沙美特罗／丙酸氟替卡松治疗儿童咳嗽变异性哮喘临床观察

目的观察沙美特罗与丙酸氟替卡松治疗儿童咳嗽变异性哮喘的疗效和安全性。方法将65例咳嗽变异性哮喘患儿随机分为治疗组32例和对照组33例。对照组予氨茶碱口服,治疗组予沙美特罗／丙酸氟替卡松粉吸入剂治疗。结果显效率治疗组为56％,对照组为27％,两组差异有显著性（P〈0．05）。治疗组和对照组的总有效率分别为97％和77％,两组差异也有统计学意义（P〈0．05）。未见明显不良反应。结论沙美特罗／丙酸氟替卡松粉吸入剂治疗儿童咳嗽变异性哮喘疗效好,使用方便。     

沙美特罗/丙酸氟替卡松治疗儿童咳嗽变异性哮喘疗效观察

目的 观察沙美特罗与丙酸氟替卡松治疗儿童咳嗽变异性哮喘（CVA）的疗效。方法 将38例CAV患儿随机分为两组，对照组17例口服止咳、抗组胺药物；治疗组19例加用沙美特罗与丙酸氟替卡松吸入。疗程均为2周，观察临床疗效。结果 治疗组和对照组总有效率分别为94．74％和58．82％，差异有统计学意义（P〈0．01）。随访6个月，治疗组临床无复发病例。结论 沙美特罗与丙酸氟替卡松合剂吸入治疗对儿童咳嗽变异性哮喘有显著疗效，无不良反应，也不易复发。     

沙美特罗、丙酸氟替卡松吸入治疗小儿咳嗽变异性哮喘的疗效观察

目的 观察吸入沙美特罗、丙酸氟替卡松对小儿咳嗽变异性哮喘(CVA)的治疗效果.方法 将48例CVA患儿随机分治疗组与对照组,治疗组给予沙美特罗、丙酸氟替卡松(舒利迭)吸入治疗,对照给予布地奈德气雾剂吸入治疗,疗程均为4周.比较两组患儿咳嗽明显缓解时间、咳嗽消失时间及平均治疗时间.结果 治疗组咳嗽明显缓解时间、咳嗽消失时间及平均治疗时间均短于对照组,差异有统计学意义(P＜0.05).结论 沙美特罗、丙酸氟替卡松吸入对小儿CVA具有良好的治疗作用.     

吸入丙酸氟替卡松治疗血清微量元素铁、锌缺乏的咳嗽变异性哮喘患儿疗效分析

目的：研究血清微量元素铁、锌缺乏的咳嗽变异性哮喘患儿吸入丙酸氟替卡松的治疗效果和病情进展。方法咳嗽变异性哮喘患儿100例分为两组,从血清微量元素铁、锌含量不足的咳嗽变异性哮喘患儿中随机抽取50例为研究组,从微量元素铁、锌含量正常的咳嗽变异性哮喘患儿中随机抽取50例为对照组,两组均给予吸入丙酸氟替卡松。持续吸入治疗6个月,随访1年,观察比较两组的治疗效果。结果研究组与对照组在咳嗽消失时间和咳嗽变异性哮喘复发例数及出现喘息和发展成为哮喘等方面有显著差异（P〈0.05）。结论血清微量元素铁、锌缺乏的咳嗽变异性哮喘患儿容易发生反复呼吸道感染,导致气道高反应机会增高,可能影响了丙酸氟替卡松吸入治疗的效果,增加了发展成为哮喘的风险。     

不同疗程丙酸氟替卡松吸入治疗儿童咳嗽变异性哮喘效果比较

目的：探讨不同疗程丙酸氟替卡松吸入治疗儿童咳嗽变异性哮喘效果比较。方法：在医院2014年4月～2015年4月诊治的咳嗽变异性哮喘患儿中抽取70例作为研究对象,均行丙酸氟替卡松吸入治疗,随机分成甲组、乙组,甲组用药6个月,前三个月分早晚各吸入1次,125μg/次,后三个月改为1次/d,125μg/次;乙组用药2个月,每日分早晚吸入1次,125μg/次;对比两组用药疗效、复发率。结果：①甲组咳嗽变异性哮喘复发率是2.86%,低于乙组的20.00%（P＜0.01）;②甲组治疗总有效率是94.29%,乙组治疗总有效率是91.43%无显著差异（P＞0.05）。结论：丙酸氟替卡松吸入治疗儿童咳嗽变异性哮喘效果肯定,6个月疗程的用药方案可降低咳嗽变异性哮喘复发率。     

布地奈德雾化吸入治疗儿童咳嗽变异性哮喘的疗效观察

目的 观察布地奈德雾化吸入治疗儿童咳嗽变异性哮喘的临床疗效.方法 将咳嗽变异性哮喘患儿83例随机分为观察组43例和对照组40例.2组患儿均给予支气管扩张药、镇咳祛痰药等,对照组在此基础上给予丙酸弗替卡松气雾剂,每次1喷,每天2次吸入;观察组给予布地奈德混悬液1ml,每天2次雾化吸入.比较2组患儿的临床疗效.结果 观察组总有效率为93.0%高于对照组的75.0%,差异有统计学意义（P＜0.05）.结论 布地奈德雾化吸入治疗儿童咳嗽变异性哮喘临床效果显著,值得临床推广应用.     

