A群链球菌制剂与平阳霉素制剂注射治疗颌面血管瘤和脉管畸形疗效观察

目的 观察比较A群链球菌制剂和平阳霉素制剂注射治疗颌面血管瘤和脉管畸形的治疗效果.方法 81例颌面血管瘤和脉管畸形病例,分别采用A群链球菌制剂和平阳霉素制剂注射治疗,记录其疗效和毒副作用,并对所有病例进行随访.结果 血管瘤 21例:A群链球菌制剂组10例,治愈5例(50.0%),平阳霉素组11例,治愈6例(54.55%);静脉畸形30例:A群链球菌制剂组14例,治愈8例(57.14%),平阳霉素组12例,治愈7例(58.33%);淋巴管畸形30例:A群链球菌制剂组17例,治愈13例(76.47%),平阳霉素组13例,治愈5例(38.46%).结论 颌面血管瘤和静脉畸形患者A群链球菌制剂和平阳霉素制剂注射治疗均有效,淋巴管畸形患者A群链球菌制剂疗效明显优于平阳霉素制剂注射.     

血管异常患者1000例硬化剂注射治疗效果分析

目的 探讨婴儿型血管瘤、化脓性肉芽肿、淋巴管畸形及静脉畸形血管异常患者硬化剂局部注射治疗的经验及效果.方法 对1 000血管异常患者进行硬化剂注射治疗,随访观察,并进行疗效评估.结果 随访时间2个月至5年,各型血管异常治疗总有效率96.5％,其中,淋巴管畸形治愈率达100％,化脓性肉芽肿治愈率100％,婴儿型血管瘤治愈率达98.0％,静脉畸形治愈率90.0％.结论 硬化剂注射治疗可以作为婴儿型血管瘤、化脓性肉芽肿、淋巴管畸形及静脉畸形的首选治疗方法.     

平阳霉素注射治疗口腔颌面部静脉畸形31例报道

目的探讨平阳霉素局部注射治疗口腔颌面部静脉畸形的疗效,提高安全性。方法采用平阳霉素、地塞米松联合局部瘤腔内注射治疗口腔颌面部静脉畸形31例,7～14d注射1次,3～5次为1疗程。行疗效观察。结果 31例患者治愈14例(45.16%),基本治愈11例(35.49%),有效6例(19.35%),治愈和基本治愈25例占80.65%。随访观察均获得了理想的效果。结论平阳霉素注射治疗口腔颌面部静脉畸形疗效及安全性满意,避免了外科手术的难度及危险性,保留了患者的容貌和功能。     

平阳霉素治疗口腔颌面部软组织淋巴管畸形的临床观察

目的:总结平阳霉素治疗口腔颌面部软组织淋巴管畸形的疗效与病变类型的关系。方法:选择2001年10月—2010年10月10年间门诊单纯局部注射盐酸平阳霉素患者236例。结果:平阳霉素治疗淋巴管畸形,微囊型病变的疗效较差,治愈和基本治愈率为60%;大囊型或较大囊型病变的疗效较好,治愈和基本治愈率为91%。结论:平阳霉素治疗口腔颌面部软组织淋巴管畸形是一种简便、安全、有效的治疗方法,必要时融合手术治疗、激光治疗,但由于平阳霉素属抗癌药物,其远期疗效和不良反应有待继续观察。     

局部尿素注射治疗体表海绵状血管瘤

目的:探讨体表海绵状血管瘤的治疗方法.方法:对869例体表海绵状血管瘤行尿素注射治疗,其中肿瘤类海绵状血管瘤618例,血管畸形类海绵状血管瘤251例,平均随访2年6个月.结果:618例肿瘤类海绵状血管瘤中546例治愈,70例有效,2例无效;251例血管畸形类海绵状血管瘤中35例治愈,203例有效,13例无效.结论:本疗...     

