Effects of high-dose glucose-insulin-potassium on acute coronary syndrome patients receiving reperfusion therapy:a meta-analysis

BACKGROUND:This meta-analysis aimed to assess the efficacy of high-dose glucose-insulinpotassium(GIK) therapy on clinical outcomes in acute coronary syndrome(ACS) patients receiving reperfusion therapy.METHODS:We searched the PubMed,Web of Science,MEDLINE,Embase,and Cochrane Library databases from inception to April 26,2022,for randomized controlled trials(RCTs) that compared high-dose GIK and placebos in ACS patients receiving reperfusion therapy.The primary endpoint was major adverse cardiovascular events(MACEs).RESULTS:Eleven RCTs with 884 patients were ultimately included.Compared with placebos,high-dose GIK markedly reduced MACEs(risk ratio [RR] 0.57,95% confidence interval [95% CI]:0.35 to 0.94,P=0.03) and the risk of heart failure(RR 0.48,95% CI:0.25 to 0.95,P=0.04) and improved the left ventricular ejection fraction(LVEF)(mean difference [MD] 2.12,95% CI:0.40 to 3.92,P=0.02) at 6 months.However,no difference was observed in all-cause mortality at 30 d or 1 year.Additionally,high-dose GIK was significantly associated with increased incidences of phlebitis(RR 4.78,95% CI:1.36 to 16.76,P=0.01),hyperglycemia(RR 9.06,95% CI:1.74 to 47.29,P=0.009) and hypoglycemia(RR 6.50,95% CI:1.28 to 33.01,P=0.02) but not reinfarction,hyperkalemia or secondary reperfusion.In terms of oxidative stress-lowering function,high-dose GIK markedly reduced superoxide dismutase(SOD) activity but not glutathione peroxidase(GSH-Px) or catalase(CAT) activity.CONCLUSION:Patients with ACS receiving reperfusion therapy exhibited a reduction in MACEs and good oxidative stress-lowering eflcacy in response to high-dose GIK.Moreover,with a higher incidence of complications such as phlebitis,hyperglycemia,and hypoglycemia.Furthermore,there were no observed survival benefits associated with high-dose GIK.More trials with long-term follow-up are still needed.

High-dose vs low-dose proton pump inhibitors for upper gastrointestinal bleeding:A meta-analysis

AIM:To evaluate the efficacy of high-dose proton pump inhibitors(PPIs)vs low-dose PPIs for patients with upper gastrointestinal bleeding.METHODS:PubMed,Embase,the Cochrane Library,and Web of Science were searched to identify relevant randomized controlled trials(RCTs).Eligible trials were RCTs that compared high-dose PPI with low-dose PPI following endoscopic hemostasis.The primary endpoint was rebleeding;secondary endpoints were patient numbers that needed surgery,and mortality.The meta-analysis was performed with a fixed effects model or random effects model.RESULTS:Nine eligible RCTs including 1342 patients were retrieved.The results showed that high-dose intravenous PPI was not superior to low-dose intra-venous PPI in reducing rebleeding[odds ratio(OR)= 1.091,95%confidential interval(CI):0.777-1.532],need for surgery(OR=1.522,95%CI:0.643-3.605) and mortality(OR=1.022,95%CI:0.476-2.196).Subgroup analysis according to different region revealed no difference in rebleeding rate between Asian patients(OR=0.831,95%CI,0.467-1.480)and European patients(OR=1.263,95%CI:0.827-1.929).CONCLUSION:Low-dose intravenous PPI can achieve the same efficacy as high-dose PPI following endoscopic hemostasis.

