Formulation of a novel fixed dose combination of salmeterol xinafoate and mometasone furoate for inhaled drug delivery

Co-administration of an inhaled corticosteroid and long acting beta agonist for chronic obstructive pulmonary disease has reduced mortality compared to either drug alone. This combination reduces exacerbations, hospitalization, emergency department visits and health care costs. A novel fixed-dose combination of the long acting beta-2 agonist salmeterol xinafoate (SX) and the corticosteroid mometasone furoate (MF) were prepared in a composite particle formulation as brittle matrix powder (BMP) and investigated for suitability as an inhaled combination product. In this study, BMP fixed dose combinations of SX and MF with or without stabilizing excipients (lactose, mannitol, glycine and trehalose) were prepared and characterized with respect to their thermal properties, morphology, aerodynamic performance and physical stability. BMP combination formulations of SX and MF exhibited improved aerodynamic properties when delivered by dry powder inhalation as compared to the micronized blends of the same substances. Aerodynamic evaluation was carried out by next generation pharmaceutical impactor (NGI) with a marketed DPI device. Results demonstrated that co-deposition occurred when SX and MF were formulated together as composite particles in a BMP, while physical blends resulted in inconsistent deposition and dose uniformity. As a result of the bottom-up particle engineering approach, combination BMP formulations allow for dual API composite formulations to be dispersed as aerosolized particles. Aerosolized BMP combination formulations resulted in delivered dose uniformity and co-deposition of each API. Further, an excipient-free formulation, BMP SXMF, delivered approximately 50% of the loaded dose in the respirable range and demonstrated stability at ambient conditions for 6 months. Single dose 24-h pharmacokinetic studies in rats demonstrated that lung tissue deposition and blood circulation (AUC_0–24h) of two APIs were higher for the BMP combination group exhibiting a significantly higher lung concentration of drugs than for the crystalline physical blend. While high system drug levels are generally undesirable in lung targeted therapies, high blood levels in this rodent study could be indicative of increased pulmonary tissue exposure using BMP formulations.     

蒙脱石散联合双歧杆菌乳杆菌三联活菌片治疗小儿急性腹泻的临床分析

目的探讨蒙脱石散联合双歧杆菌乳杆菌三联活菌片治疗小儿急性腹泻的临床疗效。方法选取我院自2013年2月~2014年2月接收的80例小儿急性腹泻患儿,随机分为观察组和对照组,每组40例,对照组行单纯蒙脱石散治疗,观察组则行蒙脱石散联合双歧杆菌乳杆菌三联活菌片治疗,比较两组患儿的临床疗效。结果 两组患儿治疗总有效率、退热时间、呕吐消失时间、腹痛消失时间、大便正常时间等比较均有显著性差异(P0.05)。结论 给予急性腹泻患儿蒙脱石散联合双歧杆菌乳杆菌三联活菌片治疗可有效的提高治疗效果,改善患儿临床症状。     

Influence of debittered,defatted fenugreek seed powder and flaxseed powder on the rheological characteristics of dough and quality of cookies

A functional ingredient mix (FIM) comprising debittered and defatted fenugreek seed powder (70%) and flaxseed powder (30%) was used in cookies. Ash, fat and protein, dough development time, resistance to extension and peak viscosity values increased as the level of FIM increased from 10 to 30% in the blend. Beyond 20% of FIM substitution, the quality characteristics of cookies were adversely affected. Use of soya lecithin produced a significant improvement in the overall quality of the cookies with 20% FIM. Linolenic acid and total dietary fiber content of the cookies with 20% FIM and lecithin contained four times the amount of linolenic acid (2.3%) and double the amount of dietary fiber (13.04%) when compared with the control cookies (0.5% and 6.22%) respectively. Surface scanning electron microscopy of cookies with different levels of FIM from 10 to 30% showed that there was a disruption in the matrix.     

