Photodynamic therapy (PDT) is a potential treatment strategy for melanoma. As a second-generation photosensitizer, Zinc phthalocyanine (ZnPc) has many advantages for anti-tumor PDTs, such as strong absorption in the red and near infrared regions, high photo and chemical stability, etc. However, ZnPc has a poor water solubility and is apt to aggregate due to the π-π interaction between molecules, which limits its applications. In this study, various solvents and surfactants were screened for dissolving ZnPc and preparing ZnPc@SDC-TPGS micelle and thermosensitive in situ gel. After the cytotoxic effects of thermosensitive gels on PDT were tested, the antitumor effects on PDT of them in mice by intratumoral injection were evaluated, including body weight, and tumor weight, volume and morphology. The cell death pathway and the relationship of reactive oxygen species yield with apoptotic rate of tumor cells induced by ZnPc in situ gel were investigated. The results were that N-methyl-pyrrolidone (NMP) mixed with 2 % SDC and aqueous solution containing 2 % TPGS and 2 % SDC were used to synthesize ZnPc@SDC-TPGS micelle and the thermosensitive in situ gel. The cytotoxic effects of thermosensitive gels showed good tumor suppression of ZnPc@SDC-TPGS in situ gel and no toxicity of the blank gel. Intratumoral injection in situ gel containing 3 µg ZnPc under irradiation demonstrated good tumor inhibition in mice with melanoma. Apoptosis has been established as the primary pathway of cell death, and the production of reactive oxygen species (ROS) plays a crucial role in cellular apoptosis induced by ZnPc@SDC-TPGS in situ gel. In conclusion, the intratumoral injection of ZnPc@SDC-TPGS thermosensitive in situ gel provides a promising local treatment option for melanoma.

Background: Chemotherapy-induced myelosuppression (CIM) is a common adverse reaction with a high incidence rate that seriously affects human health. Shengyu Decoction (SYD) is often used to treat CIM. However, its pharmacodynamic basis and therapeutic mechanisms remain unclear. Purpose: This study aimed to clarify the active components and mechanisms of SYD in CIM. Methods: LC-QTOF/MS was used to identify the absorbable components of SYD. A series of network pharmacology methods have been applied to explore hub targets and potential mechanisms. Molecular docking was used to identify the binding ability of potential active ingredients and hub targets. Finally, in vitro experiments were performed to validate these findings. Results: In this study, 33 absorbable prototype components were identified using LC-QTOF/MS. A total of 62 possible targets of SYD in myelosuppression were identified. KEGG pathway enrichment analyses showed that some signaling pathways such as PI3K-Akt and HIF-1 may be the mechanisms by which it functions. Among them, we verified the PI3K-Akt pathway. 6 Hub proteins were screened by Protein-protein interaction (PPI) network analysis. Molecular docking results showed that four absorbable components in SYD showed good binding with six Hub targets. The effectiveness of the four predicted compounds and the mechanism were verified in vitro. It has also been shown that the active component could promote the proliferation of bone marrow stromal cells (BMSCs) and block apoptosis of BMSCs, which may be related to the PI3K-Akt pathway. This result is consistent with the network pharmacology approach and molecular docking predictions. Conclusion: Our results provided not only the candidate active component of SYD, but also a new insights into mechanism of SYD in the treatment of CIM.

目的 分析我院神经外科术后患者应用单唾液酸四己糖神经节苷脂的合理性与不良反应发生的规律和特点.方法 回顾性分析我院2018年10月至2019年10月1107例神经外科术后患者应用过单唾液酸四己糖神经节苷脂的病例,参照其说明书和相关指南进行合理性分析,对不良反应发生率、发生的时间和临床表现等进行分析统计.结果 1107例病例中,用药疗程不合理13例(1.17％),用法用量不合理78例(7.05％),滴注速度不合理39例(3.52％),联合用药不合理34例(3.07％).发生不良反应的有16例(1.44％),主要累及皮肤及其附件、全身和神经系统.其中吉兰巴雷综合征的发生率比已有文献报道高.结论 神经外科术后的患者应用单唾液酸四己糖神经节苷脂存在不合理情况,其中用法用量和滴注速度不合理所占比例较大.临床工作中应提高其使用合理性,并严密观察病情变化,及早识别不良反应,尤其是吉兰巴雷综合征的发生,确保患者用药安全.