Predictors of post-treatment stenosis in cervical esophageal cancer undergoing high-dose radiotherapy

AIM To evaluate toxicity and treatment outcome of highdose radiotherapy(RT) for cervical esophageal cancer(CEC).METHODS We reviewed a total of 62 consecutive patients who received definitive RT for stage Ⅰ to Ⅲ cervical esophageal cancer between 2001 and 2015. Patients who received < 45 Gy, treated for lesions below sternal notch, treated with palliative aim, treated with subsequent surgical resection, or diagnosed with synchronous hypopharyngeal cancer were excluded. Treatment failures were divided into local(occurring within the RT field), outfield-esophageal, and regional [occurring in regional lymph node(s)] failures. Factors predictive of esophageal stenosis requiring endoscopic dilation were analyzed.RESULTS Grade 1, 2, and 3 esophagitis occurred in 19(30.6%), 39(62.9%), and 4 patients(6.5%), respectively, without grade ≥ 4 toxicities. Sixteen patients(25.8%) developed post-RT stenosis, of which 7 cases(43.8%) were malignant. Four patients(6.5%) developed tracheoesophageal fistula(TEF), of which 3(75%) cases were malignant. Factors significantly correlated with post-RT stenosis were stage T3/4(P = 0.001), complete circumference involvement(P < 0.0001), stenosis at diagnosis(P = 0.024), and endoscopic complete response(P = 0.017) in univariate analysis, while complete circumference involvement was significant in multivariate analysis(P = 0.003). A higher dose(≥ 60 Gy) was not associated with occurrence of postRT stenosis or TEF. With a median follow-up of 24.3(range, 3.4-152) mo, the 2 y local control, outfield esophageal control, progression-free survival, and overall survival(OS) rates were 78.9%, 90.2%, 49.6%, and 57.3%, respectively. Factors significantly correlated with OS were complete circumference involvement(P = 0.023), stenosis at diagnosis(P < 0.0001), and occurrence of post-RT stenosis or TEF(P < 0.001) in univariate analysis, while stenosis at diagnosis(P = 0.004) and occurrence of post-RT stenosis or TEF(P = 0.023) were significant in multivariate analysis. CONCLUSION Chemoradiation for CEC was well tolerated, and a higher dose was not associated with stenosis. Patients with complete circumferential involvement require close follow-up.

High-dose interferon-α2b induction therapy in combination with ribavirin for treatment of chronic hepatitis C in patients with non-response or relapse after interferon-a monotherapy

AIM： To evaluate the daily high-dose induction therapy with interferon-α2b （IFN-α2b） in combination with ribavirin for the treatment of patients who failed with interferon monotherapy and had a relapse, based on the assumption that the viral burden would decline faster, thus increasing the likelihood of higher response rates in this difficult-totreat patient group. METHODS： Seventy patients were enrolled in this study. Treatment was started with 10 NU IFN-α2b daily for 3 wk, followed by IFN-α2b 5 NU/TIW in combination with ribavirin （1 000-1 200 mg/d） for 21 wk. In case of a negative HCV RNA PCR, treatment was continued until wk 48 （IFN-α2b 3MU/TIW＋1000-1200 mg ribavirin/daily）. RESULTS： The dose of IFN-α2b or ribavirin was reduced in 16% of patients because of hematologic side effects, and treatment was discontinued in 7% of patients. An early viral response （EVR） was achieved in 60% of patients. Fifty percent of all patients achieved an end-oftreatment response （EOT） and d0% obtained a sustained viral response （SVR）. Patients with no response had a significantly lower response rate than those with a former relapse （SVR 30% vs 53%; P=0.049）. Furthermore, lower response rates were observed in patients infected with genotype la/b than in patients with non-1-genotype （SVR 28% vs7d%; P=0.001）. As a significant predictive factor for a sustained response, a rapid initial decline of HCV RNA could be identified. No patient achieving a negative HCV-RNA PCR at wk 18 or later eventually eliminated the virus. CONCLUSION： Daily high-dose induction therapy with interferon-α2b is well tolerated and effective for the treatment of non-responders and relapsers, when interferon monotherapy fails. A fast decline of viral load during the first 12 wk is strongly associated with a sustained viral response.

