盐酸左氧氟沙星序贯治疗老年下呼吸道感染的体会

序贯疗法是指抗生素给药方法由静脉给药变为口服给药,而其疗效不变的一种给药方法[1]。近年来,我们选用盐酸左氧氟沙星序贯治疗老年人下呼吸道感染,取得较好效果,现报告如下。1资料与方法1.1一般资料本组58例患者中,男39例,女19例,年龄53～77岁,其中肺炎22例,慢性支气管炎急性发作14例,支气管扩张并感染13例,哮喘并感染9例,均无喹诺酮类药物过敏史、肝肾功能不全、精神及神经系统病史、肿瘤合并感染、危重感染。根据病情先用盐酸左氧氟沙星0.4～0.6g/d静滴,1次/12h,疗程5～7d,临床症状改善后改为左氧氟沙星0.2g,每日2次口服,疗程5～7d,总疗…     

左氧氟沙星治疗下呼吸道感染40例疗效分析

目的：观察左氧氟沙星治疗下呼吸道感染的临床疗效、细菌清除率和不良反应.方法：40例患者均予左氧氟沙星注射液,感染者每日剂量0.4 g,静注,0.2 g/次,2次/d,疗程7～10 d.结果：0例患者中,治愈32例,好转6例,无效2例,总有效率95%.结论：左氧氟沙星治疗下呼吸道感染疗效确切、不良反应少而轻微,可作为治疗下呼吸道感染的理想用药.     

氧氟沙星治疗下呼吸道感染85例疗效分析

目的：探讨对氧氟沙星治疗下呼吸道感染疗效观察。方法：采用自身对照方法,全部患者曾用多种抗生素治疗7 d,病情控制不满意,改用0.2%氧氟沙星100 mL,静滴,2次/d,疗程为5 d。结果：痊愈率为60.6%（52/85）,显效率为32.8%（28/85）,总有效率为93.4%（80/85）。结论：氧氟沙星治疗下呼吸道感染疗效高,见效快,安全、方便,不良反应少,无需做过敏试验,可以避免发生过敏性休克的危险,值得基层社区推广应用。     

不同剂量左氧氟沙星的三联方案补救治疗幽门螺杆菌的疗效观察

目的探讨含左氧氟沙星的三联方案在抗幽门螺杆菌(HP)补救治疗中的有效性和耐受性。方法将80例HP初治失败的患者,用随机数字表法随机分为A、B、C、D四组,接受以下治疗方案:埃索美拉唑20 mg,2次/d+阿莫西林1 g,2次/d+左氧氟沙星200 mg,2次/d,连用7 d(A组)或10 d(B组);或联合左氧氟沙星300 mg,2次/d,连用7 d(C组)或10 d(D组)。治疗结束4周后复查13C尿素呼气试验。同时观察各组的不良反应。结果 HP各组根除率分别为:A组57.9%,B组88.9%,C组65.0%,D组82.4%。不同服药时间(7 d与10 d)疗程方案下,HP的根除率分别为61.5%与85.7%,两者比较差异有统计学意义(P<0.05)。不同剂量的左氧氟沙星组间根除率比较无明显差别。不良反应发生率为13.2%,各组间无明显差别。结论左氧氟沙星10 d补救治疗方案能够有效根除HP感染(根除率85.7%)。两种不同疗程的比较表明服药时间是影响根除率的重要因素。     

左氧氟沙星与头孢唑林钠治疗下呼吸道感染疗效比较

目的：探讨左氧氟沙星与头孢唑林钠治疗下呼吸道感染的疗效。方法：分成两组分别使用左氧氟沙星、头孢唑林钠治疗下呼吸道感染疗效比较。结果：左氧氟沙星痊愈18例,显效13例,进步4例。头孢唑林钠痊愈9例,显效10例,进步11例,无效2例。结论：左氧氟沙星治疗下呼吸道感染疗效优于头孢唑林钠。     

