我院氨曲南应用情况分析

目的：了解我院氨曲南使用情况,分析不合理用药病例,为临床医师提供用药参考,促进临床合理应用抗茵药物。方法：采用回顾性调查方法,对2012年1-6月我院氨曲南使用情况进行分析。结果：氨曲南使用基本合理,但仍存在选药不当、用法与用量不正确、联合用药不合理等现象。结论：2012年1-6月我院氨曲南用量有所升高,总体应用情况基本合理,但仍存在不合理应用现象,亟需引起重视并予以纠正。     

31例氨曲南不良反应分析

目的探讨氨曲南所致不良反应的特点,为临床合理用药提供参考。方法对1988～2011年中国期刊全文数据库中有关氨曲南所致不良反应的文章进行文献分析。结果氨曲南所致不良反应以皮肤、呼吸系统的表现为主。结论临床应重视氨曲南的不良反应,加强合理用药。     

氨曲南不良反应的临床特点分析

探讨氨曲南不良反应的特点及其相关因素,为临床合理用药提参考.检索氨曲南不良反应的文献报道(2000年1月～2010年12月国内医药学期刊),进行统计分析.氨曲南不良反应的临床表现多样,以过敏性反应为主,占70.83%.临床医务工作者应重视氨曲南不良反应的监测,做到合理用药,确保用药安全.     

氨曲南不良反应临床之见

目的首次报道氨曲南用药后出现迟发性过敏反应,总结近十年氨曲南导致的超敏反应,为临床安全用药提供依据。方法通过检索我院CNKI数据库(关键词:氨曲南、不良反应)及Pubmed数据库(Key words:Aztreonam,Adverse reaction),共收集11篇文献,剔除代表性不强文章,余列举分析如下。结果临床上偶尔出现氨曲南说明书上未提到的不良反应。结论使用氨曲南时应高度注意其不良反应,保证用药安全。     

我院2009年门急诊氨曲南使用合理性分析

抽查门急诊使用氨曲南处方,以药品说明书规定为标准,参考相关书籍和文献,对氨曲南的适应症、使用年龄、用法用量、药物联用等方面进行点评,分析氨曲南使用的合理性。氨曲南使用基本合理,但仍存在给药与适应症不符、用法用量不合理以及联合用药不合理等问题。医师应严格按照药品说明书的规定使用氨曲南。     

氨曲南的不良反应文献分析

目的:探讨氨曲南所致不良反应的一般规律及特点,以指导临床合理用药。方法:检索1994—2011年中国期刊全文数据库和中华医学会全文数据库内收录的30例氨曲南的不良反应,进行统计学分析。结果:氨曲南所致不良反应的数量呈逐年增加趋势。不良反应多在用药30 min内发生,有12例,占40.0%;不良反应的类型多为速发型过敏反应和迟发型过敏反应,以神经与精神系统损害、全身性损害和皮肤及附件损害最为多见,占总例数的75.4%(92例次)。结论:临床医师、药师应重视氨曲南的不良反应,坚持合理用药。     

某院围术期患者氨曲南应用分析

目的:调查某院围术期患者氨曲南应用情况,促进临床合理应用抗菌药物。方法:收集某院2009年3月1日～3月31日手术出院患者应用氨曲南的病历215份,采用回顾性分析方法,评价其用药合理性。结果:215例病历中,预防性应用122例,其中合理29例,不合理93例;治疗性应用93例,合理54例,不合理39例。结论:氨曲南在该院围术期未严格按照《抗菌药物临床应用指导原则》、《卫生部办公厅关于进一步加强抗菌药物临床应用管理的通知》应用,存在不合理之处,应引起医务人员重视,同时医院领导应加强抗菌药物管理。     

216例骨科手术患者抗菌药物应用情况与分析

目的 了解我院骨科手术患者抗菌药物使用情况,指导临床合理使用抗菌药物.方法 根据事先设计好的调查表,对2010年第四季度216份存档手术病历作回顾性分析.结果 抗菌药物使用率为100％,其中预防性应用占93.5％;氨曲南使用频率最高,其次是头孢类、青霉素类.结论 我院骨科手术病历使用抗菌药物存在诸多不合理用药现象,应加强预防性抗菌药物的合理使用.     

