改良式化疗药物配制柜的制作与应用

目的:减少化疗药物在配制过程中对护士造成的职业损害和环境污染。方法:利用自制改良式化疗药物配制柜规范化疗安全操作流程,减少护理人员在配置化疗药物时与毒性微粒的接触,保护环境及操作者,在保证化疗药物安全输注的同时达到安全防护结论:改良式化疗药物配制柜实用性强、操作简单、制作方便的防护工具,值得推广     

实习护生接触抗肿瘤药物的职业防护现状调查

目的:了解实习护生接触抗肿瘤药物的职业防护现状。方法:选取2010-2011年在我院实习的护生l65名,采用自行设计的调查问卷进行调查。结果:实习护生接触抗肿瘤药物的相关知识的认知及职业防护行为较差。结论:管理部门应加强实习护生的职业安全防护教育与管理,提高实习护生对抗肿瘤药物的职业防护的认知,规范职业防护行为,减少职业危害。     

手术室常见职业危害及防护

随着医疗条件的不断改善,各种各样的医疗设备、消毒用品、化学物质在临床上的广泛应用以及各种手术的普遍开展及新型传染病的增多,手术室护士暴露在各种化学、物理、生物、机械性损伤危险的机会也增加,如何做好手术室护士的职业防护,保障手术室护士的心身健康,现就手术室护士职业危害的防护对策探讨如下。     

护士在护理中的损伤及防护措施

医院是个具有潜在危险的工作环境,护理人员常常暴露于多种危险因素中。在护理操作中存在着多种职业危害因素,如：易感的物质,易感的疾病,特别是各种锐器的损伤,护士在操作过程中如不注意个人的防护容易造成职业性损伤,严重威胁护士的身心健康,又由于护理人员工作量大,劳动强度强,工作环境差,随着爱滋病在全球的蔓延,性病、乙肝病发病率的增多,非典、禽流感的流行,护士在护理工作中职业伤害发生比例高,因此,增强护理人员的防护能力和自身的防护意识可以减少职业性健康损害的发生。     

顺口溜助新护士职业防护强化作用的效果研究

目的通过让新护士背诵顺口溜,轻松记住职业防护的要点及注意事项,减少职业损伤的发生;方法研究对象为广西卫生职业技术学院2014届毕业生,分别应聘于南宁市的十多家二、三甲医院,工作时间在一年内的92名新护士,说明目的并取得理解,随机分为实验组和对照组各46名,两组新护士均按医院要求参加岗前培训。实验组增加了顺口溜背诵的要求;对照组只按常规培训,给两组毕业生分别建立Q群,随时解答问题。一年后给两组新护士调查问卷。问卷内容体现职业防护措施执行、锐器损伤发生及损伤后自我处理的情况,数据采用SPSS18.0软件统计。结果观察组的职业防护能力较强于对照组,对比有统计学意义P﹤0.5。结论采用顺口溜的方式助新护士提高职业防护能力有明显的效果。     

急性白血病化疗后心肌病的研究进展

目前临床上广泛用于急性白血病化疗的药物,常具有严重的毒副反应包括心肌毒性,其引起的充血性心力衰竭(congestive heart failure,CHF)已成为急性白血病患者化疗后的致死原因之一.因此在维持化疗药物治疗效果的同时,降低其心脏毒性,减少急性白血病化疗后心肌病是近年来的研究热点.关于这方面的研究进展主要包括监测技术的进展、高效低毒化疗药物的研究和应用进展以及心肌保护剂的进展.监测手段的研究进展使得对心肌损伤的监测更敏感、更便于操作.抗肿瘤药物衍生物的研究进展如去甲氧柔红霉素(idarubicin,IDA)、米托蒽醌(mitoxantrone,MTZ)及脂质体阿霉素(liposomal anthracyclines)等高效低毒药物在增强了其抗肿瘤活性的同时,明显降低了其心肌毒性,减少了心肌病的发生率.另外制定化疗方案前应充分评估患者高危因素,限制累积剂量的应用也明显降低了化疗药物的心肌毒性.心肌保护剂的应用也已成为防治急性白血病化疗后心肌病的有效手段,如右丙亚胺(Dexrazoxane,DEX)有明确的心肌保护作用,研究表明DEX的使用并不影响抗肿瘤药物原有的抗肿瘤活性,有广泛的临床应用价值.     

