吸入丙酸氟替卡松气雾剂与丙酸倍氯米松气雾剂治疗儿童哮喘疗效观察

目的:观察丙酸氟替卡松气雾剂(辅舒酮)与丙酸倍氯米松气雾剂(必可酮)吸入治疗儿童哮喘的总体疗效及差异.方法:我院门诊和住院的哮喘儿童120例随机分为两组,分别使用两种药物并观察其疗效和肺功能.结果:两组患儿肺功能均有明显改善(P<0.001),两组的临床疗效差异有统计学意义(P<0.01),丙酸氟替卡松气雾剂组临床症状改善程度明显优于丙酸倍氯米松气雾剂组.结论:丙酸氟替卡松气雾刑是一种新型、高效、安全的新一代的吸入性糖皮质激素,具有抗炎强、副作用小等优点,可以代替丙酸倍氯米松气雾剂长期吸入治疗儿童哮喘.     

丙酸氟替卡松治疗儿童咳嗽变异性哮喘42例临床观察

目的 观察辅舒酮治疗儿童咳嗽变异性哮喘的临床疗效.方法 对84例咳嗽变异性哮喘患儿随机分成两组.对照组采用常规治疗:予以盐酸班布特罗和氯雷他定口服治疗,浩疗组在常规治疗基础上加用辅舒嗣(丙酸氟替卡松)气雾荆吸入治疗.结果 辅舒酮气雾剂在治疗儿童咳嗽变异性哮喘时,其疗效优于对照组,两组比较有显著差异(P<0.01).结论...     

丙酸氟替卡松联合斯奇康治疗儿童哮喘对肺功能的影响

目的:观察哮喘患儿吸入丙酸氟替卡松(辅舒酮)和注射斯奇康治疗后对肺功能的影响程度。方法:应用MasterScope儿童肺功能仪对儿童哮喘进行用药前后肺功能指标测定。结果:在受检20例患儿中,治疗前后其肺功能指标除FVC、FEV1外,PEF、FEF25、FEF50、FEF75均有显著性差异(P<0.05)。结论:丙酸氟替卡松和斯奇康联合用于儿童哮喘的治疗及预防,对缓解症状和改善肺功能均能收到良好效果。     

孟鲁斯特、辅舒酮气雾剂、万托林气雾剂联合治疗儿童过敏性咳嗽的疗效分析

目的:孟鲁斯特、辅舒酮(丙酸氟替卡松吸入气雾剂)、万托林(沙丁胺醇吸入气雾剂)联合治疗儿童过敏性咳嗽的疗效分析.方法:2014年11月～2016年10月的80例3～5岁儿童过敏性咳嗽作为研究对象,随机等分为两组,40例联合应用孟鲁斯特、辅舒酮(丙酸氟替卡松吸入气雾剂)、万托林(沙丁胺醇吸入气雾剂),剂量:孟鲁斯特4mg,晚上顿服,连用1月;辅舒酮(丙酸氟替卡松吸入气雾剂)50μg/揿,2揿/次,每揿间隔3～5min,早晚各喷2次,万托林(沙丁胺醇吸入气雾剂)100μg/揿,2揿/次,每揿间隔3～5min,早晚各喷2次,辅舒酮(丙酸氟替卡松吸入气雾剂)、万托林(沙丁胺醇吸入气雾剂)每次均为交替口喷吸入,咳嗽完全控制后,巩固1个月,以后每7d减1揿,直至停药.40例作为对照组,给以咳特灵、痰净片及抗组胺药氯苯那敏口服镇咳化痰.治疗期间其他措施完全一致.6个月内对照两组咳嗽完全缓解率.结果:应用孟鲁斯特、辅舒酮(丙酸氟替卡松吸入气雾剂)、万托林咳嗽完全控制率85％,高于对照组咳嗽完全控制率(P<0.01).结论:孟鲁斯特、辅舒酮(丙酸氟替卡松吸入气雾剂)、万托林(沙丁胺醇吸入气雾剂)联合治疗儿童过敏性咳嗽疗效确切,且按"孟鲁斯特4mg,晚上顿服,连用1月;辅舒酮(丙酸氟替卡松吸入气雾剂)50μg/揿,2揿/次,每揿间隔3～5min,早晚各喷2次,万托林(沙丁胺醇吸入气雾剂)100μg/揿,2揿/次,每揿间隔3～5min,早晚各喷2次,辅舒酮(丙酸氟替卡松吸入气雾剂)与万托林(沙丁胺醇吸入气雾剂)每次均为交替口喷吸入,咳嗽完全控制后,巩固1个月,以后每7d减1揿,直至停药"用法安全有效,且复发率低.     

丙酸氟替卡松对儿童哮喘肺功能的影响

目的：观察哮喘患儿吸入丙酸氟替卡松（辅舒酮）治疗后对肺功能的影响程度。方法：应用德国耶格公司生产的MasterScope儿童肺功能仪对儿童哮喘进行用药前后肺功能指标测定。结果：在受检45例患儿中，经丙酸氟替卡松治疗前后其肺功能主要指标（FEVI和PEF）均有显著性差异（P＜0．05），结论：丙酸氟替卡松用于儿童哮喘的治疗及预防，对缓解症状和改善肺功能均能收到良好效果。     

对过敏性鼻炎实施丙酸氟替卡松治疗的效果评价

目的:探讨对过敏性鼻炎实施丙酸氟替卡松(辅舒良)治疗的效果.方法:将我院2015年11月～2016年11月收治的30例过敏性鼻炎患者分为两组,18例以丙酸氟替卡松展开治疗为观察组,12例以酮替芬展开治疗为对照组,对照两组疗效.结果:观察组治疗效果与副反应发生率显著比对照组优越,P<0.05.结论:对过敏性鼻炎实施丙酸氟替卡松(辅舒良)治疗效果比较好,具有较低副反应发生率,值得深究.     

