用血必净注射液治疗中、重度烧伤患者48例的疗效观察

目的：评价用血必净注射液治疗中、重度烧伤患者的安全性和有效性。方法：将48例中、重度烧伤患者随机分为治疗组和对照组（每组24例）;2组均给予常规治疗,而治疗组在常规治疗基础上加用血必净注射液;分析2组患者的体温、心率、血白细胞计数（WBC）、中性粒细胞计数、肝功能指标（AST,ALT）和肾功能指标（BUN,Cr）值的变化,以及抗菌药物的使用情况。结果：与对照组相比,治疗组能显著降低其体温、心率、血白细胞计数和中性粒细胞计数指标值,2组经统计学分析,其差异有统计学意义（P〈0．05）;肝、肾功能的有关指标值经统计学分析,其差异无统计学意义（P〉0．05）。结论：血必净注射液用于治疗中、重度烧伤的疗效确切,且ADR少,临床值得推广应用。     

关节腔注射重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白联合复方倍他米松治疗类风湿关节炎膝关节炎的临床观察

目的评价关节腔注射重组人Ⅱ型肿瘤坏死因子受体- 抗体融合蛋白联合复方倍他米松对类风湿关节炎膝关节炎的疗效及安全性.方法：对具有膝关节炎的24 例类风湿关节炎患者行膝关节腔穿刺,注入重组人Ⅱ型肿瘤坏死因子受体- 抗体融合蛋白25 mg与复方倍他米松7 mg,注射前及注射后4 周与8 周评估关节病变情况.结果：注射治疗4 周与8 周后患者关节疼痛评分、肿胀指数、压痛指数均较治疗前明显改善,差异具有统计学意义（P 〈 0.05）;治疗前、治疗后4 周及治疗后8 周患者膝关节平均滑膜厚度分别为（6.7 ± 2.0）、（5.8 ± 2.2）、（4.2 ± 2.3） mm,膝关节滑膜增厚明显减轻,治疗前与治疗后4 周乃至8 周比较,差异具有统计学意义（P 〈 0.05）.结论：关节腔注射重组人Ⅱ型肿瘤坏死因子受体- 抗体融合蛋白联合复方倍他米松可减轻关节炎症,安全性较好.     

氟康唑注射液致严重过敏反应1例

1例45岁男性患者,因确诊肺癌入院,此次化疗同时行颅脑放疗。患者咽拭子及大便中检出真菌,给予氟康唑注射液（100 mg,ivgtt）抗真菌治疗。在输注结束2 min后,患者出现寒战、高热、喘憋、剧烈咳嗽等症状,考虑为严重过敏反应,立即给予持续吸氧（4 L·min^-1）,地塞米松磷酸钠注射液（5 mg,iv）、盐酸苯海拉明注射液（1 m L,im）、二羟丙茶碱注射液（0.25 g,ivgtt）、注射用甲泼尼龙琥珀酸钠（40 mg,iv）、注射用赖氨匹林（0.9 g,iv）等对症治疗。之后患者症状逐渐缓解,3 h后症状消失。     

注射用丹参多酚酸盐在糖尿病患者中的临床应用观察研究

目的：集中监测并评估注射用丹参多酚酸盐在糖尿病患者中的临床应用情况。方法：采用真实世界研究方法,追踪记录2012年8月至2013年1月我院应用注射用丹参多酚酸盐的住院糖尿病患者的详细临床资料并进行分析。结果：共有345例糖尿病患者纳入观察,多为超重的中老年人,入住科室主要为心内科和血管外科,合并病症主要是冠心病与高血压。注射用丹参多酚酸盐用药情况基本符合药品说明书要求,且安全性良好,合并用药以心血管和血液系统药物为主,患者用药后糖尿病相关临床指标有所改善。结论：注射用丹参多酚酸盐在我院糖尿病患者中的使用安全、规范,相关临床指标的改善情况说明其对于糖尿病患者及并发症可能具有有益影响。采用真实世界研究方法评估中药的临床实际应用情况具有实用意义。     

左卡尼汀注射液的质量评价

目的：通过建立左卡尼汀注射液中的含量及有关物质A的HPLC法,评价市售左卡尼汀注射液和自制左卡尼汀注射液的质量。方法：采用左卡尼汀注射液的美国药典标准、国家标准（WS1－X－（023）－2005Z）、进口标准（WS1－X－（023）－2005Z）以及本文新建立的HPLC法测定左卡尼汀注射液的含量及有关物质A含量。结果：自制的三批左卡尼汀注射液、市售的雷卡、可益能的含量及有关物质A含量分别为102．43％、7．93μg／ml;102．22％、8．63μg／ml;100．02％、8．04μg／ml;99．14％、19．90μg／ml;103．21％、394μg／ml,本文建立的测定左卡尼汀注射液中的含量及有关物质A的HPLC法操作简单、专属性强、准确度高。结论：有必要提升左卡尼汀注射液的质量标准,准确控制左卡尼汀的含量和有关物质A的含量,以提高临床用药的安全性与有效性。     

