静脉输液临床应用分析

目的:了解静脉输液的利用现状及趋势。方法:对1996年、1999年、2002年、2004年某三级甲等综合性医院输液的利用情 况进行统计、分析。结果:输液品种数、总量、总金额均逐年增加,输液销售总额占全年药品总额的10％左右;营养类和电解质类输 液的用量占大部分,其中葡萄糖和氯化钠注射液占总输液量的74％;治疗类输液增长快速,以抗感染类为主;每瓶输液疗法药品费 用逐年增加,输液疗法涉及药品金额为全年药品总额的60％。结论:输液的用量和消耗金额呈不断上升趋势。     

克林霉素注射剂临床应用安全性调查与评价

目的:安全应用克林霉素注射剂。方法:以自制调查表等形式对2004年3月22日~2004年4月27日我院应用克林霉素注射剂的167例住院患者进行追踪调查和分析。结果:应用克林霉素预防感染98例,治疗感染76例;联合其它抗菌药物预防和治疗感染107(47+60)例;用药剂量0·6g~1·2g,bid,平均用药(17±15)d;不良反应发生率6·6%(11/167),主要表现为恶心、呕吐、腹泻、口唇麻木、发热、霉菌感染等。结论:只有严格掌握用药指征和方法,方可提高用药安全性。     

荧光分光光度法测定注射用盐酸拓普替康的含量

目的:建立注射用盐酸拓普替康的荧光光度测定法.方法:以水为溶剂,采用荧光分光光度法测定注射用盐酸拓普替康的含量,测定波长为ex-380.8nm,em=521.6nm.结果:平均回收率99.81%,RSD为0.87%,线性范围为0.16～1.6μg·ml-1.结论:该方法简便,准确,适用于注射用盐酸拓普替康的含量测定.     

注射用对氨基水杨酸钠细菌内毒素检验探讨

用<中国药典>2000年版附录细菌内毒素检验法对PAS进行细菌内毒素检测并建立实验方法.实验结果表明用TAL试剂对PAS最大无干扰浓度为5mg/ml,无干扰作用,提示用细菌内毒素检查法检查PAS中的内毒素是可行的.     

盐酸环丙沙星鱼肝油乳的制备及临床应用

目的:制备盐酸环丙沙星鱼肝油乳并观察其对萎缩性鼻炎的临床治疗效果.方法:采用胶体磨制成盐酸环丙沙星鱼肝油乳,采用紫外分光光度法测定该制剂中盐酸环丙沙星的含量,测定波长277 nm;以复方鱼肝油滴鼻液为对照进行临床疗效观察.结果:制成的盐酸环丙沙星鱼肝油乳外观、性状、鉴别、检查均符合规定,稳定性良好;盐酸环丙沙星在2～10 μg·ml-1范围内线性关系良好,回归方程A=0.090 4C 0.037 2,r=0.999 9;平均回收率为98.6%(n=3),RSD=1.23%;临床用于治疗萎缩性鼻炎,治疗组治愈率及总有效率分别为36.4%和84.8%,对照组分别为12.2%和49.0%,两组间比较均有显著性差异(P＜0.01).结论:该制剂制备方法简单,性质稳定,质量可控,临床应用安全、有效.     

紫外分光光度法测定加替沙星眼凝胶中加替沙星的含量

目的:建立加替沙星眼凝胶中加替沙星的含量测定方法.方法:采用紫外分光光度法测定,测定波长292 nm.结果:加替沙星在2.4～6.4μg·ml-1浓度范围内呈良好的线性关系,平均回收率99.77%,RSD 0.22%.结论:本法操作快速简便,结果准确,适用于加替沙星眼凝胶制剂半成品含量的快速测定.     

