已婚住院妇女患者2800例生殖道感染状况调查分析

目的对已婚住院妇女患者生殖道感染状况进行调查分析。建立住院妇女患者生殖健康档案．为该人群常见生殖道感染的预防和治疗提供科学依据,促进其身心健康。方法选择2012年1月至2013年1月住院的2800例已婚妇女患者为研究对象,对女性常见的生殖道感染病原微生物进行检查[人乳头瘤病毒（HPV）、支原体、农原体、淋球菌、假丝酵母菌、阴道滴虫],对检查结果进行统计分析。结果2800倒患者中生殖道感染患病率为35．00％（980／2800）,其中HPV、支原体、衣原体、淋球菌、假丝酵母菌、阴道滴虫的感染率分别为11．07％（310／2800）、25．18％（705／2800）、11．18％（31312800）、1．64％（46／2800）、7．29％（204／2800）、3．50％（98／2800）;不同年龄段已婚妇女患者生殖道病原微生物感染率比较,差异均有统计学意义（P〈O．05）;不同文化程度已婚妇女患者生殖道病原微生物感染率比较。差异均有统计学意义（P〈0．05）;城镇、农村已婚妇女患者生殖道病原微生物感染率比较,差异有统计学意义（P〈0．05）。结论已婚住院妇女患者生殖道感染率较高,针对性地开展妇科常见病、多发病普查和多元化的健康教育,可以降低其生殖道感染率。促进已婚妇女的生殖健康．全面提高其生活质量。     

成人结核病耐药原因分析

目的 了解不同年龄组结核病耐药产生的原因。方法 将653例痰培养阳性患者分为青年组（18～39岁），中年组（40～59岁）和老年组（60岁及以上），通过问卷调查的方式归纳耐药产生的原因。结果 调查结果显示耐药原因为化疗方案不合理、不规律治疗、经济困难以及原因不明等情况，各年龄组间初始耐药的发生率大致相同，无显著差异；获得性耐药患者中，青年组与中年组及老年组耐药发生率比较有显著差异；产生原因分析，青年组以不规律治疗为主，而中年组与老年组则以化疗方案不合理为主。结论 不同年龄组产生耐药的主要原因不同，应根据不同年龄组采取不同的措施减少耐药的产生。     

不同年龄慢性萎缩性胃炎的临床病理分析

目的:比较不同年龄阶段慢性萎缩性胃炎(CAG)患者各临床病理指标的差别,以期探讨各年龄段的患病特点。方法:按年龄将524例经病理活检证实的慢性萎缩性胃炎病例分为青年组(≤35岁)、中年组(36岁～59岁)和老年组(≥60岁)。比较不同年龄段患者的性别、病变部位、胃镜下表现、萎缩程度、肠上皮化生及幽门螺杆菌(Hp)感染情况等临床病理资料。结果:CAG以中老年多见(91.0％),青年组中患病女性多于男性(P<0.01),伴溃疡、息肉或结节状病变较中老年多见(P<0.05),而肠上皮化生率明显低于中老年组(P<0.01)。青年组和中年组萎缩程度明显低于老年组(P<0.01);各年龄组在病变部位、Hp感染方面无明显差异。结论:慢性萎缩性胃炎发病高峰年龄为40岁～60岁。青年患者中女性多见,以轻度萎缩及伴溃疡、息肉或结节状病变多见且多不伴肠上皮化生;中老年组则男性多见,以中度和重度萎缩多见且多伴有肠上皮化生。     

不同年龄痛风患者临床特征分析

目的：比较3组不同年龄痛风患者的临床特征，了解其临床特点以便于临床的诊疗及预后的判断。方法：收集2016年6月—2020年6月扬中市人民医院肾内科住院的痛风患者205例，按年龄分为青年组51例(≤44岁)、中年组67例(45～64岁)及老年组87例(≥65岁),分别收集并比较3组患者临床资料和相关生化检测结果。结果：老年组男性痛风患者所占比例(80.46%)低于中年组(97.01%)和青年组(98.04%),老年组女性痛风患者所占比例(19.54%)高于中年组(2.99%)和青年组(1.96%),差异均有统计学意义(P<0.05)。老年组高血压病合并率(85.06%)、慢性肾脏病合并率(35.63%)及脑梗死合并率(13.79%)高于中年组(58.21%、19.40%、2.99%)及青年组(29.41%、7.84%、0),中年组糖尿病合并率(14.93%)高于青年组(3.92%),老年组冠心病合并率(12.64%)高于青年组(1.96%),差异均有统计学意义(P<0.05)。老年组血尿素氮[(7.71±3.20)mmol/L]、血肌酐[(111.14±43.08)umol/...     

