2011—2013年北京市中关村医院呼吸科头孢菌素类抗菌药物应用分析

目的:了解北京市中关村医院(以下简称"我院")呼吸科头孢菌素类抗菌药物的使用情况。方法:采用世界卫生组织推荐的用药频度(DDDs)分析法,通过医院信息系统,统计2011—2013年我院呼吸科使用的头孢菌素类抗菌药物的药品名称、规格、数量等,计算出DDDs和销售金额并对其进行排序、分析。结果:近3年来,我院呼吸科使用的头孢菌素类抗菌药物的DDDs和销售金额均呈上升趋势;第3代头孢菌素使用的种类最多,且其DDDs和销售金额排序也居首位;第4代头孢菌素的DDDs和销售金额明显低于第3代和第2代头孢菌素。结论:我院呼吸科使用头孢菌素类抗菌药物较合理,但应严格控制第3代头孢菌素的用药指征,以提高疗效、延缓细菌耐药性的产生。     

2010-2012年南通市第三人民医院抗菌药物应用分析

目的：了解我院门诊药房抗菌药物使用情况,为临床合理用药和规范药品管理提供参考。方法：由药房计算机信息管理系统提供我院门诊药房2010--2012年抗菌药物使用数据,采用限定日剂量（DDD）法和销售金额排序法,对销售金额、用药频度（DDDs）、抗茵药物使用强度（AUD）等进行分析。结果：门诊使用的抗菌药物中头孢菌素类、大环内酯类、氟喹诺酮类及林可霉素类DDDs较高,其中头孢菌素类的销售金额和DDDs最高。结论：我院临床用药基本合理,安全有效且价格低廉的抗菌药物是我院抗菌用药的优先选择。掌握抗菌药物应用情况,为健全我院抗茵药物分级管理和临床合理用药提供有效的依据。     

医院住院患者抗菌药物使用情况调查

目的 了解抗菌药物在我院住院部的使用情况.方法 统计2008～2010年度住院使用抗菌药物的种类、消耗量、消耗金额、用药频度(DDDs)等并进行统计分析.结果 本院使用的抗菌药物共9大类132个品种,抗菌药物年均消耗金额占住院全部药品消耗总金额的24.9%.头孢菌素类消耗金额最大,占抗菌药物总金额的66.8%,其次为青霉素类,占14.2%,喹诺酮类占11.0%.头孢曲松钠消耗金额、DDDs均居首位,喹诺酮类和青霉素类在临床上也占相当大的比例.结论 抗菌谱广、耐酶性强、毒性低、安全性高的第3代头孢菌素类占本院抗菌药物的首位.     

2006—2009年住院部头孢菌素类药物应用分析

目的：了解南京医科大学第二附属医院住院部头孢菌素类抗菌药物的应用情况和趋势。方法：对我院住院部2006—2009年头孢菌素的销售金额、用药频度（DDDs）、日均费用（DDC）等进行回顾性统计、分析。结果：头孢菌素销售金额占药品总销售金额的12.71%～15.14%,其中第3代头孢菌素及其复方制剂销售金额最大,占头孢菌素销售金额的50%以上,第4代头孢菌素销售金额呈逐年上升趋势。大多数第2、3代头孢菌素的销售金额、DDDs和DDC均比第1代高,但第4代头孢菌素头孢吡肟的销售金额、DDDs逐年增加,至2008年和2009年均排序第1位。DDC波动范围较大,最高者达1068元/日。结论：我院住院部头孢菌素应用基本合理,但存在用药起点过高现象,应进一步规范管理头孢菌素类药物的应用。     

2012-2013年湖北鄂州二医院住院部第一季度抗菌药物应用分析

目的：了解我院住院患者抗菌药物的使用情况,为临床合理用药提供参考。方法：从2012—2013年我院第一季度住院部患者出院病历中抽取62份,统计所用抗菌药物的种类、销售金额、限定日剂量（DDD）及用药时间等,计算用药频度（DDDs）和药物利用指数（DUI）。结果：我院住院患者所用抗菌药物共计11大类、32个品种,主要为头孢菌素类、青霉素类、抗厌氧菌类及氟喹诺酮类药,其中头孢菌素类占主导地位。结论：我院抗菌素药物使用仍存在不合理问题,需进一步加强抗菌药物应用管理,以提高抗菌药物的合理用药水平。     