90例吸入型糖皮质激素治疗哮喘疗效观察

目的：观察吸入型糖皮质激素对哮喘患者的治疗效果。方法：将我院收治的90例哮喘患者随机分为3组,对照组（万托林组）、丙酸氟替卡松组（辅舒酮组）和沙美特罗替卡松组（舒利迭组）。对照组使用万托林,1日3次,1次2喷;丙酸氟替卡松组患者吸入辅舒酮,500μg,1日3次;沙美特罗替卡松组使用舒利迭,1次1吸,1日2次。3组均连续治疗6个月。结果：舒利迭组总有效率高于辅舒酮组,对照组总有效率最低;3组咳嗽症状评分、诱导痰嗜酸细胞计数方面,辅舒酮组（0.7±0.2、6.3±1.5）优于对照组（1.3±0.3、12.5±4.1）,舒利迭组（0.3±0.1、2.7±0.7）优于辅舒酮组。结论：沙美特罗替卡松粉吸入剂（舒利迭）治疗哮喘能够明显改善临床症状,对支气管哮喘的疗效显著。     

沙美特罗替卡松粉吸入剂治疗儿童哮喘疗效观察

目的探讨沙美特罗替卡松粉吸入剂(商品名舒利迭Seretide,葛兰素史克公司生产)治疗儿童哮喘的疗效及副作用.方法62例儿童哮喘按就诊顺序随机分成两组,治疗组患儿按病情严重程度分别予舒利迭50/100、100/200、150/300μg·d-1吸入,对照组按病情严重分别予丙酸氟替卡松吸入剂(商品名辅舒酮,葛兰素史克公司生产)125、250、375μg-1吸入,分别于治疗后4、8、12周评价其日、夜间哮喘症状计分及PEFR值变化.结果治疗后4、8、12周,治疗组与对照组相比,患儿日夜间哮喘症状计分明显减少(P＜0.01);治疗组PEFR值占预计值的百分比与对照组相比明显改善(P＜0.05),差异非常显著.且两组患儿在治疗期间均未发现明显副作用.结论联合应用糖皮质激素和长效β2-肾上腺素受体激动剂具有协同抗炎和平喘作用,且联合使用时可以减少糖皮质激素的用量,减少较大剂量的糖皮质激素的不良反应.舒利迭就是含有沙美特罗和丙酸氟替卡松的混合干粉吸入剂,用舒利迭治疗不同程度的儿童哮喘疗效明显优于辅舒酮.     

辅舒酮治疗儿童哮喘的对比研究

目的 观察丙酸氟替卡松气雾剂（辅舒酮）吸入治疗与布地德气雾剂（普米克）治疗儿童哮喘的总体疗效及其差别。方法 以本院儿科门诊哮喘儿童102例，随机分为两组，观察疗效和肺功能。结果 两组哮喘儿童临床疗效评价差异有非常显著意义（P＜0．01），辅舒酮组明显优于普米克星；两组病儿肺功能前后均有改善，P＜0．05。结论 辅舒酮为目前最新一代的吸入皮质激素，具有抗炎强，副作用更少等优点，且近期可获显效，明显优于普米克。     

丙酸氟替卡松气雾剂治疗儿童哮喘临床疗效及安全性观察

目的:为探讨新型糖皮质激素吸入剂丙酸氟替卡松(FP)治疗儿童哮喘的临床疗效及安全性.方法:以5～15岁哮喘患儿60例作为观察对象,按病情轻、中、重分别给予丙酸氟替卡松气雾剂125,250,375 μg·d-1吸入治疗,疗程为25周.记录治疗前、治疗后第5,15,25周的临床评分、呼吸峰流速(PEFR)值,并观察有无不良反应.结果:60例哮喘儿童气雾吸入治疗后第5,15,25周与治疗前比较,临床评分减少,肺功能明显改善(P＜0.01),且观察到均无明显不良反应.结论:不同程度儿童哮喘给予不同剂量丙酸氟替卡松气雾剂吸入治疗确有临床疗效,且耐受性好,依从性高,优于其他吸入型糖皮质激素.     

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.     

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.     

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。     

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.     

Comparison of in vitro cell models in predicting in vivo brain entry of drugs

Although several in vitro models have been reported to predict the ability of drug candidates to cross the blood-brain barrier, their real in vivo relevance has rarely been evaluated. The present study demonstrates the in vivo relevance of simple unidirectional permeability coefficient (P(app)) determined in three in vitro cell models (BBMEC, Caco-2 and MDCKII-MDR1) for nine model drugs (alprenolol, atenolol, metoprolol, pindolol, entacapone, tolcapone, baclofen, midazolam and ondansetron) by using dual probe microdialysis in the rat brain and blood as an in vivo measure. There was a clear correlation between the P(app) and the unbound brain/blood ratios determined by in vivo microdialysis (BBMEC r=0.99, Caco-2 r=0.91 and MDCKII-MDR1 r=0.85). Despite of the substantial differences in the absolute in vitro P(app) values and regardless of the method used (side-by-side vs. filter insert system), the capability of the in vitro models to rank order drugs was similar. By this approach, thus, the additional value offered by the true endothelial cell model (BBMEC) remains obscure. The present results also highlight the need of both in vitro as well as in vivo methods in characterization of blood-brain barrier passage of new drug candidates.