血浆置换治疗重型肝炎时的护理配合

目的探讨人工肝血浆置换(PE)治疗时如何建立血液回路及护理配合要点,为更好地配合人工肝血浆置换治疗提供护理依据.方法采用桡动脉/足背动脉和肘正中静脉临时穿刺建立血液回路,每次治疗置换冰冻新鲜血浆2000～3000ml,对32例患者治疗后临床症状、多项生化指标及有效维护人工肝治疗顺利进行等方面进行重点观察.结果动、静脉临时穿刺建立血液回路可使血流速度达到100～120ml/min,保证了治疗的效果.结论动、静脉临时穿刺既能保证治疗时血流速度,也能有效防止血管内血栓形成和感染的发生.在治疗过程中,临床护理配合起着重要的作用.     

Partially adaptive estimation via the maximum entropy densities

Summary We propose a partially adaptive estimator based on information theoretic maximum entropy estimates of the error distribution. The maximum entropy (maxent) densities have simple yet flexible functional forms to nest most of the mathematical distributions. Unlike the non-parametric fully adaptive estimators, our parametric estimators do not involve choosing a bandwidth or trimming, and only require estimating a small number of nuisance parameters, which is desirable when the sample size is small. Monte Carlo simulations suggest that the proposed estimators fare well with non-normal error distributions. When the errors are normal, the efficiency loss due to redundant nuisance parameters is negligible as the proposed error densities nest the normal. The proposed partially adaptive estimator compares favourably with existing methods, especially when the sample size is small. We apply the estimator to a stochastic frontier model, whose error distribution is usually non-normal.     

醒脑启智胶囊对血管性痴呆小鼠脑组织海马细胞增殖及凋亡的影响

目的:探讨醒脑启智胶囊对小鼠脑组织海马细胞增殖及凋亡的影响.方法:用双侧颈总动脉结扎反复脑缺血再灌注的方法制备血管性痴呆小鼠模型.术后15天进行行为学实验和脑组织的病理形态学观察,并用流式细胞术检测各组海马细胞增殖指数及凋亡率的变化.结果:模型组小鼠学习成绩与记忆成绩下降,各治疗组小鼠的学习成绩与记忆成绩均有提高.光镜下模型组小鼠脑组织海马区呈缺血性病理改变,各治疗组小鼠病变轻于模型组.流式细胞术检测模型组小鼠海马细胞增殖指数及凋亡率明显增高;各用药组均低于模型组.结论:醒脑启智对血管性痴呆小鼠有明显治疗作用,其作用机理可能是抑制海马细胞过度增殖及凋亡.     

我院2002-2003年急诊科用药分析

目的:了解我院急诊科治疗药物的应用情况.方法:采用药物利用分析法对我院急诊科2002-20∞年所用药物的销售金额、品种及应用频度进行分析.结果:2002-2003年急诊科用药的销售金额和用药频度呈增长趋势.结论:急诊科用药结构稳定,用药情况基本合理.     

