第四代喹诺酮类的特点

近年来,喹诺酮类药物得到了迅速发展,由于它具有抗菌谱广、抗菌力强、结构简单、给药方便,与其它常用抗菌药物无交叉耐药性,合成方法生产、疗效价格比高等优势,因而愈来愈受到人们的重视,成为竞相生产和应用的热点药品。目前,喹诺酮类药物已经发展为第四代。第四代的主要代表药     

新喹诺酮类药物治疗社区获得性肺炎的研究进展

20世纪90年代上市的10余种喹诺酮类药物中，有些对肺炎链球菌和厌氧菌抗菌活性显著提高，并保留了环丙沙星等第Ⅲ代喹诺酮类药物的抗G-杆菌的活性，而且对呼吸道非典型病原体亦具良好活性，因而被称为呼吸喹诺酮类。其虽然细菌对呼吸喹诺酮类易于耐药，在社区获得性肺炎感染治疗中是否作为一线用药尚有争议，该类药物优良的抗菌特性已日益被临床广泛接受，但应特别强调合理用药。     

医院抗生素使用调查与分析

目的 调查医院抗菌药物使用情况,分析是否合理.方法 用限定日剂量（DDD）和药物利用指数（DUI）对住院患者抗生素用药情况进行调查和分析.结果 本次调查的抗菌药物DDDs居前17位的均为注射剂,口服抗菌药物使用较少,其DDDs值排序位于20位之后,所用抗菌药物涉及23个品种.结论 头孢菌素类药物应用比例最高,三代头孢菌素类药物的频繁使用会造成耐药的流行;喹诺酮类药物抗菌谱广,已有革兰氏阴性杆菌耐药流行的趋势,使用应谨慎.     

喹诺酮类抗菌药物的不良反应

喹诺酮类又称吡啶酮酸类,属于化学合成抗菌药。本类药物按其发明先后、结构及抗菌谱的不同,分为一、二、三、四代。1962年合成第一代喹诺酮类药物,以荼啶酸(nalidixic acid)为代表,只对大肠杆菌、痢疾杆菌、克雷白杆菌等少数革兰阴性杆菌有效,口服吸收差,副作用多,仅用于敏感菌所致的尿路感染。1974年合成的第二代喹诺酮类代表药为吡哌酸(pipemidic acid),抗菌活性提高,口服吸收可达到有效尿药浓度,不良反应减少,用于尿路和肠道感染。第三代喹诺酮称为氟喹诺酮类(FQNS),因在结构中含氟离子,增加了脂溶性和对组织细胞的穿透力;因而吸收好,…     

北京地区加替沙星和左氧氟沙星药物不良反应及费用现状分析

加替沙星于1999年获得美国FDA批准上市,2003年在中国上市,是喹诺酮类抗菌药的第四代新产品,其抗菌谱广,不但对于革兰氏阴性菌作用强,而且对于革兰氏阳性菌、非典型和厌氧菌感染的抗菌作用也等于和优于同类药物.     

氟喹诺酮类药物的药理特点

作为三、四代喹诺酮药物中的氟喹诺酮,因其本身的结构多了一种氟元素,因此使得该药物在药代动力学,临床使用方面以及疗效价格比等方面都取得长足的进步.近几年来,随着β-内酰胺类和氨基糖甙类药物的耐药菌株的不断增加,使得医院在临床工作中开始重视氟喹诺酮类药物.为了能够充分了解氟喹诺酮类药的药理特点,该文将从抗菌活性的广泛性、新奇的抗菌作用机制、氟喹诺酮类药的耐药机制及药物代谢的特点等方面逐一进行阐述.     

