芩香清解口服液治疗儿童上呼吸道感染的药物经济学评价

目的：评价芩香清解口服液用于儿童上呼吸道感染的经济性。方法：基于一项随机、双盲对照的临床研究,计算2组方案的成本和健康产出,进行短期成本-效果分析。采用条件价值评估法开展问卷调查,收集患者的意愿支付阈值。对关键指标进行单因素敏感性分析。结果：芩香清解口服液联用利巴韦林注射液组相对利巴韦林组增量成本效果比为8.34元,小于支付意愿阈值15.0元,芩香清解口服液联用利巴韦林注射液具有经济性。结论：芩香清解口服液联合利巴韦林注射液用于儿童上呼吸道感染是疗效佳、经济、安全的治疗方案,值得临床推荐。     

炎琥宁注射液与利巴韦林治疗儿童急性上呼吸道感染临床研究

目的探讨并比较炎琥宁注射液与利巴韦林治疗儿童急性上呼吸道感染临床效果。方法选取本院儿科2011年4月至2012年12月收治儿童急性上呼吸道患儿120例,采用随机数字表法分为利巴韦林组和炎琥宁组,每组各60例;其中利巴韦林组患儿采用利巴韦林静脉滴注治疗,炎琥宁组患者则采用炎琥宁静脉滴注治疗;比较两组患儿临床改善总有效率,治疗前后体温、退热及咳嗽消失时间等。结果利巴韦立组和炎琥宁组患儿临床改善总有效率分别为80.0%,96.7%;炎琥宁组患儿临床改善总有效率明显高于利巴韦林组,组间比较差异具有统计学意义（P〈0.05）;两组患儿治疗前体温组间比较差异无统计学意义（P〉0.05）;治疗后两组患儿体温较治疗前均显著下降,且炎琥宁组患儿下降程度明显优于利巴韦林组,组间比较差异具有统计学意义（P〈0.05）;炎琥宁组患儿退热及咳嗽消失时间均明显少于利巴韦林组,组间比较差异具有统计学意义（P〈0.05）。结论与利巴韦林治疗相比,炎琥宁注射液与利巴韦林治疗儿童急性上呼吸道感染临床效果确切,可有效改善临床症状、体征,降低体温,缩短病程,具有临床推广使用价值。     

去感热口服液联合利巴韦林治疗急性上呼吸道感染的临床研究

目的观察去感热口服液联合利巴韦林治疗急性上呼吸道感染的临床疗效。方法选取宣汉县人民医院2015年1月—2015年12月收治的急性上呼吸道感染患者106例,随机分为对照组和治疗组,每组各53例。对照组静脉滴注利巴韦林注射液,0.5 g加入到生理盐水250 m L,1次/d;治疗组在对照组的基础上口服去感热口服液,10 m L/次,3次/d。两组均连续治疗7 d。观察两组患者临床疗效、临床症状体征改善情况,对比两组患者治疗前后白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)指标水平。结果治疗后,对照组的总有效率为73.58%,显著低于治疗组的92.45%,两组总有效率比较差异有统计学意义(P0.05)。治疗后,治疗组退热时间、咽痛消失时间、止咳时间及咽部充血消失时间均明显短于对照组,两组比较差异具有统计学意义(P0.05)。两组患者IL-6和TNF-α指标水平均显著降低,同组差异比较具有统计学意义(P0.05);且治疗组两个指标改善情况优于对照组,两组比较差异具有统计学意义(P0.05)。结论去感热口服液联合利巴韦林治疗急性上呼吸道感染疗效确切,显著改善症状体征和炎性指标,具有一定的临床推广应用价值。     

痰热清注射液联合利巴韦林治疗手足口病42例

目的探讨痰热清注射液联合利巴韦林治疗手足口病临床治疗效果。方法选择本院2009年5月～2011年5月手足口病患儿共84例,上述患儿分为观察组和对照组。两组均给予常规治疗,对照组同时给予利巴韦林治疗,观察组给予利巴韦林联合痰热清注射液治疗。观察两组患儿发热等症状的改善时间。结果观察组退热时间、疱疹结痂时间、疱疹消退时间显著短于对照组,差异有统计学意义（P〈0.05）;观察组总有效率显著高于对照组,差异有统计学意义（P〈0.05）。结论痰热清注射液联合利巴韦林能够显著改善手足口病患儿临床症状和体征,临床效果显著,值得借鉴。     