目的 探讨对支气管哮喘患者采用沙美特罗氟替卡松粉吸入剂进行治疗的临床效果.方法 108例支气管哮喘患者,按数字奇偶法分为治疗组与对照组,各54例.治疗组采用沙美特罗氟替卡松粉吸入剂进行治疗;对照组采用氟替卡松进行治疗.比较两组治疗效果及肺功能指标[最大呼气峰流速(PEF)、用力肺活量(FVC)、最大呼气中期流速(MMEF)、第1秒用力呼气容积(FEV1)].结果 治疗组治疗总有效率为96.30％,高于对照组的75.93％,差异有统计学意义(P<0.05).治疗组PEF、FEV1、MMEF、FVC分别为(4.95±0.95)L/s、(0.97±0.21)L、(0.81±0.16)L/s、(1.51±0.95)L均高于对照组的(3.77±0.85)L/s、(0.50±0.13)L、(0.50±0.18)L/s、(1.09±0.89)L,差异有统计学意义(P<0.05).结论 沙美特罗氟替卡松粉吸入剂的有效应用,可使支气管哮喘患者的肺功能指标明显改善,获得确切疗效,最终实现支气管哮喘患者的有效预后转归.

1临床资料 患者,男,61岁,因“间断胸闷胸痛5年,左肩背胀痛10h.”于2018年4月11日入院.患者5年前被诊断为广泛前壁心梗,出院后未规律服药;16年前因十二指肠溃疡行胃大部分切除;否认食物、药物过敏史.入院查体:体温36.5℃,脉搏71次/min,呼吸14次/min,血压114/67 mmHg;心电图显示:窦性心律,心率65次/min,右束支传导阻滞.患者10 h前因劳累后再发左肩背胀痛,无大汗、心悸、胸闷胸痛症状,持续时间10 min,休息后缓解,后于我院急诊就诊,给予注射用单硝酸异山梨酯、注射用磷酸肌酸钠静滴症状缓解.

病例:患者,男,46岁.因“反复发作心慌”于2018年9月26日入院.入院诊断为:心律失常、房颤;高血压;2型糖尿病.入院查体:体温36.2℃,脉搏78次/min,呼吸14次/min,血压152/89 mmHg,口唇无发绀,颈静脉无怒张,双肺呼吸音清,未闻及干湿哕音,心界不大,心率95次/min,心电图显示房颤心律,ST-T改变,心律绝对不齐,无杂音,腹软无压痛,肝脾不大,双下肢无浮肿.患者2.5年前因反复出现心慌症状入院接受药物治疗后出院,出院后未规律服用药物,偶有发作;高血压病1年,最高达160/109 mmHg;糖尿病15年.右眼白内障病史2.5年.否认脑血管病、肺部疾病及肾病病史.否认过敏史.

目的研究辽宁省人民医院（以下简称"我院"）发生的208例药品不良反应（ADR）的发生特点,为提高ADR的监测水平和指导临床合理用药提供参考。方法选取某院2017年1月～2018年12月上报国家ADR监测网的208例ADR报告作为研究对象进行回顾性分析,从患者的性别、年龄、ADR类型、给药途径、药品种类分布、累及器官或系统、报告人职业和ADR关联性评价等方面,进行回顾性统计与分析。结果我院ADR报告中,≥45岁的患者较多,共179例;女性略低于男性;ADR涉及药品14类,其中造影剂居首位;ADR累及器官或系统共11类,以皮肤及其附件损害最多见;ADR报告人职业以医师和药师为主。ADR关联性判定结果分别为肯定、很可能、可能,其中很可能所占比例最大。结论我院的ADR有其自身特点,应重点关注ADR易发的药物和人群,选择合适的给药途径,临床工作中需重视ADR的监测,不断提高临床合理用药水平,以避免或减少ADR的重复发生。

