目的:探究金樱子乙醇提取物(RLM)对系膜增生性肾小球肾炎(MsPGN)大鼠的保护作用,并初步探究其作用机制.方法:将SD大鼠分为假手术组(Sham),MsPGN组,金樱子乙醇提取物低、中、高剂量组(RLM-L、RLM-M、RLM-H),阳性对照组(醋酸泼尼松组,Prednisone acetate),每组12只大鼠,给药4周后收集24 h蛋白尿液处死大鼠,观察各组大鼠体重变化情况,检测血清肾功能相关指标肌酐(Scr)、尿素氮(BUN)等;HE染色检测肾组织病理形态学变化;蛋白免疫印迹法(WB)、免疫组化法检测肾组织中NLRP3、凋亡相关斑点样蛋白(ASC)、半胱天冬酶(caspase-1)表达;ELISA法检测肾组织匀浆中IL-1β和IL-18表达.结果:与Sham组相比,MsPGN组大鼠体重降低,24 h尿蛋白、BUN、Scr水平升高,TP、ALB水平降低,肾组织损伤评分升高,肾组织中NLRP3、ASC和caspase-1蛋白表达升高,组织匀浆中IL-1β、IL-18水平升高(P<0.05);与MsPGN组相比,RLM-L、RLM-M、RLM-H、Prednisone acetate组大鼠体重升高,24 h尿蛋白、BUN、Scr降低,TP、ALB水平升高,肾组织损伤评分降低,肾组织中NLRP3、ASC、caspase-1蛋白表达降低,组织匀浆中IL-1β、IL-18水平降低(P<0.05).结论:RLM对MsPGN大鼠肾脏损伤具有保护作用,这种作用可能通过抑制NLRP3炎性小体通路,进而抑制通路介导的促炎性因子IL-1β和IL-18的表达,最终缓解肾损伤.

目的 探讨吸入用乙酰半胱氨酸溶液辅助布地奈德治疗小儿支气管肺炎的效果.方法 选取2018年1月—2019年1月我院收治的小儿支气管肺炎患儿70例作为研究对象,以随机数字表法分成对照组和观察组,每组各35例.对照组患儿给予常规治疗并雾化吸入布地奈德,观察组在对照组基础上加用乙酰半胱氨酸溶液3 mL辅助布地奈德雾化吸入.比较2组治疗总有效率,临床症状、体征消失时间,住院时间与不良反应.结果 观察组治疗总有效率为91.43％,明显高于对照组的74.29％(P<0.05).观察组退热时间、咳嗽消失时间及住院时间均短于对照组(P<0.05),2组不良反应发生率差异无统计学意义(P>0.05).结论 乙酰半胱氨酸辅助布地奈德雾化吸入治疗小儿支气管肺炎可快速缓解患儿临床症状,不良反应较少,具有良好的安全性,值得在临床广泛运用.

Objective To investigate the influence of administrative intervention on the rational use of antibiotics in the perioperative pe-riod of hospitalization. Methods According to the implementation time of the administrative intervention measures,it was divided into two stages as before and after the intervention. Random sampling of the two stages of hospitalization records,were 1 264 and 920 re-spectively. A comparative analysis of the specific circumstances of the application of antimicrobial agents in the two stages were con-ducted. Results Compared with the first stage,the irrational application of antimicrobial agents such as no medication indication,irra-tional drug selection,irrational drug combination,irrational usage and dosage,drug replacement without any basis,irrational route of ad-ministration and preoperative delivery time more than 2 h,etc. ,in the second stage were significantly reduced;the total antibiotic use rate,antimicrobial use intensity rate and preventive medication rate on type Ⅰincision were significantly reduced;the microbial inspec-tion rate was significantly higher with statistically significant difference( P < 0. 05). There was no significant difference in the number of patients with more than 24 hours of treatment between the two stages ( P > 0. 05). Conclusion The administrative intervention measures can significantly improve the irrational use of antibacterial drugs,regulate the operation of physicians in selecting rational an-tibacterial drugs,which is worthy of promotion in the basic hospitals.

Objective To determine the cost-effectiveness analysis of different prophylactic antibiotics in the perioperative pe-riod of hemorrhoids surgery. Methods 195 cases of hemorrhoids were collected in our hospital from January 2014 to March 2016 , who were randomly divided into 4 groups:48 cases of the A group,48 cases of the B group,49 cases of the C group,50 cases of the D group. The rate of adverse reactions,the number of peripheral blood leukocytes before and after the operation,the rate of in-cision infection and the cost of antibiotics among the four groups were compared. Results The length of operative time and hospi-tal stays,the volume of blood loss,the rate of incision infection and adverse reaction,the number of peripheral blood leukocytes,a-mong the four groups had no significant difference (P>0.05). However,compared with the other three groups,the cost of antibacte-rial drugs of the D group was significantly less (P<0.05). Conclusion Combination of cefazolin sodium salt and metronidazole in a short course was a better choice as the prophylactic antibiotics regimen in the perioperative period of hemorrhoids. since it was safe,effective and less costly. The regimen is worthwhile for prompting in clinical practice.

