心血康治疗冠心病30例

我院自２０００年１０月～２００１年３月应用心血康治疗冠心病患者３０例 ,现报道如下 :１资料和方法１ １一般资料 :３０例患者中冠心病 (心绞痛型 )１４例 ,冠心病(心律失常或心衰型 )１６例 ,其中男１２例 ,女１８例 ,年龄５６～７４岁 ,平均６５岁。１ ２治疗方法 :心血康 (重庆药友制药有限责任公司生产 )２００～４００ｍｇ加入５%或１０ %葡萄糖注射液２５０～５００ｍｌ中静脉滴注 ,每日１次 ,使用３～１４天 ,平均使用１周。２结果３０例患者经治疗后临床症状如胸闷、胸痛、心悸、气短、心累等缓解 ,在常规应用强心、利尿剂外 ,除…     

硫酸镁654—2及多巴胺治疗肺心病心衰疗效观察

我院自１９９８年１月～１９９９年１０月 ,用２５ %硫酸镁、６５４ -２及多巴胺治疗肺心病心衰５０例取得了满意效果 ,现报道如下 :１临床资料本组为住院病人 ,均符合１９８０年全国第三次肺心病专业会议修订诊断标准。按随机双盲法分对照组和治疗组 ,各５０例。治疗组 :男３３例 ,女１７例 ,年龄５０～８０岁 ,平均６５岁 ;对照组 :男３１例 ,女１９例 ,年龄４８～７６岁 ,平均６２岁。按ＮＹＨＡ心功能分级标准 ,两组病例心功能均为Ⅱ～Ⅲ级。两组病例年龄 ,性别差异无显著性 (Ｐ＞０ .０５)。２治疗方法及疗效判断标准两组均选择有效抗…     

丹奥治疗脑梗死33例

应用丹奥注射液对３３例脑梗死患者进行临床疗效观察 ,现报道如下。１资料与方法１ １一般资料 :本组３３例 ,男２７例 ,女６例 ,其中４５岁～６０岁８例 ,６１岁～７０岁１２例 ,７１岁～９０岁１３例 ,均为２０００年３月～２００１年２月在我院神经内科住院患者 ,均符合以下条件 :(１)符合１９９５年全国第四届脑血管会议制定的脑血管病诊断标准 ,经头颅ＣＴ扫描证实并排除出血性脑梗死。(２)起病一周以内。 (３)首次发病或既往有脑卒中史本次发病前无后遗症。(４)入院前未经抗凝、溶栓、血液稀释等治疗 ,所有患者均有头昏、乏力、肢体运…     

针刺治疗梅核气33例

本院几年来所收治梅核气３３例 ,２３例痊愈 ,１０例好转 ,现介绍如下 :１临床资料门诊患者３３例 ,其中女３１例 ,男２例 ,年龄最大５２岁 ,最小２７岁 ,以３０～４０岁较多 ,病程最短２个月 ,最长２年。２治疗方法２ １取穴 :天突、膻中、内关 (双 )、太冲 (双 )、丰隆 (双 )。２ ２操作 :(１)患者取坐位。仰头。膻中在胸骨上窝正中取穴 ,取２８号１ ５寸毫针 ,先直刺２～３分 ,后改沿胸骨柄后缘、气管前缘平刺１～１ ５分 ,针刺不宜过深或左右偏移 ,以免损伤主动脉、气管。待患者咽部感到明显的沉紧憋闷感时 ,即可出针 ,此穴不留针。(２)…     

自发性小脑出血的外科治疗

１９８８年６月至１９９８年１０月我院共收治自发性小脑出血患者３６例,其中直接行后颅凹开颅手术２８例,钻孔引流３例,保守治疗中症状加重又行开颅２例。结果存活３３例,死亡３例,现报告如下：１　资料与方法１１　一般资料　我院自１９９８年６～１０月共收治自发性小脑出血患者３６例,男２５例,女１１例,年龄１８～７２岁,平均４５９岁。其中,有高血压病史者２７例,脑血管动静脉畸形（ＡＶＭ）７例,不明原因３例。血肿位于一侧小脑半球者３３例,位于小脑蚓部者２例,累及两侧小脑半球者１例;血肿量８～３３ｍｌ,平…     