目的:发现碘对比剂不良反应(ADR)特征和一般规律,为开展重点药品监测和减少临床用药风险提供参考.方法:监测碘对比剂ADR,分析碘对比剂品种、患者性别、年龄、用药时间、ADR累及器官/系统及临床表现等因素与ADR发生率的关系.结果:碘对比剂ADR总体发生率为0.51％,严重ADR发生率为0.20％.4种碘对比剂ADR发生率和严重ADR发生率无显著差异;男女碘对比剂发生率无显著差异.碘对比剂使用者ADR发生率随年龄增长呈下降趋势,20～29岁发生率最高(4.35％).碘对比剂ADR中27.78％属于急性不良反应,72.22％属于迟发性不良反应.ADR累及多个器官/系统,主要有皮肤及其附件、中枢及外周神经系统、心率及心律、全身性损害等.过敏性休克和昏迷对症治疗后20 min～12 h可明显好转;心悸和头晕对症治疗后在2h内可明显好转;皮疹和血管神经性水肿对症治疗一般7日内可痊愈,如使用激素可明显缩短疗程.结论:碘对比剂ADR总体发生率为偶见级别;开展重点品种监测有利于发现药品ADR的特征和规律,保障患者用药安全.

糖尿病的发病机制复杂,降糖治疗需要根据病人情况的不同选择作用机制不同的药物,或单药治疗,或联合用药.但是,很多患者都认为最好的药才是最正确的选择.对于糖尿病的治疗,什么药才是“最好的药”,并非一个简单的问题.糖尿病的管理也不仅仅是控制血糖,而是一个全方位的综合管理过程,治疗中需要平衡获益与风险,减少低血糖发生率,减少血糖波动,维持合理的体重.

天气炎热干燥时,如果体内热量不能充分排出,积蓄到一定程度时就会引起中暑.除了气温过高、人体产热增加、散热障碍、汗腺功能障碍等因素外,一些药物也会增大中暑风险,使用时应格外小心. [降压药]当气温较高时,会引起血管扩张,服用降压药尤其是利尿药之后,会使排尿增多,机体容易出现脱水和电解质失衡,可能引起乏力、倦怠、食欲不振、心慌等中暑症状.因此服用降压药后要及时补充水分,必要时在医生指导下调整剂量.

进入冬季,天气干燥,气温下降,鼻炎、咽喉炎等疾病盯上了不少人,不仅影响生活,对身体还有伤害.那么此时应该如何正确用药呢? 鼻炎:鼻塞少用滴鼻剂 很多人进入冬季后总感觉鼻子干,如果呼吸道功能较差的人在这个季节里,鼻炎是很容易复发的. 分析:鼻炎的症状为进行性鼻塞、流涕,伴有轻度发热、乏力、头痛等.患者一旦出现上述症状并反复发作,应提高警惕,及时就医,不要在家乱服药,以免使病情迁延.

Objective: To compare the efficacy, safety and economic indicators of three combination therapy scheme in type 2 diabetes subjects, and to find out the best treatment scheme. Methods: The subjects with type 2 diabetes were divided into 3 groups randomly. The efficacy, safety and economic data were colected and analyzed. Results: The blood glucose concentration of three groups al dropped obviously. Efficacy and safety were similar in 3 groups.There were significant differences among the three groups in insulin doses(F=11.06, P<0.01) and daily anti-diabetic drug costs (F=82.28,P<0.01). Conclusion: The treatment scheme B (twice-daily insulin aspart 30 injection plus metformin) were more in line with the minimum cost principle of pharmacoeconomics, and worth being advocated.

