布地奈德雾化吸入联合孟鲁司特钠治疗儿童咳嗽变异性哮喘的效果观察

目的观察布地奈德雾化吸入联合孟鲁司特钠治疗儿童咳嗽变异性哮喘的效果。方法选择2012年3月至2015年3月收治的咳嗽变异性哮喘患儿120例,随机分为观察组和对照组,每组60例。对照组在基础治疗基础上加布地奈德雾化吸入,观察组在对照组的治疗基础上加孟鲁司特钠口服。症状体征消失后继续维持治疗3个月。结果观察组总有效率(95.0%)显著高于对照组(78.3%),两组比较差异有统计学意义(P<0.05)。观察组患儿治疗前与对照组比较差异无统计学意义,治疗后观察组的改善更明显,与对照组各项指标比较差异有统计学意义(P<0.05)。两组治疗期间不良反应为胃肠道反应、头晕均自行缓解。结论布地奈德雾化吸入联合孟鲁司特钠治疗儿童咳嗽变异性哮喘可显著改善肺功能,整体效果好。     

雾化吸入布地奈德混悬液联合口服孟鲁司特钠咀嚼片治疗小儿咳嗽变异性哮喘的效果探讨

目的 研究雾化吸入布地奈德混悬液联合口服孟鲁司特钠咀嚼片的治疗方法,在治疗小儿咳嗽变异性哮喘中的效果.方法 选择2015年4月~2016年4月医院收治的小儿咳嗽变异性哮喘患儿62例,随机分为观察组和对照组,每组患儿31例.对照组患儿采用单纯雾化吸入布地奈德混悬液的方法进行治疗,观察组采用雾化吸入布地奈德混悬液联合口服孟鲁司特钠咀嚼片的方法进行治疗,对比两组患儿治疗后的FVC、FEV、FEV1/F VC等肺功能指标,以及两组患儿的治疗效果.结果 治疗后,两组患儿较治疗前相比,FVC、FEV1、FEV1/FVC等肺功能指标均有所改善,其中观察组患儿的FVC、FEV1、FEV1/FVC等肺功能指标高于对照组患儿,治疗总有效率高于对照组患儿,差异具有统计学意义(P<0.05).结论 在小儿咳嗽变异性哮喘的治疗中,采用雾化吸入布地奈德混悬液联合口服孟鲁司特钠咀嚼片的方法,能够取得更为理想的临床疗效.     

孟鲁司特钠联合硫酸沙丁胺醇气雾剂(万托林)雾化吸入在治疗小儿咳嗽变异性哮喘的临床疗效分析

目的探讨孟鲁司特钠联合硫酸沙丁胺醇气雾剂(万托林)雾化吸入在治疗小儿咳嗽变异性哮喘的临床疗效。方法采用随机数字表法将我院60例咳嗽变异性哮喘患儿分为为两组,其中对照组采用常规万托林雾化吸入进行治疗,实验组采用孟鲁司特钠联合万托林雾化吸入经行治疗,观察并比较两组患儿经过治疗后的临床效果。结果两组患儿经过治疗后,实验组总有效率(96.67%)明显高于对照组总有效率(70.00%),实验组患儿应用孟鲁司特钠联合硫酸沙丁胺醇气雾剂雾化吸入治疗后咳嗽缓解时间和住院时间(2.85±0.81,5.26±0.80)d明显短于对照组(5.31±1.42,10.35±2.23)d(t=2.649、2.448,P=0.018、0.029);实验组患儿最大呼气峰流速(1.57±0.52)L/min明显优于对照组(1.25±0.38)L/min(t=2.317,P=0.033),差异有统计学意义(P0.05)。结论孟鲁司特钠联合万托林雾化吸入对咳嗽变异性哮喘患儿具有积极作用,提高临床总有效率,改善肺功能,安全、有效,应该在临床上广泛应用。     

