磷酸奥司他韦颗粒联合单磷酸阿糖腺苷治疗小儿手足口病的疗效观察

目的观察磷酸奥司他韦颗粒联合单磷酸阿糖腺苷治疗小儿手足口病的临床疗效。方法选择2013年8月—2015年6月在首都儿科研究所附属儿童医院感染科收治的小儿手足口病患者64例。所有患者随机分为对照组和治疗组,每组各32例。对照组静脉注射或肌肉注射单磷酸阿糖腺苷治疗,5~10 mg/kg加入到0.9%氯化钠溶液2 m L中,1次/d;治疗组在对照组基础上口服磷酸奥司他韦颗粒,体质量≤15 kg:30 mg/次,15 kg体质量≤23 kg:45 mg/次,23 kg体质量≤40 kg:60 mg/次,体质量40 kg:75 mg/次,2次/d。两组患者均连续治疗10 d。观察两组的临床疗效,比较两组患者的发热消退时间、皮疹疱疹消退时间及痊愈时间。结果治疗后,对照组和治疗组的总有效率分别为87.5%、96.9%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组患者的发热消退时间、皮疹疱疹消退时间及痊愈时间均显著短于对照组,两组比较差异具有统计学意义(P0.05)。结论磷酸奥司他韦颗粒联合单磷酸阿糖腺苷治疗小儿手足口病具有较好的临床疗效,能缓解临床症状,安全性较好,具有一定的临床推广应用价值。     

小儿肺热咳喘颗粒治疗小儿支气管哮喘的疗效观察

目的观察小儿肺热咳喘颗粒治疗小儿支气管哮喘的临床疗效和安全性。方法选择2016年7月—2018年4月在丹东市中医院110例小儿支气管哮喘患儿为研究对象,随机分成对照组和治疗组,每组各55例。两组均给予基础治疗。对照组口服小儿肺热咳喘颗粒模拟剂,1～2岁1袋/次,3次/d;3～5岁1袋/次,4次/d。治疗组口服小儿肺热咳喘颗粒,1～2岁1袋/次,3次/d;3～5岁1袋/次,4次/d。两组患儿连续服药28 d。观察两组患儿临床疗效,比较治疗前后两组患儿肺功能指标用力肺活量(FVC)、第1秒用力呼气量(FEV1)、FEV1占FVC比值(FEV1/FVC)、最大呼气流速(PEF)、肺活量(VC)及中医证候疗效。结果治疗后,治疗组患儿总有效率为89.09%,明显高于对照组的72.73%(P0.05)。治疗后,治疗组患儿FEV1、FEV1/FVC、PEF、VC均明显高于对照组(P0.05)。治疗后,治疗组患儿中医证候有效率在14、28 d分别为70.91%、92.72%;对照组患儿分别为50.91%和78.18%,两组比较差异具有统计学意义(P0.05)。结论小儿肺热咳喘颗粒治疗小儿支气管哮喘患儿临床效果好且未观察到不良反应,具有一定的临床推广应用价值。     

莪术油注射液联合奥司他韦治疗小儿病毒性肺炎的临床研究

目的探讨莪术油注射液联合奥司他韦治疗小儿病毒性肺炎的临床疗效。方法选取2016年10月—2018年10月淮北矿工总医院收治的病毒性肺炎患儿101例,随机分为对照组(50例)和治疗组(51例)。对照组口服磷酸奥司他韦颗粒,体质量15 kg者30 mg/次,体质量15～23 kg者45 mg/次,体质量23～40 kg者60 mg/次,体质量40 kg者75 mg/次,2次/d。治疗组患儿在对照组治疗基础上静脉滴注莪术油注射液,10 mL/次加入生理盐水250 mL稀释,1次/d。两组患儿均治疗7 d。观察两组的临床疗效,比较两组患儿喘憋消失时间、体温恢复正常时间及X线恢复正常时间。比较两组治疗前后血清白细胞介素-8(IL-8)、C反应蛋白(CRP)、肌酸激酶(CK)和心肌肌钙蛋白(CTnT)的变化情况。结果治疗后,对照组和治疗组的总有效率分别是78.00%、94.12%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组患儿喘憋消失时间、体温恢复正常时间及X线恢复正常时间均显著短于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血清IL-8、CRP、CK、CTnT水平均较治疗前显著降低,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组这些血清学指标显著低于对照组,两组比较差异具有统计学意义(P0.05)。结论莪术油注射液联合奥司他韦治疗小儿病毒性肺炎具有较好的临床疗效,能显著改善患者临床症状,降低血清因子水平,具有一定的临床推广应用价值。     

