小儿肺咳颗粒联合吸入用布地奈德治疗支气管肺炎的疗效分析

目的:探究分析小儿肺咳颗粒和吸入用布地奈德联用治疗支气管肺炎的临床疗效。方法:选取2017年11月—2019年3月在本院接受治疗的92例患有支气管肺炎的患儿作为研究对象,随机分为对照组(46例,仅采用吸入布地奈德进行治疗)、观察组(46例,小儿肺咳颗粒联合吸入用布地奈德进行治疗),对比两组临床指标和治疗效果。结果:观察组肺部啰音消失时间、气促消失时间等临床指标明显优于对照组(P<0.05),且治疗总有效率明显高于对照组(P<0.05),差异显著。结论:小儿肺咳颗粒联合吸入用布地奈德治疗儿童支气管肺炎的临床疗效显著,值得临床推广。     

小儿肺咳颗粒联合阿奇霉素治疗儿童肺炎的有效性及可行性

目的探讨小儿肺咳颗粒联合阿奇霉素治疗儿童肺炎的有效性及可行性。方法90例肺炎患儿,按照随机数字表法分为对照组和研究组,每组45例。对照组患儿在常规治疗基础上给予阿奇霉素干混悬剂治疗,研究组患儿在对照组基础上给予小儿肺咳颗粒治疗。比较两组患儿临床疗效以及症状消失时间。结果研究组治疗总有效率95.6%高于对照组的80.0%,差异具有统计学意义(P<0.05)。研究组患儿啰音消失时间(4.73±2.27)d、咳嗽消失时间(4.37±0.68)d、退热时间(2.47±0.38)d均短于对照组的(6.86±2.45)、(6.59±0.48)、(3.97±0.75)d,差异均具有统计学意义(P<0.05)。结论肺炎患儿在治疗过程中,实施小儿肺咳颗粒联合阿奇霉素能够使临床疗效得以提升,各症状消失时间得以促进,具有较高可行性。     

小儿肺咳颗粒联合阿奇霉素治疗小儿支原体肺炎的有效性及可行性

目的 观察小儿肺咳颗粒联合阿奇霉素治疗小儿支原体肺炎的有效性及可行性。方法 选取2018年1月1日—2020年12月31日岳阳市妇幼保健院收治的小儿支原体肺炎患儿88例为研究对象,根据随机数字表法分为观察组和对照组,各44例。在常规治疗基础上,对照组给予阿奇霉素,观察组在对照组基础上加用小儿肺咳颗粒治疗,2组均治疗14 d。比较2组治疗总有效率、症状消失时间、炎性因子水平[干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]及不良反应。结果 观察组总有效率为95.45%,高于对照组的70.45%(χ²=9.724,P=0.002);观察组发热消失时间、咳嗽消失时间、肺部湿啰音消失时间及喘息消失时间均短于对照组(P <0.01);治疗14 d后,2组IFN-γ、TNF-α、CRP水平均较治疗前降低,且观察组低于对照组(P均<0.01);观察组患儿不良反应总发生率为9.09%,低于对照组的29.55%(χ²=5.905,P=0.015)。结论 小儿支原体肺炎采用小儿肺咳颗粒联合阿奇霉素治疗效果确切,提高治疗...     

小儿肺咳颗粒联合特布他林治疗小儿急性支气管肺炎的临床研究

目的观察小儿肺咳颗粒联合特布他林治疗小儿急性支气管肺炎的临床疗效。方法选取2016年9月—2017年11月郑州大学附属儿童医院收治的急性支气管肺炎患儿108例,随机分为对照组(54例)和治疗组(54例)。对照组雾化吸入硫酸特布他林雾化液,≤20 kg患儿,2.5 mg/次加入1 mL生理盐水;20 kg患儿,5 mg/次加入2 mL生理盐水,持续时间10~15 min,2次/d。治疗组在对照组基础上口服小儿肺咳颗粒,3~4岁患儿,3 g/次,4~12岁患儿,6 g/次,3次/d。两组患儿均治疗7d。观察两组患儿临床疗效,同时比较治疗前后两组患儿临床症状改善时间、心肌酶指标、血清白细胞介素-6(IL-6)、胰岛素样生长因子-Ⅱ(IGF-Ⅱ)和超敏C-反应蛋白(hs-CRP)水平及中医症状总积分。结果治疗后,对照组临床有效率为77.78%,显著低于治疗组的94.44%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组患者的体温恢复时间、肺部湿啰音消退时间及咳痰和咳嗽缓解时间均显著短于对照组(P0.05)。治疗后,两组患儿乳酸脱氢酶(LDH)、天门冬氨酸氨基转移酶(AST)、肌酸激酶(CK)、CK同工酶(CK-MB)、α-羟丁酸脱氢酶(α-HBDH)、IL-6、IGF-Ⅱ和hs-CRP水平均显著降低(P0.05),且治疗后治疗组上述指标明显低于对照组(P0.05)。治疗后,两组中医症状积分均显著降低(P0.05),且治疗后治疗组中医症状积分显著低于对照组(P0.05)。结论小儿肺咳颗粒联合特布他林治疗小儿急性支气管肺炎疗效确切,同时能明显改善心肌酶指标,具有一定的临床推广应用价值。     

