生脉注射液物质组成、临床前药动学和药效学的研究进展

生脉注射液(Shengmai Injection,SMI)是由红参、麦冬和五味子3味中药组成的中药复方制剂,在临床上除了广泛用于治疗心血管系统疾病外,还用于抗肺病、癌症化疗等的辅助治疗。近年来,SMI的临床前基础研究日渐广泛,主要包括SMI的化学成分、体内过程和作用机制等,为揭示该方的药效物质基础提供了一定的科学依据。综述了该方的物质组成、临床前药动学和药效学研究,以期为SMI的质量控制、产品二次开发和临床合理应用提供参考。     

PERINATAL FETAL WELL-BEING MONITORING: A COMPARISON BETWEEN RANDOMIZED URINARY ESTRIOL/CREATININE AND SERUM FREE ESTRIOL DETERMINATION

Randomized urinary and blood samples were obtained from three hundred and ninety-two cases of late pregnancies simultaneously for comparison of the validity in perinatal fetal monitoring. The results of randomized urinary estriol/creatinine (RUE_3/C) and serum free estriol (SFE_3) tests revealed that Ⅰ. The coefficient of correlation between RUE_3/C and SFE_3 level were close in either normal or high-risk pregnancies (y=0.1477X+14.2368, r=0.4586, n=170; y=0.1724X+8.6698, r=0.5868, n=222, respectively, P<0.001); 2.92%cases of the false positive rate of RUE_3/C were corrected by SFE_3 test. In cases of pregnancy-induced hypertension (PIH) the false positive rate of RUE_3/C were highest in comparison with those in cuses of other high-risk pregnancies (53.6%); 3. The correct rate of SFE_3 test in prenatal predication of fetal well-being was significantly higher (95.6%) than that of RUE_3/C (87.3%) (X~2=17.77, P<0.001). This paper suggests that RUE_3/C can be used as a first line test for perinatal monitoring. When RUE_3/C value is lower than normal, SFE_3 test should be added to ensure the reliability of perinatal diagnosis, especially in PIH cases. Obviously, to use these two tests for perinatal fetal monitoring simultaneously is better than to use any one test alone.     

基于深度学习的智能处方审核系统探讨

目的：建立基于深度学习的智能处方审核系统，规范开药流程，减少患者开支，节省医院人力。方法：运用深 度学习的方法，提出医院智能化处方审核系统方案，将处方结果提交医生作为处方开具参考。结果：经过智能化处方 审核系统后，门诊处方开具合格率提高 5.17%，较之前合格率出现明显改善。结论：智能化审核系统有助于医院的处方 合理性的提高，基于更大样本和更多种类的处方样本有待于进一步验证。     

左炔诺孕酮硅胶棒应用者子代细胞遗传学研究

目的 :通过对左炔诺孕酮硅胶棒 ( 6根型 )埋植剂应用者子代细胞遗传学指标的检测 ,以期对避孕埋植剂的长期安全性提供依据。方法 :在同一地区随机选择 50名埋植 4年、取药 1年后妊娠夫妇的子代为实验组 ,选择 49名正常夫妇的子代为对照组。静脉采血检测染色体畸变、姊妹染色单体交换 ( SCE)、细胞微核的发生率。结果 :实验组染色体畸变率、SCE频率、细胞微核率平均值与对照组比较 ,均无显著差异 ( P>0 .0 5)。结论 :长期使用左炔诺孕酮硅胶棒 ( 6根型 )对子代不产生潜在的细胞遗传学损伤效应。     

