Clinical study on sulbactam/cefoperazone in the field of pediatrics

Sulbactam/cefoperazone (SBT/CPZ) was used in pediatric patients with acute infections, and the following results were obtained. SBT/CPZ was administered to 18 pediatric patients with acute infections. Out of them, 14 patients, i.e., 3 with acute tonsillitis, 1 with acute laryngitis, 1 with acute bronchitis, 4 with acute pneumonia, 4 with bronchopneumonia, 1 with pyothorax, were adopted for the evaluation, and the other 4 were excluded because they were judged inadequate for clinical efficacy evaluation. The clinical efficacy of SBT/CPZ was assessed as excellent in 4, good in 9 and fair in 1. The effective rate was 92.9%. In 6 cases causative organisms were detected, i.e., Haemophilus influenzae in 3, Klebsiella in 1 and Staphylococcus aureus in 2 cases. Eradication of these organisms was confirmed in all cases except for 1 patient with pyothorax caused by S. aureus. The doses used in 12 out of the evaluated 14 cases ranged from 58.4 to 80 mg/kg/day, 84.1 mg/kg/day was used in 1 case and 101.4 mg/kg/day was used in 1 case with pyothorax. Patients with severe infections were generally given large doses. The frequency of administration was 3 times per day except 1 case, and intravenous drip infusion was used in all cases. The duration of treatment was 2- less than 3 days for 7 cases, 3-5 days for 6 cases and 9 days for 1 case (pyothorax). No clinical side effects were observed in any case. In laboratory examinations, a slight elevation of GOT was observed in 1 case, but no abnormal findings in the other cases. From the above results, SBT/CPZ was considered to be a highly useful drug in the treatment of pediatric infections.     

Clinical study on sulbactam/ampicillin in the pediatric field

A combination drug of sulbactam/ampicillin (SBT/ABPC) was intravenously administrated to 18 patients with ages 3 months to 10 years 10 months with various acute infections including 14 cases of pneumonia, 1 case each of tonsillitis, subacute bacterial endocarditis, empyema and suspected sepsis. Clinical responses were excellent in 14 cases and good in 4 cases. Bacteriological responses of 8 isolated strains were: 7 strains were eradicated and 1 strain was decreased. No side effect was observed in any case. Eosinophilia was observed in 2 cases, thrombocytosis in 2 cases, elevation of GOT in 1 case and elevations of GOT and GPT in 1 case. From the above results, it seemed that SBT/ABPC was a useful drug for the treatment of bacterial infections in the pediatric field.     

创伤性浮肩手术修复与重建的效果分析

目的探讨创伤性浮肩手术修复与重建的治疗效果。方法 15例创伤性浮肩患者,均进行钢板内固定术,并进行术后修复与重建,观察、记录术后并发症与患者满意度,并采用Herscvici评定术后肩关节功能情况。结果本组15例患者全部获得随访,随访时间12~36个月,平均随访时间(15.50±6.84)个月。所有患者术后无伤口感染、神经血管损伤、内固定断裂等并发症,所有骨折均愈合。愈合时间12~18周,平均愈合时间(14.74±1.09)周。术后Herscvici肩关节评定结果优11例,良3例,可1例,差0例,优良率为93.33%(14/15)。患者术后对关节功能和生活质量的满意度结果为非常满意12例,满意2例,一般满意1例,不满意0例,满意度为93.33%(14/15)。结论创伤性浮肩经过手术修复与重建,可以缩短肩关节制动及固定时间,有利于肩关节功能恢复,减少并发症的发生,临床效果满意。     

