氯化钾缓释片对育血性心力衰竭104例的保钾疗效

充血性心力衰竭患者１０４例（正在使用地高辛加排钾利尿剂）随机均分为氯化钾缓释片及普通氯化钾片２组进行保钾治疗２ｗｋ。而后改换进入另１组作自身对照。结果：Ｓｌｏｗ－Ｋ组治疗１ｗｋ末血钾老显著增加，日服药承受性较差，不良反应高达２６．９％。     

电解质分析仪用于复方氯化钠注射液的中间体测定

目的：探寻复方氯化钠注射液中间体的省时、快捷测定方法。方法：将复方氯化钠洲认精密稀释一倍,ｐＨ值调至７．４后,用电解质分析仪测定其稀释液中Ｋ＾＋、Ｎａ＾＋、Ｃｌ＾－、Ｃａ＾２＋的ｍｏｌ．：＾－１浓度,从而推算出复方氯化钠注射液中间体总扫（Ｃｌ）,氯化钾（ＫＣｌ）,氯化钙（ＣａＣｌ２．２Ｈ２Ｏ）的含量％（ｇ．ｍｌ＾－１）。结果：方法的平均回收率（％）：Ｋ＾＋１００．１,Ｎａ＾＋９９．９,Ｃｌ＾－１０     

受体纯化、增溶对抗胆碱能药物定量受体分析的影响

为了优化抗胆碱药物定量受体分析，作者分别用３种方法从小牛纹状体制备了膜结合受体即粗膜匀浆（Ｐ２）、己烷处理的膜结合受体（Ｈｅｘ－Ｒ）和氯化钠处理的膜结合受体（ＮａＣｌ－Ｒ），以及由此经ＰＢＩ缓冲液、２％洋地黄皂甙处理的增溶受体ＳＲ－Ｐ２，ＳＲ－ＮａＣｌ和ＳＲ－ｈｅｘ。以上受体分别置于缓冲液和血浆中，根据３Ｈ－Ｎ－甲基东莨菪碱（３Ｈ－ＮＭＳ）与受体结合试验的结果，分别计算抗胆碱药物叔胺东莨菪碱和季胺奥芬溴铵与受体结合后的离解常数Ｋｄ值。在缓冲液体系中，东莨菪碱与３种不同方法制备的膜结合受体的Ｋｄ值…     

流动注射化学发光法同时测定Mn2+和Co2+

利用 Ｎａ Ｉ Ｏ４鲁米诺流动注射化学发光法,以 ８羟基喹啉掩蔽 Ｍ ｎ２＋ 以外的其它金属离子,柠檬酸钠掩蔽 Ｍ ｎ２＋ 和 Ｃｏ２＋ 以外的金属离子,达到同时测定 Ｍ ｎ２＋ 和 Ｃｏ２＋ 的目的。 Ｍ ｎ２＋ 离子的检测限达０１９４ ｎｇ／ｍ ｌ,ｒ＝ ０．９９８４,线性范围（１０－ ９～１０－ ７）ｇ／ｍ ｌ,回收率 ８８．０％ ～１０７．６％ ,测定 Ｒ Ｓ Ｄ 为 １．４２％ 。 Ｃｏ２＋ 离子的检测限达 １．７１７ ｎｇ／ｍ ｌ,ｒ＝ ０．９９９３,线性范围（１０－ ８ ～１０－ ６）ｇ／ｍ ｌ,加标回收率 ８７．８％ ～１１５５％ ,测定 Ｒ Ｓ Ｄ 为 １．９６％ 。     

硫酸氢钾料浆两种输送方式的比较

转化法三元复混肥料生产中，转化后的产物输送到氨化造粒机有以下两种方式：（１）釜底下展阀输送；（２）插底管输送。 现结合我公司情况对硫酸氢钾料浆两种输送方式的应用进行简要分析。１料浆的两种输送方式 氯化钾与硫酸反应分两步进行 ＫＣｌ＋Ｈ２ＳＯ４──ＫＨＳＯ４＋ＨＣｌ（１） ＫＣｌ＋ＫＨＳＯ４──Ｋ２ＳＯ４＋ＨＣｌ　（２） 反应（１）温度较低（约９０ ℃），操作简便，设备简单。反应（２）反应温度高，设备复杂，操作技术要求严格。 反应（１）转化产物硫酸氢钾熔融物先后采用图１、图２两种输送方式。 两种输送方式中…     