我院骨科抗菌药物使用的调查与分析

目的了解我院骨科患者抗生素使用情况,评价其用药合理性,对不合理用药进行干预。方法采用跟踪、回顾性调查方法,对我院50例骨科患者所用抗生素进行统计分析。结果使用抗生素49例（98．0％）,未使用抗生素1例（2．0％）;其使用频率最高为氨曲南（52．2％）;抗生素使用合理与基本合理占28．0％,不合理占72．0％。结论应大力加强抗生素使用的管理,骨科医师在使用抗生素时应全面考虑、综合分析、确保用药合理。临床药师可采取一定措施对抗菌药物的使用进行干预。     

本院氨曲南对常见革兰阴性菌的耐药趋势及其不合理用药的分析与评价

目的分析本院常见G-菌对氨曲南的耐药情况,为临床合理使用氨曲南提供参考依据。方法收集本院2010年1月²013年12月患者标本中分离出来的2 485株病原菌对氨曲南的药敏试验结果,并对该结果进行统计处理,结合具体用药原因分析本院常见G-菌对氨曲南的耐药性。结果本院大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌、铜绿假单胞菌、阴沟肠杆菌以及不动杆菌属等6种主要G-菌对氨曲南的耐药率分别由2010年的44.05%、50.32%、10.00%、19.23%、48.72%和13.26%上升到2013年的64.42%、70.83%、17.69%、34.78%、65.38%和25.00%;上升比例分别为45.83%、40.75%、76.90%、80.86%、34.20%和88.54%。结论本院上述6种G-菌对氨曲南的耐药率呈逐年上升趋势,其中奇异变形杆菌、铜绿假单胞菌以及不动杆菌属对氨曲南的耐药率上升比例最快;本院临床要严格掌握该药适应证,限制其不合理应用。     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Modelling and simulation of variability and uncertainty in toxicokinetics and pharmacokinetics

Two important methodological issues within the framework of the variability and uncertainty analysis of toxicokinetic and pharmacokinetic systems are discussed: (i) modelling and simulation of the existing physiologic variability in a population; and (ii) modelling and simulation of variability and uncertainty when there is insufficient or not well defined (e.g. small sample, semiquantitative, qualitative and vague) information available. Physiologically based pharmacokinetic models are especially suited for separating and characterising the physiologic variability from the overall variability and uncertainty in the system. Monte Carlo sampling should draw from multivariate distributions, which reflect all levels of existing dependencies in the intact organism. The population characteristics should be taken into account. A fuzzy simulation approach is proposed to model variability and uncertainty when there is semiquantitative, qualitative and vague information about the model parameters and their statistical distributions cannot be defined reliably.     

成骨细胞的功能与损伤和骨质疏松的防治

骨质疏松是一种全身性骨骼疾病,导致骨折风险增加。成人的骨量通过破骨细胞的骨吸收和成骨细胞的骨形成作用来维持动态平衡,治疗骨质疏松症的理想策略是抑制破骨细胞的骨吸收和/或增强成骨细胞的骨形成功能。目前针对保护成骨细胞及增强其功能的骨质疏松疗法相对较少。因此,本文针对成骨细胞相关功能蛋白、各种细胞损伤机制（内质网应激、氧化应激、机械过载、微小RNA和长链非编码RNA的影响等）及骨质疏松的治疗与预防作一综述,以期为针对增强成骨细胞功能的骨质疏松治疗策略提供新思路。     

