结直肠癌术后患者348张肠外营养处方合理性分析

目的:调查结直肠癌术后肠外营养的应用情况,促进合理用药。方法:回顾性随机调查2012年我院结直肠癌手术患者的TPN处方进行合理性分析,依据《临床诊疗指南·肠外肠内营养学分册》(2008版)中的标准评价其合理性。结果:348张TPN处方存在组分不合理、热量供应不足、热氮比、糖类供能的比例不合理等问题。结论:临床应根据患者情况,制定个体化肠外营养给药方案;药师有必要对TPN的不合理使用进行干预,确保TPN处方用药合理、安全和有效。     

结直肠癌术后患者348张肠外营养处方合理性分析

目的调查结直肠癌术后肠外营养的应用情况,促进合理用药。方法回顾性随机调查2012年我院结直肠癌手术患者的348张全肠外营养液（TPN）处方进行合理性分析,依据《临床诊疗指南·肠外肠内营养学分册》（2008版）评价其合理性。结果处方中存在热量供应不合理（83.33%）、热氮比不合理（35.06%）、糖类供能的比例不合理（61.78%）、组分不合理（73.28%）等问题。结论临床应根据患者情况,制定个体化肠外营养给药方案;药师有必要对TPN的不合理使用进行干预,确保TPN处方用药合理、安全和有效。     

我院全胃肠外营养不合理医嘱分析

目的:分析我院全胃肠外营养(TPN)不合理医嘱情况,为提高医院安全用药水平提供参考。方法:依据我院静脉营养液配制原则、药品说明书、《中国药典.临床用药须知》、《临床营养基础》、《临床营养学》及相关文献,对我院2010年1-10月已审核的TPN医嘱进行统计,并对其中不合理医嘱进行分析。结果:共调配医嘱8877组,其中不合理医嘱313组,占总医嘱的3.53%;不合理医嘱中,主要问题为热氮比不合理(32.66%)、电解质用量不合理(16.47%)、糖脂比不合理(14.45%)等。结论:我院TPN医嘱开具基本合理,但仍存在一些问题有待改进,建议药师应适时根据患者情况调整处方用量,以保证患者的用药安全。     

1479份全肠外营养液使用情况分析

目的:了解我院全肠外营养液(TPN)的使用情况,进一步规范TPN在临床的合理使用,保证用药安全,提高营养支持水平.方法:对我院2006年1月～2011年11月的TPN处方进行统计分析.结果:TPN总共使用1479份,主要集中在普外科、神经外科、妇产科、胸心外科、泌尿外科、消化科和ICU.结论:我院临床使用TPN基本合理、规范,但是仍存在部分问题,有待改进.     

6401份全肠外营养液使用情况分析

目的:了解我院全肠外营养液(TPN)的使用情况,以提高TPN使用的合理性。方法:对我院2006年7月至2007年6月的TPN处方进行统计分析。结果:TPN总共使用6 401份,主要集中在普外科、新生儿科、肿瘤外科、肝胆外科、重症监护室和胸心外科。结论:我院临床使用TPN基本合理、规范,但是存在部分问题有待改进。     

全胃肠外营养液的合理用药分析和对策探讨

目的：了解我院全胃肠外营养液（TPN）的使用情况,为临床合理使用TPN提供参考。方法：对我院2007年7月～2009年6月TPN处方进行统计分析。结果：近两年我院有425例患者使用TPN,共4438份,主要应用于肿瘤科、消化内科、心胸外科、普外科。结论：我院TPN的应用基本合理,但仍需进一步提高TPN合理应用的水平。     

门诊314份处方抗生素不合理应用的分析

摘要:目的分析新县人民医院门诊抗生素处方不合理使用情况,促进临床抗生素合理使用.方法 随机抽取新县人民医院药房2009年6月-2010年6月抗生素处方3600份,对其中不合理用药处方统计分析.结果 不合理使用处方314份,约占8.72%.其中抗生素使用适应症掌握不严128份(40.8%);给药方法不当97份(3...     

