老年人鼻出血38例分析

鼻出血是病理条件下人体最多见的出血[1],是耳鼻喉科最常见的急症,老年人常患高血压、动脉硬化及伴各个器官不同程度的功能衰退,而且多数患者恐惧死亡引起精神紧张,了解老年人生理及心理特点,提高防范,快速有效施治非常必要,现将我院2004年1月～2006年12月诊治的严重老年人鼻出血38例总结如下。     

2007年1～11月全国医药行业经济运行情况分析

通过参考2007年1～11月医药行业统计数据，对全国医药行业经济运行情况进行了分析。结果显示，全国医药行业生产、销售保持快速增长，但产销率下降，出口增速减缓。虽然成本费用在提升，但经济效益出现了大幅度提升。     

"心希望工程"为社区群众带来佳音大型冠心病社区健康干预全面启动

冠心病在社区中是老年人群最常见的慢性疾病之一,如何来采取行动,以减慢和抑制这一慢性病上升的趋势已成为当务之急. 由中国医师协会和上海和黄药业共同发起的"心希望工程",自2007年3月正式启动以来,已在北京、上海以及浙江、江苏、广东、辽宁、山东等地的大、中城市取得了良好的社会反响.     

上医股份以最快的速度送出抗震救灾急救药品

5月12日,四川省汶川地区发生强烈地震以后,作为国家战备药品储备基地、军队战备药材代储企业的上海市医药股份有限公司,在国家重大突发事件面前,表现出高度的社会责任感,迅速启动了药品应急供应绿色通道,截至5月13日下午4点,已经送出第一批急救药品887件,并向上海市红十字会捐赠急救药品(价值人民币87.48万元).     

"入籍的中国女婿"——马海德大夫两三事

乔治·海德姆有了中国名儿 乔治·海德姆1910年9月生于美国纽约州水牛城一个阿拉伯移民家庭,祖籍黎巴嫩.他的父亲是个工人.乔治·海德姆靠奖学金资助完成了学业.1933年,23岁的他毕业于瑞士日内瓦医科大学,并获博士学位.受时代的影响,他毕业后就来到中国,结识了宋庆龄等人,因此得以在1936年和斯诺一起来到陕北.     

一动,一热,一冷,一烤霍英东勇斗癌魔4法宝

杰出的社会活动家、著名爱国人士、香港知名实业家、全国政协副主席霍英东先生于2006年10月28日在北京逝世,享年83岁.霍英东先生生前与癌症斗争了23年多,他的精神值得大家学习.霍英东先生是香港著名的大企业家,他热爱祖国,乐善好施,经常慷慨捐资救灾或为国家、社会、民众办好事和实事.     

丙酮酸对糖尿病大鼠晶状体氧化损伤与能量代谢的作用

目的:探讨丙酮酸对大鼠糖尿病性白内障的抑制作用.方法:Wistar大鼠120只,随机分为对照组、模型组及治疗组3组.模型组、治疗组应用链脲佐茵(STZ)诱发糖尿病.治疗组饲料及饮水中添加2%丙酮酸钠.在实验4、8、12周观察3组大鼠晶状体组织中GSH、MDA以及ATP的变化.结果:模型组与对照组比较,晶状体组织中GSH及ATP含量明显下降,MAD水平升高.而治疗组上述指标有不同程度改善.结论:丙酮酸减轻氧化应激反应,改善晶状体的能量代谢,抑制糖尿病性白内障的发生.     

抗震救灾捐赠药品的科学管理

2008年5月12日汶川发生8.0级大地震,引起了全世界的注意,也牵动了祖国各地人民的心.在地震发生后,祖国各地的企事业单位和个人通过各种形式表现自己的关注,很多制药企业通过捐赠药品的方式表达自己的爱心.作为四川省急救中心专门负责捐赠药品的部门,我们在具体工作中总结了一些经验,也发现了一些问题,在此提出,供参考和借鉴.     

川芎DNA提取方法的研究

目的 以伞形科蒿本属植物川芎Ligusticum chuanxiong Hort.叶为材料,研究川芎DNA的提取方法 .方法 分别采取CTAB法、高盐低pH法、木本植物DNA提取法、改良高盐低pH法提取基因组DNA,并对4种方法进行了改进.通过0.9%琼脂糖凝胶电泳和RAPD两种方法检测所提取的DNA样品.结果 比较DNA产量、质量等,确定了木本植物DNA提取法最佳.结论 木本植物DNA提取法为最佳方法.     

环孢素A眼膜研制

目的：研制环孢素A眼膜的给药新剂型，考察其稳定性、刺激性，为进一步开发眼膜提供经验。方法：以聚乙烯醇，羧甲基纤维素钠为骨架，制备环孢素A眼膜。结果：制剂稳定，工艺简单，刺激性小，使用方便。结论：环孢素A缓释眼膜是一种良好的新剂型，值得开发应用。     

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。     

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.     

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.     

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。