Importance of vancomycin loading doses in intermittent infusion regimens

Purpose

Delayed achievement of target vancomycin serum concentrations may adversely affect clinical outcomes. The objective of this retrospective study was to explore the real frequency of loading dose use and to evaluate the impact of loading dose for the achievement of vancomycin PK/PD target in adult patients treated with intermittent vancomycin. As a secondary aim we determined optimal vancomycin loading dose based on individual pharmacokinetic calculations.

股骨头坏死保头手术治疗的研究进展

股骨头坏死是多因素导致的病理生理过程。未经有效治疗的股骨头坏死患者中约80%在发病4年内出现股骨头塌陷。股骨头坏死的治疗方案应根据患者的病因和病程制定,早中期患者多可通过保头手术预防或延缓病情进展。保头手术主要包括髓芯减压术、植骨术、多孔钽棒置入术、截骨术、细胞因子或干细胞移植术。本文就上述治疗方法的研究进展作一综述。     

腹腔镜下手术治疗重症急性胰腺炎的手术时机和疗效探讨

目的：探讨腹腔镜下手术治疗重症急性胰腺炎的手术时机和手术治疗效果。方法对住院通过腹腔镜下手术治疗的30例重症胰腺炎患者的手术时机和手术效果进行回顾性分析。结果30例重症急性胰腺炎患者的手术时间为111～260 min,平均手术时间（165±30）min;患者的住院时间为19～30 d,平均住院时间（19.5±3）d。其中3例胰腺脓肿并急性肾功能不全患者引流术后3 d出现严重呼吸功能不全,术后7 d死于多系统器官功能衰竭。其余27例患者恢复正常,痊愈出院,总有效率为90%。结论腹腔镜下治疗重症急性胰腺炎对机体的创伤性小、干扰少,冲洗引流可靠,可以有效减少重症急性胰腺炎术后并发症的发生,是一种安全、可靠的治疗方法,但是手术时机的选择对治疗效果有重要影响。     

分级护理管理模式在肝胆外科护理中的应用

目的：探讨在肝胆外科护理工作中分级护理的应用效果。方法：将68例于肝胆外科住院治疗的患者作为观察对象,随机将患者分为对照组及观察组两组,每组34例。对照组在接受常规护理管理,观察组接受分级护理管理。对比两组接受护理后的护理质量情况。结果：观察组出院后的护理评分及护理相关评分均明显高于对照组（P ＜0．05）。结论：在肝胆外科护理管理中应用分级护理可有效的改善患者的护理效果,提高护理质量。     

Safety,Pharmacokinetics, and Pharmacodynamics of ME-401, an Oral,Potent, and Selective Inhibitor of Phosphatidylinositol 3-Kinase P110δ, Following Single Ascending Dose Administration to Healthy Volunteers

Purpose

ME-401 is a novel selective inhibitor of phosphatidylinositol 3 kinase p110δ, an enzyme often found overexpressed and overactive in B-cell malignancies. The current study was performed to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of single ascending oral doses of ME-401 in healthy volunteers.

去瓣与否对机械法准分子激光角膜上皮瓣下磨镶术治疗屈光不正的疗效

目的：观察去瓣与否对机械法准分子激光角膜上皮瓣下磨镶术(epipolis laser in situ keratomileusis,EPi-LASIK)治疗屈光不正的临床疗效。

方法：临床纳入接受手术治疗的近视患者68例136眼,根据手术方案的不同分为研究组与对照组。研究组进行去瓣EPi-LASIK术,对照组进行非去瓣EPi-LASIK术。观察两组患者术前、术后1wk,1、4mo裸眼视力、屈光度、角膜上皮下雾状混浊(haze)程度等指标。

结果：术后1mo裸眼视力：研究组为1.33±0.22,对照组为1.22±0.19,有统计学差异(P<0.05); 柱镜度数：研究组为0.10±0.55D,对照组为0.30±0.82D,有统计学差异(P<0.05); 术后1wk, haze：研究组明显低于对照组,有统计学差异(P<0.05)。

结论：去瓣EPi-LASIK术与非去瓣EPi-LASIK术均是目前临床治疗屈光不正较为安全、有效的表层切削手术。角膜上皮瓣的存在对患者术后极早期的临床结果有着一定程度的影响,但是随着时间的推移,该影响呈现逐渐减小的趋势。     

Withdrawal of repeated morphine enhances histamine-induced scratching responses in mice

An itch is experientially well known that the scratching response of conditions such as atopic dermatitis is enhanced under psychological stress. Morphine is typical narcotic drug that induces a scratching response upon local application as an adverse drug reaction. Although long-term treatment with morphine will cause tolerance and dependence, morphine withdrawal can cause psychologically and physiologically stressful changes in humans. In this study, we evaluated the effects of morphine withdrawal on histamine-induced scratching behavior in mice. Administration of morphine with progressively increasing doses (10–50?mg/kg, i.p.) was performed for 5 consecutive days. At 3, 24, 48, and 72?hr after spontaneous withdrawal from the final morphine dose, histamine was intradermally injected into the rostral part of the back and then the number of bouts of scratching in 60?min was recorded and summed. We found that at 24?hr after morphine withdrawal there was a significant increase in histamine-induced scratching behavior. The spinal c-Fos positive cells were also significantly increased. The relative adrenal weight increased and the relative thymus weight decreased, both significantly. Moreover, the plasma corticosterone levels changed in parallel with the number of scratching bouts. These results suggest that morphine withdrawal induces a stressed state and enhances in histamine-induced scratching behavior. Increased reaction against histamine in the cervical vertebrae will participate in this stress-induced itch enhancement.     

腹腔双套管两种不同冲洗方式引流效果的观察

目的：探讨腹腔双套管两种不同冲洗方式在肝胆胰手术后引流效果比较。方法：将80例肝胆胰术后放置双套管引流的患者随机分为对照组和观察组各40例,对照组采用冲洗管接生理盐水间断冲洗,观察组冲洗管接生理盐水匀速滴入。结果：观察组患者术后引流管堵管率(7.5%)低于对照组(30%),差异有统计学意义（P<0.05）。观察组腹腔双套管平均留置时间(4天)低于对照组(5天),差异具有统计学意义（P<0.01）。结论：腹腔双套管冲洗匀速滴入方式引流效果优于间断冲洗方式。     

健康教育对儿童龋齿患病率的影响

目的：探究健康教育对儿童龋齿患病率的影响。方法随机抽取2010年3月至2012年3月浙江省玉环县两所人数和教育水平相当的幼儿园中的儿童共1506例作为研究对象。 A幼儿园为实验组,连续2年施行每年1次氯化泡沫治疗、发放宣传手册和进行口腔保健知识教育等干预措施,男童434人,女童389人;B幼儿园为对照组,未施行任何干预措施,男童354人,女童329人。通过问卷调查的方式对儿童龋齿患病情况进行研究,得出健康教育对儿童龋齿患病情况的影响。结果实验组的龋齿患病率为35.50%,低于对照组的45.45%(χ2=5.71,P<0.05);对照组3岁、4岁及6岁的龋齿患病率分别为61.9%、55.9%和60.9%,实验组3岁、4岁及6岁的龋齿患病率分别为38.1%、44.1%、和39.1%,两组儿童各年龄段龋齿患病率差异均有统计学意义(χ2值分别为4.253、3.345及5.651,均P<0.05)。结论实施安全教育的地区儿童的龋齿患病发生率明显低于未施行地区,健康教育可显著降低儿童龋齿患病率。