痰热清注射液联合利巴韦林治疗小儿病毒性肺炎的临床研究

目的探究痰热清注射液联合利巴韦林颗粒治疗小儿病毒性肺炎的临床疗效。方法选取2018年10月—2019年10月在洛阳新区人民医院治疗的110例病毒性肺炎患儿,将所有患儿按照随机数字表法分为对照组和治疗组,每组各55例。对照组患儿口服利巴韦林颗粒,0.01 g/(kg·次),3次/d,治疗组在对照组治疗基础上静脉滴注痰热清注射液,按照0.5 mL/kg溶解于5%葡萄糖中,1次/d。两组患儿共治疗2周。观察两组的患儿临床疗效,比较两组的临床症状消失时间、血清炎症因子。结果治疗后,对照组总有效率为85.45%,治疗组总有效率为98.18%,差异有统计学意义(P0.05)。治疗后,治疗组体温恢复时间、咳嗽消失时间、肺啰音消失时间、住院时间显著短于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患儿高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平均显著下降(P0.05);治疗后治疗组患儿hs-CRP、TNF-α、IL-6、IL-8水平明显低于对照组,差异有统计学意义(P0.05)。结论痰热清注射液联合利巴韦林颗粒治疗小儿病毒性肺炎具有较好的临床疗效,能够改善临床症状,降低血清炎性指标水平,安全性好。     

金莲花颗粒联合利巴韦林治疗小儿急性上呼吸道感染的疗效及其对血清炎症标记物的影响

目的探讨金莲花颗粒联合利巴韦林治疗小儿急性上呼吸道感染的临床疗效及其对血清肿瘤坏死因子-α(TNG-α)、C反应蛋白(CPR)及白细胞介素-6(IL-6)的影响并探讨其机制。方法回顾性选取我院2017年1月～2018年11月收治上呼吸道感染患者124例,依据随机数字表法分为两组。两组患者退热、纠正水电解质等常规治疗,对照组62例给予利巴韦林治疗,研究组62例在此基础上给予金莲花颗粒联合利巴韦林治疗,观察两组患者临床疗效及血清肿瘤坏死因子-α(TNG-α)、C反应蛋白(CPR)及白细胞介素-6(IL-6)等血清炎症标记物。结果治疗后,研究组血清中内毒素、IL-6、IL-8、CRP、TNF-α均优于对照组,组间比较差异有统计学意义(P 0.05);研究组治疗后咳嗽消失时间、咽喉疼痛消失时间、鼻塞消失时间、腹泻消失时间以及体温恢复时间均优于对照组,组间比较差异有统计学意义(P 0.05);研究组总治疗有效率98.39%为优于对照组82.26%,组间比较差异有统计学意义(P 0.05)。结论金莲花颗粒联合利巴韦林治疗小儿急性上呼吸道感染可缩短干咳、全身疲倦、食欲不振等时间,加快体温恢复正常,改善血清内炎症因子内毒素、IL-8、IL-6、CRP、TNF-α水平,提高临床疗效。     

祖卡木颗粒联合利巴韦林治疗小儿急性上呼吸道感染的临床研究

目的探讨祖卡木颗粒联合利巴韦林治疗小儿急性上呼吸道感染的临床有效性和安全性。方法选取2016年3月—2017年3月在荆州市中医院就诊的小儿急性上呼吸道感染患儿141例,根据用药不同将患儿分成对照组(70例)和治疗组(71例)。对照组患儿静脉滴注利巴韦林注射液,10 mg/kg加入生理盐水稀释成1 mg/mL滴注,2次/d。治疗组患儿在对照组基础上口服祖卡木颗粒,1袋/次,3次/d。两组患儿均连续治疗5d。观察两组患儿临床疗效,同时比较治疗前后两组患者临床症状消失时间、血清淀粉样蛋白A(SAA)、白细胞计数(WBC)、超敏C反应蛋白(hs-CRP)水平及不良反应情况。结果治疗后,对照组和治疗组患儿临床有效率分别为85.71%和97.18%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组患儿体温恢复、咳嗽消失和咽喉红肿消失时间均明显早于对照组(P0.05)。治疗后,两组患儿血清SAA和hs-CRP水平均明显降低(P0.05),WBC水平明显升高(P0.05),且治疗组患儿血清SAA、hs-CRP和WBC水平明显优于对照组(P0.05)。治疗期间,治疗组患儿不良反应发生率为4.23%,明显低于对照组的15.71%,两组比较差异具有统计学意义(P0.05)。结论祖卡木颗粒联合利巴韦林治疗小儿急性上呼吸道感染临床疗效好、安全性高,具有一定的临床推广应用价值。     

静脉注射丙种球蛋白联合利巴韦林治疗重症手足口病临床疗效分析

目的研究静脉注射丙种球蛋白联合利巴韦林治疗重症手足口病临床疗效。方法将220例患者随机分成两组,即对照组和实验组,每组110例,对照组采用利巴韦林注射液加入5%的葡萄糖注射液后静脉滴注,实验组在对照组基础上应用丙种球蛋白静脉注射,比较两组患儿治疗的总有效率及发热消退时间、皮疹消退时间。结果实验组的总有效率高于对照组(81.82%VS 94.55%),两组比较差异有统计学意义(P0.05);实验组患儿的发热消退时间及皮疹消退时间均少于对照组,两组比较差异有统计学意义(P0.05)。结论丙种球蛋白联合利巴韦林治疗重症手足口病,加快了皮疹及发热的消退,提高患儿机体免疫力,利于重症手足口病患儿的康复。     

