综合性医院门诊幽门螺杆菌感染治疗用药分析及思考

目的 分析门诊幽门螺杆菌感染患者治疗用药情况,为规范治疗提供参考。方法 检索医院信息系统合理用药软件,获取2016年下半年门诊诊断为幽门螺杆菌感染的患者的处方信息,依据各临床指南及我国耐药情况等对其用药合理性进行分析。结果 在2577张处方中,主要不合理现象有使用阿莫西林克拉维酸替代阿莫西林,初始治疗方案使用左氧氟沙星,使用胃铋镁替代铋剂,儿童掰开使用质子泵抑制剂肠溶剂型,剂量不足,部分非消化科室治疗方案不合理率高。结论 幽门螺杆菌治疗存在不合理情形,临床应规范用药行为,药师应就不合理用药处方与临床沟通,职能部门进行奖惩、通过信息系统支持设定路径方案,多种措施减少不合理用药

丙氨酰谷氨酰胺注射液的临床应用调查及合理性评价

目的调查某院丙氨酰谷氨酰胺注射液的使用情况,评价其合理性,以促进临床合理使用。方法调取某院2017年7—12月所有住院使用丙氨酰谷氨酰胺注射液的2 357份病历并统计分析,随机抽取每月30份共180份病历进行合理性评价。结果该院丙氨酰谷氨酰胺使用率为4.7%,使用金额占药品总金额的0.84%。180份点评的病历不合理率为27.2%,主要存在无适应证用药(61.2%)和给药剂量不合理(30.6%)。结论丙氨酰谷氨酰胺的使用存在一定的不合理性,建议制定合理使用规范加强管理,促进临床合理用药

Efficacy and safety of buprenorphine transdermal patches in relieving moderate to severe chronic pain

目的观察丁丙诺啡透皮贴剂治疗中重度慢性疼痛的疗效和安全性。方法收集2015年10月至2016年3月在我院骨科门诊确诊为中重度慢性疼痛患者68例,给予丁丙诺啡透皮贴剂进行止痛治疗,初始剂量5 mg,qw,根据疼痛情况调整剂量至无痛或基本无痛状态。对每位患者随访1个月,分别评估患者治疗前后疼痛强度、镇痛效果、生活质量、用药依从性,同时监测药物不良反应。结果治疗前、后患者疼痛数字评分分别为（5.90±1.05）分和（1.35±0.75）分,P〈0.05;疼痛总缓解率为91.18%;治疗后SF-36生活质量量表（中文版）8个方面维度分数和用药依从性均较治疗前显著提高（P〈0.05）;药物不良反应发生率为8.82%。结论丁丙诺啡透皮贴剂具有镇痛稳定、作用持久、不良反应轻、用药依从性高等特点,可倡导应用于中重度慢性疼痛的治疗。AIM To observe the efficacy and safety of buprenorphine transdermal patches in relieving moderate to severe chronic pain. METHODS From October 2015 to March 2016,a total of 68 patients with moderate to severe chronic pain in orthopaedics clinic in our hospital were treated with buprenorphine transdermal patches,used with an initial dose of 5 mg qw and adjusted dose until pain disappeared. After one-month follow-up,the patients with moderate to severe chronic pain were respectively evaluated and pain relief,quality of life,medication compliance and adverse drug reactions were compared. RESULTS At pre-therapy and post-treatment,the scores of NRS（ numerical rating scale） of the patients were（ 5. 90 ± 1. 05） and（ 1. 35 ± 0. 75） respectively,P 〈0. 05.There was significant difference befor and after treatment in pain relief,life quality and medication compliance（ P 〈0. 05）. The total remission rate in pain was 91. 18%. It was 8. 82% in incidence rate of adverse drug reactions. CONCLUSION Buprenorphine transdermal patches have the characteristics of stable analgesia,long duration of effect,less adverse drug reactions and higher compliance,and can be advocated for in the treatment of moderate to severe chronic pain

无乳链球菌致儿童细菌性脑膜炎抗感染实践

目的分析药师参与的无乳链球菌致儿童细菌性脑膜炎的治疗实例,促进抗感染药物在细菌性脑膜炎的合理使用及探讨全敏感无乳链球菌抗感染治疗不佳情况下的药学思维。方法药师参与无乳链球菌致儿童细菌性脑膜炎病例治疗,对全敏感无乳链球菌抗感染治疗不佳原因进行剖析总结。结果药师对部分抗感染方案给出建议获得采纳后治疗取得进展,针对国内耐药情况对细菌性脑膜炎的经验治疗方案建议采用美罗培南联合万古霉素;对万古霉素进行血药浓度监测并在浓度指导下进行剂量调整;对病原菌明确为全敏感无乳链球菌抗感染治疗出现反复情况下提出细菌耐受可能并给予利奈唑胺联合青霉素抗感染建议。结论药师参与临床治疗有助于治疗方案改进,不生搬硬套并领会指南有助与临床沟通,药师深入了解细菌耐药特性及抗菌药物药动药效学有助于优化用药,纠正用药习惯

