某院门诊抗消化性溃疡药物用药分析

目的分析笔者所在医院门诊处方中抗消化性溃疡药物的合理使用情况。方法 2010年10～12月1520张门诊抗消化性溃疡的处方,分析抗消化性溃疡药物的使用合理性及其临床使用情况。结果抗消化性溃疡药用药频率最高的品种为兰索拉唑,常用抗消化性溃疡药物的DUI值≤1。结论笔者所在医院消化性溃疡病治疗的用药基本合理,应重视消化性溃疡病治疗的合理用药,提高疗效。     

门诊处方高血压用药分析

目的了解我院门诊抗高血压药物的使用情况。方法对2007年门诊抗高血压药的用药频度（DDDs）排序,计算药物利用指数（DUI）值,并对处方中降压药和降压药的联用情况进行分析。结果各类降压药DUI≤1,抗高血压药的临床使用符合规定剂量,药物联用情况合理。结论我院抗高血压药的使用情况基本合理,但在实际用药过程中应避免药物联用引起的不良反应。     

我院门诊患者抗糖尿病药应用分析

目的：了解我院门诊患者抗糖尿病药使用情况。方法：采用回顾性调查方法,查阅我院2007年9月门诊处方32 564张,对其中抗糖尿病药的药物利用指数（DUI）,联合用药情况以及合理性进行统计和分析。结果：使用抗糖尿病药的处方660张（占处方总数的2.03%）,在抗糖尿病药的使用中,处方量居前3位的是二甲双胍、格列吡嗪、瑞格列奈;联合用药处方280张,占降糖处方的42.42%,以磺脲类联合双胍类为主;抗糖尿病药的DUI值大多〈1,但格列美脲、格列喹酮、罗格列酮的DUI〉1。结论：我院门诊抗糖尿病药的使用基本合理。     

2007年我院门诊抗高血压药物应用分析

目的：了解我院门诊抗高血压药物的使用情况。方法：对去年门诊抗高血压药的用药频度（DDDS）排序,计算药物利用指数（DDDI）值,并对处方中降压药和降压药的联用情况进行分析。结果：各类降压药DUI≤1,抗高血压药的临床使用符合规定剂量,药物联用情况合理。结论：我院抗高血压药的使用情况基本合理,但在实际用药过程中应避免药物联用引起的不良反应。     

抗消化性溃疡药物门诊用药分析

用统计学的分析方法对医院的抗消化性溃疡药物的用药情况(包括指定日剂量(DDD)药物利用指数(DUI)和用药金额的信息)进行统计分析.用药频率最高的抗消化性溃疡药是奥美拉唑和雷尼替丁,常用抗消化性溃疡药物的DUI值≤1.     

抗高血压药使用情况分析

目的 对我院抗高血压药使用情况进行分析。方法 以限定日剂量（DDD）和药物利用指数（DUI）为指标分析抗高血压药的使用情况。结果 使用抗高血压药的处方占总处方量的19．9％，从处方频数及DDDs（用量总量／DDD值）看，排前六位的分别是尼群地平、依那普利、硝苯地平缓释片、美托洛尔、非洛地平和氨氯地平；大部分抗高血压药的DUI都接近1。结论 我院抗高血压药物的使用情况基本合理，比较注意联合用药。     

门诊处方高血压用药分析

目的了解我院门诊抗高血压药物的使用情况。方法对2007年门诊抗高血压药的用药频度(DDDs)排序,计算药物利用指数(DUI)值,并对处方中降压药和降压药的联用情况进行分析。结果各类降压药DUI≤1,抗高血压药的临床使用符合规定剂量,药物联用情况合理。结论我院抗高血压药的使用情况基本合理,但在实际用药过程中应避免药物联用引起的不良反应。     

我院干部门诊抗高血压用药调查与分析

目的：通过分析我院干部门诊处方,了解抗高血压药物的使用情况。方法对我院2014年度干部门诊处方抗高血压药的使用情况进行抽样统计分析。结果各种药物DUI≤1,均符合临床使用的规定剂量,联合用药基本合理。结论我院应用抗高血压药物单一、联合用药及剂量基本合理,但在实际用药过程中应注意避免药物联合使用引起的不良反应。     

上海市浦东新区周浦医院2010——2012年门诊口服抗消化性溃疡药应用分析

目的：分析我院门诊口服抗消化性溃疡药使用情况及趋势,为临床用药提供参考。方法：对我院2010—2012年门诊口服抗消化性溃疡药的类别、品种、销售金额及用药频度（DDDs）进行排序,并对日均费用（DDC）和排序比（B/A）进行分析。结果：我院门诊口服抗消化性溃疡药3年来销售金额逐年上升,质子泵抑制剂所占比例最大,单品种销售金额和DDDs最高的均为雷贝拉唑。结论：我院口服抗消化性溃疡药应用基本合理。质子泵抑制剂占口服抗消化性溃疡药的主导地位,代表了临床用药的方向。     

我院门诊抗高血压药物应用分析

目的分析该院门诊抗高血压药物的应用情况。方法选择2012年1～3月门诊抗高血压处方615张,分别对用药品种、用药频度（DDDs）、药物利用指数（DUI）等进行分析,并以DUI为指标评价抗高血压药物应用的合理性。结果该院抗高血压药物除替米沙坦、缬沙坦、左旋氨氯地平、吲达帕胺外,其余药物DUI均≤1。结论该院抗高血压药使用基本合理,基本符合我国和欧洲高血压防治指南的原则。     

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.

---

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.     

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.     

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.