Dose-individualization Efficiently Maintains Sufficient Exposure to Methotrexate without Additional Toxicity in High-dose Methotrexate Regimens for Pediatric Acute Lymphoblastic Leukemia

Objective:Methotrexate(MTX)can be safely administered to most patients but may cause severe toxicity in others.This study aimed to summarize the characteristics of high-dose methotrexate(HD-MTX)chemotherapy and to evaluate whether the modified dose-adjustment program was able to improve the maintenance of sufficient MTX exposure levels while minimizing toxicities.Methods:We evaluated 1172 cycles of high-dose MTX chemotherapy from 294 patients who were treated according to the CCCG-ALL-2015 protocol(clinical trial number:ChiCTR-IPR-14005706)and analyzed the data of actual MTX dosage,MTX concentration,toxicity,and prognosis.We compared data between the dose-adjustment Program 1(fixed 20%reduction in dose)and the dose-adjustment Program 2(dose-individualization based on reassessment of the creatine clearance rate and the MTX concentration-monitoring point at 16 h),which were applied if the MTX clearance was delayed in the previous cycle.Results:The patients who used Program 2 had higher actual MTX infusion doses and infusion rates and were able to better maintain the MTX concentration at 44 h at the established target value than those on Program 1(P<0.001).No significant differences in toxicities were found between these two programs except that abnormal serum potassium levels and prolonged myelosuppression in intermediate-risk/high-risk patients were more frequently observed in patients using Program 2(P<0.001).No significant correlations were observed between the MTX dose,dose-adjustment programs,or MTX concentrations and relapse-free survival.Conclusion:Adjusting the MTX dose using Program 2 is more efficient for maintaining sufficient MTX exposure without significantly increasing the toxicity.

The Experience of Pain and Anxiety in Cervical Cancer Patients Undergoing Multiple Fraction High-Dose Rate Brachytherapy: A Prospective Observational Study

Purpose: To evaluate the anxiety and pain levels of cervical cancer patients undergoing intracavitary multifraction high-dose rate (HDR) brachytherapy, as part of a process to develop guidelines for quality patient-centered care. Methods: Cervical cancer patients (n = 31) undergoingmultiple fraction HDR brachytherapy treatment at the National Institute of Oncology in Rabat (Morocco) completed ratings of pain and anxiety intensity using 11-point verbal analog scales, at 6 key time points over 2 brachytherapy insertion procedures and 4 brachytherapy fractions. Women were evaluated for psychological status at baseline before starting the brachytherapy process using the Hospital Anxiety and Depression Scale (HADS). Scores were grouped as follows: 0 - 7 = normal, 8 - 10 = borderline, 11 - 21 = abnormal. Factors that could affect anxiety levels such as education level, relationship status, number of pregnancies and prior surgical history were documented. Results: Between July and August 2020, 31 women with a median age of 49.6 years were evaluated (range: 27 - 70). The HADS score identified depression in 5 patients (16.1%) and anxiety in 12 patients (38.7%). Throughout both treatment procedures, anticipatory anxiety was reported, with a maximum intensity in the operating room during spinal anesthesia (3.23 ± 1.7) and during applicator insertion (2.97 ± 2.4). Moderate-to-severe anxiety scores were reported in 25.8% and 22.6% of patients respectively. Level of education showed a significant correlation with anxiety scores (p = 0.027). Pain increased significantly during the procedure (p ± 1.4) and applicator removal (4.74 ± 1.5) turned out to be the most painful parts of the procedure. No correlation was found between pain and anxiety levels. Conclusion: Intracavitary multifraction high-dose rate brachytherapy is associated with mild to moderate levels of pain and anxiety, although a subset of patients reported more severe symptoms and may require additional medical and psychological support, with particular emphasis on bed-rest duration and applicator removal. The development of effective interventions (both pharmacological and non-pharmacological) is needed to improve women’s experiences of brachytherapy for locally advanced cervical cancer.

