指数(CTDIw);对各组CT图像的窦口鼻道复合体成像质量进行评分及分析。结果低剂量组的CTDIw与常规剂量组相比较,40 mA组下降约59.97%,25 mA组下降约74.95%;40 mA组的CT图像质量与常规剂量组相比较,差异无统计学意义(P>0.05),25 mA组的CT图像质量与常规剂量组相比较,差异有统计学意义(P<0.05)。结论儿童鼻窦CT检查时,实行低剂量扫描可以有效地降低辐射剂量,100 kV、40 mA的扫描参数较为适宜。     

心理干预对产后抑郁症患者预后的影响

目的探讨心理干预对产后抑郁症患者预后的影响。方法选择产后抑郁症患者42例作为研究对象,随机分为心理干预组和常规护理组,比较两组预后情况。结果两组治疗前后SDS抑郁自评量表得分比较,差异均有统计学意义(P<0.05或<0.01),治疗后两组比较,差异也有统计学意义(P<0.05)。结论心理干预能够改善产后抑郁症患者的预后。     

蒙药剂型改革及制剂现代化的几点思考

蒙药研究基础比较薄弱,特别是药效物质基础、药理作用机制、配伍理论等方面的研究目前仍处在起步阶段。其次,人才队伍建设滞后,尚未形成一支联合攻关与科技创新能力较强的蒙药新制剂研发团队。此外,国家和自治区在蒙药研发方面的经费投入仍相对不足,政策支持力度也不够有效。目前,蒙药剂型改革与制剂现代化研究工作面临一定的发展机遇。具体表现在,国家和自治区政府对此项工作高度重视,先后出台振兴发展蒙医药产业的一系列政策措施,研发经费投入也在逐年增加。此外,近年来自治区的一些高校先后建立了专门从事蒙医药新制剂研究的重点实验室,部分蒙药生产企业也组建了蒙药制剂研究开发中心等机构,由此为今后蒙药剂型改革与制剂现代化研究奠定了坚实基础。     

不同剂量帕利哌酮缓释片治疗精神分裂症的疗效与安全性研究

目的:比较不同剂量帕利哌酮缓释片治疗精神分裂症的疗效和安全性。方法:将93例精神分裂症患者随机分成3mg、6mg、9mg、12mg四组,给予帕利哌酮缓释片口服治疗8周,在治疗前及治疗第2、4、8周末采用阳性与阴性症状量表(Positive and Negative SyndromeScale,PANSS)和不良反应症状量表(Treatment Emergent Symptoms Scale,TESS)评定疗效和不良反应。结果:在治疗的第2、4、8周末,四组的PANSS量表总分及各因子分及减分率较治疗前差异均有统计学意义(P<0.05);第4周末,12mg组的PANSS评分明显低于3mg组(P<0.05);治疗第8周末,6mg、9mg、12mg组的PANSS评分明显低于3mg组(P<0.05),差异均具有统计学意义。帕利哌酮的主要不良反应为锥体外系反应、睡眠障碍、头痛。12mg组的不良反应明显高于其它剂量组(P<0.05)。结论:帕利哌酮缓释片能有效控制精神分裂症的阳性症状、阴性症状和一般精神病理学症状,且存在一定的量效关系。     

小剂量对比剂CTU在经皮肾镜碎石取石术中的应用研究

目的 探讨小剂量对比剂联合呋塞米注射液和生理盐水CTU新技术对经皮肾镜碎石取石术（PCNL）术前穿刺通道选择的临床应用价值。方法 采用改良的小剂量对比剂CTU检查方案对23例复杂性肾结石患者行小剂量对比剂联合呋塞米注射液和生理盐水CTU检查。在分泌期扫描前进行常规平扫。采用ROI法对23例患者肾结石密度进行测量,以了解复杂性肾结石的密度分布特点;采用ROI法对23例患者分泌期肾实质上极、中部、下极及上组肾盏、中组肾盏、下组肾盏、肾盂CT值进行测量并对测量结果比较,以了解小剂量对比剂CTU肾实质及肾盂肾盏系统内对比剂分泌均匀性;对23例患者复杂性肾结石及PC系统进行分泌期轴位、冠状位MIP及VR重组并对重组图像进行评分,以了解哪种重组方法对肾结石、PC系统显示最佳。结果 23例患者复杂性肾结石密度中位数为1182.41HU,95% CI：548.26~1734.54HU;小剂量对比剂CTU肾实质对比剂分泌均匀;PC系统内对比剂分泌均匀且明显低于复杂性肾结石密度使得复杂性肾结石和PC系统重组的准确性分别达到82.6%和87%;3种重组方案中,冠状位MIP用于描述复杂性肾结石的评分最高。冠状位MIP用于显示肾盂肾盏解剖结构的评分最高。结论 小剂量对比剂CTU三维重组图像可直观显示复杂性结石的空间位置、PC系统的截面与立体解剖结构及其与周围组织的关系,有助于PCNL术前穿刺通道选择。     