急诊护理工作中的危害因素及防护

急诊科是抢救急危重症病人及参与处理各种突发事件的主要场所,属于高风险科室。由于工作环境及服务对象的复杂与特殊性．不仅使急诊科护士的生活紧张而无规律,且在工作中还会受到多种职业危害因素的威胁,若不注意个人防护或防护不当,会造成各种不同的身心损伤。为保障急诊科护士的身心健康,提高工作效率．现就影响急诊科护士身心健康的多种职业危害因素作一分析并提出相应的防护措施。     

护士职业性腰背痛的影响因素及防护措施的研究进展

对护士职业性腰背痛的影响因素及防护措施进行综述。总结护士职业性腰背痛的影响因素,包括环境、心理、生理、职业、个体因素以及缺乏相关护士职业性损伤的防护,探讨护士职业性腰背痛的防护措施,包括改善工作环境、关注护士心理健康、加强培训、建立规范流程及上报机制,改善设施及使用防护用具、编制预防手册、开设瑜伽减压课堂等,为完善并制定预防护士职业性腰背痛规范流程及措施提供参考。     

喜树碱聚前药纳米粒子包埋吲哚箐绿用于化疗与光动力联合抗肿瘤治疗

肿瘤单一药物化疗的效果往往达不到理想的肿瘤治疗效果,且容易导致耐药。因此,肿瘤的药物化疗与其他的抗肿瘤治疗方法,如光热治疗和光动力治疗等,联合治疗具有明显优势,并受到越来越多的关注。本工作构建了一种还原性响应的新型智能纳米体系,采用喜树碱聚前药两亲分子(PEG-b-PCPTM)物理包埋光敏剂吲哚箐绿(ICG)。在肿瘤细胞的还原性微环境中,控制释放化疗药物喜树碱,激活化疗;同时,光敏剂ICG用于光动力治疗,从而实现化疗与光动力的联合治疗,表现出良好的抗肿瘤活性。     

纳米递送载体在口服抗肿瘤药物给药系统中的应用

化疗治疗是目前肿瘤治疗的主要手段之一,但大部分化疗药物具有水溶性低、肠道壁通透性差、易受到P-糖蛋白(P-gp)外排的性质,极大限制了其开发为口服制剂。基于纳米技术的药物递送系统在口服抗肿瘤药物的递送中具有独特的优势,表现出良好的应用前景。笔者将深入探讨纳米递送载体在药物口服递送中所面临的生理障碍以及克服生理屏障的方法,并对聚合物胶束、脂质体、纳米粒等纳米体载体在抗肿瘤药物口服递药系统的应用进行了详细的综述。     

Antineoplastic potential of medicinal plants

Cancer is one of the most dreaded diseases worldwide and the incidence is on the rise in both developing and developed countries. It is treated by chemotherapy, radiotherapy and surgery. In spite of advances in treatment strategies, cancer still remains a major cause of death. Research is on for development of better drugs which are more effective and simultaneously cause fewer side effects. Plants have been used for the treatment of various ailments of man and animals since ages. They are being screened extensively to explore the possibility of development of economically viable anticancer drugs. Natural products of plant origin currently constitute a considerable proportion of commercially available antineoplastic drugs. This review gives an insight into commercially available anticancer drugs of plant origin and also patents granted to plant derived components, extracts and polyherbal formulations possessing anticancer activity. The exhaustive work reviewed here on antineoplastic activity of various plants both in vitro and experimental models throughout the world will help design further research in this field.     

Reinfection after treatment of schistosome infections

Today, chemotherapy has a central role in the control of schistosome infections. Although the costs involved may be high in relation to local expenditures on health, externally funded mass treatment programmes can lead to large reductions in the prevalence and intensity of schistosome infections. But the benefits of treatment to a community that has been involved in a mass chemotherapy programme, or to an individual patient seen in a health centre, will be limited if reinfection after treatment is rapid and intense. Despite the efficacy of the available drugs few, if any, control programmes based on mass chemotherapy have interrupted transmission and come anywhere near to eradicating schistosome infection.     

抗肿瘤药物临床药师培训及其参与合理用药的应用进展

临床药学是药学的重要分支,临床药师为病人提供药学监护,优化了使用药物治疗,促进康复,加强了保健和疾病的预防。开展临床药师教育,有利于临床用药审查,并将为培养临床药师的工作提供参考。回顾近年来国内外的临床药师及抗肿瘤药物专业临床药师的培训经验和合理用药的进展情况,分别对临床药师培养模式、理论课程设置、药学查房带教、临床记录书写和业务学习等方面作了总结。本文通过系统性的回顾了和对比了国内外的临床药师的培养方案,从理论和实践两方面的应用进展分析了临床药师在临床中的重要作用。     

Antineoplastic kinase inhibitors: A new class of potent anti-amoebic compounds

Entamoeba histolytica is a protozoan parasite which infects approximately 50 million people worldwide, resulting in an estimated 70,000 deaths every year. Since the 1960s E. histolytica infection has been successfully treated with metronidazole. However, drawbacks to metronidazole therapy exist, including adverse effects, a long treatment course, and the need for an additional drug to prevent cyst-mediated transmission. E. histolytica possesses a kinome with approximately 300–400 members, some of which have been previously studied as potential targets for the development of amoebicidal drug candidates. However, while these efforts have uncovered novel potent inhibitors of E. histolytica kinases, none have resulted in approved drugs. In this study we took the alternative approach of testing a set of twelve previously FDA-approved antineoplastic kinase inhibitors against E. histolytica trophozoites in vitro. This resulted in the identification of dasatinib, bosutinib, and ibrutinib as amoebicidal agents at low-micromolar concentrations. Next, we utilized a recently developed computational tool to identify twelve additional drugs with human protein target profiles similar to the three initial hits. Testing of these additional twelve drugs led to the identification of ponatinib, neratinib, and olmutinib were identified as highly potent, with EC₅₀ values in the sub-micromolar range. All of these six drugs were found to kill E. histolytica trophozoites as rapidly as metronidazole. Furthermore, ibrutinib was found to kill the transmissible cyst stage of the model organism E. invadens. Ibrutinib thus possesses both amoebicidal and cysticidal properties, in contrast to all drugs used in the current therapeutic strategy. These findings together reveal antineoplastic kinase inhibitors as a highly promising class of potent drugs against this widespread and devastating disease.     

