Research progress on pharmacology and adverse reactions of gastrodin

Gastrodin(4-hydroxymethylphenyl-β-d-glucopyranoside)is an active ingredient with high content,which is isolated from the rhizome of Gastrodia elata.Gastrodin injections,tablets and capsules are currently the main gastrodin-related preparations in clinical practice,and gastrodin injections are the most widely used.This article will summarize pharmacology and adverse reactions of gastrodin to evaluate its safety,effectiveness and quality control.Gastrodin has pharmacological effects on central nervous system(vertigo,headache,insomnia,neurasthenia,convulsions and epilepsy,etc.),cardiovascular system and other diseases(osteoporosis,osteoarthritis and bone injury,etc.),but we still need to pay attention to its clinical adverse reactions(some patients may have dry mouth and nose,dizziness and stomach discomfort).In addition,further research is needed in other fields,such as health products,food,cosmetics,etc.We also need to further develop and explore the new pharmacological effects of gastrodin and expand its medicinal value.

Study on the Management Effect of Pharmaceutical Care on Adverse Reactions of Traditional Chinese Medicines in Joint Surgery and Neurology

Objective:In general hospitals,pharmaceutical care was carried out to reduce the incidence of adverse drug reactions(ADR),and this effect was significant.It can significantly reduce the incidence of adverse drug reactions and improve the safety of drug therapy.The Joint Surgery Department and the Department of Neurology of Changle County People's Hospital in Shandong province were investigated for the effect of pharmaceutical care on reducing adverse drug reactions.Methods:120 patients were selected from the Department of Joint Surgery and Neurology,Changle County People's Hospital,Shandong Province from May 2015 to May 2020.According to the random table method,the patients were divided into experimental group(60 cases)and control group(60 cases).Control group:routine drug therapy.Experimental group:pharmaceutical care treatment was carried out jointly,and the incidence of adverse reactions was compared between the two groups.Results:The incidence of adverse reactions in experimental group was lower than that in control group.Conclusion:In general hospitals,pharmaceutical care is effective in reducing adverse drug reactions,which can significantly reduce the incidence of adverse drug reactions.At the same time,this improves the safety of drug treatment,which is worthy of clinical promotion.

Research Progress on Pharmacology and adverse reactions of hirudin

Hirudin is an active ingredient extracted from leeches(Hirudo).At present,there are many hirudin preparations on the market,which are roughly divided into three categories,the first is natural hirudin,the second is hirudin derivatives such as lepirudin,desirudin and bivalirudin,and the third is new hirudin preparations such as hirudin-bovine serum albumin(BSA)nanoparticles,polydopamine fitted titanium dioxide nanoparticles systems and recombinant hirudins-2(rhv2)-loaded picmice.The pharmacological effects and adverse reactions of hirudin were reviewed to evaluate its safety,efficacy and quality control.Hirudin has obvious pharmacological effects on cardio-cerebrovascular diseases(coronary atherosclerotic heart disease,myocardial infarction,hyperlipidemia,cerebral infarction,arteriosclerosis obliterans of lower extremities),angiogenesis(fracture,skinflaptransplantation),tissue fibrosis,tumor,ophthalmopathy,hyperuricemia and female infertility.However,attention should be paid to clinical adverse reactions(bleeding,allergic reaction,infection,cutaneous pseudolymphoma).

Observation of therapeutic effects of point application at Shenque(CV 8)plus moxa-salt hot compress for prevention of gastrointestinal adverse reactions after chemotherapy for non-Hodgkin Iymphoma

Objective:To observe the clinical efficacy of point application with De Huang(Rhizome Rhei Crude)powder at Shenque(CV 8)plus moxa-salt hot compress on the umbilicus for preventing gastrointestinal adverse reactions after chemotherapy for non-Hodgkin lymphoma(NHL).Methods:A total of 60 cases with NHL under chemotherapy were divided into two groups by hospitalization order,with 30 cases in each group.The control group was treated with routine nursing and the observation group was additionally given point application with Da Hueng(Rhizome Rhei Crude)powder plus moxa-salt hot compress on the umbilicus,to compare the effect in preventing gastrointestinal adverse reactions after chemotherapy between the two groups.Results:The occurrence rates of constipation,nausea,vomiting and poor appetite on the second day and fifth day after chemotherapy were obviously lower in the observation group than those in the control group,with statistically significant differences between the two groups(all P〈0.05).Conclusion;The point application with De Hueng(Rhizome Rhei Crude)powder at Shenque(CV 8)plus maxa-salt hot compress on the umbilicus can produce more significant efficacy in preventing the gastrointestinal adverse reactions after chemotherapy for NHL than routine nursing.Moreover,it is simple and easy to be used and popularized.

Why Don’t We Adequately Identify and Manage Adverse Drug Reactions despite Having the Needed Information?