左氧氟沙星联合阿奇霉素治疗高龄难治性呼吸道感染的临床研究

目的评价左氧氟沙星联合阿奇霉素治疗高龄人群难治性呼吸道感染的疗效与安全性。方法对68例难治性细菌性呼吸道感染的高龄患者随机分为治疗组和对照组,治疗组34例给予左氧氟沙星联合阿奇霉素治疗;对照组34例给予左氧氟沙星治疗,两组总疗程皆为15 d。结果治疗组与对照组的有效率分别为64.71%和32.35%,呼吸道细菌清除率分别为76.19%和36.36%,差异均有统计学意义（P〈0.05）。两组不良反应发生率皆低。结论左氧氟沙星联合阿奇霉素治疗高龄人群难治性呼吸道感染临床疗效优于单用可乐必妥,疗效确切而且安全。     

氟罗沙星与左氧氟沙星治疗下呼吸道感染的临床疗效对照

目的　分析氟罗沙星与左氧氟沙星治疗下呼吸道感染的临床疗效。方法　回顾性分析我院 2 0 0 2年 9月至2 0 0 3年 5月住院的 5 9例下呼吸道感染患者的病历 ,分氟罗沙星组和左氧氟沙星组进行对比分析。结果　两组有效率分别为 93 10 %、90 0 0 % ,细菌清除率分别为 88.89%、88.4 6 % ,药物敏感百分率分别为 88.0 0 %、90 0 0 % ,不良反应发生率分别为 13 79%、10 0 0 % ,统计学皆无显著差异 (P >0 .0 5 )。结论　氟罗沙星与左氧氟沙星对下呼吸道感染的治疗均可获得较好的临床疗效和微生物清除效果 ,不良反应少 ,机体耐受性好 ,不失为敏感菌感染治疗的安全、有效药物     

盐酸左氧氟沙星序贯疗法对社区获得性肺炎的疗效观察

目的观察盐酸左氧氟沙星序贯疗法对社区获得性肺炎(CAP)的疗效观察。方法对社区获得性肺炎(CAP)通过CURB-65评分为2分的患者随机分为治疗组和对照组。对照组:静脉滴注盐酸左氧氟沙星治疗7天,治疗组:静脉滴注盐酸左氧氟沙星治疗3天后改为口服盐酸左氧氟沙星胶囊治疗,两组治疗7天后观察疗效。结果两组患者的有效率差异无显著性(P>0.05)疗效相当。结论盐酸左氧氟沙星序贯疗法治疗社区获得性肺炎方便有效。     

头孢吡肟与左氧氟沙星治疗老人支气管肺炎的疗效比较

目的：比较左氧氟沙星与头孢吡肟治疗老人支气管肺炎的临床疗效。方法：将70例老人支气管肺炎患者随机分为观察组和对照组,每组各35例。对照组均给予左氧氟沙星,静脉滴注,0.2 g,2次/d;观察组采用头孢吡肟2 g,静脉滴注,2次/d,两组疗程均为14 d。结果：观察组总有效率为94.2%,对照组总有效率为71.4%,两组的总有效率比较差异有统计学意义（P〈0.05）。结论：头孢吡肟联合治疗老人支气管肺炎的临床效果优于左氧氟沙星,且副作用低。     

舒巴坦/头孢哌酮治疗老年下呼吸道感染临床观察

目的：评价头孢哌酮/舒巴坦对中老年下呼吸道感染的疗效和安全性。方法：头孢哌酮钠/舒巴坦钠2g加生理盐水100mL静脉滴注,1次/12h,7～10d1疗程。结果：痊愈14例,显效19例,好转4例,无效1例,总有效率86.8%。结论：舒巴坦/头孢哌酮是一种抗菌谱广、疗效显著、副作用少的抗生素,适用于治疗下呼吸道感染性疾病。     

Results of radioiodine treatment of autonomous thyroid adenomas taking into consideration regional iodine kinetics and paranodular uptake

In 110 patients with autonomous adenoma of the thyroid, the success rate of therapy with radioiodine using different local dosages (300 and 400 Gy) was monitored. Furthermore the relative paranodular uptake before and after radiotherapy was compared in dependence on the duration of therapy. In a short period of therapy (5-8 d) the paranodular uptake decreases as compared to a long duration (9-20 d) where it increases. This explains the higher rate of hypothyroidism found in the group of patients with a longer period of therapy. The success rate was 93.6% after applying a dosage of 300 Gy and 95% after 400 Gy. However we found a slightly smaller incidence of hypothyroidism (3.2%) after 300 Gy as compared to 400 Gy (8.8%). Nevertheless the higher dosage should be chosen to reduce the failure rate. Because of the increased rate of hypothyroidism with increasing paranodular uptake it is recommended in cases with uptake ratios between 10 and 20% (so-called transitional type) to induce exogenic suppression of the paranodular tissue by means of thyroid hormone.     

