右雷佐生联合磷酸肌酸钠对蒽环类药物致乳腺癌患者心脏损伤的保护作用

目的： 分析右雷佐生联合磷酸肌酸钠对蒽环类药物致乳腺癌患者心脏损伤的预防作用及安全性。方法：收集200例女性乳腺癌患者,随机分为对照组、A组、B组、C组,每组各50例。对照组给予标准剂量的AC或EC方案化疗,A组在对照组基础上给予注射用右雷佐生,B组在对照组基础上给予注射用磷酸肌酸钠,C组在对照组基础上给予右雷佐生及磷酸肌酸钠,3周为1个化疗周期。比较各组化疗后心脏损伤发生率,分析蒽环类药物致心脏毒性的危险因素,并观察化疗前及化疗3个周期后患者心电图、心肌酶、血清B型利钠肽（BNP）和心肌肌钙蛋白I（cTnI）水平、左室射血分数（LVEF）,以及不良反应发生率情况。结果：200例乳腺癌患者中,发生心脏损伤49例（24.5%）。4组之间的心脏损伤发生率具有显著差异（P < 0.05）,心脏损伤发生率排序为对照组（50.00%） > B组（24.00%） > A组（16.00%） > C组（8.00%）。多因素Logistic回归分析结果显示,心脏保护方案的使用、化疗周期数 ＞ 3、蒽环类药物累积剂量 ＞ 400 mg与心脏损伤的发生相关（P < 0.05）。化疗周期数 > 3、蒽环类药物累积剂量 > 400 mg是蒽环类药物致心脏毒性的独立危险因素,而使用心脏保护剂则是保护因素。对照组化疗后心电图异常发生率高于A、B、C组（P < 0.05）。化疗前各组患者心肌酶、BNP、cTnI、LVEF比较,差异无统计学意义（P > 0.05）;化疗后对照组BNP、cTnI水平高于A、B、C组（P < 0.05）。4组化疗期间不良反应发生率差异无统计学意义（P > 0.05）。结论：右雷佐生联合磷酸肌酸钠用于蒽环类药物致乳腺癌患者心脏损伤有良好的效果且安全性较好。     

尿激酶生脉注射液联合治疗不稳定性心绞痛的临床研究

目的探讨采用小剂量的尿激酶联合生脉注射液治疗不稳定性心绞痛(UAP)的临床效果。方法将120例患者随机分为两组,治疗组应用尿激酶和生脉注射液;对照组给与低分子肝素钠。观察治疗前、后患者的症状和实验室检查项目。结果治疗组总有效率达93.33%,并且对降低血小板最大聚集率(MPAR)、血小板颗粒膜糖蛋白(GMP-140)、左室射血分数及心电图的变化等效果明显(P<0.05)。结论尿激酶和生脉注射液联合应用治疗不稳定性心绞痛效果明显、稳定,具有广阔的临床前景。     

Novel Anatomical Guidelines on Botulinum Neurotoxin Injection for Wrinkles in the Nose Region

Botulinum neurotoxin injection surrounding the nose area is frequently used in aesthetic settings. However, there is a shortage of thorough anatomical understanding that makes it difficult to treat wrinkles in the nose area. In this study, the anatomical aspects concerning the injection of botulinum neurotoxin into the nasalis, procerus, and levator labii superioris alaeque muscles are assessed. In addition, the present knowledge on localizing the botulinum neurotoxin injection point from a newer anatomy study is assessed. It was observed that, for the line-associated muscles in the nose region, the injection point may be more precisely defined. The optimal injection sites are the nasalis, procerus, and levator labii superioris alaeque muscles, and the injection technique is advised. We advise the best possible injection sites in association with anatomical standards for commonly injected muscles to increase efficiency in the nose region by removing the wrinkles. Similarly, these suggestions support a more precise procedure.     

Botulinum Toxin Injection for the Treatment of Upper Esophageal Sphincter Dysfunction

Dysphagia associated with upper esophageal sphincter (UES) dysfunction remarkably affects the quality of life of patients. UES injection of botulinum toxin is an effective treatment for dysphagia. In comparison with skeletal muscles of the limb and trunk, the UES is a special therapeutic target of botulinum toxin injection, owing to its several anatomical, physiological, and pathophysiological features. This review focuses on (1) the anatomy and function of the UES and the pathophysiology of UES dysfunction in dysphagia and why the entire UES rather than the cricopharyngeal muscle before/during botulinum toxin injection should be examined and targeted; (2) the therapeutic mechanisms of botulinum toxin for UES dysfunction, including the choice of injection sites, dose, and volume; (3) the strengths and weaknesses of guiding techniques, including electromyography, ultrasound, computed tomography, and balloon catheter dilation for botulinum toxin injection of the UES.     

