奥扎格雷钠氯化钠(葡萄糖)注射液评价性抽验结果及分析

目的:评价奥扎格雷钠氯化钠注射液和奥扎格雷钠葡萄糖注射液的质量情况。方法:按照国家评价性抽验计划总体要求,采用法定检验方法结合探索性研究对来自5个厂家的53批样品进行检验,统计分析检验结果,并对2种注射液的质量现状进行评价。结果:法定检验显示奥扎格雷钠氯化钠(葡萄糖)注射液样品合格率分别为97.9%、100.0%;探索性研究显示产品中普遍存在两个杂质(杂质Ⅰ和杂质Ⅱ);灭菌工艺对产品质量无影响;渗透压摩尔浓度测定结果均在等渗范围内;细菌内毒素及无菌均符合规定。气-质联用法测定邻苯二甲酸酯类17种增塑剂的含量,样品中均含有微量的DIBP、DBP、DPP,但均在国家限度内。建立聚类分析模型,各厂家样品均能通过验证,并可与其他品种进行区分。结论:2种注射液按各执行标准检验,总体合格率较好,但存在如细菌内毒素限度及无菌检查方法需要规范统一等问题。建议改进并统一现行质量标准,进一步加强对奥扎格雷钠氯化钠(葡萄糖)注射液的监管。     

甲基强的松龙冲击治疗小儿过敏性紫癜的临床观察

目的 探讨甲基强的松龙冲击治疗小儿过敏性紫癜的疗效.方法 将50例小儿过敏性紫癜患儿随机分为治疗组(26例)和对照组(24例).治疗组给予甲基强的松龙15~30mg·kg-1·d-1加入10%葡萄糖液100~200ml,1d内滴入,3d为1个疗程,此后改为强的松1mg·kg-1·d-1口服,逐渐减药至停用.对照组给予琥珀酸氢化考的松5~10mg·kg-1·d-1静脉滴注,连续应用1周后改用相同剂量的强的松口服,逐渐减量至停用.结果 治疗组皮疹、腹痛及消化道症状完全消退,关节症状消退及肾损害恢复时间明显短于对照组(P<0.01).结论 甲基强的松龙冲击治疗过敏性紫癜安全有效,是防止复发和减轻肾脏损害较好的治疗措施.     

护理安全管理在门诊抽血室中应用的效果分析及预防交叉感染的意义

目的:探讨护理安全管理应用于门诊抽血室中的效果及预防交叉感染的意义。方法:选取某院门诊抽血室2017年3月~2018年7月接诊500例患者,随机分为对照组和研究组各250例。对照组实施常规护理管理,研究组患者实施护理安全管理,对比两组防范措施掌握情况与安全防范认知度,比较两组护理不良事件、护患纠纷及医源性感染发生率,同时对比两组护理满意度。结果:研究组防范措施掌握情况、安全防范认知度均高于对照组(P<0.05);研究组护理不良事件、护患纠纷及医源性感染发生率均低于对照组(P<0.05);研究组、对照组护理满意度分别为98.80%、90.40%(P<0.05)。结论:护理安全管理的实施具有重要临床意义,可有效减少护理不良事件的发生,增强患者风险防范意识,预防交叉感染,减少护患纠纷,提高护理满意度,值得临床推广应用。     

优化质量管理在口腔科消毒供应中心的应用

目的 探讨优化质量管理在口腔科消毒供应中心的应用及实施效果.方法 将已经使用过的口腔复用诊疗器械进行椅旁预处理后,集中回收到消毒供应中心,对器械进行程序化的分类、清洗消毒、检查保养、包装、灭菌,加强对诊疗器械清洗质量以及灭菌后湿包率的管理力度.结果 实施质量管理后清洗合格率比实施前提高(90.63％比84.00％,P=O.000 2),无菌物品的湿包发生概率明显降低(3.13％比5.56％,P=0.000 7).结论 优化质量管理能够提升口腔科复用器械的清洗质量和灭菌质量.     

