喜炎平注射液联合更昔洛韦治疗儿童流行性腮腺炎的临床研究

目的探讨喜炎平注射液联合注射用更昔洛韦治疗儿童流行性腮腺炎的临床疗效。方法选取天津市宝坻区人民医院2017年3月—2019年9月收治的82例流行性腮腺炎患儿作为研究对象,按随机数字表法将所有患儿分为对照组和治疗组,每组各41例。对照组静脉滴注注射用更昔洛韦,5mg/kg,每12小时1次。治疗组在对照组治疗的基础上静脉滴注喜炎平注射液,10 mg/(kg?d)。两组患儿连续治疗7 d。观察两组患者临床疗效,同时比较治疗前后两组患儿临床症状改善情况、疼痛程度和炎性因子水平。结果治疗组总有效率为95.12%,明显高于对照组80.49%,差异有统计学意义(P0.05)。治疗组的体温恢复时间、腮腺消肿时间、颈抵抗消失时间、嗜睡消失时间均明显短于对照组,差异有统计学意义(P0.05)。治疗后,两组患儿的VAS评分明显低于治疗前(P0.05),以治疗组患儿降低的更明显,差异有统计学意义(P0.05)。在治疗后,两组患儿的白介素-4(IL-4)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平均显著降低(P0.05);治疗后治疗组的IL-4、IL-8、TNF-α水平比对照组低,差异有统计学意义(P0.05)。结论喜炎平注射液联合注射用更昔洛韦能有效提高流行性腮腺炎的临床疗效,减轻患儿的临床症状和疼痛程度,抑制炎性因子分泌,具有一定的临床研究价值。     

更昔洛韦治疗流行性腮腺炎患儿的效果评价

目的：评价更昔洛韦治疗流行性腮腺炎患儿的疗效。方法：选择流行性腮腺炎患儿180例,将其随机分为观察组和对照组。两组患儿常规辅助治疗相同,同时对照组加用利巴韦林;观察组使用更昔洛韦。结果：观察组的总有效率为97.78%（88/90）,高于对照组的总有效率88.89%（80/90）,两者比较,差异有统计学意义（P〈0.05）;两组患儿在治疗过程中均未见明显不良反应。结论：更昔洛韦治疗流行性腮腺炎疗效佳,并有良好的安全性,可建议临床进一步推广应用。     

如意金黄散联合伐昔洛韦治疗带状疱疹的临床研究

目的探讨如意金黄散联合伐昔洛韦治疗带状疱疹的临床疗效。方法选取2017年5月—2017年11月在无锡市第三人民医院进行治疗的带状疱疹患者86例,随机分为对照组(43例)和治疗组(43例)。对照组口服盐酸伐昔洛韦片,0.3 g/次,2次/d。治疗组在对照组基础上于患处外敷如意金黄散,取适量用醋调成糊状。两组患者均治疗10 d。观察两组患者的临床疗效,同时比较治疗前后两组患者临床症状改善时间、血清学指标及数字疼痛评分量表(NRS)、皮肤病生活质量指数评分(DLQI)和匹兹堡睡眠质量评分(PSQI)。结果治疗后,对照组临床有效率为81.40%,显著低于治疗组的97.67%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组疼痛完全消失时间、皮损停止进展时间、结痂时间均明显短于对照组(P0.05)。治疗后,两组血清IL-4、IL-6、IL-1β水平显著降低,IL-2和γ-干扰素(IFN-γ)水平显著升高,同组治疗前后比较差异具有统计学意义(P0.05),且治疗后治疗组血清学指标明显优于对照组(P0.05)。治疗后,两组患者NRS、DLQI、PSQI评分显著降低(P0.05);且治疗后治疗组NRS、DLQI、PSQI评分明显低于对照组(P0.05)。结论如意金黄散联合伐昔洛韦治疗带状疱疹可有效改善患者临床症状,抑制机体炎症反应,具有一定的临床推广应用价值。     

