哌拉西林钠舒巴坦钠持续静滴治疗重症肺炎的疗效观察

目的：探讨哌拉西林钠舒巴坦钠持续静滴治疗重症肺炎的临床疗效和安全性。方法选取2012年6月—2014年2月内蒙古林业总医院收治的重症肺炎90例,随机分为治疗组（46例）和对照组（44例）。治疗组患者首先给予注射用哌拉西林钠舒巴坦钠5.0 g溶入到200 mL生理盐水中,1 h内静滴完,然后将注射用哌拉西林钠舒巴坦钠5.0 g溶入至20 mL生理盐水中,将微量泵泵入速度调整为2 mL/h持续泵入,2次/d。对照组静脉滴注注射用哌拉西林钠舒巴坦钠5.0 g溶入至200 mL生理盐水中,1 h静滴完,每8小时一次。两组均持续治疗3 d以上。比较两组的临床疗效,同时比较两组咳嗽消失时间、啰音消失时间、体温恢复正常时间、白细胞恢复正常时间。结果治疗后,治疗组和对照组的总有效率分别为80.44%、59.09%,两组总有效率比较差异有统计学意义（P＜0.05）。治疗组咳嗽消失时间、啰音消失时间、体温恢复正常时间、白细胞恢复正常时间均显著短于对照组,两组比较差异有统计学意义（P＜0.05）。结论哌拉西林钠舒巴坦钠持续静滴对重症肺炎有较好的临床疗效,可缩短各观察指标的时间,值得临床推广应用。     

双黄连注射液联合哌拉西林钠他唑巴坦钠治疗社区获得性肺炎的临床研究

目的 探讨双黄连注射液联合哌拉西林钠他唑巴坦钠治疗社区获得性肺炎的临床效果。方法 选取2020年10月—2023年9月华北医疗健康集团峰峰总医院收治的86例社区获得性肺炎患者,按随机数字表法将所有患者分为对照组和治疗组,每组各43例。对照组静脉滴注注射用哌拉西林钠他唑巴坦钠,将4.5g本品以稀释液充分溶解后,立即加入100mL5%葡萄糖注射液中,每次给药时间≥30min,2次/d。治疗组在对照组治疗基础上静脉滴注双黄连注射液,按体质量1mL/kg加入250mL5%葡萄糖注射液中,1次/d。两组疗程均为7d。观察两组临床疗效,比较两组临床表现消失时间及治疗前后氧合指数（OI）、CURB-65评分、红细胞沉降率（ESR）、中性粒细胞与淋巴细胞比值（NLR）及血清淀粉样蛋白A(SAA)、降钙素原（PCT）。结果 治疗后,治疗组总有效率是97.67%,显著高于对照组的81.40%(P<0.05)。治疗组发热、咳嗽、咯痰、胸闷痛及肺部啰音消失时间较之对照组显著缩短（P<0.05）。治疗后,两组OI均显著增高,而CURB-65评分均显著降低（P<0.05）;且治疗后,治疗组OI显...     

头孢哌酮舒巴坦钠与哌拉西林他唑巴坦钠治疗老年重症肺炎的疗效和成本比较

目的 分析头孢哌酮舒巴坦钠/哌拉西林他唑巴坦钠治疗老年重症肺炎的临床效果及对患者短期预后、临床症状及细菌清除率的影响。方法 根据治疗方法将在2019年3月至2021年3月于河南省登封嵩正中医院就诊的120例老年重症肺炎患者分为对照组（60例）和观察组（60例）。入院后2组均施以退热、止咳、平喘等基础治疗。对照组加用注射用头孢哌酮钠舒巴坦钠,观察组在基础对症治疗的基础上联合注射用哌拉西林他唑巴坦钠,所有患者均连续治疗2周。比较2组患者临床疗效、临床症状消失时间、细菌清除率及治疗成本。结果 观察组患者药品成本高于对照组（P<0.05）。2组患者临床疗效、各临床症状消失时间、单株细菌清除率与细菌总清除率以及检查、住院和总成本比较差异均无统计学意义（P>0.05）。结论 头孢哌酮舒巴坦钠/哌拉西林他唑巴坦钠对老年重症肺炎均具有疗效,但哌拉西林他唑巴坦钠的药品成本更高,头孢哌酮舒巴坦钠更具经济学优势。     