中日友好医院静脉用药调配中心全肠外营养处方的合理性分析

目的:对中日友好医院肠外营养处方的合理性进行调查分析,为进一步全面实施药学干预提供数据支持与参考。方法:通过HIS提取医嘱信息,依据《临床诊疗指南肠外肠内营养学分册》等相关指南对全营养混合液处方进行合理性评价,对部分不合理处方进行个体化干预。结果:2015年9―12月共审核处方2 903份,不合理处方297份(占10.2%),不合理问题345次,糖脂比不合理32.6%;其中阳离子超量29.5%;液量不适宜14.8%;热氮比不合理14.5%;缺少必要营养素9.5%。结论:中日友好医院肠外营养处方存在不合理现象,临床药师应充分发挥专业技能对肠外营养处方进行审核与干预,为提高患者用药安全做出贡献。     

我院门急诊使用左氧氟沙星注射液的调查分析

目的：调查医院门急诊左氧氟沙星注射液的临床使用情况。方法统计分析我院门诊和急诊2014年5月份的全部处方。结果使用左氧氟沙星注射液的处方共计442张。男性患者200例,占总处方数的45．2％;女性患者242例,占总处方数的54．8％。其中存在不合理用药的处方282张,占总处方数的63．8％。结论我院左氧氟沙星注射液在门急诊的使用中还存在许多不合理使用问题,临床医师应严格按照药品说明书和《抗菌药物临床应用指导原则》使用左氧氟沙星注射液,提高合理用药水平。     

某院300例住院患者全肠外营养药物处方分析

目的 分析住院患者全肠外营养（TPN）药物医嘱,为临床合理应用TPN提供参考依据。方法 采用回顾性调查方法,收集中国人民解放军第105医院2016年1~12月有TPN处方的住院患者病历300份,参考国内外肠外营养相关指南及最新研究进展,利用Excel表格对自行设计的TPN处方点评表中的各项指标进行统计分析,评价TPN处方的合理性。结果 在300份TPN处方中,有11份（3.7%）无适应证用药;在289份有适应证处方中,不合理糖脂比占36.3%,阳离子浓度超标占19.7%,维生素超剂量使用占12.4%,TPN配方中加入未经证实安全性的药物占3.8%。结论 该院TPN设计基本合理,但仍存在无适应证用药,成分配比及浓度不适宜等情况,建议临床医生应针对患者的营养状况进行规范化的筛查和评估,科学设计TPN配方,进一步提高合理应用TPN的水平,实现专业化规范化治疗。     

Theoretical π-π* absorption and circular dichroic spectra of cyclic dipeptides

The dipole interaction model, treated by the partially dispersive normal mode method, is used to calculate circular dichroic spectra of cyclo(Gly-Gly), cyclo (Ala-Gly), cyclo(Ala-Ala), cyclo(Pro-Gly), cyclo(Pro-Ala), cyclo(Pro-Val), cyclo (Pro-D-Val), and cyclo(Pro-Pro) in the amide π-π* absorption band near 190 nm. Assuming a standard backbone geometry, spectra which are in fair to good agreement wth experiment are obtained for these molecules. The spectra are predicted to be sensitive to conformations of Pro and Val side chains. The effects of dipeptide ring folding on calculated CD spectra are mostly consistent with those found by other workers, except that it is found that a planar ring conformation of cyclo (Ala-Ala) and cyclo (Ala-Gly) gives predicted spectra comparable to experiment. The same model gives theoretical absorption spectra consistent with available experimental data.     

Effects of Nitro-L-Arginine on Blood Pressure and Cardiac Index in Anesthetized Rats: A Pharmacokinetic-Pharmacodynamic Analysis

Purpose. Nitric oxide synthase (NOS) inhibitors such as Nitro-L-arginine (L-NA) are being considered for the management of hypotension observed in septic shock. However, little information is available regarding the pharmacokinetic and pharmacodynamic properties of these agents. Our objective was to examine the relationships between L-NA plasma concentration and various hemodynamic effects such as cardiac index (CI), mean arterial pressure (MAP), and heart rate (HR) elicited by L-NA administration in rats. Methods. L-NA was infused at doses between 2.5 – 20 mg/kg/hr in anesthetized rats over one hour. Hemodynamic effects and plasma L-NA levels were determined. Results. Infusion of L-NA resulted in dose-dependent increases in MAP and systemic vascular resistance (SVR), decreases in CI, and minimal change in HR. The relationships between the hemodynamic effects and plasma L-NA levels were not monotonic, and hysteresis was observed. Using nonparametric analysis, the equilibration half-time (t_1/2,keo) between plasma L-NA and the hypothetical effect site was determined to be 51.5 ± 6.6 min, 42.4 ± 10.1 min, 43.4 ± 9.0 min for MAP, CI, and SVR, respectively (n = 14). The E_max and EC₅₀ values obtained were + 32.5 ± 8.4 and 2.6 ± 1.3 g/ml for MAP and –52.9 ± 15.6 and 3.7 ± 1.8 g/ml for CI, respectively. Conclusions. Although L-NA can bring about beneficial elevation of MAP, such effect is always accompanied by a stronger effect on CI depression. Dose escalation of L-NA may bring about detrimental negative inotropic effect and loss of therapeutic efficacy.     