氯丙烯引起的神经电生理及细胞内Na＋，K＋，Ca2＋等离子含量的改变

为探讨氯丙烯的周围神经损伤机制，用荧光分子探针，电子探针Ｘ线微区分析和电生理学方法研究了氯丙烯引起的鸡胚神经细胞和大鼠坐骨神经纤维轴浆内的Ｎａ＋，Ｃａ２＋离子和Ｎａ，Ｋ，Ｃａ，Ｍｇ，Ｃｌ，Ｐ元素含量和神经细胞静息膜电位（ＲＭＰ），大鼠坐骨神经复合动作电位（ＣＡＰ）及小鼠肋间神经束膜内动作电位（ＡＰＩＰＳ）的改变．结果显示，随着氯丙烯剂量的增加，鸡胚脑神经细胞［Ｃａ２＋］ｉ明显增加，［Ｎａ＋］ｉ在高剂量时亦增加；大鼠坐骨神经轴浆内Ｃａ增加，Ｋ减少，Ｎａ增加不如Ｃａ明显；ＲＭＰ减小；大鼠坐骨神经ＣＡＰ的峰值明显下降，时程稍延长；小鼠肋间神经ＡＰＩＰＳ的Ｋ＋电压波形消失．表明氯丙烯引起的ＲＭＰ，ＣＡＰ及ＡＰＩＰＳ的改变，均与细胞和轴浆内的Ｎａ＋，Ｃａ２＋离子和Ｎａ，Ｋ，Ｃａ，Ｍｇ，Ｃｌ，Ｐ元素的改变有关．提示中毒患者出现运动和感觉障碍可能与轴浆内外Ｎａ＋，Ｋ＋浓度差减小造成神经兴奋与传导降低和Ｃａ２＋进入轴浆过多导致神经纤维变性有关     

HPLC和~1HNMR分析确定cis－A－和cis－B－羟甲芬太尼的组成和构型

羟甲芬太尼（１）是一个强效的镇痛剂和高亲和、高选择性的阿片μ受体激动剂。通过ＨＰＬＣ和１ＨＮＭＲ分析，ｃｉｓ－Ａ－ｌ被确定为由等量的ｃｉｓ－（＋）－（３Ｒ，４Ｓ，２＇Ｓ）－ｌ和：ｃｉｓ－（—）－（３Ｓ，４Ｒ，２＇Ｒ）－１组成的外消旋体，ｃｉｓ－Ｂ－ｌ被确定为由等量的ｃｉｓ－（—）－（３Ｒ，４Ｓ，２＇Ｒ）－１和ｃｉｓ－（＋）－（３Ｓ，４Ｒ，２＇Ｓ）－１组成的外消旋体。     

间接光度色谱测定血定安溶液中钠,钙,镁的含量

本文用间接光度色谱法（ＩＰＣ）测定了血定安溶液中钠、钙及镁的含量。采用ＳｐｈｅｒｉｓｏｒｂＳＣＸ色谱柱，以Ｃｅ＾３＋为流动相平衡离子，检测波长２５４ｎｍ。样品中各离子的回收率为：Ｎａ９８．７－１００．４％，Ｃａ９８．１－１０１．７％，ＭＧ＾２＋９９．４－１０４．２％，Ｃａ＾２＋、Ｍｇ＾２＋最小检出量分别为；３．３ｎｇ和２．０ｎｇ。本法准确、灵敏、简便。     

2—甲基—1,4—萘醌的制备

２－甲基－１,４－萘醌（又名甲萘醌,３）为重要的促凝血药维生素Ｋ３（ｖｉｔａｍｉｎＫ３,亚硫酸氢钠甲萘醌,１）的重要中间体。文献［１,２］报道,采用铬酐和浓硫酸氧化２－甲基萘（２）合成３。３再与亚硫酸氢钠加成制得１。该法对环境污染显著。本文以过氧乙酸氧化２制得３,无污染,收率４１％,与传统工艺相当。ＣＨ３ＣＯＯＨ＋Ｈ２Ｏ２Ｈ２ＳＯ４ＣＨ３ＣＯＯＯＨ＋Ｈ２ＯＣＨ３　　　２＋３ＣＨ３ＣＯＯＯＨＣＨ３ＣＯＯＨＯＯＣＨ３　　　　３ＣＨ３ＣＨ２ＯＨＮａＨＳＯ３ＯＯＣＨ３ＳＯ３Ｎａ　　　　１·３Ｈ２Ｏ实验部…     

