儿童反复呼吸道感染采用匹多莫德颗粒治疗效果观察

目的：探讨和分析采取匹多莫德颗粒治疗儿童反复呼吸道感染的临床疗效及价值。方法选取2012年3月~2013年5月在本院接受治疗的反复呼吸道感染患儿60例为研究对象,将上述选取对象随机分成对照组和观察组,对照组采取常规治疗,观察组在给予常规治疗的基础上,给予匹多莫德颗粒进行治疗,观察两组患儿治疗效果及症状改善时间。结果观察组30例患儿总治疗有效率明显优于对照组,且该组患儿症状改善时间明显短于对照组,两组间上述两项指标对比差异有统计学意义（P〈0.05）。结论对反复呼吸道感染患儿采取匹多莫德颗粒进行治疗,能明显改善患儿呼吸症状,保证治疗效果,这对改善患儿预后有着积极的意义,值得在临床上推广。     

整体护理模式在小儿反复呼吸道感染中的效果观察

目的探讨整体护理模式在小儿反复呼吸道感染中的护理效果。方法选取2010年5月~2011年12月于笔者所在医院进行治疗的84例小儿反复呼吸道感染患者,随机分为对照组和观察组每组各42例,对照组按照常规的护理程序进行护理,观察组则以整体护理模式为指导进行护理干预,然后将两组患者的症状体征消失时间、并发症发生率及家长满意率进行比较。结果观察组的症状体征消失时间较对照组显著缩短,并发症发生率低于对照组,而家长满意率则显著高于对照组,差异有统计学意义(P<0.05)。结论整体护理模式可显著缩短小儿反复呼吸道感染患者的康复时间,并且可有效控制并发症的发生率,广受患儿家长欢迎。     

The behavioural effects of intravenously administered tryptamine in mice

The behavioural effects of intravenously administered tryptamine were examined in mice. Tryptamine in a dose greater than 15 mg/kg induced distinct head-weaving and hindlimb abduction. These behavioural syndromes appeared immediately after the injection and disappeared within 3 min. The changes in time course of the behaviour induced by tryptamine were consistent with those of the levels of tryptamine in the brain. Pretreatment with p-chlorophenylalanine, a depleter of 5-hydroxytryptamine (5-HT), failed to alter the effects of tryptamine on head-weaving or hindlimb abduction but did result in head-twitches which were never seen after tryptamine alone. Metergoline strongly antagonized the behavior induced by tryptamine. Pirenperone and haloperidol inhibited the behavioural syndrome, antagonizing the head-weaving in particular. alpha-Methyl-p-tyrosine, a depleter of dopamine, reduced the head-weaving without affecting the hindlimb abduction. These results indicate that the 5-HT syndrome induced by intravenous administration of tryptamine is due to the direct effect of tryptamine on the 5-HT receptor. Tryptamine-induced behaviour, especially head-weaving, seems to be linked with dopaminergic neurones.     

Kinetics of an intratracheally administered chromium catalyst in rats

Chromium-based catalysts are used for the synthesis of polyethylene, but little is known about the hazard and biomonitoring possibilities of this type of chromium for workers who may be occupationally exposed to such compounds. Therefore, the bioavailability and toxicokinetics of chromium were studied in male Wistar rats after a single intratracheal instillation (2 ml/kg body weight) of various doses (1, 5, or 25 mg/kg body weight) of the catalyst (approximately 1% chromium bound to an amorphous silica matrix), either before (CAT-Cr[III]) or after (CAT-Cr[VI]) heat treatment. The results were compared with those of equivalent amounts of two chromium salts (CrCl(3) and K(2) Cr(2) O (7). Each dose group was composed of three rats. The concentration of chromium was determined by atomic absorption spectrometry in urine (collected daily for 7 d) and in plasma, erythrocytes, lung, and liver tissue obtained 2 d (only highest concentration) and 7 d after dosing. On d 2, a significant increase in lung weight was found in the animals treated with the highest dose of the hexavalent Cr products. On d 7, on the basis of body weights, lung weights, and lung histology, there was no overt toxicity, except after the highest dose of CAT-Cr(VI). The elimination of all forms of chromium was apparently monoexponential, with calculated half-life elimination times in urine of 4-11 h for Cr(III) (CAT-Cr[III] and CrCl3 ) and 8-21 h for Cr(VI) (CAT-Cr[VI] and K(2) Cr(2) O(7). On d 2, the erythro-cytes Cr concentrations were significantly higher for the hexavalent Cr products than for the trivalent Cr products. After 7 d, the erythrocytes Cr concentrations were significantly increased above control values (3 microg/L) only in rats treated with the 2 highest doses of Cr( VI) compounds (12 and 64 microg/L for K(2) Cr(2) O(7), and 14 and 79 microg/L for CAT-Cr[VI]). The present study shows that intratracheally instilled Cr(VI) and Cr(III) have different toxicokinetic profiles and that the Cr(VI) catalyst has the same bioavailability and excretion kinetics as a water-soluble Cr(VI) salt. Exposure to chromium compounds could be monitored by measuring Cr concen-trations in urine (shortly after exposure) and in erythrocytes (also at later time points after high Cr[VI] exposure).     