Antiinfective and encrustation-inhibiting materials--myth and facts

Catheters, urethral and ureteral stents and other urological implants are frequently affected by encrustration and infection due to their permanent contact with urine. Indwelling urinary catheters provide a haven for microorganisms and thus require extensive monitoring. Several surface modification techniques have been proposed to improve the performance of devices including the immobilization of biomolecules, the incorporation of hydrophilic grafts to reduce protein adsorption, the creation of hydrophobic surfaces, the creation of microdomains to regulate cellular and protein adhesion, new polymers and antimicrobial coatings. Physico-chemical explanation to elucidate the mechanism of such encrustation or infection inhibiting materials is still not available. Our series of experiments showed a marked decrease of silver-activity in biological fluids which corresponds with the controversial clinical results obtained with silver coated urinary catheters. Rifampicin/minocycline coated catheters had very low activity against Gram-negative rods, enterococci and Candida spp., the main causing organisms of urinary catheter infection. Surface engineered materials and antimicrobial drug delivery systems will be the next generation of sophisticated urinary catheters and stents, if both efficacy as well as efficiency has been proved clinically.     

益生菌与肿瘤防治

益生菌广泛存在于自然界中,通过维持宿主体内菌群平衡、影响肠屏障功能和调节免疫应答等作用,提高宿主健康水平,被公认为"肠道健康卫士".一些益生菌可以增强机体的免疫功能,抑制致癌物质,影响肿瘤细胞的基因表达,对肿瘤具有拮抗作用.大量研究表明,益生菌在未来的肿瘤防治中有很好的应用和发展前景.     

Synthesis and anti-nociceptive and anti-inflammatory effects of gaultherin and its analogs

The synthesis of gaultherin (1) and its analogs was carried out to provide 11 glycosides under phase-transfer catalytic conditions. The activities of all synthesized compounds were evaluated by nitric oxide production inhibitory assay in vitro. Methyl 2-O-(4-O-β-d-galactopyranosyl)-β-d-glucopyranosylbenzoate (5f) showed significantly anti-nociceptive and anti-inflammatory effects by the evaluation in vivo. Structure–activity relationships within these compounds were discussed.     

Interaction of estrone and estradiol with DNA and protein of liver and kidney in rat and hamster in vivo and in vitro

[6,7-³H] Estrone (E) and [6,7-³H]estradiol-17 (E₂) have been synthesized by reduction of 6-dehydroestrone and 6-dehydroestradiol with tritium gas. Tritiated E and E₂ were administered by oral gavage to female rats and to male and female hamsters on a dose level of about 300 g/kg (54 mCi/kg). After 8 h, the liver was excised from the rats; liver and kidneys were taken from the hamsters. DNA was purified either directly from an organ homogenate or via chromatin. The radioactivity in the DNA was expressed in the units of the Covalent Binding Index, CBI = (mol chemical bound per mol DNA-P)/(mmol chemical administered per kg b.w.). Rat liver DNA isolated via chromatin exhibited the very low values of 0.08 and 0.09 for E and E₂, respectively. The respective figures in hamster liver were 0.08 and 0.11 in females and 0.21 and 0.18 in the males. DNA isolated from the kidney revealed a detectable radioactivity only in the female, with values of 0.03 and 0.05 for E and E₂, respectively. The values for male hamster kidney were < 0.01 for both hormones. The minute radioactivity detectable in the DNA samples does not represent covalent binding to DNA, however, as indicated by two sets of control experiments. (A) Analysis by HPLC of the nucleosides prepared by enzyme digest of liver DNA isolated directly or via chromatin did not reveal any consistent peak which could have been attributed to a nucleoside-steroid adduct. (B) All DNA radioactivity could be due to protein contaminations, because the specific activity of chromatin protein was determined to be more than 3,000 times higher than of DNA. The high affinity of the hormone to protein was also demonstrated by in vitro incubations, where it could be shown that the specific activity of DNA and protein was essentially proportional to the concentration of radiolabelled hormone in the organ homogenate, regardless of whether the animal was treated or whether the hormone was added in vitro to the homogenate.Carcinogens acting by covalent DNA binding can be classified according to potency on the basis of the Covalent Binding Index. Values of 10³–10⁴ have been found for potent, 10² for moderate, and 1–10 for weak carcinogens. Since estrone is moderately carcinogenic for the kidney of the male hamster, a CBI of about 100 would be expected. The actually measured limit of detection of 0.01 places covalent DNA binding among the highly unlikely mechanisms of action. Similar considerations can be made for the liver where any true covalent DNA binding must be below a level of 0.01. It is concluded that an observable tumor induction by estrone or estradiol is unlikely to be due to DNA binding.Paper presented at the Satellite Symposium of the European Society of Toxicology, Rome, March 29, 1983     

