Wang Yue, nws lub npe menyuam yaus yog Zhongwu, tau yug los hauv Nroog Minhou (tam sim no Fuzhou), Fujian. Nws yug hauv Tongming Lane, Shangdu thaum Lub Yim Hli 1915. Nws tsev neeg muaj Wang Dasheng lub khw muag luam yeeb uas muaj keeb kwm ntau dua 200 xyoo. Nws txiv, Ainlu, yog tus kws tshawb fawb nyob rau Qing Dynasty lig. Ainlu, tus paub paub sau ntawv nyob hauv Fuzhou, tau nto moo rau nws kev sau thiab sau ntawv. Nws koom nrog Kev Tawm Tsam Xyoo 1911 hauv nws lub xyoo ntxov thiab tau ua tus tuav ntaub ntawv ntawm Lub Tsev Haujlwm Saib Xyuas Kev Tsim Kho Hauv Nroog thiab Lub Tsev Haujlwm Saib Xyuas Nyiaj Txiag tom qab kho dua tshiab.
Wang Yue ncaj ncees, ncaj ncees, ua haujlwm nyuaj, thiab ua lag luam ib yam li nws nyob deb. Thaum muaj hnub nyoog kaum ob (1927), nws kawm hauv Fuzhou Yinghua Middle School. Xyoo 1929, nws tau pauv mus rau Fuzhou Sany Middle School qhov uas nws kawm nyuaj thiab nyob qib zoo tshaj plaws.
Thaum Lub Yim Hli Ntuj xyoo 1941, nws tau txais kev pom zoo los ntawm Tus Neeg Sawv Cev Tebchaws Meskas rau Tuam Tshoj Stuart kom mus kawm ntawv qib siab ntawm Logus University hauv New Jersey, Tebchaws Meskas rau kev kawm ntxiv. Nyob rau hauv kev coj ntawm tus neeg tau txais txiaj ntsig Nobel nto moo, tus thawj coj tshawb fawb txog tshuaj tua kab mob, thiab tus tshawb pom streptomycin thiab neomycin , Xibfwb Wagsman, nws ua tiav tag nrho cov ncauj lus tshawb fawb tom qab peb xyoos ntawm kev ua haujlwm hnyav thiab tau txais txiaj ntsig zoo heev hauv xyoo 1943 Ph.D. hauv microbiology, tau txais Golden Key Award los ntawm SIGMX Society, thiab tau raug ntiav ua tus kws tshawb fawb ntawm Merck Pharmaceuticals Institute of Chemical Therapy.
Thaum nws kawm hauv Tebchaws Meskas, nws tus kws qhia xibfwb Waggsman muaj nuj nqis rau nws thiab qhia nws kom nyob hauv Tebchaws Meskas kom koom nrog kev tshawb fawb txog kab mob microbiology thiab muab nws txoj haujlwm zoo thiab tshawb fawb tshawb fawb. Tab sis nws ntseeg tias nws muaj lub luag haujlwm thiab lub luag haujlwm kom rov qab mus rau lub tebchaws niam thiab mob siab rau nws tus kheej rau kev txhim kho kev tshawb fawb hauv tebchaws. Tsav los ntawm kev tawm tsam Nyij Pooj thiab lub teb chaws txoj kev cawm seej nyob txawv tebchaws hauv Tebchaws Meskas uas tau tawg tawm thaum lub Cuaj Hli 1943, nws tau rov qab los Tuam Tshoj xyoo 1944 nrog kev mob siab rau ua haujlwm rau niam.
Nyob rau hnub ntxov ntawm kev dim, cov neeg tsis muaj tebchaws tau yuam kom ua tiav Suav teb, thiab yuam kev txwv tsis pub siv tshuaj tua kab mob rau Suav. Lub sijhawm ntawd, nws yog lub hnub nyoog kub ntawm kev tshawb fawb tshuaj tua kab mob thiab tsim khoom hauv ntau lub tebchaws hauv ntiaj teb, thaum tseem muaj cov tshuaj tua kab mob hauv Suav teb tsis txaus. Lub sijhawm tseem ceeb no, Wang Yue xav tias nws muaj lub luag haujlwm los qhia qhov kev txhawj xeeb rau lub tebchaws thiab tib neeg, thiab tau txiav txim siab los ua qhov sib txawv ntawm cov tshuaj hauv niam txiv.