对妊高征患者红细胞膜脂质过氧化和离子运输功能的观察

目的：对妊高征患者红细胞膜过氧化脂质（ＬＰＯ）含量、超氧化物歧化酶（ＳＯＤ）活性、Ｎａ＾＋－Ｋ＾＋－ＡＴＰ酶活性及膜内面Ｃａ＾２＋结合能力的变化进行研究。方法：检测１９名正常妇孕,１９例妊高征患者红细胞膜ＬＰＯ、ＳＯＤ、Ｎａ＾＋－Ｋ＾＋－ＡＴＰ酶活性（比色法）及膜内面Ｃａ＾２＋结合力（原子吸收法）。结果：（１）妊高征组红细胞膜ＬＰＯ含量明显高于正常孕妇组（Ｐ〈０．００１）。（２）妊高征组红细胞膜Ｓ     

Therapeutic assessment of Slow-K and K-tab potassium chloride formulations in hypertensive patients treated with thiazide diuretics

Therapeutic equivalency among different drug products is one of the major issues confronting many clinicians today who are functioning as members of pharmacy and therapeutic committees and state Medicaid programs (SMP). Selection of one of the available slow-release potassium chloride formulations for inclusion in a hospital formulary or SMP exemplifies one of these therapeutic equivalency issues. To evaluate this issue, we studied 20 hypertensive adult patients receiving hydrochlorothiazide 50 mg/d to determine if there are significant differences between the administration of 24 mEq of Slow-K given as 8 mEq/tablet tid, and 30 mEq of K-Tab given as a 10 mEq/tablet tid. The study was conducted in a randomized, open-label, crossover design in which the two drug formulations of potassium chloride were compared over two four-week treatment periods. Results from this study indicate that 24 mEq of Slow-K and 30 mEq of K-Tab were equally effective in maintaining serum electrolyte concentrations, blood pressure measurements, and electrocardiogram evaluations within normal limits in all 20 hypertensive patients studied. Furthermore, no adverse effects were noted with either potassium chloride formulation, and patient acceptance, tolerability, and compliance to prescribed dosing regimens were similar for both products. Based on our findings, therefore, we conclude that 24 mEq of Slow-K and 30 mEq of K-Tab given three times daily as 8 mEq and 10 mEq tablets, respectively, are therapeutically equivalent.     

Kinetics of Potassium Excretion Following Oral Supplements: Evidence of Induced Natriuresis

Twenty-four healthy normal volunteers were given 40 mEq of three oral formulations of K⁺ as potassium chloride in a three-way Latin square design. Pharmacokinetic characteristics of potassium disposition were determined using urinary excretion data. Potassium was absorbed almost instantaneously from the 10% (w/v) solution, while a slow first-order absorption could explain the slow release of potassium from Slow-K and the new slow-release tablet. A biphasic elimination of potassium observed during the first 24 hr of urinary excretion suggested the body's adaptive process of changes in rates of elimination of potassium to maintain homeostasis. There was no significant difference (P = 0.25) in total recoveries of potassium in urine during 48 hr of urinary collection among the three formulations (mean ± SE: solution, 35 ± 7.1 mEq; Slow-K, 38.1 ± 7.8 mEq; and new formulations, 33.5 ± 6.8 mEq). An increased excretion of sodium was observed and correlated with increased potassium excretion following oral potassium administration which could not be explained by changes in urine flow rate. The clinical significance of such an increase in natriuresis is yet to be determined.     

Olanzapine orally disintegrating tablets in the treatment of acutely ill non-compliant patients with schizophrenia

The objective of this study was to determine if the orally disintegrating tablet formulation of olanzapine, Zyprexa Zydis, would facilitate antipsychotic medication compliance in acutely ill, non-compliant patients. Eighty-five acutely ill patients with schizophrenia or schizoaffective disorder who met medication non-compliance criteria received open-label olanzapine orally disintegrating tablets (1020 mgd) for up to 6 wk. Improvement in medication compliance was assessed using various rating scales to measure changes in psychopathology, medication-taking and compliance attitudes, and nursing care burden. Safety variables were also measured. Significant improvement from baseline was demonstrated in the Positive and Negative Syndrome Scale total score at Week 1 and subsequently (p0.001). Significant improvement from baseline was also seen in various scales measuring medication compliance, attitude, and nursing care burden (p0.05). Olanzapine orally disintegrating tablets were well-tolerated. Olanzapine orally disintegrating tablets may benefit acutely ill, non-compliant schizophrenic patients by facilitating acceptance of active antipsychotic drug therapy.     

