阿奇霉素联合痰热清注射液治疗50例小儿支原体肺炎的疗效观察

目的 观察阿奇霉素联合痰热清治疗小儿支原体肺炎的临床疗效。方法 100例支原体肺炎患儿,采用随机数字表法分组为观察组和对照组,各50例,观察组采用阿奇霉素联合痰热清施治,对照组采用阿奇霉素施治,观察两组治疗方案的临床疗效。结果 观察组有效率94.00%明显高于对照组68.00%(P<0.05);观察组缩短临床症状与体征时间明显短于对照组(P<0.05)。结论 阿奇霉素注射液联合痰热清注射液治疗小儿支原体肺炎效果确切,能够显著改善临床症状与体征,协同治疗效果显著,值得临床对联合用药的作用机制继续研究和探讨。     

氨溴索注射液联合阿奇霉素治疗小儿支原体肺炎110例疗效观察

目的观察氨溴索注射液联合阿奇霉素治疗小儿支原体肺炎的临床疗效。方法将110例支原体肺炎患儿随机分为治疗组和对照组各55例。对照组予阿奇霉素治疗;治疗组在对照组治疗基础上加用氨溴索注射液治疗。观察2组临床疗效、病情恢复(退热、咳喘消失、啰音消失)时间及不良反应。结果治疗组总有效率为94.5%高于对照组的80.0%,差异有统计学意义(P<0.05);治疗组退热时间、咳嗽消失时间、肺部啰音消失时间均短于对照组,差异均有统计学意义(P<0.05)。2组患儿均未出现不良反应。结论氨溴索注射液联合阿奇霉素治疗小儿支原体肺炎可有效缩短病程,减少并发症的发生,提高临床疗效,值得临床推广应用。     

阿奇霉素联合炎琥宁治疗小儿支原体肺炎的临床效果分析

目的探讨阿奇霉素联合炎琥宁治疗小儿支原体肺炎的临床效果。方法将本院收治的85例支原体肺炎患儿随机分为观察组(43例)和对照组(42例),对照组给予阿奇霉素注射和口服,观察组在对照组基础上给予炎琥宁冻干粉静脉滴注,治疗2个疗程后比较两组患儿的临床疗效。结果对照组总有效率为78.57%,观察组总有效率为95.35%,两组比较差异有统计学意义(P<0.05);观察组的退热时间、咳嗽消失时间、啰音消失时间、X线体征恢复时间等临床指标改善情况优于对照组,差异有统计学意义(P<0.05)。结论阿奇霉素联合炎琥宁治疗小儿支原体肺炎,可显著提高临床总有效率,缩短临床治疗时间,具有临床推广应用意义。     

阿奇霉素联合山莨菪碱治疗儿童肺炎支原体肺炎伴喘息的临床疗效观察

目的:研究观察阿奇霉素联合山莨菪碱治疗儿童肺炎支原体肺炎伴喘息的临床疗效.方法:将2014年4月~2016年4月来我院接受治疗的94例患有肺炎支原体肺炎伴喘息的儿童作为研究对象.以数字法随机分成观察组(47例)和对照组(47例).对照组接受阿奇霉素治疗,观察组接受阿奇霉素联合山莨菪碱治疗.治疗后,从两组临床疗效以及肺部体征的变化时间进行对比.结果:对比两组疗效可以发现,观察组临床疗效表现为显效的人数显著多于对照组,总有效率明显高于对照组,观察组疗效表现为无效的人数远远少于对照组(均P<0.05).观察治疗后患儿发热消退时间、喘息症状消失时间、肺部体征、药物不良反应、住院时间.观察组各种对比指标均优于对照组(均P<0.05).结论:在对儿童肺炎支原体肺炎伴喘息治疗中,阿奇霉素联合山莨菪碱的效果最佳,值得临床推广.     

阿奇霉素联合布地奈德雾化吸入治疗小儿支原体肺炎疗效观察

目的 观察阿奇霉素联合布地奈德雾化吸入治疗小儿支原体肺炎的临床疗效。方法 130例支原体肺炎患儿随机分为对照组和观察组,各65例,对照组给予阿奇霉素治疗,观察组给予阿奇霉素联合布地奈德雾化吸入治疗,观察两组的疗效和不良反应。结果 观察组的总有效率(90.8%)高于对照组(76.9%),差异有统计学意义(P<0.05);观察组的不良反应率(10.8%)高于对照组(6.1%),差异无统计学意义(P>0.05)。结论 阿奇霉素联合布地奈德雾化吸入治疗小儿支原体肺炎疗效显著,安全性可靠,值得应用。     

