目的:分析应用尼莫地平注射液的注意事项,并对不良反应提供相应的干预措施.方法:回顾性分析2019年7月—2021年7月于本院使用尼莫地平注射液治疗的80例患者的临床资料,观察患者使用尼莫地平的不合理用药情况、不良反应发生情况.结果:80例患者中存在药物不合理情况11例,其中以给药方法、配伍禁忌为主,占比分别为36.36％、27.27％.共16例患者出现了不良反应,其中低血压、恶心呕吐为主要不良反应,分别占比31.25％、25.00％.结论:使用尼莫地平注射液会存在一定的不良反应,医护人员要注意用药方式、配伍禁忌等,并密切关注患者用药后的表现,及时对不良反应提供护理,保证患者的用药安全性.

Objective:To evaluate the effectiveness of internal control of government procurement at public hospitals.Methods:Literature review and Delphi method were used to construct the internal control evaluation index system of government procurement at public hospitals, and the weight of the index system was determined by analytic hierarchy process. The index system was used to evaluate the internal control of government procurement in Hospital Z.Results:The evaluation index system of government procurement internal control of public hospitals covers all aspects of the whole process of government procurement, including 2 level-1 indexes of government procurement internal control unit level and government procurement internal control business level, 11 level-2 indexes and 27 level-3 indexes. The internal control of government procurement of Hospital Z was evaluated with an evaluation score of 81.37 points, an evaluation result relatively effective.Conclusions:The evaluation index system of government procurement internal control of public hospitals constructed in this study could quantitatively evaluate the effectiveness of each sector of government procurement internal control of public hospitals. It could meet the basic evaluation requirements of internal control of government procurement at public hospitals.

目的:观察人性化护理在小儿支气管哮喘急性发作中的应用效果.方法:回顾性分析2018年3月至2019年3月收治的128例支气管哮喘急性发作患儿的临床资料,依据护理方式的不同将其分为对照组63例和观察组65例,对照组接受常规护理,观察组在对照组的基础上接受人性化护理,比较两组临床症状指标水平、肺功能指标水平、家长心理状态和治疗依从性.结果:入院5 d后,观察组急性发作持续时间明显短于对照组,急性哮喘发作频次明显少于对照组,第一秒用力呼气容积/用力肺活量及用力肺活量均明显高于对照组,差异有统计学意义(P<0.05);观察组家长汉密尔顿抑郁量表评分明显低于对照组,差异有统计学意义(P<0.05);观察组喷雾用药依从占比明显高于对照组,饮水依从次数、饮食依从次数、注射及采血依从次数均明显多于对照组,差异有统计学意义(P<0.05).结论:在常规护理基础上采用人性化护理,可提高支气管哮喘急性发作患儿的治疗依从性,改善临床症状指标水平和肺功能指标水平,降低家长心理状态评分,其效果优于单纯常规护理效果.

目的:探讨临床药师规范化培训中高效实用的带教模式.方法:通过分析师徒制带教和临床药师培训的相似点及优势,探讨师徒制带教模式在临床药师培训中实施的可行性和可发挥的积极作用.结果:师徒制带教模式有助于解决目前临床药师培训所面临的困难,增加学员对默会性知识的学习,增强职业认同感,提高临床药师规范化培训质量.结论:师徒制带教模式在临床药师规范化培训中具有可行性,是可采用的高效实用的带教模式.

目的 研究应用综合护理干预在小儿布地奈德雾化吸入治疗中的效果.方法随机选取进行小儿布地奈德雾化吸入治疗的患者70例分成两组,各35例.对照组采用常规的护理干预,实验组实施综合护理干预,比较两组患者的护理效果.结果实验组患儿在治疗依从性、治疗时间以及副作用发生率情况等方面显著优于对照组,有统计学意义(P＜0.05).结论 应用综合护理干预在小儿布地奈德雾化吸入治疗的过程中,可提高治疗效果,以及依从性,缩短治疗时间,并减少了副作用的发生率.

目的:参照美国“Bolar例外”及首仿药制度的设立与发展,为我国仿制药制度的建立与完善提供参考建议.方法:采用文献调研和政策解读的方式进行内容提取,运用对比分析的方法进行制度研究.结果:我国在“Bolar例外”的适用范围与首仿药制度的建设方面还存在漏洞和缺失.结论:应不断完善我国“Bolar例外”的适用范围,加强首仿药制度建设,促进医药产业的持续健康发展.