醒脑再造胶囊化痰及对体内阻塞性血栓形成影响试验

目的 观察醒脑再造胶囊化痰及抗血栓的作用.方法 采用小鼠酚红排泄量观察醒脑再造胶囊化痰作用,采用结扎大鼠下腔静脉造成血液回流阻塞观察醒脑再造胶囊抗血栓作用.结果 醒脑再造胶囊可抑制小鼠呼吸道酚红排泄量（P ＜ 0.05）;降低大鼠血管阻塞形成的血栓湿重（P ＜ 0.05）.结论 醒脑再造胶囊有化痰和抗血栓形成作用.     

儿科应用氨基糖苷类抗菌药物研究进展

目的：了解我院儿童药品不良反应（ADR）的规律及特点。方法：采用回顾性分析方法,统计我院2017-2018年收集的348例儿童ADR报告,分别从患儿性别与年龄、药品种类、发生时间、ADR累及系统/器官分布、临床转归等方面进行Pareto最优分析。结果：348例儿童ADR中,1~12岁患儿累计构成比为77.59%（A类因素）,抗感染药、心血管系统药、呼吸系统及抗肿瘤药引起的ADR累计构成比为77.87%（A类因素）;涉及的抗感染药主要为头孢菌素和大环内酯类（65.22%）,药品剂型主要为注射剂及粉针剂（77.59%）,给药途径主要为静脉滴注（67.24%）,发生ADR时间主要为用药后2 d内（79.60%）,累及系统/器官主要为皮肤及其附件和胃肠系统（77.78%）;临床转归主要为好转（62.07%）。结论：我院儿童ADR涉及的药品种类主要为抗感染药、心血管系统药、呼吸系统及抗肿瘤药,主要表现为皮肤及其附件损害和胃肠系统紊乱。在ADR监测时应重点关注1~12岁儿童,同时应掌握合理的用药方式、强化监护环节,尽可能减少ADR的发生,以确保儿童临床用药安全、有效。     

裸花紫珠总黄酮的抗炎、止血作用研究

目的探讨裸花紫珠总黄酮的抗炎、止血作用。方法通过二甲苯致小鼠耳廓肿胀,观察裸花紫珠总黄酮的抗炎作用;采用玻片法及小鼠断尾法观察裸花紫珠总黄酮对小鼠凝血、出血时间的影响。结果裸花紫珠总黄酮能明显抑制二甲苯所致小鼠耳廓肿胀,能明显缩短小鼠断尾出血时间和凝血时间。结论裸花紫珠总黄酮具有抗炎、止血作用。     

驻景丸加减方对形觉剥夺性近视小鼠视网膜自噬的影响

目的:探讨驻景丸加减方对形觉剥夺性近视小鼠视网膜自噬的影响。方法:C57BL/6小鼠30只随机分为阴性对照组、近视模型组以及中药干预组,每组10只。除了阴性对照组外,近视模型组、中药干预组小鼠均使用半透明EP管遮盖右眼制成形觉剥夺性近视(FDM)模型;中药干预组灌胃驻景丸加减方混悬液0.546g/(kg·d)(0.15mL/d),阴性对照组、近视模型组灌胃等量生理盐水(0.15mL/d),共4wk。分别于实验开始、实验结束,使用带状检影镜测量小鼠右眼屈光度,A超测量小鼠右眼眼轴长度。实验结束时,取所有小鼠右眼进行检测,免疫荧光法定位和检测视网膜小胶质细胞标志物(Iba1)活性与迁移;透射电镜观察视网膜色素上皮细胞中自噬小体形成情况;Western Blot、实时荧光定量PCR(q-PCR)检测视网膜组织自噬标志物LC3Ⅱ和p62蛋白定量及基因表达情况。结果:实验结束时小鼠右眼屈光度示,近视模型组、中药干预组形成相对近视,近视模型组、中药干预组较阴性对照组显著降低(均P<0.01)。实验结束时,近视模型组、中药干预组眼轴长度较阴性对照组眼轴长度显著增加(P<0.01)。免疫荧...     

