目的:分析医院临床患者所发生的新的和严重的药物不良反应(adverse drug reactions,ADRs)的流行病学特点,为今后患者的安全、合理用药提供参考。方法:选取2021年1月—2022年7月常熟市第一人民医院上报国家药品不良反应监测中心的696例A...目的:分析医院临床患者所发生的新的和严重的药物不良反应(adverse drug reactions,ADRs)的流行病学特点,为今后患者的安全、合理用药提供参考。方法:选取2021年1月—2022年7月常熟市第一人民医院上报国家药品不良反应监测中心的696例ADRs报告,采集患者的性别、年龄、所患疾病等,以及ADRs的累及器官(或系统)、临床表现和所涉药品的种类、给药方式等信息,分析新的和严重的ADRs的流行病学特点。结果:上报的696例ADRs报告中,新的和严重的ADRs共308例,其中报告类型为新的一般的有214例,新的严重的有23例,严重的有71例;308例新的和严重的ADRs报告中,前3位的上报部门分别为重症医学科(19例,占6.17%)、神经内科(17例,占5.52%)和骨科(17例,占5.52%),所涉患者的年龄主要集中在60~<80岁(157例,占50.97%)和40~<60岁(78例,占25.32%),而其所患疾病前3位的分别为胃恶性肿瘤(21例,占6.82%)、肺部感染(19例,占6.17%)和骨折(18例,占5.84%);308例新的和严重的ADRs报告主要涉及抗感染药物(70例,占22.73%)、血液系统药物(35例,占11.36%)和心血管系统药物(26例,占8.44%),所涉品种主要为氨甲环酸(14例,占4.55%)和左氧氟沙星(12例,占3.90%),主要累及的器官(或系统)为皮肤及其附件(114例次)、胃肠与肝胆系统(90例次)、全身性反应(74例次),出现较多的临床表现有皮疹性瘙痒(47例次)、皮疹(38例次)、恶心(23例次)、胸闷(20例次)、头晕(19例次);308例新的和严重的ADRs患者经过处置,治愈的有220例(占71.43%),好转的有85例(占27.60%)。结论:医院患者在用药过程中难免发生ADRs,而其中有较大的可能发生新的或严重的ADRs,这其中又以中老年人群发生最多,医院应督促临床安全用药长抓不懈,以确保患者的用药安全。展开更多
目的:分析医院左氧氟沙星所致药物不良反应(adverse drug reactions,ADRs)的流行病学特点,为临床左氧氟沙星的用药安全提供参考。方法:选取2018年1月—2022年12月常熟市第一人民医院上报的117例左氧氟沙星所致ADRs报告作为研究资料,采...目的:分析医院左氧氟沙星所致药物不良反应(adverse drug reactions,ADRs)的流行病学特点,为临床左氧氟沙星的用药安全提供参考。方法:选取2018年1月—2022年12月常熟市第一人民医院上报的117例左氧氟沙星所致ADRs报告作为研究资料,采集其中患者的年龄、性别、所患疾病,左氧氟沙星的品规、用法用量、给药途径,以及ADRs的累及器官、临床表现、最终转归等信息,分析左氧氟沙星所致ADRs的流行病学特点。结果:117例ADRs报告中,女性多于男性(78例vs 39例),患者所患疾病以下呼吸道感染(33例,占28.21%)、消化系统感染(23例,占19.66%)、女性盆腔及其附件感染(22例,占18.80%)和尿路感染(17例,占14.53%)为主;117例ADRs报告中,所涉左氧氟沙星共涉及7个品规(4个注射液,3个片剂),注射液共涉患者110例(占94.02%),片剂共涉患者7例(占5.98%),左氧氟沙星的给药方案主要为“0.5 g,q24h,静脉滴注”(74例,占63.25%)和“0.2 g,q12h,静脉滴注”(27例,占23.08%);左氧氟沙星所致ADRs主要累及患者的皮肤及其附属器官(66例,占56.41%)和血管系统(18例,占15.38%),有8例临床表现较为严重,具体表现为过敏性休克(6例);但经对症治疗后,所有患者均好转(38例,占32.48%)或治愈(79例,占67.52%)。结论:左氧氟沙星所致ADRs在女性中更为多见,且多发生在静脉滴注用药时,此外其临床表现多数并不严重,但临床仍应重视患者的用药监护,以确保患者的用药安全。展开更多
目的:比较药学干预前后腹膜透析管植入术(peritoneal dialysis catheter insertion,PDCI)患者围术期抗菌药物预防性使用的合理性,为侵入性诊疗操作患者合理使用抗菌药物提供参考。方法:抽取2016年1月—12月(干预前组,n=29例)和2018年1月...目的:比较药学干预前后腹膜透析管植入术(peritoneal dialysis catheter insertion,PDCI)患者围术期抗菌药物预防性使用的合理性,为侵入性诊疗操作患者合理使用抗菌药物提供参考。方法:抽取2016年1月—12月(干预前组,n=29例)和2018年1月—12月间(干预后组,n=30例)肾内科行PDCI的终末期肾功能不全患者59例病历资料,根据《抗菌药物临床应用指导原则(2015年版)》原则,统计和比较其两组患者的基本信息、医疗情况、医疗费用等指标的差异,评价药学干预对围术期预防用药及相关感染指标的影响。结果:干预后组患者抗菌药物预防使用率明显低于干预前组(63.33%vs 93.10%,P<0.05),术后导管相关并发症及炎症指标异常等发生率也显著低于干预前组(16.67%vs 48.26%,P<0.05);日均住院费(936.70 vs 964.20元/d)、日均药品费(466.20 vs 503.00元/d)、日均抗菌药物费用(21.40 vs 43.80元/d)略低于干预前组,但无统计学意义(P>0.05);两组患者在预防用药时机、疗程及所选药物品种的合理性也无明显差异(P>0.05)。结论:药学干预后PDCI患者围手术期预防性使用抗菌药物明显减少,但术后感染发生风险并未增加。展开更多
Background Although tongue cancer is a common disease of the head and neck, the choice of neck treatment between elective neck dissection and ＂watchful waiting＂ remains controversial for patients with early stage NO...Background Although tongue cancer is a common disease of the head and neck, the choice of neck treatment between elective neck dissection and ＂watchful waiting＂ remains controversial for patients with early stage NO oral tongue carcinoma. Methods On the basis of the current state of head and neck cancers