糖尿病血浆渗透压影响因素的临床研究

目的研究了不同年龄组(青年、中年、老年)血浆渗透压的情况,并探讨其相关的影响因素。方法根据患者年龄分为三组,青年组(20～39岁)、中年组(40～59岁)、老年组(≥60岁),所有受试者检查空腹血生化结果(至少禁食、禁水10小时以上)。根据血生化结果计算血浆渗透压,分析血浆渗透压与年龄、体重、体重指数、血脂、有无心脑血管病病史及糖尿病等病史的相关性。结果中年组及老年组血浆渗透压明显高于青年组(P值<0.01),老年组虽然高于中年组,但两组之间差别不明显(P值>0.05)。结论血浆渗透压与年龄、空腹血糖、体重、体重指数、血浆低密度脂蛋白水平等因素相关,但与收缩压、舒张压、心率、脑梗塞、冠心病等因素不相关。     

不同年龄段女性乳腺癌临床病理特点回顾性分析

目的:探讨不同年龄段女性乳腺癌临床病理特点。方法:对我院2013年3月-2016年3月收治的60例女性乳腺癌患者的临床资料进行回顾性分析,根据年龄段的不同将其分为青年组、中年组和老年组。比较三组患者的临床病理特征。结果:60例乳腺癌患者中,年龄≤35岁的青年女性乳腺癌患者有7例,占11.7%(7/60);年龄在35~60岁的中年女性乳腺癌患者有31例,占68.8%(41/60);年龄60岁的老年女性乳腺癌患者有12例,占20.0%(12/60)。青年组的淋巴转移率、肿瘤大小和组织学分级(Ⅱ/Ⅲ级)显著高于中年组和老年组,差异具有统计学意义(P0.05);中年组和老年组比较,差异无统计学意义(P0.05)。青年组非特殊浸润癌占比与中年组和老年组比较显著要高,差异无统计学意义(P0.05);三组比较,差异无统计学意义(P0.05)。结论:年龄在35~60岁的中年女性乳腺癌发病率较高,年龄≤35的青年女性乳腺癌相关临床病理特征显著高于中老年女性,肿瘤恶性程度较高,在临床中要尽早诊断和治疗。     

社区血糖异常人群分布与心脑血管疾病危险因素控制分析

目的 了解社区不同年龄阶段血糖异常人群分布情况与心脑血管疾病危险因素风险分析.方法 选择2011年6月至2014年12月河北省石家庄市13个社区确定血糖异常人群621例.采用统一设计调查问卷,内容包括人群情况基础资料、体格检查、实验室检查与影像学检查资料.以人群年龄分布分为老年组(年龄≥65岁)、中年组(年龄50~64岁)、青年组(年龄35~49岁)统计不同年龄阶段血糖异常分布概况(发病率)、伴发血脂异常与高血压病比例,临床疑似与确诊冠心病发病率,临床用药比例、药物依从性、目标控制理想患者比例.结果 入组621例血糖异常患者,男389例,女232例;老年组血糖异常患者368例.其中,空腹血糖受损68例,糖耐量降低75例,2型糖尿病191例,成人晚发自身免疫型糖尿病34例;中年组血糖异常患者187例.其中,空腹血糖受损42例,糖耐量降低79例,2型糖尿病39例,1型糖尿病27例;青年组血糖异常患者66例.其中,空腹血糖受损37例,糖耐量降低19例,2型糖尿病7例,1型糖尿病3例.老年组、中年组、青年组血脂异常与高血压病发生率差异无统计学意义(P>0靠.05);老年组与中年组颈动脉斑块形成发生率差异无统计学意义(P>0.05),但均高于青年组,差异有统计学意义(P<0.05).颈动脉不稳定斑块形成发生率以老年组最高.随着增龄变化,疑似冠心病比例与缺血性脑卒中发生率逐渐增加,差异有统计学意义(P<0.05),但3组间确诊冠心病比例比较差异无统计学意义(P>0.05).中、老年组患者服用药物种类<3类分别为(146例、8.08%)、(287例、77.99%).老年组临床用药比例及药物依从性高于中年组与青年组,但其危险因素控制达标比例与指南推荐比较仍较低.结论 血糖异常人群中,空腹血糖受损与糖耐量减低以青年组发病率较高,老年组中糖尿病人群比例远远高于其余2组.其中,成人晚发1型糖尿病发病率以中年组发病率较高.随着年龄增加,患者伴发心脑血管疾病并发症风险增加.青年组中临床用药比例较低,中年组患者用药依从性差,3组患者危险因素控制达标比例均低于指南推荐标准.     