参丹芎注射液对大鼠长期毒性实验研究

目的研究连续静脉给予参丹芎注射液对SD大鼠产生的毒性反应。方法参丹芎注射液342、228、152mg生药·kg^-1（高、中、低剂量）连续尾静脉注射给药30天,整个实验期间观察动物的一般状态、测定体重和摄食量,分别于给药30天及停药后14天取部分大鼠进行血液学指标、血清生化学指标、脏器系数和病理组织学检查。结果大鼠未发生因给药而引起的异常症状,各给药组大鼠体重增长和摄食正常。与阴性对照组比较,在给药30天时,高剂量组导致大鼠WBC、GR％、Urea、CR、TBIL和肝脏系数、肾脏系数、肾上腺系数明显增高,中剂量组GR％、CR、TBIL显著增高和LY％显著降低（P〈0．05）,停药恢复14天后,除CR和肾系数之外,高剂量组其他指标均恢复正常,中剂量组所有指标恢复正常。高剂量组大鼠肾脏组织出现不可逆性病变,中剂量组大鼠肾脏组织出现可逆性病变。结论中剂量静脉注射参丹芎注射液30天,可导致SD大鼠出现肾脏功能及病理组织学可逆性改变。     

60例参附注射液不良反应分析

目的探讨参附注射液发生药品不良反应（ADR）的规律和原因,为临床合理用药提供参考。方法将我院2000年5月～2012年12月临床各科室上报的60例参附注射液ADR按患者性别,年龄,用法用量,原患疾病,ADR发生时间,ADR累及系统一器官及主要临床表现等进行统计分析。结果参附注射液ADR以皮肤损害为主,消化系统次之,有迟发反应的特性,但未发现死亡报告。结论参附注射液的ADR与剂量和年龄有关,关注迟发型不良反应的发生,临床应加强参附注射液的不良反应监测。     

Intra‐articular tibiofemoral injection of a nonsteroidal anti‐inflammatory drug has no detrimental effects on joint mechanics in a rat model

Administration of intra‐articular medications, including corticosteroids and analgesics, is common clinical practice for knee pathology and dysfunction. Non‐steroidal anti‐inflammatory drugs (NSAIDs) are another category of medication commonly prescribed for their analgesic and anti‐inflammatory properties. Recent studies demonstrated the efficacy of injectable NSAIDs in the treatment of intra‐articular pathology and postoperative analgesia. However, little data exist regarding the safety of intra‐articular injection, despite the increase in its application. Therefore, we investigated the effects of intra‐articular NSAID injection on articular cartilage, the anterior cruciate ligament (ACL), and joint function in the rat. Sixty‐four Sprague‐Dawley rats were divided into either saline (SAL) or ketorolac (NSAID) tibiofemoral single injection treatment groups. Animals were euthanized at 2, 7, 28, and 84 days post‐injection for histological and mechanical analyses. Additionally, a subset of animals underwent longitudinal ambulatory evaluation to determine joint functional properties. We hypothesized that intra‐articular ketorolac injection would result in no detrimental mechanical, histological, or functional changes. No differences were reported between the NSAID and SAL groups in any of the parameters measured at any time point, demonstrating the potential safety of intra‐articular NSAID administration. Therefore, NSAID injection could be further considered for clinical application in humans. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 32:1512–1519, 2014.     

A Simple, 10-minute Procedure for Transforaminal Injection under Ultrasonic Guidance to Effect Cervical Selective Nerve Root Block

The aim is to provide a detailed procedure of a simple and 10-minute cervical nerve root block (CNRB) under ultrasonic guidance, and to report the clinical outcomes, disorders, and complications. Records of patients who had undergone CNRB, were reviewed under ultrasonic guidance at the hospital from 2010 through 2012. The procedure is described in detail. Arm and shoulder pain was evaluated by use of the visual analogue scale (VAS). Forty-three patients agreed to undergo CNRB under ultrasonic guidance. Nerve roots from C5 to C8 were affected in 41, and these nerve roots were readily distinguished. Two of the 43 participants did not receive injections because impediments in visualizing the affected nerve root. Of the 41 who received injections, radicular pain immediately disappeared in 39, who continued to feel pain relief 1 month later. However, pain recurred in 15 patients (38%), of whom 11 underwent cervical spine surgery. The rest of 24 patients felt sustained pain relief longer than 3 months after the injection, significantly. Although one patient had recurrent radicular pain 10 months later, the pain could be controlled by medication. At the final follow-up periods, 17.2 (10–24 months), the median VAS score of the patients, 23 (0 to 71 mm), was significantly improvement (P = 0.001) in comparison to before injection 88 (range; 56–100). No complications occurred. The cervical nerve root block under ultrasonic guidance simply, safely, and efficaciously decreased radicular pain for 17.2 months in 62% patients with intolerable radicular pain.