医院制剂配制方法的改进

目的：探讨医院药品制剂在实际配制过程中的改进方法。方法：本文通过查阅文献与结合我院实际临床经验，对传统药品的配制方法进行了改进，包括静脉输液、皮试用药、消毒用药、消肿用药以及外用洗剂等配制。结果：通过配制方法的改进大大提高了工作效率和药物的稳定性，增加药物的药效，同时有利于降低药物的副作用和污染。以及临床的操作和统一。结论：改进方法切实可行，操作简单，可供参考。     

静脉药物集中配制对临床工作的影响

静脉药物集中配制,是目前我国医院保障静脉输液安全的一项新措施.静脉输液是临床治疗不可缺少的方法,在输液过程中有时会发生热原反应和药物不良反应.长期以来,一旦发生输液反应只是查找大输液和注射药品的生产质量是否有问题,而很少从静脉输液操作程序、配药环境和药物配伍等临床环节查找原因[1].为了保障静脉输液的安全,2002年底我院在制剂楼建立了静脉药物集中配制中心,进行静脉药物集中配制.     

医院供应室除热原方法及其选择

医院供应室处理输液器具时的除热原效果,一直是亟待解决的问题。输液器具的除热原效果欠佳,是导致临床输液反应的主要原因之一。笔者曾用家兔法对矿区7所医院的输液器具进行热原检查,结果热原反应阳性率为42.86～50％(中国初级卫生保健1988;(10):30)。最近笔者又用鲎试验法进行检验,结果阳性率近100％(鲎试验法灵敏度较家兔法高)。经过调查发现,医院供应室在选择除热原方法上存在一些问题。本文就医院供应室除热原方法及选择应用问题作     

输液反应的原因,预防及处理

输液反应的原因、预防及处理应文真黄义驰福建省青州纸厂医院（３６５５０６）１输液反应的原因１．１体外因素①热原：常见的输液反应基本上属于热原反应，过去多归究于药物，现已认识到除药物外，还要注意输液器材。②微粒：近年来输液中微粒对人体的危害日益受到重视，...     

静脉输入甘露醇诱发热原反应因素调查分析

目的了解静脉快速输入甘露醇诱发输液热原反应的因素,为规范临床快速输入20％甘露醇操作提供依据。方法对我院静脉快速输入20％甘露醇11例操作过程进行调查分析。结果输液环境污染、通风不良、方法不当、消毒效果不佳或消毒剂存在污染、制剂不纯普遍存在。结论静脉快速输入甘露醇操作过程中输液的环境、通风与方法、消毒、输液滴速的不规范、制剂不纯是诱发输液热原反应的因素。     

医院药检室质量管理文件系统的建立和应用

目的：建立医院药检室质量管理文件系统，规范制剂检验质量管理。方法：按照国家食品药品监督管理局《医疗机构制剂配制质量管理规范（试行）》的要求，依据各级药品标准和制剂配制规范，结合本医院制剂品种及相关物料的质量管理目标，编制各项质量管理文件。结果：编写出了符合管理部门的要求又适应实际需要的检验质量管理文件，建立了检测过程、人员技术、环境、设备、物资和记录档案的质量保证体系，从而在资源有限的条件下达到实施制剂质量管理的目的。结论：建立医院药检室质量管理文件系统能有效地提高医院制剂检验的质量。     

碳酸氢钠注射液质量控制实验研究

目的 探索建立保证碳酸氢钠注射液质量稳定的方法，保证临床用药安全。方法 在医院制剂操作规程基础上，从改进制剂配制操作和含量测定方法入手，进行一系列生产实验观察和研究改进。结果 总结筛选出了保证医院制剂质量稳定的操作程序和含量测定的新方法：制剂配制水温不宜超过40℃，该制剂应采用250ml输液瓶装满为好，碳酸氢钠注射液不宜加乳酸来控制pH，制剂采用103℃、30min灭菌可确保制剂质量，含量测定方法指示剂采用甲红、溴甲酚绿，克服了甲橙指示剂终点不易观察的缺点，能确保制剂质量。     

甲硝唑葡萄糖注射液配制工艺的改进

0．2％甲硝唑葡萄糖注射液为抗厌氧菌首选药物,临床应用广泛,是医院制剂中的常规配制品种。由于活性炭对甲硝挂有很强的吸附作用［’1,按常规方法配制常造成含量被动大以致含量不准确＊］。我院制剂室在配制本品时曾采用不加活性炭吸附,直接溶解葡萄糖及甲硝峻进行配制（原法）。由于缺少活性炭对原料中热原、杂质、色素等的吸附,所配注射液细菌内毒素检查常出现阳性,特别是在原料欠佳时阳性率更高．为此根据甲硝叹在此注射液中含量低,总投料少的特点,对其配制方法进行了改进：按处方量先溶解葡萄糖加03％活性炭吸附后,过滤脱炭到…     

预防输液热原反应的护理体会

目的 探讨如何预防输液热原反应的护理措施。方法 分析输液热原反应发生的原凶和热原及微粒污染输液的可能途径。结果 减少了输液过程中的热原反应。结论 对提高基层用药安全性具重要意义。     

复方醋酸钠注射液质量控制方法探讨

目的:探讨复方醋酸钠注射液的新工艺及质量控制方法.方法:根据《中国医院制剂规范》中复方醋酸钠注射液的制备方法,结合人体血浆正常PH、渗透压及离子分布等,在原处方中加入适量硫酸镁,从容器包装、洗涤、配制及无菌等生产工艺过程进行严格控制.结果:按《中国医院制剂规范》中制备方法配制复方醋酸钠溶液时,异物表现为小白点、小白块及沉淀,平均成品率为38％.按本组改良新工艺配制的复方醋酸钠溶液平均成品率为93％,新工艺是可行的.而且新配方中加入硫酸镁后,使血浆渗透压及离子分布等更接近机体正常血浆情况.结论:在《中国医院制剂规范》复方醋酸钠注射液的处方中加入硫酸镁,改进工艺是安全可行的,更适于临床上多种疾病的补液治疗.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.