培菲康治疗早产儿喂养不耐受的疗效观察

目的观察培菲康治疗早产儿喂养不耐受的临床效果。方法 89例喂养不耐受早产儿随机分为治疗组45例和对照组44例,对照组给予常规治疗,治疗组在常规治疗基础上口服肠道微生态制剂培菲康,观察2组临床疗效。结果治疗组呕吐、胃潴留消失时间及喂养奶量达10ml/kg每2小时1次所需的时间均短于对照组,差异有统计学意义(P<0.01)。治疗期间所有患儿未出现明显不良反应。结论培菲康治疗早产儿喂养不耐受效果显著且安全,值得临床推广应用。     

双歧杆菌三联活菌散治疗晚期早产儿喂养不耐受的效果

目的观察双歧杆菌三联活菌散（培菲康）治疗喂养不耐受晚期早产儿的效果。方法 142例喂养不耐受的晚期早产儿随机分为观察组73例和对照组69例。两组均予常规治疗及护理,观察组加用培菲康口服,比较两组奶量达全量、恢复到出生体重所需时间及黄疸完全消退时间,观察3个月内感染性疾病的发生率。结果观察组奶量达全量所需时间、恢复到出生体重所需时间和黄疸完全消退时间均短于对照组,治疗后3个月内感染发生率低于对照组,差异均有统计学意义。结论应用培菲康能明显改善患儿喂养不耐受状态,缩短经口喂养达全量的时间,并提高出生体重恢复速度,缩短黄疸持续时间,从而减少蓝光照射机会及发生核黄疸的风险,并可以减少3个月内感染发生率。     

常见不同类型益生菌对早产儿喂养不耐受防治效果研究

目的：探讨培菲康、金双歧、妈咪爱、宝乐安及亿活等几种常见不同类型益生菌对早产儿喂养不耐受的防治效果,为临床治疗提供参考。方法选取2008年8月—2012年8月于该科住院的早产儿为研究对象,随机将观察对象分为对照组、培菲康治疗组、金双歧治疗组、妈咪爱治疗组、宝乐安治疗组及亿活治疗组6组。观察患儿住院期间出现生理性体重下降者恢复出生体重所需时间、达全胃肠道喂养所需时间、喂养不耐受发生情况、平均住院时间、新生儿坏死性小肠结肠炎（neonatal necro-tizing enterocolitis,NEC）发生情况。并利用统计软件 SPSS19．0进行数据处理。结果与对照组相比,治疗组恢复出生体重时间、达全胃肠道喂养所需时间及平均住院时间显著缩短,喂养不耐受发生率较对照组明显降低,但在 NEC 发生率方面无显著性差异。培菲康及金双歧治疗组的恢复出生体重时间、达全胃肠道喂养时间及平均住院时间较妈咪爱、宝乐安及亿活治疗组明显减低。各治疗组间在喂养不耐受及 NEC 发生率方面差异无显著性。结论早产儿应用益生菌可降低喂养不耐受的发生率。培菲康及金双歧等原籍菌制剂在降低恢复出生体重时间、达全胃肠道喂养时间及平均住院时间方面较妈咪爱、宝乐安及亿活等非原籍菌制剂疗效显著,但在降低喂养不耐受发生率方面各种益生菌无显著差异。     

腹部按摩结合金双岐对早产儿喂养不耐受的辅助疗效

目的探讨腹部按摩结合金双岐在早产儿喂养不耐受中的辅助疗效。方法以我院132例喂养不耐受早产儿为研究对象,将其随机分成两组,对照组66例采取常规治疗和护理,观察组66例在此基础上结合腹部按摩、喂服金双岐治疗,比较两组的临床治疗效果。结果观察组治疗后喂养耐受优良率为87.88%,对照组喂养耐受优良率为60.61%,组间比较差异具有统计学意义(x2=12.84,P0.05);观察组治疗后胃残留量、体重恢复时间、喂养耐受时间、腹胀消失时间和住院时间均优于对照组,组间比较差异具有统计学意义(P0.05)。结论腹部按摩结合金双岐辅助治疗早产儿喂养不耐受的疗效显著,值得进一步推广应用。     