柴黄颗粒联合奥司他韦治疗小儿急性上呼吸道感染的临床研究

目的探讨柴黄颗粒联合磷酸奥司他韦颗粒治疗小儿急性上呼吸道感染的临床疗效。方法以2018年7月—2020年7月在中国人民解放军联勤保障部队第九八八医院进行治疗的154例急性上呼吸道感染患儿为研究对象。根据就诊顺序分为对照组(77例)和治疗组(77例)。对照组口服磷酸奥司他韦颗粒,体质量≤15 kg,30 mg/次,2次/d,体质量>15~23 kg,45 mg/次,2次/d,体质量>23~40 kg,60 mg/次,2次/d,体质量>40 kg,75 mg/次,2次/d;治疗组在对照组基础上口服柴黄颗粒,3 g/次,2次/d。两组均连续治疗5 d。观察两组的临床疗效,比较两组临床症状消失时间和血清学因子的变化情况。结果经治疗,对照组总有效率是84.42%,显著低于治疗组(98.70%,P<0.05)。经治疗,治疗组患儿在咳嗽、发热、咽痛、鼻塞流涕消失时间上均显著短于对照组(P<0.05)。经治疗,两组血清超敏C反应蛋白(hs-CRP)、嗜酸性细胞阳离子蛋白(EOS)、白细胞介素-17(IL-17)、白细胞计数(WBC)、中性粒细胞百分比(NEU)、降钙素原(PCT)水平均显著下降(P<0.05);且治疗组血清学指标显著低于对照组(P<0.05)。结论柴黄颗粒联合磷酸奥司他韦颗粒治疗小儿急性上呼吸道感染具有较好的临床疗效,可有效改善患儿临床症状,降低机体炎症反应,有着良好的临床应用价值。     

磷酸奥司他韦联合小儿豉翘清热颗粒治疗甲型流行性感冒疗效观察

目的:观察磷酸奥司他韦联合小儿豉翘清热颗粒治疗甲型流行性感冒(流感)临床疗效。方法:以我院收治的88例甲型流感患儿为研究对象,随机分为对照组42例和观察组46例。两组均给予常规综合治疗,在此基础上对照组给予磷酸奥司他韦治疗,观察组给予磷酸奥司他韦联合小儿豉翘清热颗粒治疗,疗程5 d,比较两组住院时间、发热时间、咳嗽鼻塞好转时间、咽红肿痛好转时间和甲型流感病毒转阴时间及临床总有效率。结果:观察组总有效率95.65%,高于对照组的85.71%(P<0.05);观察组发热时间、咳嗽鼻塞好转时间、咽红咽痛好转时间均短于对照组(P<0.05);观察组住院时间(5.18±2.70)d,短于对照组的(8.62±2.10)d(P<0.05)。结论:磷酸奥司他韦联合小儿豉翘清热颗粒治疗甲型流行性感冒疗效优于单用磷酸奥司他韦。     

小儿双金清热口服液联合奥司他韦治疗甲型流行性感冒的临床研究

目的探讨小儿双金清热口服液联合磷酸奥司他韦胶囊治疗甲型流行性感冒(流感)的临床疗效。方法选取2016年2月—2017年2月在延安市人民医院儿科和门诊进行治疗的甲型流感患者113例作为研究对象,在随机分组的原则下将患者随机分为对照组(56例)和治疗组(57例)。对照组患者口服磷酸奥司他韦胶囊,75 mg/次,2次/d;治疗组患者在对照组治疗的基础上口服小儿双金清热口服液,10 mL/次,3次/d。两组患者均连续治疗5 d。观察两组患者的临床疗效,同时比较治疗前后两组患者体温恢复时间、症状消失时间、病毒核酸阳性持续时间、细胞免疫指标和体液免疫指标水平。结果治疗后,对照组、治疗组总有效率分别为83.93%、96.49%,两组总有效率比较差异具有统计学意义(P0.05)。治疗后,治疗组体温恢复时间、症状消失时间和病毒核酸阳性持续时间均显著短于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清CD8~+水平显著降低,CD4~+、IgA、IgM水平均显著升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组细胞免疫和体液免疫指标明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论小儿双金清热口服液联合奥司他韦胶囊治疗甲型流感具有较好的临床疗效,改善临床症状,提高免疫力,具有一定的临床推广应用价值。     

磷酸奥司他韦颗粒与小儿牛黄清心散治疗小儿季节性流感的疗效探究

目的:探究磷酸奥司他韦颗粒与小儿牛黄清心散治疗小儿季节性流感的疗效.方法:选取2013年10月~2016年8月我院收治的108例季节性流感小儿患者作为观察对象,按照硬币法分为两组,对照组54例采用磷酸奥司他韦颗粒进行治疗,研究组54例在对照组基础上采用小儿牛黄清心散进行治疗,比较两组临床症状改善情况和治疗效果.结果:对照组咽痛、咳嗽消失时间及退热时间明显长于研究组,两组差异具有统计学意义(P<0.05);对照组与研究组的治疗总有效率统计比较结果显示,研究组高于对照组,组间差异明显(P<0.05).结论:小儿季节性流感选择磷酸奥司他韦颗粒与小儿牛黄清心散联合治疗方案,有利于改善患儿临床症状,提高治疗效果.     

