某医院常见革兰阴性杆菌的分布与药敏分析

目的 了解珠海市人民医院2009~2010年住院患者常见的菌群分布及其耐药性,为细菌性感染的诊治提供参考依据.方法 用生物梅里埃公司的ATB鉴定系统进行菌种鉴定和药敏试验,用ATBPLUS VER3.0软件统计分析结果.结果 2009~2010年共分离出革兰阴性杆菌3 032株,其中铜绿假单胞菌占29.55%,肺炎克雷伯菌占33.44%,大肠埃希菌占27.51%,阴沟肠杆菌占5.80%,其他革兰阴性杆菌占3.70%.铜绿假单胞菌耐药率高于60%的抗菌药物有头孢噻吩、头孢噻肟、头孢西丁.肺炎克雷伯菌对美罗培南、亚胺培南、头孢吡肟、阿米卡星菌、妥布霉素、哌拉西林/三唑巴坦敏感.大肠埃希菌对第三代头孢菌素、氟喹诺酮类的耐药率增高,对亚胺培南、美罗培南、阿米卡星敏感,对哌拉西林/三唑巴坦、头孢他啶及奈替米星较敏感.阴沟肠杆菌呈多重耐药.结论 该地区常见革兰阴性杆菌的构成比及耐药率和国内其他地区有一定的差异,且细菌多重耐药情况更为严重.     

Development of drug-in-adhesive transdermal patch for α-asarone and in vivo pharmacokinetics and efficacy evaluation

A transdermal drug delivery system has been reported that can increase the bioavailability, reduce the administration duration, and maintain the concentration of drug in blood. In the present study, drug-in-adhesive transdermal patches of α-asarone using Eudragit E100 as pressure-sensitive adhesives and oleic acid plus isopropyl myristate as penetration co-enhancers were developed. In vitro permeation, in vivo pharmacokinetics in rabbits, and efficacy in asthmatic rats were evaluated. The results showed that co-enhancers could induce a synergistic effect on α-asarone permeability. In vivo study suggested that the patch can keep a relatively certain blood level of drug within 10–30?h in rabbits. Furthermore, the patch with the size of 4?cm² containing drug 3?mg/cm² showed a noticeable treating effect on asthmatic rats which is equivalent to the effect of dexamethasone, while avoiding the side-effect induced by the corticorsteroid. This suggests that the drug-in-adhesive transdermal patch is a promising delivery system containing α-asarone to be used for asthma treatment.     

Analysis on 85 Case Reports of Adverse Drug Reactions

This study investigated the occurrence and characteristics of adverse drug reactions (ADR) in our hospital and provide references for clinical rational drug use. We collected the 85 case reports of adverse drug reactions in our hospital in 2010 and made retrospective statistical analysis on them. The varieties of anti-infective drugs used are the most used. It also had the highest proportion of adverse drug reactions; the common symptom of adverse drug reactions is skin and accessory damage. Adverse drug reactions are affected by many factors, and relevant departments should strengthen ADR monitoring, to reduce or avoid the occurrence of adverse drug reactions.     

Applying open population capture–recapture models to estimate the abundance of injection drug users in Victoria,Canada

Background: Injection drug users (IDUs) are considered a hidden, hard to reach population that is difficult to measure. Multi-list recapture methods are commonly used to estimate IDU population sizes but do not allow inference on population dynamics. In Victoria, Canada, closed population capture–recapture methods have been used to estimate the abundance of IDUs. In this study, we make use of a newer sample of a survey of IDUs to relax the closure assumption.

Methods: The I-Track survey of IDUs was carried out in Victoria on three occasions (2003, 2005 and 2009). Data from the three samples were linked using unique subject identifiers. A Jolly-Seber model was used to estimate the number of IDUs.

Results: The results were very similar to a two-sample closed population analysis. However, when using open-population models, it is possible to get estimates for each time period of abundance and survival. The estimate of the number of the IDUs in Greater Victoria was relatively stable with fewer than 3000 individuals over the six-year study.

Discussion: Improved estimates of population size and dynamics will assist in improving access to harm reduction services, which may reduce higher risk drug use practices.     