注射用甘露聚糖肽不良反应因素分析

目的 探讨影响注射用甘露聚糖肽不良反应发生的相关因素，为临床用药提供参考。方法 回顾性分析2012年至2016年郑州大学附属肿瘤医院上报的注射用甘露聚糖肽药品不良反应（adverse drug reactions，ADR）病例72例，采用Stata软件对患者的临床特点和用药信息进行Logistic回归分析。结果 注射用甘露聚糖肽常见的ADR是皮肤系统损伤（41.7%），具体临床表现为皮疹；其次是呼吸系统ADR（36.1%），临床表现为胸闷和呼吸困难。肺癌患者更易发生呼吸系统ADR，与其他肿瘤相比具有统计学意义（P<0.05）。高龄和溶媒可能是影响注射用甘露聚糖肽安全性的危险因素，老年患者应谨慎用药，配伍溶媒建议选择0.9%氯化钠。结论 临床使用注射用甘露聚糖肽应严格把握适应证，对存在潜在风险的患者谨慎用药，确保临床用药安全。     

乙胺吡嗪利福异烟片(Ⅱ)治疗肺结核致不良反应/事件106例分析

目的:探讨肺结核患者应用乙胺吡嗪利福异烟片(Ⅱ)致不良反应/事件(ADR/ADE)的一般规律及特点,为临床合理用药及安全性评价提供参考。方法:采用回顾性研究方法,对2011年1月-2013年10月间接受乙胺吡嗪利福异烟片(Ⅱ)治疗的386例肺结核患者中发生ADR/ADE的相关情况进行统计和分析。结果:386例患者出现ADR/ADE共106例,发生率为27.46%。ADR/ADE发生时间最多见于用药2周内(92.45);其中,胃肠系统损害构成比为38.71%,皮肤及其附件损害构成比为29.57%,肝胆系统损害构成比为19.35%,居前3位;经停药、调整用法用量或对症治疗后105例(99.06%)好转或痊愈。结论:临床应掌握乙胺吡嗪利福异烟片(Ⅱ)所致ADR/ADE的特点,加强监测,并及时发现和正确处理,从而可提高肺结核患者的用药依从性和治愈率。     

Bioavailability of potassium from controlled-release tablets with and without water loading

Summary The relative availability of potassium from a controlled-release multiple-units tablet (Kalinorm) and a single-unit tablet (Slow-K) were compared in 13 volunteers on a low potassium diet (less than 30 mmol), by observing changes in urinary potassium excretion after administration of a single dose of 32 mmol potassium, either with or without water loading. Irrespective of procedure, the two products had the same extent of availability. The use of water loading, and special precautions about the level of dietary potassium and its composition when studying urinary potassium excretion, are discussed. It is suggested that water loading should be avoided when investigating the rate of potassium excretion.     

Assessment and Validation of Animal Models to Evaluate Topical Effects of Substances on Gastrointestinal Mucosa

The in situ rabbit colon model is a sensitive and reproducible test to evaluate the topical effect of up to three substances applied to the colonic mucosa. Vibra-Tabs (doxycycline hyclate), Inderal (propranolol hydrochloride), and Slow-K (potassium chloride) were compared for topical effects in the Carlborg–Densert cat esophagus model, the Alphin–Droppleman cat gastric mucosa model adapted for dog intestine, and the rabbit colon. Because results were comparable in the all models, additional dosage formulations were subsequently tested only in the rabbit colon model. After exposure of the tissue to drugs, macroscopic and histologic effects were scored on four- and eight-point scales, respectively. In all three models, Vibra-Tabs and Inderal produced the highest macroscopic and histologic scores, although Slow-K was also irritating. In the rabbit colon model, potassium released from Slow-K and Micro-K Extencaps caused more irritation than from controlled-release GITS (KC1) (gastrointestinal therapeutic system KC1).     