短期去乳糖奶粉喂养方法对新生儿腹泻的效果

目的：探讨短期去乳糖奶粉喂养方法对新生儿腹泻的效果。方法选取2013年3月—2014年2月腹泻患儿140例，按随机数字表法随机分为观察组和对照组各70例，观察组采用短期去乳糖奶粉喂养，对照组采用长期去乳糖奶粉喂养。比较两组患儿治疗效果、胃肠道症状、体质量增长与喂养耐受情况。结果观察组患儿痊愈51例，有效17例，无效2例；对照组痊愈47例，有效20例，无效3例，差异无统计学意义（Z＝0．758，P＝0．366）。观察组患儿平均体质量增长（34．30±7．35）g／（kg· d），平均摄入奶量（105．37±24．02）ml／（kg· d），优于对照组的（24．29±8．06）g／（kg· d），（97．21±21．66）ml／（kg· d），差异有统计学意义（t值分别为2．809，3．161；P＜0．05）。观察组排便次数、呕吐、腹胀、胃潴留发生例数均少于对照组，差异有统计学意义（P＜0．05）。结论腹泻新生儿采取短期去乳糖奶粉喂养方式既符合婴幼儿的生长发育特点，又可以维持其免疫功能的平衡，且经济实惠，值得在临床推广。     

张善举教授治疗功能性消化不良临证经验

张善举教授从事中医内科临床工作近30年,对消化病的诊治有其独特的见解,选用参苓白术散加味治疗功能性消化不良,疗效甚佳。     

参苓白术散联合西药治疗溃疡性结肠炎的Meta分析

[目的]系统评价参苓白术散联合西药治疗溃疡性结肠炎(UC)的临床疗效。[方法]计算机检索中国知网(1982~2015)、万方(2001~2015)、维普(1989~2015)、读秀(1996~2015)、PUBMED(1991~2015)、PLoS公共医学科学图书馆(1991~2015)、PMC美国国家医学图书馆生命科学期刊(1991~2015)等数据库,收集参苓白术散联合西药治疗UC的随机对照试验(RCT),由2位评价者独立按照纳入与排除标准筛选文献、提取资料和评价质量后,采用RevMan5.3软件进行Meta分析。[结果]共纳入10个文献,包含884例患者。参苓白术散联合西药组在治疗UC的总有效率[OR=3.30,95%CI(2.25,4.82),P0.01]、显效率[OR=2.02,95%CI(1.54,2.65),P0.01]均优于对照组,有效率与对照组相近[OR=1.08,95%CI(0.78,1.50),P=0.64],无效率则低于对照组[OR=0.30,95%CI(0.21,0.44),P0.01]。差异有显著统计学意义。漏斗图分析不对称,表明存在发表性偏倚。[结论]参苓白术散联合西药组治疗UC的疗效优于对照组。     

蒙脱石散联合达克宁散治疗婴幼儿红臀的疗效观察

目的：观察蒙脱石散联合达克宁散治疗婴幼儿尿布皮炎的效果。方法：将176例尿布皮炎患儿按照随机数字表法分为试验组96例和对照组80例，常规处理局部后，试验组采用蒙脱石散联合达克宁散混合剂外涂皮损部位；对照组采用0.02%高锰酸钾溶液泡浴臀部，再用棉布吸干水分后局部外涂金霉素软膏，比较两组治疗效果。结果：对照组总有效率为85.00%，试验组总有效率为97.92%，两组比较差异有统计学意义（X2=15.6382，P〈0.01）。结论：应用蒙脱石散联合达克宁散治疗婴幼儿红臀疗效显著，且操作简单，使用方便，节省时间，可提高护士的工作效率，又能缩短住院天数，免除了患者的经济负担，具有可用性和实用性，临床上值得推广。     

川芎茶调散加减治疗三叉神经痛42例疗效分析

目的：探讨川芎茶调散加减对三又神经痛的治疗效果，以供参考。方法：选择2009年10月-2012年9月我院三叉神经痛患者84例作为研究对象，根据随机分组。A组接受卡马西平治疗，B组同时接受川芎茶调散加减治疗。连续治疗4周后评价疗效，对比两组患者总有效率的差异性。结果：对比两组总有效率发现，B组明显高于A组，差异具有统计学意义（P〈0．05）。结论：采用川芎茶调散加减辅助治疗三叉神经痛具有一定的优越性，值得推广应用。