孟鲁司特钠配伍万托林雾化吸入治疗小儿咳嗽变异性哮喘的疗效观察

目的探讨孟鲁司特钠联合硫酸沙丁胺醇气雾剂(万托林)雾化吸入在治疗小儿咳嗽变异性哮喘方面的临床疗效,以及对患儿肺通气功能的影响。方法将78例咳嗽变异性哮喘患儿随机均分为两组,研究组39例给予孟鲁司特钠口服联合硫酸沙丁胺醇气雾剂雾化吸入治疗,对照组39例给予硫酸沙丁胺酸气雾剂雾化吸入治疗,均治疗1个月。疗程结束后,观察两组临床疗效,同时评价最大呼气峰流速(PEF)改善情况。结果研究组治疗的总有效率为97.44%,显著高于对照组的79.49%(P<0.05)。研究组患儿治疗后的最大呼气峰流速为(1.57±0.54)L/min,明显优于对照组的(1.39±0.48)L/min(P<0.05)。结论孟鲁司特钠联合硫酸沙丁胺醇气雾剂雾化吸入在治疗小儿咳嗽变异性哮喘方面临床疗效确切,安全可靠,能显著改善患儿肺通气功能。     

孟鲁司特钠联合糖皮质激素治疗儿童咳嗽变异性哮喘

目的评估孟鲁司特钠联合吸入糖皮质激素治疗咳嗽变异性哮喘的临床效果及对患儿肺功能的影响。方法 90例咳嗽变异性哮喘患儿,随机分为对照组45例和治疗组45例。治疗组：口服孟鲁司特钠和吸入布地奈德;对照组：吸入布地奈德。3个月后,比较两组患儿治疗前后的肺功能,对比两组临床疗效,记录患儿1年内复发情况。结果治疗组的总有效率,肺功能较治疗前的改善程度均优于对照组,治疗组的复发率明显低于对照组,差异均具有统计学意义（P〈0.05）。结论孟鲁司特钠联合糖皮质激素可有效缓解咳嗽变异性哮喘的临床症状,明显改善患儿的肺功能,疗效显著。     

孟鲁司特钠联合西替利嗪治疗小儿CVA的疗效及患儿肺功能、睡眠质量与安全性影响

目的:探讨应用孟鲁司特钠联合西替利嗪治疗小儿咳嗽变异性哮喘(CVA)的临床效果、肺功能、睡眠质量和安全性情况.方法:选择2017年4月至2019年12月接受救治的70例咳嗽变异性哮喘患儿,按入院编号的单双数将其分为对照组(单数)和研究组(双数),各35例.对照组给予吸入布地奈德雾化等常规治疗,研究组采用孟鲁司特钠联合西替利嗪进行治疗,对两组患儿的临床效果、肺功能指标、睡眠质量及不良反应发生率进行比较分析.结果:研究组治疗总有效率为82.86％,明显高于对照组的57.14％(P<0.05);研究组患儿治疗后FEV1、FVC、FEV1/FVC均高于对照组(P<0.05);研究组患儿治疗后PSQI评分均低于对照组(P<0.05);研究组不良反应发生率为14.29％,明显低于对照组的40.00％(P<0.05).结论:对于小儿咳嗽变异性哮喘患儿,应用孟鲁司特钠联合西替利嗪进行治疗,不但临床效果较好,而且可改善患儿肺功能,提高睡眠质量,安全性较高.     

雾化吸入联合孟鲁司特钠治疗82例小儿感染后咳嗽的临床疗效分析

目的 观察探讨布地奈德混悬液联合硫酸特布他林雾化液雾化吸入联合孟鲁司特治疗小儿感染后咳嗽的临床疗效.方法 选取感染后咳嗽的患儿164例,随机分为两组,对照组采取孟鲁司特钠咀嚼片治疗,观察组采取雾化吸入联合孟鲁司特钠治疗,观察治疗效果.结果 观察组总有效率为95.1%;对照组总有效率为79.3%,疗效比较差异显著(P<0.05).结论 布地奈德混悬液联合硫酸特布他林雾化液雾化吸入联合孟鲁司特钠治疗小儿感染后咳嗽的临床疗效显著.     