Pulmonary radiographic findings and mortality in hospitalized patients with lower respiratory tract infections

Lower respiratory tract infections (LRTIs) remain a widespread problem and have a significant impact on primary healthcare resources. Previous studies have reported conflicting results on whether pulmonary radiographic findings at presentation predict lethality for patients with LRTIs.The aim of this study was to determine if the pulmonary radiographic findings at the third day of hospitalisation were independently associated with lethality in patients with LRTIs.A total of 616 patients with LRTIs, admitted to our hospital, were evaluated with regard to radiographic data. The prognostic analysis included an univariate approach of the following radiographic findings: focal alveolar infiltrates in one or more segments, focal alveolar infiltrates in one or more lobes, cavitations, diffuse infiltrates, solitary or multiple nodules, pleural effusion and fibrosis. Of the 616 patients, 560 patients (90.0%) had at least one pulmonary radiographic finding confirmed by a panel of radiologists. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) for Windows. Eleven independent radiographic variables were examined for association with lethality.Overall lethality was 10.2% (553 survivors, 63 non-survivors). The only parameter found to be significantly different between survivors and non-survivors was cavitations on chest radiograph (p-value: 0.047).In conclusion, the presence of cavitations on chest radiograph at third day of hospitalisation can help physicians' assessment of prognosis in patients with LRTIs, as it is an independent predictor of lethality.     

Colon transit scintigraphy in health and constipation using oral iodine-131-cellulose

The purpose of the study was to assess if a new scintigraphic method for noninvasive assessment of colonic transit could differentiate between subjects with normal bowel transit and those with constipation. Eleven normal subjects and 29 constipated patients were given 4 MBq iodine-131-cellulose (131I-cellulose) orally and sequential abdominal scans were performed at 6, 24, 48, 72, and 96 hr from which total and segmental percent retentions were calculated. There were clear differences between the normal subjects and the constipated patients for the total percent retention at all time intervals, on a segmental basis in the right colon at 24 hr, and in all segments at 48 and 72 hr. Three-day urinary excretion of radioiodine was minimal; 2.4% +/- 1.2% (mean +/- s.d.) in constipated patients and 3.1% +/- 0.8% in normals, with approximately 75% occurring in the first day. The use of oral radiotracers in the investigation of constipation appears promising.     

博来霉素化疗的同期联合放疗治疗头颈部中晚期鳞癌

目的　观察使用博来霉素化疗的同期给予放疗治疗头颈部中晚期鳞癌的疗效。方法　 62例头颈部中晚期鳞癌患者随机分为观察组和对照组。观察组 3 2例 ,每天用博来霉素 8mg加地塞米松 5 mg,静滴 ,1次 / d,化疗后采用直线加速器放疗。5次 /周 ,2 Gy/次 ,照射总量 60～ 70 Gy,博来霉素总量 1 60～ 2 0 0 mg。对照组 3 0例 ,给予单纯放疗治疗 ,剂量同观察组。结果　观察组和对照组在放疗 40 Gy及放疗结束后 3个月 ,颈淋巴结消退率分别为 :44% ,3 0 %和 88% ,73 % (P<0 .0 5 ) ,毒副反应均较轻。结论　博来霉素化疗同期进行放疗 ,有利于提高头颈部中晚期鳞癌患者淋巴结转移灶全消率 ,减少残存 ,是治疗头颈部中晚期鳞癌有效方法     