茵栀黄口服液联合培菲康治疗新生儿母乳性黄疸40例疗效观察

目的：观察茵栀黄口服液联合培菲康治疗新生儿母乳性黄疸的临床疗效。方法80例新生儿母乳性黄疸患儿随机分为观察组和对照组,各40例,对照组予人工喂养,口服培菲康治疗,观察组予人工喂养,口服培菲康,加服茵栀黄口服液,连用5d。观察两组患儿黄疸消退时间及每天胆红素下降速度。结果观察组日均胆红素下降速度大于对照组,且下降至102.6μmol/L所需时间短,差异有统计学意义（P〈0.01）。结论茵栀黄口服液联合培菲康治疗新生儿母乳性黄疸疗效确切,值得临床推广。     

小剂量红霉素治疗早产儿极低出生体质量儿喂养不耐受40例效果观察

目的 观察小剂量红霉素治疗早产儿极低出生体质量儿喂养不耐受的临床疗效.方法 随机将早产极低出生体质量儿80例分成治疗组和对照组各40例,2组均给予常规治疗,治疗组在常规治疗的基础上加用小剂量红霉素静脉滴注.观察2组临床疗效.结果 治疗组总有效率高于对照组,差异有统计学意义（P〈0.05）.结论小剂量红霉素治疗早产儿极低出生体质量儿喂养不耐受临床疗效满意.     

小儿推拿辅助治疗早产儿喂养不耐受35例临床观察

目的观察小儿推拿辅助治疗早产儿喂养不耐受的临床疗效。方法选取喂养不耐受早产儿70例,随机分为治疗组和对照组,各35例。对照组予常规治疗,治疗组在对照组治疗方法的基础上加用小儿推拿,2组均以7 d为1个疗程,1个疗程后比较2组的疗效、临床症状消失时间、恢复出生体质量时间、达全肠道喂养时间。结果治疗组总有效率为88.57%,高于对照组的62.86%,2组比较差异有统计学意义(P0.05);治疗组症状消失时间、恢复出生体质量时间、达全肠道喂养时间均短于对照组,差异有统计学意义(P0.05)。结论小儿推拿辅助治疗早产儿喂养不耐受疗效显著,值得临床推广应用。     

早产儿早期微量喂养的临床观察

目的观察早产儿合理的胃肠内营养方法。方法 80例早产儿随机分为治疗组与对照组各40例,对照组为常规喂养,治疗组为早期微量喂养,观察两组患儿达全肠道喂养时间及喂养不耐受的情况。结果治疗组达全肠道喂养时间明显短于对照组(P<0.01),不耐受发生率低于对照组,早期微量喂养并未增加上消化道出血及坏死性小肠结肠炎(NEC)的发生率。结论早产儿早期微量喂养可缩短达全肠道喂养时间,减少喂养不耐受及并发症,提高早产儿生存质量。     

小剂量红霉素治疗喂养不耐受早产儿的临床观察

目的观察及研究小剂量红霉素治疗喂养不耐受早产儿的临床效果。方法选取2013年2月至2015年1月本院的50例喂养不耐受早产儿为研究对象,将其随机分为对照组(常规治疗干预组)25例和观察组(常规治疗加小剂量红霉素治疗组)25例,然后将两组早产儿的呕吐及腹胀消失时间构成、干预前后的机体发育指标进行分别统计及比较。结果观察组早产儿的呕吐及腹胀消失时间构成、干预后的机体发育指标均显著地好于对照组早产儿,P均<0.05,两组早产儿干预后的评估指标间均有显著性差异。结论小剂量红霉素治疗喂养不耐受早产儿的临床效果较好,对于改善早产儿的各方面状态均有积极的临床作用。     

微生态制剂和非营养性吸吮协同治疗早产儿喂养不耐受临床观察

目的:探讨微生态制剂和非营养性吸吮协同治疗早产儿喂养不耐受的临床价值.方法:回顾性总结2008年7月至2011年6月在我院新生儿科收住的喂养不耐受的早产儿病例,并依据是否加用微生态制剂和非营养性吸吮随机将患儿分为2组,对照组30例给予常规处理,治疗组30例在对照组治疗的基础上加用微生态制剂和非营养性吸吮.统计2组患儿的临床情况,并进行分析.结果:治疗组患儿呕吐或腹胀消失时间、喂养耐受时间及体质量增长时间与对照组比较,差异均有统计意义(P＜0.05或P＜0.01).结论:微生态制剂和非营养性吸吮协同治疗能安全、有效地解决早产儿喂养不耐受.     

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.