Outcome of transcutaneous retrobulbar injection of liposomal amphotericin B in post-COVID-19 rhino-orbito-cerebral mucormycosis: Our experience

Purpose:To assess the outcome and response of transcutaneous retrobulbar injection of amphotericin B (TRAMB) in post-coronavirus disease of 2019 (COVID-19) rhino-orbito-cerebral mucormycosis (ROCM) and to establish a scoring system in guiding treatment modalities.Methods:An interventional, prospective study was done on 82 eyes of post-COVID-19 ROCM from May 2021 to July 2021. A comprehensive multi-departmental evaluation along with detailed ophthalmic examination, laboratory investigations, and radiological examination was done. Scoring points were given to each symptom, sign, and radiological features of orbit and the total score was taken. Based on these scores, severity of disease was grouped into A, B, and C corresponding to mild, moderate, and severe orbital ROCM. One milliliter of reconstituted liposomal amphotericin B was given to all patients every alternate day as three doses. Efficacy of these injections was assessed in all groups, even though other treatment modalities like orbital debridement and exenteration were considered for moderate and severe cases. Patients were followed up for a period of 8 weeks.Results:Out of 82 eyes, symptomatic improvement was seen in a major proportion (72%) of patients. A statistically significant improvement in scores was noted in group A (93% improved) with a P value of 0.002, while 68.4% showed improvement in group B (P-value- 0.0001). Group C with severe disease showed minimal improvement in post-injection scores of 41% (P-value 0.086), necessitating surgical intervention. No serious adverse effect of the drug or procedure was noted.Conclusion:Significant improvement in scores of groups A and B highlights TRAMB as an effective and safe treatment modality in mild to moderate ROCM. It is an effective adjunct in severe cases, along with other interventions. Also, the scoring system helps in assessing the severity and guiding in management strategies.     

多药联合治疗小儿过敏性紫癜疗效分析

目的:为探索治疗小儿过敏性紫癜(HSP)最佳方案.方法:在对症治疗基础上,采用丹参加普鲁卡因静滴联合西米替叮口服治疗小儿过敏性紫癜60例,并将其疗效与以往治疗方法作对比分析.结果:丹参加普鲁卡因治疗的疗效明显优于原治疗方法.有效率91.66%.平均住院时间为(11.08±2.20)天,与原两治疗方法比较有减少,经统计学处理有显著性差异.结论:本治疗方法对小儿过敏性紫癜有明显疗效,且治疗方便,价格低廉,未发现毒副作用,适于基层医疗单位推广应用.     

血必净注射液在颅脑损伤中的临床研究

目的:探讨血必净注射液治疗颅脑损伤的疗效.方法:93例脑损伤患者随机分为两组,对照组47例常规治疗,治疗组46例在常规治疗的基础上辅以血必净注射液治疗,并比较其疗效.结果:治疗组的有效率明显高于对照组,降低NDS,降低肝、肾功能不全、心律失常和消化道出血的发生率,P均＜0.01.结论:血必净辅助颅脑损伤的综合治疗可明显改善患者预后,降低并发症,值得临床推广.     

条形码在中药注射剂安全性监测中的应用探索

将条形码引入中药注射剂安全性监测,对于保质保量完成监测任务,节省监测成本均具有重要意义。该文从条形码系统的组成、条形码扫描和数据采集流程、条形码系统设计要点3个方面介绍在中药注射剂安全性监测中应用条形码的经验和教训,以为相似工作之参考。     

15例生脉注射液致过敏性休克文献分析

目的通过对15例生脉注射液致过敏性休克的文献进行分析,探讨其引起不良反应的规律和原因,为临床合理用药提供参考。方法在中国期刊全文数据库（CNKI）和万方数据医药信息系统中以＂生脉注射液＂并含＂过敏性休克＂为主要检索词进行文献检索,并统计分析。结果共检索到个案15例,50岁以上患者占66.7%,有过敏史者5例,过敏性休克多发生在用药5 min之内,累及多个系统-器官损害,表现为大汗、意识模糊、胸闷、气短、心悸等。结论临床应用生脉注射液应加强监护,密切防范过敏性休克的发生。     

针灸加穴位注射治疗椎动脉型颈椎病90例临床观察

目的　观察穴位注射与单纯中药治疗椎动脉型颈椎病的疗效。方法　随机将 180例患者分成针灸加穴位注射组和单纯中药组治疗。结果　针灸加穴位注射组痊愈显效率与中药组相比差异有非常显著意义 (P<0 .0 1) ,而且经治疗后随访 ,针灸加穴位注射组复发率明显低于中药组 (P<0 .0 1)。结论　针灸加穴位注射组近期和远期疗效均优于对照组