醒脑静注射液辅助治疗化脓性脑膜炎患儿观察

目的：观察醒脑静注射液联合头孢曲松治疗化脓性脑膜炎患儿的疗效。方法：100例化脓性脑膜炎患儿随机分为对照组50例和观察组50例,对照组予常规治疗;观察组在对照组基础上加用醒脑静注射液0.4-0.6ml·kg-1·d-1。两组疗程均为3 d。比较两组体温正常、外周血及脑脊液WBC计数正常时间与住院时间,以及两组患儿治疗前后血及脑脊液中肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）水平变化,评价两组临床疗效,比较并发症及随访6个月后的后遗症发生情况。结果：与对照组相比,观察组体温正常时间和脑脊液WBC计数正常时间均明显缩短（P〈0.05）,血清及脑脊液TNF-α含量下降更显著（P〈0.05）,观察组临床总有效率明显高于对照组（P〈0.05）。其余指标两组比较差异无统计学意义（P〉0.05）。结论：醒脑静注射液辅助治疗化脓性脑膜炎能有效改善患儿症状,纠正炎症因子异常,临床疗效高,值得临床推广。     

葛根素注射液所致临床发热反应的系统评价

目的在治疗心脑血管疾病方面,评价葛根素注射液与发热反应的相关性。方法计算机检索Cochrane Central Register of Controlled Trials、EMbase、Pubmed、CBM、WanFang Data和CNKI（至2013年8月）中有关葛根素注射液与发热相关性的临床试验,并手工检索相关研究及其参考文献。根据纳入和排除标准选择纳入文献、提取资料和进行方法学质量评价。在此基础上,以不良反应发生率为指标,利用系统评价的方法考察葛根素注射液与发热的相关性。结果依据纳入排除标准共纳入8项随机对照临床研究。结果显示,葛根素注射液组整体的不良反应发生率为1．20％,提示发热为葛根素注射液的常见不良反应。进一步的亚组分析结果显示,天保康葛根素注射液未见发热反应;普润葛根素注射液的发热反应发生率为0．90％,为偶见不良反应;其他产家的葛根素注射液的发热反应发生率为5．13％,为常见不良反应。葛根素注射液的发热反应发生率从2005年之前的4．04％降至2005年之后的0．32％。结论发热为葛根素注射液不良反应,除药物本身因素外,该不良反应与葛根素注射液的制备工艺具有一定的相关性。     

复方苦参注射液联合盐酸吗啡缓释片治疗中重度癌痛的临床疗效研究

目的：研究复方苦参注射液联合盐酸吗啡缓释片治疗中、重度癌痛的临床疗效。方法：设对照组和治疗组,每组30例,对照组予以盐酸吗啡缓释片,治疗组予以盐酸吗啡缓释片联合复方苦参注射液。观察两组患者疼痛缓解率、不良反应以及生活质量改善情况。结果：两组患者疼痛缓解总有效率比较具有统计学差异（P<0.05）;治疗组疼痛完全缓解和中度缓解优于对照组,具有统计学意义（Z=-1.996）;治疗组便秘反应发生率明显低于对照组（χ2=4.812,P=0.028）。结论：复方苦参注射液具有协同镇痛、缓解便秘和改善患者生活质量的作用。     

Sonography-guided trigger point injections in abdominal myofascial pain syndrome

Even though chronic abdominal pain is 1 of the most common reasons for hospital visits, diagnostic testing is often time-consuming and treatment is inadequate. Abdominal myofascial pain syndrome (AMPS) is usually not included as a differential diagnosis, but it should be considered in cases of chronic abdominal pain. The purpose of this study was to investigate the clinical characteristics of AMPS and to assess the effect of sonography-guided trigger point injections (TPI).A total of 100 patients with AMPS from 2012 to 2018 were retrospectively evaluated for clinical characteristics and TPI effects. AMPS was diagnosed using Srinivasan and Greenbaum''s criteria, and the TPIs were performed at intervals of 2 to 4 weeks. The Visual Analog Scale (VAS) ratio was calculated by subtracting the final VAS from the initial VAS score and dividing it by the initial VAS score after injections, and the patients were divided into 4 groups: non-responders, mild, moderate, and good responders.The median duration of pain was 12 months, and the median number of hospital visits before TPI was 2. Of the 100 patients, 66 (66%) were categorized as good responders, 11 (11%) as moderate responders, 7 (6.9%) as mild responders, and 16 (15.7%) as non-responders. When the initial and final VAS scores were compared, the sonography-guided injections were found to be effective in alleviating pain (P < .001). Moreover, patients who received the injections 2 or more times tended to have more significant pain reduction than those who received a single injection (P < .001).Patients with AMPS suffer from long-term pain and undergo many hospital visits and diagnostic tests. TPI with lidocaine can be an effective and safe treatment for patients with chronic AMPS.     

