合理用药国际指标现场调查

目的 :了解我国现行合理用药状况 ,促进合理用药水平的提高。方法 :选择7家不同等级医院5个月门诊处方和当日门诊就医的患者 ,采取多中心、随机、平行试验方法 ,对合理用药国际指标的核心指标进行现场调查研究 ,用SPSS10 0软件进行统计分析。结果 :处方指标 :平均用药品种数2 63种 ;抗生素应用率38 3 % ;针剂应用率20 4 % ;基本药物应用率69 6 %。患者关怀指标 :平均就诊时间7 17分钟 ;平均调配药时间15 4秒钟 ;实际调配药物率100 % ;药物标示完整率99 % ;患者了解正确用药方法率86 3 %。结论 :采用国际指标评价用药合理性具有可操作性和有效性。我国合理用药水平较低 ,医师、药师对患者的交流关怀不够 ,有待于提高和进行干预。     

我院合理用药国际指标现场调查

目的了解我院合理用药状况,促进合理用药水平的提高。方法采用我院2005年1-5月门诊处方和5月11日门诊患者。采取随机抽样方法,对合理用药国际指标进行现场调查研究。结果处方指标:平均用药品种数2.84种;抗生素应用率46.0%;针剂应用率42.3%;基本药物应用率68.0%;患者关怀指标:平均就诊时间5.36m in;平均配药时间10.42 s;药物标示完整率100%;患者了解正确用药方法率71.4%。结论采用国际指标评价用药合理性具有可操作性和有效性。我院合理用药水平较低,医师、药师对患者的交流关怀不够,有待于提高。     

实施处方评价 促进合理用药

目的 了解首都医科大学附属北京朝阳医院合理用药情况,进行国际指标对照分析,促进合理用药水平的提高.方法 对该院2007年1～5月门诊处方和2007年5月25日门诊就医患者,采用多中心、随机、平行抽样试验方法,对合理用药指标进行现场调查分析.结果 处方指标显示平均用药品种数2.71种;抗生素应用率35.9%;针剂应用率21.9%;基本药物应用率83.2%;患者关怀指标:平均就诊时间8.17min;平均发药时间12.7s;药物完整标示率100%;患者了解正确用药方法率91.5%.结论 北京朝阳医院门诊用药基本合理,医师、药师对患者还应加强沟通.     

我院门诊合理用药国际指标调研分析

目的对医院门诊合理用药国际指标进行调研,提高合理用药水平。方法采用世界卫生组织和合理用药国际网络开发的合理用药国际指标方法,对2010年1月至10月的5 000张门诊处方和2010年8月19日的60例门诊患者进行调研,分别统计处方指标、关怀指标并进行分析。结果处方指标中平均用药品种数为2.30种,抗菌药物应用率达45.70%,注射剂应用率达11.00%,通用名使用率达100%,基本药物应用率达14.84%;关怀指标中患者平均就诊时间为8.48 min,药品平均调配时间为25.60 s,实际药品调配率达100%,药品标示完整率达100%,患者对药品正确用法了解率达81.30%。结论医院门诊合理用药国际指标大多数控制较好,但基本药物应用率低,医师、药师与患者的交流关怀不够,需采取措施予以干预。采用国际指标评价用药合理性具有可操作性和有效性。     

深圳地区临床合理用药国际指标现场调查

目的:了解深圳地区临床合理用药状况,促进合理用药水平的提高。方法:选择6家不同等级医院2个月门诊处方和当日门诊就医患者,采取多中心、随机、平行试验方法,对合理用药国际指标的核心指标进行现场调查,并进行统计、分析。结果:相关处方指标平均用药品种数2.44种、抗生素应用率43.7%、注射剂应用率22.3%;相关患者关怀指标平均就诊时间6.97分钟、平均调配药时间16.77秒、实际调配药物率100%、药物标示完整率100%、患者了解正确用药方法率96.5%。结论:深圳地区合理用药水平目前还存在较多问题,医师、药师对患者的交流关怀不够,有待提高和进行干预。     

