3种治疗方案治疗小儿肺炎的成本-效果分析

目的:分析评价用于治疗小儿肺炎的3种治疗方案,指导临床合理用药。方法:采用药物经济学成本-效果分析方法,对用于治疗小儿肺炎的3种治疗方案A(头孢他啶 炎琥宁)、B(头孢曲松 炎琥宁)、C(阿莫西林/克拉维酸钾 病毒唑)进行回顾性的药物经济学分析。结果:3种治疗方案中,即A、B、C中,A组有效率88.9%,费用为2 278.71元,有效率每增加1个百分点,成本为25.63元;B组有效率93.3%,费用为2 138.63元,有效率每增加1个百分点,成本为22.92元;C组有效率83.3%,费用为2 038.13元,有效率每增加1个百分点,成本为24.47元;从多种因素考虑,B组方案较其他两种方案好。结论:从药物经济学的观点分析,B组方案是3种小儿肺炎治疗方案中最合理的方案。     

晚期非小细胞肺癌3种化疗方案的成本-效果分析

目的探讨晚期非小细胞肺癌不同化疗方案的临床疗效和经济学效果。方法收集我院58例晚期非小细胞肺癌患者,根据不同治疗方案分为3组,运用药物经济学成本-效果分析方法,对3组治疗方案进行回顾性分析。A组：顺铂＋酒石酸长春瑞滨注射液（NP方案）。B组：顺铂＋紫杉醇（DP方案）。C组：顺铂＋依托泊苷注射液（VP-16）。结果 A组、B组和C组方案的有效率分别为33.3%,40%和25%。化疗1个疗程住院费用分别为4996.1元、6722.3元和2945.0元。每获得1个单位效果,三组方案所需成本分别为252.3元、248.9元和168.4元,在C组方案的基础上,每增加1个单位效果,A组和B组所追加的成本分别为240.9元和208.74元。结论本文研究结果提示,B组方案为治疗晚期非小细胞肺癌较好的方案。     

格列吡嗪、活血降糖胶囊及两者联用治疗2型糖尿病的成本-效果分析

目的:比较格列吡嗪、活血降糖胶囊及两者联用治疗2型糖尿病的近期疗效和经济学效果。方法:105例患者按随机双盲法分为3组,分别给予活血降糖胶囊(A组)、格列吡嗪(B组)、活血降糖胶囊+格列吡嗪(C组)治疗,疗程均为2个月。运用药物经济学方法分析其成本-效果。结果:A、B、C组总有效率分别为74.3%、68.6%、94.3%,治疗2个月的费用分别为951.2、744.2、1097.0元。每获得1个单位效果,A、B、C组方案所需成本分别为12.8、10.8、11.6元。在B组方案的基础上,每增加1个单位效果,A、C组所追加的成本分别为36.3、13.7元。结论:C组方案治疗2型糖尿病最佳。     

PVM和PVMK化疗方案治疗肺癌的成本 效果分析

目的:探讨PVM和PVMK两种化疗方案治疗中晚期非小细胞肺癌的疗效,并进行成本 效果分析.方法:采用药物经济学成本 效果分析方法.结果:PVM方案有效率为22.58%,PVMK方案有效率为48.39%,差异有显著性(P＜0.05). PVM方案1个疗程费用为20 412.96元,有效率每增加1个百分点成本为904.03元;PVMK方案1个疗程费用为38 862.46元,有效率每增加1个百分点成本为803.11元.生存质量改善以PVMK方案为优(P＜0.05).结论: PVMK方案治疗中晚期非小细胞肺癌优于PVM方案.     

3种预防顺铂所致呕吐方案的成本-效果分析

目的探讨不同药物治疗方案对同一疾病所产生的经济效果.方法202例顺铂化疗患者,随机分为3组,分别给予舒必利、恩丹西酮和甲氧氯普胺进行预防呕吐治疗,运用药物经济学的成本-效果分析方法进行评价.结果3种治疗方案中,舒必利方案有效率为87.1%,1个疗程费用为93.30元,有效率每增加1个百分点,成本为1.07元;恩丹西酮方案有效率为93.5%,1个疗程费用为448.26元,有效率每增加1个百分点,成本为4.79元;甲氧氯普胺方案有效率为57.5%,1个疗程费用为54.33元,有效率每增加1个百分点,成本为0.94元.结论舒必利方案是3种治疗方案中较为合理的方案.     