复方樟柳碱联合地西泮治疗眼睑痉挛的临床疗效与安全性

目的 观察复方樟柳碱联合地西泮注射治疗眼睑痉挛的临床疗效与安全性。方法 分析眼睑痉挛患者48例 52只眼,随机分为研究组与对照组,每组 24例 26只眼;记录眼睑痉挛分级。研究组给予患眼复方樟柳碱 2 mL 颞浅动脉旁注射联合地西泮0.5 mL眼轮匝肌注射。复方樟柳碱每日1次,连续14 d。地西泮每周1次,连续3次。对照组口服甲钴胺片 0.5 mg,每日 3次,连续 14 d。配合充足休息与心情放松。评估 2组的治疗后眼睑痉挛分级、总有效率、复发率与安全性。结果 研究组治疗后完全缓解率、明显缓解率、部分缓解率分别为42.31%、30.77%、19.23%, 对照组分别为15.38%、23.08%、26.92%,差异有统计学意义（Z=-2.829,P＜0.01）。研究组总有效率为92.31%,对照组总有效率为65.38%,差异有统计学意义（χ2=5.650,P＜0.05）。研究组复发率为7.69%,对照组复发率为38.46%,差异有统计学意义（χ2＝6.933,P＜0.01）。研究组眼睑皮下淤血发生率为19.23%,对照组眼睑皮下淤血发生率为11.54%,差异无统计学意义（χ2＝0.148,P＞0.05）。2组均未见严重不良反应或并发症。结论 复方樟柳碱联合地西泮注射可以安全有效地治疗眼睑痉挛,是眼睑痉挛的简单经济有效的治疗方法。     

某院肿瘤化疗科使用中药注射剂的合理性分析

目的：了解某院肿瘤化疗科中药注射剂的使用情况,并评价其使用的合理性。方法选取该院肿瘤化疗科2012年1月～12月使用过中药注射剂的病历资料643例,从中药注射剂使用的适应症、单次剂量、溶媒、疗程及联合用药等方面进行分析。结果该院肿瘤化疗科使用的中药注射剂有11种,使用例次最多的是康艾注射液和参芪扶正注射液。11种中药注射剂的使用适应症及用药频次均与说明书相符,不合理使用主要表现在疗程不足（36.8％）,其次是溶媒量不适宜（4.6％）及剂量不适宜（4.1％）。结论该院肿瘤化疗科中药注射剂不规范使用的情况须引起重视,临床药师应加强医嘱审核,共同促进中药注射剂的合理使用。     

Collagenase clostridium histolyticum for Dupuytren's contracture

Importance of the field: Dupuytren's disease is a non-malignant, progressive disorder of the hands that can severely limit hand function and diminish overall quality of life. With global life expectancy increasing, the prevalence of this disease appears to be increasing amongst all ethnic groups. Treatment has traditionally remained surgical with few effective, nonsurgical options. However, with the introduction of collagenase clostridium histolyticum to treat Dupuytren's contractures, physicians and surgeons may be provided with a new, office-based, non-surgical option to treat this disease.

Areas covered in this review: The literature behind the use of collagenase to treat Dupuytren's disease; including its mechanism of action, safety, efficacy and clinical evidence behind its recent FDA approval.

What the reader will gain: The latest information available on collagenase through a comprehensive review of PubMed and the websites of licensing organizations for medicinal products.

Take home message: Phase III, clinical trials on collagenase for treatment of Dupuytren's contractures have recently been completed. Meeting primary and secondary objectives, collagenase has obtained FDA approval for clinical use. Collagenase now provides a non-operative option for Dupuytren's disease. Although short-term results show that collagenase is safe and efficacious, long-term effects of repeat injections and contracture recurrence rates have yet to be examined.     

Second‐look endoscopy with thermal coagulation or injections for peptic ulcer bleeding: A meta‐analysis

Background and Aims: In the management of peptic ulcer bleeding, the benefits of second‐look endoscopic treatment with thermal coagulation or injections in controlling recurrent bleeding is unsure. This study set out to compare efficacy of routine second‐look endoscopy with treatment using either thermal coagulation or injections versus single endoscopy by pooling data from published work. Methods: Full publications in the English‐language published work as well as abstracts in major international conferences were searched over the past 10 years, and six trials fulfilling the search criteria were found. Outcome measurements included: (i) recurrent bleeding; (ii) requirement of surgical intervention; and (iii) mortality. We examined heterogeneity of trials and pooled the effects by meta‐analysis. The quality of studies was graded according to the prospective randomization, methods of patient allocation, the list of exclusion criteria, outcome definitions and the predefined salvage procedures for uncontrolled bleeding. Results: Among 998 patients recruited in these five randomized trials, 119 received routine second‐look endoscopy with thermal coagulation, and 374 received second‐look with endoscopic injection and 505 had single endoscopic therapy. Less recurrent bleeding was reported after thermal coagulation (4.2%) than single endoscopy (15.7%) (relative risk [RR] = 0.29; 95% confidence interval [CI] = 0.11–0.73), but no reduction was reported for the requirement of surgical intervention and all‐cause mortality. Injection therapy did not reduce re‐bleeding (17.6%) when compared to single endoscopy (20.8%; RR = 0.85; 95% CI = 0.63–1.14), requirement for surgery and mortality. Conclusion: Routine second‐look endoscopy with thermal coagulation, but not injection therapy, reduced recurrent peptic ulcer bleeding. There is no proven benefit in reducing surgical intervention and overall mortality.     

Effects of Calcium Infusion on Gastric Secretion in Heidenhain Pouch Dogs

Calcium salts were infused against a background of stimulation by histamine or porcine gastrin or against the release of endogenous gastrin (feeding test). Raising the plasma calcium to values noted in clinical chronic hyperparathyroidism did not influence histamine-stimulated secretion but had a strong inhibitory action on gastrin-stimulated secretion. In the feeding tests (endogenous gastrin) the onset of secretion was delayed by calcium infusion.

The results of these experiments cannot be related directly to the problem of hyperparathyroidism, hypercalcemia, and peptic ulcer. The results do, however, indicate a difference in the stimulant actions of gastrin and histamine.     

鱼腥草类注射液临床严重不良反应的原因研究（Ⅰ）

由于鱼腥草类注射液在临床应用中多次出现严重不良反应,我们利用豚鼠及 Beagle 犬进行了有关动物实验研究,结果证明助溶剂聚山梨酯80是引起鱼腥草类注射液临床严重不良反应的主要原因之一。