哌拉西林钠/他唑巴坦钠治疗下呼吸道感染36例

目的：评价注射用哌拉西林钠/他唑巴坦钠治疗下呼吸道感染的临床疗效。方法：下呼吸道感染患者68例，分为治疗组36例，给予注射用哌拉西林钠/他唑巴坦钠4.5 g；对照组32例，给予注射用头孢他啶1.0 g，分别加入0.9%氯化钠注射液100 mL中静脉滴注，q 8 h，疗程均为7～14 d。结果：治疗组和对照组有效率分别为94.4%，90.6%；细菌清除率分别为93.1%，84.6%(P＜0.05)；不良反应发生率分别为5.6%，3.1%。结论：哌拉西林钠/他唑巴坦钠对下呼吸道细菌感染临床疗效好且不良反应少，是一种高效、安全的抗菌药。     

参附注射液联合头孢哌酮钠舒巴坦钠治疗重症肺炎的临床研究

目的 探讨参附注射液联合注射用头孢哌酮钠舒巴坦钠治疗重症肺炎的临床疗效。方法 选取2019年4月-2022年12月重庆市江北区中医院收治的120例重症肺炎患者,根据随机数字表法将所有患者分为对照组和治疗组,每组各60例。对照组静脉滴注注射用头孢哌酮钠舒巴坦钠,3支加入100 mL生理盐水充分稀释后滴注,1次/12 h。治疗组在对照组基础上静脉滴注参附注射液,50 mL/次,然后以20 mL/h持续泵注50 mL,1次/12 h。两组患者连续治疗14 d。观察两组的临床疗效,比较两组患者的高热、咳嗽、气喘、肺部阴影消失时间,以及血氧分压、氧合指数、血氧饱和度、D-二聚体、纤维蛋白原、中性粒细胞-淋巴细胞比值（NLR）。结果 治疗后,治疗组患者总有效率95.00%高于对照的总有效率83.33%,组间比较差异显著（P<0.05）。治疗后,治疗组患者高热、咳嗽、气喘、肺部阴影消失时间均短于对照组,差异有统计学意义（P<0.05）。治疗后,两组的血氧分压、氧合指数、血氧饱和度高于治疗前（P<0.05）,治疗组的血氧分压、氧合指数、血氧饱和度高于对照组（P<0.05）。治疗后,两组的血清D-二聚体、纤维蛋白原、NLR低于治疗前（P<0.05）,且治疗组的D-二聚体、纤维蛋白原、NLR明显低于对照组（P<0.05）。结论 参附注射液联合注射用头孢哌酮钠舒巴坦钠治疗重症肺炎的疗效确切,能改善临床症状和肺通气功能,降低炎症反应和血液高凝状态。     

莲必治注射液联合头孢曲松钠他唑巴坦钠治疗老年肺炎的临床研究

目的探讨莲必治注射液联合头孢曲松钠他唑巴坦钠治疗老年肺炎患者的有效性和安全性。方法选取2016年1月—2017年12月石家庄市第三医院收治的老年肺炎患者110例,随机分成对照组和治疗组,每组各55例。对照组静脉滴注注射用头孢曲松钠他唑巴坦钠,3 g加入250 mL生理盐水,2次/d;治疗组在对照组基础上静脉滴注莲必治注射液,10 mL加入250m L生理盐水,2次/d。两组患者均连续治疗14d。观察两组患者临床疗效,同时比较治疗前后两组患者临床体征消失时间和血清学指标。结果治疗后,对照组和治疗组临床有效率分别为80.00%和94.55%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组患者咳嗽消失时间、退热时间、肺啰音消失时间及X线胸片炎症完全吸收时间均要显著早短于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血清C-反应蛋白(CRP)、可溶性髓样细胞触发受体-1(sTREM-1)和脑钠肽(BNP)水平显著降低(P0.05),且治疗组患者CRP、sTREM-1和BNP水平较对照组降低更明显,两组比较差异具有统计学意义(P0.05)。结论莲必治注射液联合头孢曲松钠他唑巴坦钠治疗老年肺炎疗效好、安全性高,可显著改善患者血清学生化指标,具有一定的临床推广应用价值。     