谈临床护理中的人文关怀

在现代医疗技术、经济利益的猛烈冲击下,临床护理中的人文关怀严重迷失,急需重建。通过切实搞好医院三级人文关怀建设,能有效缓解目前很紧张的医患关系,有效提高护理服务质量,实现临床护理的人文关怀本质回归。     

肇庆市城区居民主要腹泻病原菌现状分析

目的了解肇庆市城区居民的主要腹泻病原菌,为建立食源性疾病主动监测体系,提供必要的监测数据。方法采集监测点腹泻门诊腹泻患者粪便(或肛拭)标本,分离沙门氏菌、志贺氏菌、霍乱、肠出血性大肠杆菌EHECO157:H7和副溶血性弧菌。结果314份标本共分离各类病原菌51株(16.24%),其中,以副溶血性弧菌检出率为最高,占总检出率的49.02%,沙门氏菌、志贺氏菌的检出率分别为25.49%和15.69%,霍乱、肠出血性大肠杆菌EHECO157:H7未检出;女性患者病原菌检出率显著高于男性患者(P<0.01);50.98%的患者年龄集中在21～40岁(P<0.001);检出的25株副溶血性弧菌分属其6个血清型,其中O3和O4血清型最为多见,分别占64.00%和20.00%。结论肇庆市城区居民主要腹泻病原菌为副溶血性弧菌O3血清型,患者主要为中青年。     

Practical applications of snake venom toxins in haemostasis

Snake venom toxins affecting haemostasis have facilitated extensively the routine assays of haemostatic parameters in the coagulation laboratory. Snake venom thrombin-like enzymes (SVTLE) are used for fibrinogen/fibrinogen breakdown product assay and for the detection of fibrinogen dysfunction. SVTLE are not inhibited by heparin and can thus can be used for assaying antithrombin III and other haemostatic variables in heparin-containing samples. Snake venoms are a rich source of prothrombin activators and these are utilised in prothrombin assays, for studying dysprothrombinaemias and for preparing meizothrombin and non-enzymic forms of prothrombin. Russell's viper (Daboia russelli) venom (RVV) contains toxins which have been used to assay blood clotting factors V, VII, X, platelet factor 3 and, importantly, lupus anticoagulants (LA). Other prothrombin activators (from the taipan, Australian brown snake and saw-scaled viper) have now been used to assay LA. Protein C and activated protein C resistance can be measured by means of RVV and Protac^®, a fast acting inhibitor from Southern copperhead snake venom and von Willebrand factor can be studied with botrocetin^® from Bothrops jararaca venom. The disintegrins, a large family of Arg-Gly-Asp (RGD)-containing snake venom proteins, show potential for studying platelet glycoprotein receptors, notably, GPIIb/IIIa and Ib. Snake venom toxins affecting haemostasis are also used in the therapeutic setting: Ancrod (from the Malayan pit viper, Calloselasma rhodostoma), in particular, has been used as an anticoagulant to achieve ‘therapeutic defibrination’. Other snake venom proteins show promise in the treatment of a range of haemostatic disorders.     

Rational use of medicines – an important issue in pharmaceutical policy

In this article the authors deal with issues of drug utilisation from a clinical and policy perspective. They address the difficulties of managing drug therapy on a population level, which is known among professionals, as the problem of rational use of medicines. Various definitions and interpretations are presented and compared. This is followed by a presentation of the concerns associated with pharmaceutical marketing from a policy perspective, including the fear that the dominance of information produced by industry may lead to irrational drug use. Next, the authors review the tools for policy making including educational, managerial, and regulatory interventions. The (often overlapping) concepts of medicines management, clinical pharmacy and pharmaceutical care are then discussed to show how professionals, sometimes in collaboration with policymakers, have tackled the problem of nonrational use of medicines. The authors address the question as to whether the rational use of medicines a universal concept, whether it can be and whether it should be? They argue that, as with most concepts, the rational use of medicines must always be viewed in context. They conclude that pharmacy needs to adapt its way of thinking to include the issue of context. They point out that clinical pharmacists today already adapt their decisons to each patient and patient group. Policymakers are encouraged to adopt a similar approach because populations as well as particular market situations vary and therefore policy solutions cannot be considered universal.*This article is the second in a series of articles on this topic that will appear in Pharmacy World & Science during 2005.