我院产科抗菌药物应用情况分析

目的了解本院产科抗菌药物使用情况,提高产科应用抗菌药物合理性。方法采用随机抽样的方法,抽查本院2011年7－12月产科出院病历186份进行分析统计,分析抗菌药物的使用情况。结果共调查产科186份病历,抗菌药物应用率为84．9％,联合应用以B一内酰胺类和硝基咪唑类为主,联合应用率为70．8％。结论本院产科抗菌药物预防性应用在预防用药指征、抗菌药物选择、预防用药时间等方面存在不合理现象,需加强管理。     

我院2009年抗菌药物应用情况分析

目的：通过调查本院2009年度的抗菌药物使用情况,并对其使用合理性进行分析。方法：随机抽查2009年1～12月本院住院病历557份,分析用药频率及联合用药情况。结果：本院使用抗菌药物6大类20多个品种,抗菌药物使用率为70.7%,联合用药率为12%。细菌培养送检率为71.3%;药敏实验率为23.7%。用药频率最高的抗菌药物为头孢菌素类,其次为青霉素类。结论：本院住院患者抗菌药物应用率偏高,需加强抗菌药合理应用与规范化管理。     

外科围手术期抗菌药物应用调查分析

目的:了解外科围手术期抗菌药物应用情况,以指导临床合理用药。方法调查我院外科11个科室的手术病历262份。结果262份病历有261份应用了抗菌药物,应用率为99.62%。其中治疗用药占5.34%,预防用药占99.62%。使用频率较高的抗菌药物为头孢噻肟钠、第四代头孢和泰能等。结论加强手术病人预防应用抗菌药物管理,做到合理使用抗菌药物,减少耐药菌株的产生,降低医院感染率。     

抗菌药物临床应用调查分析

目的探讨本院抗菌药物的应用状况,指导临床合理使用抗菌药物。方法对2005年1月至2007年12月份出院病历75份的抗菌药物的使用情况编制调查表,进行统计分析。结果本院抗菌药物总应用率为71.38%,预防性用药占66.14%,联合用药率为50.46%,以经验用药为主,抗菌药物应用频率最高的种类是头孢菌素类,其次为青霉素类和喹诺酮类,抗菌药物费用占总药费24.43%,新型、昂贵抗菌药物所占费用大,主要存在问题有外科系统预防性使用抗菌药物过宽,围手术期预防用药不规范,经验用药和选用高档抗菌药物较多,病原学送检率低。结论本院抗菌药物应用率处于国内中位水平,不合理应用仍占相当比例。     

小儿腹外疝手术围术期预防性应用抗菌药物调查分析

目的:调查分析小儿腹外疝手术围术期的抗菌药物预防性应用情况.方法:随机调取我院儿科2014~2016年出院的544份小儿腹外疝手术病历,对抗菌药物应用情况进行调查分析.结果:我院抗菌药物的预防性应用率从2014年的78.14%逐渐下降为2016年的35.16%,术前0.5~2h给药率从2014年的74.83%上升为2016年的93.75%,3年间预防用药疗程3~7d的占31.63%;294例抗菌药物处方共涉及六类,头孢菌素类最多,占81.97%.结论:通过整改,我院近年来抗菌药物的应用日趋规范,但依然存在不合理现象,有待加强监督管理.     

我院抗菌药物应用调查分析

目的：促进临床合理应用抗菌药物。方法：采用回顾性调查分析方法,对我院2007年1 710份出院病历进行抗菌药物应用情况统计分析。结果：我院抗菌药物应用率72.59%,其中预防用药占57.29%,治疗用药占42.72%,标本送检率62.00%,合理使用率83.58%。结论：我院抗菌药物使用基本合理,但仍存在问题,应加强管理。     

儿童肺炎治疗中抗菌药物使用情况调查分析

目的：了解我院儿童肺炎患者治疗中抗菌药物使用情况及存在问题,为临床用药提供参考。方法：采用回顾性调查分析方法,查阅2008年10-12月出院的肺炎患儿病例资料209份,对使用抗菌药物的品种、使用频度、联合用药等情况进行统计分析。结果：209例肺炎患儿全部使用了抗菌药物,其中单用占31.6％,二联用药占64.6％,三联用药占3.8％。使用频度高的抗菌药物依次为大环内酯类、头孢菌素类。行病原学检查171例,占81.8％。结论：我院肺炎治疗中抗菌药物使用基本合理,但仍存在某些问题需要改进。     

我院抗菌药物专项点评结果与分析

目的 通过对我院抗菌药物处方用药情况进行专项点评分析,对不合理用药处方进行干预,提高处方合理率,促进临床合理用药。方法 以回顾性调查研究的方法,对我院2021年1月～2022年12月门诊2400张抗菌药物处方和住院使用抗菌药物病历共1163份进行点评,将点评结果进行分析。结果 2021年不合理应用抗菌药物门诊处方和住院病历总数94份,占抽取处方和病历总数比例5.55%;2022年不合理应用抗菌药物门诊处方和住院病历总数67份,占抽取的处方和病历总数比例3.58%。2022年与2021比较,处方及病历医嘱不合理率下降2.03%,处方医嘱合格率明显提高。结论 我院门诊及住院抗菌药物专项点评经过前置审核、药师人工干预和行政管理多重干预措施后抗菌药物使用不合理率有所下降,但仍存在不合理使用现象,需继续加强干预管理,不断提高临床合理用药。     

我院抗菌药物应用情况调查与分析

目的找出不合理应用抗菌药物症结,为临床合理用药提供科学依据.方法调查我院2001年3月出院患者病历1 175份,并分析抗菌药物应用的合理性.结果共应用抗菌药物2 013例次,抗菌药物应用率为73.45%.其中,预防用药49.18%,治疗用药49.18%,盲目用药1.64%;合理用药67.76%,基本合理用药23.40%,不合理用药8.84%;共用药13类、58种,居前5位者依次为喹诺酮类、头孢菌素类、青霉素类、硝咪唑及大环内酯类.结论我院抗菌药物应用率仍高于卫生部要求,应用合理率偏低.     

某院2010年下半年门诊处方抗菌药物应用分析

目的对河南省人民医院门诊处方抗菌药物应用情况进行统计分析,了解门诊患者抗菌药物应用情况,为规范抗菌药物合理应用提供依据。方法随机抽取2010年9月16日和12月16日处方各100张,调查其用药情况。结果处方平均用药品种数为1.88种,抗菌药物应用率为19.50%,平均处方金额为213.81元,平均抗菌药物处方金额为226.39元,单用、联用抗生素处方各占应用抗菌药物处方总数的87.18%、12.82%。结论河南省人民医院应用抗菌药物基本合理,但处方平均金额、应用抗菌药物处方平均金额偏大,应加强对抗菌药物应用的管理。     

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.

---

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.     

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.     

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.