左氧氟沙星的不良反应和临床应注意的问题

喹诺酮类药物的问世是划时代的,它是一类人工合成的含4-喹诺酮基结构,对细菌的DNA螺旋酶具有选择性抑制作用,自1962年Lesher等合成第一个喹诺酮类药物萘啶酸以来,科学家对喹诺酮类药物的结构不断地进行修饰,发展迅速,当前临床应用的都是在喹诺酮的基本结构上连有氟原子的衍生物,即氟喹诺酮类的第三代喹诺酮类的衍生物,左氧氟沙星是属于第四代的喹诺酮类,是氧氟沙星光学异构体的左旋体,水中溶解度高,抗菌活性强,抗菌活性是氧氟沙星的2倍,不良反应的发生率仅仅为氧氟沙星的1/3[1]。由于抗菌活性强,抗菌谱广,生物利用度高,组织细胞内渗透性好…     

医院感染病原菌的耐药性监测分析

目的 分析医院感染病原菌耐药情况,为临床合理使用抗菌药物、减少耐药性提供参考.方法 对2010年医院感染病例中分离出的病原菌的耐药性进行统计分析.结果 革兰阴性菌占75.28％,革兰阳性菌占18.80％,真菌占5.92％;病原菌检出首位的是铜绿假单胞菌756株,占38.61％,对碳青霉烯类药物亚胺培南耐药率为65.34％,检出第2位的是鲍氏不动杆菌317株,占16.19％,对氨基糖苷类抗菌药物阿米卡星较为敏感,其耐药率为70.98％,检出第3位的是大肠埃希菌114株,占5.82％,产ESBLs对青霉素类药物、头孢菌素类药物、喹诺酮类药物耐药率偏高;金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌除对万古霉素敏感外,对其他抗菌药物均显示高耐药性.结论 医院感染病原菌耐药性明显,加强耐药性监测,合理使用抗菌药物,提高医务人员手卫生的依从性,是减缓耐药菌传播,控制医院感染的有力措施.     

铜绿假单胞菌对氟喹诺酮类药物耐药机制的研究进展

铜绿假单胞菌是最严重的院内获得性感染条件致病菌之一,对多种抗菌药物表现出天然耐药,使得治疗铜绿假单胞菌感染、控制其传播和流行十分困难.在抗生素领域内,氟喹诺酮类抗生素是唯一可与β-内酰胺类抗生素相媲美的合成抗菌药.但随着其广泛应用,细菌在抗生素选择性压力下不断出现新的耐药机制而导致耐药性不断增强,造成临床治疗困难甚至失败.因此研究铜绿假单胞菌对氟喹诺酮类药物的耐药性和耐药机制,可以为临床合理用药、减少耐药发生以及新的氟喹诺酮类药物的开发提供依据.     

安全高效的喹诺酮类药物

喹诺酮类药物属化学合成的一类抗菌药物。第一代,1962年问世,代表药萘啶酸,因疗效不佳现已不用;第二代,1973年合成的吡哌酸,对大多数革兰氏阴性菌有效,因抗菌作用不强且细菌耐药严重,现仅用于尿路和肠道感染;第三代,20世纪80年     

Trends in meningococcal disease in Italy in 1988

Meningococcal disease in Italy decreased 15% in 1988 from the previous year (290 vs. 342 cases). The decline was particularly evident in military cases (1.7/100,000 in 1988 vs. 5/100,000 in 1987) reflecting the full coverage of bivalent serogroup (A + C) meningococcal polysaccaride vaccine in army recruits, achieved since January 1988. The highest proportion of cases was seen in people older than 25 years of age (25%). Serogroup C constituted 60% of the isolates, while 19% belonged to serogroup B. The proportion of strains resistant to sulphonamides was 45%, while 15% were resistant to Minocycline and none to Rifampin. Out of the five military cases, only one (due to serogroup C) was attributable to the vaccine failure. A single coprimary case, but no secondary cases occurred among civilians. These findings are consistent with the trends reported in Italy in the previous years.     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

