Analysis of antibacterial use density in the inpatients in 2011

目的:分析某医院2011年住院患者抗菌药物的使用强度,为合理使用抗菌药物提供参考。方法:回顾性收集该医院2011年抗菌药物相关使用数据,采用EXCEl 2003软件对各项数据进行汇总、排序;以限定日剂量(ddd)为单位,计算抗菌药物的使用频度(dddS)和使用强度(Aud)并进行统计、分析。结果:某医院2011年住院患者抗菌药物使用强度为66.08dddS/100人天。头孢菌素类、β-内酰胺酶抑制剂及其复合制剂和喹诺酮类的Aud值依次排前三名,绝大多数都是注射剂;头孢地嗪钠的Aud在所有品种中位居第一。结论:某医院2011年抗菌药物的总Aud低于全国平均水平,但也存在个别抗菌药物选用频度过高、滥用广谱抗菌药等不合理现象。应严格限制三代头孢菌素、β-内酰胺酶抑制剂及其复合制剂的临床应用,加强抗菌药物应用的监督管理及知识培训,加强临床药师的监督用药作用,预防和纠正不合理用药现象。Objective: To analyze the application of antibacterials in inpatients of a hospital in 2011,in order to provide references for rational use of antibacterials.Methods: The data about use of antibacterials in 2011 were retrospectively collected and sorted by Excel 2003.With defined daily dose(DDD) as the unit,DDDs and antibacterial use density(AUD) were analyzed statistically.Results: The mean value of AUD was 66.08 DDDs/100 persons/day.Cephalosporins,beta-lactamase inhibitors and quinolones ranked in the first three places in terms of AUD,and the majority of antibacterials were injections.The AUD of cefodizime sodium ranked the first in antibacterials.Conclusion: On the whole,AUD of the hospital was lower than national average level in 2011.But there were still irrational drug use,such as frequent use of some antibacterials,abuse of broad-spectrum antimicrobial agents.Third-generation cephalosporins,beta-lactamase inhibitors and combinations should be strictly restricted in clinical application.It is necessary to strengthen management and education of use of antibacterials and the supervision function of clinical pharmacists for controlling irrational medication

医院322例药品不良反应报告分析

目的分析药品不良反应发生的基本情况,为临床安全、合理用药提供参考。方法回顾性分析某医院2011年1月至12月收集的322例Adr报告,并进行统计分析。结果322例Adr报告中,严重Adr为133例,占41.30%。中老年患者比例最大(57.14%),给药途径引发的以静脉给药为主(77.01%)。抗菌药物引起的Adr居首位(34.78%),其中喹诺酮类Adr发生率最高,其次为头孢菌素类。结论在Adr监测中应加强对抗菌药物、中药注射剂的监测,并关注抗肿瘤药物的严重Adr,针对性地实施Adr防治措施,降低用药风险

肾移植患者伏立康唑与他克莫司药物相互作用的病例分析

目的探讨他克莫司(TAC)和伏立康唑(VRC)相互作用的机制,为临床合理用药提供依据。方法观察分析1例服用TAC的肾移植术后随访患者,在应用VRC治疗肺部真菌感染前后,TAC体内药物浓度的变化。结果联合用药前,TAC平均谷浓度C0为4.95ng·m L-1(4.3~6.0 ng·m L-1),平均C0/D为2.475 ng/(mg·m L)(2.15~3.0 ng/(mg·m L)),合用VRC后,C0为27.0ng·m L-1,C0/D为13.5 ng/(mg·m L),比未用VRC之前C0/D升高了445.5%。结论长期服用TAC的肾移植术后患者在应用VRC治疗肺部真菌感染时,应综合考虑患者遗传因素(CYP2C19和CYP3A5基因多态等)和非遗传因素,个体化给药。二者相互作用的机制是:VRC抑制肝脏CYP3A4/CYP3A5酶,使TAC的药物浓度显著升高;CYP2C19和CYP3A5基因多态在TAC与VRC相互作用中起了重要作用

A k-means-based Algorithm for Soft Subspace Clustering

软子空间聚类是聚类研究领域的一个重要分支和研究热点。高维空间聚类以数据分布稀疏和“维度效应“现象等问题而成为难点。在分析现有软子空间聚类算法不足的基础上,引入子空间差异的概念;在此基础上,结合簇内紧凑度的信息来设计新的目标优化函数;提出了一种新的k-MEAnS型软子空间聚类算法,该算法在聚类过程中无需设置额外的参数。理论分析与实验结果表明,相对于其他的软子空间算法,该算法具有更好的聚类精度。Soft subspace clustering is an important part and research hotspot in clustering research.Clustering in high dimensional space is especially difficult due to the sparse distribution of the data and the curse of dimensionality.By analyzing limitations of the existing algorithms,the concept of subspace difference is proposed.Based on these,a new objective function is given by taking into account the compactness of the subspace clusters and subspace difference of the clusters.And a subspace clustering algorithm based on k-means is presented.The additional parameter is not necessary in the novel algorithm.Theoretical analysis and experimental results demonstrate that the proposed algorithm significantly improves the accuracy.国家自然科学基金No.10771176---

