多肽和蛋白质及疫苗类药物干粉吸入给药的研究进展

针对多肽和蛋白质类药物体内过程和药学性质的特殊性,介绍了多肽和蛋白质类药物非注射给药途径研究现状,干粉吸入剂的剂型优点和制剂工艺技术特点,以及多肽和蛋白质类药物干粉吸入剂的研究进展,着重介绍了胰岛素等全身作用类药物、局部作用类药物及疫苗药物的干粉吸入给药的研究现状。     

干粉吸入剂给药装置研究现状及前景

简述了干粉吸入装置发展现状及前景,我国应加快对主动式吸入装置的研发。     

吸入给药肺沉积的研究进展

吸入给药治疗哮喘已成为一线疗法，吸人性药物作用依赖于其达到肺内的浓度。目前有多种药物和吸入装置应用于临床，理想的吸入型糖皮质激素应该具有肺内沉积多，受体结合力强，肺内停留时间长，全身消除快，起到较好的气道抗炎作用并尽可能减少全身副作用。吸入给药还可用于多肽和蛋白质类口服吸收会被破坏的药物，取代注射给药途径。但是经吸入给药，药物大部分滞留于口咽部，只有少部分能到达肺，吸入药物粒子肺沉积的研究，变得非常重要。     

现代给药技术的研究进展

药物治疗在临床上是一个不可或缺的重要环节,在疾病防治过程中起着举足轻重的作用。但药物在体内的作用效果在很大程度上,受制于药物剂型、释药系统和给药途径。因此,拓宽给药途径、发展释药系统已成为近几年来较受关注的研究课题。随着研究的不断深入和现代技术的发展,人们发现采用不同的药剂学手段可以广泛提高药物的生物利用度和作用效果。现就有关方面的进展综述如下:     

浅论吸入给药

吸入给药属中医嗅法范畴。综述了吸入给药的历史渊源、作用机理、治疗优势以及吸入给药与植物精气之间的关联,以此说明中药吸入给药治疗疾病的理论基础和用于“治未病”的现实意义。     

雾化吸入给药误区

在临床上,经常见到将一些静脉用药如糖皮质激素、氨茶碱、庆大霉素等作为雾化吸入的药物使用,这是不可取的。（1）糖皮质激素的注射剂型如地塞米松、氢化可的松等经呼吸道局部雾化吸入时,产生的雾化颗粒较大,达不到3～5μm的有效颗粒,因而药物只能沉积在大气道。     

内耳局部给药及其研究进展

内耳疾病的治疗研究是一个进展缓慢的领域，尚有许多亟待解决的难题。近年来，材料科学、药物剂型和给药方式等领域研究不断发展，为提高内耳疾病的疗效带来了新的希望。本文综述了近年来针对内耳病变药物治疗的给药方式，侧重于圆窗膜给药的药物分布、吸收方面的研究进展，旨在为建立内耳疾病药物治疗的新方法提供思路。     

生化药物鼻腔给药的研究进展

鼻腔给药系统(nasal dray delivery system，NDDS)是指在鼻腔内使用，经鼻粘膜吸收而发挥局部或全身治疗作用的制剂。鼻腔给药是传统的给药方式，在耳鼻喉科应用极为广泛，一般用来治疗各种鼻腔和鼻窦疾病。随着新辅料和治疗新技术的应用，发挥全身治疗作用的鼻腔给药制剂的研究越来越受到人们的广泛关注。     

基因药物呼吸道给药载体的发展

基因药物的呼吸道给药是基因治疗的主要途径之一.基因药物呼吸道给药系统由基因药物、基因载体和吸入装置组成.基因载体具有保护基因药物以及协助基因药物发挥作用等功能,分为病毒载体和非病毒载体两类.病毒载体由于不良反应较重,使用不广泛.阳离子脂质是最早用于基因药物呼吸道给药的非病毒载体,后被阳离子聚合物取代.聚乙烯亚胺是目前研究最多的阳离子聚合物载体,有良好的介导基因药物给药能力.新一代阳离子聚合物载体聚酯胺具有广阔的应用前景.     