a decision analysis model was created to compare two treatment strategies for early tongue cancer. Expected value （EV） was calculated according to the literature which met the defined criteria. Sensitivity analyses were performed. Results The results showed that the decision model favored elective neck dissection （EV=0.87）, over ＂watchful waiting＂ （EV=0.77）. One-way sensitivity analyses demonstrated that the outcome was influenced by regional recurrence, threshold value of 0.28 for the elective neck dissection group and 0.17 for the ＂watchful waiting＂ group, and a salvage rate threshold value 0.73 for the ＂watchful waiting＂ group. Conclusions These results suggested that elective neck dissection strategy of the neck should be applied for early stage NO oral tongue carcinoma patients with no clinical nodal metastases. When the occult lymph node metastases rate was less than 0.17 and the salvage rate was more than 0.73, ＂watchful waiting＂ strategy would be preferable.展开更多
Background It has been widely observed that infants and young children can reossify large calvarial defects when they are younger than 2 years of age; afterwards, they lose this regenerative potential. Previous studie...Background It has been widely observed that infants and young children can reossify large calvarial defects when they are younger than 2 years of age; afterwards, they lose this regenerative potential. Previous studies have implicated that the dura mater serves as a key regulator of calvarial regeneration. However, the molecular mechanism of calvarial reossification remains elusive. Methods In order to identify the proteins that may participate in this process, we performed a proteome-wide comparison of the protein expression levels of immature and mature dura using 2D electrophoresis and MALDI-TOF mass spectrometry. The Western blotting was used to verify the results of the 2D electrophoresis/MALDI-TOF mass spectrometry. Results Eleven proteins were found to express with significant differences in the immature and the mature dura. Among them, the emergence of vimentin, tropomyosin, 13-actin and y-actin were further confirmed by the Western blotting analysis. Conclusion The proteins and proteomic profiles provide a better understanding of the molecular mechanism of calvarial regeneration.展开更多
文摘目的:分析医院临床患者所发生的新的和严重的药物不良反应(adverse drug reactions,ADRs)的流行病学特点,为今后患者的安全、合理用药提供参考。方法:选取2021年1月—2022年7月常熟市第一人民医院上报国家药品不良反应监测中心的696例ADRs报告,采集患者的性别、年龄、所患疾病等,以及ADRs的累及器官(或系统)、临床表现和所涉药品的种类、给药方式等信息,分析新的和严重的ADRs的流行病学特点。结果:上报的696例ADRs报告中,新的和严重的ADRs共308例,其中报告类型为新的一般的有214例,新的严重的有23例,严重的有71例;308例新的和严重的ADRs报告中,前3位的上报部门分别为重症医学科(19例,占6.17%)、神经内科(17例,占5.52%)和骨科(17例,占5.52%),所涉患者的年龄主要集中在60~<80岁(157例,占50.97%)和40~<60岁(78例,占25.32%),而其所患疾病前3位的分别为胃恶性肿瘤(21例,占6.82%)、肺部感染(19例,占6.17%)和骨折(18例,占5.84%);308例新的和严重的ADRs报告主要涉及抗感染药物(70例,占22.73%)、血液系统药物(35例,占11.36%)和心血管系统药物(26例,占8.44%),所涉品种主要为氨甲环酸(14例,占4.55%)和左氧氟沙星(12例,占3.90%),主要累及的器官(或系统)为皮肤及其附件(114例次)、胃肠与肝胆系统(90例次)、全身性反应(74例次),出现较多的临床表现有皮疹性瘙痒(47例次)、皮疹(38例次)、恶心(23例次)、胸闷(20例次)、头晕(19例次);308例新的和严重的ADRs患者经过处置,治愈的有220例(占71.43%),好转的有85例(占27.60%)。结论:医院患者在用药过程中难免发生ADRs,而其中有较大的可能发生新的或严重的ADRs,这其中又以中老年人群发生最多,医院应督促临床安全用药长抓不懈,以确保患者的用药安全。
