尼莫地平治疗脑出血30例

脑出血是神经内科常见疾病,死亡率、致残率均高。１９９７年～１９９９年９月,采用尼莫通治疗脑出血取得较好疗效。报告如下。１临床资料１．１一般资料：选取１９９７年１０月～１９９９年９月脑出血病人中,年龄４２～７０岁、头颅ＣＴ检查血肿量≤４０ｍｌ、Ｇｌａｓｇ记分≥７分的共计 ６０例,随机分为两组。治疗组 ３０例,血肿≤３０ｍｌ ２５例,３０～４０ｍｌ５例;对照组 ３０例,血肿≤３０ｍｌ ２６例, ３０～４０ｍｌ４例。两组一般资料比较无显著性差异。１．２治疗方法：两组均使用甘露醇等降颅压治疗,均在发病后５～７…     

氯硝西泮注射液对250例阿片脱毒者的躁狂、抑郁症疗效观察

２５０例阿片瘾患者，男２２２例，女２８例，年龄１８～５０岁，平均年龄３０±５岁，轻型６９例，中型１２５例，重型５６例；吸毒年限：最短４个月，最长５年，平均２１±１３个月，全部患者均采用氯硝西洋静脉滴注，剂量为０．０５～０．１ｍｇ／ｋｇ。日，分２～３次加入１０％葡萄糖２５０ｍｌ内或５％葡萄糖盐水５００ｍｌ内静脉点滴，疗程５～７天，疗程第３天加服氯硝西泮６～１０ｍｇ，必要时临时加２ｍｇ肌肉注射，治疗结果氯硝西泮具有快速抗躁狂和抗抑郁症作用，为阿片痛患者脱毒过程中产生的戒断症状的治疗起到重要作用。     

疗尔健治疗乙型肝炎45例

为了探讨疗尔健治疗乙型肝炎的疗效，我院于２０００－０５－２００１－０５对４５例住院及门诊乙型病毒性肝炎患者进行临床观察，报道如下．１资料与方法１．１ 临床资料 治疗组４５例，男２９例，女１６例，年龄２３～５６岁，平均４０．３岁；其中急性１８例，慢性２３例，肝炎肝硬变４例．对照组３８例，与治疗组在性别年龄病程病情等方面具有可比性．１．１　治疗方法 对照组用常规护肝药物不用免疫调节剂或抗病毒制剂。治疗组用疗尔健１～２ｇ／ｄ，用 ４ｍｌ注射用水稀释后加 ５％葡萄糖２５０ｍｌ中，缓慢静脉滴注或每次２粒ｐｏ，…     

甘露醇与氟桂利嗪治疗偏头痛的疗效比较

目的：甘露醇与氟桂利嗪治疗偏头痛近期疗效比较。方法：偏头痛病人４７例，随机分为２组。甘露醇组２４例（男性６例，女性１８例，年龄４０±ｓ８ａ）。用２０％甘露醇２５０ｍＬ静脉滴注，４０ｍｉｎ滴完，ｑｄ，连用３～５ｄ。氟桂利嗪组２３例（男性７例，女性１６例，年龄３９±８ａ）。用氟桂利嗪胶囊２粒（５ｍｇ／粒），ｐｏ，ｑｄ，用药３～５ｄ。结果：２组总有效率均为９６％（Ｐ＞０．０５）。２组用药后起效时间，甘露醇组是０．８±０．６ｄ，氟桂利嗪组是１．５±０．８ｄ，Ｐ＜０．０１。结论：２药治疗偏头痛的疗效近似，但甘露醇起效时间较氟桂利嗪迅速。     

新加桂枝茯苓丸治疗输卵管阻塞不孕症60例

我院自１９９９年２月～２００２年２月 ,采用新加桂枝茯苓丸治疗输卵管阻塞性不孕症６０例 ,疗效满意 ,现报道如下 :１资料与方法１ １一般资料 :患者９６例 ,随机分为两组。治疗组６０例 ,年龄２３～４０岁 ,平均２９ ５岁。病程３～１５年 ,平均７ ５年。对照组３６例 ,年龄２３～４０岁 ,平均２９岁。病程３～１４ ５年 ,平均７ ５年。两组患者年龄、病程均无差异 ,(Ｐ＞０ ０５) ,有可比性。１ ２治疗方法 :两组患者均于月经干净后３～７天 ,以生理盐水２０ｍｌ加庆大霉素１６万Ｕ ,地塞米松５ｍｇ ,ａ—糜蛋白酶５ｍｇ行输卵管通液术 …     