强的松联合霉酚酸酯与联合环磷酰胺治疗重症IgA肾病疗效比较

 目的比较强的松联合霉酚酸酯(mycophenolatemofetil,MMF)与强的松联合环磷酰胺(cyclophosphamide,CYC)治疗重症IgA肾病的临床疗效。方法84例重症IgA肾病患者分别给予强的松联合MMF治疗(MMF组,n=42),强的松联合CYC治疗(CYC组n=42)。强的松起始剂量40mg/d,MMF诱导期剂量1.5g/d,持续6个月;维持期剂量0.75~1.0g/d,持续12个月。CYC诱导期剂量为0.8~1.0g/月,静脉滴注,持续6个月;维持期剂量0.8~1.0g/3月,持续12个月。两组患者基础病情无差异,随访时间18个月,观察两组患者临床缓解率及相应实验室指标,如24h尿蛋白定量、血肌酐、血浆白蛋白、总蛋白、血脂变化,并比较两组治疗的不良反应。结果(1)临床缓解率:治疗18个月时MMF组临床总有效率高于CYC组,分别为85.7%vs61.8%(P＜0.05);(2)观察期末,MMF组患者24h尿蛋白定量(0.6±0.3)明显低于CYC组(1.4±0.5)(P＜0.05),血浆白蛋白和总蛋白(43.2±4.3和70.2±8.1)均显著高于CYC组患者(36.9±3.6和60.3±7.6)(P＜0.05);(3)血脂变化:MMF组血脂较治疗前明显降低,而CYC组无变化(P＜0.05);(4)不良反应发生率:MMF组不良反应发生率(4.76%)明显低于CYC组(19.0%)。结论MMF组治疗重症IgA肾病,临床缓解率高于CYC组疗法,能更有效降低患者24h尿蛋白定量,改善患者血脂和血浆白蛋白水平,维持患者肾功能稳定,并且MMF组不良反应发生率显著低于CYC组疗法。     

Circulatory responses to orthostasis during alpha1-adrenergic receptor blockade at high altitude.

BACKGROUND: Increased blood level of norepinephrine, a primary alpha-adrenergic agonist, is associated with high-altitude exposure, and may help regulate key physiological functions (e.g., blood pressure). We hypothesized that blocking alpha1-adrenergic receptors would impair circulatory compensation for an orthostatic challenge to a greater extent at altitude than at sea level. METHODS: Sixteen healthy women (23 +/- 2 yr) were randomly assigned to receive either 2 mg prazosin (n = 8) or placebo (n = 8) t.i.d. (double-blind design) for 12 d at sea level and during the first 12 d of altitude residence (4300 m). Passive 60 degrees upright tilt was performed at sea level (10 d of treatment), and after 3 and 10 d at altitude. Mean arterial BP (MABP, via auscultation) and heart rate (HR, via ECG) were measured every min during 10 min each of supine rest and tilt. RESULTS: For the prazosin group compared with the placebo group: 1.) Supine and tilt MABP were consistently lower (p < 0.05) at sea level; 2.) MABP did not differ (p > 0.05) for either day at altitude; 3.) HR was similar for both positions at sea level and altitude; and 4.) MABP was consistently less only at sea level and HR was consistently greater only at altitude (both p < 0.05) in response to tilt. CONCLUSIONS: alpha1-adrenergic blockade altered MABP and HR responses to tilt at sea level and altitude, but circulatory responses to orthostasis were well maintained in both environments. At altitude, BP during tilt was sufficiently maintained by a compensatory increase in heart rate, likely mediated by parasympathetic withdrawal.     

