976例新的严重药品不良反应病例报告分析

目的了解新的、严重药品不良反应在淄博市的发生情况,为临床安全用药提供参考。方法采用回顾性研究方法,对淄博市2008年收集的976例新的、严重ADR病例报告进行分类统计和分析评价。结果本组资料中涉及ADR的药物共22类,中药注射剂居首位,其次为抗微生物药物。用药途径以静脉滴注为主(68.44%)。不良反应发生程度以中度居多(70.49%),重度ADR 212例(21.72%),严重ADR发生例数最多的药物是氯氮平片。结论继续加强中药注射剂和精神类药物的安全性监测,提高临床合理用药水平。     

淄博市4940例药品不良反应报告分析

了解淄博市2006年药品不良反应的发生和分布情况,为临床合理用药提供科学依据,发挥药品不良反应监测工作的指导作用.采取回顾性研究方法,结合Excel电子表格,对2006年淄博市药品不良反应监测中心收集的4940例药品不良反应病例报告进行统计和分析.药品不良反应涉及的药品以抗微生物药最多,占48.62%;不良反应累及的系统-器官以皮肤及其附件损害最多,占30.85%;给药途径以静脉滴注为主,占67.06%.     

2006年全国儿童严重不良反应报告分析

目的:以国家药品不良反应监测中心数据库中2006年儿童严重不良反应报告为研究对象,分析基本情况及相关风险因素。方法:采用病例回顾性研究方法对国家中心2006年收集到的1 088份儿童的严重药品不良反应报告进行综合分析。结果:儿童严重药品不良反应报告占全部严重药品不良反应报告(8 128份)的13.40%,不良反应涉及的药品以抗微生物药物最多,其次为中药和生物制品,不良反应累及的系统-器官以全身性损害最多,表现为过敏样反应。101份儿童死亡病例报告中涉及的药物中抗微生物药物和生物制品较多,死亡原因多为过敏性休克。结论:儿童自身的免疫系统发育特点、药动学特点、儿科常用药物的使用等相关因素可能导致儿童严重药品不良反应的发生。     

2006年全国老年人严重药品不良反应报告分析

目的通过对老年人严重药品不良反应病例报告的统计、分析,为促进老年人临床用药安全提供参考。方法采用病例回顾性研究方法对国家药品不良反应监测中心2006年收集到的1844例老年人严重药品不良反应报告进行综合分析。结果严重药品不良反应涉及的药品以抗微生物药物最多,不良反应累及的系统一器官以全身性损害最多,给药途径以静脉给药最多。结论提高合理用药水平,加强药品不良反应监测工作,保障老年人用药安全。     

105例静脉滴注致新的严重的药品不良反应病例报告分析

目的通过分析105例因静脉滴注引起的新的、严重的药品不良反应病例报告,为临床安全合理用药提供参考依据。方法采用回顾性研究方法,对临邑县2009年收集的105例经静脉滴注引起的新的、严重的病例报告进行分类汇总及分析评价。结果中老年人不良反应所占比例最高,引起药品不良反应的品种主要是抗微生物药物,累及17个系统-器官,涉及国家基本药物35个。结论临床必须重视静脉滴注不良反应的监测,以减少或避免严重药品不良反应的发生。     

社区卫生服务体系药品不良反应病例报告分析

目的阐述抚顺市社区卫生服务体系药品不良反应病例报告分析情况，探索在我国社区卫生服务体系中药品不良反应监测规律。方法收集2006年全市社区卫生服务体系上报的药品不良反应病例报告，从性别和年龄分布、用药情况等进行分析。结果40岁以上的中老年人药品不良反应构成比较高，占60％；抗微生物药物和中药制刹药品不良反应构成比较高；新的、严重的不良反应占30%.结论通过对社区卫生服务体系上报的药品不良反应病例报告进行有益的探讨，可为社毒区卫生服务系统开展药品不良反应监测提供借鉴，也为基层社区医务人员的合理用药提供指导。     

我院389例药品不良反应报告分析

目的了解医院药品不良反应（iDa）发生的特点,以促进临床合理用药。方法对医院2008年至2010年收集的389例药品不良反应报告,采用Excel电子表和手工筛选方法进行统计、分析。结果389例报告中,60岁及以上人群所占比例最大,有201例（占51．67％）;女性患者发生药品不良反应的几率明显较男性高;涉及的药品中,中成药和中药注射剂、循环系统用药、抗微生物药的药品不良反应发生率高（各占22．88％,22．88％,12．85％）;药品不良反应临床表现以消化系统反应最多（28．79％）;新的严重的药品不良反应5例（1．29％）;好转303例,治愈86例,无死亡病例。结论中成药和中药注射剂、循环系统用药、抗微生物药是药品不良反应监测工作的重点,临床应加强药品不良反应监测,提高合理用药水平。     

120例静脉输液不良反应报告分析

目的 通过对我院2011年1至12月收集的120例药物静脉输液不良反应汇总,了解药品不良反应(ADR)的特点,为临床合理用药提供依据.方法 采用病例回顾性研究的方法,总结不良反应发生状况.结果 120例静脉输液ADR报告中,女性患者发生ADR概率高,占59.2% ;涉及的药物中,抗微生物药物引发ADR居首位,占50.9%,其中头孢菌素类药物占50.6%.中药制剂其次,占36.7%;ADR涉及例次最多的系统/器官为皮肤及其附件,主要表现为皮疹、瘙痒等.结论 儿童和女性等特殊人群是ADR监测的重点,同时抗微生物药物、中药制剂是ADR监测的重点药物.临床医务工作人员应提高合理使用药物,尽量减少ADR发生.     

娄底市2008年药品不良反应报告分析

目的了解娄底市2008年药品不良反应的发生和分布情况,为临床合理用药提供科学依据,发挥药品不良反应监测工作的指导作用。方法采取回顾性研究方法,对2008年娄底市药品不良反应监测中心收集的3111例药品不良反应病例报告进行统计和分析。结果严重的不良反应发生率为3.41%;药品不良反应涉及的药品以抗微生物药最多,占49.70%;不良反应累及的系统—器官以皮肤及其附件损害最多,占33.13%;给药途径以静脉滴注为主,占71.61%。结论进一步加强药品不良反应监测工作,确保人民群众用药安全、合理。     

抗微生物药物所致的严重不良反应分析

目的:分析我院抗微生物药物引起的严重不良反应,以便临床医师和护士在用药时能及时、准确作出判断并处理,减轻对患者的伤害。方法:将我院药品不良反应监测小组于2005年1月~2006年7月收集到的1 360份不良反应病例进行分析,按照国家药品不良反应监测中心制定的严重不良反应定义进行筛选、分析、讨论。结果:由抗微生物药物引起的严重不良反应的病例数为111例(含死亡2例),占不良反应总例数的8.2%,涉及到抗微生物药物44种。结论:加强药品不良反应监测,尤其是抗微生物药物引起的严重不良反应。合理地使用抗微生物药物,杜绝滥用,以保证抗微生物药物用药安全、有效。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.