硫酸奈替米星与阿米卡星治疗重症监护病房中肺部感染的 …

将重症监护病房１１９例继发肺部感染病人随机分为两组，分别给予硫酸奈替米星３００ｍｇ／ｄ或阿米卡星６００ｍｇ／ｄ治疗，根据临床表现、白细胞计数、痰培养、胸片及肝肾功能等其它辅助检查，观察其疗效及不良反应。结果显示：硫酸奈替米星有效率（７９．７％）比阿米卡星（５７．８％）高；辅助检查中白细胞计数、胸片恢复正常率和痰培养转阴率前组均高于后组，而不良反应前组低于后组。本文认为：对重症监护病房肺部感染初期，     

奈替米星与阿米卡星治疗下呼吸道感染的疗效比较

目的：比较奈替米星（Ｎｅｔ）与阿米卡星（Ａｍｉ）在下呼吸道细菌性感染疾病中的疗效及不良反应。方法：对痰细菌培养有致病菌生长的１６０例患者随机分成２组,分别用Ｎｅｔ３００ｍｇ或Ａｍｉ４００ｍｇ,ｉｖｇｔｔ,ｑｄ,疗程７～１０ｄ结果：Ｎｅｔ组有效率（８７．５％）明显高于Ａｍｉ组（６６．２％）。辅助检查中白细胞及分类恢复正常率、胸片恢复正常率和痰菌转阴率,前组均高于后组,而不良反应发生率前组低于后组。结论：Ｎｅｔ治疗下呼吸道感染的疗效优于Ａｍｉ,且不良反应也较少。     

重症监护病房中肺部感染的抗生素应用探讨

在重症监护病房（ＩＣＵ）中１８９例伴有肺部感染的病人分成甲、乙两组，分别给予氨基糖苷类抗生素和第三代头孢菌素治疗，并在治疗前后随访其临床症状、体征、血白细胞计数、胸片和痰细菌学检查。发现甲组中硫酸妥布霉素和其他氨基糖苷类抗生素的临床有效率分别为８２．５％和６０．５％，前者细菌阴转率等均高于后者；乙组中头孢哌酮／舒巴坦和其他第三代头孢菌素临床有效率分别为８８．４％和７５．０％，前者细菌阴转率等均高于后者。结合实验结果对重症监护病房中的肺部感染病人，提议适当的治疗方案。     

硫酸奈替米星治疗ICU中肺部感染19例疗效观察

<正> 1998年1至6月份,我院重症监护病房(ICU)中,对伴有肺部感染的19例患者采用硫酸奈替米星治疗取得了较满意疗效。 临床资料:伴有肺部感染病19例,其中男性15例,女性4例,平均年龄43.4(17～78)岁。其中14例未用抗生素,3例对庆大霉素、2例对阿米卡星均发生耐药性,昏迷病人6例。11例继发于多发病后;4例继发于脑出血或脑血栓;2例继发于外科手术后;2例原有肺部疾病5年以上而本次均为急性发作。临床     

奈替米星治疗老年下呼吸道感染及药物浓度测定

观察奈替米星ｑｄ治疗老年下呼吸道感染的临床疗效，体外药物敏感率及病原菌清除情况，了解血浆及气道分泌物中药物浓度、不良反应等。方法：下呼吸道感染老年病人用Ｎｅｔ３００ｍｇ，ｉｖｇｔｔ，ｑｄ，疗程。     

硫酸奈替米星注射液临床疗效及药效学研究

使用国产硫酸奈替米星注射液治疗呼吸系统和泌尿系统感染共63例．临床有效率为98．4％，细菌阴转率和细菌清除率均为98．3％，不良反应发生率为9．1％。同时用庆大霉素随机对照治疗泌尿系统感染35例，奈替米星的临床疗效和细菌学疗效明显优于庆大霉素（P＜0．05），但不良反应发生率两者之间无显著性差异（P＞0.05）。体外药敏试验结果表明奈替米星的药物敏感率大于阿米卡星和庆大霉素，77．3％庆大霉素耐药菌和92．9％环丙沙星耐药大肠杆菌对奈替米星敏感，国产奈替米星的体外抗菌活性与进口产品相同。     

奈替米星治疗中风病人肺部感染疗效评价

目的　评价奈替米星治疗中风合并肺部感染病人的临床效果和安全性。方法　 12 0例中风合并肺部感染病人随机分为两组 ,奈替米星组 62例 ,男性 3 4例 ,女性 2 8例 ,年龄 ( 64± 8)岁 ,用硫酸奈替米星葡萄糖注射液 4mg·kg-1·d-1,静脉滴注 ,每天 1次或 2次 ,疗程 7～ 10d。头孢曲松钠组 5 8例 ,男性 3 1例 ,女性 2 7例 ,年龄( 64± 8)岁 ,用头孢曲松钠粉针剂 ( 2 0～ 4 0 ) g/d加入氯化钠注射液 2 5 0ml,静脉滴注 ,每天 1次或 2次 ,疗程 7～10d。结果　两组疗效、细菌清除率和不良反应发生率差异均无显著性 (P >0 0 5 )。结论　奈米替星用于治疗中风合并肺部感染病人疗效确切 ,使用安全     