目的 循证护理对于手足口病患儿产生的影响.方法 选择本院收治的80例手足口病患儿实施护理干预研究,其中40例纳入普通干预组,采取普通的干预措施,另外40例纳入循证护理组,在行普通干预同时采取循证护理,比较两组患儿临床疗效以及家长护理满意率.结果 循证护理组患儿临床疗效、患儿家长对护理服务的满意率都优于普通干预组(P<0.05).结论 循证护理可提升手足口病患儿的临床疗效,转变患儿家长对护理的认识,提升其护理服务满意率.

Aim:To develop a quantitative method for simultaneous determination of puerarin,mignonette,quercetin and catechin in hawthorn lipid-lowering soft capsules using ultra performance liquid chromatography-tandem triple quadrupole mass spectrometry.Methods: Hawthorn lipid-lowering soft capsules were extracted with methanol under the condition of ultrasound.The separation was carried out on a Waters ACQUITY UPLC BEH C18(2.1 mm×50 mm,1.7 μm) column.And the mobile phase was consisted of acetonitrile-0.1%(V/V) formic acid and H2O-0.1%(V/V) formic acid in a gradient elution mode.Then the sample solution was analyzed in electrospray ionization-ion mode with multiple reaction monitoring.Results: The results suggested that puerarin,mignonette,quercetin and catechin exhibited a good linearity in the range of 0.03~8.10,0.04~8.27,0.02~4.45 and 0.01~3.11 mg/L,respectively.And the correlation coefficient was higher than 0.992.The average recovery rate of the 4 flavonoids was in the range of 93.6%~107.5%,while the range of relative standard deviation was 1.62%~2.21%.Conclusion: The established method is sensitive,accurate and stable,and meet the requirement for determination of the 4 major flavonoids in awthorn lipid-lowering soft capsules,thus could be used for quality control of hawthorn lipid-lowering soft capsules.

Aim:To develop a method for the content determination of residual solvents in ticagrelor raw material in -cluding methanol,ethanol,acetonitrile,ethyl acetate,isooctane,and acetic acid.Methods:Capillary gas chromatography was adopted.The determination was performed on DB-624(30 m ×0.320 mm ×1.8 mm) capillary column, a flame ionization detector( FID) and the external standard method were used for the separation and quantitative analysis .The condition was that the injector temperature was 200 ℃, the FID temperature was 250 ℃ and the residual organic solvents were deter-mined by the split injection mode .Results: The good linear range of the 6 kinds of residual solvents had been obtained (r=0.99831-0.99999) with average recoveries of 91.49%-100.48%(RSD=2.85%-7.17%,n=9).The limits of quantification of the 6 kinds of residual solvents were 7.92,7.89,6.29,0.90,0.23 and 4.20 mg/L; the detection limits were 1.98,0.99,0.79,0.22,0.08 and 1.05 mg/L .The proposed method was successfully applied to analyze the residual organic solvent in the real sample of ticagrelor raw material , and the results showed that only ethyl acetate and isooctane were detected in the samples .Conclusion:The method is rapid, stable and repeatable for the content determination of the 6 kinds of residual solvents in ticagrelor raw material .

目的:采用Meta分析的方法,对喜炎平注射液临床使用中不良反应的发生率进行研究,以评价其在临床应用中的安全性和疗效.方法:由2位研究者分别独立检索中国知网、万方数据库、维普数据库、Web of Knowledge、PubMed、Elsevier Science Direct电子期刊等数据库(1950年1月至2016年4月)中与喜炎平注射液不良反应有关的临床研究文献.根据制定的纳入标准以及排除标准收集数据,提取信息并交叉核对筛选.用RevMan5.3软件对筛选后数据进行Meta分析.结果:共有73篇文献共8485例患者纳入研究,喜炎平注射液组不良反应发生率(4.3％)低于对照组(8.9％).喜炎平注射液组与对照组不良反应发生率的比值比OR值为0.46,95％ CI [0.38,0.55],P＜0.00001,结果呈显著性差异.在疗效的考察上,除热毒宁外,有效率均高于对照组.结论:喜炎平注射液的有效性和安全性相对较好,但临床使用中应密切注视其引发的严重过敏反应.不排除失访偏倚和发表偏倚对结果的影响.喜炎平注射液不良反应研究的文献质量有待进一步提高,确保是随机双盲临床对照研究.

