头孢唑啉钠在剖宫产围术期中的预防效果探讨

目的 观察剖宫产围术期中应用头孢唑林钠的预防效果.方法 行剖宫产分娩的产妇136例,随机分为实验组和对照组各68例,实验组产妇围术期中预防性应用头孢唑林钠1d,对照组产妇围术期中预防性应用头孢唑林钠3d,观察两组产妇术后热病率、切口感染及生殖道感染发生率,观察两组产妇术后体温情况,并记录发热患者退热时间,血象升高情况.结果 实验组患者术后热病率、切口硬结红肿发生率、血象升高发生率、术后体温及退热时间低于对照组,差异具有统计学意义(P<0.05);两组患者术后生殖道感染发生率差异无统计学意义(P>0.05).结论 剖宫产围术期中预防性应用头孢唑林钠1d即可有效预防术后切口感染情况,促进患者康复.     

剖宫产围手术期预防性应用抗生素不同用药方法预防术后感染的效果

目的分析剖宫产围手术期预防性应用抗生素不同用药方法预防术后感染的效果。方法 2019年1月至2020年1月,选择我院剖宫产产妇共80例,数字表随机分成两组(各40例),对照组的产妇给予术后常规使用头孢噻肟钠3 g,每日2次,用药3～5 d的方法,观察组采取术前半小时给予头孢噻肟钠3 g,术后6 h重复使用1次的方法。比较两组抗生素总使用时间、药物费用、住院的时间、术后切口感染率、术后发热的比例。结果观察组抗生素总使用时间、药物费用、住院的时间、术后切口感染率、术后发热的比例均低于对照组,P <0.05。结论剖宫产围手术期预防性应用抗生素不同用药方法预防术后感染的效果存在差异,采取术前半小时给予头孢噻肟钠3 g,术后6 h重复使用1次的方法可缩短抗生素使用时间,减少术后感染风险,并缩短住院时间和减少治疗费用。     

头孢唑林钠对剖宫产患者围术期中预防用药价值的评价

目的:评价头孢唑林钠对剖宫产患者围术期中预防用药的疗效与成本。方法:选取2015年1月—2015年7月间妇产科收治的需剖宫产产妇136例为观察对象,将其分为对照组和观察组,每组68例;对照组患者均给予头孢替安围术期治疗用药,观察组患者均给予头孢唑林钠围术期治疗用药,比较和评价两组患者围术期用药后的临床各指标。结果:两组患者围术期用药后的住院时间经比较其差异无统计学意义(P>0.05);观察组患者围术期用药后人均抗菌药物费用明显低于对照组(P<0.05),中性粒细胞计数、白细胞总数和体温恢复正常时间,以及子宫腔感染、切口感染和术后发生产褥病率等观察指标均明显优于对照组(P<0.05)。结论:剖宫产患者围术期给予头孢唑林钠治疗,有助于其产后的快速康复,缩短药物治疗时间,促进其生命体征指标的改善,其临床应用价值优于头孢替安。     

妇产科围术期预防性应用抗生素200例临床观察

目的:探讨剖宫产围术期预防性应用抗生素不同用药方法预防术后感染的效果.方法:将该院200例妇产科手术患者随机分试验组和对照组,各100例.试验组于术前30min给予二联抗生素单次预防性静脉滴注,对照组按常规方法于手术后对产妇给予二联抗生素静脉滴注3-7d.分析比较2组术后治愈率、最高体温、退热时间和术后住院天数及腹部切口感染情况.结果:2组术后治愈率均为100%.试验组术后退热时间为(39±8)h快于对照组的(63±12)h,差异有统计学意义(P<0.05);且试验组术后住院天数为(4.31±1.56)d明显少于对照组的(7.32±3.23)d,差异有统计学意义(P<0.05);试验组术后切口感染率为3%少于对照组的7%,差异有统计学意义(P<0.05).结论:妇产科围术期预防性应用抗生素是预防剖宫产术后感染安全、有效的较好方法.     

头孢唑林钠与头孢替安对剖宫产围术期患者术后切口感染预防用药的价值及其用药费用比较

目的:比较头孢唑林钠与头孢替安对剖宫产围术期患者术后切口感染预防用药的价值及其用药费用。方法:选取2014年12月—2016年12月期间收治的行剖宫产产婴患者96例临床资料,按照其入院顺序号将其分为治疗组和对照组(每组48例);在剖宫产围手术期内对照组患者给予头孢替安预防术后切口感染,治疗组患者则给予头孢唑林钠预防术后切口感染,比较两组患者用药后各项指标(治疗时间、抗菌药物费用、体温复常时间、白细胞计数和中性粒细胞计数值的变化情况。结果:治疗组患者用药后各项指标(治疗时间、抗菌药物费用、体温复常时间、白细胞计数和中性粒细胞计数值均优于对照组(P<0.05)。结论:头孢唑林钠对剖宫产围术期产妇术后切口感染的预防作用和用药费用均优于头孢替安。     