Xyoo 1965, nws thawj zaug tau tawm tswv yim txog kev tshawb nrhiav cov tshuaj tua kab mob tshiab los ntawm Micromonospora hauv Suav teb. Xyoo 1966, nws thiab nws cov neeg pab tau cais cov kab mob uas tsim cov tshuaj gentamicin los ntawm Micromonospora, thiab tau muab tso rau hauv kev tsim khoom rau hnub tseem ceeb 20 xyoo ntawm kev tsim lub koom pheej ntawm Suav teb xyoo 1969. Raws li cov ntaub ntawv txheeb cais, txij li thaum pib tsim khoom mus txog xyoo 1985, muaj 40 lub Hoobkas thoob plaws lub tebchaws tsim tau 868 tons nrog tus nqi tso tawm ntau dua 1 billion yuan. Kev tshawb pom ntawm gentamicin tau thawb kev tshawb fawb thiab kev tsim cov tshuaj tua kab mob hauv Suav teb mus rau theem tshiab, thiab tau ua rau muaj kev pab tseem ceeb rau kev lag luam kho mob Suav teb.
3. Cov teebmeem tshuaj
Gentamicin yog ib hom tshuaj aminoglycoside. Lub tshuab ua haujlwm ntawm Gentamicin yog ua rau cov ribosomes hauv cov kab mob, tiv thaiv cov protein synthesis ntawm cov kab mob, thiab rhuav tshem qhov kev ua haujlwm ntawm cov cell membranes ntawm cov kab mob. Gentamicin tuaj yeem kis mus rau hauv cov porins ntawm cov cell membrane sab nraud los ntawm kev sib kis tsis tu ncua, tom qab ntawd nkag mus rau hauv cell los ntawm cov cell membrane los ntawm lub cev thauj mus los, thiab khi rau ribosomal 30S subunit uas raug cais tawm, ua rau puas tsuaj rau A site, thiab tom qab ntawd:
Tiv thaiv kom raug qhov tseeb ntawm ammonia tRNA ntawm txoj haujlwm A, tshwj xeeb tshaj yog cuam tshuam qhov kev khi ntawm methionyl tRNA, yog li cuam tshuam nrog kev sib dhos ntawm kev ua haujlwm ribosomes thiab tiv thaiv kev tsim ntawm 70S pib nyuaj.
Induce qhov tsis sib xws ntawm tRNA thiab mRNA code triplet, ua rau 30S subunit ntawm cov kab mob tsis tu ncua kom nkag siab tsis raug cov lej caj ces, ua rau cov amino acid tsis raug tso rau hauv cov qauv protein, ua rau txawv txav thiab tsis ua haujlwm cov protein ua ke.
Nws tiv thaiv qhov txiav tawm los ntawm kev khi rau A site, yog li cov saw peptide sib txuas tsis tuaj yeem tso tawm, thiab tiv thaiv kev sib cais ntawm 70S tsis muaj ribosome.
Kev txhaj tshuaj intramuscular ua ke nrog clindamycin lossis tshuaj metronidazole tuaj yeem siv los txo qhov tshwm sim ntawm kev kis mob tom qab phais hnyuv.
Kev txhaj tshuaj Intrathecal tuaj yeem siv los ua kev kho mob hnyav rau lub hauv nruab nrab lub paj hlwb mob (mob purulent meningitis, ventriculitis) tshwm sim los ntawm Pseudomonas aeruginosa lossis Staphylococcus.
Gentamicin kuj tseem siv tau los kho tus mob listeriosis.
Kev tso dej tawm hauv dej: Cov koob tshuaj yog tib yam li kev txhaj tshuaj intramuscular; txhua koob tshuaj ntxiv rau 50 ～ 200ml ntawm 0.9% saline lossis 5% cov kua qab zib kom cov tshuaj concentration tsis ntau tshaj 1g/L (hauv paus) (sib npaug 0.1% kev daws), maj mam ntws hauv 30-60 feeb.
