炎琥宁联合双嘧达莫治疗轮状病毒性肠炎效果观察

目的观察注射用炎琥宁联合双嘧达莫治疗婴幼儿轮状病毒肠炎的疗效。方法轮状病毒性肠炎患儿186例随机分为A组、B组、C组各62例,A组采用双嘧达莫治疗,B组采用炎琥宁治疗,C组采用炎琥宁联合双嘧达莫治疗,比较3组临床疗效。结果 C组止泻时间为（2.8±1.1）d,明显短于A组的（5.1±0.8）d和B组的（4.6±0.9）d,差异均有统计学意义（P〈0.01）。C组总有效率为88.7%明显高于A组的46.8%,差异有统计学意义（P〈0.01）,但与B组比较差异无统计学意义（P〉0.05）;C组显效率为59.7%明显高于B组的24.2%和A组的11·3%,差异均有统计学意义（P〈0.01）。所有患儿用药后均未见明显不良反应,复查肝功能、血白细胞、血小板均正常。结论炎琥宁联合双嘧达莫治疗轮状病毒性肠炎疗效好、安全,值得临床推广应用。     

炎琥宁联合蒙脱石散灌肠治疗轮状病毒性肠炎的疗效观察

目的观察炎琥宁联合蒙脱石散灌肠治疗婴幼儿轮状病毒肠炎的疗效。方法将126例轮状病毒肠炎患儿随机分为蒙脱石散灌肠治疗组（41例）、炎琥宁治疗组（40例）和炎琥宁＋蒙脱石散灌肠治疗组（45例），疗程5～7d，比较3组患儿止泻时间、显效率与总有效率。结果炎琥宁＋蒙脱石散灌肠组止泻时间较蒙脱石散灌肠组及炎琥宁组明显缩短，差异均有统计学意义（P〈0．01）。炎琥宁组、炎琥宁＋蒙脱石散灌肠组治疗总有效率高于蒙脱石散灌肠组（P〈0．01）；炎琥宁＋蒙脱石散灌肠组总有效率与炎琥宁组比较差异无统计学意义（P〉0．05），但显效率明显高于炎琥宁组，差异有统计学意义（P〈0．01）。结论炎琥宁联合蒙脱石散灌肠治疗轮状病毒肠炎疗效较好，值得临床应用。     

干扰素联合去乳糖奶粉治疗轮状病毒性肠炎的疗效观察

目的:探讨干扰素联合去乳糖奶粉治疗轮状病毒(Rotavirus RV)性肠炎的疗效。方法:对134例RV性肠炎患儿随机分为四组(A组,予以补液对症处理;B组,去乳糖奶粉治疗组;C组,干扰素治疗组;D组,干扰素联合去乳糖奶粉治疗组),分别进行治疗,观察泻止时间。结果:D组泻止时间明显低于其他三组(P＜0.05)。结论:干扰素联合去乳糖奶粉可视为目前治疗RV性肠炎的有效方案之一,值得推广应用。     

炎琥宁治疗婴幼儿轮状病毒肠炎86例

目的探讨炎琥宁治疗婴幼儿轮状病毒肠炎的疗效。方法采用炎琥宁（治疗组）和利巴韦林（对照组）分别治疗婴幼儿轮状病毒性肠炎156例。结果治疗组显效率为72.1%（62/86）,总有效率为97.1%（83/86）;对照组显效率为42.9%（30/70）,总有效率为68.6%（48/70）。两组间疗效有显著性差异（P〈0.01）,止泻时间、平均退热时间均有显著性差异（P〈0.01或0.05）。结论炎琥宁治疗婴幼儿轮状病毒肠炎疗效明显优于利巴韦林。     

锌剂联合无乳糖奶粉治疗婴幼儿轮状病毒性肠炎疗效观察

目的探讨锌剂联合无乳糖奶粉对轮状病毒肠炎的治疗作用。方法选取婴幼儿轮状病毒肠炎80例,随机分为治疗组（40例）和对照组（40例）,均口服思密达及补液、纠正酸碱失衡等常规治疗。对照组：继续母乳喂养或牛乳喂养;治疗组给予无乳糖奶粉喂养及口服葡萄糖酸锌片,3～5 mg.kg-1.d-1,分2次口服,疗程3～5 d。结果治疗组止泻时间及住院时间较对照组明显缩短,差异有统计学意义（P〈0.01）;且总有效率达92.5%,明显高于对照组（P〈0.01）。结论锌剂联合无乳糖奶粉治疗婴幼儿轮状病毒肠炎疗效显著,能较快减少腹泻次数,有效缩短腹泻病程,且无明显不良反应,值得临床推广使用。     