护士对雾化吸入疗法的认知调查

目的 了解护士对雾化吸入疗法的认知现状.方法 采用自行设计的问卷对118名门急诊及临床护士进行调查.结果 门急诊及临床护士对雾化吸入知识的掌握情况均不理想,呼吸内科护士对雾化吸入疗法知识的掌握优于非呼吸内科护士(P＜0.05),护龄＜5年的低年资护士对雾化吸入疗法知识的掌握情况明显低于其他组别的护士(P＜0.05).结论 建议加强对非呼吸内科护士和低年资护士雾化吸入疗法知识的培训,鼓励护士参与雾化吸入治疗的临床实践.     

药品批准文号申请与转让的管理创新研究

目的 探讨在我国放开药品批准文号申请及转让的制度可行性并提出建议.方法 采用文献阅读法、专家咨询法及实例举证法等分析我国对于药品批准文号限制管理的现状及影响.结果 我国仅限药品生产企业申请获得药品批准文号,并且不允许文号在市场上转让,实际限制了药品技术的有效流通,违背了客观规律,造成一定程度上的资源浪费及监管负担.结论 在医药产业市场亟待盘活的今天,在国务院授权部分省市开展药品上市许可人制度试点的背景下,我国应逐步放开药品批准文号的申请及转让,使其更加符合市场规律及科学创新监管的需求.     

Effectiveness of azithromycin mass drug administration on trachoma: a systematic review

Backgrounds:Azithromycin mass drug administration (MDA) is a key part of the strategy for controlling trachoma. This systematic review aimed to comprehensively summarize the present studies of azithromycin MDA on trachoma; provide an overview of the impact of azithromycin MDA on trachoma in different districts; and explore the possible methods to enhance the effectiveness of azithromycin MDA in hyperendemic districts.Methods:PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and ClinicalTrials.gov were searched up to February 2021 with no language restriction. Studies reporting the effect of azithromycin MDA on trachoma were included. Mathematical modeling studies, animal studies, case reports, and reviews were excluded. The trachomatous inflammation-follicular (TF) <5.0% was used to judge the effect of azithromycin MDA on eliminating trachoma as a public health problem. Two researchers independently conducted the selection process and risk of bias assessment.Results:A total of 1543 studies were screened, of which 67 studies including 13 cluster-randomized controlled trials and 54 non-randomized studies were included. The effect of azithromycin MDA on trachoma was closely related to the baseline prevalence in districts. For the districts with baseline prevalence between 5.0% and 9.9%, a single round of MDA achieved a TF <5.0%. For the districts with baseline between 10.0% and 29.9%, annual MDA for 3 to 5 years reduced TF <5.0%. However, for the districts with high level of baseline prevalence (TF >30.0%), especially with baseline TF >50.0%, annual MDA was unable to achieve the TF <5.0% even after 5 to 7 years of treatment. Quarterly MDA is more effective in controlling trachoma in these hyperendemic districts.Conclusions:Azithromycin MDA for controlling trachoma depends on the baseline prevalence. The recommendation by the World Health Organization that annual MDA for 3 to 5 years in the districts with TF baseline >10.0% is not appropriate for all eligible districts.     

150例住院病历不合理用药情况分析

目的对医院2007～2010年住院病历用药情况进行随机抽样调查,汇总医院住院患者不合理用药情况,进行分析,并提出了正确的用药方法,以达到合理用药的目的。方法采用回顾性分析,对抽查病历中的医嘱单进行审查、分析。结果共抽取950份病历,150份病历有不合理用药现象,占15%。结论发挥临床药师的作用,重视合理用药,提高临床医疗质量。     

农村集体服药后肠道线虫感染情况调查

目的了解深圳市龙岗区居民集体服药驱除肠道线虫效果。方法于2006年9月对肠道线虫感染高的龙岗区区居民集体服甲苯咪唑糖片驱虫,2007年1月经盐水漂浮法和改良加藤氏法粪检调查550名居民的感染情况,分析驱虫效果。结果肠道线虫卵总检出率为18．73％（103／550）。单虫阳性率以鞭虫卵最高,为9．27％,钩虫卵次之,为6．36％,蛔虫卵最低,为4．00％。用饱和盐水漂浮法检出率为8．18％;改良加藤氏法检出率为10．36％,经统计学处理（x^2=1．296,P〉0．05）,无统计学意义。从单虫检出情况看,盐漂法检出钩虫卵阳性21人,加藤法为13人,经统计学处理无统计学意义（x^2=3．379,P〉0．05）。蛔虫卵分别检出16人和6人,显示盐漂法明显高于加藤法（x^2=4．638,P〈0．05）。鞭虫卵检出分另0为12人和39人,显示加藤法明显高于盐漂法（x^2=29．987,P〈0．01）。结论甲苯咪唑糖片对人体肠道线虫有良好的驱除效果。通过集体驱虫后当地肠道线虫感染率大副下降。     