洛美沙星体内外抗菌活性研究

洛美沙星对革兰氏阴性菌具有强的抑菌活力。对克氏肺炎杆菌的抗菌活性最强,MIC_(50)为0.12mg/L;对痢疾杆菌、产气杆菌、粘质沙雷氏菌、不动杆菌和枸椽酸杆菌的MIC_(50)分别为1和4mg/L。洛美沙星对肠细菌科细菌的活力比诺氟沙星和依诺沙星强2～16倍,明显地比丁胺卡那霉素、庆大霉素强。对金葡球菌MIC_(50)为1mg/L, MRSA对洛美沙星同样敏感。洛美沙星对表葡球菌、链球菌、粪链球菌及肺炎双球菌等的抗菌活性与地氟沙星相似,比诺氟沙星、依诺沙星、丁胺卡那霉素、庆大霉素和头孢三嗪分别强2～4倍。 洛美沙星对小鼠全身感染的疗效优于诺氟沙星。对大肠杆菌、克氏肺炎杆菌和绿脓杆菌感染小鼠iv的ED_(50)分别是0.74、0.13和3.45mg/kg, po的ED_(50)分别是0.94、1.46和6.20mg/kg。     

HPLC法测定丝裂霉素C聚氰基丙烯酸正丁酯纳米粒中丝裂霉素C的含量

目的:建立高效液相色谱法测定丝裂霉素 C 聚氰基丙烯酸正丁酯纳米粒(MMC-PBCA-NP)中药物含量。方法:采用C_(18)柱(4.6 mm×150 mm,5 μm),以混合磷酸盐缓冲液-乙腈(85:15)为流动相,流速为1 mL·min~(-1),紫外检测器,检测波长为365 nm。结果:丝裂霉素 C(MMC)浓度在5～250 μg·mL~(-1)范围内与峰面积呈良好的线性关系,r=0.9998;平均回收率(n=6)为98.15%。结论:本法专属性强,操作简便,结果准确。适用于 MMC-PBCA-NP 的质量控制。     

The pathogenesis of,and pharmacological treatment for,Canavan disease

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Protective role of exogenous α-lipoic acid (ALA) on hippocampal antioxidant status and memory function in rat pups exposed to sodium arsenite during the early post-natal period

The present work focussed on the effect of exogenous α-lipoic acid (ALA) administration on retention memory and oxidative stress markers in the hippocampus subsequent to early post-natal exposure of rat pups to sodium arsenite (NaAsO₂). Wistar rat pups were divided into the control groups receiving either no treatment (Ia) or distilled water by intraperitoneal route (i.p.) (Ib) and the experimental groups receiving either NaAsO₂ alone (1.5 and 2.0?mg/kg body wt.) (IIa, IIb) or NaAsO₂ (1.5 and 2.0?mg/kg body wt.) followed by ALA (70?mg/kg body wt.) (IIIa, IIIb) (i.p.) from post-natal day (PND) 4–15. The initial and retention transfer latency (ITL and RTL) was determined on PND 14 and 15 using elevated plus maze. The animals were sacrificed by cervical decapitation (PND 16) and the brains were obtained. The dissected out hippocampus was processed for estimation of oxidative stress markers, glutathione (GSH), and superoxide dismutase (SOD). NaAsO₂ exposure resulted in longer RTL in animal groups IIa and IIb, thereby suggestive of arsenic-induced impairment in retention memory. RTL was significantly shorter in animal groups (IIIa, IIIb) receiving ALA following NaAsO₂, thereby suggestive of improvement in retention memory. GSH and SOD levels were significantly decreased in animals receiving NaAsO₂ alone as against group Ib and administration of ALA following NaAsO₂ increased the levels of hippocampal GSH and SOD. These observations are suggestive of the role of exogenous ALA in ameliorating the adverse effects induced by NaAsO₂ exposure of rat pups on retention memory and oxidative stress markers.     

