RP-HPLC法测定盐酸哌唑嗪片的含量及有关物质

目的　以HPLC法测定盐酸哌唑嗪片的含量及有关物质。方法　采用ZorbaxSB C1 8色谱柱(2 5 0mm×4 .6mm ,5μm) ,流动相为甲醇-水-冰醋酸-三乙胺(490∶4 6 0∶4 5∶5 ) ,流速为1 . 0ml·min-1 ,柱温30℃,检测波长为2 4 7nm ,用外标法测定。结果　盐酸哌唑嗪的保留时间约为4 . 2min ,且与其它峰的分离度大于1 . 5。盐酸哌唑嗪的线性范围为5～5 0 μg·ml-1 (r=0 . 9999) ,最低检测限为0 .4ng·ml-1 ,平均回收率和RSD分别为1 0 0 .8%和0 . 6 8%。结论　该方法简便、快速,结果准确可靠,适用于盐酸哌唑嗪片的含量及有关物质的定量检测。     

GC法测定小儿氨酚烷胺颗粒中盐酸金刚烷胺

目的建立GC法测定小儿氨酚烷胺颗粒中盐酸金刚烷胺。方法采用HP-5毛细管柱（30 m×0.32 mm×0.25μm）,FID检测器;气化室温度为220℃,检测室温度为300℃。采用程序升温,初始温度为70℃,以10℃/min升至140℃。载气：氮气,流速为4 mL/min;进样量为1μL;分流比：1∶50。采用内标法定量。结果盐酸金刚烷胺在0.1~0.7 mg/mL线性关系良好（r=0.999 6）。平均回收率为99.27%,RSD值为0.66%（n=9）。结论本法简便、准确、重复性好,可用于小儿氨酚烷胺颗粒中盐酸金刚烷胺的测定。     

可达灵片联合替罗非班治疗非ST段抬高型心肌梗死的临床研究

目的探讨可达灵片联合替罗非班治疗非ST段抬高型心肌梗死的安全性与有效性。方法选取2020年1月—2021年1月于开封市中心医院诊治的99例非ST段抬高型心肌梗死患者,根据入组顺序分成对照组(50例)和治疗组(49例)。对照组患者静脉滴注盐酸替罗非班氯化钠注射液,起始滴加速度为0.4μg/(kg·min),0.5 h后以0.1μg/(kg·min)维持,连续治疗72 h;治疗组在对照组基础上口服可达灵片,3片/次,3次/d。两组患者治疗2周。观察两组患者临床疗效,比较治疗前后两组患者SF-36、GRACE和VAS评分,血清心型脂肪酸结合蛋白(H-FABP)、和肽素和同型半胱氨酸(Hcy)水平及不良反应情况。结果治疗后,治疗组总有效率为94.00%,明显高于对照组的75.51%(P0.05)。治疗后,两组患者SF-36评分明显升高,而GRACE和VAS评分显著降低(P0.05),且治疗组评分明显优于对照组(P0.05)。治疗后,两组患者血清H-FABP、和肽素和Hcy水平均显著降低(P0.05),且治疗组明显低于对照组(P0.05)。治疗期间,治疗组不良反应发生率明显低于对照组(4.00%vs 18.37%,P0.05)。结论可达灵片联合替罗非班能够显著提升非ST段抬高型心肌梗死患者的临床治疗效果,改善患者的危险程度和生活质量,调节血清因子水平,安全性较高。     

系数倍率法测定膀胱镜检表面麻醉剂中盐酸利多卡因的含量

目的：研究不经提取直接测定膀胱镜检表面麻醉剂中盐酸利多卡因的含量。方法：采用系数倍率法，选择测定的波长为270nm和280nm。结果：盐酸利多卡因线性关系良好，r=0．9993,，平均回收率为100．1％。结论：该方法可靠、简便、准确，可作为医院制剂的质量控制。     