Very-high-dose olanzapine for treatment-resistant schizophrenia

Treatment-resistant schizophrenia has an extremely negative impact on mental health and social life. If clozapine, the gold standard treatment, fails, there are very few options left. The literature suggests that high-dose olanzapine (20 - 60 mg/day) is a possible alternative. We report two cases in which very high doses of olanzapine were administered, with significant clinical improvements above 60 mg/day. Clinical, metabolic and cardiac tolerance was good. This report highlights the usefulness of very-high-dose olanzapine in treatment-resistant schizophrenia. The main hypotheses concerning the psychopharmacological mechanisms of very-high-dose olanzapine are discussed.

Comparison of High-Dose Dexamethasone and Prednisone for Initial Treatment of Adult Primary Immune Thrombocytopenia

Prednisone is the most common first-line treatment for adult primary immune thrombocytopenia (ITP). However, the best initial therapeutic approach is still a matter of debate. Prior studies have shown that high-dose dexamethasone (HD-DXM) produces a high sustained efficacy not achieved by conventional prednisone therapy. However, the definition of response widely differs between individual reports, and this heterogeneity makes comparison of the efficacy difficult. The aim of our study was to compare the therapeutic outcomes of a conventional dose of prednisone with HD-DXM for adult ITP patients as initial therapy. Thirty patients treated with prednisone and 22 patients treated HD-DXM were retrospectively analyzed. No significant differences between the HD-DXM and prednisone groups were observed for the rates of complete response (68% vs. 70%) and response (18% vs. 17%). However, 1 year probability of sustained response was significantly greater in the HD-DXM group than in the prednisone group (78% vs. 38%;P = 0.008). No adverse events necessitating discontinuation of treatment were observed in either group. Our retrospective analysis showed that initial treatment with HD-DXM produced longer response duration compared to a conventional dose of prednisone. Randomized clinical trials are warranted to establish the optimal initial steroid therapy for adult ITP.

A New Variant of Combined Pulmonary Fibrosis and Emphysema from Long-Term High-Dose of Glucocorticoid Therapy: A Case Report

Recent studies have described the combination of both pulmonary emphysema and idiopathic interstitial lung disease (ILDs) by means of high-resolution computed axial tomography (HRCT). Definition of this syndrome was first named by Cottin as combined pulmonary fibrosis and emphysema (CPFE). Functional and radiological findings have showed that these patients are suffering from severe breathlessness, but whose pulmonary functional tests revealed no signs of obstruction, normal static lung volumes, and depressed DLco, most with a history of smoking [1] [2]. The radiological and endoscopic studies especially show that these patients have both areas of upper-lobe predominant emphysema and lesions compatible with fibrosis in both lung bases [3]. No prior research has reported any cases of such condition in person with no prior history of smoking as well as long-term high-dose of glucocorticoid therapy. In this case report, we discuss the presentation, diagnosis, and management of a 53-year-old non-smoker with increasing shortness of breath with a long-term high-dose of glucocorticoid therapy discovered to have an abnormal variant or presentation of CPFE. The cause of disease was attributed to a certain history of smoking in most studies;other potential risk factors have yet to be properly analyzed. This clinical report features a special case about the problem and solution surrounding this issue.

Effects of mucosolvan combined with fiberoptic bronchoscopy on respiratory function, inflammatory response and stress state in patients with severe pneumonia