小剂量β-受体阻滞剂治疗慢性充血性心力衰竭48例临床分析

笔者对１９９７年～２０００年我院收治的４８例慢性充血性心力衰竭老年病人 ,在常规治疗基础上加用小剂量倍它乐克 ,在减慢心率的同时 ,心功能得到改善 ,现报道如下 :１资料与方法１ １一般资料 :男３２例 ,女１６例 ,病程３～１０年 ,其中冠心病２２例 ,高血压１９例 ,扩张型心肌病４例 ,甲亢性心脏病３例。心功能按ＮＹＨＡ分级标准 ,Ⅳ级８例 ,Ⅲ级２４例 ,Ⅱ级１６例。上述病人符合下列治疗条例 :(１)经过抗心衰治疗后 ,心功能控制不理想 ;(２)须排除导致心率增快的其他原因。１ ２方法 :所有受试者在原有抗心衰治疗基础上 ,加用倍它乐…     

附桂牵正汤治疗面瘫23例

笔者根据面瘫的病理特点 ,自拟附桂牵正汤治疗面瘫２３例 ,另选１０例为对照组 ,现报道如下。１临床资料３３例面瘫患者分为２组 ,治疗组２３例 ,男６例 ,女１７例 ,年龄２１～７８岁 ,平均年龄５９岁 ,病程３天～１０个月。对照组１０例 ,男３例 ,女７例 ,年龄３０～７１岁 ,平均年龄５７岁 ,病程５天～９个月 ,两组疗程均为５～１０天。２治疗方法２ １治疗组基本方药 :熟附子１０ｇ、桂枝６ｇ、干姜４ｇ、白芍１０ｇ、党参１５ｇ、白术１０ｇ、生黄芪１５ｇ、当归１０ｇ、全蝎３ｇ、白僵蚕１０ｇ、乌梢蛇１０ｇ、防风１０ｇ、天麻１０ｇ…     

咽喉部结核12例临床分析

现对我院１９９３年９月～２００１年６月诊治的１２例咽喉结核进行初步分析 ,报道如下 :１临床资料１ １一般资料 :１２例中男７例 ,女５例 ,年龄２０～５６岁 ,平均年龄３３岁。既往有结核病史１例。病程２个月～３年 ,平均１０个月。合并肺结核３例 ,颈部淋巴结核１例 ,腭扁桃体Ⅱ度肿大３例 ,其中１例原诊为“慢性扁桃体炎”术前常规胸透发现有肺结核时再检查咽喉而确诊。１ ２临床表现 :均慢性发病 ,有反复咽痛。干咳少痰 ,伴有异物感、烧灼感６例 ,缩窄感３例 ,伴声嘶２例 ,伴颈部肿块１例 ,体温升高 (３８ ５℃ )１例。检查 :１２例…     

改良Sugiura术治疗门静脉高压症9例报告

门静脉高压症较常见 ,最严重的并发症是食管胃底静脉曲张破裂出血。目前手术方法较多 ,各有利弊。我院１９９７年９月～２００１年９月采用保留胃冠状静脉与奇静脉侧支的改良Ｓｕｇ ｉｕｒａ术治疗门静脉高压症９例 ,疗效较满意。现报道如下 :１临床资料１ １一般资料 :９例中男７例 ,女２例。年龄３３～６５岁 ,平均４８ ６岁。８例有１～４次出血史 ,曾分别在胃镜下硬化剂注射 (５例 ) ,三腔二囊压迫 (４例 )治疗。急诊手术３例 ,择期手术６例。全组病例均无肝炎后肝硬化。肝功能Ｃｈｉｌｄ分级Ａ级１例 ,Ｂ级５例 ,Ｃ级３例。１ ２手术方…     

益血生治疗小儿营养性贫血50例

笔者于２００１年５月～２００１年１０月 ,用益血生胶囊 ,每粒０ ２５ｇ(由延边敖东制药厂提供 ) ,治疗小儿营养性贫血５０例 ,现报道如下 :１临床资料本组５０例中 ,男３０例 ,女２０例 ,年龄最小６个月 ,最大１０岁 ,贫血分类 :缺铁性贫血１０例 ,巨幼红细胞性贫血１５例 ,混合性贫血２５例。均为轻、中度贫血 ,血红蛋白６０～１００ｇ／Ｌ ,红细胞 (２～３)×１０１２／Ｌ。２治疗方法及结果５０例均服益血生胶囊 ,其中６个月～４岁患儿用量每次１～２粒 ,每日３次 ,４～１０岁患儿用量每次２～４粒 ,每日３次 ,２周为一疗程 ,一般观察…     

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.