复方盐酸二甲双胍片在人体内药物动力学和生物等效性研究

目的 建立人血浆中盐酸二甲双胍的反相离子对高效液相色谱和格列本脲的液相色谱-质谱测定方法,研究复方盐酸二甲双胍片(盐酸二甲双胍250mg/格列本脲1.25mg×2片)相对于联合使用的盐酸二甲双胍片(500mg)和格列本脲片(2.5mg)在男性健康志愿者体内的药物动力学行为,评价其生物利用度和生物等效性。方法 采用双交叉随机实验设计:20名受试者交叉口服复方盐酸二甲双胍片2片或口服盐酸二甲双胍片与格列本脲片各1片,服药后于0.5、1.0、1.5、2.0、2.5、3.0、3.5、4.0、5.0、6.0、8.0、12、24、36h分别取血,分离血浆,分别依法测定盐酸二甲双胍和格列本脲的血药浓度。结果 测得口服复方盐酸二甲双胍片或联合使用盐酸二甲双胍片与格列本脲片后,盐酸二甲双胍的达峰时间分别为(2.0±0.7)h和(2.1±0.9)h,峰浓度分别为(1402.4±349.2)μg·L^-1和(1329.7±315.4)μg·L^-1,消除半衰期分别为(3.84±0.61)h和(4.26±0.96)h,AUC_0-24分别为(7292.7±1967.5)μg·L^-1和(7416.2±1843.9)μg·h·L^-1；格列本脲的达峰时间分别为(3.1±0.9)h 和(3.0±0.8)h，峰浓度(71.7±22.7)μg·L^-1和(70.3±20.7)μg·L^-1,消除半衰期分别为(5.05±2.01)h 和(4.78±1.64)h，AUC_0-24分别为(367.6±168.7)μg·L^-1和(352.6±144.7)μg·h·L^-1；以联合服用等剂量的盐酸二甲双胍片与格列本脲片为参比，以AUC_0-24计算得复方盐酸二甲双胍片之盐酸二甲双胍和格列本脲的相对生物利用度，分别为101.1%±28.5%和123.7%±82.9%。结论 建立的分析方法准确灵敏，测得数据可靠。统计学分析表明复方盐酸二甲双胍片与联合使用盐酸二甲双胍片和格列本脲片显生物等效。     

萘哌地尔片治疗111例良性前列腺增生症的疗效分析

目的 评价萘哌地尔(Naftopidil)治疗前列腺增生症(BPH)的有效性和安全性。方法 225例诊断为BPH的病人,随机分为试验组111例和对照组114例。试验组给予萘哌地尔片25mg,每晚口服,42d;对照组给予哈乐胶囊0.2mg,每晚口服,42 d。采用随机、双盲、双模拟、阳性药物平行对照法。最后213例进入统计分析。以国际前列腺症状评分(IPSS)、最大尿流率(Qmax)和平均尿流率(Qave)的变化,作为患者主要疗效指标。以生活质量评分(QOL)、残余尿量、前列腺体积的变化作为患者次要疗效指标。结果 IPSS、Qmax、Qave、QOL治疗前后两组比较差异有统计学意义(P<0.05),治疗后两组间比较差异无统计学意义(P>0.05);残余尿量治疗前后两组间比较差异有统计学意义(P<0.05),前列腺体积治疗前后两组比较及两组间差异均无统计学意义(P>0.05)。试验组不良事件少(3.74%),两组间比较差异无统计学意义(P>0.05)。未出现有临床意义的实验室指标异常。结论 萘哌地尔是治疗BPH的有效和安全的药物。     

续断对成骨细胞增殖、分化、凋亡和细胞周期的影响

在动物实验的基础上,探讨续断对成骨细胞增殖、分化、凋亡、细胞周期和Ⅰ型前胶原αmRNA表达影响.根据文献方法培养大鼠成骨细胞株UMR-106/01,采用3H-Tdr法检测细胞增殖,PNPP法、RIA法、茜素红染色法以及定量RT-PCR法分别检测碱性磷酸酶活性、骨钙素活性、矿化结节形成和Ⅰ型胶原αmRNA的表达,从而了解续断对成骨细胞增殖、分化的影响;FCM法检测细胞周期.结果显示续断中、高剂量能显著促进成骨细胞的增殖、增加碱性磷酸酶的表达及矿化结节形成的数量,促进成骨细胞骨钙素和Ⅰ型前胶原mRNA的表达(P＜0.01,P＜0.05),和雌激素组比较差异无显著性.续断高剂量组细胞增殖率、S期细胞比率和细胞增殖指数等均显著高于空白对照组(P＜0.01,P＜0.05),和雌激素组比较差异也无显著性.细胞凋亡率和G0-G1期细胞比率显著低于空白对照组(P＜0.01,P＜0.05).表明续断能有效促进成骨细胞的分化、增殖,防止成骨细胞凋亡,可能是该药促进骨折愈合、防治骨质疏松的机制之一.     