婴幼儿颌面部血管瘤及海绵状血管畸形平阳霉素注射治疗体会

目的评价平阳霉素注射治疗婴幼儿颌面部血管瘤及海绵状血管畸形的疗效。方法采用平阳霉素瘤内注射治疗45例婴幼儿颌面部血管瘤及海绵状血管畸形患儿。7d注射1次,3～5次为1个疗程。结果45例患儿平均疗程21d,治疗完成后经12个月随访,治愈和有效率为97.78%。结论平阳霉素瘤内注射治疗婴幼儿颌面部血管瘤及海绵状血管畸形安全、简便、疗效高、疗程短。     

平阳霉素治疗口腔颌面部静脉畸形的临床评价

目的总结平阳霉素(PYM)瘤内注射治疗口腔颌面部静脉畸形的疗效。方法收集1999年2月—2008年2月,用平阳霉素(PYM)注射治疗口腔颌面部静脉畸形120例。7～10d注射1次,2～3次为一个疗程。结果 2年随诊治愈80例,基本治愈30例,好转7例,无效3例;治愈和基本治愈统计为治愈率,共110例,占91%。结论平阳霉素(PYM)治疗口腔颌面部静脉畸形,疗程短,是一种简便、安全的有效方法。     

平阳星治疗眼睑部海绵状血管瘤的疗效分析

目的探讨平阳星治疗眼睑部海绵状血管瘤的疗效。方法对我科自2001年12月至2005年12月应用平阳星注射治疗眼睑部海绵状血管瘤118例的疗效进行分析。结果经过3个月~4年随访,治愈和基本治愈率为92.4%,好转7.6%,总有效率为100%,发热反应为7.6%,无一例过敏反应。结论平阳星瘤体内注射治疗眼睑部海绵状血管瘤,痛苦小、疗程短、疗效高,是治疗眼睑部海绵状血管瘤最安全有效的方法。     

尿素局部注射治疗婴幼儿特殊部位血管瘤167例

目的总结和探讨眼、唇、鼻、耳等特殊部位的婴幼儿血管瘤的临床特点和治疗方法,评价尿素局部注射治疗婴幼儿特殊部位血管瘤的疗效。方法回顾分析河南省人民医院2009年1月—2011年12月婴幼儿特殊部位血管瘤167例的临床和随访资料,所有患儿均采用局部注射尿素方法治疗。结果随访1-4.8年,平均随访1.4年。167例患儿中146例（87.4%）治愈,好转21例（12.6%）。无严重不良并发症。结论局部注射尿素方法操作简单、疗效肯定,副反应少,值得推广应用。     

颌面部脉管瘤200例治疗体会

我们从 1988年 9月至 2 0 0 0年 6月治疗颌面部脉管瘤2 0 0例 ,总治愈率 89%以上 ,认为颌面部血管瘤如不影响美观及功能者 ,可严密观察 ,随访 ;对于颌面部血管畸形、淋巴管瘤或已影响到外观及功能的血管瘤可以用硬化剂、平阳霉素局部注射、手术切除或两者联合 [1 ] ,以提高疗效。1　资料与方法1.1　临床资料 :本组 2 0 0例 ,其中血管瘤 40例 ,血管畸形144例 ,淋巴管瘤 12例 ,淋巴血管瘤 4例。年龄为 5个月～6 2岁 ,平均年龄 2 8岁。病程 4个月～ 6 0 a,平均为 5 a。男性92例 ,女性 10 8例。发生于上眼睑者 2例 ,面部 98例 ,唇部6 0例 ,颊黏…     

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.     

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。     

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.     

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.     

Study of potential in vitro and in vivo genotoxicity in hepatocytes of quinolone antibiotics

The genotoxicity of quinolone antibiotics has been evaluated in hepatocytes following in vitro and in vivo exposure. Unscheduled DNA synthesis (UDS) was induced in vitro in rat hepatocytes by norfloxacin, ofloxacin, pefloxacin, and ciprofloxacin but not by nalidixic acid. In vivo UDS was not observed in hepatocytes isolated 4 to 24 hr after exposure of adult male F344 rats to either a single dose (30 to 190 mg/kg) or repeated doses (40 mg/kg) of ciprofloxacin. Using the 32P-postlabeling technique, no modified bases were detected in hepatocytes exposed in vitro to ciprofloxacin. In summary, UDS was induced in hepatocytes by in vitro exposure to high concentrations of norfloxacin, ofloxacin, pefloxacin, or ciprofloxacin. There was no evidence of in vitro DNA adduct formation by ciprofloxacin or in vivo DNA damage under the conditions tested. These findings suggest that ciprofloxacin is not DNA reactive, but it induces in vitro UDS as a consequence of some indirect action.