小儿肺咳颗粒联合哌拉西林钠他唑巴坦钠治疗婴幼儿支气管肺炎的临床研究

目的 探讨小儿肺咳颗粒联合哌拉西林钠他唑巴坦钠治疗婴幼儿支气管肺炎的临床疗效。方法 选取2021年3月—2023年2月沧州市人民医院收治的120例婴幼儿支气管肺炎患儿,按随机数字表法将患者分对照组（60例）和治疗组（60例）。对照组患儿静脉滴注注射用哌拉西林钠他唑巴坦钠,3.375 g/次加入生理盐水100 m L,1次/d。在对照组的基础上,治疗组口服小儿肺咳颗粒,1袋/次,3次/d。两组用药7 d观察疗效。观察两组患儿临床疗效,比较治疗前后两组患儿症状改善时间,白细胞（WBC）和中性粒细胞（NE）水平,及血清肿瘤坏死因子-α(TNF-α)、降钙素原（PCT）、乳酸脱氢酶（LDH）、C反应蛋白（CRP）水平,及不良反应情况。结果 治疗后,治疗组总有效率（98.33%）明显高于对照组（83.33%,P<0.05）。治疗后,治疗组肺部啰音、发热、气促、咳嗽改善时间均明显短于对照组（P<0.05）。治疗后,两组患儿WBC、NE、LDH、PCT、TNF-α、CRP水平均明显低于治疗前（P<0.05）,且治疗组这些指标明显低于对照组（P<0.05）。治疗后,治疗组不良反...     

注射用他唑巴坦钠/哌拉西林钠治疗新生儿感染的疗效观察

目的:观察注射用他唑巴坦钠/哌拉西林钠治疗新生儿感染的疗效。方法:将140例新生儿感染患儿随机分成治疗组和对照组。治疗组给予注射用他唑巴坦钠/哌拉西林钠100～200mg/(kg·d),对照组给予青霉素G钠10～20万IU/(kg·d),疗程均为5d～10d。结果:治疗组和对照组有效率分别为91.43%、52.86%(P<0.05),细菌总清除率分别为91.6%、65.1%(P<0.05),表皮葡萄球菌清除率分别为81.2%、65.0%(P<0.05),革兰阴性杆菌清除率分别为86.9%、50.0%(P<0.05)。结论:注射用他唑巴坦钠/哌拉西林钠治疗新生儿感染的疗效明显优于青霉素钠,且安全。     

哌拉西林他唑巴坦负荷剂量两步输注治疗ICU病房革兰阴性菌致重症医院获得性肺炎的临床研究

目的 探讨哌拉西林他唑巴坦负荷剂量两步输注与传统延长输注治疗重症监护病房革兰阴性菌（GNB）致重症医院获得性肺炎（HAP）的临床疗效。方法 选择2019年5月—2022年11月入住衡水市人民医院重症监护病房（ICU）的多重耐药革兰阴性菌（GNB）致重症医院获得性肺炎患者150例,按照随机数字表分为对照组和治疗组,每组各75例。对照组静脉泵入注射用哌拉西林钠他唑巴坦钠,4.5 g加入生理盐水100 mL,静脉泵持续输注3 h,1次/8 h。治疗组静脉泵入注射用哌拉西林钠他唑巴坦钠,4.5 g加入生理盐水100 mL,前2.25 g采用静脉泵在30 min内输注,后2.25 g采用静脉泵在150 min内持续输注。两组患者均治疗7～14 d。观察两组患者临床疗效,比较治疗前后两组患者细菌清除率,临床感染症状恢复时间,炎性指标降钙素原（PCT）、C反应蛋白（CRP）和白细胞计数（WBC）水平,及住院时间、机械通气时间和治疗总费用。结果 治疗后,治疗组临床总有效率（85.33%）显著高于对照组（70.67%,P＜0.05）。治疗后,治疗组细菌清除率（73.33%）显著高于对照组（56.00%,P＜0.05）。治疗后,治疗组啰音消失时间、咳嗽咳痰消失时间和退热时间均短于对照组（P＜0.05）;治疗后,两组WBC、PCT和CRP均显著下降（P＜0.05）,且治疗组比对照组下降更显著（P＜0.05）。治疗后,治疗组在住院时间、机械通气时间和治疗总费用方面均明显小于对照组（P＜0.05）。结论 哌拉西林他唑巴坦负荷剂量两步输注能显著提高入住ICU病房GNB致重症HAP的临床疗效和细菌清除率,能明显缩短症状改善时间,从而缩短患者住院时间和降低治疗费用。     