他克莫司原研药与仿制药在肾移植术后早期患者中的浓度、有效性与安全性对比评价

目的:评价他克莫司原研药和仿制药的浓度、有效性和安全性在中国肾移植术后早期患者中的一致性。方法:通过筛选纳入2015年1月到2021年1月肾移植术后使用他克莫司原研药(普乐可复)、仿制药(赛福开)的病例。采用倾向性得分匹配2组体质量及CYP3A5基因分型后,比较术后3,7,14d的剂量校正谷浓度(dose-adjusted trough concentration,C₀/D)、有效性和安全性的差异。结果:最终初步纳入137例患者(411个C₀点),其中普乐可复58例(174个C₀点),赛福开79例(237个C₀点)。倾向性得分匹配后共纳入96例患者(288个C₀点),每组各48例。2组患者在第3天,第7天,第14天的C₀/D和C₀达标率的差异无统计学意义(P＞0.05)。有效性方面,2组患者6个月的存活率均为100%,普乐可复组急性排斥反应发生率为3.3%,赛福开组为1.7%,2组间差异无统计学意义(P＞0.05)。安全性方面,普乐可复组和赛福开组在肾移植术后6个月内的肝功能异常均为1例、院内感染分别为3例和1例、院外感染分别为3例和6例、总感染事件分别为6例和7例,血糖异常分别为31例和33例,2组间差异均无统计学意义(P＞0.05)。结论:他克莫司原研药普乐可复和仿制药赛福开在肾移植术后早期患者中的C₀/D、C₀达标率、有效性和安全性具有一致性。     

Clinical experience with sulbactam/ampicillin in the pediatric field

Sulbactam/ampicillin (SBT/ABPC) was given intravenously to 20 children with the following acute bacterial infections; 14 cases of pneumonia, 2 cases of purulent cervical lymphadenitis and 1 case each of bronchitis, pyothorax, cellulitis, and purulent meningitis. Good clinical responses were obtained in 18 out of 20 patients, and bacteriologically, all of the 14 isolated strains were eradicated. No side effect was observed except 2 cases of eosinophilia, and 1 case each of loose stool and elevated thrombocyte. From the above clinical results, it is apparent that SBT/ABPC is a useful antibiotic for the treatment of pediatric patients with various kinds of bacterial infections.     

卡泊芬净治疗重症监护患者侵袭性真菌感染对氟康唑无效/不能耐受的疗效分析

目的:评价卡泊芬净治疗重症监护病房(ICU)患者侵袭性真菌感染(IFI)对氟康唑无效/不能耐受的疗效和安全性。方法:回顾分析我院14例ICU患者IFI对氟康唑治疗无效/不能耐受时继以卡泊芬净的治疗结果,首日给予卡泊芬净负荷剂量70mg,之后以50mg·d-1维持,疗程3～28d。结果:14例患者中,确诊2例,包括白色念珠菌菌血症和肺光滑念珠菌病各1例;拟诊5例,包括肺曲霉病2例,肺白念珠菌病2例以及肺近平念珠菌病1例;疑似7例,病原真菌不明。1例患者用药第3天死于呼吸衰竭,疗效无法判断,在可评价疗效的13例患者中,痊愈2例(2/13,15.4%),显效4例(4/13,30.8%),进步2例(2/13,15.4%),无效5例(5/13,38.5%),总有效率为46.2%。治疗过程患者均能耐受,未见与用药有关的严重不良反应。结论:卡泊芬净治疗ICU患者IFI对氟康唑无效/不能耐受时疗效确切、安全,可作为ICU中抗IFI的首选药物之一。     

半椎板、全椎板切除减压椎间融合术治疗腰椎管狭窄症疗效观察

目的半椎板、全椎板切除减压加椎间融合术治疗退变性腰椎管狭窄症的中远期临床疗效观察。方法依据患者椎管狭窄、腰椎失稳、滑脱的情况不同,分别采用开窗减压、半椎板减压、全椎板减压及椎间融合的手术方法治疗腰椎管狭窄症。结果本组共43例,其中男28例,女15例,年龄53～68岁,平均(61±7)岁;随访时间8～38个月,平均(27.6±3.5)个月。术后按改良腰椎功能障碍指数,优26例,良12例,可4例,差1例,优良率为90.9%,下腰疼痛完全缓解率为82.2%(23/28),跛行改善率为85.7%(12/14),26例感觉障碍者,完全恢复21例(80.7%),部分恢复4例(15.4%),无明显恢复1例(3.9%)。结论对于退变性腰椎管狭窄症的患者,依据狭窄的情况单纯采用半椎板减压、全椎板减压、椎间融合的手术方法是一种有效的治疗方法。     