101例门诊中晚期癌痛患者疼痛治疗效果分析

目的从疼痛治疗角度,探讨影响门诊中晚期癌痛患者疼痛治疗的可能因素,以期为临床合理用药提供参考。方法采用随访调查法,对本院2016年12月~2017年5月间,持有门诊麻醉药品取用特殊病历的中晚期癌痛患者101例,进行2周以上的阿片类药物止痛治疗随访,收集疼痛治疗指标,比较不同年龄、性别、肿瘤部位使用阿片类药物的疗效、剂量及不良反应。结果本研究,不同年龄段间,50~59岁患病人数所占的比例最高,60~69岁吗啡日均剂量达到最大值;不同年龄段,癌痛治疗的效果及剂量比较,差异无统计学意义;男性组NRS评分值,疼痛缓解程度值和吗啡日均剂量均略高于女性组;不同肿瘤部位间癌痛治疗的效果及剂量比较差异无统计学意义;≥60岁组恶心、呕吐和便秘发生率均高于<60岁组,差异有统计学意义(P <0. 05),男性组ADR发生率高于女性组,差别均无统计学意义。结论在癌痛治疗中,性别、年龄、肿瘤部位是临床使用阿片类药物时需要考虑的因素

Studies of preparation and properties of RGD-tTF water-based ferrofluids

目的探讨RGD-tTF水基磁流体通过磁场和RGD多肽在体外对内皮细胞双靶向的功能。方法通过化学沉淀法以柠檬酸钠为表面活性剂制备水基磁流体(MnFe2O4),弱酸改性后与重组的RGD-tTF融合蛋白结合,利用H-600透射电镜观测纳米粒径,以SUQID鉴定磁性,用MTT法、因子X活化检测和流式细胞仪检测RGD-tTF磁流体生物活性。结果成功制备出的水基磁流体能在磷酸盐缓冲液中稳定分布且具有生物兼容性,实验表明RGD-tTF与水基磁流体结合后对RGD和tTF生物活性均无显著影响,并证实在磁场的作用下能实现了水基磁流体对RGD-tTF的定位作用。结论一种具有内皮细胞双靶向功能的RGD-tTF水基磁流体已制备成功。 【英文摘要】 Purpose To study the property of RGD-tTF water-based ferrofluids double targeting EC304 cells in vitro by magnet and RGD peptide.Methods Water-based ferrofluids(MnFe2O4) were prepared by chemical precipitation method using citrate as surfactant, dispersed in weak acid to create surface charges,and coated with recombinant RGD-tTF protein.Proteins coated ferrofluids were characterized by H-600 transmission electron microscopy(TEM)and Superconducting Quantum Interference Device(SQUID),and its biological activi...教育部和厦门大学出国留学人员启动基金资

化学模拟生物固氮——Ⅸ 铁钼辅基模型化合物的合成和性能表征

本文曾在全国化学摸拟生物固氮协作组领导小组扩大会议(昆明,1980,8)上宣读。[中文文摘]采用乙二醇基阴离子作为活插头(可通过水解除去的双配位螯形配位体),对前文提出的合成方法作了重要改进,以期所合成的铁钼辅基模型化合物中Mo~(Ⅳ(Ⅲ))第一配位界内两个不稳定的配位体处于相邻的位置,如厦门模型Ⅲ(或厦门模型Ⅱ)所要求。合成和重组活性评价结果,重组活性比使用乙腈等为活插头的提高2个数量级,化学催化活性和选择性接近于天然FeMo-co水平。[英文文摘]A significant improvement has been made to the method previously proposed[3] for synthesizing FeMo-co modeling compounds. With the use of ethylene glycolate anion as labilizable blocking agent (hydrolyzable bidentatc chelating ligand)to protect two neighboring coordination sites in the first coordination sphere of MoIV(III) of the synthesized FeMo-co modeling compound, an increase in reconstituted-nitrogenase activity of 2 orders of magnitude of the sample synthesized (as compared with the use of acetoni-trile or other monodentare ligands as bloeking agents)has been obtained.Catalytic activity and selectivity assays as well as preliminary characterization by EPR method have also been made

Kinetic Investigation on the Mechanism of the Reduction of Imidazole Cobalt(Ⅲ) Complexes

Kinetic studies on the electron transFer(ET) reaction of [Co(NH3)5(ImH)]3+/[Fe(CN)6]4- and trans-[Co(NH3)(en)2(ImH)]3+/[Fe(CN)6]4- have been carried out at various temperatures.The results indicated that these two ET reactions Followed the outersphere mechanism.At 25℃,I=0.50mol'L-1, the ion pair Formation constants Qip ofthe prectirsor complexes in the ET reactions are 2.6×102 and 4.9 × 1O2mol'L-1 ,and theelectron transFer rate constants kct are 2.1 ×10-4 and 5.2 ×10-5s-1 respectively.The activation enthalpy and the activation entropy of these two processes are 1.2×1O2,0.8 ×102kJ 'mol -1 and 5.1×102, 3.6 ×102J·mol-1 ·K-1 respectively.国家自然科学基

InGaAsP/InP MQW电流控制型双稳/非线性增益开关激光器

一种电流控制型二端及三端MOW(多量子阱)InGaAsP/InP双区共腔双稳/非线性增益开关激光器业已研制成功,文中报道了部分结果