Determination of Serum Voriconazole Concentration by HPLC

目的建立测定人血清中伏立康唑浓度的高效液相色谱法,用于临床该药的治疗药物浓度监测。方法采用乙腈沉淀处理血清样品,采用高效液相色谱紫外检测法测定。以硝西泮为内标,色谱柱为HyPErSIl OdS柱(200 MMx4.6 MM,5μM),流动相为25 MMOl/l磷酸二氢钾缓冲液-乙腈(32∶68),流速为1.0 M l/MIn,柱温为35℃,波长为256 nM。结果伏立康唑质量浓度在0.3~12μg/M l范围内与峰面积比线性关系良好(r=0.999 3),低、中、高质量浓度回收率分别为(105.0±3.6)%,(101.9±3.3)%,(101.1±3.4)%;日内、日间精密度的rSd均小于5%,定量限为0.3μg/M l。结论该方法简便快速、准确,适用于伏立康唑血药浓度的临床监测。Objective To establish a HPLC method to determine the concentration of voriconazole in human plasma for its clinical application in the curative drug concentration monitoring.Methods The serum sample was performed the precipitation treatment by actetonitrile, then HPLC- UV was adopted for detection.With nitrazepan as the internal standard, the chromatographic column was the Hypersil ODS columm( 200.0 mm × 4.6 mm, 5 μm), the mobile phase was 25 mmol / L potassium dihydrogen phosphate buffer solution-acetonitrile( 32 ∶ 68).The detection wavelength was at 256 nm with a flow rate of 1 m L / min and the column temperature of 35 ℃.Results The concentration of voriconazole in the range of 0.3-12 μg / mL( r = 0.999 3) showed the good linearity.The recovery rates of low, middle and high concentrations were( 105.0 ± 3.6) %,( 101.9 ± 3.3) % and( 101.1 ± 3.4) %, respectively.The intra- day and inter- day RSD were both less than 5%.The limit of quantitation was 0.3 μg / m L.Conclusion The established method is fast,accurate and suitable for the determination of blood voriconazole concentration

Evaluation of convective PCR for the detection of influenza A virus

目的评价热对流PCR应用于口岸现场甲型流感病毒快速检测的效果。方法设计热对流PCR的引物和探针,用于甲型流感病毒的检测。用甲型和乙型流感病毒毒株和入境发热人员的鼻咽拭子样本验证热对流PCR的检测灵敏度、特异性及稳定性,并与市售商品化实时荧光定量PCR试剂比较检测甲型流感病毒的效果。结果通过对8株甲型流感病毒和1株乙型流感病毒毒株进行检测,热对流PCR对H1、H3及H5亚型的甲型流感病毒毒株的检测下限为0.001~0.005HAU,具有较好的检测广谱性,且不与乙型流感病毒发生交叉反应。对155份鼻咽拭子样本进行检测,和实时荧光定量PCR相比,检测灵敏度为94.74%,特异性为97.44%,且具有很好的检测稳定性。结论热对流PCR具有很高的检测灵敏度和特异性,可用于口岸现场的甲型流感病毒快速筛查。Objective To evaluate the efficiency of convective PCR on rapid detection of influenza A virus at frontier ports. Methods The convective PCR primers and probe were designed for the detection of influenza A virus.Influenza A virus strains,influenza B virus strain and nasopharyngeal swabs of entry travelers with fever were used to analyze the sensitivity,specificity and stability of convective PCR. The detection efficiency of convective PCR was compared with commercial Real-time PCR kit. Results A broad detection spectrum of convective PCR was observed in testing 8 influenza A virus strains with different genotypes（H1、H3 and H5）and 1 influenza B virus strain,the detection limit of convective PCR for influenza A virus strain was 0.001 ~0.005 HAU. There was no cross reaction with influenza B virus. When convective PCR was applied to the detection of 155 nasopharyngeal swabs,comparison with Real-time PCR,the detection sensitivity was 94.74%,the detection specificity was 97.44%,and the detection stability was good. Conclusion Convective PCR had a high sensitivity and specificity,was fit for the rapid detection for influenza A virus at frontier ports.厦门市科技惠民计划项目（3502Z20174044）; 国家质检总局科技计划项目（2014IK045）; 福建省自然科学基金项目（2010J01152