隆突性皮肤纤维肉瘤磁共振影像特征分析

目的通过对14例隆突性皮肤纤维肉瘤(DFSP)的磁共振影像进行分析, 提高对DFSP磁共振影像特征的认识。方法本文为描述性研究。收集广东医科大学附属医院2011年3月至2022年6月经病理及免疫组化检测确诊的14例DFSP患者的磁共振影像资料, 分析DFSP磁共振影像特征情况, 包括T1加权成像(T1WI)、T2加权成像(T2WI)、弥散加权成像(DWI)、增强扫描等序列影像特征。结果 14例DFSP患者中, 男9例、女5例, 年龄21～58(43.8±12.2)岁。14例均为单发, 表现为突出皮肤表面的结节/肿块, 最大长径21～160(57.1±37.0)mm, 平均体积大小为57.1 mm×40.4 mm×28.4 mm。DFSP平扫T1WI信号与肌肉相仿, T2WI高信号, 6例病灶内可见少量线状低信号分隔, 3例DWI呈明显高信号, 10例增强扫描病灶呈明显均匀强化, 4例呈不均匀强化, 内可见斑片低强化区域。6例病灶内T2WI压脂低信号分隔增强扫描强化不明显。1例肿块内可见流空血管影。1例肿块内可见出血信号, T1WI平扫呈高信号。14例病灶局限在皮肤及皮下脂肪组织内, 5...     

奥氮平换药治疗精神分裂症60例临床观察

目的了解奥氮平治疗精神分裂症的疗效和安全性。方法同时符合CCMD-3精神分裂症诊断标准和连续30d以上使用其他药物并且疗效不佳或有严重副反应不能耐受需要换药治疗两项基本条件60例,停用已用抗精神病药物,改用奥氮平5—30mg／d,共治疗8周,以阳性和阴性症状量表（（PANSS）评定临床疗效,以TESS和实验室监测评价安全性。结果60例患者中,基本痊愈14例（23．33％）,显著进步22例（36．67％）,好转15例（25．00％）,无效9例（15．00％）,总有效率率85．00％。不良反应：轻微震颤1例,白天思睡6例,口干2例,鼻塞1例,轻微恶心1例,均未处理。在用量超过20mg／d时出现静坐不能3例、窦性心动过速5例经普奈洛尔处理症状减轻。4周后体质量增加24例（40％）,体质量增加2～7kg不等。结论奥氮平对阳性、阴性症状以及一般精神病症状均有良好疗效,常见副反应为胆碱能作用、嗜睡、体质量增加等。奥氮平是替代其他药物后,总体安全有效,患者的服药依从性好。     

急性出血性肠炎15例诊疗体会

目的：总结急性出血性肠炎的诊治经验,评价个体化治疗方法的应用效果。方法：对7年来15例急性出血性肠炎病人,按其临床表现进行分型,针对不同病情采取手术和非手术的个体化治疗。结果;14例治愈,1例死亡。手术9例,其中5例行病变肠段切除,1例一期肠吻合,4例肠造口,另4例未做特殊处理。非手术治疗6例,1例死亡,5例康复。结论：采用个体化治疗方案效果良好。有肠管坏死倾向者,果断手术。反之,密切观察病情变化,综合治疗,防止多器官衰竭的发生。     

Clinical study in cefuroxime in pediatric field (author's transl)

Cefuroxime (CXM), a new cephalosporin antibiotic, was used in pediatric field, and the following results were obtained. 1. Absorption and excretion CXM was administered by intravenous drip infusion to 3 patients aged 14 years, 1 year and 1 month, and 5 years and 3 months, respectively, at doses of 15.4 mg/kg, 14.1 mg/kg, and 13.2 mg/kg. The following blood levels were obtained; 71 micrograms/ml at the completion of infusion, 26.8 micrograms/ml at 30 minutes, 13.2 micrograms/ml at 1 hours, 5.05 micrograms/ml at 2 hours, 2.07 micrograms/ml at 4 hours, and less than 0.45 micrograms/ml at 6 hours after the infusion. Urinary excretion of the drug administered was measured in one of these cases. The urinary excretion rate at 1 approximately 6 hours after intravenous drip infusion was 50.4%. 2. Clinical result CXM 17 approximately 55 mg/kg were administered for 2 approximately 4 days to 6 patients with acute respiratory tract infection, 1 with acute cervical lymphadenitis, and 1 with acute enteritis. The clinical results was poor in the case with acute enteritis and good in the other 7 cases. No side effect was observed in 9 cases (the above 8 cases plus 1 unassessable case), and the laboratory examination results showed no abnormality, either.     