热毒宁注射液联合亚胺培南西司他丁治疗重症肺炎的临床研究

目的 考察热毒宁注射液联合注射用亚胺培南西司他丁钠治疗重症肺炎的临床疗效。方法 选择2020年7月—2023年2月在南京市中西医结合医院就诊的94例重症肺炎患者作为研究对象，参考随机数字表法将94例患者分为对照组（n＝47）和治疗组（n＝47）。对照组静脉滴注注射用亚胺培南西司他丁钠，1.0 g加入100 mL生理盐水中，1次/12 h。治疗组在对照组治疗的基础上静脉滴注热毒宁注射液，20 mL热毒宁注射液加入250 mL葡萄糖溶液中，滴速30～60滴/min，1次/d。两组连续治疗10 d。对比两组患者临床疗效、病情严重程度、症状消失时间、肺通气功能、血清指标。结果 治疗后，治疗组总有效率与对照组的总有效率组间比较差异显著（P＜0.05）。治疗后，两组的序贯性脏器功能衰竭（SOFA）评分显著减少（P＜0.05），治疗组的SOFA评分小于对照组（P＜0.05）。治疗后，治疗组高热、咳嗽、喘息、肺啰音消失时间明显短于对照组（P＜0.05）。治疗后，两组的气道阻力、吸气峰压、平均气道压显著降低（P＜0.05），治疗组气道阻力、吸气峰压、平均气道压明显低于对照组（P＜0.05）。治疗后，两组的血清高迁移率族蛋白B1（HMGB1）、白细胞介素-18（IL-18）、可溶性髓系细胞触发受体-1（sTREM-1）水平均显著降低（P＜0.05），治疗组的血清HMGB1、IL-18、sTREM-1水平明显低于对照组（P＜0.05）。结论 热毒宁注射液联合注射用亚胺培南西司他丁钠可显著提高重症肺炎的临床疗效，缓解患者的临床症状和病情严重程度，改善肺通气功能，显著减轻炎症反应。     

高效液相色谱法测定膦甲酸钠氯化钠注射液中膦甲酸钠的含量

目的建立HPLC法测定膦甲酸钠氯化钠注射液中膦甲酸钠含量的方法.方法采用阴离子交换柱(Waters IC Pak A柱,50 mm× 4.6 mm,5 μm);以0.05 mol·L-1邻苯二甲酸氢钾溶液(取邻苯二甲酸氢钾0.204 g,加水适量,振摇使溶解,加1mol·L-1硝酸溶液5 mL,加水稀释至2 000 mL,摇匀即得)为流动相;流速1.4 mL·min-1,检测波长290nm.结果本方法在0.98～4.90g·L-1浓度范围呈良好线性关系(r=0.999 4),进样重现性RSD为0.71%(n=5),平均回收率为98.93%.结论本法简便、快速、结果准确可靠,可用于膦甲酸钠氯化钠注射液中膦甲酸钠的含量测定.     

哌拉西林钠他唑巴坦钠致抽搐

1例26岁男性患者,4年前行肾移植术,近5个月接受血液透析,因肺部感染给予哌拉西林钠他唑巴坦钠4.5 g加入0.9%氯化钠注射液100 ml、1次/d静脉滴注。第2次用药后5 h,患者突发抽搐、意识丧失、双眼上翻、双腿抽动。先后给予地西泮10 mg肌内注射及7 mg静脉注射,上述症状消失。     

Inhaled sodium metabisulphite induced bronchoconstriction: inhibition by nedocromil sodium and sodium cromoglycate.