Acamprosate and naltrexone treatment effects on ethanol and sucrose seeking and intake in ethanol-dependent and nondependent rats

Rationale  Two pharmacotherapies are approved for treating alcohol craving (acamprosate and naltrexone), but both have shown mixed findings in animals and humans. Objectives  The present experiments utilized a “reinforcer blocking” approach (i.e., rats were able to consume ethanol during treatment) to better understand the efficacy of these treatments for ethanol seeking and drinking using ethanol-dependent and nondependent rats. Materials and methods  In “nondependent” experiments, drugs (acamprosate 50, 100, and 200 mg/kg; naltrexone 0.1, 0.3, and 1.0 mg/kg) were administered over 3-week periods prior to operant sessions with a low response requirement to gain access to reinforcers for 20 min. For “dependent” experiments, rats were made dependent in vapor/inhalation chambers. Results  Acamprosate and naltrexone had similar effects on intake in nondependent and dependent rats; neither drug was selective for ethanol over sucrose drinking. In nondependent animals, naltrexone was more efficacious at more doses than acamprosate, and acamprosate’s effects were limited to a dose that also had adverse effects on body weight. Both pharmacotherapies showed more selectivity when examining reinforcer seeking. In nondependent rats, acamprosate and naltrexone had response-attenuating effects in ethanol, but not sucrose, groups. In dependent animals, acamprosate had selective effects limited to a decrease in sucrose seeking. Naltrexone, however, selectively decreased ethanol-seeking in nondependent rats. Conclusions  The naltrexone-induced decreases in seeking suggested a change in incentive motivation which was selective for ethanol in nondependent rats. The “nondependent” paradigm may model early stages of “problem drinking” in humans, and the findings suggest that naltrexone could be a good intervention for this level of alcohol abuse and relapse prevention.     

Isolation and characterization of glycosylated and non-glycosylated prolactins from alligator and crocodile

Two molecular forms of prolactin (PRL). glycosylated and non-glycosylated, were isolated from pituitary glands of two reptiles, alligator and crocodile. The reptilian PRLs were extracted under alkaline conditions from the precipitate obtained after pituitaries were first extracted with 0.25 m sucrose, 1 mM NH₄HCO₃, pH 6.3. Purification was performed by ion exchange chromatography on DE-52, gel filtration on Sephadex G-75 superfine, and reversed phase high performance liquid chromatography. Two forms of both alligator and crocodile PRL, designated PRLI and PRLII, with molecular weights of 26000 and 24000 were isolated. Alligator and crocodile PRLI and PRLII were stained specifically in immunoblots with anti-sea turtle PRL and anti-ostrich PRL. Sequence analysis revealed that both forms of alligator and crocodile PRLs consisted of 199 amino acid residues with a glycosylation consensus sequence (Asn-Ala-Ser) at position 60 in alligator and crocodile PRLs with a molecular weight of 26000 (PRLI). In contrast, Thr was substituted for Asn at position 60 in the PRLs with a molecular weight of 24000 (PRLII). The sequences of alligator PRLs differed from crocodile PRLs only in position 134: Val for alligator PRLs and He for crocodile PRLs. There is a high degree of structural conservation between the reptilian PRLs isolated in this study and avian PRL; each showed 92% sequence identity with chicken PRL and 89% with turkey PRL.