Clinical study of S 6472 granule preparation (sustained-release cefaclor) in chronic respiratory airway infections

S 6472 granule preparation, a sustained-release preparation of cefaclor, was administered to 21 patients with chronic respiratory airway infections for its clinical study; a daily dosage between 750 and 1,500 mg was orally given in 2 divided doses after breakfast and dinner for a duration of 3 to 14 days. Clinical effects were good in 15 cases, fair in 1 case, poor in 4 cases and unknown in 1 case. No side effects were observed except for a case of impaired appetite. There appeared to be no abnormal laboratory test valued due to the drug.     

腹腔镜下治疗小儿小肠出血18例效果观察

目的:探讨腹腔镜诊断和治疗儿童下消化道出血的临床价值.方法:对18例术前不明原因下消化道出血,怀疑小肠病变的患儿行腹腔镜探查术,15例确诊后14例经右下腹延伸小切口,提出肠管在腹腔外手术,1例免于手术;3例病因不明.结果:14例患儿均无中转开腹手术,手术时间40～90 min,平均75 min.术后5～10 d出院,无任何并发症.结论:小儿腹腔镜具有创伤小、安全可靠、诊断率高等特点,可替代剖腹探查术,适用于不明原因的儿童下消化道出血病例,尤其怀疑小肠出血.     

Clinical trial of cefmenoxime in children

Cefmenoxime (CMX) was intravenously administered to 20 children with the following bacterial infection; pneumonia in 14 cases, purulent meningitis in 2 cases, pyothorax in 2 cases, urinary tract infection in 1 case and brain abscess in 1 case. The daily dosage administered in meningitis, pyothorax and brain abscess ranged from 145-311 mg/kg/day, from 43-88 mg/kg/day in other bacterial infections. The therapeutic efficacy was excellent in 15, good in 3, poor in 2 patients, efficacy rate being 90%. Causative organisms were H. influenzae in 4 cases, S. aureus in 2 cases, Streptococcus sanguis in 1 case, E. coli in 1 case and unknown in 12 cases. All were eliminated with the exception of 2 strains of S. aureus after the administration of CMX. As for side effect, transient eosinophilia was only observed in 1 case.     

单鼻孔经蝶垂体腺瘤显微切除附20例报告

目的介绍经单鼻孔蝶窦入路显微切除垂体腺瘤的手术方法及经验。方法分析经单鼻孔蝶窦入路显微神经外科手术治疗的20例垂体腺瘤患者的相关临床资料。结果肿瘤全切14例,次全切除4例,部分切除2例。1例出现电解质紊乱,3例出现一过性尿崩,无永久性尿崩,1例出现脑脊液漏。结论单鼻孔蝶窦入路能减少垂体腺瘤手术并发症,降低病死率和伤残率。     

Clinical studies on S 6472 granule preparation (sustained-release cefaclor) in chronic respiratory tract infections

S 6472 granule preparation (sustained-release cefaclor) was orally administered to 15 patients with chronic respiratory tract infections (2 acutely exacerbated cases of chronic bronchitis, 13 cases of secondary infections consisting of 1 case of bronchial asthma, 2 cases of bronchial asthma/pulmonary emphysema, and 10 cases of bronchiectasis) at a daily dose of 750 mg divided into 2 doses administered after breakfast and dinner, for a duration of 14 days. The drug was ineffective in 3 of the 10 cases of bronchiectasis but was effective in the other 12 cases, with a rate of efficacy of 80%. There were no side effects of abnormal laboratory findings due to administration of this drug.     

老年人胫骨平台骨折的手术治疗的探析

目的：探讨手术治疗老年人胫骨平台骨折的疗效与价值。方法：研究近10年来14例老年患者，其中10例伴有各种疾病，均为不同类型的胫骨平台骨折。并制定术后治疗计划，然后术后随访6个月～8年。结果：12例患者，X线示骨折愈合无移位，2例骨折轻度移位。优10例，良2例，可1例，差1例，优良率达85．7％。结论：对老年患者采取早期积极的手术治疗，可不发生并发症，取得良好效果。     

