临床药师对高血压患者的药学服务及效果比较

目的：探讨临床药师为高血压患者提供药学服务的效果和意义。 方法：100例依从性差、血压控制不佳的高血压病患者随机分为干预组和对照组各50例。临床药师通过问卷调查了解患者高血压用药知识和潜在问题,对干预组患者实施个体化药学服务,对照组不予以干预,并分别在干预前和干预后3个月对患者的治疗结果、用药依从性、用药知识等进行随访研究。结果：干预组患者的用药依从性、血压控制情况等较对照组有明显改善,高血压用药知识水平也较对照组有明显提高。结论：临床药师通过面向高血压患者的药学服务可及时发现和解决患者治疗过程中的潜在问题,有助于提高患者的治疗效果、治疗依从性和用药知识水平,避免严重药物不良反应的发生。     

药学干预对社区高血压患者用药依从性的影响

目的 探究药学干预下社区高血压患者的药物治疗依从性,为患者的安全有效用药提供指导,亦为转型期的二级医院临床药师探索药学服务新路径提供参考。方法 采用药师干预与不干预对照试验方法,比较药师干预前后干预组与对照组高血压患者临床治疗依从性、血压变化和生活方式改善依从性。结果 经过12个月实验,药师干预组高血压患者的临床治疗依从性和生活方式改善依从性均明显高于对照组（P<0.05）,收缩压和舒张压也都有明显降低（P<0.05）。结论 药学干预对社区高血压患者用药依从性有积极的影响。     

全程药学干预对2型糖尿病合并高血压患者用药依从性、血压和血糖达标率的影响

目的 ：评估全程药学干预对2型糖尿病合并高血压患者用药依从性、血压和血糖达标率的影响。方法 ：选取80例2型糖尿病合并高血压患者，随机分为对照组和观察组，各40例。对照组运用常规宣教；观察组基于对照组方法上进行全程药学干预。比较两组患者血压和血糖的控制效果及用药依从性。结果 ：观察组干预后的血压、血糖水平、用药不良反应发生率等低于对照组；血压、血糖达标率、干预后完全用药依从率等高于对照组（P <0.05）。结论 ：全程药学干预可提高2型糖尿病合并高血压患者用药依从性，强化血压、血糖的控制水平。     

药师参与门诊老年高血压患者慢病管理的效果评价

目的：评价药学服务对门诊老年高血压患者开展药学干预的效果。方法：选取本院门诊就诊的高血压患者200例,随机分成两组：对照组行常规用药指导;干预组行高血压病的相关医学知识、合理用药知识教育,定期随访、用药指导等干预措施,历时12个月。以患者血压控制率、对高血压知识的认知程度和用药依从性作为评价指标。结果：干预组血压达标率从31.13％提高到74.71％,高血压认知问卷分数从干预前的61.07分提高到77.07分,不及格率从39.08%下降到2.30%;用药依从性从31.00%提高到86.20%,与干预前比较均有显著差异（P<0.05）,与对照组比较差异有统计学意义（P<0.05）。结论：药师主导的药学服务有助于增强患者对疾病和合理用药的认知,提高血压达标率和用药依从性。     

门诊药师参与慢性病管理对提高高血压患者用药依从性及血压达标率与药学服务满意率的影响

目的：分析门诊药师参与慢性病管理对提高高血压患者用药依从性及血压达标率与药学服务满意率的影响。方法：选取医院2021年7月—12月门诊诊治的原发性高血压患者304例为研究对象,将其分为接受药师参与慢性病管理的为观察组（n=152）,非药师参与慢性病管理的为对照组（n=152）,用药干预持续6月后,比较2组高血压患者用药的依从性（Morisky问卷）、血压达标率与药学服务满意度,以及患者不合理用药率、药物不良反应发生率和非药物治疗情况。结果：经Morisky问卷调查结果显示,药师有助于患者用药依从性的提高（P<0.05）;经干预后2组患者血压达标率均较干预前有所上升,但观察组患者血压达标率高于对照组（P<0.05）;不合理用药率低于对照组（P<0.05）;观察组患者用药不良反应发生率低于干预前（P<0.05）,对照组患者干预前后用药不良反应发生率差异无统计学意义（P>0.05）,但观察组患者不良反应发生率低于对照组（P<0.05）;观察组患者吸烟、饮酒率低于干预前,低盐饮食及规律运动率高于干预前（P<0.05）,对照组患者干预前后非药物治疗行为均...     