目的 建立测定人血清中利福布汀浓度的方法.方法 采用反相高效液相色谱法,HYPERSIL ODS(200 ×4.6mm,5.0μl)色谱柱,流动相:乙腈-0.04mol/L KH2 PO4(PH2.5)(15:85,v/v);流速1.0ml/min;检测波长298nm;柱温:35℃.结果 利福布汀在0.51-32μg/ml范围内,峰面积对浓度呈良好的线性关系(r =0.9997),血清中药物最低检测浓度为0.2μg/ml(S/N=3),提取回收率为90％,血清中3种浓度回收率分别为104.95％、103.47％、99.38％,日内、日间RSD分别为3.2％、2.7％、1.6％及4.9％、3.6％、1.8％.结论 本法操作简单、快速,方法灵敏度和准确度较高,适用于利福布汀的血药浓度及生物利用度的测定.

Objective: To compare the blood glucose fluctuation of three combination therapy scheme of insulin aspart 30 in type 2 diabetes subjects. Methods: The subjects with type 2 diabetes were divided into 3 groups randomly. Group A: insulin aspart 30 injection, twice daily, plus metformin tablets; Group B: insulin aspart 30 injection, three times daily, plus metformin tablets; Group C: insulin aspart 30 injection, twice daily, plus metformin and acabose tablets. The efficacy and safety economic data were collected and analyzed. Results:The blood glucose of three groups all dropped obviously, and the efficacy and safety were similar in 3 groups. There is no significant diference among three groups, but there were obvious differences among three groups in SDBG, B group<C group<A group, (F=6.02, P<0.01); blood glucose before supper of group A showed highest, (7.14±1.06mmol/L,F=5.63,P<0.05 ).Conclusion: The blood glucose fluctuation of scheme B showed least. Scheme A showed poorer control of the blood glucose before supper, compared with scheme B and C. Scheme C showed the shortest time to decrease blood glucose in early-stage.

在日常生活中，有人经常会因为种种原因漏服药物，特别是一些需要长期服药的糖尿病、高血压、血脂异常等慢性病患者。如果遇到漏服的情况，要视药物的种类和具体情况选择补服的办法。

如果遇到漏服的情况,要视药物的种类和具体情况选择补服办法.无论是哪种情况,都不要"合二为一"加量补服,以免出现药物不良反应,甚至引起药物中毒. 漏服普通药物.

在日常生活中,有人经常会因为种种原因漏服药物,特别是一些需要长期服药的糖尿病、高血压、高血脂等慢性病患者.实际上,漏服药物会对血压、血糖的控制造成影响.此时有的患者会选择多吃一次,将上次漏掉的补上.这样做科学吗? 随意补服和加量药物,对健康无益.如果遇到漏服的情况,要视药物的种类和具体情况选择补服的办法.但无论是哪种情况,都不建议"合二为一"加量补服,以免出现药物不良反应,甚至引起药物中毒.

Objective To investigate the characteristics and regular pattern of the adverse drug reactions(ADR)occurred in our hospital in order to promote clinical rational drug use.Methods By a descriptive study,the ADR reports of 190 cases collected from 2006 to 2009 in our hospital were analyzed statistically.Results The ADR were induced by 16 categories(86 kinds)of drugs,predominantly by the anti-microbial agents(25 kinds,86 cases),followed by cardiovascular system agents and nervous system agents(27 cases and 21 cases);the ADR of 65 cases manifested chiefly as lesions of skin and its appendages.Conclusion Great importance should attached to ADR monitoring and reporting timely so as to reduce or avoid the repeated occurrence of ADR,and promote clinical rational drug use.

本文仅就我院使用药品标签质量情况,按照相关规定进行评价。当前药品标签质量管理水平参差不齐,大部分药品标签能够符合国家规定,尚有小部分标签质量不符合规定要求。因此,药品标签质量管理应当进一步规范。

<正>西咪替丁为H2受体阻断药,属抑制胃酸分泌药,因其价格较低、疗效确切,在临床广泛应用。上消化道溃疡及慢性浅表性胃炎患者多为中老年人,该患者群同时合并高血压的比例