Pulmonary Toxicity of Antineoplastic Agents

Pulmonary parenchymal or pleural reactions to chemotherapeutic agents used in the management of patients with malignant diseases are being recognized with increasing frequency. Alkylating agents, asparaginase, bleomycin, methotrexate and procarbazine have all been implicated. Some of the reactions, such as the rare procarbazine pleuritis and pneumonitis, represent hypersensitivity phenomena. Others, such as alkylating agent pulmonary toxicity, appear to be direct toxic effects of the drugs. The severity of the toxicity is variable. The appearance of these pulmonary changes must be differentiated from tumor progression or a variety of possible infections. The awareness of possible pulmonary toxicity is of great importance since early discontinuation of the agent following the first hint of pulmonary toxicity may allow partial or complete reversal of the process. Continued therapy in the face of drug-related pulmonary toxicity may enhance the likelihood of irreversible pulmonary compromise with respiratory failure and death.     

Tuberculosis: Hospitalization and Outpatient Treatment

Initial hospitalization terminated by discharge upon medical advice to continue with chemotherapy on an outpatient basis represents the treatment of choice for most patients with active pulmonary tuberculosis. Any departure from this plan for any patient should be accepted only after careful consideration of all the circumstances. Patients with active pulmonary tuberculosis who are to receive outpatient chemotherapy without adequate initial hospitalization should be carefully selected by the local or provincial department of public health. Approval in writing should be required from the appropriate public health authority before antituberculosis chemotherapy is provided at public expense for any such patient, except possibly for a limited period while awaiting formal approval. In all instances, the clinic which dispenses the antituberculosis drugs should have the patient under supervision with recall for follow-up examinations as required. Prophylactic antituberculosis chemotherapy may be provided to certain groups of persons without hospitalization.     

Antifungal Prophylaxis in Children Receiving Antineoplastic Chemotherapy

Purpose of the review

The purpose of this study was to summarize data on available antifungal prophylaxis of invasive fungal disease (IFD) in children and when it should be administered during antineoplastic chemotherapy.

Recent findings

Antifungal prophylaxis should be considered when incidence of IFD is ≥?10%, as acute myeloblastic leukemia, high-risk acute lymphoblastic leukemia, and second-line therapy for any relapsing leukemia. In absence of specific pediatric studies, data from adults indicate that triazoles, especially posaconazole tablets, could represent the most attractive option, even if some troubles (mainly regarding drug interactions and intestinal absorption) must be underlined. Echinocandins and liposomal amphotericin B (intravenous or nebulized) can represent alternatives in specific conditions. Other infection control measures (hand hygiene, respiratory masks) can represent adjunctive and effective measures.

Summary

Antifungal prophylaxis should be implemented in children receiving aggressive chemotherapy for acute leukemia, and triazoles represent the first choice for this purpose.

     

The effect of heterogeneity on optimal regimens in cancer chemotherapy

Optimal drug regimens for cancer chemotherapy are determined when knowledge is only available on the behaviour of the tumour and the drugs used, over a population of patients. The case of two drugs is investigated where they are equivalent on average. Our calculations indicate that the optimal regimen has both drugs given initially but then sequences the two drugs. Our calculations also indicate that as tumour heterogeneity increases, the benefit to be gained from the optimal regimen can decrease in comparison to reasonable regimens. This has the effect of complicating the calculation of optimal regimens in a clinical setting, and may explain why results in experimental oncology fail to carry over to clinical oncology.     

Antineoplastic antibiotics in the combined chemotherapy of squamous cell carcinoma

Sixty five patients with squamous cell carcinoma of various localization at stages III-IV or with severe relapses were subjected to chemotherapy according to 3 schemes: AMB (adriamycin + methotrexate + bleomycin or bleomycetin), 34 patients; AMBP (adriamycin + methotrexate + bleomycetin + platidiam), 17 patients and AMFP (adriamycin + methotrexate + fluorofur + platidiam), 14 patients. The efficacy of the schemes was 35, 17.7 and 43 per cent respectively. The AMB scheme in treatment of the patients with maxillofacial carcinoma resulted in remission in 8 out of 20 cases (40 per cent). Analysis of the adverse reactions to the chemotherapy showed that all the three schemes were relatively low toxic. The AMB and AMFP schemes may be recommended for treatment of patients with disseminated or inoperable forms of epidermoid tumors in oncological departments.