Gatifloxacin in community-acquired respiratory tract infection

Gatifloxacin (Tequin^®, Kyorin Pharmaceutical Co. Ltd) is a new fluoroquinolone with a broad spectrum of activity for pathogens implicated in community-acquired respiratory tract infections, including Gram-positive, -negative and atypical bacteria. Excellent oral bioavailability, a half-life allowing once-daily administration and excellent penetration into respiratory tissues are desirable pharmacokinetic characteristics of gatifloxacin. Monte Carlo simulation of gatifloxacin in Streptococcus pneumoniae infection demonstrates that adequate levels of pharmacokinetic/pharmacodynamic parameters are obtained with gatifloxacin in almost all instances. In randomised, controlled trials and a large open-label, community-based study, gatifloxacin has shown excellent clinical and bacteriological efficacy in acute bacterial sinusitis, acute exacerbations of chronic bronchitis and community-acquired pneumonia. Current guidelines recommend the initial empiric use of gatifloxacin (along with the other new fluoroquinolones) for community-acquired respiratory tract infection in patients who have increased likelihood of infection with resistant pathogens. Another group of patients where this agent is recommended for initial antimicrobial therapy are those who, because of underlying disease and/or comorbid conditions, need an antibiotic with high antimicrobial efficacy to achieve optimal outcomes.     

Gatifloxacin in community-acquired respiratory tract infection

Gatifloxacin (Tequin, Kyorin Pharmaceutical Co. Ltd) is a new fluoroquinolone with a broad spectrum of activity for pathogens implicated in community-acquired respiratory tract infections, including Gram-positive, -negative and atypical bacteria. Excellent oral bioavailability, a half-life allowing once-daily administration and excellent penetration into respiratory tissues are desirable pharmacokinetic characteristics of gatifloxacin. Monte Carlo simulation of gatifloxacin in Streptococcus pneumoniae infection demonstrates that adequate levels of pharmacokinetic/pharmacodynamic parameters are obtained with gatifloxacin in almost all instances. In randomised, controlled trials and a large open-label, community-based study, gatifloxacin has shown excellent clinical and bacteriological efficacy in acute bacterial sinusitis, acute exacerbations of chronic bronchitis and community-acquired pneumonia. Current guidelines recommend the initial empiric use of gatifloxacin (along with the other new fluoroquinolones) for community-acquired respiratory tract infection in patients who have increased likelihood of infection with resistant pathogens. Another group of patients where this agent is recommended for initial antimicrobial therapy are those who, because of underlying disease and/or comorbid conditions, need an antibiotic with high antimicrobial efficacy to achieve optimal outcomes.     

Pulmonary toxicity of thuringiensin administered intratracheally in Sprague-Dawley rats

The purpose of this work is to evaluate the pulmonary toxicity of purified thuringiensin in Sprague-Dawley rats. Rats were intratracheally instillated with 0, 0.4, 0.8, 1.6, 3.2, 6.4 and 9.6 mg/kg body weight of thuringiensin. The results indicated that the acute pulmonary LD(50) of thuringiensin for rats was 4.4 mg/kg. The total number of inflammatory cells and lactate dehydrogenase (LDH) activity in the bronchoalveolar lavage (BAL) fluid increased in a dose-dependent manner after thuringiensin instillation. Furthermore, an effective dose of 1.6 mg/kg was selected for the time course study of pulmonary toxicity. The treated animals showed a significant increase in the weights of the lungs, hydroxyproline levels in the lungs and total number of cells in BAL fluid 2, 4, 7, 14, 28 and 56 days after treatment. In comparison with the control, the total protein concentrations in BAL fluid were increased by 361, 615, 116, 41, 34 and 41%, after 2, 4, 7, 14, 28 and 56 days, respectively. The LDH activity in BAL fluid showed a significant increase after 1, 2, 4, 7, 14, 28 and 56 days. The increases in fibronectin levels were 164, 552, 490, 769, 335, 257 and 61% at the corresponding times, but neither tumor necrosis factor nor interleukin-1 increased. The treated rats presented abnormal histology including distributed inflammation in the bronchioles and alveoli, bronchial cellular necrosis on days 1 and 2, and areas of septal thickening with cellular infiltration and collagen deposit in the intestinal and alveolar spaces on days 4-56. Based on these biochemical and pathological parameters, intratracheal instillation of purified thuringiensin might cause significant pulmonary toxicity in rats.     

