目的:探究甘草素对来曲唑诱导的多囊卵巢综合征(PCOS)大鼠的保护作用及机制研究.方法:将40只雌性SD大鼠随机分为4组:A组:不做任何处理,B组:造大鼠多囊卵巢综合征模型,C组;给予甘草素300 mg· kg-,D组:给予甘草素100 mg· kg-1.末次给药结束12h后,称取大鼠卵巢质量;采用HE染色的方法观察大鼠卵巢组织形态的变化;采用ELISA法检测血清中促卵泡雌激素(FSH)、促黄体生成素(LH)、雌二醇(E2)、孕酮(P)和睾酮(T)含量变化;采用Western blot法检测各组大鼠卵巢组织中P450芳香化酶(P450arom)的表达量.结果:大鼠卵巢质量测定结果表明,C组较B组大鼠卵巢质量降低(P＜0.05).HE染色结果表明,B组大鼠的卵巢组织形态学出现异常改变,C组较B组卵巢组织形态有明显改善,D组大鼠卵巢组织形态未见明显改善.ELISA结果表明,B组与A组大鼠血清中LH、T、E2含量比较,差异有显著性(P＜0.05);C组与B组大鼠血清中LH、T、E2含量比较,差异有显著性(P＜0.05).PCR结果表明,C组大鼠卵巢组织中CYP19 mRNA含量较B组降低(P＜0.05).WB结果表明,B组大鼠卵巢组织中P450arom蛋白表达水平比A组增多(P＜0.05);C组大鼠卵巢组织中P450arom蛋白表达水平比B组减少(P＜0.05);D组与B组大鼠卵巢组织中P450arom蛋白相比无明显变化(P＞0.05);C组大鼠卵巢组织中P450arom蛋白表达水平比D组降低(P＜0.05).结论:甘草素可明显改善来曲唑诱导的多卵巢综合征大鼠的卵巢组织形态,调节性激素分泌,抑制卵巢组织中P450arom的表达.

幼年特发性关节炎(juvenile idiopathic arthritis, JIA)是儿童时期常见的结缔组织病,全身型幼年特发性关节炎(systemic-onset JIA,SOJIA)是其中一个亚型,SOJIA合并严重肝功能不全并不常见,但发展成肝脏衰竭死亡率高.本文通过比较2例幼年特发性关节炎全身型合并严重肝功能不全患儿的临床特点和治疗及预后,探讨血液灌流的作用,以期为此类患者的治疗提供借鉴.

>新生儿红斑狼疮(neonatal lupus erythematosus,NLE)是母体自身抗体通过胎盘引起的临床综合征,NLE包括几种主要的临床表现:完全性先天心脏传导阻滞和皮肤狼疮最常见,肝胆疾病、血液系统及中枢神经系统受累也可能发生。NLE一般预后较好,但出现严重系统损伤需引起高度关注并及时处理。现报告苏州大学附属儿童医院收治的1例NLE换血治疗难治性肝功能不全患儿的临床表现、治疗及随访结果,为临床提供参考。

Objective To discusses the effectiveness of tocilizumab in the treatment of hypomyopathic dermatomysositis (HDM) combined with interstitial lung disease (ILD) in children. Methods The clinical characteristic, treatment, and prognosis of HDM combined with ILD were analyzed in 2 patients. The related literatures were reviewed. Results Both ten-year-old girl and 8-year-old boy had shortness of breath after activities, but had no clinical manifestations of muscle damage; both of them had typical rash, but had nornal muscle strength and muscular tension. Laboratory tests showed the elevation of serum ferritin, lactate dehydrogenase, glutamate aminotransferase, and aspartate aminotransferase. Creatine kinase slightly increased in the initial test, and then was in the normal range in the following tests. The high resolution computed tomography showed that pulmonary interstitial lesions. HDM combined ILD was diagnosed clinically. The girl died after treatment with high-dose hormones, cyclophosphamide, cyclosporine, pirfenidone, and gamma globulin failed. The boy was stabled after conventional hormone treatment plus tocilizumab (240 mg twice). His laboratory indicators were in the normal range in the follow-up. Conclusions The clinical manifestations and laboratory indicators aren't typical in childhood HDM. The mortality is high. Combined with tocilizumab treatment is effective in one case.

目的:探讨输液药房药品管理和调配模式对工作和患者的影响.方法:介绍输液药房自动化信息系统的流程和调配流程,通过对药房请领模式和药品管理的介绍和新旧调配模式下患者输液等候时间的比较,评价输液药房成立的效果.结果:输液药房领药上药模式,药品有效期、批号的管理模式对药品的管理工作化繁为简;调配流程使患者输液步骤明显简化,并且不需要患者自己取药至输液中心;输液等候时间从29～76 min缩短到6～13min,同时也减少了护士首次核对药品、书写输液贴和卡的工作环节.结论:输液药房的管理模式加强了对药品的监管和调配模式,减少了患者输液等候时间,减轻了护士的工作量.

目的:考察不同厂家的克拉霉素缓释片体外溶出度,为药品采购及临床选用药物提供参考.方法:采用转篮法进行体外溶出度实验,并用高效液相色谱法测定克拉霉素缓释片溶出含量,计算累积溶出百分率;以威布尔方程(Weibull's equation)拟合溶出参数t50、td、t80、m,再对参数进行方差分析.结果:3家生产厂的克拉霉素缓释片体外溶出参数t50、td、t80、m,经比较其差异有统计学意义(P＜0.01).结论:不同厂家生产的克拉霉素缓释片溶出度存在显著差异,采购药品及临床用药时应加以注意.

OBJECTIVE:To improve the passing rate of prescription,and to promote rational use of drugs.METHODS:The quality control circle(QCC) activity was carried out through a series of steps,such as plan,implementation,confirmation and disposal.The number of unqualified prescriptions per day in certain period was compared before and after the implementation of QCC to calculate to the extent of improvement.RESULTS:The number of unqualified prescriptions decreased from 209.6 per day to 114.8 per day.The extent of improvement was 45.23%.CONCLUSION:The implementation of QCC can improve medical quality and protect the safety of patients by standardizing prescription management.