我院开展治疗药物监测的实践与思考

目的讨论开展治疗药物监测(TdM)的临床意义,查找存在不足,并思考解决问题的对策。方法全面总结回顾该院TdM工作开展的基础、主要内容、药学服务举措及教学与科研创新成果,并结合临床实际,探讨今后开展工作的新思路。结果TdM工作中遇到的问题主要是医务人员利用TdM手段实施个体化给药的意识还不够强,医药团队协作能力有待提高。结论应通过加大TdM宣传力度,以TdM为切入口,加强与临床的密切配合与协作,配备更多高素质的临床药师,并通过与药物基因组学的结合,进一步提高治疗药物监测的工作质量

格列卫联合异基因造血干细胞移植治疗慢性粒细胞白血病

目的:为了考察格列卫联合异基因造血干细胞移植治疗慢性粒细胞白血病(CML)对移植及造血重建的影响。方法:对6例CML患者于移植前6周开始口服格列卫600~800mg/d至移植当日,预处理方案是福达拉宾、白消安、环磷酰胺,人类白细胞抗原(HLA)不相合者加用抗胸腺细胞球蛋白。移植物抗宿主病防治采用环孢素A加短程甲氨喋呤加霉酚酸酯。结果:6例全部成功植入,WBC>0.5×109·L-1平均为14.2d,PLT>20×109·L-1平均为15.6d。结论:CML患者移植前给予大剂量格列卫治疗不影响干细胞植入和骨髓造血的恢复

嗜虫耶尔森氏菌HlyA及HasA外分泌表达系统的构建

【目的】构建一株具备外分泌蛋白功能的工程菌,解决杀虫毒素无法由胞内分泌至胞外,无法直接作用于虫体等问题,为松墨天牛防治提供新思路。【方法】本研究先测定从松墨天牛肠道及其生境中分离出的嗜虫耶尔森氏菌(CSLH88)的生长特性及抗性,进而对其进行分子改造。构建HlyA (pGHKW2)以及HasA (pGHKW4)外分泌表达载体,利用电穿孔法将其转入CSLH88菌株,获得能够表达绿色荧光蛋白的工程菌。利用稀释涂板及荧光体式镜检测技术对两个质粒进行遗传稳定性检测,并采用SDS-PAGE及Western blotting技术验证蛋白外分泌功能。【结果】CSLH88菌株培养2–4 h能够进入对数生长期,并对卡那霉素(Kan)敏感。成功构建了含有Kan抗性基因的pGHKW2(GenBank:MK562405)和pGHKW4(GenBank:MK562404)两个外分泌表达载体的CSLH88工程菌株。其中,发现pGHKW4质粒更加适合在嗜虫耶尔森氏菌中稳定遗传。SDS-PAGE及Western blotting检测结果表明HlyA系统无法在CSLH88菌株中将目的蛋白分泌到胞外,而HasA系统则可以有效地发挥外分泌表达功能。【结论】通过对HlyA及HasA两个外分泌表达系统进行研究,从中筛选出HasA型血红素转运系统作为CSLH88菌株的外分泌表达系统,为后续外分泌杀虫毒素蛋白菌株构建以及CSLH88菌株的致病性研究奠定基础。国家重点研发计划课题(2017YFD0600105);;\n国家自然科学基金(31601905);;\n福建省科技厅自然科学基金(2016J01097);;\n福建省科技计划项目(2018N5002);;\n福建农林大学科研基金(xjq201614);福建农林大学林学院林学高峰学科项目(71201800720,71201800753,71201800779);;\n福建省大学生创新创业训练计划项目(201810389102);;\n福建省林业科学研究项目[Minlinke(2017)03]~

沿海产盐区与非产盐区8～10岁儿童碘营养与智力水平分析

目的了解和比较沿海产盐区和非产盐区8~10岁儿童碘营养状况与智力水平,为采取针对性防治措施提供依据。方法选择产盐区翔安区和非产盐区集美区的小学为调查点,8~10岁儿童为调查对象,调查其家中碘盐食用情况、尿碘含量、甲状腺肿大情况和智商水平。结果产盐区和非产盐区儿童合格碘盐食用率分别为81.5%和98.6%;甲状腺肿大率分别为3.0%和0.7%,尿碘中位数分别为202.8μg/L和238.4μg/L,<50μg/L的比例分别为3.5%和1.0%。产盐区8~10岁儿童智商均明显低于非产盐区儿童;产盐区8岁儿童智商明显高于9岁和10岁儿童;非产盐区8岁儿童智商明显高于9岁和10岁儿童,9岁儿童智商明显高于10岁儿童。结论补碘能提高儿童智商,降低智力损害。要坚持食用碘盐,开展对孕妇、哺乳妇的碘营养监测