小儿肺咳颗粒联合溴己新雾化治疗小儿支气管肺炎的疗效分析

目的 探讨小儿肺咳颗粒联合溴己新雾化治疗小儿支气管肺炎的疗效.方法 采用前瞻性随机试验方法,选取收治的支气管肺炎患儿86例作为研究对象,采用随机数字表法分为A组和B组,各43例.A组采用溴己新雾化治疗,B组在A组基础上,加用小儿肺咳颗粒,治疗1周后,对两组临床疗效、炎性因子水平进行对比.结果 治疗1周后,B组总有效率为95.35％,高于A组的76.74％,差异有统计学意义(P＜0.05);相较治疗前,两组治疗后血清CRP、IL-6水平均降低,且相较A组,B组更低,差异有统计学意义(P＜0.05).结论 小儿支气管肺炎采用小儿肺咳颗粒联合溴己新雾化治疗效果较好,可有效降低其炎性因子水平,疗效显著.     

小儿肺咳颗粒联合环酯红霉素治疗小儿急性支气管炎的临床研究

目的观察小儿肺咳颗粒联合环酯红霉素治疗急性小儿支气管炎的临床疗效。方法选择2018年6月—2019年6月在彭州市妇幼保健计划生育中心就诊的急性支气管炎患儿216例,随机分为对照组和治疗组,每组各108例。对照组口服环酯红霉素干混悬剂,10～15 mg/kg,1次/12 h;治疗组在对照组基础上口服小儿肺咳颗粒,1岁以下患儿2 g/次、1～4岁患儿3 g/次、5～8岁6 g/次,3次/d。两组患儿均治疗7 d。观察两组患者临床疗效,同时比较治疗前后两组患者临床症状改善情况,及超敏C反应蛋白(hs-CRP)、白细胞介素-10(IL-10)和IL-13水平。结果治疗后,对照组和治疗组临床有效率分别为75.93%和93.52%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组患者体温恢复正常时间、咳嗽消失时间、肺部喘鸣音消失时间均较对照组明显缩短(P0.05)。治疗后,两组患者hs-CRP、IL-10和IL-13水平均明显降低(P0.05),且治疗组患者的炎症指标水平显著低于对照组(P0.05)。结论小儿肺咳颗粒联合环酯红霉素治疗急性小儿支气管炎能够快速缓解症状,改善炎症指标,具有一定的临床推广应用价值。     

小儿宝泰康颗粒联合头孢呋辛酯治疗小儿上呼吸道感染的临床研究

目的评价小儿宝泰康颗粒联合头孢呋辛酯治疗小儿上呼吸道感染患者的安全性与有效性。方法选取新乡市妇幼保健院于2016年7月—2017年7月收治的小儿上呼吸道感染患者154例,随机分成对照组和治疗组,每组各77例。对照组患儿口服头孢呋辛酯分散片,0.125 g/次,2次/d;治疗组患儿在对照组用药基础上口服小儿宝泰康颗粒,3岁以下儿童4 g/次,3～12岁儿童8g/次,3次/d。两组患儿均连续用药7d。观察两组患者临床疗效,同时比较治疗前后两组患者症状积分和炎症指标水平。结果治疗后,对照组临床有效率为85.71%,显著低于治疗组的96.10%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者症状积分,血清淀粉样蛋白A(SAA)、降钙素原(PCT)、超敏C反应蛋白(hs-CRP)水平均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组症状积分和炎症指标水平明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论小儿宝泰康颗粒联合头孢呋辛酯治疗小儿上呼吸道感染疗效确切,安全性好,且能够显著减轻患者机体的炎症反应,具有一定的临床推广应用价值。     