Intrathecal lossis intracerebroventricular txhaj: 4-8mg txhua lub sijhawm, ib zaug txhua 2-3 hnub. Kos txhua koob tshuaj (concentration ntawm 2g/L) rau hauv 5ml lossis 10ml lub raj mis uas tsis muaj menyuam. Tom qab lumbar puncture, nqa ib qho piv txwv ntawm cov kua dej hauv lub paj hlwb thiab xa mus rau lub chaw kuaj mob, thiab tom qab ntawd muab lub koob txhaj tshuaj uas muaj gentamicin Txuas rau lub lumbar puncture koob, ua kom muaj txiaj ntsig ntau ntawm cerebrospinal kua ntws mus rau hauv rab koob, thawb thaum tso dej, thiab tom qab ntawd maj mam hno tag nrho cov kua hauv rab koob tsis pub dhau 3 txog 5 feeb. Thaum txhaj tshuaj, lub lumbar puncture koob yuav tsum tau nce me ntsis nce siab, yog tias cov kua dej hauv lub cev tsis huv thiab tsis yooj yim ntws tawm, gentamicin kuj tseem tuaj yeem diluted nrog kev txhaj tshuaj ntsev.
Dos thaum lub sij hawm lim ntshav: Tom qab hemodialysis, raws li qhov hnyav ntawm kev kis tus kab mob, koob tshuaj 1 txog 1.7 mg/kg tuaj yeem muab tau raws li lub cev hnyav.
Ceev faj
Cov tshuaj ntshav ntshav yuav tsum tau saib xyuas, tshwj xeeb hauv cov menyuam mos, cov neeg laus thiab cov neeg mob uas lub raum tsis txaus. Kev kho kom zoo zoo ntawm gentamicin yog li ntawm 4 txog 10μg/ml. Nws yuav tsum raug zam tias qhov siab tshaj plaws ntawm cov ntshav ntshav txuas ntxiv mus siab dua 12μg/ml thiab lub qhov dej siab tshaj 2μg/ml. Txawm li cas los xij, vim yog qhov sib txawv ntawm cov neeg mob hauv kev phais mob, kev kho mob poj niam, cev xeeb tub, lossis kub nyhiab, qhov kev suav tshuaj yuav qis dua qhov qis tshaj plaws uas tau siv ntau dua lossis siab dua li qhov siv ntau tshaj plaws. Cov neeg mob tau txais intrathecal kev txhaj tshuaj gentamicin yuav tsum tau saib xyuas cov tshuaj ntau hauv cov kua dej hauv lub paj hlwb.
Tom qab thawj zaug koob tshuaj (1 ～ 2 mg/kg) tau muab, cov tshuaj kho rau cov neeg mob uas lub raum tsis txaus, lub cev ua haujlwm lossis lub ntsej muag tsis hnov lus yuav tsum tau txo qis: koob tshuaj yuav zoo ib yam, tab sis yuav tsum ncua sijhawm ntxiv lossis lub sijhawm siv tshuaj tsis hloov pauv, thiab txo lossis nres gentamicin txhua lub sijhawm. Txij li thaum gentamicin tsis tau hloov pauv hauv lub cev, tab sis raug tso tawm los ntawm cov zis, yog li cov neeg mob uas lub raum tsis ua haujlwm tuaj yeem ua rau cov tshuaj txuam rau hauv cov tshuaj lom.
Cov neeg mob yuav tsum tau muab dej txaus kom txo tau lub raum puas.
Daim ntawv thov mus sij hawm ntev tuaj yeem ua rau muaj cov kab mob tiv taus.
Nws muaj cov txiaj ntsig ntawm kev tiv thaiv kev ua pa, yog li tsis txhaj tshuaj txhaj tshuaj. Nws tsis muaj txiaj ntsig zoo rau kev kis tus kab mob streptococcal. Cov kab mob ua pa ntawm lub ntsws ua rau mob streptococci yuav tsum tsis txhob siv.
Gentamicin Cov Teeb Meem
Nws tau tshaj tawm tias kev siv cov tshuaj gentamicin ua ke nrog kev txhaj tshuaj rau hauv lub cev ua rau muaj kev sib tw ntawm tes, tawv nqaij ua pob, ua npaws thiab ua rau lub cev nruj. Qhov tshwm sim ntawm lub raum tsis ua haujlwm los ntawm gentamicin siab dua li ntawm tobramycin.
