我院住院患儿抗生素使用情况分析

目的：了解住院患儿抗生素使用情况,评价其用药合理性。方法：利用自行研制的抗生素合理应用自动监控系统列抗生素使用情况进行调查与分析。结果：调查住院患儿2959例。抗生素使用率为64．11％,其中预防用药占22．35％,单独用药、二联及三联用药使用率分别为54．03％、45．65％、0．32％。临床使用以青霉素类、头孢菌素类为主,给药途径主要为静脉给药,占94．63％,给药频率以1次／d为主．占57．48％。结论：抗生素临床使用存在一定的不合理现象,应引起重视。     

我院门诊儿科抗生素用药情况分析

目的了解并分析儿科门诊抗生素用药合理性情况。方法 2011年度我院儿科门诊6 800例患儿用药情况进行统计。结果儿科门诊抗生素处方使用率达85.5%,其中针剂处方占69.9%,单用和二联用药分别占61.5%和6.5%,静脉给药和口服给药分别达到68.0%和20.1%,品种分布以二、三代头孢菌素为主。结论儿科门诊抗生素用药存在不合理现象,应进一步加强监督管理。     

我院儿科门诊抗菌药物使用情况调查与分析

目的了解我院儿科门诊抗菌药物使用情况,促进临床合理用药。方法计算机随机抽取我院2011年8月～9月儿科门诊处方共3360张,对抗菌药物使用处方数、使用频率、给药途径、联合使用情况等进行统计分析。结果使用抗菌药物处方1441张,抗菌药物使用率43％,包括6大类、28个品种,使用频率前3位为头孢美唑、头孢泊肟和阿奇霉素。给药途径中静脉给药占58．1％,其中入壶给药方式占静脉给药96％;单联抗菌药物使用率达89％。二联为11％,无三联及以上处方;存在中药注射剂与抗菌药物配伍情况达24％。结论我院儿科门诊抗生素应用存在诸多不合理,如抗菌药物使用率偏高、药物选用起点过高、中药配伍等问题,医院应加强儿科抗菌药物的遴选和规范化使用,促进安全、经济、合理用药。     

儿科抗生素使用情况的调查与分析

目的调查儿科抗生素使用情况，促进儿科合理使用抗生素。方法2007年度1000例住院患儿用药情况进行统计，对抗生素使用情况进行调查和分析。结果抗生素使用率达87．3％，口服、静脉。肌内注射用药分别达14．8％、97．6％、6．2％；其中单用、联用药分别占总抗生素用药的68．7％和81．5％；静脉用药不良反应26例，占3％。结论儿科抗生素的使用儿童抗生素使用率高，存在滥用抗生素现象；并且静脉用药过多及联合用药频率高等问题。     

我院门诊抗生素使用调查与主要联合用药方式评价

目的：通过我院门诊处方中抗生素的使用情况调查，为临床合理使用抗生素提供参考。方法：随机抽取2001年11月我院门诊西药处方5271张，统计处方中抗生素使用率，前10位使用品种以及前10位二联、三联联合用药方式。结果：抗生素使用率60．46％，其中两联及两联以上占44．52％，前10住的大多为β-内酰胺抗生素。结论：门诊抗生素使用率普遍较高，有无指征预防用药的情况，个别联合用药方式缺乏依据，其合理性有待进一步评价。     

合理用药国际指标在我院的调查分析

目的：了解我院注射剂、抗生素的使用情况及费用比例，通过合理用药国际指标的调查分析，推动我院合理用药工作的进展：方法：收集我院门诊西药房2002年1～12月处方2127张，逐张统计。注射剂及抗生素使用情况。结果：注射剂使用率为41．65％，占总药费的44．02％。抗生素使用率为31．31％，占药费的27．24％。结论：我院注射剂使用率占比较高，抗生素的使用较为合理，说明我院就抗生素使用的各种干预措施行之有效。     

门诊抗生素类药物应用调查分析

目的：了解门诊患儿抗生素类药物应用情况,评价使用的合理性.方法：回顾性调查重庆医科大学儿童医院门诊患儿抗生素类药物使用情况.结果：4 649张门诊处方中抗生素类药物的使用率平均高达71.1%,其中单用一种抗生素的处方占34.7%,两药联用占40.0%,三药联用占11.8%,四药、五药联用占3.1%.常用抗生素类药物有磺棕合剂、青霉素类、头孢菌素类等,氨基苷类药物用量较少.结论：该院抗生素类药物选用基本合理,三药、四药联用占的比例太高.     

我院门诊抗生素使用情况分析

目的：了解我院抗生素使用情况,评价其用药合理性。方法：随机抽查门诊处方4140份。对抗生素的使用情况进行调查与分析。结果：抗生素使用率57．61％,其中单用、二联使用率分别为86．92％、11．82％。使用率较高的以头孢类、青霉素类、大环内酯类为主。结论：抗生素使用较为合理,但使用率偏高,应引起重视。     

用后效应理论分析抗菌药物给药方案

目的：本文通过对抗菌药物给药方案进行分析，探讨利用后效应理论指导临床合理用药的必要性。方法：运用后效应理论对不同抗菌药物给药方案进行回顾性分析评价。结果：全院抗菌药物使用率为54．5％。符合抗生素后效应给药方案占当日使用抗菌药物总例数的44．4％，不符合的占55．6％。结论：后效应理论在优化给药方案，为临床合理用药方面提供了循证依据。     

我院儿科处方抗生素使用情况调查

目的了解西昌市人民医院儿科患者抗生素使用情况,评价其用药合理性。方法对1200张门诊及住院患儿处方的抗生素使用情况进行调查和分析。结果抗生素使用率80％,其中单用、二联使用率分别为60．6％、38．8％,临床使用以头孢类药物、大环内酯类、青霉素类药物为主。结论我院儿科患者抗生素使用基本合理。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.