布地奈德雾化吸入治疗儿童咳嗽变异性哮喘的疗效观察

目的 观察布地奈德雾化吸入治疗儿童咳嗽变异性哮喘的临床疗效.方法 将咳嗽变异性哮喘患儿83例随机分为观察组43例和对照组40例.2组患儿均给予支气管扩张药、镇咳祛痰药等,对照组在此基础上给予丙酸弗替卡松气雾剂,每次1喷,每天2次吸入;观察组给予布地奈德混悬液1ml,每天2次雾化吸入.比较2组患儿的临床疗效.结果 观察组总有效率为93.0%高于对照组的75.0%,差异有统计学意义(P＜0.05).结论 布地奈德雾化吸入治疗儿童咳嗽变异性哮喘临床效果显著,值得临床推广应用.     

糠酸莫米松鼻喷剂联合丙酸氟替卡松吸入对咳嗽变异性哮喘患儿的疗效分析及对肺功能、FeNO水平的影响

目的分析糠酸莫米松鼻喷剂联合丙酸氟替卡松吸入治疗咳嗽变异性哮喘患儿的影响。方法选2017年2月～2019年10月我院收治的112例咳嗽变异性哮喘患儿为研究对象,采用随机数字表法分为参照组与试验组,各56例;对参照组患儿仅采用丙酸氟替卡松吸入治疗,试验组患儿采取糠酸莫米松鼻喷剂联合丙酸氟替卡松治疗;治疗后对比两组疗效、肺功能及呼出气一氧化氮(Fe NO)水平。结果治疗前,两组患儿的咳嗽诊治积分、治疗总有效率、肺功能指标VC、FEV1、FEV1/FVC及PEFpred、Fe NO水平比较,差异无统计学意义(P 0.05);治疗后,试验组患儿咳嗽诊治积分显著低于参照组,差异有统计学意义(P 0.05),且试验组患儿治疗总有效率、肺功能指标VC、FEV1、FEV1/FVC及PEFpred、Fe NO水平均显著优于参照组,差异有统计学意义(P 0.05)。结论以糠酸莫米松鼻喷剂联合丙酸氟替卡松吸入针对咳嗽变异性哮喘患儿,能够有效缓解患儿的临床症状,其肺功能得到良好恢复,Fe NO水平趋于正常,疗效较为显著,具有临床推广意义。     

沙美特罗/氟替卡松干粉剂治疗咳嗽变异型哮喘疗效观察

目的 探讨沙美特罗/氟替卡松干粉剂吸入治疗咳嗽变异型哮喘(CVA)的临床效果及安全性.方法 45例CVA患儿随机分为治疗组23例和对照组22例,治疗组给予沙美特罗/氟替卡松干粉剂吸入,早晚各1次;对照组单纯给予丙酸氟替卡松干粉剂吸入,早晚各1次;两组疗程均为3个月.观察两组治疗前、后临床症状缓解情况、哮喘控制时间、肺功能改善情况和不良反应.结果 治疗后两组咳嗽哮喘症状均有明显改善,治疗后1周治疗组改善情况好于对照组(x2=10.24,P＜0.05);治疗后2周、4周时两组差异均无统计学意义(均P＞0.05);治疗组哮喘完全控制时间明显短于对照组(t=8.36,P＜0.05).治疗后1周、2周、4周,治疗组PEF％均明显高于对照组(t=6.22、7.68、7.95,均P＜0.05);治疗后12周,治疗组PEF％与对照组差异无统计学意义(P＞0.05).两组无严重不良反应发生.结论 沙美特罗/丙酸氟替卡松干粉吸入治疗CVA安全、有效、使用方便,值得推广.     

儿童咳嗽变异性哮喘采用孟鲁司特钠治疗的临床疗效观察

目的探讨分析采用孟鲁司特钠治疗儿童咳嗽变异性哮喘的临床效果。方法选取我院2012年10月至2013年10月收治的68例咳嗽变异性哮喘患儿为研究对象,将其随机分成两组,观察组38例患儿给予孟鲁司特钠咀嚼片治疗,对照组30例患儿给予丙酸氟替卡松定量气雾剂吸入治疗,观察两组临床治疗效果。结果观察组患儿临床治疗总有效率为94.7%,对照组患儿总有效率为70.0%,观察组患儿临床效果明显优于对照组,差异具有统计学意义(P<0.05)。结论采用孟鲁司特钠治疗儿童咳嗽变异性哮喘的临床效果较显著,值得临床应用推广。     

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.