职业已婚育龄妇女生殖健康及保健需求现况调查分析

目的 调查职业已婚育龄妇女的生殖健康问题,并对其生殖保健方面进行探讨.方法 随机抽取该县不同职业不同年龄的已婚育龄妇女612名进行问卷调查,调查内容包括年龄、职业、受教育程度、家庭总收入情况、生殖道感染情况、个人保健方面、产前体检率等.结果 年龄处于25～35岁的年轻职业已婚育龄妇女对自身的保健方面重视程度高于其他妇女,有工作的已婚育龄妇女对自身生殖保健的关注高于无职业者,受教育程度高的妇女比受教育程度低的妇女更重视产前体检,收入水平高的妇女对生殖道感染的治疗情况高于收入水平低者,差异均有统计学意义（P〈0.05）.结论 职业已婚育龄妇女的生殖健康及生殖保健的影响因素包括其年龄、职业、文化程度、家庭收入情况等,职业已婚育龄妇女需增加对自身生殖健康及生殖保健方面的知识,减少妇科疾病的发生.     

秦皇岛市海港区农村女性外阴阴道假丝酵母菌病现状调查及干预策略研究

目的 分析秦皇岛市海港区农村女性外阴阴道假丝酵母菌病(VVC)流行现状及干预措施.方法 采用整群抽样法抽取2010年4月至2011年10月秦皇岛海港区农村3个乡镇,2个自然村的3000名已婚育龄女性作生殖健康普查,从所有生殖道感染女性中筛选VVC患者,统计建档,并给予跟踪治疗,总结秦皇岛市海港区农村女性VVC感染的流行病学现状,分析其相关因素及有效干预措施.结果 (1)本组共调查女性3000名,其中生殖道感染占44 Z.67%,VVC占32.09%,在各类阴道炎中VVS患病率最高;(2)职业为渔民、既往VVC病史、季节因素、年龄、应用不洁卫生用品、乱用阴道冲洗液、滥用抗生素、阴道pH值、阴道清洁度均为已婚育龄女性患VVC的相关因素.结论 年龄、既往阴道炎病史、季节、不良行为因素、阴道清洁度、阴道pH值等均与VVC农村地区女性VVC发病有关,明确农村地区女性VVC发病特点,并予以个体化、规范化治疗,有助于改善VVC患者病情.     

无痛胃镜检查胆汁反流的临床分析

目的:探讨无痛胃镜检查中胆汁反流的临床发病特点。方法:对480例原发性胆汁反流性胃炎的临床特点进行分析,观察不同年龄组的检出率及中医证型特点,并且对所有患者进行了胃黏膜幽门螺杆菌(Hp)快速尿素酶检测。结果:胆汁反流检出率以青年组为最高,明显高于中年组及老年组,青年组中医证型以肝脾不和为最多,青年组Hp感染阳性率明显高于中年组及老年组。结论:胆汁反流以青年人发病率最高,其中医证型以肝脾不和为主,其Hp感染率也最高。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

基层医院护士在临床合理用药中的作用

目的充分利用护士在医师和患者间的特殊地位和作用,促进基层临床合理用药。方法从护士的工作性质出发,论述护士参与促进合理用药的方便和优势。结果通过实践,护士在促进合理用药中的作用得到有效发挥,基层合理用药环境得到极大改善。结论充分利用护士与医师和患者间的特殊桥梁作用,在基层医院促进合理用药,规范医师用药行为,防止药物滥用,引导患者安全用药,降低药源性疾病。