米索前列醇片与缩宫素联合治疗中期妊娠引产产后出血患者的疗效比较

目的 为了观察舌下含化米索前列醇片联合宫颈注射缩宫素治疗中期妊娠引产产后出血的临床疗效.方法 总结在本院治疗的中期妊娠引产产后出血患者34例资料,按照患者自主选择治疗方法进行分组：用缩宫素联合米索前列醇片进行治疗的17例资料为治疗组,单纯选择宫颈注射缩宫素进行治疗的17例资料为对照组,术后统计中期引产后2h内出血量和24h内出血量,最后用统计学方法比较组间差异性.结果 治疗组产后2h平均出血量（109.5±11.2）ml,产后24h内平均出血量（190.5±13.3）ml,缩宫强度为强,与对照组疗效相比,组间差异具有统计学意义（P＜0.05）.结论 中期妊娠引产产后出血患者使用舌下含化米索前列醇片联合宫颈注射缩宫素治疗具有满意的临床疗效.     

中期妊娠引产产后出血患者使用舌下含化米素前列醇片联合宫颈注射缩宫素治疗的比较

目的为了观察舌下含化米素前列醇片联合宫颈注射缩宫素治疗中期妊娠引产产后出血的临床疗效。方法总结在我院治疗的中期妊娠引产产后出血患者46例资料,按照患者自主选择治疗方法进行分组:用缩宫素联合米素前列醇片进行治疗的26例资料为对照组,单纯选择宫颈注射缩宫素进行治疗的20例资料为对照组,术后统计中期引产后2 h内出血量和24 h内出血量,最后统计学方法比较组间差异性。结果治疗组产后2 h平均出血量(109.5±11.2)mL,产后24 h内平均出血量(190.5±13.3)mL,缩宫强度为强,与对照组疗效相比,组间差异具有统计学意义(P<0.05)。结论中期妊娠引产产后出血患者使用舌下含化米素前列醇片联合宫颈注射缩宫素治疗具有满意的临床疗效。     

米索前列醇联合缩宫素预防产后出血疗效分析

目的：观察米索前列醇舌下含化联合缩宫素对产后出血的预防效果。方法足月阴道分娩产妇共500例,随机分为治疗组和对照组。治疗组250例,在胎儿娩出后予米索前列醇舌下含化,并静脉滴注缩宫素;对照组250例,仅静脉滴注缩宫素。比较两组产后2 h的出血量、产后24 h出血总量、第三产程时间及用药不良反应。结果与对照组比较,治疗组产妇在产后2 h出血量为（180.2±75.3）ml、第三产程时间（7.25±3.21）min及产后24 h出血总量为（199.5±108.6）ml均有明显减少,差异有统计学意义（P〈0.01）,并且使用米索前列醇未见严重不良反应。结论米索前列醇联合缩宫素用于预防阴道分娩产后出血效果好,副作用少,值得临床推广使用。     

缩宫素与卡前列甲脂栓联合预防产后出血患者的临床治疗

目的：为了观察舌下含化卡前列甲酯栓联合宫颈注射缩宫素预防产后出血的临床疗效。方法符合自然分娩患者400例资料,用卡前列甲酯栓缩宫素联合进行预防的200例资料为治疗组,单纯选择舌下含化卡前列甲酯栓进行预防的200例资料为对照组,统计产后2 h内出血量和24 h内出血量,比较组间差异性。结果治疗组产后2 h和24 h出血量小于对照组,治疗组宫缩强度大于对照组。对比两组差异有统计学意义(P<0.05)。结论产后出血患者使用舌下含化卡前列甲酯栓联合宫颈注射缩宫素治疗具有满意的临床疗效。     

缩宫素联合米索前列醇预防产后出血的临床观察

目的观察缩宫素联合米索前列醇预防产后出血的效果。方法将经阴道分娩的住院产妇100例随机分为观察组和对照组各50例。2组均于胎儿娩出后肌内注射缩宫素20U;观察组另同时舌下含服米索前列醇片200μg,至胎盘娩出时再舌下含服米索前列醇片200μg。观察2组产后2h、24h出血量。结果观察组产后2h和24h出血量均少于对照组,差异均有统计学意义(P<0.01)。结论缩宫素联合米索前列醇是一种安全、有效、简便的预防产后出血的联合用药方法,值得临床推广应用。     