STATISTICAL INFERENCE FOR RELATIVE POTENCY IN BIVARIATE DOSE-RESPONSE ASSAYS WITH CORRELATED RESPONSES

ABSTRACT

The analysis of dose-response assays measuring two correlated responses is considered. Attention is given to statistical inference for the potency ratio. Results from a simulation study suggest that a post hoc adjustment for the correlation in parameter estimates obtained from univariate fits provides nearly as much power to detect differences in potency as a bivariate response model fit.     

Suicidal poisonings with methadone in France: Results of a two year national survey by the Toxicovigilance Network

Context. Methadone is used in France since March 1995, only for opioid maintenance treatment, in a syrup form. For the launching of a capsule form in April 2008, French health authorities requested a prospective survey of all cases involving exposure to methadone in either of the two available pharmaceutical forms. Objective. The aim was to document, in different circumstances and compare the safety of the new capsule form to the syrup. This report presents the findings of one arm of the study, devoted to methadone-related suicide attempts. Materials and method. From April 15, 2008 to April 15, 2010, all self-injurious methadone poisonings notified to or managed by the French Toxicovigilance Centers network were included. Analysis mainly focused on patients’ age and gender, estimated quantity ingested, eventual concomitantly taken substances, distribution of symptoms, and site of treatment. Results. 135 methadone-related suicide attempts were recorded. Analysis showed identical epidemiologic and clinical patient characteristics for the two pharmaceutical forms. Ten deaths occurred. The only discrepancy was a higher incidence of suicide attempts in the capsule group. However, as the number of capsule-treated patients increased during the second year, this difference remained significant but tended to decrease. Discussion. Combining these results with Pharmacovigilance and Addictovigilance arms, health authorities estimated that the benefit/risk balance of this new pharmaceutical form remains positive. They revised their position on requirements for prescribing and dispensing of the capsule form, and made them slightly easier. Following this, this “suicide” arm of Toxicovigilance survey was suspended, whereas the second one, concerning accidental pediatric methadone-related poisonings, has been extended until April 2014. Conclusion. In France, suicide attempts were more likely to occur with the capsule formulation. The clinical severity of intoxication was similar between the capsule and liquid forms.     

Assessing compressibility and compactibility of powder formulations with Near-Infrared Spectroscopy

Context: The compressibility and compatibility of a powder formulation is usually determined by compaction and following destructive tensile strength and relative density measurement of the final compact.

Objective: In this study, a non-destructive method with Near-Infrared Spectroscopy (NIRS) was designed and evaluated for the measurement of powder compressibility and compactibility.

Materials and Methods: 12 different formulations with a wide range of difference in properties were investigated by compaction and analysis of the resulting tablets. Two similar tablet batches were produced with every formulation. Relative density and tensile strength were measured with the traditional, destructive method on one tablet batch while a newly developed non-destructive chemometric NIRS method was applied for the second batch. The outcomes of the two approaches were compared to validate the developed method. All data sets were applied to three established mathematical equations to calculate equation factors, which are claimed to represent the formulation compressibility and compactibility. The study focus was set on the equation factor value comparison between the traditional and the newly designed method.

Results & Discussion: The results showed a high similarity between the outcomes of the two methods. An essential difference was noticed for the outcomes of the equation factors after application to the Leuenberger equation.

Conclusion: The approach with the NIRS is suggested as a promising tool for a reliable inline quality monitoring in the tablet manufacturing process.