货款省级统一支付制度在山东省基本药物集中采购中的应用效果分析

目的：分析货款省级统一支付制度在山东省基本药物集中采购中的应用情况及效果。方法收集2011年6～10月山东省基本药物集中采购实施货款省级统一支付制度后的落实情况,采用SPSS16．0软件,以描述性方法对基本药物中标及供应保障情况进行分析。结果山东省基本药物在可获得性、可负担性、质量和供应方面均取得显著效果。结论基于货款省级统一支付制度的基本药物集中采购可显著提高药品生产和配送企业参与供应保障体系的积极性,有效推动省基本药物制度的全面实施。     

In vitro and in vivo models for testing arrhythmogenesis in drugs

The steadily increasing list of drugs associated with prolongation of the QT interval and torsades de pointes (TdP) constitute a medical problem of major concern. Hence, there is a need at an early stage to identify drug candidates with an inherent capacity to induce repolarization-related proarrhythmias, avoiding exposure of large populations to potentially harmful drugs. Furthermore, the availability of clinically relevant and predictive animal models should reduce the risk that effective and potentially life-saving drugs never reach the market. This review will discuss the pros and cons of some in vivo and in vitro animal models for assessing proarrhythmia liability.     

Differences in HIV Risk Behaviors by Gender in a Sample of Tanzanian Injection Drug Users

This study investigated differences in drug use and sexual behaviors among from 237 male and 123 female heroin users in Dar es Salaam, Tanzania. Multivariate models of risk of needle sharing were estimated using multivariate logistic regression. Men were significantly older, more likely to inject only white heroin, share needles, and give or lend used needles to other injectors. Women were more likely to be living on the streets, have injected brown heroin, have had sex, have had a higher number of sex partners, and have used a condom with the most recent sex partner. Being male and earning less than US $46 in the past month were significant predictors of increased risk of needle sharing. Despite differences in sociodemographic, drug use, and sexual behaviors by gender, both male and female injectors in Dar es Salaam exhibit elevated risk of HIV infection associated with drug use.     

Assessment of the incidence of substandard drugs in developing countries

In a number of developing countries there is reportedly a high incidence of the availability of substandard drugs. The majonty of these reports do not contain quantitative data to support these claims, nor do they describe the methodology employed for the quality assessment. Many assume counterfeiting as the reason for the poor quality and in some cases this is not justified. We collected 96 samples of chloroquine and selected antibacterials from Nigeria and Thailand in a controlled and methodical manner and analysed them using appropriately validated methods based on high-performance liquid chromatography capable of detecting drug-related impurities and quantifying active drug(s). The results indicate that 36.5% of the samples were substandard with respect to pharmacopoeial limits. Decomposition was the cause of poor quality in a number of the samples but overall, poor manufacturing appeared to be prevalent. The analyses generated little evidence to indicate fraudulent manufacturing. Treatment failure and drug-resistance are possible consequences of the use of substandard drugs.     

国家基本药物中口服降糖药的药物经济学分析

比较国家基本药物中口服降糖药治疗2型糖尿病的经济效果.选取体重指数19～27 kg/m2的2型糖尿病患者200例,分为5组,每组40例,分别给予格列本脲(A组)、格列吡嗪(B组)、二甲双胍(C组)、格列本脲+二甲双胍(D组)、格列吡嗪+二甲双胍(E)进行治疗,观察疗效,采用药物经济学中的成本-效果分析法(CEA)进行分析.5组均可有效控制血糖,均可显著降低HbA1c.格列本脲更符合药物经济学原则,但由于易发生严重而持久的低血糖限制其临床广泛应用,老年患者应更加慎重;在以控制空腹血糖和体重为主要目标时选择二甲双胍更经济;在以控制餐后血糖为主要目标时选择格列吡嗪更为合理,尤其是体形偏瘦者更为合适;格列吡嗪+二甲双胍联合用药方案适合单用格列吡嗪或二甲双胍效果不佳者,值得推荐.     

In vitro generation of procoagulant activity by leukemic promyelocytes in response to cytotoxic drugs

Disseminated intravascular coagulation (DIC) is a frequent occurrence in acute promyelocytic leukemia (APL), especially after onset of chemotherapy. We have used a human promyelocytic leukemic established cell line (HL-60) and various other human leukemic cells to investigate the effect of cytotoxic drugs on generation of procoagulant activity (PCA). The results indicate that, unlike normal human peripheral blood monocytes and certain other cell types where PCA induction requires active mRNA and protein synthesis, in HL-60 cells, compounds such as actinomycin D, puromycin, and cytosine arabinoside and a variety of other cytotoxic agents, induced generation of a potent PCA. Although different in its mechanism of induction, this HL-60 cell PCA was similar, and may be identical, to mononuclear cell tissue factor. The PCA induction was rapid and preceded the lytic effect of the drugs. It was first detected on the outer cell surface but, following prolonged exposure to the drugs, upon lysis of the cells, it was also found in the extracellular medium. This in vitro effect mimics the development of DIC in patients with APL. The system may, therefore, serve as a model for the study of the cellular and molecular events associated with PCA generation by malignant promyelocytes and DIC occurrence in patients with APL and other malignancies.     

