奥利司他对比二甲双胍降低超体质量或肥胖患者体质量疗效和安全性的Meta分析

目的:系统评价奥利司他对比二甲双胍降低超体质量或肥胖患者体质量的疗效和安全性,为临床提供循证参考。方法:计算机检索Pub Med、Embase、Ovid、Web of Science、Cochrane图书馆、中国期刊全文数据库(CJFD)、万方数据库及中文科技期刊数据库(VIP),收集奥利司他单用或联合二甲双胍方案(试验组)对比二甲双胍单用(对照组)降低超体质量或肥胖患者体质量、体质量指数(BMI)及不良反应发生率的随机对照试验(RCT),提取资料并按照改良后的Jadad进行质量评价后,采用Rev Man 5.3统计软件进行Meta分析。结果:共纳入9项RCT,合计502例患者。Meta分析结果显示,奥利司他与二甲双胍联用时,试验组患者BMI降低水平均显著优于对照组,差异有统计学意义[SMD=-0.74,95%CI(-1.22,-0.26),P=0.002];两组患者体质量降低水平[SMD=-0.04,95%CI(-0.27,0.20),P=0.76]、不良反应发生率[RR=1.07,95%CI(0.68,1.68),P=0.78]比较,差异均无统计学意义。结论:奥利司他、二甲双胍均可起到一定的降低体质量效果,且均有较高的安全性,联合使用可使BMI降低更显著。     

二甲双胍、达英-35联合治疗多囊卵巢综合征的疗效分析

目的:对比分析单用达英-35与达英-35联合二甲双胍治疗多囊卵巢综合征(PCOS)的疗效差异.方法:62例PCOS患者采取随机双盲法分为两组,对照组单用二甲双胍治疗,研究组选择达英-35联合二甲双胍的治疗方案,综合评价两组治疗前后内分泌情况及促排卵结局.结果:两组LH、T、LH/FSH和E2等指标水平前后对比差异均有统计学意义(P<0.05).结论:二甲双胍联合达英-35治疗PCOS可奏协同之效,有效改善内分泌,纠正胰岛素抵抗,且安全有保障,建议推广.     

达英-35联合二甲双胍治疗多囊卵巢综合征效果初评

目的:初步分析达英-35联合二甲双胍治疗多囊卵巢综合征(PCOS)的临床效果。方法:收治于新疆和田地区人民医院的140例PCOS伴有胰岛素抵抗(IR)不孕患者,随机分为对照组和观察组。对照组70例,单独应用达英-35治疗;观察组70例,应用达英-35联合二甲双胍治疗。治疗3个疗程后观察2组患者促排卵效果。结果:2组患者治疗后,观察组患者黄体生成素(LH)、促卵泡素(FSH)、睾酮(T),以及HOMA-IR明显降低。同时治疗后,观察组TC和TG都低于对照组(P<0.05),差异显著。结论:PCOS伴有IR不孕患者应用达英-35联合二甲双胍治疗,可明显改善内分泌失控状态,在此基础上可促进排卵,提高妊娠率。     

吡格列酮联合二甲双胍治疗胰岛素抵抗多囊卵巢综合征临床研究

目的比较单用二甲双胍和吡格列酮联用二甲双胍2种用药方案对胰岛素抵抗(IR)多囊卵巢综合征(PCOS)患者在胰岛素敏感、血糖控制和卵巢排卵功能方面的治疗效果,为胰岛素抵抗多囊卵巢综合征的有效治疗提供依据。方法 86例胰岛素抗性PCOS患者随机分为二甲双胍组(Met组)和二甲双胍与吡格列酮联合应用组(Met+Pio),分别考察2组用药前后PCOS患者症状改善情况、血糖和血脂代谢情况、胰岛素抵抗指标、性激素水平。结果 Met组和Met+Pio组患者在体重指标上未出现显著变化,而Met+Pio组在降低多毛症评分上更加明显(P<0.05),Met组和Met+Pio组在提高排卵率等恢复卵巢功能上均显示出显著效果,而且Met+Pio组月经正常率和排卵率均显著高于Met组(P<0.05)。Met组和Met+Pio组均可以提高胰岛素敏感性,而且Met+Pio组在降低HOMA-IR指数上更为显著(P<0.05)。结论二甲双胍或吡格列酮联合二甲双胍均可有效改善胰岛素抵抗多囊卵巢综合征患者临床症状及内分泌水平,吡格列酮联合二甲双胍在改善PCOS患者临床症状和增强胰岛素敏感性方面更具优势,空腹血糖及HOMA-IR与PCOS患者各项代谢指标和性激素指标具有不同相关性,对临床诊断具有参考价值。     

奥利司他联合二甲双胍治疗肥胖并发高血压24例

目的观察奥利司他合用二甲双胍对肥胖并发高血压患者的降血压、降体重等作用。方法肥胖并发高血压的患者36例，分为治疗组24例，对照组12例。两组患者均给予低热量饮食及抗高血压治疗。治疗组给予奥利司他120mg，bid，po，二甲双胍0．25g，tid，po；对照组给予相应安慰药，服用方法与治疗组相同。治疗24周。观察体重、腰围、血脂、血糖及血压变化情况。结果治疗组体重及腰围均较对照组显著下降，同时两组血压均较治疗前下降，治疗组在24周时舒张压下降更为明显。结论奥利司他合用二甲双胍在降低体重的同时，可显著降低血压。     