盐酸氨溴索对老年肺炎祛痰作用疗效分析

目的评价盐酸氨溴索注射液对老年肺炎患者祛痰作用的临床疗效及安全性。方法将124例老年肺炎住院患者随机分成治疗组64例和对照组60例，治疗组使用左氧氟沙星注射液0．2g＋10％葡萄糖液（糖尿病患者用生理盐水）100mL，静脉滴注，2次／d；加用盐酸氨溴索注射液45mg，静脉注射，2次／d。对照组用左氧氟沙星注射液（用法同治疗组），加用必嗽平片16mg，口服，3次／d。疗程7～14d，2组均不同时使用其他抗生素，有基础疾病者按相应疾病常规治疗。结果治疗组对咳嗽的临床控制率＋显效率（31％＋38％）明显高于对照组（15％＋20％），有极显著性差异（P〈0．01）；对痰性状的改变及肺部哆音的改变2组间无显著性差异（P〉0．05）。治疗组盐酸氨溴索注射液的主要不良反应为胃部灼热，治疗过程中有6例出现，发生率为9％，患者能耐受，未作特殊处理。对照组必嗽平片治疗过程中有7例出现胃部不适，表现为上腹胀痛，恶心、欲呕，发生率为12％，经服用西咪替丁片后好转，未中断治疗。结论盐酸氨溴索注射液对老年肺炎患者祛痰效果显著，是一种安全、经济、有效的祛痰药物。     

盐酸法舒地尔对脑梗死患者的疗效及对血清中lL-1β、TNF-α和RHO激酶影响的观察

目的:本实验观察盐酸法舒地尔对脑梗死患者的治疗作用及对血清中白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)和RHO激酶的影响,为临床工作提供理论帮助.方法:选取我院住院诊治的脑梗死患者186例,依患者的入院顺序分为两组,观察组共93例,在常规治疗基础上加用盐酸法舒地尔治疗,对照组共93例,只应用常规治疗...     

The Severity of Toxic Reactions to Ephedra: Comparisons to Other Botanical Products and National Trends from 1993–2002

Objective. Ephedra is a botanical product widely used to enhance alertness, as a weight loss aide, and as a decongestant. Its reported adverse effects led the Food and Drug Administration (FDA) to ban ephedra-containing products in the United States in 2004. This study's purpose was to compare toxicity from botanical products containing ephedra to nonephedra products. Methods. The Toxic Exposure Surveillance System (TESS), a national poison center database, was utilized to determine the number and outcomes of cases involving botanical products reported from 1993–2002. Cases listing both a botanical product and any other drugs or chemicals were excluded a priori. Ten-year hazard rates (moderate outcomes + major outcomes + deaths per 1000 exposures) were used to compare botanical product categories. Results. There were 21,533 toxic exposures with definitive medical outcomes reported over the 10 yrs where a botanical product was the only substance involved. Of these, 4,306 (19.9%) had moderate or major medical outcomes and there were two deaths, for an overall hazard score of 200 per 1000 exposures. The number of ephedra reports to poison centers increased 150-fold over the 10-yr period. The hazard rate for products that contained only ephedra was 250 per 1000 exposures and 267 per 1000 exposures for products that contained ephedra and additional ingredients; whereas the hazard score for only nonephedra botanical products was 96 per 1000 exposures. The rate ratios for multibotanical products with ephedra (RR 1.33; 95% C.I. 1.27–1.40) and for single-ingredient ephedra products (RR 1.25; 95% C.I. 1.11–1.40) were both two to six times higher than those of other common botanical products. Yohimbe-containing products had the highest hazard score (417) and rate ratio (2.08; 95% C.I. 1.59–2.80). Conclusion. Ephedra-containing botanical products accounted for a significant number of toxic exposures with severe medical outcomes reported to poison centers. Hazard rate analysis suggests poison center–reported events involving ephedra-containing botanical products were much more likely to result in severe medical outcomes than those involving nonephedra-containing botanical products. These data support recommendations by policymakers that the sale of ephedra should be prohibited to protect consumers. Our data suggest that the botanical product, yohimbe, may also be associated with unacceptably high risks of toxicity and should receive close scrutiny from health policymakers.     

