当前儿科使用抗生素存在的问题

近20年来，抗生索和其它合成抗生素及抗菌药物大量涌现，使细菌感染性疾病的疗效发生了根本性的变化，它的合理应用治愈了无数的严重感染患儿．挽救了成千上万的患儿的生命。而不合理的应用产生种种恶果也应引起医务工作者的重视。在家长的心目中孩子是太上皇，故稍有伤风，咳嗽、流鼻涕，家长在未到医院就诊前就用上了抗生素。据北京儿童医院1991年～1993年抽样调查，     

急性病毒性肝炎1例治验

张××,男,40岁,1979-2就诊.患者自觉近两周身倦乏力,不欲食,厌油腻,右胁下疼痛,尿包发黄。诊见患者面黄、目黄如桔子色,身热,舌质胖,苔厚中心黄.脉弦数,查体:肝右肋缘下2.5cm,边清,质软.实验室检查:脑絮(+++),麝浊10单位,锌浊16单位,丙谷转氨酶300单位。黄疸指数35单位。证属肝胆湿热,郁结而成,热重于湿.治以清热解毒,利湿退黄,方用逍遥散加减:当归20g、白芍20g、柴胡20g、云苓30g、白木20g、甘草15g、白花蛇舌草50g、栀子30g、茵陈50g、小蓟50g。水煎服,日1     

活血化瘀法治疗乳癖临床验例

乳癖乃现代医学的乳房囊性增生病,发病原因多因卵巢功能失调所致(即与内分泌功能紊乱有关),故多发于中年及老年女性。因有恶变之虑,欲根除必施行乳房单纯切除术,患者不易接受。祖国医学治疗乳癖有较为丰富的经验。     

Meta-analysis of Concurrent Chemoradiotherapy Comparison of Taxanes and Platinum versus 5-Fluorouracil and Platinum in Nasopharyngeal Carcinoma Treatment

Background: To evaluate the efficacy and safety of the regimen of concurrent chemoradiotherapy (CCRT) with taxanes and platinum versus the regimen of CCRT with 5-fluorouracil (5-FU) and platinum in nasopharyngeal carcinoma (NPC) treatment. Methods: Medline, the Cochrane library, and the Chinese medical literature database were searched for eligible studies. Meta-analysis was performed by Review Manager (Version 5.2). Results: Six random controlled trials (RCTs) including 514 patients met our criteria. Meta-analysis showed that the regimen of CCRT with taxanes and platinum had an improved significant difference in complete remission (CR) and less incidence rate in adverse reactions (AR) such as gastrointestinal impairment grade III-IV, liver and kidney impairment grade I-II and radiodermatitis grade III-IV versus the conventional regimen of CCRT with 5-FU and platinum, while the long-term effectiveness rate of overall survival (OS), locoregional failure-free survival (LFFS), or distant metastasis failure-free survival (DMFS) between the two groups was therapeutic equivalence. Conclusion: The regimen of CCRT with taxanes and platinum in NPC therapy may be more efficacy and safety than the conventional modality of 5-FU and platinum in CCRT. However, we need more high-quality studies of multi-center and randomized double-blind clinical trials to compare with, analyze, and confirm the findings further.     

小儿止咳平喘露的平喘作用及其对外周血可溶性细胞黏附分子-1的影响

目的探讨小儿止咳平喘露的平喘作用及其对外周血可溶性细胞黏附分子-1的影响。方法选取本院2010年10月～2012年3月收治的咳喘患儿236例,随机分为两组,采用小儿止咳糖浆治疗患儿118例为对照组,采用小儿止咳平喘露治疗患儿118例为观察组,分别进行组胺引喘法观察、枸橼酸引咳法观察、痰液嗜酸性粒细胞计数、外周血可溶性细胞黏附分子-1检测,比较两组患儿的各项临床指标。结果观察组组胺引喘潜伏期[（81．4±16．5）s]明显长于对照组[（52．7±12．0）s],观察组枸橼酸引咳潜伏期[（48．3±12．6）s]明显长于对照组[（30．1±9．2）s],观察组痰液嗜酸性粒细胞计数[（1．3±0．6）×10^6个,mL]明显低于对照组[（2．1±1．0）×10^6个／mL],观察组外周血可溶性细胞黏附分子-1[（42．7±13．8）μg,L]明显低于对照组[（59．2±17．5）μg／L],差异均有统计学意义（P〈0．05）。结论小儿止咳平喘露具有显著的止咳平喘功效,不仅能明显减少患儿痰液中的嗜酸性粒细胞,还能有效降低患儿外周血可溶性细胞黏附分子-1的水平。