2007年我院住院患者抗菌药物利用情况分析

目的：全面了解我院住院患者抗菌药物的使用情况,为临床合理用药提供参考。方法：对我院2007年住院患者抗菌药物的品种、消耗量、用药金额和用药频度等进行统计分析。结果：抗菌药用药金额前三位依次是头孢菌素类、碳青霉烯类、青霉素类,口服抗菌药DDDs排名前三位的依次是左氧氟沙星、头孢克洛、阿莫西林,注射用抗菌药物DDDs排名前三位的依次是头孢哌酮钠他唑巴坦钠、亚胺培南西司他汀、依替米星。结论：我院抗菌药物使用基本合理。     

2009—2010年我院抗菌药物应用分析

目的了解我院抗菌药物的使用情况,为临床合理用药提供参考。方法采用销售金额排序和用药频度(DDDs)排序分析方法对我院2009—2010年抗菌药物的使用情况进行统计分析。结果我院抗菌药物销售金额占药品总销售金额的比例有所下降;头孢菌素类、β内酰胺酶抑制剂、喹诺酮类药销售金额排序各年度均列抗菌药物的前3位;庆大霉素注射液和庆大霉素片分列DDDs排序首位。结论我院抗菌药物使用基本合理,但仍存在不合理性和盲目性、用药档次偏高等问题,需进一步加强监管,合理用药,减少耐药菌的产生。     

2011年重庆涪陵中心医院住院患者抗菌药物应用分析

目的：了解2011年我院住院患者抗菌药物使用情况,给临床合理用药提供参考。方法：提取2011年每月我院住院患者抗菌药物消耗数据,对用药频度（DDDs）、限定日费用（DDC）、抗菌药物使用强度（AUD）等进行统计分析。结果：2011年我院住院患者抗菌药物使用剂型以注射剂为主;头孢菌素类和β-内酰胺＋β-内酰胺酶抑制剂复方制剂占抗菌药物总DDDs的1/2,头孢菌素类中又以第3代头孢菌素的DDDs最高;大环内酯类的使用主要以口服制剂为主。氟喹诺酮类与β-内酰胺＋β-内酰胺酶抑制剂复方制剂的DDDs、AUD和销售金额构成比逐月下降。结论：我院抗菌药物使用日趋合理,但仍存在用药不合理现象,有待进一步提高。     

2009-2010年我院抗菌药物应用分析

目的 了解我院抗菌药物的使用情况,为临床合理用药提供参考.方法 采用销售金额排序和用药频度(DDDs)排序分析方法对我院2009-2010年抗菌药物的使用情况进行统计分析.结果 我院抗菌药物销售金额占药品总销售金额的比例有所下降;头孢菌素类、β内酰胺酶抑制剂、喹诺酮类药销售金额排序各年度均列抗菌药物的前3位;庆大霉素注射液和庆大霉素片分列DDDs排序首位.结论 我院抗菌药物使用基本合理,但仍存在不合理性和盲目性、用药档次偏高等问题,需进一步加强监管,合理用药,减少耐药菌的产生.     

2006—2010年解放军第101医院头孢菌素类抗菌药物临床应用分析

目的:了解我院近5年来头孢菌素类抗菌药物的临床应用情况,为其临床合理应用提供参考。方法:对2006—2010年我院头孢菌素类抗菌药物的品种、用药金额、用药频度(DDDs)和限定日费用(DDC)等进行统计分析。结果:近5年来,医院头孢菌素类抗菌药物的用药金额、DDDs和DDC均呈逐年上升趋势,其中第3代头孢菌素占临床治疗的主导地位。结论:我院头孢菌素类抗菌药物应用总体情况基本合理,但是为延缓细菌耐药的产生,应进一步规范头孢菌素类药物的应用。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.