武汉市海洛因依赖患者美沙酮维持治疗剂量的影响因素

目的 分析武汉市海洛因依赖患者美沙酮维持治疗（Methadone Maintenance Treatment, MMT）剂量的影响因素。方法 武汉市3所MMT门诊的549例海洛因依赖患者完成社会人口学特征和临床特征问卷,并收集其MMT剂量、计算BMI指数和用5点口述分级评分法测量患者的疼痛强度。结果 MMT门诊海洛因依赖患者的MMT剂量为（70.4±29.2）mg/d,高MMT剂量（≥60mg/d）患者占比59%。多因素线性回归分析结果显示,年龄20~39岁、BMI正常、BMI超重及肥胖、人际关系一般/差、注射吸毒、吸毒时间>10年、焦虑和疼痛患者的MMT剂量水平较高。结论 武汉市MMT门诊的海洛因依赖患者MMT剂量相对较高。需综合考虑患者的社会人口学、临床和心理因素特征以确定MMT剂量。     

中药用量对临床疗效的影响

笔者通过刻苦学习中医经典和名医经验,结合多年临床实践,致力探讨中医临证时遣方用药剂量对疾病疗效的影响。认识到只有通过长期临床实践,审证准确,立法精当,才能在处方用药时,做到得心应手,恰到好处,药到病除。而认真探究、正确对待药物剂量与疗效的关系,既能结合病情,灵活变通,合理用药,提高疗效,也有益于纠正盲目强调必用大量中药才能治病的思潮。     

《伤寒论》竹叶石膏汤“竹叶二把”考辨

仲景原方中竹叶剂量以"二把"来描述为模糊剂量,本研究拟在采用文献考证竹叶药物品种的基础上,依据语言学知识、临床实际和竹叶的形状进一步探讨名量词"把"的含义,对竹叶石膏汤中"竹叶二把"进行药物实测研究。研究得出,张仲景竹叶石膏汤中竹叶当属竹亚科,并通过抓取竹叶实测,结合现代方剂学剂量,本课题组推荐"竹叶二把"剂量为10g。     

Advances in oral transmucosal drug delivery

The successful delivery of drugs across the oral mucosa represents a continuing challenge, as well as a great opportunity. Oral transmucosal delivery, especially buccal and sublingual delivery, has progressed far beyond the use of traditional dosage forms with novel approaches emerging continuously. This review highlights the physiological challenges as well as the advances and opportunities for buccal/sublingual drug delivery. Particular attention is given to new approaches which can extend dosage form retention time or can be engineered to deliver complex molecules such as proteins and peptides. The review will also discuss the physiology and local environment of the oral cavity in vivo and how this relates to the performance of transmucosal delivery systems.     

Contextualism adds realism: nursing students' perceptions of and performance in numeracy skills tests

This project investigated nursing students' perceptions of and performance in a de-contextualised diagnostic maths paper (i.e. questions only) and a contextualised diagnostic maths paper (i.e. visual pictures along with questions). Sampling was purposive, the criteria being that participants would be from the population of student nurses (n=700) in their second year, of a three-year Bachelor of Nursing course, undertaking a Unit 'Medical-Surgical Nursing 1' (MSN1) at one of four campuses across the University of Western Sydney (UWS), NSW, Australia. The numerical test scores for both papers were analysed with the assistance of SPSS software and a Professional Development Officer. The survey data were analysed manually and thematically by the researcher. There was a substantive improvement in scores from Test 1 (de-contextualised) to Test 2 (contextualised). It is uncertain whether the change occurred because Test 2 is a genuinely better presentation than Test 1 or just a practice effect. Nevertheless, the contextualised paper was preferred by the majority of students (80%). Students preferred the visual images and revealed that it led to a "deeper learning" of numeracy skills, reduced stress and anxiety levels and simulated 'the real life' clinical setting, thus adding "an element of realism" to the situation.     

某三甲医院呼吸科药物使用情况调查分析

目的了解我院呼吸内科用药的情况,为医院药品管理和临床合理用药提供依据。方法调查我院医院697例呼吸内科病人的基本用药情况,用DDD分析法和消耗金额统计法,分析用药频率和药物费用。结果在调查统计的697份病例中男性多于女性,年龄以51～60岁居多;DDDs排序前3位的药物为左氧氟沙星、氨溴索、美洛西林钠舒巴坦;药物总费用占总住院费的63.77%,抗微生物药物销售金额占药品总销售金额的46.78%;Ⅱ联用药占药物联用的47.33%。结论我院呼吸内科用药基本合理,头孢菌素类药物在抗微生物药物的临床使用中占主导地位,随着抗生素的大量使用,细菌耐药性不断发展,应严格按照《抗菌药物临床应用指导原则》合理使用。     

LA45医用高能加速器测试场所辐射安全评价

目的 为了评价LA45医用高能加速器测试场所是否符合辐射安全评价要求,估算了其对工作人员和公众年受照剂量,依据相关标准,进行评价。方法 基于NCRP151号报告剂量估算模式计算了高能加速器测试产生的X射线、电子束、中子等不同种类射线产生的辐照剂量。结果 结果表明该场所的辐射防护设施屏蔽和防护效果可以有效保障工作人员和公众的辐射安全。结论 医用高能加速器在我国的使用尚属起步阶段,随着射线能量的提高,其存在的辐射风险也逐渐增大,本文提供的高能加速器辐射安全评价方法,为工作人员和公众的辐照安全提供了技术参考。     

吡喹酮制剂的发展和应用

吡喹酮是临床有效治疗血吸虫病的首选药物, 然而其生物利用度低、 剂型单一、 对童虫作用不明显等缺点, 限制了其发挥最大效用。本文针对吡喹酮性质及药代动力学特点, 并结合现有吡喹酮新型制剂的研究进展做一综述, 为充分发挥吡喹酮的抗血吸虫作用以及吡喹酮新制剂的研究开发提供参考及借鉴。