药物利用研究与合理用药

药物是治病防病的重要物质。药物的合理利用与人们的健康水平密切相关，也是医院现代化管理的重要组成部分。药物利用研究是解决合理用药的有力工具之一，目的在于建立用药的合理性、安全性和有效性的质量保证体系。近年来，药物利用研究在医院逐步展开，它是医院了解药品使用规律的重要手段之一。本文阐述了药物利用的概念、发展、作用及意义，合理用药的现代涵义。论证了医院开展药物利用研究是合理用药的根本，是医院可持续发展的保障。     

An ex vivo evaluation of a new root canal irrigation technique with intracanal aspiration

AIM: To evaluate the effectiveness of a new root canal irrigation technique with intracanal aspiration in removing the smear layer and to assess irrigant extrusion ex vivo. METHODOLOGY: Thirty-five instrumented canals of extracted human canine teeth that had been resected apically by removing 3 mm of the root tip were divided into one control and four experimental groups of seven teeth each. The roots were fixed in a plastic case and surrounded with normal saline agar coloured with 1% acid red. No irrigation was performed in the control teeth. Each root canal in the experimental groups was irrigated with 9 mL of 14% ethylenediaminetetraacetic acid for 3 min, and then with 6 mL of 6% sodium hypochlorite (NaOCl) for 2 min. In the intracanal aspiration technique, the irrigant was delivered from the tip of an injection needle placed 12 mm from the apical root-end and an aspiration needle that was connected to a Root ZX apex locator placed 2 and 3 mm short of the apical root-end in groups 1 and 2, respectively. In the conventional method, the tip of an injection needle used for delivery of the irrigant and as an active electrode was placed 2 and 3 mm short of the apical root-end in groups 3 and 4, respectively, the tip of the aspiration needle was placed 12 mm from the apical root-end in these groups. The readings of the Root ZX during irrigation were recorded. The cleanliness of the canal was evaluated by scoring smear layer from scanning electron microscopy (SEM) images of the canal. Extrusion of NaOCl was detected by measuring the discoloured area of the agar around the apical root-end. The data obtained were statistically analysed by one-way anova, the Kruskal-Wallis test and Friedman's test. RESULTS: In the SEM study, the canals in groups 1-3 were significantly cleaner than those in the control and group 4 (P < 0.05). The mean Root ZX readings in groups 1-3 were approximately "0.5". The discoloured area in group 3 was significantly larger than the other groups (P < 0.05). CONCLUSIONS: Irrigation using the intracanal aspiration technique allowed more effective removal of the smear layer than that performed by the conventional method in an apically resected canine tooth. The intracanal aspiration technique produced limited extrusion of the irrigant beyond the apical foramen.     

扶正和胃合剂治疗大肠癌48例

目的:观察中药扶正和胃合剂治疗晚期大肠癌的疗效.方法:扶正和胃组单用扶正和胃合剂治疗,扶正和胃合剂联合化疗组,中成药对照组用鸦胆子乳注射液治疗,观察Karnofsky评分、中位生存时间、生存率.结果:扶正和胃合剂可以显著地提高患者的生活质量,延长生存时间,提高生存率.结论:扶正和胃合剂可提高患者生活质量,延长晚期大肠癌患者的生存期.     

抗生素预防剖宫产感染的投药时机探讨

目的:探讨围手术期抗生素预防剖宫产感染的投药时机。方法:将278例孕妇随机分为3组,Ⅰ组于麻醉开始同时单次静脉滴注头孢哌酮针3.0g,Ⅱ组在术前4h时同法用药,Ⅲ组术后开始连续用药3d或至体温正常,比较3组预防感染的效果。结果:Ⅰ、Ⅱ组的术后平均每日最高体温及连续2d≥38.0℃的例数明显比Ⅲ组低(少),并有显著差异(P<0.05);Ⅰ组又比Ⅱ组效果优。结论:剖宫产预防感染应选择在麻醉开始同时单次用抗生素。     

抗青光眼药物与眼表结构的改变分析

目的通过对长期滴用抗青光眼药物患者的症状、眼部检查、实验室指标的分析,了解抗青光眼药物对眼表结构的影响,并对引起眼表结构改变的机理进行分析和探讨。方法29例(50只眼)长期局部滴用抗青光眼药物的患者均给予详细询问病史、眼部常规检查和干眼实验检查:Sch irm er 1、BUT、眼表活体染色、印痕细胞(C IC)检查。结果表麻下的Sch irm er 1、BUT的值均低于正常,角膜荧光素染色评分和虎红染色评分、印痕细胞评分均高。结论长期局部滴用抗青光眼药物可引影响眼表正常结构。     

Characterization of Histopathology and Microbiota in Contemporary Regenerative Endodontic Procedures: Still Coming up Short

IntroductionThis study aimed to investigate microbiota and the histopathology of infected immature teeth microenvironments after disinfection with calcium hydroxide, triple antibiotic paste, and a synthetic antimicrobial peptide (synthetic human beta-defensin-3-C15) for regenerative endodontic procedures (REPs). The null hypothesis was that there is no difference among intracanal medications on disinfection in REPs.MethodsPulp necrosis and periapical lesions were induced in immature beagle dog premolars. Block randomized teeth were uninfected (negative control, n = 6), left infected (positive control, n = 6), or medicated with a disinfectant (n = 6/group). After disinfection (2 weeks), teeth were reaccessed, irrigated with 17% EDTA, blood clot induced, sealed with ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK), and restored with resin-modified glass ionomer. Animals were monitored radiographically and euthanized (12 weeks) for histopathologic and metagenomic analyses.ResultsREP-treated roots showed radiographic repair of periapical radiolucency (67.65%, 23/34), continued root development (73.53%, 25/34), and apical closure (70.59%, 24/34) regardless of the disinfectant used (P > .05). Canal microenvironments histologically devoid of bacteria contained new mineralized and pulp-like tissues in characteristic patterns that varied by disinfectant. Next-generation sequencing (16S ribosomal RNA) identified Firmicutes, Proteobacteria, Actinobacteria, and Bacteroidetes as dominant phyla of microbiota in immature teeth. Infection-induced teeth showed changes in diversity and richness of microbiota from negative controls. Compared with positive controls, all treated teeth exhibited depleted operational taxonomic units, with lower phylogenic diversity from synthetic human beta-defensin-3-C15–treated teeth.ConclusionsThere were no differences among the medicaments investigated in radiologic treatment outcomes, but disinfectants in REPs showed altered microbiota from normal and diseased immature teeth with different histologic patterns of regeneration.     

“复方香菇多糖口腔膜剂”研究的定题跟踪服务的体会

从分析课题组的信息需求、选择检索工具及数据库、确定检索词、课题文献文本的制定等方面,总结了学科馆员为科研人员提供单项科研课题定题跟踪服务的体会。