二甲双胍与罗格列酮治疗多囊卵巢综合征疗效观察

目的探讨二甲双胍、罗格列酮及二者联合对胰岛素抵抗(IR)的多囊卵巢综合征(PCOS)患者的治疗作用。方法伴IR的PCOS患者85例,随机分为A、B、C 3组。A组:29例,口服二甲双胍治疗;B组:28例,口服罗格列酮治疗;C组:28例,口服二甲双胍+罗格列酮治疗。3组用药时间均为5个月。比较3组用药前后体重指数(BMI)、Homa IR、睾酮(T)及黄体生成素与卵泡刺激素的比值(LH/FSH)的变化。结果治疗前后A组及C组BMI、HomaIR、T及LH/FSH均明显降低(P<0.05);B组治疗前后Homa IR、T及LH/FSH均显著降低(P<0.05),但BMI变化无统计学意义;用药前后C组的BMI降低程度与A组相比及C组的t值变化与A、B组相比均无统计学意义,但C组的Homa IR及LH/FSH降低程度明显小于A组与B组(P值均<0.05)。结论二甲双胍与罗格列酮均有改善多囊卵巢综合征的代谢指标的作用,但二者联合治疗比单一用药更有效。     

二甲双胍联合达英-35治疗PCOS不孕的临床研究

目的评估达英-35联合二甲双胍对多囊卵巢综合征(PCOS)不孕患者的治疗作用。方法将58例PCOS伴不孕妇女随机分为两组,A组(29例)单用二甲双胍,B(29例)组服用达英-35联合二甲双胍,A、B组均连续服用3个月,两组3个月后用克罗米芬(CC)促排卵治疗,比较治疗前后的生殖激素水平的变化以及排卵率和妊娠率。结果 A、B两组治疗后,促卵泡刺激素(FSH)、促黄体生成素(LH)、睾酮(T)及空腹胰岛素(IN)水平均明显下降,B组排卵率31.6%和妊娠率78.9%明显高于A组(11.5%,51.9%)(P<0.05)。结论达英-35联合二甲双胍能有效纠正高雄激素血症,同时改善胰岛素抵抗,增加克罗米芬治疗后排卵率和妊娠率。     

奥利司他可望用于多囊卵巢综合征患者的辅助治疗

据2005年2月的Clin Endocrinol Metab杂志报道，英国Hull大学的Vijay博士的研究表明，奥利司他(orlistat，赛尼可，Xerlical)可用于治疗多囊卵巢综合征女性(PCOS)，且对同时存在肥胖和PCOS的患者尤其有效，疗效似乎与二甲双胍相当。     

罗格列酮联合二甲双胍治疗多囊卵巢综合征促排卵效果

目的 观察应用二甲双胍、罗格列酮和两者联合治疗对存在胰岛素抵抗(IR)的多囊卵巢综合征(PCOS)患者促排卵的效果.方法 选择IR的PCOS患者90例随机分为A、B、C三组,分别口服二甲双胍(28例)、罗格列酮(30例)和罗格列酮联合二甲双胍(32例).三组用药时间均为3个月,比较用药前后胰岛素抵抗指数(HOMA-IR)和排卵情况.结果 A、B、C组HOMA-IR分别由(3.67±1.06)、(3.63±0.71)、(3.62±0.68)下降为(2.20±0.46)、(2.18±0.44)、(1.81±0.34);C组明显低于A、B两组(P<0.01).C组治疗后排卵率为84.3%,明显高于A组的35.8%和B组的36.7%(P<0.01).结论 罗格列酮联合二甲双胍能有效改善全身、尤其卵巢局部的IR;在并未应用促排卵药物的情况下,同样能达到相当高的促排卵率.     

肥胖型2型糖尿病患者联用奥利司他与沙格列汀、二甲双胍治疗的效果

目的:探讨肥胖型2型糖尿病患者联用奥利司他与沙格列汀、二甲双胍治疗的效果.方法:将我院2018年11月—2019年10月收治的60例肥胖型2型糖尿病患者随机分为相同例数的两组:研究组(n=30)、对照组(n=30).对照组口服二甲双胍治疗,研究组联用奥利司他、沙格列汀及二甲双胍治疗,对两组的临床疗效进行比较,比较治疗前后的FPG(空腹血糖)、2hPG(餐后2h血糖)及HbAlc(糖化血红蛋白)、TC(总胆固醇)、TG(甘油三酯)、LDL-C(低密度脂蛋白胆固醇)水平.结果:在临床治疗有效率方面,研究组较对照组患者显著提高(93.33％VS 73.33％),差异具有显著性(P<0.05).两组患者的FPG、2hPG以及HbAlc水平在治疗后均显著降低(P<0.05),且研究组患者上述血糖指标水平降低较对照组更加显著(P<0.05).两组患者的TC、TG、LDL-C水平在治疗后均显著降低(P<0.05),且研究组患者血脂指标水平降低较对照组更加显著(P<0.05).结论:肥胖型2型糖尿病患者联用奥利司他、沙格列汀及二甲双胍可以取得显著疗效,患者糖脂代谢水平得到显著改善,临床推广应用的价值较高.     

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.     

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。     

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.     

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。     

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.     

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.     

舒乐洗剂治疗外阴阴道念珠菌病的体内外实验研究

目的：观察舒乐洗剂治疗外阴阴道念珠菌病（VVC）的效果。方法建立体外白念珠菌生物膜模型,采用 XTT 法检测生物膜抑制率;建立 VVC 小鼠模型,采用阴道涂片检查和病理组织检测法,比较给药前后炎症状况的变化。结果舒乐洗剂对体外白念珠菌生物膜的形成有明显抑制作用,并成一定的剂量依赖性;能够抑制体外白念珠菌菌落形成,其中原液稀释一倍的效果最为显著;能够明显减少小鼠体内白念珠菌菌落形成,并能够减少炎性细胞向阴道黏膜的浸润。结论舒乐洗剂具有体外抗生物膜形成的作用,并能降低体内小鼠白念珠菌的感染状况,减轻VVC 小鼠阴道黏膜炎症,从而达到治疗 VVC 的作用。