我院门诊口服降糖药的用药现状及趋势

目的:评估我院门诊口服降糖药的用药现状及趋势.方法:对我院门诊口服降糖药的用药频度(DDDs)、销售金额等进行统计、分析.结果:我院门诊α-葡萄糖苷酶抑制剂的DDDs及比例呈上升趋势,其销售金额也呈上升趋势,其中阿卡波糖几年来的使用均居DDDs排序第一位;双胍类药物DDDs排序保持在第二位,其销售金额也是呈逐年上升趋势;磺酰脲类DDDs及比例、销售金额及比例排在第三位,但呈下降趋势.结论:我院口服降糖药的使用基本合理.     

我院2004～2006年口服降糖药应用分析

目的:了解我院口服降糖药的应用情况及趋势。方法:采用限定日剂量(DDD)方法,对我院2004～2006年口服降糖药的用药频度(DDDs)、销售金额、日均费用等进行统计、分析。结果:我院口服降糖药的使用品种和数量呈逐年上升趋势,销售金额所占比例呈逐年下降趋势;3年中DDDs排序列前5位的依次是格列吡嗪、二甲双胍、格列喹酮、格列齐特、格列本脲。结论:我院口服降糖药的应用基本合理。     

2001年～2004年7月我院口服降糖药利用分析

目的 :评估我院口服降糖药的应用现状及发展趋势。方法 :对我院2001年～2004年7月口服降糖药的用药频度(DDDs)、销售金额等进行统计、分析。结果 :磺酰脲类药品的DDDs呈下降趋势 ,但其DDDs仍占总DDDs的70 %以上 ,其中格列吡嗪几年来均居DDDs排序第1位 ;双胍类药品的DDDs逐年增高 ;α -葡萄糖苷酶抑制剂和噻唑烷二酮类药品的销售金额呈上升趋势 ;“医保”药品均占总DDDs的97 %以上。结论 :我院口服降糖药的利用基本合理。     

2003年～2006年5月我院降糖药应用分析

目的评估我院降糖药的应用现状及发展趋势。方法对我院2003年～2006年5月降糖药的用药频度(DDDs)、销售金额等进行统计、分析。结果磺酰脲类药品的DDDs呈下降趋势,其中格列吡嗪几年来均居DDDs排序第一位,胰岛素注射液的DDDs呈上升趋势,其销售金额占所有降糖药金额的50%以上,打破了传统的阶梯式治疗模式;双胍类药品的DDDs逐年增高;葡萄糖苷酶抑制剂和噻唑烷二酮类药品的销售金额呈上升趋势。结论我院降糖药的利用基本合理。     

2011～2013年我院门诊口服抗糖尿病药物应用分析

对我院门诊部2011~2013年度口服降糖药的种类、用量、销售金额、用药频度(DDDs)、限定日费用(DDC)等进行统计与分析。我院门诊口服抗糖尿病药物销售金额呈上升趋势,3年销售金额排序变化不大。阿卡波糖片、二甲双胍、格列美脲片销售金额居前三位;用药频度(DDDs)呈逐年增加趋势,二甲双胍、阿卡波糖和瑞格列奈的用药频度(DDDs)连续3年排名前三位。限定日费用(DDC)略有下降。说明我院口服抗糖尿病药物的销售金额和用药频度呈增长趋势,口服抗糖尿病药物的使用基本合理。     

2006～2008年我院门诊口服降糖药应用分析

目的：对我院门诊患者口服降糖药的使用情况进行评估,为以后合理用药提供参考。方法：对我院门诊药房2006～2008年使用口服降糖药的年用量、各品种的年用药金额、用药频度（DDDs）及限定日费用（DDC）分别进行统计、分析。结果：口服降糖药的消费金额呈上升趋势,所占用药金额的比例基本稳定;各品种年用药金额排序前3位是阿卡波糖、二甲双胍、格列美脲;DDDs排序前5位是二甲双胍、阿卡波糖、格列美脲、格列齐特、格列吡嗪;年用药金额序号与DDDs序号的比值在0.5～3.0之间。结论：我院门诊使用口服降糖药的品种基本符合临床和患者的需要,用药合理。     

我院2008年~2011年门诊口服降糖药用药分析

目的:调查分析我院2008～20011年门诊口服降血糖药物的使用情况及趋势,为临床合理使用降血糖药物提供参考。方法:调取我院微机管理系统提供的2008年～20011年门诊口服降血糖药物的应用数据,分析比较各药物的使用情况。结果:我院门诊口服降血糖药物的数量及销售金额呈增长趋势,DDDs排序前3位是阿卡波糖、二甲双胍及格列喹酮。药品销售金额首位为阿卡波糖,另外那格列奈销售金额逐年上升,稳居第2位。结论:2008年～2011年我院门诊患者口服降血糖药的数量和销售金额呈上升趋势,价廉且疗效确切的降糖药在临床应用中占优势,品种选择中体现了有效性和安全性的特点,使用情况基本合理。     

2009～2011年某院降糖药物的应用分析

目的了解和分析我院降糖药物的使用情况和发展趋势,为临床合理、经济、有效地选用药物提供参考依据。方法以我院2009～2011年降糖药物的出库记录为依据,采用金额排序法和频度分析法,分析统计降糖药物的年消耗金额,各类药物消耗金额排序以及用药频度(DDDs)、限定日费用(DDC)排序。结果降糖药总销售金额呈逐年上升趋势,其中口服降糖药占主导地位,胰岛素类降糖药占总销售金额比例逐年下降;磺酰脲类格列本脲DDDs连续3年位居首位,诺和灵30R笔芯和二甲双胍的DDDs也位居前列。结论我院临床对磺酰脲类、双胍类及诺和灵30R笔芯的选择倾向较大,降糖药的使用结构比较合理。     

我院门诊药房2009—2012年口服降糖药使用情况分析

目的：了解我院门诊药房口服降糖药物的临床应用情况。方法：采用金额排序和限定日剂量（DDD）分析法,统计2009-2012年我院门诊药房降糖药物的消耗情况、用药费用、日用药金额（DDC）、品种分布、以及化学类与中成药降糖药的构成比。结果：我院口服降糖药销售金额呈逐年上升趋势,阿卡波糖、瑞格列奈和二甲双胍位于各年度销售金额前3位。二甲双胍在各年度用药频度（DDDs）中均居前3位。2009-2012年格列美脲DDDs呈逐年上升趋势。在6类化学降糖药中,α-葡萄糖苷酶抑制剂销售金额的构成比居首位。阿卡波糖的DDC居首位。噻唑烷二酮胰岛素增敏剂类降糖药销售金额构成比呈逐年降低趋势。我院口服降糖中成药销售金额的构成比呈逐年上升趋势。结论：我院口服降糖药的应用基本合理。     

皮肤病专科医院抗感染药物利用分析

目的：评价我院抗感染药的应用现状及趋势。方法:对我院2005-2008年抗感染药的销售金额、用药频度（DDDs）等进行回顾性分析。结果:我院抗感染药销售金额占西药总销售金额比例呈逐年下降趋势,口服抗感染药平均占抗感染药销售金额78.30%;大环内酯类、抗真菌药、抗病毒药销售金额排序各年度均列抗感染药前3位。大环内酯类在我院使用频率最高（平均占抗感染药DDDs的29.85%）;克拉霉素缓释片、伊曲康唑胶囊（2005年除外）销售金额及DDDs排序各年度均列前3位。结论:我院应用的抗感染药中服用方便、患者依从性好的口服抗感染药占主导地位。     

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.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

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.