目的:探讨榄香烯注射液辅助治疗肺癌脑转移患者的临床疗效.方法:将2012年6月-2014年9月某院收治的84例肺癌脑转移患者随机分为观察组和对照组,对照组采用常规放疗治疗,观察组采用榄香烯辅助放疗治疗,按RECIST制定的实体瘤客观疗效评定标准进行疗效评定,2组患者的生活质量应用卡式评分法评定.结果:观察组有效率(CR+ PR)为52.4％,明显高于对照组的28.6％,差异有统计学意义(P＜0.05);2组治疗后KSP评分观察组有效率为81.0％,对照组为50.0％,差异有统计学意义(P＜0.05);对照组骨髓抑制、放射性肺炎、头痛、恶心、呕吐等不良反应发生率为73.8％(31/42),观察组为31.0％(13/42),差异有统计学意义(P＜0.05).结论:榄香烯注射液辅助治疗肺癌脑转移患者有助于改善临床症状,增加放疗效果,改善患者生活质量,可在临床上推广.

Developing chemicals that inhibit checkpoint kinase 1 (Chk1) is a promising adjuvant therapeutic to improve the efficacy and selectivity of DNA‐targeting agents. Reliable prediction of binding‐free energy and binding affinity of Chk1 inhibitors can provide a guide for rational drug design. In this study, multiple docking strategies and Prime/Molecular Mechanics Generalized Born Surface Area (Prime/MM‐GBSA) calculation were applied to predict the binding mode and free energy for a series of benzoisoquinolinones as Chk1 inhibitors. Reliable docking results were obtained using induced‐fit docking and quantum mechanics/molecular mechanics (QM/MM) docking, which showed superior performance on both ligand binding pose and docking score accuracy to the rigid‐receptor docking. Then, the Prime/MM–GBSA method based on the docking complex was used to predict the binding‐free energy. The combined use of QM/MM docking and Prime/MM–GBSA method could give a high correlation between the predicted binding‐free energy and experimentally determined pIC50. The molecular docking combined with Prime/MM–GBSA simulation can not only be used to rapidly and accurately predict the binding‐free energy of novel Chk1 inhibitors but also provide a novel strategy for lead discovery and optimization targeting Chk1. © 2011 Wiley Periodicals, Inc. J Comput Chem, 2011

The c‐Jun N‐terminal kinases are attractive targets because of their involvement in several diseases. In this work, a combined molecular modeling study for a set of isoquinolones as inhibitors of JNK1 was performed by molecular docking, genetic algorithm–multiple linear regression and comparative molecular field analysis to rationalize the structural requirements responsible for the inhibitory activity of these compounds. Molecular docking study was employed to explore the binding mode of the active compound at the active site of JNK1. Based on the docked conformations, highly predictive 2D, 3D quantitative structure–activity relationship models were developed. The best 2D quantitative structure–activity relationship model was established using genetic algorithm–multiple linear regression method containing four molecular descriptors. The best comparative molecular field analysis model was obtained with a cross‐validated coefficient q 2 of 0.562, non‐cross‐validated r 2 values of 0.994. The information from quantitative structure–activity relationship models and molecular docking is useful for the design of novel JNK1 inhibitors with improved activities.

Inhibition of the protein chaperone Hsp90α is a promising approach for cancer therapy. In this work, a molecular modeling study combining pharmacophore model, molecular docking and three-dimensional quantitative structure-activity relationships (3D-QSAR) was performed to investigate a series of pyrazole/isoxazole scaffold inhibitors of human Hsp90α. The pharmacophore model can provide the essential features required for the biological activities of the inhibitors. The molecular docking study can give insight into the binding mode between Hsp90α and its inhibitors. 3D-QSAR based on CoMFA and CoMSIA models were performed from three different strategies for conformational selection and alignment. The receptor-based models gave the most statistically significant results with cross-validated q 2 values of 0.782 and 0.829 and r 2 values of 0.909 and 0.968, for CoMFA and CoMSIA respectively. Furthermore, the 3D contour maps superimposed within the binding site of Hsp90α could help to understand the pivotal interaction and the structural requirements for potent Hsp90α inhibitors. The results show 4-position of pyrazole/isoxazole ring requires bulky and hydrophobic groups, and bulky and electron repulsion substituent of 5-amides is favorable for enhancing activity. This study will be helpful for the rational design of new potent Hsp90α inhibitors.

This case by using psychosocial therapy pattern and skills to help the client realize egotism eliminate diseases of suspected.Through the strengthening of physical and psychological counseling, client had good mental state, and reached the expected effect.

患者男性,20岁.2008年9月酒驾时摔倒,石灰溅入左眼内,顿觉疼痛流泪,视力下降.当地医院给予结膜囊冲洗,"典必舒""润舒"滴眼液点眼.治疗1个月,患者症状未有明显好转,遂转至我院.专科查体:左眼视力为眼前指数,结膜水肿,角膜中央上皮纵椭圆形缺损,横径2.5mm,纵径3mm,角膜布满新生血管.入院后给予维生素C和地塞米松局部注射,乙酰半胱氨酸和阿托品凝胶点眼.同时配制碘伏冲洗结膜囊.反复与患者沟通其治疗原则与预后,患者表示配合. 1个月后,患者自觉症状缓解出院.2008年11月,患者再次入院,未有不适主诉.专科查体:左眼上睑睑球粘连,角巩膜缘肉芽增生,余同前.