上消化道异物68例临床特点分析

目的探讨上消化道异物的临床特点。方法对2009年9月至2012年8月昆明市第一人民医院进行胃镜下上消化道异物取出的68例患者的临床资料进行回顾性分析。结果 68例上消化道异物患者中,男45例66.18%(45/68),女23例33.82%(23/68),平均年龄(42.25±29.42)岁,其中14岁以下占22.51%,14岁到82岁占77.49%;食管异物33.82%(23/68),胃异物55.89%(38/60),十二指肠异物10.29%(7/68)。在所有异物中,碎骨头、铁丝、毒品居前三位,分别占23.53%(16/68),19.12%(13/68),16.18%(11/68)。异物停留时间平均(26.48±12.43)h;64例异物经内镜取出,1例嵌顿于球部,1例下行至空肠,2例手术治疗。结论本地区上消化道异物特点:发病率较高;发病年龄以14岁以下及40岁以上较多;14岁以下异物多为硬币,14岁以上多为食物相关及特殊人群相关异物;异物种类不同,滞留部位不同;大部分异物可经内镜取出,极少患者需外科手术治疗。     

甲状腺滤泡状腺癌和髓样癌的彩超表现及病理分析

目的：探讨超声诊断甲状腺滤泡状腺癌和髓样癌的临床应用价值。方法2006年1月~2012年12月我院共收治甲状腺滤泡状腺癌和髓样癌患者66例,其中甲状腺滤泡状腺癌38例,髓样癌28例,对上述病例分别进行超声检查。结果38例滤泡状甲状腺癌以实质肿块为主（35/38,92.1％）,实质肿块表现为等回声（19/35,54.3％）及低回声（16/35,45.7％）,边界尚清晰（28例）,10例有包膜,不完整低回声晕,未见钙化。甲状腺滤泡状癌的血流分布：0级1例,I级16例,Ⅱ级8例,Ⅲ级13例。血流频谱呈低阻,阻力指数（RI）为0.53~0.58。甲状腺髓样癌二维声像特征多呈实性低回声,内部分布不均,后方回声衰减,边界不清（14例）,无或无完整声晕,结节内可见钙化,特别是沙粒样钙化灶。颈部淋巴结转移多见（71.4%,20/28）,且多为双侧。28例患者结节周边及内部均可见较丰富血流信号,周边分布为主,多为断续环状血流,以静脉血流为主,其中0级1例,Ⅰ级4例,Ⅱ级6例,Ⅲ级17例。阻力指数（RI）为0.55~0.82。结论超声诊断甲状腺滤泡状腺癌和髓样癌具有便捷、高效、无痛、无创的特点,优势明显,通过超声的声像图特征可以较准确评估病变的特征,并结合病理检查结果为甲状腺癌的诊断提供指导依据。     

创伤性血胸合并胸椎爆裂骨折的救治体会

目的 探讨创伤性血胸合并胸椎爆裂骨折救治体会,提高创伤所致的血胸合并胸椎爆裂骨折的认识及处理能力. 方法 回顾性分析解放军第175医院2014年6月至2016年5月收治的36例创伤性血胸合并胸椎爆裂骨折患者的临床资料.36例患者中男22例,女14例,年龄42.6(18~52)岁.胸椎骨折的分布:单个节段1例,2个节段8例,3个节段17例,4个节段6例,5个节段4例.采取急诊科、骨科、胸心外科、康复医学科联合救治模式:4例失血性休克失代偿期患者生命体征不稳定,急诊即予抗休克治疗;32例接受手术治疗. 结果 36例中,4例因失血性休克经积极抗休克等综合救治血压仍不稳定,出现"致死三联征"(低体温、代谢性酸中毒、凝血功能障碍)死亡;3例术后2~3周因全身多器官功能衰竭死亡;29例成功救治,术后恢复良好.脊柱Frankel分级:术前A级14例中术后恢复至B级4例、C级2例、无明显改善5例、死亡3例;B级8例中恢复至C级3例、D级1例、无明显改善2例、死亡2例;C级8例中恢复至D级5例、无明显改善3例;D级6例中恢复至E级4例、死亡2例.成功救治的29例经康复治疗后26例可坐立、3例可下床活动. 结论 创伤性血胸合并胸椎爆裂骨折是一种复杂的多发伤,采取多学科联合救治的快速康复医学模式,完善院内早期救治平台,预防损伤所致的不可逆性病理损害,早期抗休克、手术及康复治疗是抢救生命、改善生活质量的关键所在.