Objective: To investigate the effect of mucosolvan combined with fiberoptic bronchoscopy on respiratory function, inflammatory response and stress state in patients with severe pneumonia. Methods: From January 2017 to June 2018, 82 patients with severe pneumonia were randomly divided into observation group and control group (all 41 cases). Patients in the control group received conventional anti-infective treatment, and the observation group was treated with fiberoptic bronchoscopy combined with mucosolvan on the basis of the control group. Respiratory function, inflammatory response and stress status were compared between the two groups. Results: Before treatment, there was no significant difference in Cdyn, WOB and PaO2/FiO2 between the two groups. After treatment, Cdyn and PaO2/FiO2 in the observation group were (36.28±4.28) mL/cmH2O and (376.23±24.21) mmHg respectively, while those in the control group were (26.89±3.76) mL/cmH2O and (322.12±23.16) mmHg, respectively. The levels of Cdyn and PaO2/FiO2 in the observation group were higher than those in the control group. After treatment, the WOB in the observation group was (7.81±0.72) J/L, and the WOB in the control group was (8.33±1.23) J/L. WOB of both groups was lower than that before treatment, and in observation group WOB was lower than that of control group, the difference was statistically significant. In CRP, PCT and sTREM-1 levels, there was no significant difference between the two groups before treatment. After treatment, CRP, PCT and sTREM-1 in the observation group were (39.10±6.03) mg/L, (14.57±2.05) ng/L, (15.02±3.02) ng/L respectively, while those in the control group were (59.72±8.81) mg/L, (20.03±3.09) ng/L, (34.21±5.28) ng/L, respectively. CRP, PCT, sTREM-1 in both groups were lower than those before treatment, and CRP, PCT, sTREM-1 in observation group were lower than those in control group. Before treatment, there was no significant difference with Cor, Ang-I and Ang-II in two groups. After treatment, the levels of Cor, Ang-I and Ang-II in the observation group were (114.76±15.85) ng/mL, (6.72±0.64) ng/mL, (27.28±3.43) ng/mL respectively, while those in the control group were (193.15±22.64) ng/mL, (12.10±1.68) ng/mL, (43.02±5.57) ng/mL, respectively. In the observation group, the levels of Cor, Ang-I and Ang-II were lower than those in the control group. Conclusion: Mucosolvan combined with fiberoptic bronchoscopy can effectively improve the respiratory function of patients with severe pneumonia, and reduce inflammation and stress state of the body.

Nutritional management and autism spectrum disorder:A systematic review

BACKGROUND Autism spectrum disorder(ASD)presents unique challenges related to feeding and nutritional management.Children with ASD often experience feeding difficulties,including food selectivity,refusal,and gastrointestinal issues.Various interventions have been explored to address these challenges,including dietary modifications,vitamin supplementation,feeding therapy,and behavioral interventions.AIM To provide a comprehensive overview of the current evidence on nutritional management in ASD.We examine the effectiveness of dietary interventions,vitamin supplements,feeding therapy,behavioral interventions,and mealtime practices in addressing the feeding challenges and nutritional needs of children with ASD.METHODS We systematically searched relevant literature up to June 2024,using databases such as PubMed,PsycINFO,and Scopus.Studies were included if they investigated dietary interventions,nutritional supplements,or behavioral strategies to improve feeding behaviors in children with ASD.We assessed the quality of the studies and synthesized findings on the impact of various interventions on feeding difficulties and nutritional outcomes.Data extraction focused on intervention types,study designs,participant characteristics,outcomes measured,and intervention effectiveness.RESULTS The review identified 316 studies that met the inclusion criteria.The evidence indicates that while dietary interventions and nutritional supplements may offer benefits in managing specific symptoms or deficiencies,the effectiveness of these approaches varies.Feeding therapy and behavioral interventions,including gradual exposure and positive reinforcement,promise to improve food acceptance and mealtime behaviors.The findings also highlight the importance of creating supportive mealtime environments tailored to the sensory and behavioral needs of children with ASD.CONCLUSION Nutritional management for children with ASD requires a multifaceted approach that includes dietary modifications,supplementation,feeding therapy,and behavioral strategies.The review underscores the need for personalized interventions and further research to refine treatment protocols and improve outcomes.Collaborative efforts among healthcare providers,educators,and families are essential to optimize this population's nutritional health and feeding practices.Enhancing our understanding of intervention sustainability and long-term outcomes is essential for optimizing care and improving the quality of life for children with ASD and their families.

