某三甲医院处方前置审核系统运行效果研究

目的：应用处方前置审核系统实现门诊处方收费和调剂之前对其适宜性进行审核,优化工作流程,促进合理用药。方法：汇总芜湖市第二人民医院2020年1月至2020年12月处方前置审核系统的门诊干预数据,对干预结果进行描述分析。另分别抽查2019和2020下半年各6个月处方进行点评,比较系统运行前后处方合格率变化等。结果：处方前置审核系统上线后第1年共审核处方580556张,日均审核 1587张;拦截处方25497张,日均70张;干预后医师修改处方13736张,有效干预率为53.87%。与之前相比,处方前置审核系统运行后,全院处方合格率逐月升高,至2020年12月,处方合格率为99.01%。结论：院门诊处方前置审核系统工作模式切实可行,可提高医院处方安全性,促进临床合理用药。     

Effects of essential oil from Croton tiglium L. on intestinal transit in mice

AIM OF THE STUDY: Croton tiglium (Croton tiglium L., Euphorbiaceae) is widely used as a herb for treatment of gastrointestinal disturbances. Previous studies established its purgative and inflammational properties. The present study aimed to investigate the effects of Croton tiglium oil (CO) on intestinal transit in mice. MATERIALS AND METHODS: Gastrointestinal transit in mice and contractile characteristics of isolated intestinal strips from mice were evaluated. Intestinal inflammation was confirmed by histological examination. RESULTS: Low dose of CO increased the gastrointestinal transit of charcoal and barium meal as well as the production of fecal pellets in mice. In contrast, high dose exerted inhibitory effects. For normal colonic circular strips, both high and low dose of CO inhibited the contractile frequency. Low doses (0-20 microg/ml) of CO enhanced the phasic contractions, while high doses (>40 microg/ml) reduced them. Colonic longitudinal strips in CO-treated mice were less sensitive to electrical field stimulation than those in control mice. The contraction of colonic longitudinal, colonic and jejunal circular strips in CO-treated mice was more sensitive to atropine than that in control mice. CONCLUSIONS: CO might modulate gastrointestinal motility and induce intestinal inflammation related to immunological milieu and motor activity. Our findings may highlight the ethno-medical uses of Croton tiglium on intestinal disorders.     

医药信息服务工具在临床医药人员中的应用状况分析

基于临床医药人员关注的专业信息的内容、目的和渠道等特点,介绍医药信息服务工具在我国的应用现状,分析临床医药人员对于信息服务工具的期望和需求.     

家庭无创通气对慢性肺心病肺动脉高压的影响

目的探讨家庭无创机械通气对慢性肺源性心脏病（简称慢性肺心病）肺动脉高压的影响。方法慢性肺源性心脏病代偿期患者60例,随机分成治疗组30例（家庭无创机械通气联合常规治疗12周）和常规组30例（常规治疗12周）,测定治疗前后患者血浆ET-1、NO水平、血气变化及肺动脉压力等。结果①治疗组患者血浆NO水平明显升高（P<0.05）、血浆ET-1水平明显下降（P<0.05）。②治疗组肺动脉压、PaCO₂明显下降（P<0.05）,PaO₂明显升高（P<0.05）。③血浆NO水平变化与肺动脉压、PaCO₂呈负相关,与PaO₂呈正相关;血浆ET-1与肺动脉压、PaCO₂呈正相关,与PaO₂呈负相关。结论家庭无创机械通气治疗是慢性肺心病失代偿期患者肺动脉高压的重要治疗措施。     

柴胡功效的历史演变与入药品种及药用部位的相互关系

目的:探析柴胡功效演变与入药品种及入药部位间的关系。方法:通过梳理历代文献,总结柴胡功效的演变,并分析其与柴胡入药品种及入药部位间的关系。结果:《神农本草经》时期应用的柴胡品种已不可考。唐代以后,狭叶柴胡、银州柴胡被认为是柴胡上品,而银柴胡在很长一段时期内亦被当做上品柴胡应用,这有可能成为柴胡出现"补虚劳"功效描述的原因。古来柴胡皆以根入药,清末以来,在长江一线逐流行以全草或地上部分入药。同时期兴起的"柴胡劫肝阴"之说或许与入药部位的改变而造成的有效成分改变有关,但仍需进一步的实验研究。结论:历代对柴胡功效认识的不统一,有可能是不同时期内应用柴胡的品种及入药部位不同造成的。     

西洋参茎叶皂苷对脑缺血大鼠细胞凋亡及caspase-3表达的影响

目的：研究西洋参茎叶皂苷对大鼠局灶性脑缺血损伤的保护作用及其机制。方法：采用大鼠大脑中动脉内栓线阻断法制备局灶性脑缺血损伤模型，通过HE染色、TUNEL、免疫组化及RT—PCR等方法，观察西洋参茎叶皂苷对脑缺血损伤大鼠脑组织形态学改变，细胞凋亡及半胱氨酸天冬氨酸蛋白酶（caspase）-3mRNA和蛋白表达的影响。结果：西洋参茎叶皂苷（100、50mg／kg，ig）均可明显改善脑缺血损伤所致的大鼠脑组织病理形态学改变，抑制神经细胞凋亡，降低促凋亡基因caspase-3mRNA和caspase-3蛋白的表达。结论：西洋参茎叶皂苷对大鼠局灶性脑缺血损伤具有保护作用，其作用机制可能与抑制caspase-3表达有关。     

