透析前注射单剂量低分子量肝素对透析器复用效率的评价

目的 评价血透前注射单剂量低分子量肝素（LMWH）与持续输注普通肝素（SH）对复用透析器效率的影响。方法 对30例慢性透析患者进行随机交叉对照研究,观察第1、4次透析的透析器纤维包裹容量（FBV）、透析前血球压积（HCT）及透析2h尿素氮、肌酐清除率;另外,利用生色底物法测定透析0h,2h,4h血浆肝素抗－Fxa水平。结果 同SH组比,LMWH组透析器复用次数增加（P＜0．05）,第4次复用透析器FBV及透析2h尿素氮、肌酐清除率无下降（P＞0．05）,SH组则下降（P＜0．05）,透析2h两组血浆肝素活性－Fxa水平差异无显著性（P＞0．05）,透析4hLWMH组高于SH组（P＜0．05）。结论 透析前单剂量注射LMWH能有效地保护复用透析器清除率,值得临床上进一步推广。     

IL-2联合吡柔比星膀胱灌注预防膀胱癌复发

目的：探讨生物制剂联合化疗药物膀胱灌注预防膀胱癌术后复发的机制。方法：对比研究白细胞介素2（IL－2）和吡柔比星联合膀胱灌注与单用吡柔比星膀胱灌注前后患者血、尿肿瘤坏死因子（TNF）和血IL－2受体的动态变化。结果：联合膀胱灌注组的TNF和IL－2受体水平显著高于吡柔比星组（P＜0．01）。结论：联合灌注组机体的细胞免疫功能得到更好改善,IL－2增加肿瘤细胞对免疫反应的应答,两者间有免疫促进及协同作用。     

简论激励在学校管理中的运用

激励在学校管理中具有十分重要的意义。目标激励、物质激励、精神激励、榜样激励是学校管理中经常运用的激励方法。适时、适度 ,公平、公正 ,物质与精神并重 ,是学校管理中必须坚持的科学的激励原则     

病毒唑雾化吸入治疗上呼吸道感染40例

目的　探讨病毒唑雾化吸入在上呼吸道感染中的疗效。方法　治疗组 4 0例 ,应用病毒唑 15mg/kg雾化吸入 ,15min吸完 ;。对照组 4 0例静脉滴注病毒唑。 结果　治疗组治愈率为 95% ,对照组为 6 3.2 % ,两组差异明显 (P <0 .0 5)。结论　静脉滴注到达呼吸道剂量较少 ,超声雾化可使吸入 70 %药物直接分布于呼吸道表面 ,且无副作用。     

Injecting nation: achieving control of hepatitis C in Australia

Since Australia banned heroin in 1953 consumption of illicit drugs, deaths, crime and corruption related to drugs have steadily increased. Injecting drug use (IDU) in Australia is now a significant public health problem linked each year to approximately 500 overdose deaths and more than 6000 hepatitis C infections. At least 85% of prevalent and incident hepatitis C cases in Australia are injecting drug users (IDUs) with annual incidence estimated at 15%. Although poorly documented, increasing numbers of patients with end-stage liver disease from hepatitis C now appear to present in Australia. This reflects a heroin-injecting epidemic commencing a quarter of a century ago, the close association between drug injecting and hepatitis C and the long delay between hepatitis C infection and complications. The overall health and economic burden of hepatitis C may soon exceed HIV. Control is far more difficult to achieve for hepatitis C than HIV because of much higher baseline prevalence levels and far greater infectiousness by blood to blood spread. Transmission appears to follow minimal breaches of infection control guidelines. Hepatitis C has not yet become a priority public health issue in Australia. No national prevention strategy has been proposed. Prevention strategies (such as needle exchange or methadone) which controlled HIV among IDUs should be expanded, with the expectation of some useful reduction of spread but without achieving control of hepatitis C. Other options for control must be considered. Eradicating illicit drug use in Australia is unachievable. Virtually eradicating injecting drug use by facilitating a switch to non-injecting routes of administration (NIROA) is achievable (although difficult) and this could control hepatitis C. NIROA will have the probable additional benefit of reducing drug overdose deaths. NIROA has begun recently to replace injecting in several countries without government intervention. Powerful cultural, pharmacological and economic factors strongly reinforce drug injecting. Economic impediments to NIROA could be reduced by drug policy reform. Facilitating a switch to NIROA carries some risk of increased discrimination directed against an already marginalized population. A major obstacle to harm reduction is the common assumption that any relaxation of drug policy invariably leads to increased consumption. Switching the predominant route of administration of illicit drugs from IDU to NIROA should be the major focus of national efforts to control hepatitis C and overdose deaths in Australia.     

Pharmacokinetic and Pharmacological Profiles of Free and Liposomal Recombinant Human Erythropoietin After Intravenous and Subcutaneous Administrations in Rats

Purpose. Recombinant human erythropoietin (Epo) is used frequently through intravenous (i.v.) and subcutaneous (s.c.) administration for the clinical treatment of the last stage of renal anemia. We encapsulated Epo in liposomes to develop an alternative administration route. The purpose of our study was to evaluate the pharmacokinetics and the pharmacological effects of liposomal Epo in comparison with the Epo after i.v. and s.c. administration to rats. Methods. Epo was encapsulated in liposomes composed of dipalmitoylphosphatidylcholine (DPPC) and soybean-derived sterol mixture (SS) prepared by the reversed-phase evaporation vesicle method. After filtration through a 0.1 m polycarbonate membrane, liposomes were gel filtered (Epo/liposomes). Results. Epo/liposomes showed higher pharmacological activity than Epo/liposomes before gel filtration after i.v. administration to rats. Non-encapsulated Epo lost its activity, whereas encapsulated Epo in liposomes retained it. The pharmacological effects of Epo/liposomes were greater than those of Epo after i.v. administration. Epo/liposomes afforded 3–9 times higher AUC, lower clearance and lower steady-state volume of distribution than Epo after both i.v. and s.c. administrations. Epo/liposomes had an improved pharmacokinetic profile compared with Epo. S.c. administration of Epo/liposomes at 7 h may penetrate primarily (40% of dose) through the blood as a liposome and partly (7% of dose) in lymph. Conclusions. Epo/liposomes may reduce the frequency of injections required for a certain reticulocyte effect in comparison to Epo. The lower clearance of Epo/liposomes may increase the plasma concentrations of Epo, which increases the efficacy.     