宣肺平喘汤联合沐舒坦、胸腺肽治疗小儿支气管哮喘的效果

目的探讨宣肺平喘汤联合沐舒坦、胸腺肽治疗小儿支气管哮喘(BA)的效果。方法将2021年1月至2023年3月商丘市第四人民医院收治的108例BA患儿随机分为对照A组、对照B组、联合组,各36例。3组均接受对症支持治疗,对照A组在此基础上采取沐舒坦氧驱雾化吸入治疗,对照B组采取沐舒坦联合胸腺肽治疗,联合组采取宣肺平喘汤联合沐舒坦、胸腺肽治疗。治疗2周后,比较3组哮喘控制率、不良反应,并比较治疗前后哮喘日间、夜间症状评分、变态反应指标、肺功能指标。结果治疗2周后,联合组哮喘总控制率高于对照A组、对照B组(P<0.05);治疗2周后,哮喘日间评分、夜间症状评分及血清单核细胞趋化蛋白-1(MCP-1)、白三烯B4(LTB4)、免疫球蛋白E(IgE)、呼出气一氧化氮(FeNO)比较:联合组<对照B组<对照A组(P<0.05),第1秒用力呼气容积(FEV_(1))、呼气峰值流速(PEF)、50%呼气流速(MEF50%)、25%呼气流速(MEF25%)比较:联合组>对照B组>对照A组(P<0.05);联合组不良反应总发生率高于对照B组和对照A组,但3组间差异无统计学意义(P>0.05)。结论宣肺平喘汤联合沐舒坦、胸腺肽治疗小儿BA效果确切,有利于减轻变态反应和炎症反应,改善肺功能,且安全性高。

大剂量盐酸氨溴索在AECOPD治疗中的临床疗效观察

目的探讨大剂量的盐酸氨溴索在慢性阻塞性肺病急性发作(AECOPD)治疗中的疗效。方法通过采集该院70例住院病人(治疗组36例,对照组34例)入组治疗后的临床资料,分析其临床及实验室检查的特点。结果治疗组患者在使用大剂量的盐酸氨溴索后,其临床症状改善及肺功能的改善较对照组差异有显著性。结论大剂量的盐酸氨溴索在AECOPD治疗中对改善患者的临床症状及肺功能有明显的疗效,值得在临床实践中广泛使用。

大剂量沐舒坦对老年重症肺炎的疗效观察

目的探讨大剂量沐舒坦静滴治疗老年性重症肺炎的临床疗效。方法随机将符合诊断老年性重症肺炎病例60例分为治疗组和对照组各30例,两组均予以机械通气、解痉、抗感染及营养支持等常规治疗,对照组予以常规沐舒坦(30mg Q8 H)静脉推注,治疗组予以大剂量沐舒坦(500mg Q12 H)静脉滴注,治疗前、治疗后7天分析所有入选病例临床症状、血气、血常规等指标改善情况及不良反应发生情况。结果治疗组在临床综合疗效,症状体征改善及实验室指标改善方面均明显优于对照组(P<0.05),且不良反应发生率较低。结论早期长程的大剂量沐舒坦对老年重症肺炎是安全有效的,可以阻止病情进一步加重。

沐舒坦糖浆临床疗效随机对照研究

观察口服沐舒坦糖浆对咳嗽痰多患儿的临床疗效 ,将120例1～12岁患儿随机分为沐舒坦糖浆组60例、急支糖浆组60例 ,疗程7天。结果显示沐舒坦糖浆服用第3天可使痰量减少、咳痰程度减轻、痰液性状转稀和咳嗽症状减轻 ,至第7天可使抗生素使用频率降低 ,临床症状综合改善率74.7 % ,总有效率71.6 %。表明沐舒坦糖浆化痰祛痰止咳疗效可靠 ,具有良好的安全性和依从性。

沐舒痰临床疗效验证63例总结

口服沐舒痰(盐酸氨溴索)3次/d,30mg/次,共服3周,对慢性支气管炎、支气管扩张及矽肺共63例进行治疗。未给其他镇咳、祛痰剂。除治疗开始前和疗程开始时一直服用同一种抗生素外,中途未服用任何抗生素。观察结果表明,痰量减少中度以上者有45/63例(71.4%),咳嗽减轻达中度以上者有59/63(93.7%)例。对沐舒痰总疗效评价在中等以上者达82.6%,该药无副作用。