Value of combined detection of serum amyloid A,C-reactive protein and procalcitonin in differential diagnosis of respiratory tract infection in children of China

ObjectiveTo explore the diagnostic value of combined detection of serum amyloid A (SAA), C-reactive protein (CRP) and procalcitonin (PCT) in children with bacteria or non-bacterial respiratory tract infection.Methods200 children with respiratory tract infections diagnosed in our hospital were included in the study. According to the results of the aetiological examination, they were divided into bacterial infection group and non-bacterial infection group. At the same time, 100 healthy children admitted to the hospital for physical examination during the same period were selected as the healthy subjects control group. Changes in serum SAA, PCT and CRP in three groups were compared. Comparison of a positive rate of the single index and combined detection were performed. Children with bacterial infections were treated with conventional antibiotics. The changes in serum SAA, PCT and CRP in the infection group before and after treatment were compared. The efficacy of SAA, PCT and CRP alone and in combination was compared.ResultsThe serum SAA, PCT and CRP levels in the bacterial infection group were higher than those in the non-bacterial infection group and healthy children, and the differences were statistically significant. The positive detection rates and combined detection rates of serum SAA, PCT and CRP in the bacterial infection group were higher than those in the non-bacterial infection group and the healthy subject''s control group. After conventional antibiotic treatment, serum SAA, PCT and CR levels in children with bacterial infection were significantly decreased.ConclusionThe combined detection based on SAA, CRP and PCT can effectively identify and diagnose respiratory tract infection in children, providing a certain reference for the promotion of the diagnostic scheme.

Key messages

• Serum SAA, PCT and CRP were highly expressed in children with respiratory tract infection, and the expression level was the highest in children with bacterial pneumonia.
• The combined detection of serum SAA, CRP and PCT indicators have higher diagnostic efficiency and can effectively make a differential diagnosis of respiratory tract infection in children.

     

EGFR mutation types and abundance were associated with the overall survival of advanced lung adenocarcinoma patients receiving first-line tyrosine kinase inhibitors

BackgroundEpidermal growth factor receptor tyrosine kinases inhibitors (EGFR-TKIs) are currently recognized as the standard treatment for advanced non-small cell lung cancer (NSCLC) patients with EGFR mutations. Clinically found patients with different EGFR mutational status have different prognosis.MethodsA retrospective cohort study was performed to explore the relationship between EGFR mutations and abundance with patient survival by using patient data from the Affiliated Cancer Hospital of Zhengzhou University between January 2013 and November 2016. All patients involved in the present study had sensitive EGFR mutations [either exon 19 deletion (DEL) or exon 21 L858R] and treated by EGFR-TKIs. They were followed up every three months until lost or dead. Mutation abundance was calculated as the copies of EGFR mutation divided by copies of EGFR locus, and the cut-off values for 19DEL and L858R were 4.9% and 9.5%, respectively.ResultsTotal of 236 patients were included, comprising 116 (49.2%) patients with 19DEL mutation and 120 (50.8%) patients with L858R mutation. The median follow-up duration was 23.2 months (95% CI: 14.9–26.7 months). Overall survival (OS) was significantly longer in patients with 19DEL mutation (20.9 months, 95% CI: 17.7–24.1 months versus 17.0 months, 95% CI: 14.4–19.6 months in patients with L858R; P=0.008) and in patients with high mutation abundance (20.9 months, 95% CI: 18.3–23.5 months versus 13.0 months, 95% CI: 10.3–15.7 months in patients with low mutation abundance; P<0.001). Multivariate Cox regression including age, performance status and tumor stage revealed that longer OS was independently associated with 19DEL mutation (HR: 0.48, 95% CI: 0.39–0.67, P=0.033) and high mutation abundance (HR: 0.62, 95% CI: 0.50–0.79, P=0.027).ConclusionsEGFR mutation types and abundance was associated with the patients’ survival which might be used to predict the efficacy of targeted therapy by EGFR-TKIs.