目的 了解妇幼保健院住院患者抗菌药物应用情况。 方法 采用横断面调查法，对2012年2月份患者的抗菌药物使用情况进行调查。 结果 抗菌药物横断面使用率为71.14%，其中单用率为79.27%，二联使用率为20.73%；住院患者使用频率排行前10位的抗菌药物中应用最多的是头孢硫脒；儿科抗菌药物使用率最高为93.27%；产科抗菌药物使用频率强度最高为77.37，妇科为67.19；所有患者临床微生物检验样本送检率仅为39.3%。 结论 抗菌药物使用率及抗菌药物使用强度不符合相关规定，需要加强其抗菌药物临床应用的管理。
【摘要】 目的 观察激素加霉酚酸酯（mycophenolate mofetil，MMF）和他克莫司（tacrolimus，FK506）的多靶点方案治疗难治性肾小球疾病的疗效及安全性。 方法 2008年5月-2010年3月收治的15例狼疮性肾炎（lupus nephritis，LN）、3例膜增生性肾小球肾炎（membranoproliferative glomerulonephritis，MPGN）及3例膜性肾病（membranous nephropathy，MN）患者，因多种免疫抑制剂治疗无效或复发而改用多靶点疗法。泼尼松以30~40 mg/d起始，逐渐减量。MMF 和FK506起始剂量分别为0.5 g/d或1 mg/d，目标血药浓度分别为20~40 mg/（h·L）或5~8 ng/mL。定期随访观察肝肾功能、尿蛋白定量、不良反应等指标。 结果 治疗6个月时15例LN中7例（46.7%）完全缓解（complete remission，CR），5例（33.3%）部分缓解（partial remission，PR），3例（20%）无效（no response，NR）。3例MPGN均表现为NR。3例MN中2例（66.7%）PR，1例（33.3%）NR。治疗过程中呼吸道感染及脱发各1例，胃肠不适2例，肌酐逐步升高3例，无死亡或退出者。 结论 多靶点疗法对难治性LN安全、有效，可作为其他免疫抑制剂治疗无效或复发时的选择方案，但对MPGN和MN疗效欠佳，需进一步研究。【Abstract】 Objective To investigate the efficacy and safety of multitarget therapy with steroid, mycophenolate mofetil (MMF) and tacrolimus (FK506) in the treatment of refractory glomerular diseases. Methods Fifteen patients with lupus nephritis (LN), 3 patients with membranoproliferative glomerulonephritis (MPGN) and 3 patients with membranous nephropathy (MN) who failed the previous immunosuppressive therapy from May 2008 to March 2010 in our hospital were treated with multitarget therapy. The initial dose of prednisone was 30-40 mg/d and then tapered gradually. MMF and FK506 were started at 0.5 g/d or 1 mg/d, and the target blood concentration of the two drugs was 20-40 mg/(h·L) and 5-8 ng/mL respectively. Clinical parameters such as liver and renal function, urine protein, and side effects were recorded and analyzed in the regular follow-up. Results After 6 months of treatment, 7 (46.7%) of the 15 LN patients achieved complete remission (CR), 5 (33.3%) achieved partial remission (PR), while 3 (20%) failed this treatment and had no response (NR). All of the three MPGN patents had NR to this combined therapy. Two (66.7%) of the 3 MN patents achieved PR while 1 (33.3%) had NR. No patient withdrew or died because of side effects. One patient developed upper respiratory infection, one experienced alopecia, two developed gastrointestinal syndrome and three experienced gradual increasing in the serum creatinine. Conclusion Multitarget therapy with FK506, MMF and steroid is an effective and safe therapy for refractory lupus nephritis and it can be used in patients who are resistant to the conventional immunosuppressive therapy. However, this combined therapy does not meet a satisfactory result in patients with MN and MPGN, which entails further study.
ObjectiveTo evaluate the reporting quality of clinical randomized controlled trials (RCTs) published in five Chinese psychiatric journals from 2016 to 2020 and to compare the reporting quality with that from 2004 to 2008. MethodsRCTs in five Chinese psychiatric journals were collected through a computerized search of the CNKI, WanFang Data, and CBM databases and manual searches of paper journals, all with a search timeframe from 2016 to 2020. The CONSORT 2010 statement and two extensions (CONSORT extension for abstracts and CONSORT harms extension) were used to evaluate the RCTs. The criteria for reporting quality were the evaluation score, reporting proportion, and compliance proportion. The reporting quality of RCTs in the past 5 years was compared by year group. In addition, the RCT reporting quality from 2004 to 2008 was compared with that from 2016 to 2020. ResultsIn total, 226 RCTs were included. There was no statistically significant difference in the total evaluation score or abstract score from 2016 to 2020 (F=0.54, P=0.71; H=1.49, P=0.83). However, there were statistically significant differences in the harm scores from 2016 to 2020 (H=10.78, P=0.03). Further analysis of the items revealed statistically significant differences in the reporting proportion of items 16 and 19 (Fisher’s=8.61, P=0.04; χ2=11.63, P=0.02) and no significant differences in the other items (P>0.05). The reporting proportion of defined primary and secondary outcome indicators, allocation concealment, randomization implementation, outcomes and estimation, generalization, trial registration, and flow chart was <10% in each year. There was a statistically significant difference in the compliance proportion of RCT reporting quality from 2016 to 2020 versus 2004 to 2008 (39.54%±8.92% vs. 34.76%±9.16%, t=6.60, P<0.001). ConclusionThe reporting quality of RCTs in five Chinese psychiatric journals from 2016 to 2020 is better than that from 2004 to 2008. However, the reporting quality of RCTs within the latter 5 years still have reporting deficiencies in important items, and many aspects still are needed to be improved and enhanced.