妇产科围术期预防性应用抗生素200例临床观察

目的探讨剖宫产围术期预防性应用抗生素不同用药方法预防术后感染的效果。方法将该院200例妇产科手术患者随机分试验组和对照组,各100例。试验组于术前30min给予二联抗生素单次预防性静脉滴注,对照组按常规方法于手术后对产妇给予二联抗生素静脉滴注3～7d。分析比较2组术后治愈率、最高体温、退热时间和术后住院天数及腹部切口感染情况。结果 2组术后治愈率均为100%。试验组术后退热时间为(39±8)h快于对照组的(63±12)h,差异有统计学意义(P<0.05);且试验组术后住院天数为(4.31±1.56)d明显少于对照组的(7.32±3.23)d,差异有统计学意义(P<0.05);试验组术后切口感染率为3%少于对照组的7%,差异有统计学意义(P<0.05)。结论妇产科围术期预防性应用抗生素是预防剖宫产术后感染安全、有效的较好方法。     

剖宫产术围手术期应用抗生素的观察

目的比较剖宫产术预防性应用抗生素不同用药方法预防产褥感染的效果。方法将住院符合研究条件的择期剖宫产产妇按顺序分奇数组：A组100例（围手术期用药组）;偶数组：B组100例（传统术后用药组）。两组均使用同一种抗生素头孢噻肟钠。结果术后最高体温、退热时间2组间差异有统计学意义（P〈0.05）。结论围手术期使用抗生素是预防剖宫产术后感染安全、有效、经济的理想方法 。     

抗生素在剖宫产围术期中的应用

目的探讨剖宫产围术期抗生素的应用效果。方法 68例择期剖宫产产妇随机分为观察组和对照组各34例,观察组剖宫产术前30min给予头孢唑啉钠3g,溶于生理盐水250ml中静脉滴注,术后用法同术前,每天2次,共3d。对照组术前不用任何抗生素,术后用药方法同观察组。观察2组术后体温变化、退热时间、术后病率、子宫内膜炎及切口感染的发生率。结果观察组术后病率、子宫内膜炎和切口感染发生率、术后体温、术后退热时间均优于对照组,差异均有统计学意义（P〈0.05）。结论剖宫产围术期应用抗生素预防感染,具有高效、经济、安全等特点,可在临床推广应用。     

剖宫产术预防性应用抗生素67例临床观察

目的：探讨预防性应用抗生素对防止剖宫产术后发生感染等并发症的作用,并分析其必要性。方法选择2012年1月~2014年1月在本院行剖宫产的34例术前应用抗生素的产妇作为观察组,将同一时期在本院行剖宫产仅术后应用抗生素的33例产妇作为对照组,观察手术后两组产妇的体温、并发症和感染情况。结果两组产妇手术后均未发生感染,但是观察组产妇术后的体温波动幅度、并发症与对照组相比较低,差异具有统计学意义（P〈0.05）。结论剖宫产术预防性应用抗生素十分必要,且手术前用药效果优于手术后。     

剖宫产围手术期预防性应用抗生素疗效观察

目的探讨剖宫产围手术期预防性应用抗生素和剖宫产术后预防性应用抗生素的效果。方法对剖宫产围手术期和术后预防性应用抗生素各150例预防感染情况进行对比分析。围手术期预防性用药组(研究组)胎头娩出断脐后即单次静脉冲击给抗生素1次,术后12h内重复给药1次,术后共预防性用药24~48h。术后预防性用药组(对照组)术前术中不用药,术后常规应用抗生素3~5d。结果两组在术后体温、术后2d血象变化、抗生素用量及术后西药费方面差异有统计学意义(P<0.05),但两组在术后病率、切口感染率、生殖道感染率及术后住院日方面差异无统计学意义(P>0.05)。结论剖宫产围手术期预防性应用抗生素优于术后预防性应用抗生素。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

Study of potential in vitro and in vivo genotoxicity in hepatocytes of quinolone antibiotics

The genotoxicity of quinolone antibiotics has been evaluated in hepatocytes following in vitro and in vivo exposure. Unscheduled DNA synthesis (UDS) was induced in vitro in rat hepatocytes by norfloxacin, ofloxacin, pefloxacin, and ciprofloxacin but not by nalidixic acid. In vivo UDS was not observed in hepatocytes isolated 4 to 24 hr after exposure of adult male F344 rats to either a single dose (30 to 190 mg/kg) or repeated doses (40 mg/kg) of ciprofloxacin. Using the 32P-postlabeling technique, no modified bases were detected in hepatocytes exposed in vitro to ciprofloxacin. In summary, UDS was induced in hepatocytes by in vitro exposure to high concentrations of norfloxacin, ofloxacin, pefloxacin, or ciprofloxacin. There was no evidence of in vitro DNA adduct formation by ciprofloxacin or in vivo DNA damage under the conditions tested. These findings suggest that ciprofloxacin is not DNA reactive, but it induces in vitro UDS as a consequence of some indirect action.