泡球蚴组织的体外培养及在药物筛选中的应用

目的 建立泡球蚴组织的体外培养模型，对4种药物的体外抗泡球蚴疗效进行初步筛选。方法 泡球蚴组织体外培养9周后，分为7组：阿苯达唑组、汉防己甲素组、己酮可可碱组、苦豆碱组、氧氟沙星组、未用药组和二甲基亚砜组。在加药24h和18d后，分别取样固定并在电子显微镜下观察超微结构。实验期间对囊泡计数。实验结束后，将培养物接种BALB／c小鼠进行活力测试。结果 汉防己甲素和己酮可可碱在体外能抑制泡球蚴的生长（P〈0．005），氧氟沙星对泡球蚴没有作用（P〉0．005），苦豆碱能促进泡球蚴生长。接种各药物组培养物的BALB／c小鼠饲养80d后处死并解剖，发现所有小鼠的腹腔中均有泡球蚴生长。结论 汉防己甲素和己酮可可碱在体外对泡球蚴有一定的抑制作用，氧氟沙星和苦豆碱对寄生虫无治疗作用。活力测试提示所选药物只能抑制寄生虫生长而无杀灭作用。     

良姜挥发油对两种人体蠕形螨的体外抑杀作用

良姜挥发油体外对毛囊蠕形螨的抑杀时间为(14.42±1.14)min,对皮质蠕形螨的抑杀时间为(8.3±0.86)min;生理盐水对2种人体蠕形螨抑杀时间均超过24 h。良姜挥发油对2种人体蠕形螨具有较强的抑杀作用,并且对皮脂蠕形螨的抑杀作用明显强于毛囊蠕形螨。因此良姜挥发油是治疗人体蠕形螨的一个非常有效的物质,良姜挥发油治疗人体蠕形螨病具有较好的应用前景。     

抗痛风药的合理应用

痛风作为一种常见的关节炎,发病率在逐年上升。不恰当的治疗可以造成慢性疼痛、肾功能不全以及关节破坏和畸形,从而影响患者的生活质量。治疗痛风的药物主要包括控制痛风急性发作期的药物和降尿酸的药物。作者结合临床经验及国内外痛风指南,对治疗痛风药物的疗效、安全性及合理用药作一综述。     

大肠埃希菌对含酶抑制剂药物耐药性分析

检测216株大肠埃希菌，超广谱β-内酰胺酶（ESBLs）阳性68株，阳性率为31．5％。大肠埃希菌对含酶抑制剂复合剂的耐药性不同，非产生ESBLs菌株的耐药率均较低。     

原发性高血压患者发生尿微量白蛋白列线图的构建和评价

目的:研究未治疗的原发性高血压患者发生尿微量白蛋白的危险因素,构建列线图预测模型并验证其有效性.方法:本研究连续纳入2018年1月—2019年12月在我院门诊和病房未治疗的原发性高血压共456例患者.随机分为建模组(318例)与验证组(138例).以上述指标构建列线图模型,在建模组中,应用LASSO回归和非条件二分类L...     

我国药物灭螺研究进展

血吸虫病是严重危害人类身体健康、阻碍疫区经济发展和社会进步的重大传染病.钉螺是日本血吸虫的惟一中间宿主,在血吸虫病传播中起着极其重要的作用,药物灭螺是控制血吸虫病流行的重要措施之一.该文就药物灭螺的概念、灭螺药物的种类与特点、最新研究应用的灭螺药物、当前药物灭螺中存在的主要问题以及今后药物灭螺的研究方向作一综述.     

Use of inappropriate prescription drugs by older people

OBJECTIVES: To determine the prevalence and predictors of inappropriate drug prescribing defined by expert national consensus panel drug utilization review criteria for community-dwelling older people. DESIGN: Survey. SETTING: Five adjacent urban and rural counties in the Piedmont area of North Carolina. PARTICIPANTS: A stratified random sample of participants from the fourth (n = 3,234) and seventh (n = 2,508) waves of the Duke Established Populations for Epidemiological Studies of the Elderly. MEASUREMENTS: The prescribing appropriateness for digoxin, calcium channel blockers, angiotensin-converting enzyme inhibitors, histamine(2) receptor antagonists, nonsteroidal antiinflammatory drugs (NSAIDs), benzodiazepines, antipsychotics, and antidepressants as determined by explicit criteria (through Health Care Financing Administration expert consensus panel drug utilization review criteria for dosage, duplication, drug-drug interactions and duration, and U.S. and Canadian expert consensus panel criteria for drug-disease interactions). Multivariable analyses, using weighted data adjusted for sampling design, were conducted to assess the association between inappropriate prescribing and demographic, health-status, and access-to-healthcare factors cross-sectionally and longitudinally. RESULTS: We found that 21.0 of the fourth wave and 19.2 of the seventh wave participants who used one or more agents from the eight drug classes had one or more elements identified as inappropriate. The therapeutic classes with the most problems were benzodiazepines and NSAIDs. The most common problems were with drug-disease interactions and duration of use. Longitudinal multivariable analyses found that participants who were white (adjusted odds ratio (AOR) = 1.67, 95 confidence interval (CI) = 1.28-2.17), were married (AOR = 1.40, 95% CI = 1.01-1.93), had arthritis (AOR = 1.74, 95% CI = 1.27-2.38), had one or more physical function disabilities (AOR = 1.42, 95% CI = 1.02-1.96), and had inappropriate drugs prescribed at wave 4 (AOR = 6.87, 95% CI = 5.11-9.22) were more likely to have inappropriate prescribing at wave 7. CONCLUSION: These results indicate that inappropriate prescribing is common among community-dwelling older people and persists over time. Longitudinal studies in older people are needed to examine the impact of inappropriate drug prescribing on health-related outcomes.     