炎琥宁与思密达治疗婴幼儿轮状病毒肠炎的疗效观察

目的观察炎琥宁与思密达对婴幼儿轮状病毒肠炎的疗效。方法将婴幼儿轮状病毒肠炎315例,随机分为炎琥宁与思密达组(简称A组),病毒唑组(简称B组)。两组均于治疗后追踪粪便性状、次数,全身症状变化。结果 A组患者在退热时间、止吐时间、止泻时间、脱水纠正时间以及总病程均比B组少,而总有效率为96.8%,明显高于B组总有效率75.2%。结论炎琥宁与思密达治疗婴幼儿轮状病毒肠炎能较快的减轻症状,缩短病程。     

炎琥宁联合双嘧达莫治疗轮状病毒性肠炎效果观察

目的 观察注射用炎琥宁联合双嘧达莫治疗婴幼儿轮状病毒肠炎的疗效.方法 轮状病毒性肠炎患儿186例随机分为A组、B组、C组各62例,A组采用双嘧达莫治疗,B组采用炎琥宁治疗,C组采用炎琥宁联合双嘧达莫治疗,比较3组临床疗效.结果 C组止泻时间为(2.8±1.1)d,明显短于A组的(5.1±0.8)d和B组的(4.6±0.9)d,差异均有统计学意义(P<0.01).C组总有效率为88.7%明显高于A组的46.8%,差异有统计学意义(P<0.01),但与B组比较差异无统计学意义(P>0.05);C组显效率为59.7%明显高于B组的24.2%和A组的11.3%,差异均有统计学意义(P<0.01).所有患儿用药后均未见明显不良反应,复查肝功能、血白细胞、血小板均正常.结论 炎琥宁联合双嘧达莫治疗轮状病毒性肠炎疗效好、安全,值得临床推广应用.     

干扰素联合去乳糖奶粉治疗轮状病毒肠炎的疗效观察

目的观察干扰素联合去乳糖奶粉治疗轮状病毒肠炎的疗效。方法研究对象为2005年9月～2008年12月住本科的120例病例,随机分为两组,治疗组60例,对照组60例,对照组予补液、对症等常规治疗,治疗组予去乳糖奶粉喂养联合a-2b干扰素,观察两组病情变化。结果治疗组有效率优于对照组（P〈0.01）。结论干扰素联合去乳糖奶粉治疗轮状病毒性肠炎可提高疗效,值得推广。     

无乳糖奶粉辅助治疗轮状病毒肠炎并发乳糖不耐受症疗效观察

目的观察轮状病毒肠炎并发乳糖不耐受症的婴幼儿使用无乳糖奶粉作为辅助治疗的临床作用。方法将92例临床诊断为轮状病毒肠炎并发乳糖不耐受症患儿随机分成两组。对照组45例给以液体疗法及口服思密达、微生态制剂等常规治疗,治疗组47例在常规治疗的基础上,加用无乳糖奶粉辅助治疗。比较两组的临床治疗效果和病程进展时间等指标,并对其进行统计学分析。结果治疗组总有效率为93.62%,对照组为77.78%。两组总有效率的差异有统计学意义（χ2=4.753,P=0.029）;平均止泻时间在两组间的差异也有统计学意义（t=3.576,t=5.102,t=4.690,P〈0.05）。结论在轮状病毒肠炎并发乳糖不耐受症的婴幼儿秋季腹泻的治疗措施中,无乳糖奶粉作为辅助治疗措施有助于缩短病程,疗效肯定。     

去乳糖奶粉联合葡萄糖酸锌治疗轮状病毒肠炎60例疗效观察

目的 探讨去乳糖奶粉联合葡萄糖酸锌治疗轮状病毒肠炎的疗效.方法 选择60例轮状病毒肠炎患儿,随机分为三组,各20例.甲组:给予常规治疗;乙组:在甲组基础上给予葡萄糖酸锌治疗;丙组:在乙组基础上加去乳糖奶粉.甲、乙组在上述治疗期间进行母乳或一般配方奶粉喂养,丙组给予去乳糖奶粉.观察患儿疗效、止泻时间、退热时间、脱水纠正时间及住院时间.结果 甲组治愈率为55.0％(11/20),乙组治愈率为65.0％(13/20),丙组治愈率为95.0％(19/20).三组患儿治愈率比较,差异有统计学意义(P＜0.05),丙组患儿治愈率最高.丙组退热时间、止泻时间、脱水纠正时间及住院时间均短于甲、乙组,三组比较,差异有统计学意义(P＜0.01).结论 去乳糖奶粉联合葡萄糖酸锌治疗轮状病毒肠炎疗效肯定,值得临床推广使用.     

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.