1. The effects of nedocromil sodium and sodium cromoglycate on bronchoconstriction induced by inhaled sodium metabisulphite have been studied in eight atopic subjects, three of whom had mild asthma. 2. Nedocromil sodium (4 mg, 7.8 X 10(-6) M), sodium cromoglycate (10 mg, 24.1 X 10(-6) M) and matched placebo were administered by identical metered dose inhalers 30 min before a dose-response to sodium metabisulphite (5-100 mg ml-1) was performed. 3. Maximum fall in sGaw after placebo pre-treatment was -43.9 +/- 3.3% baseline (mean +/- s.e. mean). At the same metabisulphite concentration maximum fall in sGaw after sodium cromoglycate was -13.0 +/- 3.6% and after nedocromil sodium was +4.3 +/- 6.8%. Nedocromil sodium prevented any significant fall in sGaw even after higher concentrations of metabisulphite. 4. Both nedocromil sodium, 4 mg, and sodium cromoglycate, 10 mg, inhibited sodium metabisulphite induced bronchoconstriction but nedocromil sodium was significantly more effective. Relative in vivo potency of the two drugs is broadly in line with other in vivo and in vitro studies.     

头孢哌酮钠-舒巴坦钠致血小板减少

1名83岁男性患者因胆道系统感染,静脉给予注射用头孢哌酮钠-舒巴坦钠2.0g,1次/白天;1.0g,1次/晚上。用药6d内血小板进行性下降,由164×109/L下降到68×109/L。停用头孢哌酮钠-舒巴坦钠,改用左氧氟沙星治疗。1周后患者PLT恢复正常。     

哌拉西林钠他唑巴坦钠致白细胞减少

1例46岁女性患者,因术后颅内感染静脉滴注哌拉西林钠他唑巴坦钠4.5 g,1次/8 h。用药第13、15天外周血白细胞计数从用药前的10.61×109/L分别降至1.79×109/L和1.00×109/L。立即换用其他抗菌药物,同时给予重组人粒细胞巨噬细胞集落刺激因子(rhGM-CSF)150μg皮下注射,1次/d。改变治疗后4 d,血白细胞计数升至6.95×109/L。改变治疗后6 d脑脊液白细胞数由首次用药后15 d的8×106/L升至56×106/L,再次给予哌拉西林钠他唑巴坦钠4.5 g静脉滴注,1次/8 h,rhGM-CSF剂量未变。用药6 d颅内感染治愈,遂停用抗菌药物。治疗第2、5天白细胞计数分别为2.67×109/L和1.65×109/L。第8天停用rhGM-CSF后为5.75×109/L,第15天为4.56×109/L。     

Fondaparinux sodium

black triangle Fondaparinux sodium, a selective factor Xa inhibitor, is the first in a new class of antithrombotics. It binds selectively with high affinity to antithrombin III and specifically catalyses the inactivation of factor Xa. The elimination half-life of fondaparinux sodium permits once daily treatment. black triangle A randomised, double-blind, parallel-group, dose-ranging, multicentre phase IIb study in 933 eligible patients established that a subcutaneous dose of between 1.5 and 3mg of fondaparinux sodium has the optimum efficacy and safety profile for prophylaxis of venous thromboembolism in patients undergoing major orthopaedic surgery. black triangle Fondaparinux sodium, given to more than 3600 patients undergoing major orthopaedic surgery who participated in prospective, randomised, double-blind, multicentre phase III clinical trials, significantly reduced the incidence of venous thromboembolism, with an overall risk reduction of 55.2% compared with enoxaparin. black triangle Fondaparinux sodium was well tolerated by patients undergoing major orthopaedic surgery, and at the recommended clinical dose of 2.5mg has a similar tolerability profile, including bleeding events, to standard enoxaparin regimens. Fondaparinux sodium has not been reported to cause antibody-induced thrombocytopenia.     

Talaporfin sodium

Importance of the field: Despite therapeutic advances, cancer remains the cause of an estimated 23% of deaths in the USA. New treatments for malignancy are greatly needed.