我院合理用药国际指标现场调研

目的:评价我院门诊合理用药水平。方法:结合世界卫生组织推荐的合理用药指标,选择我院6个月门诊处方和门诊就医患者进行调查。结果:我院处方指标中平均用药品种数为2.15种,抗菌药物应用率达24.68%,注射剂应用率达10.25%,基本药物应用率为97.4%;患者关怀指标中患者平均就诊时间为3.8min,药品平均调配时间为25s,实际药品调配率达100%,药物标示完整率达95%,患者了解药品正确用法率达85%。结论:我院处方平均用药品种数、抗菌药物应用比例均较低。采用世界卫生组织推荐的合理用药指标来评价和比较医疗单位的用药状况具有可操作性。     

门诊合理用药国际指标的门诊用药调查与分析

目的:采用合理用药国际指标对某院门诊合理用药状况进行调查,为制定和实施促进合理用药的干预措施提供依据。方法:取某院2010年3个月的门诊处方和3d的门诊就医患者,对合理用药国际指标的核心指标进行调查并统计、分析。结果:平均用药品种2.37种,抗菌药物应用率48.9%,注射剂应用率33.8%,基本药物使用率49.2%,平均就诊时间11.1min,平均调配时间37.8s,药品调配率97%,药品标示完整率89.2%,患者了解正确用药率91.3%。结论:某院门诊合理用药目前存在一些问题,抗菌药物应用率和注射剂应用率较高,医师、药师对患者的交流关怀不够,有待干预和提高。     

我院门诊处方合理用药国际指标调查与分析

目的了解门诊合理用药状况,分析造成不合理用药的原因,促进合理用药水平的提高。方法应用世界卫生组织（WHO）推荐的合理用药国际指标,随机抽查医院6个月门诊处方1 000张,并对1个月内60例门诊就医患者进行调研。结果处方指标平均用药品种数为2.86种,抗菌药物使用率为48.10%,注射剂使用率为31.10%,基本药物使用率为63.05%;患者关怀指标中,平均就诊时间为5.20 min,平均调配时间为55 s,实际调配药品率为98.33%,药品标示完整率为80.00%,患者了解药品正确用法率为78.33%。结论门诊处方合理用药国际指标偏高,而基本药物使用率、患者关怀指标偏低,合理用药水平有待提高,医师、药师应加强对患者的交流、关怀。     

我院2011年门诊处方合理用药国际指标分析

随机抽取我院2010年门诊处方,并对120名门诊就医患者进行调查,以世界卫生组织制定的合理用药国际指标为标准,统计分析评价我院合理用药水平。结果处方指标:平均用药2.97种,药品通用名使用率100%,基本药物使用率为11.2%,抗菌药物使用率34.97%,注射剂使用率为26.05%;患者关怀指标:平均就诊时间7.25min。平均用药交代时间为22s,调配药物率100%,药品标签完整率100%,患者了解全部处方药用法91.26%。     

我市三家医院儿科门诊合理用药国际指标调研

目的：评价我市儿科门诊合理用药水平,为探索、推进儿科临床合理用药提供参考。方法：结合WHO推荐的合理用药指标,选择我市具有代表性三家医院2008年10月-2009年6月份儿科门诊处方和各30名儿科门诊就医患者进行调查。结果：处方指标中平均用药品种数为3．07种,通用名使用率为63．90％,抗菌药应用率为59．26％,注射剂应用率为22．96％,基本药物应用率为61．02％,平均每张处方金额为68．48元;患者关怀指标中患者平均就诊时间为7．73min,药品平均调配时间为45．75s,实际药品调配率为100％,药物标示完整率为100％,患者了解药品正确用法率为94．44％。结论：用药情况基本合理,但基本药物应用率、通用名使用率偏低,抗菌药使用率也有待降低,有待采取相关措施提高合理用药水平。     

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.