文摘目的:比较药学干预前后腹膜透析管植入术(peritoneal dialysis catheter insertion,PDCI)患者围术期抗菌药物预防性使用的合理性,为侵入性诊疗操作患者合理使用抗菌药物提供参考。方法:抽取2016年1月—12月(干预前组,n=29例)和2018年1月—12月间(干预后组,n=30例)肾内科行PDCI的终末期肾功能不全患者59例病历资料,根据《抗菌药物临床应用指导原则(2015年版)》原则,统计和比较其两组患者的基本信息、医疗情况、医疗费用等指标的差异,评价药学干预对围术期预防用药及相关感染指标的影响。结果:干预后组患者抗菌药物预防使用率明显低于干预前组(63.33%vs 93.10%,P<0.05),术后导管相关并发症及炎症指标异常等发生率也显著低于干预前组(16.67%vs 48.26%,P<0.05);日均住院费(936.70 vs 964.20元/d)、日均药品费(466.20 vs 503.00元/d)、日均抗菌药物费用(21.40 vs 43.80元/d)略低于干预前组,但无统计学意义(P>0.05);两组患者在预防用药时机、疗程及所选药物品种的合理性也无明显差异(P>0.05)。结论:药学干预后PDCI患者围手术期预防性使用抗菌药物明显减少,但术后感染发生风险并未增加。
文摘Background Although tongue cancer is a common disease of the head and neck, the choice of neck treatment between elective neck dissection and ＂watchful waiting＂ remains controversial for patients with early stage NO oral tongue carcinoma. Methods On the basis of the current state of head and neck cancers a decision analysis model was created to compare two treatment strategies for early tongue cancer. Expected value （EV） was calculated according to the literature which met the defined criteria. Sensitivity analyses were performed. Results The results showed that the decision model favored elective neck dissection （EV=0.87）, over ＂watchful waiting＂ （EV=0.77）. One-way sensitivity analyses demonstrated that the outcome was influenced by regional recurrence, threshold value of 0.28 for the elective neck dissection group and 0.17 for the ＂watchful waiting＂ group, and a salvage rate threshold value 0.73 for the ＂watchful waiting＂ group. Conclusions These results suggested that elective neck dissection strategy of the neck should be applied for early stage NO oral tongue carcinoma patients with no clinical nodal metastases. When the occult lymph node metastases rate was less than 0.17 and the salvage rate was more than 0.73, ＂watchful waiting＂ strategy would be preferable.
文摘Background It has been widely observed that infants and young children can reossify large calvarial defects when they are younger than 2 years of age; afterwards, they lose this regenerative potential. Previous studies have implicated that the dura mater serves as a key regulator of calvarial regeneration. However, the molecular mechanism of calvarial reossification remains elusive. Methods In order to identify the proteins that may participate in this process, we performed a proteome-wide comparison of the protein expression levels of immature and mature dura using 2D electrophoresis and MALDI-TOF mass spectrometry. The Western blotting was used to verify the results of the 2D electrophoresis/MALDI-TOF mass spectrometry. Results Eleven proteins were found to express with significant differences in the immature and the mature dura. Among them, the emergence of vimentin, tropomyosin, 13-actin and y-actin were further confirmed by the Western blotting analysis. Conclusion The proteins and proteomic profiles provide a better understanding of the molecular mechanism of calvarial regeneration.
