中药眩晕宁片治疗椎-基底动脉供血不足102例疗效观察

目的 评价眩晕宁治疗椎-基底动脉供血不足的临床疗效.方法 将253例患者完全随机分为2组,治疗组102例采用眩晕宁治疗,对照组151例采用静脉输注藻酸双酯钠注射液治疗.60 d后分别观察两组患者临床疗效和HDI 5000超声检查.结果 总有效率眩晕宁治疗组为88.5%,对照组藻酸双酯钠注射液68.1%,差异有统计学意义(P<0.05);HDI 5000超声指标明显改善优于对照组(P<0.05).结论 眩晕宁治疗椎-基底动脉供血不足的疗效优于藻酸双酯钠,是治疗椎-基底动脉供血不足的理想药物.     

通心络治疗椎-基底动脉供血不足性眩晕疗效观察

目的：观察通心络胶囊治疗椎-基底动脉供血不足性眩晕患者的临床疗效。方法：选择153例椎-基底动脉供血不足性眩晕患者，随机分为两组，观察两组患者治疗前后的症状及体征变化。结果：治疗组总有效率83．75％，明显优于对照组。结论：通心络对椎-基底动脉供血不足性眩晕有较好疗效。     

前列地尔对糖尿病患者椎动脉供血不足引起的眩晕的临床疗效

目的探讨前列地尔对糖尿病患者椎动脉供血不足引起的眩晕的临床疗效。方法选取我院于2015年10月～2017年10月收治的78例糖尿病合并椎动脉供血不足患者为研究对象,按随机数字表法分为研究组和对照组各39例,对照组采用常规治疗,研究组在对照组的基础上采用前列地尔注射液进行治疗,比较两组患者治疗前后眩晕残障程度评定量表(DHI)评分和椎-基底动脉平均血流速度。结果研究组患者经治疗后眩晕残障程度评定量表(DHI)评分和椎-基底动脉平均血流速度明显改善,与对照组相比较,差异有统计学意义(P 0.05)。结论前列地尔治疗糖尿病患者椎动脉供血不足引起的眩晕显著减轻患者的眩晕症状,取得较好的的临床疗效。     

银杏达莫注射液治疗椎-基底动脉供血不足性眩晕30例

目的 观察银杏达莫注射液治疗椎-基底动脉供血不足性眩晕的临床效果.方法 椎-基底动脉供血不足性眩晕患得60例,随机分为治疗组和对照组各30例.治疗组给予银杏达莫注射液20 mL静脉滴注,qd,14 d为1个疗程;对照组选用纳洛酮2 mg静脉滴注,qd,疗程相同.观察治疗前后临床症状及椎-基底动脉平均血流速变化.结果 两组临床疗效、总有效率比较均差异无显著性（P＞0.05）,但治疗组治疗后椎-基底动脉血流速改善明显（P＜0.05）.结论 银杏达莫注射液治疗椎-基底动脉供血不足眩晕与纳洛酮疗效同样显著.     

参附注射液治疗椎-基底动脉供血不足性眩晕的临床观察

目的:观察参附注射液治疗椎-基底动脉供血不足性眩晕的临床疗效.方法:将60例椎-基底动脉供血不足性眩晕患者随机分为两组.治疗组给予参附注射液静滴,对照组给予丹参注射液静滴,观察临床疗效、平均血流速度及血液流变学水平和TCD情况.结果:治疗组的疗效、平均血流速度及血液流变学指标、TCD指标与对照组比较有显著差异.结论:参附注射液治疗椎-基底动脉供血不足性眩晕疗效显著,毒副反应轻微.     

天眩清联合络泰治疗椎-基底动脉供血不足性眩晕患者60例疗效观察

目的：观察天眩清联合络泰治疗椎-基底动脉供血不足性眩晕患者临床疗效。方法：180例椎-基底动脉供血不足性眩晕患者随机分为天眩清联合络泰治疗组60例,单用天眩清治疗组60例和长春西汀注射液的对照组60例,14 d为1个疗程,治疗前后进行临床症状改善程度评估及椎-基底动脉收缩期血流最大流速和血流变学的对比检测。结果：临床总有效率,天眩清联合络泰治疗组96.7%,单用天眩清治疗组90.0%,对照组82.0%,治疗组优于对照组,以天眩清联合络泰组疗效更显著;血流变参数和椎-基底动脉供血改善程度,治疗组优于对照组,以天眩清联合络泰组改善程度更显著。结论：天眩清和络泰对椎-基底动脉供血不足性眩晕均有较好的治疗效果,如两者联合应用疗效更显著。     

心血康注射液联合甘露醇治疗椎-基底动脉供血不足性眩晕50例

目的：观察心血康注射液联合甘露醇治疗椎-基底动脉供血不足性眩晕的临床疗效。方法：98例椎-基底动脉供血不足性眩晕按就诊登记顺序,随机单盲分为两组,治疗组50例静脉用心血康注射液联合甘露醇静滴,对照组48例静脉用能量合剂。结果：治疗组总有效率100%,对照组77.1%,差异具有显著性（P〈0.01）。两组均未见药物不良反应。结论：心血康注射液联合甘露醇可调节椎-基底动脉供血不足性眩晕患者血脂代谢,改善其异常血流动力学和血液流变学,临床疗效显著,值得临床推广使用。     

葛根素联合倍他司汀治疗椎-基底动脉供血不足性眩晕疗效观察

目的 探讨葛根素联合倍他司汀治疗椎-基底动脉供血不足性眩晕的疗效.方法 将46例椎-基底动脉供血不足性眩晕患者随机分为治疗组和对照组.治疗组采用葛根素注射剂（250 ml,0.5 g）及倍他司汀（6 mg/片）口服治疗,对照组予复方丹参注射剂（0.9%氯化钠溶液250 ml＋复方丹参20 ml）治疗.比较2组临床疗效和椎-基底动脉血液平均流速.结果 治疗组疗效优于对照组,其椎-基底动脉血液平均流速提高程度亦优于对照组（P〈0.05）.结论 葛根素联合倍他司汀是治疗椎-基底动脉供血不足性眩晕的一种有效选择.     

中西医结合治疗椎-基底动脉供血不足性眩晕疗效观察

目的 探讨中西医结合治疗椎-基底动脉供血不足性眩晕的临床疗效.方法 依据治疗方式不同将90例患者分为观察组（采用中西医结合治疗）60例和对照组（采用西医治疗）30例,分析两组临床疗效.结果 治疗后观察组椎动脉和基底动脉血流流速均明显优于对照组（t=5.17、4.32、3.63,均P＜0.05）,观察组总有效率（100%）明显高于对照组（70%）（χ2=35.29,P＜0.05）.结论 中西医结合治疗椎-基底动脉供血不足性眩晕临床疗效明显,预后良好,值得临床借鉴.     

长春西汀治疗椎基底动脉供血不足性眩晕疗效观察

目的 观察长春西汀治疗椎基底动脉供血不足性眩晕的临床疗效.方法 95例椎基底动脉供血不足性眩晕患者随机分为两组,治疗组49例用长春西汀治疗,对照组46例用复方丹参治疗,均治疗10d.结果 治疗组总有效率93.9%,对照组总有效率78.3%,两组疗效经统计学处理,差异有显著性,两组均未发现明显副反应.结论 长春西汀治疗椎基底动脉供血不足性眩晕疗效显著.     

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.