目的评估万古霉素早产儿治疗药物监测(Therapeutic Drug Monitoring,TDM)及用药情况,分析万古霉素在早产儿重症感染治疗过程中进行TDM的必要性。方法采用回顾性分析方法,制定相应标准,按标准收集2016—2018年南京医科大学附属无锡妇幼...目的评估万古霉素早产儿治疗药物监测(Therapeutic Drug Monitoring,TDM)及用药情况,分析万古霉素在早产儿重症感染治疗过程中进行TDM的必要性。方法采用回顾性分析方法,制定相应标准,按标准收集2016—2018年南京医科大学附属无锡妇幼保健院早产儿34例,统计分析其基本情况、血培养、痰培养等相关病原学检查、药敏试验结果、血药浓度结果、化验室指标、药物疗效及药品不良反应(Adverse Drug Reaction,ADR)等结果。结果统计分析的34例病儿中,诊断以新生儿脓毒血症为主(48.94%),病原学送检率100%,阳性检出率76.47%,22例(占83.33%)为革兰阳性菌感染,药敏试验结果均显示对万古霉素敏感;监测范围在10~20μg/mL的初次血药谷浓度病儿极少(仅占26.47%),而通过临床药师合理干预可大大提高谷浓度的达标率(占76.92%),差异有统计学意义(P<0.05)。经万古霉素治疗后有效率达85.29%,复查病儿的各项指标较前有明显好转[降钙素原(PCT)为(0.86±0.28)比(0.31±0.43)ng/mL,尿素(Urea)为(5.39±3.91)比(2.24±1.35)mmol/L,血肌酐(Cr)为(64.24±20.44)比(34.43±9.82)μmol/L,胱抑素C(CysC)为(1.85±0.55)比(1.29±0.28)mg/L、天冬氨酸氨基转移酶(AST)为(43.72±25.03)比(25.03±11.01)IU/L,均P<0.05];未检测到万古霉素引起的耳肾损害等ADR。结论万古霉素治疗早产儿感染,特别是革兰阳性菌引起的重症感染效果明确。进行TDM可以实现早产儿万古霉素治疗个体化,使早产儿用药更加安全有效。展开更多
Regarding the sizing surface zone as a quasi-plasticity one and using yielding criterion,a new drawing force calculating formula in which the sizing surface friction was taken into account is deducted.The calculated a...Regarding the sizing surface zone as a quasi-plasticity one and using yielding criterion,a new drawing force calculating formula in which the sizing surface friction was taken into account is deducted.The calculated and experimental results show that for rod drawing and tube sinking,it is permissible to neglect the effect of the friction at the sizing surface,but for tube drawing with a stationary mandrel,especially for thin-wall tube drawing this friction should not be neglected.展开更多
目的探讨临床药师在参与新生儿万古霉素治疗药物监测(therapeutic drug monitoring,TDM)临床实践中发挥的作用,为医师调整给药方案提供参考。方法采用回顾性分析方法,收集符合条件的新生儿31例,对其一般情况、病原学检查、血药浓度监测...目的探讨临床药师在参与新生儿万古霉素治疗药物监测(therapeutic drug monitoring,TDM)临床实践中发挥的作用,为医师调整给药方案提供参考。方法采用回顾性分析方法,收集符合条件的新生儿31例,对其一般情况、病原学检查、血药浓度监测结果、影响血药谷浓度的因素、药物疗效及药品不良反应(adverse drug reaction,ADR)等结果进行统计分析。结果31例患儿中,新生儿脓毒血症占46.34%;病原学检查88.00%为革兰阳性菌,其中多重耐药菌占77.27%。初次血药谷浓度监测范围在10~20μg·mL-1的患儿仅占32.26%,医师采纳临床药师干预建议后谷浓度的达标率提高至83.33%(P<0.05);给药间隔与血药谷浓度呈负相关(P<0.05)。本次研究万古霉素治疗有效率80.65%,且未发生万古霉素相关ADR。结论万古霉素在TDM下治疗由革兰阳性菌引起的新生儿重症感染疗效确切,但经验性用药后血药谷浓度达标率低,医师采纳临床药师干预建议、减少给药间隔可显著提高血药谷浓度,为医师调整给药方案提供了参考。展开更多
Pendent drop method was adopted to measure the surface tension of dimethyl sulfoxide（DMSO）/water mixtures. A new pendent drop apparatus was built up and checked with water, and a good agreement of our data with lite...Pendent drop method was adopted to measure the surface tension of dimethyl sulfoxide（DMSO）/water mixtures. A new pendent drop apparatus was built up and checked with water, and a good agreement of our data with literature could be found. With the new apparatus, the surface tensions of nine DMSO/water mixtures with mass frac- tions of water from 0.1 to 0.9 were investigated in a temperature range of 298--338 K. The expanded uncertainty for surface tension measurement was estimated to be 0.5% at a confidence level of 95%（k=-2） in the whole temperature range. A thermodynamic-based relation was used to predict the surface properties of DMSO/water mixtures. Based on the relation and Gibbs adsorption theory, a prediction model was proposed for the calculation of surface relative excess and the thickness of the surface molecule layer.展开更多
