我院2006～2007年活血化瘀类中成药门诊患者用药分析

目的：了解我院门诊活血化瘀类中成药应用情况及发展趋势。方法：收集整理我院2006—2007年的药品出入库数据，采用各药总金额与DDDs排序方法，进行活血化瘀药用药情况分析。结果：我院活血化瘀类中成药销售总金额呈上升趋势，日均费用金额略有下降，复方丹参滴丸销售金额与DDDs排序连续2年都居首位。结论：虽然活血化瘀类中成药品种越来越多，但我院应用基本合理，尤以疗效确切、价格合理的药品得到医患双方的肯定。     

沈阳市1992—2000年间日平均气温与居民循环系统疾病日均死亡率的关系

目的定量评价沈阳市日平均气温短期变化与城市居民循环系统疾病日均死亡率的关系。方法运用半参数一般递加模型,在控制长期趋势、湿度、气压、工作日和季节等混杂因素的基础上,分析了沈阳市1992年1月1日—2000年12月31日平均气温与居民日循环系统疾病死亡的关系。结果沈阳市全人群循环系统疾病死亡率最低点的气温（最适日均气温）为23.4℃,其中男性最适气温为23.6℃,女性为23.2℃。日平均气温与循环系统疾病死亡率成“V”字型关系,气温变化与循环系统疾病中的心血管疾病死亡率关系较显著,而与脑血管疾病死亡率关系不明显。超过23.4℃后,气温每上升1℃,全人群循环系统日均死亡率增加0.027 5/10万;气温低于23.4℃时,气温每下降1℃,全人群日均死亡率增加0.0062/10万。65岁以上人群对气温变化敏感,特别是对于高温（气温超过26.6℃）,每增加1℃,日均死亡率增加1.1909/10万。65岁以下人群对于气温变化不敏感,无论气温高于或低于最适气温1℃,死亡率改变量均〈0.001 1/10万。男性和女性对于气温变化的敏感程度近似。结论气温变化与城市居民循环系统疾病死亡率变化间的“V”字型关联提示,非极温状态下的气温远离最适气温的变化也可能增加人群循环系统疾病死亡率,而气温靠近最适气温的变化则可能减少人群循环系统疾病死亡率。     

我院抗菌药物应用分析

目的：了解我院2005年～2006年抗菌药物的使用情况,为抗菌药物的合理应用和管理提供依据。方法：运用WHO推荐的限定日剂量（DDD）分析方法,对我院2年中使用的抗菌药物的消耗金额和用药频度进行排序,并比较其位次比,同时计算每个品种的日治疗费用。结果：2年中抗菌药物的消耗占药品消耗总金额的比例分别为43.56%,45.59%,在卫生部规定的限定标准之内（〈50%）;β-内酰胺类应用频率较高,且金额占抗菌药物总量的70%左右;2005年头孢类抗生素的DDDs排序占据前3位,2006年头孢类抗生素的DDDs排序有所下降。结论：我院抗菌药物应用基本合理,但仍有少数品种存在过量使用现象。     

Measurement and prediction of medication compliance in problem drinkers

BACKGROUND: A variety of methods have been used to measure medication compliance. Although electronic monitoring has been considered to be the best method, it has some potential for error and its high cost may limit its feasibility. This study examined the concordance of data on medication compliance that was obtained by using an electronic monitoring system (Medication Event Monitoring System, or MEMS), daily diary reports, and tablet counts. METHODS: Subjects were 150 problem drinkers participating in a pharmacotherapy trial. Subjects were randomly assigned to receive naltrexone 50 mg (n = 75) or placebo (n = 75) and to receive either daily (n = 72) or targeted (n = 78) medication administration. Comparisons between methods were conducted at the aggregate and individual daily levels, and the association between compliance and three alcohol-related outcomes was evaluated. RESULTS: Daily diaries showed good day-to-day concordance with MEMS and a higher correlation with MEMS than did tablet counts. However, high-compliance subjects did no better than low-compliance subjects on any of three alcohol-related outcome measures. CONCLUSIONS: Compliance measurement using a daily diary method yielded results that are comparable to those obtained with electronic monitoring, which served as a criterion measure. In contrast, tablet counts provided data that were less concordant with the criterion measure. The unique nature of the study sample (i.e., the majority of subjects were not committed to a goal of abstinence), combined with the targeted approach to treatment, may explain the lack of association between compliance and alcohol-related outcomes. Further research should aim to ascertain the factors affecting the relationship between compliance and outcomes.     