A NEW TEST IN ANTENATAL MONITORING-THE EVALUATION OF SALIVARY UNCONJUGATED ESTRIOL MEASUREMENT

A new unconjugated saliva estriol (SE_3) determination by radioimmunoassay(~3H-E_3) was used to monitor 497 fetuses of late pregnancies, including 280 high-risk and217 normal pregnant women. The normal pregnant SE_3 values had been established by themeasurement of 1378 cases from 20 to 41 weeks of gestation. The results of SE_3 assaysrevealed that 1. In prenatal prediction of fetal well-being, the total false negative andfalse positive rates were 2.0% and 0.6%, respectively, the correct rate which was similarto that of serum free E_3 (SFE_3) values was 97.4%, and was significantly higher thanthat of overnight 12-hour urine E_3/C analyses as formerly reported. 2. There were 8 fetaldeathe in 11 cases with low SE_3 levels. No perinatal death occurred in the 486 cases withnormal SE_3 values, except one fetus who died of nuchal cord strangulation. It is highlyimportant that the saliva specimen be correctly collected and the technique ofmeasurement of SE_3 be carefully carried out. Our observations suggest that the clinicaluse of SE_3 assays are scientific, reliable, and it is more practicable than that of SFE3 as-says. The determination of SFE_3 can be replaced by SE_3 test for assessing fetal-placentalwell-being.     

临床药师运用PDCA循环法对内分泌科患者抗菌药物的合理性使用与管理的实践研究

目的：探究PDCA循环管理的运用对降低住院患者抗菌药物使用率、使用强度及联合用药的影响,为临床合理使用抗菌药物提供参考。方法：运用PDCA循环法对内分泌科住院患者抗菌药物的使用进行干预,利用医院HIS信息系统回顾性抽取邵阳学院附属第二医院内分泌科（2019-2021年）住院患者的抗菌药物使用率、抗菌药物使用强度、联合使用抗菌药物人数占比、住院患者平均使用抗菌药物疗程等,在临床药师干预跟踪后,对抗菌药物的使用数据进行对比。结果：经过PDCA循环管理后,内分泌科室住院患者的抗菌药物使用率从实施前（2019年）的41.17%,经干预后下降至（2021年）39.17%;使用强度从实施前的43.76 DDDs,经干预后下降至32.07 DDDs;抗菌药物联合使用人数占比从干预前的41.97%,下降至干预后的24.73%;人均使用抗菌药物天数从实施前的21.17天,经干预后下降至17.17天;以上数据干预前后差异均具有统计学意义（P<0.05）。结论：应用PDCA循环法对患者的用药进行管控可降低患者抗菌药物使用率、使用强度,减少抗菌药物的联用,缩短使用疗程,PDCA循环法的干预有利于抗菌药物...     

高职高专药学专业基于工作过程的药剂学实训师资培训探讨

从高职高专实训教师培训的现状、内容、方法及培训保障系统建设等方面探索高职基于工作过程药剂学实训教师培训工作改革。     

尼莫地平治疗高血压性脑出血疗效分析

目的:探讨尼莫地平治疗高血压性脑出血的临床疗效。方法:选择高血压性脑出血患者80例随机分为观察组与对照组各40例,对照组给予传统治疗如降低颅内压、卧床休息、抗感染等对症处理,观察组在对照组基础上加用尼莫地平治疗。结果:两组患者治疗效果比较,观察组有效率为95.0%(38/40),显著高于对照组的72.5%(29/40)(P<0.01)。两组患者血肿量与水肿面积较治疗前比较均显著改善(P<0.01),观察组改善显著优于对照组(P<0.01)。结论:尼莫地平可有效缩小脑出血血肿体积,减轻血肿周围水肿带,促进神经功能的恢复,提高临床疗效,值得临床推广。     

神经内镜经鼻蝶垂体腺瘤日间手术12例临床分析

目的 探讨神经内镜经鼻蝶垂体腺瘤日间手术的安全性及可行性。方法 回顾性分析2017年4月至2017年5月收治的12例垂体腺瘤日间手术的 临床资料。制定垂体腺瘤日间手术流程,所有病人均知情同意,经过严格的术前评估、微创手术、围手术期管理、出院标准、随访等环节,术后按照 日间手术模式治疗和护理。结果 12例,11例完成日间手术,1例脱落。11例日间手术平均手术时间80 min;住院时间30~34 h,平均32.5 h;术后住 院时间5~8 h,平均6 h。11例均密切随访至出院后第7 d,未出现发热、尿崩、脑脊液漏等并发症;无再入院、再手术病例。结论 通过规范神经内镜 经鼻蝶垂体腺瘤日间手术流程,进行垂体腺瘤日间手术安全可行,并能够达到加快床位周转、缩短住院时间的目的。