中成药复方制剂联合常规治疗用于寻常型银屑病疗效与安全性的贝叶斯网状Meta分析

目的:系统评价中成药复方制剂联合常规治疗用于寻常型银屑病疗效与安全性的差异,为临床用药提供循证参考。方法:计算机检索中国知网、万方数据、维普网、中国生物医学文献数据库、Pub Med、Cochrane图书馆、Web of Science等数据库,收集不同中成药复方制剂联合常规治疗对比常规治疗用于寻常型银屑病的随机对照试验(RCT),检索时限均为各数据库建库起至2020年2月。筛选文献,提取资料后采用Cochrane系统评价员手册5.1推荐的偏倚风险评估工具对纳入文献质量进行评价,采用Stata 15.0软件、Addis 1.16.6软件以及马尔科夫链-蒙特卡洛方法进行贝叶斯网状Meta分析。结果:共纳入41项RCT,共计4122例患者;涉及复方青黛胶囊、消银颗粒、克银丸、郁金银屑片、常规治疗等5种干预措施。网状Meta分析结果显示,在提高总有效率方面,与常规治疗比较,4种不同中成药复方制剂联合常规治疗均可显著提高患者的总有效率(P<0.05);网状Meta排序结果为克银丸联合常规治疗>复方青黛胶囊联合常规治疗>消银颗粒联合常规治疗>郁金银屑片联合常规治疗>常规治疗。在降低治疗后银屑病面积和严重程度指数(PASI)评分方面,与常规治疗比较,克银丸、消银颗粒联合常规治疗均显著可降低患者的PASI评分(P<0.05),而复方青黛胶囊、郁金银屑片联合常规治疗与常规治疗比较,差异均无统计学意义(P>0.05);网状Meta排序结果为消银颗粒联合常规治疗>克银丸联合常规治疗>复方青黛胶囊联合常规治疗>郁金银屑片联合常规治疗>常规治疗。在降低血清炎性因子水平方面,与常规治疗比较,复方青黛胶囊、消银颗粒联合常规治疗均可显著降低患者的白细胞介素17水平(P<0.05),而克银丸、郁金银屑片联合常规治疗与常规治疗比较,差异均无统计学意义(P>0.05);网状Meta排序结果为消银颗粒联合常规治疗>复方青黛胶囊联合常规治疗>郁金银屑片联合常规治疗>克银丸联合常规治疗>常规治疗。在安全性方面,4种中成药复方制剂联合常规治疗与常规治疗的不良反应发生率比较,差异均无统计学意义(P>0.05);网状Meta排序结果为复方青黛胶囊联合常规治疗>消银颗粒联合常规治疗>克银丸联合常规治疗>常规治疗>郁金银屑片联合常规治疗。结论:与常规治疗比较,加用4种中成药复方制剂均可提高寻常型银屑病血热证患者的疗效,以克银丸最佳;在降低患者皮损程度及血清炎性因子方面,以消银颗粒最佳;加用4种中成药复方制剂的安全性均较好,以复方青黛胶囊最佳。     

临床药师在实施慢性阻塞性肺疾病临床路径中的作用分析

目的：对临床药师参与慢性阻塞性肺疾病（COPD）临床路径的过程进行分析,讨论临床药师在实施临床路径中的工作模式及作用。方法：将纳入COPD临床路径的患者分为治疗组和对照组,临床药师通过戴明循环（PDCA）模式参与管理治疗组患者的药物治疗,经过2个PDCA循环后,对比分析2个循环组及治疗组和对照组病例平均住院日、平均住院费、药物治疗费、药品不良反应（ADR）发生率、患者药物治疗依从性、满意度有无统计学意义。结果：2个PDCA循环组之间药物治疗费差异有统计学意义（P＜0.05）;平均住院日、平均住院费、ADR发生率、药物治疗依从性、满意度差异无统计学意义（P＞0.05）;治疗组与对照组比较除平均住院日、平均住院费差异无统计学意义外,药物治疗费、ADR发生率、药物治疗依从性、满意度差异均有统计学意义（P＜0.05）。结论：临床药师通过PDCA的管理模式参与临床路径的实施,能够有效促进药物治疗的规范使用、加强患者的药物治疗监护,ADR得到及时处置和上报,患者药物治疗依从性和满意度得到提高。     

某院风湿免疫科以药师为主导的患者慢性疾病药物治疗管理模式的建立与实践

目的：探讨药师为风湿免疫疾病患者提供慢性疾病药物治疗管理（medication therapy management,MTM）的模式。方法：以某院风湿免疫科中类风湿性关节炎、系统性红斑狼疮及强直性脊柱炎患者为研究对象,收集患者200例,随机分成药学干预组和对照组,对药学干预组实施MTM。将2组患者入院初期、出院后1个月、出院后3个月、出院后6个月的临床评价指标、患者依从性评分、药学干预期内再入院率和不良反应发生率进行2组间的比较,观察MTM的实施效果。结果：与对照组相比,临床疗效指标在出院后3个月、6个月有更好的改善,差异具有显著性（P<0.05）;患者依从性在出院后3个月、6个月有较高的评分,差异具有显著性（P<0.05）;药学干预组的再入院发生事件略有下降,但差异无显著性;出院后6个月药学干预组ADR发生率明显低于对照组,差异具有显著性（P<0.05）。结论：通过对风湿免疫患者实施MTM,可以达到提高药学服务质量和临床疗效的目的。