干扰素联合更昔洛韦治疗儿童带状疱疹疗效及安全性研究

目的:探讨干扰素联合更昔洛韦治疗儿童带状疱疹的临床效果。方法:将2016年1月～2018年1月接受治疗的70例儿童带状疱疹患儿资料进行研究,根据不同治疗方法将患儿分为观察组和对照组,每组35例。观察组采用干扰素、更昔洛韦联合治疗,对照组单用更昔洛韦治疗,比较两组的治疗效果。结果:资料统计显示,观察组治疗有效率为94.29%(33/35),对照组治疗有效率为80.00%(28/35),两数据组间比较有统计学意义(P0.05);观察组治疗后炎性因子IL-6、IL-10均优于对照组,各项数据组间比较均有统计学意义(P0.05);随访3个月提示,观察组患儿后遗神经痛42.86%(15/35),对照组后遗神经痛51.43%(18/35),两数据组间比较无统计学意义(P0.05);观察组治疗后VAS评分(3.9±1.0)分,对照组VAS评分(5.5±1.4)分,两数据比较有统计学意义(P0.05)。结论:干扰素联合更昔洛韦治疗儿童带状疱疹安全有效,值得在临床中借鉴。     

人免疫球蛋白联合更昔洛韦治疗小儿腺病毒肺炎的临床研究

目的探讨静注人免疫球蛋白(pH 4)联合注射用更昔洛韦治疗小儿腺病毒肺炎的临床疗效。方法选择2014年6月—2016年12月华中科技大学同济医学院附属武汉儿童医院收治的腺病毒肺炎患儿90例,所有患儿按随机数字表法随机分为对照组和治疗组,每组各45例。对照组静脉滴注注射用更昔洛韦,5 mg/kg,滴注时间1 h,2次/d。治疗组在对照组基础上静脉滴注静注人免疫球蛋白(pH 4),400 mg/kg,1次/d。两组患儿均连续治疗14 d。观察两组的临床疗效,比较两组的临床症状、肿瘤坏死因子-α(TNF-α)、分泌型磷脂酶A2(sPLA2)、克拉拉细胞分泌蛋白(CCSP)和白细胞介素-1(IL-1)水平情况。结果治疗后,对照组和治疗组的总有效率分别为71.11%、95.56%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组退热时间、咳嗽停止时间、咽痛消失时间、肺部湿啰音消失时间和住院时间均明显短于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组血清TNF-α、sPLA2、CCSP和IL-1水平均明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论静注人免疫球蛋白(pH 4)联合注射用更昔洛韦治疗小儿腺病毒肺炎具有较好的临床疗效,可改善临床症状,降低TNF-α、sPLA2、CCSP和IL-1水平,具有一定临床推广应用价值。     

更昔洛韦联合复方甘草酸苷治疗带状疱疹的疗效观察

目的观察更昔洛韦联合复方甘草酸苷治疗带状疱疹的临床疗效。方法将70例带状疱疹患者随机分为两组,治疗组35例,给予更昔洛韦联合复方甘草酸苷治疗;对照组35例,给予更昔洛韦治疗,比较两组止疱、结痴、止痛、痊愈时间及后遗神经痛发生率。结果治疗组总有效率为80.9%,明显优于对照组的54.3%(P<0.01),后遗神经痛发生率两组差异无统计学意义(P>0.05)。结论更昔洛韦联合复方甘草酸苷治疗带状疱疹疗效明显优于单用更昔洛韦。     

更昔洛韦治疗小儿轮状病毒肠炎临床观察

目的探讨更昔洛韦治疗小儿轮状病毒性肠炎的临床疗效.方法对76例轮状病毒肠炎患儿随机分成两组,观察组用更昔洛韦治疗,采用临床症状、体征评分法.结果观察组总评分显著下降(P＜0.01),治疗有效率显著提高(P＜0.05).结论更昔洛韦治疗轮状病毒性肠炎临床疗效良好.     

