29家医院门诊西药房药品贮存的设备配置情况调查

目的通过调查我市各级医院门诊西药房药品贮存的设备配置情况,揭示存在的问题,旨在引起有关部门重视医院药房规范化建设。方法:笔者于2006年2月10日至2006年2月27日,调查了我市29家医院的门诊西药房药品贮存设备配置的情况,并将调查的结果逐一记录。按《药品经营质量管理规范》中的第六十八条关于“药品零售企业营业场所和药品仓库应配置的设备”为标准,与调查的结果进行比较。结果:29家医院中只1家三级甲等医院的门诊西药房药品贮存的设备配置达100%。结论:其余医院门诊西药房药品贮存的设备配置存在不足。为保证药品质量,保障患者用药的安全有效,建议进一步完善门诊西药房药品贮存的设备配置。     

长江流域六大城市典型医院2001年上半年度用药分析

我国不久将加入WTO ,各城市又相继实施了医疗保险制度 ,所以对城市典型医院用药状况作一分析 ,对准确掌握市场命脉和调整产品结构是非常有价值的。笔者使用上海市药监局科技情报研究所医院用药分析研究室所采集的长江流域六大城市 (上海、南京、杭州、武汉、成都、重庆 ) 1 36家医院 (三级医院 70家、二级医院 5 2家、一级医院 1 4家 )的药品购入种类与金额进行分析。2 0 0 0年上半年度这些医院的统计数表明 ,使用不同性质企业的药品市场份额的平均数是 :国产药为 5 3.88% ,合资药为 2 5 .4 4% ,进口药为 2 0 .88% ,但各城市医院用药由于…     

医院西药库房管理现状与对策

目的为医院西药库房药品质量管理规范化提供参考。方法通过对全市医疗机构(三级甲等医院2所,二级甲等医院11所)药房药库检查记录表进行分析。结果大部分医院对药品贮存条件和药品拆零不够重视。结论通过一些对策,使药品质量管理规范化。     

质量风险管理在医院药房退药环节的应用

目的:控制医院药房退药环节的药品质量风险,为药品质量风险管理(QRM)在医院药房的应用提供参考。方法:通过风险识别、风险评估、风险控制、风险审核等步骤对我院药房退药环节实施药品QRM;以各风险因素的发生率和退回药品可再利用率为指标,比较我院实施QRM前(2015年7月-12月)、后(2016年1月-6月)的相关数据,评价药品QRM实施效果。结果:确定需特殊贮存药品是否按所需贮存条件保存、退回药品的数量是否清点到最小包装等5项因素为高风险因素(各因素风险评分均大于4分);经对各高风险因素分别采取相应的控制措施后均降低至可接受水平(风险评分均小于4分);实施QRM后与实施前比较,各风险因素的发生率均降低(降低1.35%~6.19%),退回药品可再利用率升高(98.64%vs.86.32%)(P均小于0.05)。结论:医院药房在退药环节实施QRM可降低药品质量风险。     

某三甲中医医院门诊西药房药品贮存的研究

目的了解药品贮存要求和现状,改进药品贮存方法。方法对医院门诊西药房所贮存的538种药品的贮存项内容及其贮存现状进行调查。结果同剂型或属性的药品对贮存的要求有所不同;我院对低温(2⁸℃)控制、避光贮存和需特殊管理的药品贮存控制良好,但对某些说明书贮存项内容模糊,对环境耐受度较大的药物的贮存还有待加强。结论应加强硬件设施的建设,规范药品标签贮存项的标识,做好养护日志,定期抽检,以保障药品质量和用药安全。     

在库药品养护的温度把握

药品的贮存安全、保证质量、减少损耗、促进药品疏通有着重要的作用。本文介绍药品在仓库贮存过程中应如何进行保养和维护的经验，特别是仓库温度和干湿度尤为重要。     

1997～2001年湖南省20家医院用药情况分析

医院药品直接用于患者，是药品生产和销售的终点，比药品生产或销售企业更能反映药品的实际需求。到2001年前，我国药品消耗的90％在医院，因此对医院用药进行分析是研究我国医药经济的重要手段之一。湖南作为我国的农业大省，人口达6700万人，近年医疗卫生费用增长迅速，尤其是药品费用显著增长，给国家和人民群众造成了一定的压力。对医院用药特点的调查，掌握药品市场规律，是制定合理的卫生政策的前提之一。卢安瑛等曾对湖南省10家大型综合性医院1996～2000年的用药情况进行了初步分析。为了更进一步了解湖南地区药物的使用情况，我们将研究的医院扩大到20家，包括大型综合医院和部分县、市级医院、厂矿职工医院，对湖南省20家医院的用药特点以及药品市场的竞争情况进行了分析。     

儿童医院病区备用药品管理现状调研

目的:调研我国儿童医院病区备用药品管理现状,探索管理对策,保障病区备用药品的临床用药安全。方法:面向我国45家儿童专科医院(三级医院34家和二级医院11家),自行设计问卷展开调研,采用Excel 2010软件统计基础数据,分析可能存在的风险点,结合政策法规与文献,探索规范化管理对策。结果:共发放问卷853份,回收有效问卷823份,有效回收率96.5%。现阶段儿童医院病区备用药品管理存在的主要问题为种类数量过多(42.2%)、分区分类标示标签不完善(27.6%)、贮存条件不达标或缺少温/湿度记录(26.9%)、无使用补充破损登记记录(25.3%)等。结论:现阶段儿童医院病区备用药品仍主要采用人工管理,在保障临床用药及时性与便捷性方面存在不足,病区备用药品在临床使用中存在安全隐患;通过自动化与信息化实现药品使用的全程可追溯,可以从根源上解决病区备用药品管理问题。     

医院药品有效期管理探讨

目的:对医院药品效期管理提出合理化建议,使药品管理更加科学有效.方法:剖析医院药品流通的各个环节,包括:医院库房;门、急诊药房;住院药房以及病区药品的有效期管理,提示应该控制的关键环节和关键点.结果:医院药品流通各个环节都应严格对药品的效期实行分类管理.建立完善的药剂科内部和各临床科室间的药品调剂使用制度、过期药品报废制度、药品退回制度和滞销药品淘汰制度.结论:工作人员的责任心是药品有效期管理的关键,有效的管理制度是药品有效期管理的重要手段,良好的贮藏设施是保证有效期内药品质量的基础条件.     

加强医院药品及库存物资的管理

1药品管理(1)药品管理要遵循“定额管理、安全有效、加速周转、保证供应”的原则。(2)药品应根据医疗业务的需要,实行计划采购、计划供应的办法。(3)药品的购入和领用,必须履行严格的出入库手续,未经办理出入库手续的药品采购不得入帐;仓库管理员应坚持先入库、后领出的原则。(4)药房和药库至少每季度应进行1次有会计人员参与的盘点。对盘盈、盘亏的药品要查明原因,按规定及时进行帐务处理。(5)药品管理按照核定的药品周转金定额组织药品储备,合理划分药库和药房储备金额;严格执行国家《药品管理法》和公费医疗管理的有关制度规定;我院制剂中心的自制药品一律按市物价局批准的批发价办理入库手续。(6)药品定价应严格执行物价部门的有关规定,不得擅自提价销售。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.