止遗合剂对水负荷肾阳虚大鼠排尿次数及排尿量的影响

目的:通过动物试验观察止遗合剂对小儿遗尿的治疗作用。方法:用氢化可的松造成大鼠水负荷肾阳虚模型,观察止遗合剂对大鼠的排尿量及排尿次数的影响。结果:止遗合剂可显著减少水负荷肾阳虚大鼠各个时间段的排尿量及排尿次数,以及减少观察期间总排尿次数及总排尿量。结论:止遗合剂能明显减少水负荷肾阳虚大鼠排尿次数及排尿量。     

2013-2016年西安交通大学第一附属医院麻醉性镇痛药应用分析

目的 对西安交通大学第一附属医院麻醉性镇痛药的临床应用情况及用药趋势进行分析,为麻醉性镇痛药的规范化管理和临床合理用药提供参考.方法 采用回顾性分析方法,调取西安交通大学第一附属医院2013—2016年麻醉性镇痛药的用药数据,对用药总量、销售金额、用药频度(DDDs)、限定日费用(DDC)和排序比(B/A)等进行统计分析.结果 麻醉性镇痛药的总销售金额呈逐年递增趋势.枸橼酸芬太尼注射液、注射用盐酸瑞芬太尼与芬太尼透皮贴剂在各年度DDDs均居于前几位.2013—2016年各药品的DDC值基本稳定不变,缓释剂型的DDC普遍高于普通剂型.盐酸羟考酮缓释片(10 mg)和注射用盐酸瑞芬太尼的B/A较小,而枸橼酸芬太尼注射液(0.1 mg)的B/A偏高.结论 西安交通大学第一附属医院麻醉性镇痛药应用基本合理,基本符合《癌症三阶梯止痛指导原则》.     

Leishmania major: inhibition of the chemiluminescent response of human polymorphonuclear leukocytes by promastigotes and their excreted factors

The effect of various leishmanial preparations on the chemiluminescent response (CR) of human polymorphonuclear leukocytes (PMN) was studied. Almost no CR was observed with PMN stimulated with either Leishmania promastigotes or their excreted factors (EFs). Promastigotes added to PMN stimulated with phorbol myristate acetate (PMA), at a proportion of 20 to 1, respectively inhibited approximately 80-83% of the CR activity. Leishmanial promastigotes, whether live or dead, infective or non-infective as well as whole parasite homogenates, soluble and insoluble fractions, all decreased the CR of the PMN (PMN-CR). A similar effect was also observed with leishmanial EFs. The degree of inhibition was dose dependent and increasing the amount of EFs in the reaction mixture resulted in decrease of the PMN-CR. More than 80% of the total activity of the PMN-CR was inhibited by 500 micrograms EFs added at zero time to the reaction mixture. The inhibition of PMN-CR obtained from a patient suffering from a chronic infection caused by L. major was not significantly different from that observed with PMN from normal donors. The present study suggests that the PMN-CR is impaired by the Leishmania parasites and their EFs and thus may allow a greater survival of the parasites within these cells.     

Surgically affected sulfisoxazole pharmacokinetics in the morbidly obese

Intestinal bypass surgery in 4 morbidly obese females (110-150 kg) had no permanent effect on the rate or amount of sulfisoxazole absorption. The loss of weight up to 44 per cent within an individual over a year's time had no significant effect on the apparent volumes of distribution or other pharmacokinetic parameters of sulfisoxazole and its N⁴- acetylsulfisoxazole metabolite. Dosing of this drug on a mgkg^{? 1} basis is contraindicated. Renal clearances of sulfisoxazole were reasonably constant within a study but those of the N⁴-acetylsulfisoxazole decreased with time. Integrated pharmacokinetic models were applied to plasma and urine data to estimate the metabolic clearance of sulfisoxazole and the apparent volume of distribution of the N⁴-acetylsulfisoxazole. Sulfisoxazole solution is absorbed readily by primarily a zero order process after a short lag period, indicative of rate-determining gastric emptying. The classical Bratton-Marshall assays were compared with an HPLC assay of both drug and metabolite. There was greater confidence in plasma levels of the metabolite from the HPLC method.     

多次连续捐献2U机采血小板对献血者的影响

目的探讨连续多次机采2U血小板对献血者的影响。方法120例连续献血>10次的机采血小板献血者,随机分为A组、B组,每组60例。A组机采血小板1U/次,B组机采血小板2U/次。比较两组献血者单采前后血小板计数(PLT)以及首次、10次后外周血象指标[PLT、红细胞计数(RBC)、血红蛋白(Hb)、红细胞压积(HCT)]。结果A组献血者上次单采前PLT为(271±30)×10^9/L,下次单采前PLT为(269±31)×10^9/L;B组献血者上次单采前PLT为(273±31)×10^9/L,下次单采前PLT为(268±34)×109/L。两组献血者单采前后PLT组内比较差异无统计学意义(P>0.05)。两组献血者首次与10次后PLT、RBC、Hb、HCT组内及组间比较,差异均无统计学意义(P>0.05)。结论献血者采集血小板前后的血常规改变不明显,根据国家规定的健康体格检查标准,献血者采集血小板前PLT>230×10^9/L,体重>50 kg,连续多次采集2U血小板血常规无显著变化,对献血者健康状况无明显影响。由于献血者人数限制,需要扩大样本量进一步探讨。     

