参麦注射液联合黄芪注射液辅治小儿病毒性心肌炎37例疗效观察

目的 观察参麦注射液联合黄芪注射液辅治小儿病毒性心肌炎的临床疗效.方法 将75例病毒性心肌炎患儿随机分为治疗组37例和对照组38例.对照组采用西医常规疗法,治疗组在常规治疗的基础上加用黄芪、参麦注射液.治疗4周后比较2组疗效.结果 治疗组患者临床症状(胸闷、心悸、气短、乏力)改善总有效率高于对照组,差异有统计学意义(P＜0.05);治疗组心电图改善总有效率为62.2%高于对照组的42.1%,差异有统计学意义(P＜0.05).2组治疗后红细胞沉降率(ESR)、肌酸激酶同工酶(CK-MB)、天冬氨酸氨基转移酶(AST)水平均降低,差异均有统计学意义(P＜0.05或P＜0.01).治疗组治疗后CK-MB及AST水平均低于对照组,差异均有统计学意义(P＜0.05).结论 参麦注射液联合黄芪注射液辅治小儿病毒性心肌炎,疗效显著,值得推广应用.     

磷酸肌酸钠对病毒性心肌炎患儿心肌保护作用的观察

目的观察与研究磷酸肌酸钠对病毒性心肌炎患儿心肌保护作用。方法选取2016年10月至2017年12月本院诊治的70例病毒性心肌炎患儿为研究对象,将其随机分为对照组(常规病毒性心肌炎治疗组)35例和观察组(常规治疗加磷酸肌酸钠组)35例。比较两组患儿治疗前后的心肌损伤相关指标(血清c Tn I、CK及CK-MB)表达情况。结果治疗前两组患儿的心肌损伤相关指标(血清c Tn I、CK及CK-MB)表达比较,差异无统计学意义(P> 0.05),治疗后观察组的表达水平均显著低于对照组(P <0.05)。结论磷酸肌酸钠对病毒性心肌炎患儿心肌保护作用较好,在病毒性心肌炎患儿中具有较高的应用价值。     

磷酸肌酸钠联合黄芪注射液治疗小儿病毒性心肌炎46例

目的 观察磷酸肌酸钠联合黄芪注射液治疗小儿病毒性心肌炎的疗效.方法 将92例病毒性心肌炎患儿随机分为治疗组和对照组各46例,对照组在常规治疗基础上给予磷酸肌酸钠注射液静脉滴注,治疗组在对照组基础上加用黄芪注射液静脉滴注,均每日1次,以14d为1个疗程.比较两组治疗后的临床疗效及心肌酶、肌钙蛋白Ⅰ(cTnI)水平的变化.结果 治疗组的临床疗效、心肌酶、肌钙蛋白的改善均优于对照组(P＜0.05).结论 磷酸肌酸钠联合黄芪注射液治疗小儿病毒性心肌炎,具有协同作用,明显提高疗效,值得临床推广.     

磷酸肌酸钠联合维生素C治疗对病毒性心肌炎患儿心肌酶和肌钙蛋白水平的影响

目的：探讨磷酸肌酸钠联合维生素C治疗病毒性心肌炎患儿的临床疗效及对心肌酶和肌钙蛋白水平的影响。方法选取116例病毒性心肌炎患儿,按照入院就诊的先后顺序分为2组,对照组患儿给予常规内科综合治疗,观察组患儿在此基础上给予磷酸肌酸钠联合维生素C治疗。结果观察组患儿治疗后的CK、CK-MB、HBDH以及CTnI水平显著优于对照组患儿,组间差异有统计学意义（P〈0.05）。结论磷酸肌酸钠和维生素C联合使用治疗病毒性心肌炎能够互补协同,提高临床疗效,有效保护心肌细胞,改善患儿的心肌酶和肌钙蛋白水平。     

喜炎平注射液联合磷酸肌酸钠治疗小儿病毒性心肌炎的临床研究

目的讨论喜炎平注射液联合注射用磷酸肌酸钠治疗小儿病毒性心肌炎的疗效及其安全性。方法选取天津市泰达医院2014年6月—2016年6月收治的病毒性心肌炎患儿78例,随机分为对照组(36例)和治疗组(42例)。对照组静脉滴注注射用磷酸肌酸钠,1 g溶于5%葡萄糖注射液100 m L中后30~45 min给药,1次/d。治疗组在对照组基础上静脉滴注喜炎平注射液,5~10 mg/kg(0.2~0.4 m L/kg)加入5%葡萄糖注射液或0.9%氯化钠注射液100~250 m L中,1次/d。两组患儿均连续给药14 d。观察两组的临床疗效,比较治疗前后两组心肌学指标和心肌钙蛋白(c Tn I)改善情况。结果治疗后,对照组、治疗组总有效率分别为83.3%、96.6%,两组总有效率比较差异具有统计学意义(P0.05)。治疗后,两组血清磷酸肌酸激酶(CK)、磷酸肌酸激酶同工酶(CK-MB)、天冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、心肌钙蛋白(c Tn I)水平均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组各指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。治疗过程中治疗组和对照组患者均未出现明显的不良反应。结论喜炎平注射液联合磷酸肌酸钠注射液治疗小儿病毒性心肌炎具有较好的临床疗效,能够明显改善心肌学指标和心肌钙蛋白,具有一定的临床推广应用价值。     