Effect of intratracheally administered anticancer drugs on lung hydroxyproline content

The systemic administration of the anticancer drug bleomycin is associated with the development of lung damage and fibrosis. Intratracheal (i.t.) instillation of bleomycin has often been employed in animal models of this lesion to more rapidly elicit lung damage. However, various drugs and chemicals are known to induce lung damage and fibrosis when given i.t. The results presented here demonstrate that, in addition to bleomycin, the i.t. instillation of dactinomycin, mitomycin c, doxorubicin, and cyclophosphamide resulted in increased lung levels of hydroxyproline, an indicator of fibrosis. In contrast, increases were not seen following i.t. doses of 5-fluorouracil or vincristine, and 1,3-bis(2-chloroethyl)-1-nitrosourea(BCNU) actually decreased lung hydroxyproline content. These findings suggest that i.t. treatments with bleomycin may produce lung damage more representative of anticancer drugs in general than the specific lesion which is produced when bleomycin is administered systemically. The mechanisms underlying i.t. drug-induced increases in lung hydroxyproline are not known, but may be related to the ability of cell-cycle-nonspecific anticancer drugs to directly damage alveolar epithelial cells.     

Effects of methacrolein on the respiratory tract in mice

The acute respiratory effects of airborne exposure to methacrolein were studied in a recent refinement of the standard test method with mice (ASTM, 1984. American Society for Testing and Materials, Philadelphia). Irritation of the upper respiratory tract caused a concentration-dependent decrease in the respiratory rate of 2-26 ppm methacrolein. In this range, only a minor airflow limitation occurred in the lower respiratory tract, suggesting that the main effect of methacrolein is sensory irritation. During exposure, the sensory irritation response maintained the same level, i.e. no desensitisation occurred. The concentration 10.4 ppm methacrolein reduced the respiratory rate by 50% (RD50). The extrapolated threshold for the respiratory depressing effect, RD0, was 1.3 ppm. The sensory irritation effect of methacrolein was compared with results from closely related compounds in order to elucidate the mechanism of the interaction between methacrolein and the sensory irritant receptor.     

铜绿假单胞菌下呼吸道感染模型的制作及感染机制的初步研究

通过小鼠 PA 下呼吸道感染模型的制作及光镜、电镜技术对 PA 呼吸道感染机制进行了初步的研究。初步建立了 BALB/C 小白鼠呼吸道 PA 感染动物模型.提出了模型的参考指标并动态观察了 PA 呼吸道感染过程中不同时间在呼吸道、肺内的粘附、定值又侵袭部位.在粘液型PA 及非粘液型 PA 呼吸道感染机制的研究中明确了粘液型 PA 的肺内向肝、脾、血中的侵袭力要比非粘液型强。     

国产头孢替唑钠用于临床急性呼吸道及泌尿道感染治疗的疗效观察

目的 评价国产头孢替唑钠用于急性呼吸道及泌尿道感染治疗的有效性及安全性.方法 以进口注射用头孢替唑钠(特子社复)为对照,136例急性呼吸道及泌尿道感染患者随机分为观察组(n=70)和对照组(n=66),分别接受国产和进口注射用头孢替唑钠治疗,疗程均为7～14 d.以临床有效率和细菌清除率评价药物疗效,以不良反应发生率评价其安全性.结果 观察组和对照组临床有效率和细菌清除率分别为94.3%对92.5%,89.7%对87.0%;不良反应发生率分别为5.7%对6.1%,组间相比差异均无统计学意义(P>0.05).结论 国产头孢替唑钠用于急性呼吸道及泌尿道感染疗效及安全性与进口头孢替唑钠相当.     