中药注射剂安全性医院集中监测研究数据管理内容与要点

按照中药注射剂安全性再评价相关要求,中药注射剂安全性医院集中监测研究陆续展开。安全性集中监测研究属于大规模真实世界研究,涉及到大量数据的采集、传递、核查和分析。数据采集和数据核查的质量,直接影响数据分析和研究结果的真实性和可靠性。因此,数据管理是中药注射剂安全性集中监测研究的重要环节。在分析前期相关研究的基础上,结合项目实施的经验和体会,本文探讨了中药注射剂安全性集中监测研究数据管理实施内容、环节及常出现的问题及相应的解决方法。     

Comparison of the safety and prognosis of sequential regorafenib after sorafenib and lenvatinib treatment failure in patients with unresectable hepatocellular carcinoma: a retrospective cohort study

BackgroundThere is lack of studies on sequential regorafenib after sorafenib and lenvatinib treatment failure in patients with unresectable hepatocellular carcinoma (HCC). This study was to explore the safety and prognosis of sequential regorafenib after sorafenib and lenvatinib failure in HCC patients.MethodsThis study was a retrospective, real-world study that included 50 HCC patients who received sequential regrafinib after sorafenib and lenvatinib failure. The safety and prognosis of two groups were compared.ResultsThe incidence of all grade and III/IV adverse events were 68% and 24%. According to Response Evaluation Criteria in Solid Tumours (RECIST) 1.1 and modified (m) RECIST standards, the objective response rates (ORRs) after receiving regorafenib were 14.0% and 22.0%, respectively. The disease control rates (DCRs) were 62.0% and 60.0%, respectively. Based on different first-line targeted drugs, 50 patients were divided into sorafenib (n=22) and lenvatinib group (n=28). There was no differences between two groups except age and bilirubin. And there was no differences in other treatments before or after regorafenib. The baseline between two groups was basically same and had good comparability. There was no difference in incidence of all grade and III/IV adverse events, ORR and DCR between two groups (P>0.05). On long-term prognosis, total overall survival (TOS) in sorafenib and lenvatinib group were 23.0 (95% CI: 15.1–30.9) vs. 29.7 (95% CI: 21.4–38.1) months. The difference was statistically significant (P=0.041). Besides, regorafenib overall survival (ROS) in sorafenib and lenvatinib group were 11.7 (95% CI: 7.1–16.3) vs. 15.9 (95% CI: 8.3–23.5) months. The difference was statistically significant ( P=0.045). The regorafenib progression-free survival (RPFS) was 5.6 (95% CI: 1.9–9.2) vs. 8.0 (95% CI: 5.1–10.9) months in sorafenib and lenvatinib group, respectively, and difference was not statistically significant (P=0.380).ConclusionsRegorafenib is an effective drug for second-line treatment of HCC, with fewer severe adverse events, ORR and DCR was 14–22% and 62–60%, respectively. Both TOS and ROS in lenvatinib group were better than those in sorafenib group. For HCC patients whose first-line targeted drug is lenvatinib, it is safe and effective to accept regorafenib after disease progresses.     

hs-CRP在急性脑梗死患者动态水平及预后的临床意义

目的：观察超敏C-反应蛋白（hs-CRP）在脑梗死患者的动态水平与其病情预示作用,了解hs-CRP同脑梗死患者病情关系。方法：收集126例脑梗死患者发病后72h内,第（4—7）d和第14d的血清进行超敏免疫比浊法测定hs-CRP。应用美国国立卫生研究院卒中量表（NIHSS）及Barthel指数（BI）记分法测定神经功能缺损评分。结果：脑梗死后72h血清hs-CRP浓度即开始升高,1周左右达高峰,至14d时接近对照组水平,并发多脏器功能衰竭者CRP水平最高。结论：hs—CRP是判断脑梗死病情轻重和预后的特异性指标,适时终止或减轻炎症反应损害,可以降低脑梗死的病死率及并发多脏器衰竭的危险。     

紫草素抑制胃癌细胞增殖、黏附及诱导凋亡

目的探讨异紫草素AJ-7及其衍生物AJ-9、AJ-5和AJ-8对人胃癌细胞SGC 7901增殖及黏附的抑制作用,以及凋亡诱导作用。方法应用MTT比色法检测新疆紫草素对细胞的增殖、黏附抑制作用,用流式细胞术(FCM)、Annexin-V-FITC联合法及透射电镜检测新疆紫草素对胃癌细胞的凋亡诱导效应。结果新疆紫草素能够抑制胃癌细胞的增殖,并呈浓度时间依赖性。FCM出现明显的亚二倍体峰并将细胞阻滞于G1期,Annexin-V-FITC联合法染色可见细胞凋亡的特征性贯穿胞质穿过胞膜的红色颗粒,电镜下可见染色质边集及生发小体的凋亡形态特征。结论新疆紫草素能够有效抑制胃癌细胞的增殖、黏附,并诱导凋亡。