Confocal Laser Scanning Microscopic Visualization of the Transport of Dextrans After Nasal Administration to Rats: Effects of Absorption Enhancers

Purpose. To visualize the transport pathway(s) of high molecular weight model compounds across rat nasal epithelium in vivousing confocal laser scanning microscopy. Furthermore, the influence of nasal absorption enhancers (randomly methylated -cyclodextrin and sodium taurodihydrofusidate) on this transport was studied. Methods. Fluorescein isothiocyanate (FITC)-labelled dextrans with a molecular weight of 3,000 or 10,000 Da were administered intranasally to rats. Fifteen minutes after administration the tissue was fixed with Bouin. The nasal septum was surgically removed and stained with Evans Blue protein stain or DiIC18(5) lipid stain prior to visualization with the confocal laser scanning microscope. Results. Transport of FITC-dextran 3,000 across nasal epithelium occurred via the paracellular pathway. Endocytosis of FITC-dextran 3,000 was also shown. In the presence of randomly methylated -cyclodextrin 2% (w/v) similar transport pathways for FITC-dextran 3,000 were observed. With sodium taurodihydrofusidate 1% (w/v) the transport route was also paracellular with endocytosis, but cells were swollen and mucus was extruded into the nasal cavity. For FITC-dextran 10,000 hardly any transport was observed without enhancer, or after co-administration with randomly methylated -cyclodextrin 2% (w/v). Co-administration with sodium taurodihydrofusidate 1% (w/v) resulted in paracellular transport of FITC-dextran 10,000, but morphological changes, i.e. swelling of cells and mucus extrusion, were observed. Conclusions. Confocal laser scanning microscopy is a suitable approach to visualize the transport pathways of high molecular weight hydrophilic compounds across nasal epithelium, and to study the effects of absorption enhancers on drug transport and cell morphology.     

Caffeine enhances the stimulant effect of methamphetamine,but may not affect induction of methamphetamine sensitization of ambulation in mice

Methamphetamine (MAP: 1 and 2 mg/kg SC) and caffeine (CAF: 1, 3, 10 and 30 mg/kg SC) dose-dependently increased ambulation in mice. Repeated administration (5 times at 3 to 4-day intervals) of MAP, but not CAF, induced sensitization to its effect. Furthermore, the mice repeatedly receiving CAF showed no significant change in the sensitivity to MAP. Combined administration of MAP with CAF increased the effect. In the combinations of MAP (1 mg/kg) with CAF (3, 10 and 30 mg/kg), and MAP (2 mg/kg) with CAF (1 and 3 mg/kg), the effect was enhanced by the repeated administration. However, MAP sensitization was not modified by the combination with CAF in the repeated administration schedule, except in the combination of MAP (1 mg/kg) with CAF (30 mg/kg). The ambulation-increasing effects of MAP (1 mg/kg), CAF (10 mg/kg) and combination of MAP with CAF were almost equivalently inhibited by SCH 23390 (0.01 and 0.1 mg/kg SC) and YM-09151-2 (0.01 and 0.1 mg/kg SC). However, the inhibitory effects of apomorphine (0.05 mg/kg SC) andN ⁶-(L-phenylisopropyl)-adenosine (0.1 and 0.2 mg/kg SC) were stronger for CAF than for MAP and the combination, and those of -methyl-p-tyrosine (200 mg/kg IP, 4 h before) and reserpine (1 mg/kg SC, 4 h before) were stronger for MAP and CAF alone than for the combination. The present results suggest that, although the combination of MAP and CAF enhances the ambulation-increasing effect through an interaction at dopaminergic system, CAF may not significantly modify the induction of MAP sensitization in mice.     

江苏省集中式供水卫生监督管理现状

为全面了解我省集中式供水单位卫生监督管理的基本情况,我们对 １９９８年度全省 １３个市的市、县、乡和村级水厂进行了调查,结果表明：乡、村两级水厂未受到有效监督和管理,其卫生许可证持证率、自检能力、消毒剂和净水剂应用、对水源水和末梢水的监测率都明显低于市级水厂（Ｐ＜０．０１）。全省水厂消毒问题较突出,乡、村级水厂消毒率仅为５１．９％、５．７％,全省以地下水为水源的水厂消毒率仅１９．５％;全省乡和村级水厂出厂水余氯达标率分别为５７．１％、２０．７％,末梢水分别为５７．４％、２２．４％。加强对乡、村两级水厂的监督管理显得十分重要。     

护理人员信息管理系统的开发与应用

本文回顾了国内护理人员信息系统研究的背景和现状,介绍了作者自行研制的护理人员信息管理系统的结构和功能,并将其用于护士继续教育和规范化培训的管理过程,已取得较好成果。护理人员信息管理系统的开发与应用旨在适应未来护理的发展需求,促进护理管理的现代化。