2015年郑州市饮用水放射性水平状况调查

目的了解郑州市不同地区、不同季节、不同水源类型的放射性水平。方法分别于丰水期和枯水期采集郑州市区黄河水源水、井水源水、丹江口水源水、出厂水和末梢水各一份;以县为单位,每单位采集出厂水、末梢水、水库水、河水、井水各1份,按《生活饮用水生活标准检验方法》(GB/T 5750.13-2006)检测饮用水中总α和总β放射性水平,依据《生活饮用水卫生标准》(GB 5749-2006)进行判定。结果丰水期、枯水期水体总α、总β放射性水平均低于国家标准限值。结论郑州市不同水源类型均处于正常的天然放射性本底水平。     

Occupational stress in nurses in psychiatric institutions in Taiwan

Nurses are known to be exposed to occupational stress. However, occupational stress is not well documented for nurses in psychiatric institutions in Taiwan. A cross-sectional study was conducted to explore the work-related stress and risk factors of nurses in psychiatric institutions in Taiwan. A structured questionnaire was distributed to nurses at five state-owned psychiatric hospitals in Taiwan in 2001. Demographic information, working environment, and personal health status were inquired. Occupational stress was assessed based on the Chinese version of Job Content Questionnaire (JCQ). General health status and mental health were evaluated by the International Quality of Life Assessment Short Form-36 (IQOLA SF-36). A total of 573 questionnaires were disseminated to nurses and 518 (90.4%) were satisfactorily completed by nurses, including 408 female full-time nurses who had been in their current work for more than 6 months. In the past one month, 17.2% of nurses reported being under significant stress often or always. Assault episodes were reported by 45.1% of nurses in the past 6 months. Among the nurses, 16.9%, 25.2%, 50.0%, and 7.8% belong to the "High strain", "Low strain", "Active", and "Passive" groups, respectively. Perceived occupational stress was associated with young age, widowed/divorced/separated marital status, high psychological demand, low workplace support, and threat of assault at work. Lower general health score was associated with low job control, high psychological demand, and perceived occupational stress. A lower mental health score was associated with low job control, high psychological demand, low workplace support, and perceived occupational stress. We concluded that nurses in psychiatric institutions are under significant stress related to work factors.     

Changes in nursing administration in supporting transplantation in Brazil

This historical and bibliographic study aimed to understand how Nursing was organized to support care in transplantation. The HISA, LILACS, BDENF, PERIENF and DEDALUS databases were consulted, and thirteen references were found, ten of which were scientific articles, two were master's dissertations and one was a doctoral thesis. The span of time chosen for study ranges from the date of the first kidney transplant in Brazil (1965), to the date of publication of the last scientific article found in the databases mentioned above (2003). After reading these articles, the ones that were similar in topic were grouped together, thus creating the thematic axis for the presentation of the results. The results showed that the Nursing profession has played an important and active role in transplants ever since the first procedure in 1965.     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。     

2012年绵阳市蔬菜中农药残留状况

目的 了解绵阳市2012年市售蔬菜中农药残留情况,为食用蔬菜监管提供依据.方法 全部样品均按照GB/T 5009-2003的方法进行农药的残留检测.依据GB 2763-2005《食品中农药最大残留限量》进行判定.结果 2012年共检测蔬菜165份,农药检出率和超标率分别为72.12％和23.64％.豆类、根茎类、叶菜类、瓜果菜类和食用菌类蔬菜检测农药残留超标率分别为8.00％、23.53％、36.00％、5.26％和27.03％,差异有统计学意义(x2=11.41,P＜0.01).不同种类农药超标率差异有统计学意义(x2 =62.42,P＜0.01).夏季和冬季蔬菜农药超标率差异无统计学意义(x2=3.44,P＞0.05).结论 绵阳市叶菜类蔬菜中农药残留情况较为严重,应采取有效措施,加强蔬菜的监督管理,从源头禁止高毒农药的使用,加大蔬菜种植、销售环节的监测,确保市民食用蔬菜的安全.