磷酸肌酸钠联合参麦注射液治疗儿童病毒性心肌炎疗效观察

目的 研究磷酸肌酸联合参麦注射液治疗儿童病毒性心肌炎的临床疗效。方法 将2011年10月至2013年10月164例病毒性心肌炎患儿随机分为试验组和对照组,每组82例,在对照组一般治疗、保护心肌的基础上,治疗组加用磷酸肌酸联合参麦注射液治疗,比较2组临床、心电图疗效及肌酸激酶同工酶（CK-MB）的变化。结果 试验组的临床总有效率、心电图总有效率明显高于对照组（P〈0.05）,2组治疗后CK-MB水平明显降低,与治疗前比较,差异有统计学意义（P〈0.05）。并且实验组治疗后CK-MB水平明显低于对照组（P〈0.05）。结论 磷酸肌酸联合参麦注射液治疗儿童病毒性心肌炎,能够提高治疗效果,改善心肌功能,是儿童病毒性心肌炎的一种良好治疗方案,值得推广应用。     

磷酸肌酸钠联合大剂量维生素C治疗小儿病毒性心肌炎的疗效观察

目的:探讨分析磷酸肌酸钠联合大剂量维生素C治疗小儿病毒性心肌炎的效果。方法:以某院2017年3月～2018年3月进行治疗的82例小儿病毒性心肌炎患儿为研究对象,按照入院号随机分为对照组和观察组每组41例,对照组使用磷酸肌酸钠治疗,观察组使用磷酸肌酸钠联合大剂量维生素C治疗,在研究结束后对两组患儿治疗效果以及心肌酶水平进行对比。结果:观察组患儿治疗总有效率高于对照组,心肌酶水平低于对照组,差异具有统计学意义(P<0.05)。结论:磷酸肌酸钠联合大剂量维生素C治疗小儿病毒性心肌炎的效果比较显著,可以提高治疗效果,临床值得应用。     

磷酸肌酸钠联合大剂量维生素C治疗小儿病毒性心肌炎的疗效分析

目的 分析磷酸肌酸钠联合大剂量维生素C治疗小儿病毒性心肌炎的疗效.方法 按照治疗方法的不同将80例病毒性心肌炎患儿分成两组,对照组(40例)患儿选择临床常规方案治疗,实验组(40例)患儿则在常规治疗的同时,给予磷酸肌酸钠联合大剂量维生素C治疗.结果 在临床治疗总有效率方面,实验组显著高于对照组(P<0.05);两组患者治疗前血清cTnI水平差异不显著(P>0.05),治疗后间比较差异有统计学意义(P<0.05).结论 在对病毒性心肌炎患儿进行治疗时,磷酸肌酸钠联合大剂量维生素C治疗具有比较显著的临床效果,值得临床推广.     

磷酸肌酸钠联合维生素C对病毒性心肌炎患儿心肌酶及肌钙蛋白Ⅰ的影响

目的:探究磷酸肌酸钠联合维生素C对病毒性心肌炎(VM)患儿心肌酶及肌钙蛋白Ⅰ的影响.方法:选取我院2014年9月~2016年9月收治的病毒性心肌炎患儿72例为研究对象,依入院顺序分为两组,各36例.给予对照组常规治疗,观察组在对照组基础上联合使用磷酸肌酸钠与维生素C,将两组治疗后心肌酶及肌钙蛋白I水平进行对比.结果:观察组治疗后心肌酶LDH、AST、CK、CK-MB水平均低于对照组,差异显著(P<0.05);治疗后两组肌钙蛋白I水平均有下降,观察组下降幅度优于对照组,差异显著(P<0.05).结论:磷酸肌酸钠联合维生素C可明显改善病毒性心肌炎患儿心肌酶及肌钙蛋白I水平,疗效确切.     

参麦注射液联合黄芪注射液辅治s],JL病毒性心肌炎37例疗效观察

目的观察参麦注射液联合黄芪注射液辅治小儿病毒性心肌炎的临床疗效。方法将75例病毒性心肌炎患儿随机分为治疗组37例和对照组38例。对照组采用西医常规疗法,治疗组在常规治疗的基础上加用黄芪、参麦注射液。治疗4周后比较2组疗效。结果治疗组患者临床症状（胸闷、心悸、气短、乏力）改善总有效率高于对照组,差异有统计学意义（P〈0．05）;治疗组心电图改善总有效率为62．2％高于对照组的42．1％,差异有统计学意义（P〈0．05）。2组治疗后红细胞沉降率（ESR）、肌酸激酶同工酶（CK-MB）、天冬氨酸氨基转移酶（AST）水平均降低,差异均有统计学意义（P〈0．05或P〈0．01）。治疗组治疗后CK-MB及AST水平均低于对照组,差异均有统计学意义（P〈0．05）。结论参麦注射液联合黄芪注射液辅治小儿病毒性心肌炎,疗效显著,值得推广应用。     

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.