3种方案治疗乳腺增生药物经济学分析

目的：探讨乳腺增生不同用药方案的临床疗效和经济学效果。方法：选择乳腺增生患者90例,随机分成3组,口服新癀片（A组）、小金丸＋他莫昔芬片（B组）、乳宁颗粒＋他莫昔芬片（C组）进行治疗。运用药物经济学的成本-效果分析方法进行分析评价。结果：治疗总成本A组为309.40元、B组为1435.20元、C组为749.20元,总有效率分别为A组56.7%、B组90.0%、C组86.7%。每获得1个单位效果,3组方案所需成本分别为5.46元、15.95元和8.64元,在A组方案的基础上,每增加1个单位效果,B组和C组所追加的成本分别为33.81元和14.66元。结论：乳宁颗粒＋他莫昔芬片方案为最佳治疗方案。     

3种预防顺铂所致呕吐方案的成本-效果分析

目的 :探讨不同药物治疗方案对同一疾病所产生的经济效果。方法 :202例顺铂化疗患者 ,随机分为3组 ,分别给予舒必利、恩丹西酮和甲氧氯普胺进行预防呕吐治疗 ,运用药物经济学的成本 -效果分析方法进行评价。结果 :3种治疗方案中 ,舒必利方案有效率为87 1 % ,1个疗程费用为93 30元 ,有效率每增加1个百分点 ,成本为1 07元 ;恩丹西酮方案有效率为93 5 % ,1个疗程费用为448 26元 ,有效率每增加1个百分点 ,成本为4 79元 ;甲氧氯普胺方案有效率为57 5 % ,1个疗程费用为54 33元 ,有效率每增加1个百分点 ,成本为0 94元。结论 :舒必利方案是3种治疗方案中较为合理的方案     

3种治疗恶性胸腔积液方案的成本-效果分析

目的 :探讨不同药物治疗方案对同一疾病所产生的经济效果。方法 :根据文献选择70例恶性胸腔积液患者 ,随机分为3组 ,分别给予沙培林、白介素 -2、丝裂霉素治疗 ,运用药物经济学的成本 -效果分析方法进行评价。结果 :3种治疗方案中 ,沙培林组有效率为86 7 % ,1个疗程费用7243 50元 ,有效率每增加1个百分点 ,成本为83 55元 ;白介素 -2组有效率为60 0 % ,1个疗程费用3180 00元 ,有效率每年增加1个百分点 ,成本为53 00元 ;丝裂霉素组有效率为45 0 % ,1个疗程费用386 40元 ,有效率每增加1个百分点 ,成本为8 59元。结论 :沙培林是3种治疗方案中较为合理的方案。     

三种治疗方案用于乳腺癌化疗的成本-效果分析

目的分析评价3种乳腺癌化学治疗方案,指导临床合理用药.方法采用药物经济学成本-效果分析方法.结果 3种化疗方案,即PP、FAC、IFAF中,PP组有效率为80.0%,1个疗程的费用为54290.09元,有效率每增加1个百分点,成本为678.63元;FAC组有效率为52.4%,1个疗程的费用为20902.47元,有效率每增加1个百分点,成本为398.90元;IFAF组有效率为38.9%,1个疗程的费用为16932.48元,有效率每增加1个百分点,成本为435.28元;从多种因素考虑,FAC组方案较其余两种方案好.结论 FAC方案是3种乳腺癌化疗方案中最合理的方案.     

非小细胞肺癌住院病例的成本-效果回顾性研究

目的评价中医药对提高中晚期非小细胞肺癌临床疗效的价值。方法从药物经济学角度回顾性研究,选择符合纳入标准的住院患者,按治疗方案分为中医组、中西医结合组、西医组,以瘤体变化、生存质量、主要症状3项加权评分作为衡量疗效的效果指标,对3种治疗方案进行成本-效果分析。结果共纳入合格病例233例。中医组56例,中西医组77例,西医组100例。中医组总有效率为73.21％,稳定率为96.43％;完成疗程人均费用12663.94元;总有效率、稳定率每增加1个百分点成本分别为173.00元,131.64元。中西医结合组总有效率为80.52％,稳定率为98.70％;完成疗程人均费用22924.05元;总有效率、稳定率每增加1个百分点成本分别为284.77元,232.26元。西医组总有效率为54.00％,稳定率为89.00％;完成疗程人均费用30077.80元;总有效率、稳定率每增加1个百分点成本分别为557.00元,337.95元。结论中医药治疗是中晚期非小细胞肺癌的一种经济、有效的治疗方案。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.