注射用盐酸氨溴索祛痰作用的疗效和安全性评价

目的 :评价注射用盐酸氨溴索祛痰作用的临床疗效及安全性 .方法 :以沐舒坦注射液为对照药 ,采用随机单盲、平行对照的试验方法 ,试验组与对照组各 1 8例 .试验组给予注射用盐酸氨溴索 ,每次 30mg ,对照组给予沐舒坦注射液 ,每次 30mg ,均为缓慢iv ,每日 2次 ,疗程 5 7d .结果 :两组总有效率分别为 89%和 94 % ,试验组与对照组的药物不良反应发生率分别为 1 1 %和 6 % .两组总有效率和不良反应发生率均无统计学差异 (P >0 .0 5 ) .结论 :注射用盐酸氨溴索是一种安全。

大剂量氨溴索联合气管镜治疗高位截瘫患者肺部感染临床研究

目的观察大剂量氨溴索联合纤支镜在治疗高位截瘫患者合并肺部感染的临床效果。方法合并严重肺部感染的高位截瘫患者30例，随机分成3组：小剂量氨溴索组（氨溴索30mg，壶入3次／d）；大剂量氨溴索组（氨溴索300mg，壶入3次／d）；联合治疗组（氨溴索300mg，壶入3次，d），联合纤支镜下吸痰治疗。比较各组患者治疗前以及治疗第3d，第7d的临床效果、体征、X线表现、血气分析及呼吸机使用时间等。结果大剂量组患者在临床效果、体征及X线表现好转程度明显优与小剂量组（均P〈0．05），且感染控制及脱机时间均显示缩短。联合治疗组较大剂量组治疗效果更加明显。结论对高位截瘫合并肺部感染患者，应用大剂量氨溴索可以有效化痰，控制感染，减少控制感染时间，减少呼吸机辅助呼吸时间，联合纤支镜治疗效果更好。

沐舒坦经超声电导透皮给药治疗小儿支气管肺炎的临床疗效观察

目的探讨沐舒坦经超声电导透皮给药治疗小儿支气管肺炎的临床疗效。方法将319例小儿支气管肺炎患儿随机分为3组,将沐舒坦注射液分别以超声电导透皮(Ⅰ组,n=107)、雾化吸入(Ⅱ组,n=103)、静脉推注(Ⅲ组,n=109)3种方式给药,对比分析3种给药方式的疗效及不良反应。结果Ⅰ组显效73例(68.22%),好转32例(29.91%),无效2例(1.87%);Ⅱ组显效55例(53.40%),好转37例(35.92%),无效11例(10.68%);Ⅲ组显效38例(34.86%),好转47例(43.12%),无效24例(21.02%),3组患儿的疗效间差异有统计学意义(Hc=30.739,P<0.05)。组间两两比较,Ⅰ组与Ⅱ组的疗效间差异有统计学意义(P<0.05),Ⅰ组与Ⅲ组的疗效间差异有统计学意义(P<0.05),Ⅱ组与Ⅲ组的疗效间差异也有统计学意义(P<0.05)。结论沐舒坦经超声电导透皮给药具有高效、低创伤、无痛苦、易操作及可配合性高的优点,是儿科临床较有前景的给药途径。

盐酸氨溴索治疗分泌性中耳炎疗效观察

目的观察盐酸氨溴索 (沐舒坦 )治疗分泌性中耳炎的疗效。 方法 76例 ( 81耳 )分泌性中耳炎患者随机分二组 ,用药组 40例 ,用沐舒坦针剂鼓室内注射并口服沐舒坦 ;对照组 36例 ,用地塞米松和α -糜蛋白酶针剂混合液行鼓室内注射 ,比较治疗前后的临床症状、体征、纯音测听和鼓室图的变化情况。 结果治疗后 2～ 3周随访 ,用药组中 2 4例 2 5耳显效 ,12例 15耳有效 ,4例 5耳无效 ,总有效率达 88.9%。对照组中 14例 14耳显效 ,9例 9耳有效 ,13例13耳无效 ,总有效率 6 3.9%。 结论沐舒坦是治疗分泌性中耳炎的一种安全有效的药物。