The anaesthetist as determinant factor of quality of surgical antimicrobial prophylaxis. A survey in a university hospital.

In actual surgical antimicrobial prophylaxis, the anaesthetist administers the drugs at induction of anaesthesia. In the first phase of our qualityofuse intervention study on antimicrobial drugs in a large university hospital, information on the practice of antimicrobial prophylaxis was needed. The staff of 44 anaesthetists was interviewed by means of a questionnaire. Response rate was 36/44 (82%). The anaesthetists' method of administering surgical prophylaxis was rather uniform and inexpensive: cephalosporins were almost exclusively administered by bolus method. The main reason was that infusion was more cumbersome (range 7785%). Communication between surgeon and anaesthetist was reported to be poor, and in two out of three operating departments, orders of prophylaxis transmitted at or after induction accounted for more than 80%. Seventyseven percent of the responders asked the surgeon if prophylaxis was necessary if they were in doubt; 20% responded that they checked it systematically. The data collected by the inquiry proved useful in the process of optimizing surgical prophylaxis in our hospital.     

Pediatric intestinal transplantation

Advancements in donor management, organ preservation and operative techniques, as well as immunosuppressive therapies, have provided children with intestinal failure and its complications a chance not only for enteral autonomy but also long-term survival through intestinal transplantation (ITx). First described in the 1960’s, experience has grown in managing these complex patients both pre- and post-transplant. The goals of this review are to provide a brief history of intestinal transplantation and intestinal rehabilitation in pediatric patients, followed by focused discussions of the indications for ITx, induction and maintenance immunosuppression therapies, common post-operative complications, and outcomes/quality of life post-transplant.     

精乌口服液的质量标准研究

目的:完善精乌口服液的质量标准。方法:采用薄层色谱法对精乌口服液中的制何首乌和黄精(制)进行定性鉴别,并采用高效液相色谱法对其中2,3,5,4’—四羟基二苯乙烯—2—O—β—D—葡萄糖苷含量进行测定。结果:精乌口服液中制何首乌和黄精(制)供试品薄层色谱中,在与对照品色谱相应的位置上,显相同颜色的斑点;2,3,5,4’—四羟基二苯乙烯—2—O—β—D—葡萄糖苷进样量在0·0562μg~0·6744μg范围内与峰面积积分值线性关系良好(r=0·9996),平均加样回收率为100·1%(RSD=1·89%)。结论:本方法回收率高、重现性好、简便、快速、准确,可用于本品的质量控制。     

黄莪胶囊治疗良性前列腺增生症疗效分析

目的探讨黄莪胶囊治疗良性前列腺增生症的疗效和安全性。方法采用随机、开放、平行对照的多中心II、III期临床试验及补充临床试验,869例入选病例为经确诊的良性前列腺增生患者。试验组516例,服用黄莪胶囊,每日3次,每次4粒;II、III期临床试验对照组患者分别有117、162例,均服用癃闭舒胶囊,每日2次,每次3粒;补充临床试验对照组患者74例,服用安慰剂,每日3次,每次4粒,疗程均为42 d。结果黄莪胶囊对良性前列腺增生患者气虚血瘀、湿热阻滞证的主要疗效指标IPSS积分、终点尿流率的改善均有临床意义。结论黄莪胶囊是一种治疗良性前列腺增生症气虚血瘀、湿热阻滞证安全有效的中药。     

UPLC法测定一捻金中人参皂苷Rg1、人参皂苷Re、人参皂苷Rb1的含量

目的:建立超高效液相色谱法测定一捻金中人参皂苷Rg1、人参皂苷Re、人参皂苷Rb1含量的方法。方法:色谱柱:ZORBAX Eclipse Plus C18柱(2.1 mm×50 mm,1.8μm);流速:0.21 ml·min-1;柱温:30℃;流动相:乙腈-水梯度洗脱;检测波长:203 nm;进样量:1μl。结果:人参皂苷Rg1在浓度为0.020 3~0.303 9 mg·ml-1时线性关系良好(r=0.999 6),平均回收率为99.05%,RSD为1.3%(n=6);人参皂苷Re在浓度为0.020 2~0.302 7 mg·ml-1时线性关系良好(r=0.999 8),平均回收率为101.31%,RSD为1.1%(n=6);人参皂苷Rb1在浓度为0.020 3~0.305 1 mg·ml-1时线性关系良好,r=0.999 8,平均回收率为100.71%,RSD为0.9%(n=6)。结论:该方法简单、准确,可同时测定3种人参皂苷的含量,可作为一捻金的质量控制。     

大科学研究模式背景下药学学科发展方向的思考

在大科学研究模式的背景下,科学的大格局正在发生着深刻的变化。尤其是随着21世纪科学技术的发展,药学的学科方向也随之发生了一定的变化,深刻地影响了药学人才的思维与相关的行为。本文基于大科学背景下的科学格局变化,论述大科学研究模式对药学学科以及中医药学的影响,展望其发展前景。     

左旋门冬酰胺酶在儿童急性淋巴细胞白血病临床应用的安全性分析

左旋门冬酰胺酶(L-ASP)作为儿童急性淋巴细胞白血病治疗联合化疗方案中的最基本药物之一,在对维持患儿长期处于带病生存状态中起着极为重要的作用。但长期以来其在儿童临床应用的安全性也一直是人们关注的重点。就近些年L-ASP在国内外儿童临床应用引起不良反应的类型、原因以及发展方向等方面的研究进展进行综述。     

甲状腺乳头状微小癌合并桥本甲状腺炎的临床病理分析

目的研究甲状腺乳头状微小癌（PTMC）合并桥本甲状腺炎（HT）的临床病理特点,为临床诊治提供参考。方法：收集我院2010年10月-2013年9月收治并经手术病理证实为PTMC患者的临床病理资料,以是否合并HT分组比较,并进行回顾性分析。结果 119例PTMC中,男女比例1：2.6,年龄（44.4±12.4）岁,术前甲状腺功能正常者97例（81.5%）,肿瘤平均最大径（6.8±2.3）mm,有颈部淋巴结转移36例（30.3%）,合并HT 41例（34.5%）。与未合并HT组相比,合并HT组中女性更多,发病年龄较小,术前促甲状腺激素（TSH）较高,肿瘤最大径较小,相互比较存在统计学差异（P〈0.05）。合并HT组的颈部淋巴结转移率（36.6%）稍高于未合并HT组（26.9%）,且与年龄、肿瘤最大径显著相关。结论 PTMC合并HT在较年轻的女性、术前血TSH水平偏高者中较常见。起病年龄较小、癌灶最大径≥7.0 mm时更易发生颈淋巴结转移。     

Specular microscopic and histologic observations in nonguttate corneal endothelial degeneration

Six phakic patients with unilateral corneal edema and clinically normal-appearing fellow eyes were examined with specular microscopy and found to have endothelial pleomorphism and reduced cell counts in the nonedematous cornea. None of these patients had any previous eye disease, trauma, inflammation, or surgery. Clinically unrecognized endothelial disease was proposed as a cause for the unilateral corneal edema and was verified by light and electron microscopic studies in five patients. These pathologic findings vary somewhat from those found in Fuchs' dystrophy and may represent either a variant or a form of endothelial cell degeneration of as yet undetermined etiology. Our studies suggest that this condition is not detectable in the nonedematous cornea by standard high magnification biomicroscopy and requires the use of the clinical specular microscope to confirm the diagnosis in suspected cases.