复方片仔癀软膏联合伐昔洛韦治疗带状疱疹的临床研究

目的探讨复方片仔癀软膏联合盐酸伐昔洛韦片治疗带状疱疹的疗效。方法选择2019年4月—2020年4月在商丘第一人民医院治疗的带状疱疹患者92例,根据用药的差别分为对照组(46例)和治疗组(46例)。对照组口服盐酸伐昔洛韦片,0.3 g/次,2次/d;治疗组在对照组基础上涂抹复方片仔癀软膏,取适量涂抹于患处,3次/d。两组患者均进行10 d治疗。观察两组患者临床疗效,同时比较治疗前后两组患者临床症状改善时间、DLQI评分、PSQI评分、VAS评分,及血清疼痛物质P(SP)、前列腺素E2(PGE2)、降钙素基因相关肽(CGRP)、神经生长因子诱导蛋白(VGF)、β-内啡肽(β-EP)和神经降压素(NT)水平。结果经治疗,治疗组总有效率显著高于对照组(P<0.05),治疗组在临床症状改善时间上均优于对照组(P<0.05)。两组治疗后DLQI评分、PSQI评分和VAS评分均显著降低(P<0.05)。治疗组DLQI评分、PSQI评分和VAS评分明显低于对照组(P<0.05)。两组患者血清SP、PGE2、CGRP、VGF水平均显著下降,而β-EP、NT水平均升高(P<0.05)。治疗组SP、PGE2、CGRP、VGF、β-EP和NT水平明显好于对照组(P<0.05)。结论复方片仔癀软膏联合盐酸伐昔洛韦片治疗带状疱疹可有效改善患者临床症状,提高患者睡眠及生活质量,改善机体疼痛介质水平,具有一定的临床推广应用价值。     

蒲地兰消炎口服液联合更昔洛韦对流行性腮腺炎患儿生活质量及不良反应的影响

目的:观察流行性腮腺炎(Epidemic Parotitis,EP)患儿采用蒲地兰消炎口服液和更昔洛韦治疗效果.方法:将60例流行性腮腺炎患儿按入院时间进行随机分组(n=30),用更昔洛韦治疗的为对照组,同期联合蒲地兰治疗的为试验组,比较两组治疗后症状改善状况、生活质量及不良反应发生情况.结果:试验组用药后各种临床症状的消退时间和不良反应发生率都比对照组低,生活质量评分则明显高于对照组,差异明显(P<0.05),有统计学意义.结论:在用更昔洛韦滴注的同时,服用蒲地兰消炎口服液是控制病情,快速消除各种病症表现,并保证用药安全性和生活质量的理想治疗措施.     

更昔洛韦联合复方甘草酸苷治疗小儿带状疱疹的疗效观察

目的 评价更昔洛韦联合复方甘草酸苷治疗小儿带状疱疹的疗效及安全性.方法36例小儿带状疱疹患者分为两组,治疗组用更昔洛韦5 mg·kg-1静脉滴注,每日2次,联合复方甘草酸苷10 mL静脉滴注,每日1次.对照组单用更昔洛韦5 mg·kg-1静脉滴注,每日2次.两组疗程均为7 d.结果 治疗组有效率为90.0%,对照组有效率为75.0%,两组比较差异有统计学意义,(P＜0.05).患者各项症状、体征消退时间,治疗组比对照组明显缩短(P＜0.01) :不良反应的发生,治疗组与对照组相比P＞0.05,两组之间无统计学意义.结论 更昔洛韦联合复方甘草酸苷治疗小儿带状疱疹起效快,疗效高,毒副作用小,安全性好.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Hyperkalaemia in patients in hospital

A survey of all laboratory blood specimens with a plasma potassium concentration greater than or equal to 5.5 mmol/L was conducted over a three month period. Of 331 specimens with hyperkalaemia, 71 were excluded because the specimens was haemolysed, old or contaminated. The laboratory served a population of 348,561 and during this time measured the plasma potassium on 25,016 occasions. Sixty-six outpatients and 20 neonates were not evaluated. The survey was undertaken on 86 of 102 inpatients (46 males), 48 of whom were over 66 years of age. Fifty-seven patients were admitted under a medical service and 29 under a surgical service. Fifty-nine had a single episode of hyperkalaemia. Thirty-two underwent a surgical procedure. The commonest contributing factor was impaired renal function which was present in 71 (83%) patients. Although a definitive causative role for drugs could be identified in only five patients, in 52 (60%) patients drugs were a contributing factor (potassium supplements 24, ACE inhibitors 16, nonsteroidal antiinflammatory drugs 12). Thirty-five of the 86 (41%) patients died during their hospital admission. Nineteen of the 35 deaths occurred within three days of the hyperkalaemia being recorded. A normal plasma potassium was eventually documented in 50 of the 86 patients. Of the remaining 36 patients, 25 (69%) subsequently died. In general the treatment of patients with hyperkalaemia focused on identifying and treating the underlying cause. Hyperkalaemia must always be considered seriously and regard given to the overall clinical status of the patient, with particular attention to drug therapy, renal and cardiac function, acid base status and the possibility of sepsis.