薄层扫描法测定腰痛宁中麻黄碱的含量

腰痛宁胶囊中，麻黄碱是其主要成分之一，为更加有效的控制该制剂的内在质量，特增加麻黄碱的含量测定。对腰痛宁胶囊中麻黄碱含量进行测定，可以有多种方法，如高效液相色谱法、容量法、分光光度法、薄层扫描法等。但本实验建立了薄层扫描法对腰痛宁胶囊中麻黄碱进行含量测定，认为是精确、可靠、灵敏、简便的测定方法。     

Comparative study between ephedrine infusion vs. CO/post loading of fluids for prevention of hypotension in emergency cesarean section under spinal anesthesia

IntroductionMaternal hypotension is the most common complication during cesarean section under spinal anesthesia. The aim of this study was to compare the effectiveness of CO/post loading of fluids versus immediate post spinal infusion of ephedrine in prevention of hypotension.MethodsNinety healthy pregnant patients ASA I with single term fetus arrived to the operating room with nonlife threatening cause for emergency cesarean section under spinal anesthesia. The patients were allocated randomly into 3 groups, Group R: started the CO/post loading at the time of spinal injection and continued after it with 0.5 ml/kg/min Lactated Ringer's solution until delivery of the fetus. Group V: started the CO/post loading with 0.5 ml/kg/min Voluven at the same period. Group E: started ephedrine infusion at 1 mg/min via the infusion pump immediately after spinal anesthesia until delivery of the fetus.ResultsThe systolic blood pressure changes were statistically significant but they failed to reach clinical significant values in the three groups. The total dose of ephedrine was significantly higher in Ephedrine group than the other two groups. Intraoperative heart rate increased in the first 30 min in Ephedrine group without any clinical significance. All fetal data were within normal range and comparable between groups. Apger score of the fetuses was not less than 8 in the three groups. The incidence of nausea and vomiting was higher in group R and group V compared to group E.ConclusionIntravenous infusion of ephedrine 1 mg/min immediately after spinal anesthesia for emergency cesarean sections, even if there is no enough time for proper prehydration, can control effectively the hypotension without episodes of hypertension or significant tachycardia, and it had no effect on fetal well-being. It could be as effective as CO/post loading of 0.5 ml/kg/min lactated Ringer or Voluven in controlling systolic blood pressure with fewer incidences of post operative complications.     

Randomized double-blind comparison of ephedrine and phenylephrine for management of post-spinal hypotension in potential fetal compromise

BackgroundMost studies comparing phenylephrine and ephedrine have been conducted during elective caesarean sections in healthy mothers with no fetal compromise. The effect of vasopressors on fetal outcome may differ between healthy and compromised fetuses. There has been little research into the effect of phenylephrine and ephedrine, when used for management of post-spinal hypotension in the presence of potential fetal compromise.MethodsHealthy women with a singleton pregnancy undergoing emergency caesarean section for fetal compromise under spinal anaesthesia were studied. One-hundred-and-six consecutive subjects, who developed hypotension after spinal anaesthesia, were randomly allocated to two groups of 53 each, to receive either phenylephrine (Group P) or ephedrine (Group E). For every systolic blood pressure reading <100 mmHg patients received phenylephrine 100 μg or ephedrine 8 mg depending on group allocation. Umbilical blood gas parameters and Apgar scores were recorded.ResultsThere was no statistically significant difference in umbilical arterial pH (P=0.79), umbilical venous pH (P=0.98), other blood gas parameters, incidence of fetal acidosis (P=1.00) and Apgar scores. The number of hypotensive episodes, vasopressor doses for treatment of the first hypotensive episode and the total number of doses used during the study period were comparable. The median [IQR] total number of doses of phenylephrine and ephedrine used before delivery were 2 [1–2] and 2 [1–2], respectively (P=0.67). More patients receiving ephedrine (24.5%) developed tachycardia than those receiving phenylephrine (3.8%) (P=0.004). Bradycardia was more common with phenylephrine, with 39.6% of patients in Group P as compared to only 1.9% of patients in Group E developing a heart rate <60 beats/min after vasopressor administration (P=0.001).ConclusionsBoth phenylephrine 100 μg and ephedrine 8 mg boluses are equally efficacious when treating post-spinal hypotension in the presence of potential fetal compromise. However, phenylephrine may be a better choice in the presence of maternal tachycardia.