光量子血疗法治疗生殖器疱疹58例分析

我院于１９９９年８月～２０００年８月采用光量子血疗法治疗生殖器疱疹５８例,取得满意疗效,现报告如下：１ 临床资料 患者均为门诊病人,临床症状典型,分为治疗组和对照组,治疗组５８例,其中男３３例,女２５例,年龄２０～６５岁,平均３８．５岁,病程１０天～１年,平均３月左右。对照组３０例,具有典型症状和体征,其中男１９例,女１１例,年龄１８—７０岁,平均３５．１岁,病程５天～１年,平均４月左右。２ 治疗方法２．１ 治疗组：患者取卧位,常规消毒后加用有构椽酸钠抗凝剂的血袋采集患者静脉血２００ｍｌ,在无菌条件…     

肯特令加庆大霉素治疗小儿秋季腹泻疗效观察

目的：观察肯特令联合庆大霉素治疗小儿秋季腹泻的疗效。方法：８０例患儿随机分为两组,治疗组４０例（男２６例,女１４例,年龄３个月￣６岁）用肯特令加庆大霉素治疗,对照组４０例（男２１例,女１９例,年龄４个月￣６岁）用庆大霉素治疗。肯特令剂量为：〈１岁者１．５ｇ一天２次;１￣２岁者１．５ｇ一天３次;〉２岁者每次３ｇ,一天３次。加温水５０ｍｌ空腹口服,疗程３天。庆大霉素剂量为：浓度为１．８％溶液,按１０ｍ     

降纤酶与右旋糖酐-40治疗急性脑梗死的比较

目的：比较降纤酶与右旋糖酐＿４０治疗急性脑梗死的疗效及其安全性。方法：经ＣＴ证实的急性脑梗死５８例，分为２组，均用常规治疗（脑活素、甘露醇），降纤酶组３２例，加用降纤酶１０ＩＵ（ｄ１～３），５ＩＵ（ｄ４～６）各溶于０．９％氯化钠注射液２５０ｍＬ中静脉滴注（静滴），共用６ｄ；右旋糖酐组２６例，加用右旋糖酐＿４０，５００ｍＬ，静滴，ｑｄ，共用７～１４ｄ。结果：降纤酶组用药２４ｈ内起效１２例，快于右旋糖酐组（２例），Ｐ＜０．０５；２组治疗４ｗｋ的总有效率降纤酶组８４％略高于右旋糖酐组（６９％），Ｐ＞０．０５。降纤酶有非常显著的降低凝血因子Ｉ、血小板最大聚集率、血细胞比容和血栓指数Ｑ值的作用（Ｐ＜０．０１），且无明显不良反应。结论：降纤酶治疗急性脑梗死优于右旋糖酐＿４０。     

高舒达治疗64例消化性溃疡合并出血的疗效观察

我院从１９９９年９月～２０００年７月应用高舒达（法莫替丁注射液）治疗消化性溃疡合并出血６４例,现报告如下：１临床资料１．１ 一般资料：１２４例消化性溃疡合并出血患者男６４例,女６０例;年龄１４—５８岁。均为住院患者,均有呕血、黑便、或黑便病史,既往无肝病史。均经日镜检查证实为消化性溃疡并活动性出血,其中胄溃疡２０例,十二指场球部溃疡６４例,复合性溃疡 ４０例,溃疡直径最大 ２ｃｍ,最小 ０．５ｃｍ。１．２ 重度出血≥１０００ｍｌ,中度５００～１０００ｍｌ。１．３ 治疗方法：患者随机分为两组,其年龄、性…     

大剂量垂体后叶素治疗门脉高压出血72例

近年来，大剂量垂体后叶素持续静脉滴注治疗肝硬化门脉高压出血已作为一种较好的急救措施而被临床广泛采用［１］［２］。我院自１９８９年１月～１９９９年６月治疗７２例患者，疗效满意。１　资料与方法１．１　病例资料：７２例为住院患者，均经临床、生化、胃镜、肝Ｂ超、肝ＣＴ确诊为肝硬化失代偿并发门脉高压食管胃底静脉破裂出血，其中男４７例，女２５例，平均年龄４９岁。１．２　治疗方法：采用均　３ｄ持续静脉滴注垂体后叶素，第１ｄ剂量为０．３Ｕ／ｍｉｎ，第２ｄ　０．１５Ｕ／ｍｉｎ，第３ｄ　０　０７５Ｕ／ｍｉｎ，加入１…     

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.