呼吸道感染的合理用药

<正>呼吸道感染是常见的疾病。在下呼吸道感染中, 肺炎对人类的威胁最大。2005年美国胸科学会和美国感染性疾病学会联合公布了有关肺炎的指南,对于肺炎的含义做了补充修订。该指南将肺炎发生情     

利奈唑胺治疗老年下呼吸道感染患者疗效分析

目的评价利奈唑胺治疗老年下呼吸道感染患者的临床疗效及安全性。方法选择老年下呼吸道感染患者62例单盲完全随机分为治疗组和对照组各31例。治疗组选用利奈唑胺注射液0．6g,静脉滴注,2次／d,疗程7—14d;对照组选用盐酸去甲万古霉素注射液0．4g,静脉滴注,2次／d,疗程7—14d。结果治疗组、对照组有效率分别为87．1％（27／31）、64．5％（20／31）,差异有统计学意义（P〈0．05）;细菌阴转率分别为87．9％、83．9％,差异无统计学意义（P〉0．05）;不良反应发生率分别为12．9％（4／31）、41．9％（13／31）,差异有统计学意义（P〈0．05）。结论利奈唑胺是治疗老年下呼吸道感染患者的较为安全有效的药物。     

Clinical studies on ciprofloxacin in chronic respiratory tract infection

Ciprofloxacin (CPFX), a new pyridone carboxylic acid, was administered orally to the patients with chronic respiratory tract infection and its clinical efficacy and safety were studied in a multicenter open trial. The results and summarized as follows. 1. The efficacy rate for the patients with acute exacerbation as 52.5% (21/40) in 2 week-treatment, and 75.0% (24/32) in 4 week-treatment. 2. The efficacy rate for the patients with chronic phase was 23.1% (6/26) in 2 week-treatment, and 26.9% (7/26) in 4 week-treatment, but acute exacerbation was not observed in any of the patients. 3. CPFX was administered to 6 patients over 60 days for the prophylaxis of acute exacerbation. Only 2 patients had acute exacerbation in 2 and 3 months after the start of the therapy, respectively. 4. Bacteriological eradication rate was high except P. aeruginosa, for which the eradication rate was about 20%. 5. Side effects were observed in 3 patients, and abnormal findings of laboratory tests were observed in 5 patients, though they were not severe. These results show that CPFX is a useful antimicrobial agent for the treatment of chronic respiratory tract infections.     

3种治疗下呼吸道感染方法的成本-效果分析

目的　评价 3种方案治疗下呼吸道感染的药物经济学效果。方法　运用药物经济学成本 -效果分析法对氧氟沙星序贯疗法组 (L1组 )、左氧氟沙星静脉输注组 (L2 组 )、舒巴坦 /头孢哌酮静脉输注组 (L3 组 )三种治疗方案进行回顾性分析评价。结果　无论是治愈率还是有效率 ,L1组的成本效果比均低于L2 组和L3 组。结论　治疗下呼吸道感染疾病 ,L1组为最佳治疗方案。     

3种治疗下呼吸道感染方法的成本-效果分析

目的评价3种方案治疗下呼吸道感染的药物经济学效果.方法运用药物经济学成本-效果分析法对氧氟沙星序贯疗法组(L1组)、左氧氟沙星静脉输注组(L2组)、舒巴坦/头孢哌酮静脉输注组(L3组)三种治疗方案进行回顾性分析评价.结果无论是治愈率还是有效率,L1组的成本效果比均低于L2组和L3组.结论治疗下呼吸道感染疾病,L1组为最佳治疗方案.     

儿童呼吸道病毒感染的病因治疗

急性呼吸道感染是小儿最常见的疾病。病毒在儿童急性呼吸道感染的病原地位十分突出,临床常见的呼吸道病毒主要有呼吸道合胞体病毒（RSV）、流感病毒（InfV）、副流感病毒（PifV）、腺病毒（AdV）、巨细胞病毒（CMV）和肠道病毒（EV）。我国的儿童医院尚未建立病毒分离鉴定的常规病原检测手段,加上呼吸道病毒感染大多为急性感染,而且具有自限性,因此对轻症感染通常采用对症治疗,而对重症感染才根据临床判断采用抗病毒治疗。然而,21世纪发生的严重急性呼吸综合征（SAILS）、人禽流感以及EV71手足口病的肆虐对人类健康发出了严重挑战。