孟鲁司特钠联合布地奈德混悬液雾化吸入治疗咳嗽变异型哮喘75例的临床研究

目的探讨孟鲁司特钠联合布地奈德混悬液雾化吸入治疗咳嗽变异型哮喘(CVA)的临床疗效。方法 75例CVA患者随机分为对照组和研究组。对照组36例,给予常规基础治疗和布地奈德混悬液雾化吸入;研究组39例,在对照组基础上给予孟鲁司特钠口服。观察治疗前、治疗10 d后临床疗效及肺活量(FVC)、最大呼气峰流速(PEF)及超敏C反应蛋白(hs CRP)、肿瘤坏死因子-α(TNF-α)和白介素-13(IL-13)水平变化。结果治疗前两组患者FVC、PEF及hs CRP、TNF-α和IL-13水平比较,差异无统计学意义(P>0.05)。治疗10 d后,研究组FVC、PEF升高幅度明显优于对照组(P<0.05),血清hs CRP、TNF-α、IL-13水平明显低于对照组(P<0.05),研究组治疗总有效率94.87%明显高于对照组总有效率77.78%(P<0.05)。结论孟鲁司特钠联合布地奈德混悬液雾化吸入治疗咳嗽变异型哮喘疗效显著、不良反应较少,明显改善哮喘、咳嗽等临床症状。     

孟鲁司特钠联合布地奈德治疗小儿咳嗽变异性哮喘的效果观察

目的：探讨孟鲁司特钠联合布地奈德治疗小儿咳嗽变异性哮喘的临床效果。方法将2012年1月~2014年1月汕头市澄海区人民医院儿科收治确诊的68例小儿咳嗽变异性哮喘患儿随机分为治疗组和对照组,各34例。对照组主要采用布地奈德治疗,治疗组采用孟鲁司特钠联合布地奈德治疗,比较两组患儿的相关临床指标和临床效果。结果治疗组的总有效率为97.06%,明显高于对照组的79.41%,咳嗽缓解、消失时间,治疗时间明显短于对照组(P<0.05)。结论孟鲁司特钠联合布地奈德雾化吸入治疗小儿咳嗽变异性哮喘的临床效果明显,值得临床推广应用。     

孟鲁司特钠治疗小儿咳嗽变异性哮喘的临床疗效及安全性分析

目的:探讨孟鲁司特钠治疗小儿咳嗽变异性哮喘的临床疗效与安全性。方法:选择2018年1月～2018年9月某院收治的咳嗽变异性哮喘患儿130例,根据随机数表法将所有患儿分为观察组和对照组各65例。两组患儿均实施止咳、化痰、抗感染等综合治疗,对照组患儿实施雾化吸入布地奈德治疗,观察组患儿在对照组基础上服用孟鲁司特钠治疗,治疗2个月后对比分析两组的治疗效果。结果:观察组患儿治疗后肺功能及治疗效果均优于对照组,差异有统计学意义(P0.05);两组均未出现恶心、呕吐等不良反应。结论:孟鲁司特钠治疗小儿咳嗽变异性哮喘的效果较好,利于改善患儿肺功能,且安全无副作用,可促进患儿临床症状改善。     

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.     

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 x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 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。     

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.     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Hyperkalaemia in patients in hospital

A survey of all laboratory blood specimens with a plasma potassium concentration greater than or equal to 5.5 mmol/L was conducted over a three month period. Of 331 specimens with hyperkalaemia, 71 were excluded because the specimens was haemolysed, old or contaminated. The laboratory served a population of 348,561 and during this time measured the plasma potassium on 25,016 occasions. Sixty-six outpatients and 20 neonates were not evaluated. The survey was undertaken on 86 of 102 inpatients (46 males), 48 of whom were over 66 years of age. Fifty-seven patients were admitted under a medical service and 29 under a surgical service. Fifty-nine had a single episode of hyperkalaemia. Thirty-two underwent a surgical procedure. The commonest contributing factor was impaired renal function which was present in 71 (83%) patients. Although a definitive causative role for drugs could be identified in only five patients, in 52 (60%) patients drugs were a contributing factor (potassium supplements 24, ACE inhibitors 16, nonsteroidal antiinflammatory drugs 12). Thirty-five of the 86 (41%) patients died during their hospital admission. Nineteen of the 35 deaths occurred within three days of the hyperkalaemia being recorded. A normal plasma potassium was eventually documented in 50 of the 86 patients. Of the remaining 36 patients, 25 (69%) subsequently died. In general the treatment of patients with hyperkalaemia focused on identifying and treating the underlying cause. Hyperkalaemia must always be considered seriously and regard given to the overall clinical status of the patient, with particular attention to drug therapy, renal and cardiac function, acid base status and the possibility of sepsis.