本院门、急诊小儿急性上呼吸道感染用药分析

目的分析本院门、急诊治疗小儿急性上呼吸道感染的用药发展趋势,提出促进合理用药的办法。方法回顾性调查、分析、比较本院门、急诊儿科在2009-01-03与2010-01-03治疗急性上呼吸道感染的2组病例的用药情况,以处方点评等模式考察、评价其临床用药的合理性。结果 2010年组的抗菌药物使用率、抗菌药物的联合使用率及抗菌药物注射剂使用率降低(P<0.01);抗菌药物单用的比例及口服抗菌药物比例增加(P<0.01);青霉素类、广谱头孢类抗菌药物使用比例增高;抗病毒药物及中成药使用率高。结论滥用抗菌药物的现象得到控制,用药物结构趋于合理;但抗菌药物的用药适应症欠明确,使用抗菌药物类型、药及品种过于集中,需进一步加强抗菌药物的使用管理。     

我院儿科门诊急性上呼吸道感染患者抗菌药物应用情况分析

目的：探讨本院儿科门诊急性上呼吸道感染（AURI）患者抗菌药物应用情况,为指导临床合理用药提供依据。方法：随机抽取本院2009年10月～2010年10月儿科门诊首诊为急性上呼吸道感染的处方756张,回顾性调查分析抗菌药物应用情况。结果：抗菌药物使用率为69.04%,给药方式以口服为主,阿奇霉素使用频度最高,存在无指征用药、用药剂量过大、用药时间过长等情况。结论：急性上呼吸道感染治疗中存在不合理使用抗菌药物的现象,医院应加强对抗菌药物临床合理应用的培训和管理。     

急性上呼吸道感染患者抗菌药物应用分析

目的 分析急性上呼吸道感染患者抗菌药物的合理性应用.方法 对本院2010年6月520例上呼吸道感染患者的门急诊处方进行回顾性分析.结果 520张处方中,应用抗菌药物406例,使用率为78.1%,多为单一用药与静脉注射给药.上呼吸道感染抗菌药物使用率头孢菌素居首位,其次为大环内酯类和青霉素类.用药导致的不良反应稍多.结论 我院医师在治疗急性上呼吸道感染时,医院应加强对临床医师抗菌药物知识的培训与再教育,提高抗菌药物的临床合理应用水平.     

400例急性上呼吸道感染抗菌药物使用分析

目的通过调查分析,了解本院成人急性上呼吸道感染抗菌药物使用的合理性,促进本院抗菌药物合理使用。方法随机抽查我院2012年1月至2012年3月门（急）诊诊断为急性上呼吸道感染（含急性咽喉炎、急性鼻炎）处方400张,根据抗菌药物相关使用管理规定分析其合理性。结果抗菌药物使用率为72.3%,抗菌药物使用合理的处方120张,占抗菌药物处方总数的41.6%,不合理处方169张,占抗菌药物处方总数的的58.4%。结论本院急性上呼吸道感染抗菌药物使用率比较高,存在较多不合理用药情况,医院应加强对临床医师抗菌药物知识的培训与再教育,提高抗菌药物的临床合理应用水平。     

基层医院上呼吸道感染抗菌药物使用分析

目的 调查本院2010年上呼吸道感染抗菌药物的使用情况,为临床合理用药提供依据.方法 抽取2010年-10月～12月共900张上呼吸道感染门诊处方,进行统计分析.结果 抗菌药物使用率为82.89%,其中一联使用89.28%,二联使用10.32%,三联使用0.4%;本院上呼吸道感染抗菌药物的使用存在应用指征不明确、品种选...     

基层医院上呼吸道感染抗菌药物使用分析

目的调查本院2010年上呼吸道感染抗菌药物的使用情况,为临床合理用药提供依据。方法抽取2010年-10月~12月共900张上呼吸道感染门诊处方,进行统计分析。结果抗菌药物使用率为82.89%,其中一联使用89.28%,二联使用10.32%,三联使用0.4%;本院上呼吸道感染抗菌药物的使用存在应用指征不明确、品种选择不当、联用不当、用法用量不当等不合理现象。结论本院上呼吸道感染抗菌药物的使用存在不合理现象,应对临床医生加强抗菌药物合理使用的培训和管理。     

我院上呼吸道感染患者抗菌药物使用调查

目的:了解本院上呼吸道感染患者抗菌药物使用情况。方法:抽查2005年1月—12月上呼吸道感染患者门诊处方4 548份,对抗菌药物的使用率、种类、联合用药及用药时间进行分析。结果:4 548例上呼吸道感染患者抗菌药物使用率为91.3%,使用种类为25种,以头孢菌素类、青霉素类和氟喹诺酮类最多见。结论:本院上呼吸道感染治疗存在抗菌药物滥用现象。     

小儿急性上呼吸道感染患者抗菌药物应用合理性分析

目的：分析小儿急性上呼吸道感染患者抗菌药物应用的合理性。方法：对本科2009年3～10月住院的300例上呼吸道感染患儿进行回顾性分析。结果：抗菌药物使用率为73.3%,多为单一用药与静脉注射用药,以拉米夫定的DDDs（用药频度）和DDDc（日均费用）最大。结论：当前本院临床医师在治疗急性上呼吸道感染患儿时,抗菌药物的应用存在着药物品种选择不恰当、用药方法和疗程不适当等问题;医院应加强对临床医师抗菌药物知识的培训与再教育,更新对感染性疾病的诊治观念,提高抗菌药物的临床合理应用水平。     

2014年我院门、急诊抗菌药物不合理处方调查分析

目的 调查分析本院2014年门、急诊抗菌药物不合理处方使用情况。方法 回顾性分析本院2014年1~12月门、急诊开具的抗菌药物处方共500例,对上述处方进行分析研究,评估其合理性。结果 2014本院门、急诊抗菌药物不合理处方为28张,占全年抗菌药物处方总数的5.60%。其中单联处方19张,占不合理处方的67.86%;二联处方6张,占21.43%;三联处方3张,占10.71%。不合理处方具体情况为:无指征用药、药理拮抗、溶媒选用不当、用药疗程不当及抗菌药物联用等。结论 本院2014年门、急诊抗菌药物不合理处方开出率低于国家规定标准,但仍存在不合理用药,需积极制定监管方案以进一步降低抗菌药物不合理使用率,为临床合理使用抗菌药物提供指导依据。     

抗菌药物在儿科治疗上呼吸道感染中的应用分析

目的了解抗菌药物在治疗儿科急性上呼吸道感染上的使用情况,促进临床合理使用抗菌素。方法随机抽取儿科住院及门诊留观急性上呼吸道感染患儿352例,对使用抗菌药物的病例进行了用药统计分析。结果抗菌药物的使用率达87.3%,其中头孢类药物使用率最高,其次为大环内酯类。结论笔者所在医院治疗急性上呼吸道感染患儿存在给药频次错误、联合用药指征不明确、病原学送检率低等不合理用药情况,需要进一步规范管理,促进抗菌药物的合理使用。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.