文摘目的评估万古霉素早产儿治疗药物监测(Therapeutic Drug Monitoring,TDM)及用药情况,分析万古霉素在早产儿重症感染治疗过程中进行TDM的必要性。方法采用回顾性分析方法,制定相应标准,按标准收集2016—2018年南京医科大学附属无锡妇幼保健院早产儿34例,统计分析其基本情况、血培养、痰培养等相关病原学检查、药敏试验结果、血药浓度结果、化验室指标、药物疗效及药品不良反应(Adverse Drug Reaction,ADR)等结果。结果统计分析的34例病儿中,诊断以新生儿脓毒血症为主(48.94%),病原学送检率100%,阳性检出率76.47%,22例(占83.33%)为革兰阳性菌感染,药敏试验结果均显示对万古霉素敏感;监测范围在10~20μg/mL的初次血药谷浓度病儿极少(仅占26.47%),而通过临床药师合理干预可大大提高谷浓度的达标率(占76.92%),差异有统计学意义(P<0.05)。经万古霉素治疗后有效率达85.29%,复查病儿的各项指标较前有明显好转[降钙素原(PCT)为(0.86±0.28)比(0.31±0.43)ng/mL,尿素(Urea)为(5.39±3.91)比(2.24±1.35)mmol/L,血肌酐(Cr)为(64.24±20.44)比(34.43±9.82)μmol/L,胱抑素C(CysC)为(1.85±0.55)比(1.29±0.28)mg/L、天冬氨酸氨基转移酶(AST)为(43.72±25.03)比(25.03±11.01)IU/L,均P<0.05];未检测到万古霉素引起的耳肾损害等ADR。结论万古霉素治疗早产儿感染,特别是革兰阳性菌引起的重症感染效果明确。进行TDM可以实现早产儿万古霉素治疗个体化,使早产儿用药更加安全有效。
文摘Regarding the sizing surface zone as a quasi-plasticity one and using yielding criterion,a new drawing force calculating formula in which the sizing surface friction was taken into account is deducted.The calculated and experimental results show that for rod drawing and tube sinking,it is permissible to neglect the effect of the friction at the sizing surface,but for tube drawing with a stationary mandrel,especially for thin-wall tube drawing this friction should not be neglected.
文摘目的探讨临床药师在参与新生儿万古霉素治疗药物监测(therapeutic drug monitoring,TDM)临床实践中发挥的作用,为医师调整给药方案提供参考。方法采用回顾性分析方法,收集符合条件的新生儿31例,对其一般情况、病原学检查、血药浓度监测结果、影响血药谷浓度的因素、药物疗效及药品不良反应(adverse drug reaction,ADR)等结果进行统计分析。结果31例患儿中,新生儿脓毒血症占46.34%;病原学检查88.00%为革兰阳性菌,其中多重耐药菌占77.27%。初次血药谷浓度监测范围在10~20μg·mL-1的患儿仅占32.26%,医师采纳临床药师干预建议后谷浓度的达标率提高至83.33%(P<0.05);给药间隔与血药谷浓度呈负相关(P<0.05)。本次研究万古霉素治疗有效率80.65%,且未发生万古霉素相关ADR。结论万古霉素在TDM下治疗由革兰阳性菌引起的新生儿重症感染疗效确切,但经验性用药后血药谷浓度达标率低,医师采纳临床药师干预建议、减少给药间隔可显著提高血药谷浓度,为医师调整给药方案提供了参考。
基金Supported by the Specialized Research Fund for the National Natural Science Foundation of China（Nos.51506140, 51306127） and the Research Funds from Taiyuan University of Technology, China.
文摘Pendent drop method was adopted to measure the surface tension of dimethyl sulfoxide（DMSO）/water mixtures. A new pendent drop apparatus was built up and checked with water, and a good agreement of our data with literature could be found. With the new apparatus, the surface tensions of nine DMSO/water mixtures with mass frac- tions of water from 0.1 to 0.9 were investigated in a temperature range of 298--338 K. The expanded uncertainty for surface tension measurement was estimated to be 0.5% at a confidence level of 95%（k=-2） in the whole temperature range. A thermodynamic-based relation was used to predict the surface properties of DMSO/water mixtures. Based on the relation and Gibbs adsorption theory, a prediction model was proposed for the calculation of surface relative excess and the thickness of the surface molecule layer.