Cov neeg feem coob tau hnov tsis hnov lus, hnov pob ntseg lossis hnov pob ntseg tag nrho (ototoxicity), hematuria, txo qis hauv kev tso zis ntau zaus lossis txo qis hauv cov zis, tsis qab los noj mov, nqhis dej heev (lub raum lom), taug kev tsis khov, thiab kiv taub hau ( Ototoxicity, cuam tshuam rau lub vestibule; nephrotoxicity). Cov uas muaj qhov xwm txheej qis dua muaj qhov ua tsis taus pa, qaug zog, thiab qaug zog heev (neuromuscular block lossis nephrotoxicity).
Yog tias tsis hnov lus, hnov pob ntseg, lossis pob ntseg tag nrho tshwm sim tom qab siv tshuaj, yuav tsum them sai sai. Cov tshuaj tiv thaiv tsis zoo yog zoo ib yam li ntawm kanamycin, thiab cov tshuaj tiv thaiv yog qhov sib dua thaum cov tshuaj me me. Yog tias qhov ntau npaum li cas, txoj kev kho mob ntev, thiab cov hnyuv hauv lub cev tau cuam tshuam qee zaum, thaum koj tso tseg cov tshuaj, koj tuaj yeem rov zoo li qub. Hauv qee tus neeg, loog, kiv taub hau, thiab tinnitus ntawm daim tawv nqaij ntawm lub qhov ncauj, ntsej muag thiab nqua yuav tshwm sim. Qee zaum, cov tsos mob tseem ceeb yog ua pa nyuaj thiab ua rau lub cev tsis sib xws, ntau dua li ib nrab ntawm cov neeg tuag tom qab tsis ua hauj lwm cawm, yog li qee tus neeg xav tias cov khoom lag luam yog qhov ua rau muaj kev phom sij loj tshaj yog qhov ua rau mob anaphylactic sai, uas tuaj yeem ua rau muaj tsos mob ntawm Romberg tus kab mob ( nyuaj rau sawv nrog kaw qhov muag, tsis khov nyob hauv qhov tsaus ntuj).
Kev siv tshuaj loj tuaj yeem ua rau edema tau yooj yim. Kev siv tshuaj ntau tuaj yeem ua rau tso zis tso zis, lub raum tsis ua haujlwm, thiab cov tsos mob ntawm lub paj hlwb. Kev nqus nws tuaj yeem ua rau muaj kev tsis haum thiab mob hawb pob. Gentamicin qhov muag dauv tuaj yeem ua rau mob edema, mob qog noj ntshav. Cov khoom no tuaj yeem ua rau qee zaum ua rau muaj kev nyuaj siab ua pa, cov ntawv ceeb toom tau tshaj tawm hauv tsev thiab txawv teb chaws. Cov khoom lag luam tuaj yeem ua rau qee zaum ua rau mob polyneuropathy thiab mob qog noj ntshav. Kev ua xua tsis tshua muaj tshwm sim, thiab qee zaum khaus tawv nqaij thiab urticaria, thiab lwm yam tuaj yeem tshwm sim ib ntus, uas feem ntau tsis cuam tshuam rau daim ntawv thov txuas ntxiv, thiab yuav ploj mus sai tom qab siv tshuaj lawm.
Cov khoom ua rau muaj kev tsis haum leukopenia thiab neutropenia qee zaum. Nws tuaj yeem ua rau ntshav tsis txaus, leukopenia, neutropenia, thrombocytopenia, thiab hypotension, thiab lub plab tsis xis nyob xws li xeev siab, tsis qab los, ntuav, thiab mob plab. Ob peb tus neeg mob tuaj yeem hloov pauv lub siab ua haujlwm, xws li nce cov ntshav aminotransferase, cov tshuaj tiv thaiv flocculation zoo, thiab lwm yam.
gentamicin-xeem
xaus
Gentamicin muaj kev ruaj khov zoo thiab ntau yam kev ua haujlwm zoo. Thiab qhov tseem ceeb tshaj, nws yog qhov tseem ceeb heev hauv keeb kwm ntawm kev tshawb pom tshuaj tua kab mob hauv Suav teb. Txawm li cas los xij, gentamicin, zoo li lwm yam tshuaj tua kab mob, muaj qee qhov kev phiv, tshwj xeeb tshaj yog rau kev hnov lus thiab kev ua haujlwm ntawm lub siab thiab lub raum.