痰热清注射液联合利巴韦林对手足口病患儿免疫功能的影响

目的:探讨痰热清注射液与利巴韦林联合治疗对手足口病患儿免疫功能的影响。方法:选取2016年7月～2018年9月于某院就诊的78例手足口病患儿,按随机数字表法分为对照组和观察组各39例。对照组静滴利巴韦林注射液治疗,观察组在此基础上联合痰热清注射液治疗,比较两组临床疗效、免疫功能及不良反应。结果:观察组总有效率高于对照组,IgG、IgA水平高于对照组,差异有统计学意义(P0.05);两组IgM水平及不良反应对比,差异无统计学意义(P0.05)。结论:痰热清注射液与利巴韦林联合对手足口病患儿疗效更佳,可有效调节患儿免疫功能,且安全可靠,值得应用。     

痰热清注射液联合利巴韦林治疗手足口病临床观察

目的：观察痰热清注射液联合利巴韦林治疗手足口病的临床疗效。方法将168例手足口病患儿随机分为治疗组和对照组各84例,对照组给予抗病毒利巴韦林等常规治疗,治疗组在上述常规治疗的基础上给予痰热清注射液治疗。比较2组临床疗效、不良反应及患儿体温下降、皮疹结痂和消退时间。结果治疗组总有效率为97.6％高于对照组的78.6％,差异有统计学意义（P ﹤0.05）;2组未发生明显的不良反应;治疗组患儿体温下降、皮疹结痂及消退时间均短于对照组,差异均有统计学意义（P ﹤0.05）。结论痰热清联合利巴韦林治疗手足口病其临床症状及体征改善时间较单一应用利巴韦林缩短,疗效显著,且不良反应小,值得临床推广应用。     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Polymorphisms in genes involved in neurotransmission in relation to smoking

Smoking behavior is influenced by both genetic and environmental factors. The genetic contribution to smoking behavior is at least as great as its contribution to alcoholism. Much progress has been achieved in genomic research related to cigarette-smoking within recent years. Linkage studies indicate that there are several loci linked to smoking, and candidate genes that are related to neurotransmission have been examined. Possible associated genes include cytochrome P450 subfamily polypeptide 6 (CYP2A6), dopamine D₁, D₂, and D₄ receptors, dopamine transporter, and serotonin transporter genes. There are other important candidate genes but studies evaluating the link with smoking have not been reported. These include genes encoding the dopamine D₃ and D₅ receptors, serotonin receptors, tyrosine hydroxylase, trytophan 2,3-dioxygenase, opioid receptors, and cannabinoid receptors. Since smoking-related factors are extremely complex, studies of diverse populations and of many aspects of smoking behavior including initiation, maintenance, cessation, relapse, and influence of environmental factors are needed to identify smoking-associated genes. We now review genetic polymorphisms reported to be involved in neurotransmission in relation to smoking.     

Tramadol concentrations in blood and in cerebrospinal fluid in a neonate

Based on blood and cerebrospinal fluid samples collected in a full-term neonate, the penetration of tramadol in the central nervous system is described. Following intravenous administration of tramadol, a lag time of about 4 h was observed until full blood–brain equilibration was achieved. This pharmacokinetic observation is in line with a recent pharmacodynamic evaluation of the central opioid effects of tramadol in adults.     

Disease control in asthmatic children seen in private practice in Switzerland

ABSTRACT

Background: Asthma is the most common chronic childhood disease in Switzerland with a prevalence of 10%. Asthma has a high economic burden accounting for high medical costs. Assessment of disease control is likely to be of help in the implementation of strategies to improve asthma. Therefore, we aimed to evaluate asthma control and therapy regimens among children in private practice.

Methods: We assessed asthma control as well as therapy regimens in 575 asthmatic children in an experience programme in Switzerland by using an abbreviated questionnaire based on the asthma control questionnaire and the child health questionnaire on Visit 1 and Visit 2.

Results: Good asthma control at Visit 1 was only present in 25.7% of asthmatic children. Occasional asthma symptoms, limitation of physical activity, nocturnal awakening and anxiety of the parent was present in 80.5%, 41.2%, 46.8% and 57% of the children, respectively. After adjustment of therapy regimens at Visit 1, mainly by adding a leukotriene receptor antagonist, asthma control was reported to be much better in 53.4% of the children at Visit 2.

Conclusions: As asthma control is inadequately achieved within a major portion of asthmatic children, it is imperative to find measures to improve asthma control and hence, to reduce the burden of disease.