雾化吸入联合孟鲁司特钠治疗82例小儿感染后咳嗽的临床疗效分析

目的 观察探讨布地奈德混悬液联合硫酸特布他林雾化液雾化吸入联合孟鲁司特治疗小儿感染后咳嗽的临床疗效.方法 选取感染后咳嗽的患儿164例,随机分为两组,对照组采取孟鲁司特钠咀嚼片治疗,观察组采取雾化吸入联合孟鲁司特钠治疗,观察治疗效果.结果 观察组总有效率为95.1%;对照组总有效率为79.3%,疗效比较差异显著(P<0.05).结论 布地奈德混悬液联合硫酸特布他林雾化液雾化吸入联合孟鲁司特钠治疗小儿感染后咳嗽的临床疗效显著.     

布地奈德雾化吸入联合孟鲁司特佐治小儿肺炎支原体感染后咳嗽效果观察

目的观察布地奈德雾化吸入联合孟鲁司特钠佐治小儿肺炎支原体感染后咳嗽的效果。方法肺炎支原体感染患儿174例按入院单双日分为观察组96例与对照组78例。两组均使用大环内酯类等药物常规治疗,观察组加用布地奈德雾化吸入联合孟鲁司特钠咀嚼片口服,3周后评定疗效。结果观察组治疗后咳嗽程度评分低于对照组,痊愈率远高于对照组,差异均有统计学意义。结论在常规治疗基础上加用布地奈德雾化吸入联合孟鲁司特咀嚼片佐治肺炎支原体感染后咳嗽效果明显,且不良反应少,依从性高。     

雾化吸入联合孟鲁司特钠治疗小儿感染后咳嗽临床效果分析

目的 探讨雾化吸入联合孟鲁司特钠治疗小儿感染后咳嗽临床效果分析.方法 将2016年1月~2017年1月在我院儿科治疗的140例小儿感染后咳嗽患儿随机分为两组,对照组采用口服孟鲁司特钠治疗,观察组采用雾化吸入布地奈德+异丙托溴铵联合孟鲁司特钠治疗,比较两组患儿的治疗效果、症状改善情况及不良反应.结果 观察组治疗有效率为94.29%,明显高于对照组的77.14%,差异有统计学意(P<0.05);观察组治疗后咳嗽、睡眠质量明显较对照组改善,差异有统计学意义(P<0.05);观察组嗜睡、头痛、腹泻等不良反应发生率为4.29%,而对照组为2.86%,差异无统计学意义(P>0.05).结论 雾化吸入联合孟鲁司特钠治疗小儿感染后咳嗽效果显著,有利于咳嗽的快速控制,不良反应轻微,具有积极的临床意义.     

雾化吸入联合孟鲁司特钠治疗小儿感染后咳嗽疗效观察

目的：研究雾化吸入布地奈德及口服孟鲁司特钠联合治疗在小儿感染后咳嗽治疗中的应用价值。方法：选择2015年3～10月我院收治的120例感染后咳嗽患儿,按照随机数字表法分成研究组与对照组,每组60例,对照组运用孟鲁司特钠咀嚼片治疗,研究组在对照组基础上加用布地奈德雾化吸入剂实施治疗,比较两组临床疗效及不良反应。结果：研究组治疗总有效率为96.7%,对照组的治疗总有效率为80%,差异有统计学意义（P<0.05）。研究组不良反应发生率为3.3%,对照组不良反应发生率为5%,差异无统计学意义（P＞0.05）。结论：雾化吸入布地奈德及口服孟鲁司特钠联合治疗感染后咳嗽患儿效果显著,不良反应少,安全可靠,值得推广。     

雾化吸入布地奈德对上呼吸道感染咳嗽患儿孟鲁司特钠疗效的影响

目的 评价雾化吸入布地奈德对上呼吸道感染咳嗽患儿口服孟鲁司特钠疗效的影响.方法 上呼吸道感染感染后咳嗽患儿60例,性别不限,年龄1～8岁,体重指数为16～24 kg/m2,采用随机数字表法分为2组(n=30):对照组(C组)和布地奈德组(B组).B组雾化吸入布地奈德0.5 mg,2次/d,同时口服孟鲁司特钠咀嚼片4 mg,1次/d,疗程为10 d;C组只口服孟鲁司特钠咀嚼片.于第4 d至10 d采用咳嗽发生情况评价治疗效果,记录患儿相关并发症发生情况.结果 与C组比较,B组第4 d至10 d治疗痊愈率增高(P<0.05),两组间并发症差异无统计学意义,具有可比性.结论 雾化吸入布地奈德可增强上呼吸道感染后咳嗽患儿口服孟鲁司特钠的疗效,缩短治疗时间.     

布地奈德雾化吸入联合孟鲁司特钠治疗儿童咳嗽变异性哮喘的效果观察

目的观察布地奈德雾化吸入联合孟鲁司特钠治疗儿童咳嗽变异性哮喘的效果。方法选择2012年3月至2015年3月收治的咳嗽变异性哮喘患儿120例,随机分为观察组和对照组,每组60例。对照组在基础治疗基础上加布地奈德雾化吸入,观察组在对照组的治疗基础上加孟鲁司特钠口服。症状体征消失后继续维持治疗3个月。结果观察组总有效率(95.0%)显著高于对照组(78.3%),两组比较差异有统计学意义(P<0.05)。观察组患儿治疗前与对照组比较差异无统计学意义,治疗后观察组的改善更明显,与对照组各项指标比较差异有统计学意义(P<0.05)。两组治疗期间不良反应为胃肠道反应、头晕均自行缓解。结论布地奈德雾化吸入联合孟鲁司特钠治疗儿童咳嗽变异性哮喘可显著改善肺功能,整体效果好。     