抗HIV-1药物的研发特点及进展

目前高效抗逆转录病毒联合疗法在HIV的治疗中取得了很好的疗效,在国内外得到广泛应用。目前已有6类30余种抗逆转录病毒药物应用于抗病毒治疗,主要包括核苷类逆转录酶抑制剂、非核苷类逆转录酶抑制剂、蛋白酶抑制剂、整合酶抑制剂、膜融合抑制剂和CCR5辅助受体拮抗剂,分别作用于HIV复制的不同环节。此外,还有许多其他新型药物正处于研发和临床试验阶段。     

The effect of anti-malarial drugs on human natural killer cells in vitro

Human natural killer (NK) cell cytotoxicity against K-562 target was found to be markedly depressed by quinacrine, mefloquine, pyrimethamine and chloroquine. The most potent were quinacrine and mefloquine. Two other drugs tested, quinine and primaquine, displayed no significant effects even after long incubation periods with effector cells. The results showed that the inhibitory effects were not related to an inhibition of effector cell binding to target or to a toxic effect on NK cells.     

三药和二药固定剂量复合剂需求测算方法的初步研究

目的 通过探讨结核病防治中固定剂量复合制剂需求测算方法 ,为各地进行药品测算提供参考依据,并为其他疾病进行药品需求测算提供借鉴。 方法 根据世界卫生组织推荐的固定剂量复合制剂的测算原理,获得符合我国特点的计算公式;通过对484例初治涂阳病人测量体质量,并且治疗随访获得2个月末未阴转率以及不良反应停药率以获得需求测算的参数。 结果三药复合制剂测算量：X×（A_30-39×180+A_30-39×R×90+A_40-49×240+A_40-49×R×120+A₅₀×300+A₅₀×R×150）×1.25;链霉素累计测算量：X×（22.5+11.25×R）×1.25。二药复合制剂累计测算量：X×（A_30-39×180+A_30-39×180+A₅₀×240）×1.25。需要准备的单一制剂的人份数：X×B×1.25。X：某地区药品供应年新涂阳肺结核病人数,R：2个月末未阴转率,A_30-39：30～39 kg 病人比例,A_40-49：40～49-kg病人比例,A₅₀：大于等于50 kg病人比例。需求测算的参数：体质量构成比为南方省份30～39 kg体质量组为5.88%（2.89%,8.87%）,40～49 kg为40.34%(34.1%,46.6%),大于等于50 kg为53.78%(47.5%,60.1%);北方省份30～39 kg体质量组为3.7%（1.3%,6.0%）,40～49 kg为21.6%（16.5%,26.8%）,大于等于50 kg为74.7%（69.3%,80.1%）。2个月末未阴转率为5.5％（3.5％,7.5％）。不良反应停药率为2.7％（1.3％,4.1％）。 结论 该固定剂量复合制剂的计算原理和计算方法 ,能够为国家进行药品测算提供参考,并且可以为其他疾病的药品需求测算所借鉴。各地在开展药品测算时,应当开展小范围的预试验,以判断文中的参数是否符合本地情况。     

青蒿素类药物与其他药物配伍治疗疟疾的研究进展

近年来抗疟药耐药现象的出现严重影响了疟疾的防治,新药的研发和疟疾疫苗的研究离临床应用还存在一定距离,联合用药是疟疾治疗的有效途径,已成为当今疟疾防治研究的热点。本文综述了青蒿素类药物与其他药物联合治疗疟疾的研究进展。     

Implications for school-based health programmes of age and gender patterns in the Tanzanian primary school

This paper examines children's potential access to school health services by analysing data on the demographic structure, enrolment patterns and reported causes of early school-leaving in 347 schools in Tanga Region, Tanzania served by a school-based health programme. The analysis indicates that net enrolment ratios have risen over the previous 6 years, particularly among children under 10 years. However, in 1994 children were still much older than expected for a basic school population: 81% were adolescents ($10 years) and the mean age was 12 years. These data suggest that schools can provide equitable access to health education and school-based health services for a majority of children, even in a low-income country, and that the primary school population is predominantly adolescent and would benefit from health programmes targeted at that age group.