This study was designed to investigate the interaction between (S)-2-(9H-purin-6-ylamino)-4-(methylthio) butanoic acid (PYMBA) and human serum albumin (HSA) using fluorescence spectroscopy. The combination of UV absorption and molecular docking under simulative physiological conditions was also applied to comprehensively understand the binding mechanism of PYMBA to HSA. Fluorescence data indicated that PYMBA has a strong ability to quench the intrinsic fluorescence of HSA. The binding constants (K) at different temperatures, thermodynamic parameters including enthalpy change (ΔH) and entropy change (ΔS) of PYMBA–HSA were correlated to the relevant fluorescence data, which suggested that the hydrophobic force played a very important role for the PYMBA binding to the HSA. The experimental results were in agreement with the results obtained via a molecular docking study. The effects of other ions on the binding constants were also studied.

Structure-based quantitative structure-activity relationship (QSAR) studies on a series of checkpoint kinase 1 (Chk1) inhibitors were performed to find the key structural features responsible for their inhibitory activity. Molecular docking was employed to explore the binding mode of all inhibitors at the active site of Chk1 and determine the active conformation for the QSAR studies. Ligand and structure-based descriptors incorporating the ligand-receptor interaction were generated based on the docked complex. Genetic Algorithm-Multiple Linear Regression (GA-MLR) method was used to build 2D QSAR model. The 2D QSAR model gave a squared correlation coefficient R(2) of 0.887, cross-validated Q(2) of 0.837 and the prediction squared correlation coefficient R(2)(pred) of 0.849, respectively. Furthermore, three-dimensional quantitative structure-activity relationship (3D QSAR) model using comparative molecular field analysis (CoMFA) with R(2) of 0.983, Q(2) of 0.550 and R(2)(pred) of 0.720 was also developed. The obtained results are helpful for the design of novel Chk1 inhibitors with improved activities.

Quantitative structure-activity relationship studies on 54 aminothiazole derivatives as Aurora A kinase inhibitors were performed to explore the important factors affecting their biologic activity. For 2D-quantitative structure-activity relationship study, genetic algorithm combined with multiple linear regression was used to select significant molecular descriptors. The MLR model gave squared correlation coefficient of 0.828 and squared cross-validated correlation coefficient of 0.771 for the training set compounds. Comparative molecular field analysis and comparative molecular similarity indices analysis were used to develop 3D-quantitative structure-activity relationship models. The comparative molecular field analysis model gave cross-validated correlation coefficient q² of 0.695 and non-cross-validated correlation coefficient r² of 0.977. For comparative molecular similarity indices analysis model, the corresponding q² and r² were 0.698 and 0.960, respectively. The proposed 3D-quantitative structure-activity relationship models were validated by the test set compounds not used in the modeling process, with r²(pred) values of 0.788 for comparative molecular field analysis and 0.798 for comparative molecular similarity indices analysis. The 3D contour maps suggested that further modification of the aniline group of compound 22 considering electrostatic, hydrophobic and hydrogen bond properties would influence the inhibitory activity. The results from quantitative structure-activity relationship models would be very useful to understand the structure-activity relationship of these inhibitors and to guide the further structural modification of new potential inhibitors.

Zinc-dependent matrix metalloproteinase (MMP) family is considered to be an attractive target because of its important role in many physiological and pathological processes. In the present work, a molecular modeling study combining protein-, ligand- and complex-based computational methods was performed to analyze a new series of beta-N-biaryl ether sulfonamide hydroxamates as potent inhibitors of gelatinase A (MMP-2) and gelatinase B (MMP-9). Firstly, the similarities and differences between the binding sites of MMP-2 and MMP-9 were analyzed through sequence alignment and structural superimposition. Secondly, in order to extract structural features influencing the activities of these inhibitors, quantitative structure-activity relationship (QSAR) models using genetic algorithm-multiple linear regression (GA-MLR), comparative molecular field (CoMFA) and comparative molecular similarity indices analysis (CoMSIA) were developed. The proposed QSAR models could give good predictive ability for the studied inhibitors. Thirdly, docking study was employed to further explore the binding mode between the ligand and protein. The results from all the above analyses could provide the information about the similarities and differences of the binding mode between the MMP-2, MMP-9 and their potent inhibitors. The obtained results can provide very useful information for the design of new potential inhibitors.