Detection of ECG effects of (2R,4R)-monatin,a sweet flavored isomer of a component first identified in the root bark of the Sclerochitin ilicifolius plant

Enzymatically-synthesized (2R,4R)-monatin has, due to its pure sweet taste, been evaluated for potential use in foods. Non-clinical studies have shown that (2R,4R)-monatin is well tolerated at high dietary concentrations, is not genotoxic/mutagenic, carcinogenic, or overtly toxic. In a pharmacokinetic and metabolism study involving 12 healthy males, consumption of a single oral dose (2 mg/kg) of (2R,4R)-monatin resulted in a small reduction of heart rate and prolongation of the QTcF interval of 20–24 ms, corresponding to the time of peak plasma levels (t_max). These findings were evaluated in a cross-over thorough QT/QTc study with single doses of 150 mg (2R,4R)-monatin, placebo and positive control (moxifloxacin) in 56 healthy males. Peak (2R,4R)-monatin plasma concentration (1720 ± 538 ng/mL) was reached at 3.1 h (mean t_max). The placebo-corrected, change-from-baseline QTcF (ΔΔQTcF) reached 25 ms three hours after dosing, with ΔΔQTcF of 23 ms at two and four hours. Using exposure response (QTc) analysis, a significant slope of the relationship between (2R,4R)-monatin plasma levels and ΔΔQTcF was demonstrated with a predicted mean QT effect of 0.016 ms per ng/mL. While similarly high plasma levels are unlikely to be achieved by consumption of (2R,4R)-monatin in foods, QTc prolongation at this level is a significant finding.     

周期使用量分析对医院制剂精细化管理的意义

目的 对制剂生产、供应进行精细化管理。方法以医院开发的《药品综合查询》程序对19种代表制剂周期使用量进行汇总,以Excel2000程序对汇总数据进行统计分析。结果19种代表制剂中,多数制剂周期使用量RSD在25％以下,为稳定使用型制荆;少数制剂周期使用量RSD在35％以上,为波动使用型制刑。结论以1／3制剂效期为时间单元对制剂进行管理,可达到较好的管理目的。     

Assessment of alcoholic standard drinks using the Munich composite international diagnostic interview (M‐CIDI): An evaluation and subsequent revision

The quantity and frequency of alcohol consumption are crucial both in risk assessment as well as epidemiological and clinical research. Using the Munich Composite International Diagnostic Interview (M‐CIDI), drinking amounts have been assessed in numerous large‐scale studies. However, the accuracy of this assessment has rarely been evaluated. This study evaluates the relevance of drink categories and pouring sizes, and the factors used to convert actual drinks into standard drinks. We compare the M‐CIDI to alternative drink assessment instruments and empirically validate drink categories using a general population sample (n = 3165 from Germany), primary care samples (n = 322 from Italy, n = 1189 from Germany), and a non‐representative set of k = 22503 alcoholic beverages sold in Germany in 2010–2016. The M‐CIDI supplement sheet displays more categories than other instruments (AUDIT, TLFB, WHO‐CIDI). Beer, wine, and spirits represent the most prevalent categories in the samples. The suggested standard drink conversion factors were inconsistent for different pouring sizes of the same drink and, to a smaller extent, across drink categories. For the use in Germany and Italy, we propose the limiting of drink categories and pouring sizes, and a revision of the proposed standard drinks. We further suggest corresponding examinations and revisions in other cultures.     

2018—2019年复旦大学附属妇产科医院紫杉醇类药品的使用合理性分析

目的 调查2018—2019年复旦大学附属妇产科医院紫杉醇类药品的使用情况,为妇科恶性肿瘤患者治疗合理用药提供相关数据资料。方法 回顾性分析复旦大学附属妇产科医院2018—2019年医嘱中含紫杉醇类药品的使用情况,对药品的使用量、销售金额、患者年龄、临床诊断、药品的用法用量、用药疗程等进行整理与分析。结果 共收集含紫杉醇类药品医嘱12 398条,涉及7种紫杉醇类药品,两年年总使用量68 170瓶,用量前3名分别是国产多西他赛注射液22 633瓶,构成比为33.20%;国产注射用紫杉醇脂质体20 273瓶,构成比为29.74%,国产紫杉醇注射液13 430瓶,构成比为19.70%。销售金额前3名的分别是国产注射用紫杉醇脂质体1 625.59万元,构成比为46.93%,进口紫杉醇注射液587.99万元,构成比为16.98%,进口注射用紫杉醇（白蛋白结合型）577.70万元,构成比为16.68%。使用紫杉醇类药品最多的年龄段是59～60岁,构成比为34.88%。临床诊断数的前3位分别宫颈癌908例,构成比为53.57%,卵巢癌697例,构成比为41.12%,乳腺癌564例,构成比为33.27%。紫杉醇脂质体和紫杉醇注射液的最常使用量为210 mg,进口多西他赛注射液的最常使用量为100 mg,国产多西他赛注射液的最常使用量为120 mg,进口注射用紫杉醇（白蛋白结合型）的最常使用量为150 mg。紫杉醇类药品疗程数分布1～39次,其中疗程小于10次的人数构成比为96.74%。结论 2018—2019年复旦大学附属妇产科医院紫杉醇类药品的使用合理,但还需要更多地关注不良反应发生等相关问题,确保患者安全、有效、经济用药,并进一步结合临床真实数据的分析,规范紫杉醇类药品领域评价原则,建立较为完整的评估系统。