Dailv QA 3在肿瘤放射物理技术质量保证中的使用及性能评价

放射物理技术质量保证是肿瘤放射治疗质量保证中的一个重要方面。简述了DailyQA3日常质量保证仪的组成及工作原理,介绍了其在肿瘤放射物理技术质量保证中的使用方法和应用体会,并评价了其性能优缺点。总体来讲,Daily QA 3可以方便、快捷地满足日常的肿瘤放射物理技术质量,保证工作的需要。     

Daily QA3在肿瘤放射物理技术质量保证中的使用及性能评价

放射物理技术质量保证是肿瘤放射治疗质量保证中的一个重要方面。简述了Daily QA3日常质量保证仪的组成及工作原理，介绍了其在肿瘤放射物理技术质量保证中的使用方法和应用体会，并评价了其性能优缺点。总体来讲，Daily QA3可以方便、快捷地满足日常的肿瘤放射物理技术质量，保证工作的需要。     

除草剂麦草丹的毒性研究

麦草丹是新型选择性激素除草剂。急性毒性试验结果:麦草丹纯品对雄性大鼠口服LD_(50)为1,710mg/kg,雌性为3,830mg/kg。其胺盐制剂LD_(50)雄性大鼠为650mg/kg,雌性为1,720mg/kg。二者皆属于低毒性农药。麦草丹纯品喂养大鼠3个月亚急性试验,从肝肾功能、脏器系数和病理学检查证明无毒害作用剂量为640ppm。麦草丹的蓄积系数为8.4,表明基本无蓄积作用。据亚急性试验初步推算麦草丹的每日容许摄入量(ADI)为0.64mg/kg。     

Effect of daily saline, drug or blank injections on the susceptibility to the convulsant effect of drugs.

The daily intraperitoneal injection to rats of doses of metrazol (30 mg/Kg), strychnin sulfate (1 mg/Kg) or picrotoxin (1.2 mg/Kg) that were initially subconvulsant, caused after a number of days which varied with the drug, clonic convulsions in a high percentage of the animals. However, after 18 daily injections of saline there was a similar increase of seizure susceptibility to the 3 drugs. The daily handling of rats as for injection, either followed or not by actual abdominal pricking (blank injection), had a similar though less pronounced effect. In animals that were housed in the same room where the others were tested, but which were not handled, the above mentioned doses of metrazol, strychnine and picrotoxin had no convulsant effect. These results indicate that the procedure of submitting rats to daily intraperitoneal injections is not as unconsequential as is usually thought to be, and that it may induce neurological changes.     

Palmar skin conductance compared to a developed stress score and to noxious and awakening stimuli on patients in anaesthesia

BACKGROUND: The number of fluctuations in the skin conductance per s (NFSC) as a measure of the sympathetic nervous system may be a tool for monitoring physiological stress during surgery and general anaesthesia. The purpose of this study was to find the sensitivity and specificity of the NFSC when compared to a peroperative clinical stress score. Moreover, different patterns of skin conductance responses were compared with the BIS score to find out if the mean level of skin conductance (SC) and NFSC monitoring could differentiate between awakening and noxious stimuli. METHODS: Fourteen patients were studied during stressful or non-stressful registration periods. During each registration period, the NFSC was compared to a five-point clinical stress score (CSS) (systolic blood pressure >130 mmHg, cough, tears, EMG in the forehead >50 or movements) and BIS score. RESULTS: The NFSC and the CSS both indicated physiological stress at 12 registrations and no stress at 186 registrations. The NFSC indicated physiological stress without signs of clinical stress (CSS = 0) in 28 registrations, whereas signs of clinical stress (CSS > 0) were indicated on two occasions without signs of stress in the NFSC. The sensitivity of the NFSC when compared to the CSS was 86% and the specificity was 86%. Moreover, in all situations (n = 16) where NFSC indicated stress and the BIS score >50, the SC increased. This was different from situations (n = 13) where NFSC indicated stress and the BIS score <50, then the SC did not increase (P < 0.001). CONCLUSION: The NFSC is sensitive to clinical stress during surgical stimulation. Moreover, the combined use of SC and NFSC may have a potential to differentiate between situations of stress due to inadequate hypnotic effect vs. inadequate analgesic effect.     

Rapid eye movement activity before spontaneous awakening in elderly subjects

Previous research in young subjects found that rapid eye movement (REM) density is higher in those REM phases which are followed by an awakening (REM-W) than in those preceding NREM (REM-N), suggesting a 'gating role' of REM sleep toward the awakening. It is not yet known whether this evidence is maintained in elderly subjects, who display, relative to young subjects, more awakenings, different sleep states from which the awakenings come (NREM in a high proportion of cases) and a general impairment of rapid eye movement activity (REMA). To investigate this issue, we have compared in three different age groups (young, old and 'old old' subjects) the features of REMA, including REM density and the amount and duration of REM bursts, between REM-W and REM-N. Whereas in the young REM density is higher in REM-W than in REM-N, this difference is already reduced in the old group and fully cancelled in the old old subjects. The evidence that old individuals spontaneously wake up despite the absence of an increase of REMA could imply that in the aged awakening is not preceded by an increase of the arousal level (expressed in REM sleep by the REMA). The similar duration of REM bursts for REM-W and REM-N in both groups of old subjects suggests that with age a marked impairment occurs in the organizational aspects of REMs, independently from the following state.