儿童咳嗽变异性哮喘76例疗效分析

目的：探讨雾化吸入普米克令舒联合口服孟鲁司特治疗儿童咳嗽变异性哮喘（CVA）的临床疗效。方法选择2010年7月~2013年7月新疆省乌鲁木齐市兵团医院儿科门诊及住院CVA患儿76例,随机分为两组,每组38例：观察组予普米克令舒（布地奈德）雾化吸入＋孟鲁司特咀嚼片口服;对照组予孟鲁司特咀嚼片口服。治疗4周,并随访4周。结果两组患者的显效率和总有效率进行比较,观察组疗效显著高于对照组,差异有统计学意义（P〈0.05）。结论吸入布地奈德联合口服孟鲁司特钠治疗儿童咳嗽变异性哮喘,疗效优于单纯口服孟鲁司特钠。     

雾化吸入布地奈德混悬液联合口服孟鲁司特钠咀嚼片治疗小儿咳嗽变异性哮喘的效果探讨

目的 研究雾化吸入布地奈德混悬液联合口服孟鲁司特钠咀嚼片的治疗方法,在治疗小儿咳嗽变异性哮喘中的效果.方法 选择2015年4月~2016年4月医院收治的小儿咳嗽变异性哮喘患儿62例,随机分为观察组和对照组,每组患儿31例.对照组患儿采用单纯雾化吸入布地奈德混悬液的方法进行治疗,观察组采用雾化吸入布地奈德混悬液联合口服孟鲁司特钠咀嚼片的方法进行治疗,对比两组患儿治疗后的FVC、FEV、FEV1/F VC等肺功能指标,以及两组患儿的治疗效果.结果 治疗后,两组患儿较治疗前相比,FVC、FEV1、FEV1/FVC等肺功能指标均有所改善,其中观察组患儿的FVC、FEV1、FEV1/FVC等肺功能指标高于对照组患儿,治疗总有效率高于对照组患儿,差异具有统计学意义(P<0.05).结论 在小儿咳嗽变异性哮喘的治疗中,采用雾化吸入布地奈德混悬液联合口服孟鲁司特钠咀嚼片的方法,能够取得更为理想的临床疗效.     

雾化吸入联合孟鲁司特钠治疗72例小儿感染后咳嗽的疗效分析

目的 探讨雾化吸入联合孟鲁司特钠治疗小儿感染后咳嗽的疗效.方法 选取本院144例感染后咳嗽患儿分成治疗组和对照组.治疗组采用雾化吸入联合孟鲁司特钠的治疗方法,对照组采用孟鲁司特钠的治疗方法,比较两组患儿的临床疗效和不良反应发生率.结果 治疗组患儿的总有效率显著高于对照组,P＜0.05,两组患儿之间的不良反应发生率差异无统计学意义.结论 雾化吸入联合孟鲁司特钠治疗小儿感染后咳嗽临床疗效好,安全可靠,值得临床上推广应用.     

布地奈德联合孟鲁司特治疗儿童感染后咳嗽的临床疗效观察

目的 探讨布地奈德雾化吸入联合口服孟鲁司特治疗儿童感染后咳嗽的临床效果.方法 选择我院收治的感染后咳嗽患儿共82例,随机分为观察组和对照组.对照组实施常规治疗、给予布地奈德雾化吸入.观察组除了常规治疗外,给予布地务德雾化吸入联合口服孟鲁司特治疗.现察两组患儿治疗前后咳嗽评分改变情况,评定治疗后的临床效果.结果 观察组和对照组治疗前咳嗽评分差异无统计学意义(P＞0.05);观察组治疗第3天和治疗第7天咳嗽评分分别和同期对照组的咳嗽评分比较,差异有统计学意义(P＜0.05).观察组治疗后总有效率(治愈、显效和好转所占比例)为97.5％;对照组治疗后总有效率(治愈、显效和好转所占比例)为73.1％;观察组治疗后总有效率高于对照组,差异有统计学意义(P＜0.05).结论 布地奈德雾化吸入联合口服孟鲁司特在儿童感染后咳嗽治疗中效果显著,值得借鉴.     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Comparison of in vitro cell models in predicting in vivo brain entry of drugs

Although several in vitro models have been reported to predict the ability of drug candidates to cross the blood-brain barrier, their real in vivo relevance has rarely been evaluated. The present study demonstrates the in vivo relevance of simple unidirectional permeability coefficient (P(app)) determined in three in vitro cell models (BBMEC, Caco-2 and MDCKII-MDR1) for nine model drugs (alprenolol, atenolol, metoprolol, pindolol, entacapone, tolcapone, baclofen, midazolam and ondansetron) by using dual probe microdialysis in the rat brain and blood as an in vivo measure. There was a clear correlation between the P(app) and the unbound brain/blood ratios determined by in vivo microdialysis (BBMEC r=0.99, Caco-2 r=0.91 and MDCKII-MDR1 r=0.85). Despite of the substantial differences in the absolute in vitro P(app) values and regardless of the method used (side-by-side vs. filter insert system), the capability of the in vitro models to rank order drugs was similar. By this approach, thus, the additional value offered by the true endothelial cell model (BBMEC) remains obscure. The present results also highlight the need of both in vitro as well as in vivo methods in characterization of blood-brain barrier passage of new drug candidates.