Clinical index to predict bacteraemia caused by staphylococci

Abstract. Objectives. To define risk factors associated with bacteraemia caused by Staphylococcus aureus or coagulase-negative staphylococci; and to use them to define patients in need of empiric anti-staphylococcal antibiotic treatment. Design, Derivation set: observational, prospective study; validation set: retrospective analysis of a prospectively collected database. Setting. Derivation set: Beilinson Medical Centre, Petah Tiqva, Israel—a 900-bed university hospital. Validation set: St Thomas's Hospital, London, UK—an 800-bed teaching hospital. Subjects. All episodes of bacteraemia detected at Beilinson Medical Centre between March 1988 and September 1990 (derivation set, n = 1410), and at St Thomas's Hospital during 1987–1990 (validation set, n = 1040). Interventions. None. Main outcome measures. Percentage of staphylococcal bacteraemia in groups of patients defined by the models. Results. The following factors were associated with Staphylococcus aureus bacteraemia: focus of infection (whether high or low risk), haemodialysis, intravenous drug abuse and infection acquired in the orthopaedic ward. A logistic model was used to divide the derivation set into three groups with percentages of Staphylococcus aureus bacteraemia of 1.8%, 13.2% and 33.7% (P < 0.0001); and the validation group 2.5%, 18.2% and 53.2% (P < 0.0001). Factors associated with coagulase-negative staphylococcal bacteraemia were: central or peripheral intravenous catheter as the focus of infection, a preterm neonate, the presence of a central intravenous catheter, low temperature, and a low white blood cell count. A second model including those factors was used to divide the derivation set into three groups with percentages of coagulase-negative staphylococcal bacteraemia of 1.9%, 22.8%, and 43% (P < 0.0001). In the validation set, the percentages were 2.9%, 22.4% and 31.0% (P < 0.001). Conclusions. The present study defines groups at high risk for staphylococcal bloodstream infection, in which empiric treatment should include an anti-staphylococcal drug.     

A型肉毒杆菌毒素治疗麻痹性斜视

采用眼外肌注射A型肉毒杆菌毒素的方法,治疗17例(18只眼)麻痹性内斜视患者。最大的肌肉麻痹作用发生于注射后7～14天,最大斜视矫正度为50-,随访时间为4～20周,5例最终获得双眼视。未见全身副作用。认为,这种疗法可在部分患卉中替代斜视矫正术。     

阿霉素不同剂量静脉注射的药动学及其临床意义

采用ＨＰＬＣ法测定１４例肿瘤患者使用不同剂量阿霉素的血药浓度，并计算药代参数。４０ｍｇ／ｍ２和２５ｍｇ／ｍ２两组的血药峰浓度、ＡＵＣ、Ｖｃ差异有显著性。阿霉素的药代动力学存在明显的个体差异，血药峰浓度、Ｖｃ、Ｋ１２与疗效相关。     

附子理中丸方药的药物动力学研究

附子理中丸是中医治疗脾胃虚寒、脘腹冷痛、呕吐泄泻、手足不温的常用成药。本文通过小白鼠急性死亡实验,测得ip LD_(50)=42.4870g/kg;运用药物累积法对该复方方药进行了药物动力学研究。结果表明:附子理中丸在小鼠体内按一级动力学消除,呈二房室开放式模型分布。测得其t_(1/2)α=0.1922h,t_(1/2)β=11.2888h等动力学参数。阐明了该药的体内动态过程,为评价该药的内在质量及临床安全合理应用提供了参考依据。     

Comparison of Simulated and in-Vivo Plasma Levels of Cilastatin Following Intravenous in-Line Drug Administration

The primary objective of this work was to establish a method to simulate the plasma levels of cilastatin, a model drug, following an intravenous in-line delivery scheme. In-vivo data in dogs obtained from this work were used to demonstrate the validity of the proposed approach. The in-line drug delivery system consists of a drug containing device which is placed between a large volume parenteral and a patient. Numerous advantages have been identified for this automatic in-line reconstitution delivery system. The numerical convolution integral algorithm was used in this work to perform plasma profile simulation. The results indicated that the simulated cilastatin plasma profile following in-line delivery closely agreed with the in-vivo data.     

Colonic Drug Delivery: Enhanced Release of Indomethacin from Cross-Linked Chondroitin Matrix in Rat Cecal Content

Pharmaceutical Research -     

空管药物疗法治疗牙髓病和根尖周病疗效观察

用ＳＭＴＤ复合药物对牙髓病和根尖周病实施空管药物疗法。７８例１０３颗获得完整随访资料患牙经两年观察，９２．２％治愈率。文章介绍了治疗方法，讨论了空管药物疗法的愈合机理、优点、失败原因及其预防措施。     

龙眼参提取物对耐药口腔上皮样癌细胞株KB／MIT及耐药乳腺癌细胞株MCF-7／ADR的逆转作用

目的：研究龙眼参提取物XCKB／MIT细胞及MCF-7／ADR细胞株的耐药逆转作用。方法：设计4个不同浓度的龙眼参提取物组，采用MTT方法．测定体外培养的阿霉素敏感株MCF-7及其耐药株MCF-7／ADR以及米托蒽醌敏感株KB及其耐药株KB／MIT的IC50。结果：MCF-7／ADR耐药株及KB／MIT耐药株在龙眼参提取物与阿霉素或米托蒽醌的联合用药中其IC50值分别接近于单独用约于敏感株MCF-7和KB的水平．而与单独用药于耐药株其IC50有显著性差异。结论：龙眼参提取物可以逆转MCF7／ADR和KB／MIT的耐药性。