小儿肺咳颗粒辅助治疗儿童支气管肺炎的疗效及对机体炎症、血小板指标的影响

目的 探讨支气管肺炎患儿运用小儿肺咳颗粒展开辅助治疗所取得的效果及对机体炎性因子水平、血小板参数指标所产生的影响。方法 选取支气管肺炎患儿共计80例,均为我院2021年1月至2022年12月收治,采用随机数表法进行分组,各40例,对照组患儿运用布地奈德给药方案,观察组在此基础上辅助加用小儿肺咳颗粒,就两组总有效率、临床症状消失时间、血清炎性因子、血小板参数、不良反应发生率展开对比。结果 观察组患儿总有效率为97.50%,相较于对照组的82.50%更高（P <0.05）。观察组患儿临床症状即体温恢复至正常时间、肺部啰音消失时间、咳嗽消失时间、喘息消失时间,相较于对照组更短（P <0.05）。在实施药物治疗后,两组CRP、IL-6,IL-10均下降,观察组患儿相较对照组更低（P <0.05）。实施治疗后,两组PDW、PLT均降低,MPV均升高,且对照组患儿较观察组降低、上升更为显著（P <0.05）。观察组在给药期间,烦躁不安、头晕头痛、荨麻疹等不良反应发生率相较对照组患儿更低（P <0.05）。结论 针对支气管肺炎患儿,运用小儿肺咳颗粒展开辅助治疗,可提高总...     

小儿肺咳颗粒联合氨溴特罗口服溶液治疗社区获得性肺炎患儿54例疗效分析

目的：探讨小儿肺咳颗粒联合氨溴特罗口服溶液治疗社区获得性肺炎患儿的效果。方法：选取2019年9月至2021年1月荥阳市人民医院社区获得性肺炎患儿108例,随机分为两组,每组54例。对照组给予氨溴特罗口服溶液治疗,治疗组给予小儿肺咳颗粒联合氨溴特罗口服溶液治疗。比较两组疗效,用力肺活量(FVC)、第一秒用力呼吸容积(FEV1)、呼吸气流量峰值(PEF),血清白细胞介素-4(IL-4)、白细胞介素-18(IL-18)、C反应蛋白(CRP),主要症状积分及不良反应发生率。结果：治疗组治疗7 d后,FEV1、PEF、FVC高于对照组(P<0.05);治疗组治疗总有效率98.15%(53/54)高于对照组85.19%(46/54)(P<0.05);治疗组治疗7 d后主要症状(咳嗽、咳痰、喘息)积分低于对照组(P<0.05);治疗7 d后治疗组IL-4、IL-18、CRP低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论：氨溴特罗口服溶液联合小儿肺咳颗粒治疗社区获得性肺炎患儿疗效确切,能有效缓解临床症状,改善患儿肺功能,减轻炎性...     

探析小儿感冒退热糖浆联合磷酸奥司他韦颗粒治疗儿童急性上呼吸道感染的效果

目的:探析对儿童急性上呼吸道感染患儿给予小儿感冒退热糖浆联合磷酸奥司他韦颗粒治疗的临床疗效。方法:选取2021年3月—2022年12月期间我院收治的儿童急性上呼吸道感染患儿168例,按照电脑随机分配原则的1:1比例分为对照组(n=84)、研究组(n=84)。对照组选择常规治疗方案联合磷酸奥司他韦颗粒治疗,研究组采取小儿感冒退热糖浆联合磷酸奥司他韦颗粒治疗。评价及对比两组的疗效、症状改善情况、炎性因子、不良反应。结果:研究组的总有效率高于对照组(P<0.05);研究组的退热时间、鼻塞流涕消退时间、咳嗽消退时间均短于对照组(P<0.05);研究组的血清炎性因子水平均低于对照组(P<0.05);两组的不良反应率比较无统计学意义(P>0.05)。结论:对儿童急性上呼吸道感染患儿给予小儿感冒退热糖浆联合磷酸奥司他韦颗粒治疗,对改善症状有促进作用,可减轻炎症,疗效显著,且无明显不良反应,值得临床借鉴与应用。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Comparison of in vitro cell models in predicting in vivo brain entry of drugs

Although several in vitro models have been reported to predict the ability of drug candidates to cross the blood-brain barrier, their real in vivo relevance has rarely been evaluated. The present study demonstrates the in vivo relevance of simple unidirectional permeability coefficient (P(app)) determined in three in vitro cell models (BBMEC, Caco-2 and MDCKII-MDR1) for nine model drugs (alprenolol, atenolol, metoprolol, pindolol, entacapone, tolcapone, baclofen, midazolam and ondansetron) by using dual probe microdialysis in the rat brain and blood as an in vivo measure. There was a clear correlation between the P(app) and the unbound brain/blood ratios determined by in vivo microdialysis (BBMEC r=0.99, Caco-2 r=0.91 and MDCKII-MDR1 r=0.85). Despite of the substantial differences in the absolute in vitro P(app) values and regardless of the method used (side-by-side vs. filter insert system), the capability of the in vitro models to rank order drugs was similar. By this approach, thus, the additional value offered by the true endothelial cell model (BBMEC) remains obscure. The present results also highlight the need of both in vitro as well as in vivo methods in characterization of blood-brain barrier passage of new drug candidates.