目的 了解医师对超说明书用药的认知情况,促进对超说明书用药的管理.方法 通过纸质问卷调查的形式,对全院范围内的临床医师和实习医师进行超说明书用药认知情况调查,并用SPSS 19.0软件对调查结果进行统计分析.结果 总共回收到有效问卷204份.受访医师中认为超说明书用药具有一定合理性的占73.53％,超说明书用药的原因为药品说明书修订滞后于药品研究的占86.76％,认为缺乏科学依据是说明书用药存在问题的占65.20％,认为具有充分文献报告支撑方可实施超说明书用药的占89.71％,认为患者对超说明书用药有必要知道的占92.71％,认为厂家应该对说明书及时修订规范超说明书用药管理的占81.37％,认为超说明书有效的占48.04％,知道申请院内超说明书用药具体流程的仅占10.29％,为患者实施超说明书用药时考虑到患者用药效果的占94.12％.结论 超说明书用药情况与医师对其认知有着直接的关系.应加强对医师的合理用药教育和对超说明书用药管理,促进超说明书用药走向科学、合理和规范的方向发展.
龙胆泻肝汤属于传统的中医汤药,包括10味中药,有泻肝但不伤肝、利湿但不伤阴的功效,诸药配伍应用相辅相成,疗效确切.龙胆泻肝汤主要用于治疗皮肤科疾病,具有抗菌、解热、利胆、消炎、安神、利尿等作用.近年来,随着对龙胆泻肝汤的深入研究,其药理作用不断增多,本文就龙胆泻肝汤的药理作用及其临床应用研究进展进行综述.
Objective To study the inhibitory effect and mechanism of dipeptide peptidase inhibitors analogues on LPS -induced inflam-matory response on microglia .Methods Microglia cells were cultured ,isolated and purified from the neonatal Sprague-Dawley rats.Divided them into blank group ,negative control ,LPS group and medicine group ( parallel determination for 3 times each group ) after pharmacological preconditioning for 48 hours.The optimal concentration of microglia proliferation induced by LPS were measured by MTT assay .Observed the role of dipeptide peptidase inhibitors analogues on LPS-induced microglia in different concentrations .The interleukin1β( IL-1β) ,tumor necro-sis factor alpha ( TNF-α) were assayed by enzyme-linked immunorrbent assay ( ELISA ) .The expression of TLR-4 was detected by Western blotting and the expression of NF-κB was detected by RT-PCR.Results LPS induced the proliferation of microglia and significantly in-creased the release of inflammatory cytokines in LPS-stimulated primary microglia .Compared with the blank group ,dipeptide peptidase inhibi-tors analogues could inhibit this effect and the IC 50 values was 1.014 ×10 -2 mol/L to MG after pretreatment for 48 hours.Dipeptide peptidase inhibitors analogues could inhibit the release of TNF-αand IL-1 significantly(P<0.01),and it decreased the expression of TLR4 and NF-κB signif-icantly(P<0.01).Conclusion This research suggests that dipeptide peptidase inhibitors analogues restrain cell proliferation and inflammatory re-sponse of LPS-stimulated microglia,and the possible mechanism may be related to the inhibition of the expression of TLR-4 and NF-κB.