国产与进口托烷司琼胶囊的人体生物等效性

目的:评价国产和进口托烷司琼胶囊的生物等效性。方法:采用双周期两制剂交叉试验设计,用LC-MS/MS法对国产和进口托烷司琼胶囊在20名中国健康男性受试者中的血药浓度进行测定。药动学参数用ANOVA处理。结果:国产与进口托烷司琼胶囊的AUC0-→t分别为:(543.61±415.55),(547.04±455.59)μg·h·L-1;AUC0→∞分别为(573.30±439.11),(591.77±513.15)μg·h·L-1;cmax为分别(39.13±14.45),(37.44±14.30)μg·L-1;tmax分别为(1.61±0.71),(1.85±0.79)h;T1／2分别为(9.69±4.81),(9.77±5.51)h。国产托烷司琼胶囊的相对生物利用度为(106.47±24.07)％(n=20)。2组参数cmax,AUC0→t经对数转换后,行方差分析和双单侧t检验,均未见统计学意义。结论:托烷司琼国产的制剂与进口制剂具有生物等效性。     

Theoretical analysis of drug release into a finite medium from sphere ensembles with various size and concentration distributions.

Release kinetics for heterogeneous sphere ensembles with a dissolved drug, i.e., initial drug loading below or equal to the drug solubility in the matrix, in a finite external medium was modeled with consideration of heterogeneity among and within spheres. Numerical solutions were obtained using the finite element method for sphere ensemble with normal or log-normal distribution of particle size or initial drug loading among spheres. Exact series solutions were derived for ensembles with various initial loading distributions within spheres, namely linear, quadratic, sigmoidal and uniform distribution, using their mean or average radii. Simplified solutions retaining only one term of the series for non-uniform distributions and three terms for uniform distribution were suggested because of their good approximation to the exact solution. The results of finite element analysis showed that the release rate of an ensemble decreased with increasing standard deviation of particle size. Using weight-average radii in the exact solution gave a prediction of release profile closer to that from the actual size distribution than using mean radii. The three non-uniform loading patterns within spheres all showed reduced initial burst and release rate, leading to more steady release rates than uniform loading, among which the sigmoidal distribution offered the best near-zero order release. Non-uniform initial loading among spheres seemed to have insignificant influence on the release profiles. The volume ratio of liquid to a sphere ensemble played an important role in release kinetics. The derived analytical solutions are applicable to multiple spheres or a single sphere in a finite medium or in a perfect sink.     

Chemical modification of arginine residues of Notechis scutatus scutatus notexin.

Notexin, a presynaptic phospholipase A2 (PLA2) neurotoxin isolated from Notechis scutatus scutatus venom, was inactivated by arginine-specific reagents, phenylglyoxal and 1,2-cyclohexanedione. Kinetic analyses of the modification reaction revealed that the inactivation of notexin followed pseudo-first order kinetics and the loss of PLA2 activity was correlated with the incorporation of one molecule of modification reagent per toxin molecule. However, the results of amino acid analysis and sequence determination revealed that two arginine residues at positions 43 and 79 of notexin were modified simultaneously. Modification of the arginine residues was accompanied with a decrease in the ability to inhibit the indirectly evoked contraction of chick biventer cervicis muscle and bind with synaptic membranes. The secondary structure of the toxin molecule did not significantly change after modification with phenylglyoxal as revealed by the CD spectra. The modified derivative retained its affinity for Ca2+, indicating that the modified arginine residues did not participate in Ca2+ -binding. Together with the notion that Arg-43 and Arg-79 of notexin are located in the proximity of its catalytic site and toxic site, respectively, our results suggest that modification of Arg-43 and Arg-79 should differently contribute to the observed decrease in the PLA2 activity and neurotoxic effect of notexin.