奥曲肽联合乌司他丁治疗急性胰腺炎的临床效果评价

目的分析奥曲肽联合乌司他丁治疗急性胰腺炎患者的临床效果。方法选择2016年11月22日至2017年11月11日来我院就医的急性胰腺炎患者98例,通过就诊顺序单双号分为对照组和观察组各49例,对照组给予奥曲肽治疗,观察组给予奥曲肽联合乌司他丁治疗,对比两组临床各项指标情况、不良反应发生情况。结果观察组血清钙恢复正常时间为(7.24±0.24)d、上腹部压痛症状改善时间为(5.57±2.20)d、血清淀粉酶恢复正常时间为(5.30±1.11)d、血糖恢复正常时间为(9.54±0.54)d,数据明显优于对照组,P<0.05,而在不良反应发生情况的比较中,观察组与对照组数据之间并不存在较大的差异性,P>0.05。结论奥曲肽联合乌司他丁治疗急性胰腺炎效果显著,可在临床推广应用。     

奥曲肽联合丹参治疗急性胰腺炎疗效观察

目的:探讨奥曲肽联合丹参治疗急性胰腺炎的临床疗效。方法:78例急性胰腺炎患者,随机分为治疗组和对照组各39例,分别采用奥曲肽联合丹参治疗和单用奥曲肽治疗。结果:治疗组的腹痛缓解时间、淀粉酶恢复到正常时间、腹部压痛消失时间以及住院时间均短于对照组,差异具有统计学意义;治疗组的疗效(94.87%)大于对照组(82.05%),两组差异具有统计学意义(P<0.05)。结论:奥曲肽联合丹参治疗急性胰腺炎临床疗效显著,值得临床推广。     

丹参酮ⅡA联合奥曲肽治疗轻症急性胰腺炎临床观察

目的探讨丹参酮ⅡA磺酸钠联合奥曲肽治疗轻症急性胰腺炎(MAP)的临床疗效。方法 106例MAP患者随机分为两组,每组各53例,对照组予奥曲肽,观察组加用丹参酮ⅡA磺酸钠。10d一疗程。比较临床症状改善时间、住院时间、住院费用、生化指标及临床疗效,记录不良反应。结果观察组腹痛腹胀消失时间、体温正常时间、血淀粉酶正常时间、尿淀粉酶正常时间、CRP正常时间、住院时间、住院费用分别为(2.32±0.53)、(2.69±0.58)、(3.87±1.09)、(4.22±0.98)、(3.80±0.86)、(6.23±1.11)d和(7800.4±940.1)元,临床有效率为94.3%,组间差异均有统计学意义(P0.05)。两组均无明显不良反应。结论丹参酮ⅡA磺酸钠联合奥曲肽治疗MAP安全有效,值得临床推广     

奥曲肽治疗急性胰腺炎的疗效分析

目的：分析奥曲肽治疗急性胰腺炎的临床效果。方法选取普定县中医医院2010—2013年收治的56例急性胰腺炎患者,随机分为奥曲肽组和对照组,每组28例。患者入院后均采取基础治疗,奥曲肽组患者在此基础上采取奥曲肽治疗,对照组患者在此基础上采用氟尿嘧啶治疗。比较两组患者的临床疗效、临床指标恢复时间及住院时间等。结果奥曲肽组患者的总有效率（92.8%）高于对照组（71.4%）,差异有统计学意义（ P<0.05）。奥曲肽组患者腹痛缓解时间、腹部压痛减轻时间、血淀粉酶恢复时间、尿淀粉酶恢复时间及住院时间均短于对照组,差异有统计学意义（ P<0.05）。奥曲肽组患者在治疗中有3例出现口干,不影响治疗。结论奥曲肽治疗急性胰腺炎的临床效果明显,且不良反应小。     

奥曲肽在急性胰腺炎中的疗效和安全性观察

目的观察奥曲肽在治疗急性胰腺炎的效果和安全性。方法将急性胰腺炎患者64例按其治疗方法不同分为奥曲肽组34例和对照组30例。对照组采用常规治疗;奥曲肽组在对照组治疗基础上予奥曲肽注射液静脉滴注。治疗后对2组治疗效果及安全性进行观察。结果奥曲肽组有效率为82.4%高于对照组的63.3%,差异有统计学意义(P<0.05);奥曲肽组腹痛缓解时间、胰腺水肿消退时间、血尿淀粉酶消退时间和住院时间均明显短于对照组,差异均有统计学意义(P<0.05)。结论急性胰腺炎患者在综合治疗的基础上加用奥曲肽能明显提高治疗效果,无明显不良反应,值得推广应用。     

奥曲肽联合乌司他丁在重症急性胰腺炎治疗中的效果分析

目的探讨重症急性胰腺炎(SAP)治疗中奥曲肽联合乌司他丁用药的临床效果。方法 86例重症急性胰腺炎患者,随机分为对照组与观察组,各43例。对照组患者给予奥曲肽治疗,观察组给予奥曲肽联合乌司他丁治疗。比较两组患者的临床疗效,血、尿淀粉酶恢复时间,格拉斯哥昏迷量表(GCS)评分,不良反应发生情况。结果用药1个周期后,观察组治疗总有效率为100.00%,高于对照组的74.42%,差异具有统计学意义(P<0.05)。观察组患者的血、尿淀粉酶恢复时间分别为(5.5±2.5)、(5.2±2.7)d,均短于对照组的(7.7±2.9)、(7.9±2.9)d,差异均具有统计学意义(P<0.05)。观察组GCS评分为(13.1±0.5)分,高于对照组的(9.1±1.0)分,差异具有统计学意义(t=23.461, P<0.05)。观察组患者的不良反应发生率为9.30%,低于对照组的32.56%,差异具有统计学意义(χ2=7.026, P<0.05)。结论奥曲肽联合乌司他丁在重症急性胰腺炎治疗中疗效确切,安全性较高,能够明显改善血、尿淀粉酶水平。     