热毒宁联合阿奇霉素治疗小儿支原体肺炎的疗效及对血清炎性因子的影响

目的:探析热毒宁联合阿奇霉素治疗小儿支原体肺炎的临床疗效及对血清炎性因子的影响.方法:选取2014年7月~2015年7月到我院就诊的小儿支原体肺炎患者90例,随机分成观察组和对照组,各45例.对照组使用阿奇霉素治疗,观察组在对照组治疗基础上静脉注射热毒宁.将两组治疗有效率、炎性因子水平、不良反应发生率及住院时间进行对比.结果:观察组治疗有效率、炎性因子水平及住院时间均优于对照组,差异显著(P<0.05).结论:热毒宁与阿奇霉素联合治疗小儿支原体肺炎安全性高,可明显改善患儿炎性因子,缓解临床症状,增强治疗效果,加速患儿康复进程.     

阿奇霉素联合匹多莫德治疗小儿支原体肺炎临床疗效

目的观察阿奇霉素联合匹多莫德治疗小儿支原体肺炎临床疗效,探讨临床治疗小儿支原体肺炎的有效方法。方法将150例确诊的小儿支原体肺炎患者随机分为对照组50例和观察组100例,对照组采用阿奇霉素序贯疗法治疗,治疗组在此基础上加用匹多莫德口服治疗。观察治疗前后的临床症状、体征好转时间、外周血免疫细胞的变化及3个月内的再发率。结果观察组临床症状、体征持续时间均明显低于对照组(P<0.05),总有效率达95%,显著高于对照组的86%(P<0.01)。观察组在治疗3个月后,血液CD3+、CD4+细胞数、CD4+/CD8+比值均明显高于治疗前(P<0.05)。结论阿奇霉素联合匹多莫德治疗小儿支原体肺炎,疗效显著,并可减少复发,值得临床推广。     

氨溴特罗口服液和阿奇霉素治疗小儿支原体肺炎83例疗效评价

目的探讨氨溴特罗口服液联合阿奇霉素治疗小儿支原体肺炎的临床疗效。方法将83例支原体肺炎患儿随机分成两组,治疗组42例口服氨溴特罗口服液联合阿奇霉素10mg/(kg.d)静脉滴注,对照组41例仅静脉滴注阿奇霉素10mg/(kg.d),疗程5d。结果治疗组总有效率治疗组为92.8%,对照组为82.9%,两组间有有显著差异(P<0.05);治疗组发热、咳嗽、肺部啰音消失和胸部X线恢复正常时间明显少于对照组(P<0.05)。结论氨溴特罗口服液联合阿奇霉素治疗小儿支原体肺炎可缩短疗程,减轻临床症状。     

丙种球蛋白联合阿奇霉素序贯治疗小儿支原体肺炎疗效观察

目的观察丙种球蛋白联合阿奇霉素序贯治疗小儿支原体肺炎的临床疗效。方法 100例纳入观察的患儿随机分为治疗组和对照组各50例,治疗组采用丙种球蛋白联合阿奇霉素序贯治疗,对照组仅接受阿奇霉素序贯治疗,两组均连续治疗3周后对比疗效。结果治疗组总有效率为100.0%,高于对照组的92.0%,差异具有统计学意义(P<0.05);治疗组体温、咳嗽、肺部啰音消失时间均短于对照组,差异均具有统计学意义(P<0.05)。结论丙种球蛋白和阿奇霉素序贯应用治疗小儿支原体肺炎起到了协同作用,较单纯阿奇霉素治疗有效缩短了病程,提高临床疗效,且不良反应发生率并未明显增加,值得同道斟酌应用。     

阿奇霉素治疗小儿支原体肺炎的临床疗效观察

目的观察阿奇霉素治疗小儿支原体肺炎的临床疗效及安全性。方法将122例支原体肺炎患儿随机均分为观察组和对照组,观察组在常规治疗基础上给予阿奇霉素治疗,对照组在常规治疗基础上给予红霉素治疗,观察并对比两组的临床疗效和不良反应情况。结果观察组和对照组的总有效率分别为95.10%和78.69%,两组比较差别有统计学意义(P<0.05)。观察组患儿退热时间、咳嗽消失时间、肺部啰音消失时间均明显短于对照组,差异有统计学意义(P<0.05)。两组不良反应均较轻微,不良反应发生率比较,差异无统计学意义(P>0.05)。结论阿奇霉素静脉滴注治疗小儿支原体肺炎具有疗效好、见效快、不良反应少等优点,可显著缩短患儿症状消失时间,缩短住院时间,值得临床推广。     

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.