目的 了解某院药品不良反应(ADR)发生的规律及特点,为临床合理用药提供依据.方法 收集该院2013年上报的154例ADR报告,按患者的年龄、性别、给药途径、主要临床表现及所涉及的药品种类等进行统计分析.结果 154例ADR报告中,不同给药途径中,静脉给药引发的ADR最多,占76.6%(118例);不同种类药品中,抗感染药物引发的ADR最多,占49.4%(76例),中成药占10.4%(16例);临床表现以皮肤及其附件损害最为常见,占50.0%(77例).结论 应加强专业人员的业务和服务素质培养,并展开全方位的ADR监测工作,以减少和避免ADR的发生.

目的：调查萍乡市人民医院北院癌痛患者麻醉药品的使用情况，为临床合理应用麻醉药品提供参考。方法依据萍乡市人民医院电脑药房管理系统提供的2010～2012年麻醉药品应用数据，包括药品名称、规格、数量、金额、用药频度（DDDs）等情况进行统计分析。结果本院2010～2012年麻醉药品共涉及9个品规三种剂型，临床使用最多的是口服制剂硫酸吗啡缓释片和盐酸羟考酮片，使用最少的是盐酸布桂嗪注射液和盐酸哌替定注射液。结论本院癌痛晚期患者麻醉药品使用基本合理，符合癌痛三阶梯用药原则。

采取PDCA循环模式应用于医院药学部的质量安全管理，能够带动全员参与，通过质量管理员以点带面，渗透质量与安全意识，逐步规范管理工作，使药事工作纳入规范化、统一化管理。

OBJECTIVE:To introduce our experience with the clinical pharmacy work carried out in our hospital. METHODS:The clinical pharmacy work carried out in our hospital was elaborated. RESULTS&CONCLUSIONS:The practice of clinical phar-macy work has solved some practical problems,gained approval and welcome among clinicians,promoted the rational use of drugs,improved clinical pharmacists’confidence in engaging in clinical pharmacy,and gradually a“patient-centered”pharmacy management mode has been achieved. It is necessary to develop high level clinical pharmacists,enhance their communication and collaboration,to be included into hospital planning,ensure the time access to clinic and establish a clinical way of thinking,to fa-cilitate the carrying out of clinical pharmacy work.

目的 制备复方克林霉素凝胶,建立质量控制方法,在临床中应用研究观察疗效.方法 复方克林霉素凝胶是由克林霉素磷酸酯和尿囊素为主药,卡波姆940 2.0 g、丙二醇 10 ml、尼泊金乙酯 0.1 g、三乙醇胺 2.0 ml、甘油 4.0 ml、氮酮 2.0 g组成制备复方凝胶,HPLC测定克林霉素磷酸酯、尿囊素的含量,建立质量控制方法.结果 克林霉素磷酸酯线性范围为: 2.0 mg/ml～18.0 mg/ml,平均回收率为:99.80%,RSD=0.617%,尿囊素线性范围为: 0.4 mg/ml～3.6 mg/ml,平均回收率为 99.92%,RSD=0.113%(n=3).结论 制备方法和质量控制方法简便、快捷、准确.临床疗效好,值得临床推广应用.

目的了解本院口服降糖药的用药情况和发展趋势。方法回顾性调查我院药房2006-2008年间口服降糖类药物的药物利用指数、并进行合理性的统计分析和比较。结果我院口服降糖药的用药金额逐年增长,但2008年较2007年增长相对缓慢;口服降糖药的药物利用指数(DUI)大多接近1,盐酸二甲双胍片、阿卡波糖的DUI值偏小。结论口服降糖药在糖尿病的临床治疗中占有重要的地位,且有很大的市场潜力。我院口服降糖药的使用基本合理。

目的通过退药原因分析,讨论如何加强管理,减少退药行为发生,促进合理用药。方法对我院2006年9月至2007年9月门诊药房205份退药申请单进行统计分析。结果退药原因以出现不良反应、患者病情变化、不合理用药等为主。结论退药问题是影响门诊药房服务质量和患者满意度的因素之一,在用药过程中必须注意药品的不良反应,加强药品管理质量,合理用药,强化服务意识,构建和谐医患关系。