急性胰腺炎采用奥曲肽联合乌司他丁治疗的临床效果评价

目的探讨奥曲肽联合乌司他丁治疗急性胰腺炎的临床效果。方法按随机数字表法将我院2012年6月至2014年6月收治的120例急性胰腺炎患者分为对照组和观察组,每组60例。两组患者均在常规治疗的基础上加用其他药物治疗,对照组加用奥曲肽治疗,观察组采用奥曲肽联合乌司他丁治疗,比较两组患者的临床疗效。结果经治疗后,观察组共治愈38例,显效15例,有效5例,无效2例,治疗总有效率为96.67%;对照组共治愈27例,显效18例,有效5例,无效10例,治疗总有效率为83.33%,两组有效率差异对比具有统计学意义(P<0.05)。观察组的腹痛腹胀缓解时间为(5.3±1.9)h,血淀粉酶恢复正常时间为(3.5±1.2)h,平均住院时间为(15.2±4.5)d;对照组分别为(8.8±3.6)h、(5.5±1.8)h和(21.9±3.2)d,差异对比均具有统计学意义(P<0.05)。结论急性胰腺炎采用奥曲肽联合乌司他丁治疗可获得良好疗效,具有临床推广价值。     

中西医结合治疗急性胰腺炎的价值探讨

目的探讨中西医结合治疗水肿型急性胰腺炎的疗效。方法选择我院在2010年1月～2013年2月收治的100例急性胰腺炎患者作为观察组,另外选择我院在2005年10月～2008年12月收治的100例急性胰腺炎患者作为对照组,其中观察组给予中西医结合治疗,对照组患者给予西医治疗,比较分析它们的疗效。结果观察组患者的治疗有效率为94.00%,腹痛缓解时间为(4.13±1.11)d、腹部压痛缓解时间为(3.78±1.01)d,血淀粉酶恢复时间为(3.96±0.47)d,尿淀粉酶恢复时间为(6.18±1.65)d,白细胞恢复时间为(5.14±0.41)d,平均住院时间为(15.54±2.54)d。对照组患者的治疗有效率为76.00%,腹痛缓解时间为(5.66±1.87天)d,腹部压痛缓解时间为(6.68±1.09)d,血淀粉酶恢复时间为(6.65±0.62)d,尿淀粉酶恢复时间为(7.62±1.55)d,白细胞恢复时间为(7.47±0.72)d,平均住院时间为(21.59±3.43)d。观察组患者腹痛缓解时间、腹部压痛缓解时间,血淀粉酶恢复时间,尿淀粉酶恢复时间,白细胞恢复时间以及平均住院时间明显优于对照组患者,并且观察组的疗效也明显优于对照组患者。结论中西医结合治疗急性胰腺炎的疗效确切、安全,值得临床推广使用。     

奥曲肽对轻症急性胰腺炎的疗效观察

目的观察药物奥曲肽对轻症急性胰腺炎的疗效。方法前瞻性将2010年1月至2011年8月收治于我院的110例轻症急性胰腺炎患者随机分为两组,分别为观察组和对照组,其中观察组60例,对照组50例,观察组给予常规治疗+奥曲肽治疗,对照组仅给予常规治疗,回顾性的对两组的不同治疗成果进行对比。结果观察组的上腹压痛消失时间、腹痛缓解时间、血尿淀粉酶恢复正常时间均比对照组所需时间短,且P<0.05,差异具有统计学意义。结论奥曲肽对于轻症急性胰腺炎的药用价值是积极肯定的,可供临床治疗的推广使用。     

奥曲肽治疗重症胰腺炎的疗效评价与临床分析

目的研究并分析治疗重症胰腺炎患者时使用奥曲肽的效果。方法收集重症胰腺炎患者共86例,根据随机对照、平行、单盲的原则将其分为对照组(43例)和观察组(43例),对照组接受常规治疗,观察组联合使用奥曲肽,将两组患者治疗后的总有效率、腹痛消失时间、尿淀粉恢复时间和血淀粉酶恢复时间进行观察和对比。结果观察组治疗后的总有效率明显高于对照组,观察组的腹痛消失时间、尿淀粉恢复时间和血淀粉酶恢复时间均显著短于对照组,P均<0.05。结论在重症胰腺炎患者的治疗过程中,奥曲肽能够迅速缓解患者症状,使患者获得更佳疗效,值得推广应用。     

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.     

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.     

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。     

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.     

Comparison of in vitro cell models in predicting in vivo brain entry of drugs

Although several in vitro models have been reported to predict the ability of drug candidates to cross the blood-brain barrier, their real in vivo relevance has rarely been evaluated. The present study demonstrates the in vivo relevance of simple unidirectional permeability coefficient (P(app)) determined in three in vitro cell models (BBMEC, Caco-2 and MDCKII-MDR1) for nine model drugs (alprenolol, atenolol, metoprolol, pindolol, entacapone, tolcapone, baclofen, midazolam and ondansetron) by using dual probe microdialysis in the rat brain and blood as an in vivo measure. There was a clear correlation between the P(app) and the unbound brain/blood ratios determined by in vivo microdialysis (BBMEC r=0.99, Caco-2 r=0.91 and MDCKII-MDR1 r=0.85). Despite of the substantial differences in the absolute in vitro P(app) values and regardless of the method used (side-by-side vs. filter insert system), the capability of the in vitro models to rank order drugs was similar. By this approach, thus, the additional value offered by the true endothelial cell model (BBMEC) remains obscure. The present results also highlight the need of both in vitro as well as in vivo methods in characterization of blood-brain barrier passage of new drug candidates.