卡前列素氨丁三醇治疗宫缩乏力性产后出血28例疗效观察

目的：观察卡前列素氨丁三醇联合缩宫素、米索前列醇治疗宫缩乏力性产后出血的效果。方法宫缩乏力引起的产后出血患者56例,随机分成治疗组和对照组,每组28例。对照组按摩子宫,静脉滴注缩宫素,同时使用无菌手套直肠内放置米索前列醇;治疗组：在此基础上,卡前列素氨丁三醇深部肌内注射,如宫缩仍差,间隔15min再次卡前列素氨丁三醇深部肌内注射。结果治疗组28例,25例阴道出血立即减少,3例30min内出血减少,产后24h内出血量统计为（752.5±52.3）ml;对照组19例阴道出血立即减少,9例30min内出血减少,产后24h内出血量统计为（961.2±48.5）ml,2组差异有统计学意义（ P＜0.01）。结论卡前列素氨丁三醇配伍缩宫素、米索前列醇能使产后24h内出血量明显减少,产后出血量降低。     

米索前列醇与缩宫素联合应用预防产后出血的临床观察

目的:观察米索前列醇配合缩宫素应用于预防产后出血的疗效.方法:将204例顺产产妇随机分为两组.在胎儿娩出后,观察组给予缩宫素10 U静脉小壶内注入,同时给予舌下含化米索前列醇片400 μg;对照组则只给予缩宫素10 U静脉小壶注入.观察两组产后2 h出血量.结果:两组产妇产后2 h阴道出血量有显著差异,观察组出血量较对照组明显较少,产后出血发生率明显较低.结论:米索前列醇与缩宫素联合应用可减少产后出血量,降低产后出血率的发生.     

缩宫素联合米索预防产后出血的临床观察

目的探讨缩宫素联合米索预防产后出血的临床效果。方法 A组（290例）胎儿娩出即予缩宫素注射剂10U宫颈或宫体注射,同时予以米索前列醇200μg舌下含服;B组（280例）胎儿娩出即予宫颈注射或宫体注射缩宫素10U,同时予缩宫素20U静脉滴注。结果两组产妇的出血量在产后24h比较,存在明显差异。结论与缩宫素比较,米索能有效减少产后出血量。     

米索前列醇预防产后出血的疗效观察

目的：观察舌下含化米索前列醇预防产后出血的效果。方法：选择在我院住院剖宫产的120例产妇,随机分为米索前列醇（以下简称米索）组和对照组各60例,两组年龄、孕周高危因素等无统计学差异。米索组胎儿娩出后立即舌下含化米索前列醇400μg,对照组胎儿娩出后立即宫体注射缩宫素20U,分别观察两组术中、产后2h和24h出血量的差异。结果：米索组产后出血量明显减少（P〈0.01）。结论：米索能有效促进子宫收缩,预防和减少产后出血的发生率。     

米索前列醇联合缩宫素在预防宫缩乏力致产后出血中的应用

目的探讨米索前列醇联合缩宫素对预防宫缩乏力致产后出血的临床效果。方法将单胎、足月、头位妊娠且经阴道分娩的初产妇120例随机分为观察组65例和对照组55例。观察组在胎儿娩出后立即予缩宫素20U肌内注射和米索前列醇600μg口服;对照组在胎儿娩出后即予缩宫素20U肌内注射。比较2组产后出血量及产后出血发生率。结果观察组产后2h和产后24h出血量均少于对照组,产后出血发生率均低于对照组,差异均有统计学意义(P<0.01)。结论米索前列醇联合缩宫素治疗宫缩乏力性产后出血疗效显著,用药方便、价格便宜、起效快、不良反应少,值得临床推广应用。     

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。     

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.     

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.     

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.     

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.