Areas covered in this review: Talaporfin sodium is a light-activated drug that causes tissue death through induction of apoptosis. Systemic antitumor effects mediated by CD8⁺ T cells have been demonstrated in preclinical studies, providing a mechanism for distant response of tumors noted in clinical trials. Talaporfin sodium is approved in Japan for early-stage endobronchial cancer. Phase I and II studies in solid tumors have shown tumor regression in patients refractory to other therapies. Phase III pivotal studies against hepatocellular carcinoma as monotherapy and liver-metastatic colorectal cancer in combination with chemotherapy are ongoing. Talaporfin sodium is also in studies in men with symptomatic benign prostatic hyperplasia. Substantial safety data from clinical trials so far indicate that the drug is well tolerated.

What the reader will gain: Talaporfin sodium has a broad safety profile and a mode of action that could affect growth in treated and untreated tumors.

Take home message: Clinical and preclinical studies indicate that talaporfin sodium treatment may offer a powerful option to synergize current therapies, as well as an alternative monotherapy in treating cancer.     

Danaparoid sodium

Danaparoid sodium (Orgaran, Organon) is a heparinoid glycosamino-glycuronan antithrombotic agent approved for the prophylaxis of post-operative deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE) in patients undergoing elective hip replacement surgery. Danaparoid is a low molecular weight heparinoid consisting of a mixture of heparan sulphate (84%), dermatan sulphate (12%) and small amounts of chondroitin sulphate (4%), whose antithrombotic activity has been well established. Its pharmacological effect is exerted primarily by inhibiting Factors Xa (FXa) and IIa (FIIa) at a ratio greater than heparin, with a minimal effect on platelet function. Danaparoid exhibits low cross-reactivity with heparin-induced antibodies when compared with heparin or low molecular weight heparins (LMWH), thereby making it an excellent choice for the management of heparin-induced thrombocytopenia (HIT). It has excellent bioavailability following s.c. injection. Danaparoid has little effect on routine coagulation tests (activated partial thromboplastin time [aPTT], prothrombin time [PT], and thrombin time [TT]). Patients with elevated serum creatinine should be monitored carefully. For its FDA approved indication (DVT prophylaxis during hip replacement surgery), its cost per day is approximately eight times more than LMWH. Even though monitoring is not routinely necessary according to the manufacturer for its approved indication, monitoring is frequently necessary when it is used in other clinical scenarios. Its higher cost than comparable therapies for DVT prophylaxis and the low availability of the FXa assay in most non-tertiary care hospitals has limited the widespread use of danaparoid. Danaparoid has been found to be effective in the treatment of HIT although this is an off label use, despite being the most frequent reason why danaparoid is used.     

Diclofenac sodium

The pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and dosage of diclofenac sodium are reviewed. Diclofenac, the first nonsteroidal anti-inflammatory agent (NSAID) to be approved that is a phenylacetic acid derivative, competes with arachidonic acid for binding to cyclo-oxygenase, resulting in decreased formation of prostaglandins. The drug has both analgesic and antipyretic activities. Diclofenac is efficiently absorbed from the gastrointestinal tract; peak plasma concentrations occur 1.5 to 2.0 hours after ingestion in fasting subjects. Even though diclofenac has a relatively short elimination half-life in plasma (1.5 hours), it persists in synovial fluid. The drug is metabolized in the liver and is eliminated by urinary and biliary excretion. In clinical trials, diclofenac was as effective as aspirin, diflunisal, indomethacin, sulindac, ibuprofen, ketoprofen, and naproxen in improving function and reducing pain in patients with rheumatoid arthritis. For treatment of osteoarthritis, diclofenac was equivalent in efficacy to aspirin, diflunisal, indomethacin, sulindac, ibuprofen, ketoprofen, naproxen, flurbiprofen, mefenamic acid, and piroxicam. Diclofenac was as effective as indomethacin or sulindac in treating ankylosing spondylitis. The most frequent adverse effects reported for diclofenac were gastrointestinal, but these effects were fewer and less serious than occurred with aspirin or indomethacin; in addition, diclofenac caused fewer central nervous system reactions than indomethacin. Diclofenac is administered in divided doses with meals. The recommended total daily dosage is 100 to 150 mg (osteoarthritis and ankylosing spondylitis) or 150 to 200 mg (rheumatoid arthritis). Diclofenac is effective, but no more so than other NSAIDs. It is structurally distinct and offers another choice in the treatment of rheumatological conditions.