老年人下呼吸道感染疗效观察

目的观察头孢哌酮钠舒巴坦钠联合硫酸阿米卡星治疗老年人下呼吸道感染。方法将80例患者随机分两组,治疗组40例,头孢哌酮钠舒巴坦钠2．0g静脉滴注,2次／d,同时给予硫酸阿米卡星0．4g静脉滴注,1次／d。对照组40例,头孢哌酮钠舒巴坦钠2．0g静脉滴注,2次／d,同时给予硫酸奈替米星0．2g静脉滴注,1次／d,疗程均为10～14d。结果治疗组与对照组疗效及不良反应均相当,两组比例无统计学差异,P〉0．05。结论头孢哌酮钠舒巴坦钠联合硫酸阿米卡星治疗40例老年人下呼吸道感染疗效较好,安全性好。     

奈替米星治疗肺部感染的疗效观察

目的观察奈替米星治疗肺部感染的临床疗效及其不良反应。方法89例确诊为肺部感染的住院急者给予奈替米星300mg加入5％葡萄糖溶液或0．9％生理盐水溶液500ml中静脉滴注,1次／d,连续7—14d。结果临床疗效总有效率为75．9％;对各种致病菌感染细菌学疗效总有效率为79．5％;对各种致病菌感染细菌清除率为77．3％。不良反应发生率为4．5％。结论奈替米星是一种值得推广应用的新氯基糖甙类抗生素。     

国产硫酸奈替米星注射剂疗效与安全性评价

目的 评价国产硫酸奈替米星注射剂的疗效与安全性. 方法 采用自制调查表对应用过国产硫酸奈替米星注射剂的住院患者疗效和安全性进行回顾性调查和统计分析. 结果 使用过国产硫酸奈替米星注射剂及联合其他抗菌药物治疗感染的病例71例,其中15例单独使用. 均采用静脉滴注的给药方式. 用药剂量为0.1～0.4 g,qd或bid, 溶媒量100～250 mL,平均用药天数（8.09 ±4.95） d. 治疗感染总有效率81.4%. 不良反应发生率11.3%（8/71）,主要为皮疹、腹泻、血尿素氮升高、转氨酶升高等. 结论 国产硫酸奈替米星治疗感染有效,只要严格按适应证合理使用,不良反应较少,较轻,易于处理. 老年患者应用时需按轻度肾功能减退患者的用法用量减量用药,有变态反应史和年龄偏高患者应慎用.     

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.     

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.     

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。     

Polymorphisms in genes involved in neurotransmission in relation to smoking

Smoking behavior is influenced by both genetic and environmental factors. The genetic contribution to smoking behavior is at least as great as its contribution to alcoholism. Much progress has been achieved in genomic research related to cigarette-smoking within recent years. Linkage studies indicate that there are several loci linked to smoking, and candidate genes that are related to neurotransmission have been examined. Possible associated genes include cytochrome P450 subfamily polypeptide 6 (CYP2A6), dopamine D₁, D₂, and D₄ receptors, dopamine transporter, and serotonin transporter genes. There are other important candidate genes but studies evaluating the link with smoking have not been reported. These include genes encoding the dopamine D₃ and D₅ receptors, serotonin receptors, tyrosine hydroxylase, trytophan 2,3-dioxygenase, opioid receptors, and cannabinoid receptors. Since smoking-related factors are extremely complex, studies of diverse populations and of many aspects of smoking behavior including initiation, maintenance, cessation, relapse, and influence of environmental factors are needed to identify smoking-associated genes. We now review genetic polymorphisms reported to be involved in neurotransmission in relation to smoking.     

Tramadol concentrations in blood and in cerebrospinal fluid in a neonate

Based on blood and cerebrospinal fluid samples collected in a full-term neonate, the penetration of tramadol in the central nervous system is described. Following intravenous administration of tramadol, a lag time of about 4 h was observed until full blood–brain equilibration was achieved. This pharmacokinetic observation is in line with a recent pharmacodynamic evaluation of the central opioid effects of tramadol in adults.     

Disease control in asthmatic children seen in private practice in Switzerland

ABSTRACT

Background: Asthma is the most common chronic childhood disease in Switzerland with a prevalence of 10%. Asthma has a high economic burden accounting for high medical costs. Assessment of disease control is likely to be of help in the implementation of strategies to improve asthma. Therefore, we aimed to evaluate asthma control and therapy regimens among children in private practice.

Methods: We assessed asthma control as well as therapy regimens in 575 asthmatic children in an experience programme in Switzerland by using an abbreviated questionnaire based on the asthma control questionnaire and the child health questionnaire on Visit 1 and Visit 2.

Results: Good asthma control at Visit 1 was only present in 25.7% of asthmatic children. Occasional asthma symptoms, limitation of physical activity, nocturnal awakening and anxiety of the parent was present in 80.5%, 41.2%, 46.8% and 57% of the children, respectively. After adjustment of therapy regimens at Visit 1, mainly by adding a leukotriene receptor antagonist, asthma control was reported to be much better in 53.4% of the children at Visit 2.

Conclusions: As asthma control is inadequately achieved within a major portion of asthmatic children, it is imperative to find measures to improve asthma control and hence, to reduce the burden of disease.