磷酸奥司他韦颗粒联合小儿牛黄清心散治疗小儿季节性流感临床研究

目的研究磷酸奥司他韦颗粒联合小儿牛黄清心散在治疗小儿季节性流感中的临床效果。方法 102例流感患儿随机分为治疗组52例,对照组50例。治疗组在口服磷酸奥司他韦颗粒的基础上加用小儿牛黄清心散治疗,对照组口服磷酸奥司他韦颗粒治疗,两组患者以5 d为1个疗程,观测治疗前后平均退热天数、咳嗽/咽痛消失时间、出现高热惊厥例数及进展为肺炎例数。结果治疗组治疗后,在症状消失时间、症状积分降低程度、症状总疗效方面,与对照组相比,差异有统计学意义（P〈0.05）。结论磷酸奥司他韦颗粒联合小儿牛黄清心散治疗小儿季节性流感效果显著,联合治疗既能迅速抑制流感病毒,阻断疾病进展,又能有效地控制体温、减轻症状、缩短病程,同时避免了因高热导致的患儿神经系统受累以及不必要的抗生素治疗。可作为小儿流感治疗的首选方法,值得临床推广使用。     

小儿肺热咳喘口服液治疗支气管肺炎的临床观察

目的观察小儿肺热咳喘口服液治疗支气管肺炎的临床疗效。方法将118例支气管肺炎患儿随机均分为观察组和对照组,观察组应用抗生素的同时服用咳喘口服液(10ml/支)。对照组应用抗生素加病毒唑(10mg/kg.d)治疗。结果观察组痊愈40例,好转19例,总有效率98.33%;对照组分别为30例,16例和79.31%。两组疗效差异有显著意义(χ2=6.67,P<0.05)。观察组症状体征消失时间明确优于对照组。结论小儿肺热咳喘口服液治疗支气管肺炎疗效更佳,与抗生素合用,可以提高疗效,缩短病程,减少并发症,故值得推广应用。     

中西医结合用药治疗小儿冷热惊厥的临床观察

目的:探讨小儿咽扁颗粒联合磷酸奥司他韦用于流行性感冒伴热性惊厥患儿治疗的疗效.方法:选取2019年1月—2020年7月本院诊治的100例流行性感冒伴热性惊厥患儿作为研究对象,采用随机数字表法将患儿分为对照组和观察组,每组50例.对照组给予磷酸奥司他韦治疗,观察组给予小儿咽扁颗粒+磷酸奥司他韦治疗,比较两组临床疗效、临床...     

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     

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.     

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。     

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.     

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.     

Genotoxic effects of chlorophenoxy herbicide diclofop-methyl in mice in vivo and in human lymphocytes in vitro

Diclofop-methyl (DM) is a chlorophenoxy derivative used in large quantities for the control of annual grasses in grain and vegetable crops. In this study, the genotoxic effects of DM were investigated by measuring chromosomal aberrations (CAs) in mouse bone-marrow cells and CA and the comet assay in human peripheral lymphocytes. Mice were treated with 15.63, 31.25, 62.5, and 125?mg/kg body weight of DM intraperitoneally for 24 hours, and 15.63-, 31.25-, 62.5-, 125-, and 250-µg/mL concentrations were applied to human lymphocytes for both 24 and 48 hours. In in vivo treatments, DM significantly, but not dose dependently, increased the total chromosome aberrations, compared to both negative and solvent controls. Cell proliferation was significantly, but not dose dependently, affected by all doses. In in vitro treatments, DM (except 15.63 µg/mL) significantly and dose dependently increased the frequency of chromosome aberrations. Also, 250 µg/mL of 48-hour treatment was found to be toxic. Cell proliferation was significantly and dose dependently affected by DM applications, when compared to negative control. In in vitro treatments, DM significantly decreased the mitotic index only at the highest concentration for 24 hours, and 62.5- and 125-µg/mL concentrations for 48 hours. In the comet assay, a significant and dose-dependent increase in comet-tail intensity was observed at 62.5-, 125-, and 250-µg/mL concentrations. The mean comet-tail length was significantly increased in all concentrations. Our results demonstrate that DM is genotoxic in mammalian cells in vivo and in vitro.     

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.     

2010调脂治疗领域进展

2010年在调脂治疗领域针对他汀治疗心血管病的防治又进行了许多探索。本文通过综述他汀类药物的国际大规模临床试验结果,重新评价了他汀类药物在冠心病一级预防和冠心病二级预防中的地位,阐明了强化他汀治疗的意义;对他汀的心肾保护作用和安全性新证据进行了说明。