分化型甲状腺癌131I治疗后TgAb由阳转阴时间与临床转归的关系

目的 探究131I治疗前甲状腺球蛋白抗体（TgAb）阳性（≥40 IU/ml）的分化型甲状腺癌（DTC）患者131I治疗后TgAb转阴时间与临床转归的关系,并分析影响的因素。 方法 回顾性分析2014年1月至2019年1月在青岛大学附属医院行甲状腺全切术及131I治疗前TgAb阳性的126例DTC患者的临床资料,其中男性15例、女性111例,年龄11~74（42.1±11.5）岁。将患者按末次随访时的治疗反应分为疗效满意组和疗效不满意组。采用卡方检验、独立样本t检验、Mann-Whitney U检验分析2组间年龄、性别、原发灶最大径、肿瘤是否多灶、是否合并桥本甲状腺炎、术前甲状腺过氧化物酶抗体（TPOAb）水平、TgAb水平（术前及首次131I治疗前）、首次131I治疗后（1、6、12个月）TgAb水平的下降率、TgAb转阴时间、131I治疗总剂量、肿瘤分期、淋巴结分期、淋巴结转移率、首次131I治疗前复发危险分层的差异,对差异有统计学意义的变量进一步行Logistic回归分析,明确影响患者临床转归的独立危险因素。通过受试者工作特征（ROC）曲线确定预测患者临床转归的最佳临界值。 结果 疗效满意组患者共109例,疗效不满意组患者共17例。2组间首次131I治疗后12个月TgAb水平下降率[89.84%（82.81%,94.70%）对83.01%（74.99%,91.08%）,Z=?2.168,P=0.030]、TgAb转阴时间[（25.06±17.96）个月对（45.41±22.11）个月,t=?4.206,P<0.001]、131I治疗总剂量[3 700（3 700,3 700） MBq对5 550（3 700,10 545） MBq,Z=?4.388,P<0.001]的差异有统计学意义;而Logistic回归分析结果显示,TgAb转阴时间（OR=1.036,P=0.034）及131I治疗总剂量（OR=1.033,P=0.001）为预测临床转归的独立危险因素。ROC曲线分析结果显示,当TgAb转阴时间临界值为31.5个月（曲线下面积为0.766,95%CI:0.650~0.881,P<0.001）时,其预测临床转归的灵敏度及特异度最高,分别为78.00%和70.60%。 结论 对于131I治疗前TgAb阳性的DTC患者,其TgAb转阴时间和131I治疗总剂量是预测患者临床转归的独立危险因素。TgAb在首次131I治疗后31.5个月内转阴的患者更易获得满意疗效,且疗效满意组患者所需的131I治疗总剂量比疗效不满意组更低。     

七里散加六味地黄丸治疗神经根型颈椎病104例疗效观察

目的总结七里散加六味地黄丸治疗神经根型颈椎病的价值。方法对1996—2005年12月我队收治的104例颈椎病先用七里散1 g 1次/d,连服5 d;接着用六味地黄丸8丸3次/d,连服20 d。结果1疗程后治愈率为94.23%(98/104),总有效率100%,随访3个月~1年,无复发。结论七里散加六味地黄丸治疗神经根型颈椎病疗效高,安全无副作用。     

高渗氯化钠溶液治疗失血性休克的实验研究

目的：筛选出最佳氯化钠溶液浓度,最佳滴注速度和最佳剂量;了解高渗氯化钠溶液复苏后血浆渗透压及电解质的变化情况。方法：45只犬,制成失血性休克模型,用不同浓度和剂量的氯化钠溶液在不同滴注速度下,对失血性休克犬进行复苏,比较其复苏效果。结果：质量浓度为75g/L的高渗氯化钠溶液为最佳浓度,20ml/min为最佳滴速,相当于放血量的15％（5．71mg/kg体重）为最佳剂量;复苏效果确切,使平均动脉到基础水平的89％,且维持时间至少1h左右。结论：以20ml/min的滴速,用相当于失血量15％的75g/L氯化钠溶液复苏失血性休克效果最佳。     

177Lu-labeled cyclic polyaminophosphonates as potential agents for bone pain palliation.

177Lu (T 1/2 = 6.71 d, Ebeta(max) = 497 keV) has radionuclidic properties suitable for use in palliative therapy of bone pain due to metastasis. 177Lu was produced in high-specific activity (3-4TBq/g) and excellent radionuclidic purity (100%) by thermal neutron bombardment of natural Lu target. Two cyclic tetraaminomethylene phosphonate ligands, namely DOTMP and CTMP were synthesized and radiolabeled with 177Lu. The 177Lu-DOTMP complex was formed with very high yield (> 99%) and showed excellent stability (up to 40 d at room temperature). Biodistribution of 177Lu-DOTMP was carried out in Wistar rats and the complex showed significant bone uptake (4.23%/g in femur and 5.23% in tibia at 3 h p. i.), rapid clearance from blood (no activity at 3 h p. i.) and minimum uptake in soft tissues.