天然药物化学双语教学的初步探讨

本文探索和分析了双语教学在天然药物化学教学中的必要性和存在的问题，并通过具体的教学实践，提出了天然药物化学双语教学应当采取的方法、步骤及措施，为培养具有国际竞争力的高级医学人才提供了参考和借鉴。     

经气道应用尼可刹米的实验研究

本文报告给犬经气道和静脉应用尼可刹米。结果显示经气道和静脉应用同等剂量的尼可刹米(8.3mg/kg),其血药浓度在1.5分钟后差异不显著(P>0.05)。经气道应用高剂量尼可刹米时(25mg/kg),其血药浓度随之升高。经气道和静脉用药后,呼吸频率、潮气量均增加。经气道用药后半吸收期为0.48分钟,3小时内生物利用度为86％。以上结果提示,经气道应用尼可刹米能经肺部迅速吸收并能达到与静脉应用等剂量药物时的相同药理效应。     

Awareness of health personnel about lymphatic filariasis and mass drug administration in Karnataka state of South India

Background

A third of world''s filariasis cases occur in India. As a result Mass Drug Administration (MDA) was commenced in 1997 with the aim of eliminating this disease by 2015. However the coverage of MDA was not satisfactory. The underlying reasons for the poor coverage need to be identified. This study was conducted to assess the awareness of health personnel of lymphatic filariasis and the MDA programme.

Method

This cross-sectional study was conducted in Kundapura taluk of Karnataka state in India during the 6^th round of the MDA which was held between December 11 to 13, 2009.78 health personnel who were posted for drug distribution were selected by convenience sampling. After obtaining informed consent health personnel were interviewed individually using a semi-structured questionnaire. Performance of health personnel was assessed according to points scored for their responses.

Results

The mean age of all participants were 22.7± 8.9 years, 74(94.1%) were females and 58(74.4%) were nursing students. Only 17 (21.8%) participants had prior experience before taking part in this round of MDA. Only 4 (5.1%) participants achieved good scores while 45 (57.7%) got average scores. Performance scores were significantly better among paramedical workers (P<0.025) and participants with at least 4 years of experience in MDA (P<0.004).10 (12.8%) participants held the misconception that MDA should not be given to patients with DM (diabetes mellitus) and 7 (9.0%) felt that it should not be given to patients with hypertension or elderly people. This was seen significantly more (P<0.001) among non medical workers compared to others.

Conclusion

Very few participants in this study attained good performance scores regarding their knowledge of lymphatic filariasis and the MDA programme. Performance scores were better among paramedical workers compared to others. However misconceptions about contraindications to MDA were seen in all participants and this must be addressed by future training.     

不同途径给予咪达唑仑临床效果比较

目的: 比较静脉、肌肉、滴鼻、舌下四种途径给予咪达唑仑的临床效果。方法: ASA Ⅰ~Ⅱ级择期手术患者40例,按不同给药途径随机分成静脉组(V组)、肌肉组(M组)、鼻腔内滴注组(N组)、舌下含服组(S组)。各组依不同途径给予咪达唑仑,观察镇静(OAA/S)程度、BIS指数、VAS评分及记忆情况。结果: 镇静(OAA/S)程度:各组达到3级满意率为V、M组70%,N、S组30%。BIS值:V、M、N、S组分别在用药后5 min、25 min、35 min、35 min逐渐下降,BIS值分别维持在84.3±2.17、89.9±1.23、91.1±0.84、91.3±0.61水平。VA S评分:V、M、N组在用药后均低于治疗前(P<0.05~P<0.01)。遗忘情况:V、M、N、S组产生完全遗忘的百分率间差异有显著性(P<0.005)。结论: 四种途径给予咪达唑仑50 μg/kg,V、M组产生的临床效果优于N、S组。     

Influence of the nasal mucociliary system on intranasal drug administration

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