临床药师参与高血压慢病管理的效果评价

目的:评价临床药师对高血压慢病管理患者开展药学干预的效果。方法:选取北仑区新矸街道紫荆社区的所有高血压慢病管理患者为研究对象,由临床药师定期和社区医生一起对慢性病患者进行面对面用药指导、电话交流沟通、上门随访、专题健康讲座等方法,为慢病管理患者提供用药指导,实施药学干预,将干预前后患者对自身疾病的认知水平、血压控制水平、用药依从性等进行统计并比较。结果:临床药师干预后患者对高血压和抗高血压用药的认识水平有明显提高(P<0.05或P<0.01),患者血压控制水平及用药依从性明显改善(P<0.01),非预约就诊率、急诊率、住院率及住院次数明显下降(P<0.05或0.01)。结论:临床药师开展高血压慢病管理患者的药学干预,可以为患者提供科学合理的用药保障,提高患者的生活质量,值得推广。     

药学服务在2型糖尿病合并高血压患者治疗中的作用

摘 要 目的：观察药学服务在2型糖尿病（T2DM）合并高血压患者治疗中的应用效果。方法: 160例T2DM合并高血压患者随机分为观察组和对照组各80例,观察组由临床药师提供全程化药学服务,对照组无临床药师进行药学服务,观察两组患者入院治疗前后空腹血糖（FPG）、餐后2 h血糖（2 hPG）及血压、用药依从性、药物不良反应变化。结果: 治疗后,两组患者FPG、2 hPG均较入院前明显降低（P<0.05）,且观察组明显低于对照组（P<0.05）。治疗后两组血压达标率和用药依从率均较前明显改善（P<0.05）;且观察组出院时血压达标率和用药依从率明显优于对照组（P<0.05）。两组药物不良反应发生率差异无统计学意义（P>0.05）。结论:药学服务在T2DM合并高血压患者治疗中的应用效果较好,其可有效降低血糖,改善血压,提高患者用药依从性。     

药学服务干预对原发性高血压患者服药依从性的影响分析

目的:探讨药学干预对原发性高血压患者服药依从性的影响.方法:随机抽取确诊原发性高血压患者100例,分为药学干预治疗观察组(58)和常规治疗对照组(42例).观察组实施健康教育、个性化用药指导等药学服务干预,对照组不实施药学服务干预,定期考察2组患者依从性的变化及血压控制效果.结果:干预前,观察组与对照组患者用药依从性分别为52.03%和49.83%,两组差异无明显性,6个月后观察组依从性87.81%,对照组51.00%,两组患者用药依从性在6个月后均差异具有显著性;与对照组相比,舒张压改变值平均下降了15.9 mmHg(1 mmHg＝0.133 kPa),收缩压改变值平均下降了8.9 mmHg,两组血压改变值差异具显著性.结论:针对原发性高血压患者的药学服务干预,可以提高患者用药依从性,促进患者持续用药.     

药学服务对门诊糖尿病患者用药依从性和血糖控制的影响

目的探讨药学服务对门诊糖尿病患者用药依从性和血糖控制的影响。方法将我院2017年1月~2017年12月救治的100例糖尿病患者,按照随机数字法分为两组各50例,研究组采取药学服务,对照组采取常规用药指导,比较两组治疗效果。结果治疗前两组血糖无明显差别(P>0.05),治疗后发现研究组空腹血糖,餐后2h血糖、糖化血红蛋白水平较对照组改善(P<0.05);且相关知识知晓,用药依从性,药物认知能力评分较对照组提高(P<0.05)。结论药师为门诊糖尿病患者开展药学服务,可使患者的用药依从性和血糖控制得到明显改善。     

药学服务对高血压患者合理用药的干预效果分析

目的:分析药学服务对高血压患者合理用药的干预效果。方法:选取我院2017年4月～2018年4月期间收治的170例高血压患者,随机分为观察组与对照组各85例,将基础护理实施于对照组,将药学服务实施于观察组,对比两种护理的效果。结果:观察组高血压患者的血压水平要明显优于对照组;观察组服药依从性明显高于对照组,差异存在统计学意义(P0.05)。结论:将药学服务应用于高血压患者,患者的血压水平得到明显改善,并提高患者的服药依从性,具有临床推广价值。     

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.     

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.     

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.