注射用核糖核酸Ⅱ专项评价方法的构建与安全合理性

目的：探讨注射用核糖核酸Ⅱ安全与合理性专项评价研究。方法：本研究按月份分层随机抽取某院2016年9月-2017年8月临床使用核糖核酸Ⅱ的病例270份，药品说明书定量评价、药物利用研究及药品不良反应/事件Logistic回归分析综合评价方法，初步评价核糖核酸Ⅱ的安全合理性。结果：依据药品说明书评价结果提示合理性较高，其中给药剂量（100%），溶媒选择（100%），溶媒剂量（72.59%），给药浓度（74.07%），给药频次（98.15%），给药时间（100%），6项指标12个月内波动幅度与均值保持一致（90.80%）；药物利用研究结果提示，存在超剂量、超浓度给药情况（aDDDs=5.68，aDDCs=7.37，dDUI=1.19，cDUI=1.53）。研究期内发现4例不良反应，均为一般不良反应，经Logistic回归分析提示与药物使用浓度有关。结论：此种评价方法可有效评价药物临床使用的安全合理性，应加强我院核糖核酸Ⅱ临床监测工作，尤其是超剂量、超浓度给药情况。     

Longer duration of homelessness is associated with a lower likelihood of non-detectable plasma HIV-1 RNA viral load among people who use illicit drugs in a Canadian setting

Homelessness is common among people who use drugs (PWUD) and, for those living with HIV/AIDS, an important contributor to sub-optimal HIV treatment outcomes. This study aims to investigate the relationship between the duration of homelessness and the likelihood of plasma HIV-1 RNA viral load (VL) non-detectability among a cohort of HIV-positive PWUD. We used data from the ACCESS study, a long-running prospective cohort study of HIV-positive PWUD linked to comprehensive HIV clinical records including systematic plasma HIV-1 RNA VL monitoring. We estimated the longitudinal relationship between the duration of homelessness and the likelihood of exhibiting a non-detectable VL (i.e., <500?copies/mL plasma) using generalized linear mixed-effects modelling. Between May 1996 and June 2014, 922 highly active antiretroviral therapy-exposed participants were recruited and contributed 8188 observations. Of these, 4800 (59%) were characterized by non-detectable VL. Participants reported they were homeless in 910 (11%) interviews (median: six months, interquartile range: 6–12 months). A longer duration of homelessness was associated with lower odds of VL non-detectability (adjusted odds ratio?=?0.71 per six-month period of homelessness, 95% confidence interval: 0.60–0.83) after adjustment for age, ancestry, drug use patterns, engagement in addiction treatment, and other potential confounders. Longer durations of episodes of homelessness in this cohort of HIV-positive illicit drug users were associated with a lower likelihood of plasma VL non-detectability. Our findings suggest that interventions that seek to promptly house homeless individuals, such as Housing First approaches, might assist in maximizing the clinical and public health benefits of antiretroviral therapy among people living with HIV/AIDS.     

A Point Mutation at F1737 of the Human Nav1.7 Sodium Channel Decreases Inhibition by Local Anesthetics

Abstract: Voltage-gated sodium channels (VGSC) contribute to the initiation and propagation of action potentials within the nervous system. These channels are important targets for inhibition by several classes of drugs, including antiarrhythmics and local anesthetics. Structural and pharmacological studies have localized the binding of these drugs to a common site near the channel's intracellular pore region. Point mutations within this region disrupt local anesthetic inhibition of cardiac, CNS, and skeletal muscle VGSC subtypes. This study was designed to test whether a similar structural requirement for drug binding exists on the peripheral neuronal VGSC subtype; Na_v1.7. In support of this hypothesis, an alanine substitution for phenylalanine at position 1737 (F1737A) in the pore lining S6 segment of domain IV in human Na_v1.7 reduced both use- and state- dependent inhibition of the local anesthetics, lidocaine and tetracaine, by 8–21-fold. We also saw a 2–3-fold reduction in tonic inhibition with the F1737A mutant. The voltage dependence of both activation and inactivation were unaffected by the F1737A mutation, however, fast inactivation kinetics were impaired, such that a significant portion of inward current remained at the end of a 20-ms depolarization. These data suggest that F1737 forms a part of the high affinity binding of local anesthetics as well as mediating inactivation processes of neuronal Na_v1.7 channels.