Latent role of in vitro Pb exposure in blocking Aβ clearance and triggering epigenetic modifications

Both β-amyloid (Aβ) catabolism and epigenetic regulation play critical roles in the onset of neurodegeneration. The latter also contribute to Pb neurotoxicity. The present study explored the role of epigenetic modifiers and Aβ degradation enzymes in Pb-induced latent effects on Aβ overproduction in vitro. Our results indicated that in SH-SY5Y cells exposed to Pb, the expression of NEP and IDE remained declined during the recovery period, accompanied with abnormal increase of Aβ_1-42 and amyloid oligomer. A disruption of selective global post-translational histone modifiers including the decrease of H3K9ac and H4K12ac and the induction of H3K9me2 and H3K27me2 dose dependently was also showed in recovery cells. Moreover, histone deacetylase inhibitor VPA could attenuate latent Aβ accumulation and HDAC activity induced by Pb, which might be by regulating the expression of NEP and IDE epigenetically. Overall, our results suggest sustained reduction of NEP and IDE expression in response to Pb sensitizes recovery SH-SY5Y cells to Aβ accumulation; however, administration of VPA is demonstrated to be beneficial in modulating Aβ clearance.     

乙酰吉他霉素临床前药理学研究

乙酰吉他霉素对临床分离的革兰氏阳性球菌有较好的抑菌活力，其对金葡球菌、β－溶血性链球菌、表葡球菌的ＭＩＣ_（５０）分别为１、０．２２和４ｍｇ／Ｌ，对耐红霉素、青霉素的金葡球菌、表葡球菌半数以上较敏感，与吉他霉素相似，但其对革兰氏阴性菌无明显作用。乙酰吉他霉素对小鼠实验性细菌感染有明显保护作用。对金葡球菌、肺炎双球菌感染小鼠口服用药的ＥＤ_（５０）分别为７９．６和２５．１ｍｇ／ｋｇ。其疗效与吉他霉素、麦白霉素、乙酰螺旋霉素相似。乙酰吉他霉素小鼠１次口服的ＬＤ_（５０）＞１５ｇ／ｋｇ，与吉他霉素相比毒性无差异。     

大鼠溃疡性结肠炎模型的实验研究

目的对不同剂量的三硝基苯磺酸（ＴＮＢＳ）引起的大鼠溃疡性结肠炎（ＵＣ）模型进行观察和评价。方法采用一次性直肠注入大鼠ＴＮＢＳ（２５～１５０ｍｇ·ｋｇ－１）的３０％乙醇溶液，引起慢性炎症性肠疾病（ＩＢＤ），３ｗｋ后外死动物对各剂量下动物结肠的重量、髓过氧化物酶（ＭＰＯ）活性及组织形态学变化进行观察和评价。结果ＴＮＢＳ在１００～１５０ｍｇ·ｋｇ－１剂量下引起的ＵＣ肠壁明显增厚，炎症和溃疡至少维持７ｗｋ时间，ＭＰＯ活性值显著性升高，组织学检查发现粘膜及粘膜下层有大量中性粒细胞及淋巴细胞、巨噬细胞、纤维细胞浸润，肉芽组织及隐窝脓肿形成，５０ｍｇ·ｋｇ－１剂量时有一较轻度的损伤。２５ｍｇ·ｋｇ－１时对结肠的重量、ＭＰＯ活性及损伤指数都没有显著性改变（Ｐ＞０．０５）。结论用ＴＮＢＳ引起大鼠实验性ＵＣ，其溃疡和炎症维持一较长时间，这一病理特征为炎症性疾病防治药物的研究提供了条件；本模型的最佳剂量为１００ｍｇ·ｋｇ－１左右     

Dinoflagellate polyether within the yessotoxin, pectenotoxin and okadaic acid toxin groups: Characterization, analysis and human health implications

Diarrhetic Shellfish Poisoning (DSP) is a specific type of food poisoning, characterized by severe gastrointestinal illness due to the ingestion of filter feeding bivalves contaminated with a specific suite of toxins. It is known that the problem is worldwide and three chemically different groups of toxins have been historically associated with DSP syndrome: okadaic acid (OA) and dinophysistoxins (DTXs), pectenotoxins (PTXs) and yessotoxins (YTXs). PTXs and YTXs have been considered as DSP toxins because they can be detected with the bioassays used for the toxins of the okadaic acid group, but diarrhegenic effects have only been proven for OA and DTXs. Whereas, some PTXs causes liver necrosis and YTXs damages cardiac muscle after intraperitoneal injection into mice. On the other hand, azaspiracids (AZAs) have never been included in the DSP group, but they cause diarrhoea in humans. This review summarizes the origin, characterization, structure, activity, mechanism of action, clinical symptoms, method for analysis, potential risk, regulation and perspectives of DSP and associated toxins produced by marine dinoflagellates.