Importance/Objective: Adverse Drug Reactions (ADRs) are unavoidable, but recognizing and addressing ADRs early can improve wellness and prevent permanent injury. We suggest that available medical information and digital/electronic methods could be used to manage this major healthcare problem for individual patients in real time. Methods: We searched the available digital applications and three literature databases using the medical subject heading terms, adverse drug reaction reporting systems or management, filtered by clinical trial or systemic reviews, to detect publications with data about ADR identification and management approaches. We reviewed the reports that had abstract or summary data or proposed or implemented methods or systems with potential to identify or manage ADRs in clinical settings. Results: The vast majority of the 481 reports used retrospectively collected data for groups of patients or were limited to surveying one population group or class of medication. The reports showed potential and definite associations of ADRs for specific drugs and problems, mostly, but not exclusively, for patients in hospitals and nursing homes. No reports described complete methods to collect comprehensive data on ADRs for individual patients in a healthcare system. The digital applications have ADR information, but all are too cumbersome or incomplete for use in active clinical settings. Several studies suggested that providing information about potential ADRs to clinicians can reduce these problems. Conclusion and Relevance: Although investigators and government agencies agree with the need, there is no comprehensive ADR management program in current use. Informing the patient’s healthcare practitioners of potential ADRs at the point of service has the potential for reduction of these complications, which should improve healthcare and reduce unneeded costs.

Clinical characteristics of gastrointestinal immune-related adverse events of immune checkpoint inhibitors and their association with survival

BACKGROUND Despite the popularity of immune checkpoint inhibitors(ICIs)in the treatment of advanced cancer,patients often develop gastrointestinal(GI)and non-GI immune-related adverse events(irAEs).The clinical characteristics and survival outcomes of GI-irAEs have not been fully elucidated in previous reports.This necessitates the evaluation of the impact of GI-irAEs on patients receiving ICI treatment.AIM To evaluate the clinical characteristics of GI-irAEs and their impact on survival in patients treated with ICIs.METHODS In this single-center,retrospective,observational study,we reviewed the records of 661 patients who received ICIs for various cancers at Nagoya University Hospital from September 2014 to August 2020.We analyzed the clinical characteristics of patients who received ICI treatment.We also evaluated the correlation between GI-irAE development and prognosis in non-small cell lung cancer(LC)and malignant melanoma(MM).Kaplan-Meier analysis was used to compare the median overall survival(OS).Multivariate Cox proportional hazards models were used to identify prognostic factors.A P value<0.05 was considered statistically significant.RESULTS GI-irAEs occurred in 34 of 605 patients(5.6%)treated with an anti-programmed cell death-1/programmed death-ligand 1(anti-PD-1/PD-L1)antibody alone and in nine of 56 patients(16.1%)treated with an anti-cytotoxic T-lymphocyte antigen 4(CTLA-4)antibody alone or a combination of anti-PD-1 and anti-CTLA-4 antibodies.The cumulative incidence and median daily diarrhea frequency were significantly higher in patients receiving anti-CTLA-4 antibodies(P<0.05).In 130 patients with MM,OS was significantly prolonged in the group that continued ICI treatment despite the development of GI-irAEs compared to the group that did not experience GI-irAEs(P=0.035).In contrast,in 209 patients with non-small cell LC,there was no significant difference in OS between the groups.The multivariate analyses showed that a performance status of 2-3(hazard ratio:2.406;95%confidence interval:1.125–5.147;P=0.024)was an independent predictive factor for OS in patients with MM.CONCLUSION Patients receiving anti-CTLA-4 antibodies develop GI-irAEs more frequently and with higher severity than those receiving anti-PD-1/PD-L1 antibodies.Continuing ICI treatment in patients with MM with GI-irAEs have better OS.

Progress in the Research of Radix Astragali in Treating Chronic Heart Failure:Effective Ingredients,Dose-Effect Relationship and Adverse Reaction

Radix Astragali,a Chinese herbal medicine possessing important cardiovascular pharmacologic effects,is widely applied for the treatment of chronic heart failure（CHF） in clinical practice.This paper summarizes briefly the researches in the last 10 years on its chemical compositions,effective ingredients for improving cardiac function,dose-effect relationship in treating CHF,and adverse reactions that occurred in clinical practice.

Clinical efficacy of gamma-oryzanol combined with Femoston for perimenopausal syndrome

BACKGROUND Perimenopausal syndrome(PMS)is a chronic disease associated with estrogen deficiency.Because of the unsatisfactory outcomes of current conventional treatments for this condition,its treatment must be continuously explored and optimized.AIM To assess the clinical effectiveness ofγ-oryzanol in combination with Femoston for PMS.METHODS A total of 119 patients with PMS were selected from June 2023 to December 2023,which included 59 and 60 patients in the control and observation group,respectively.The control and observation groups were treated with Femoston andγ-oryzanol+Femoston,respectively.Comparative analyses were performed in terms of clinical effectiveness,safety(dizziness and headache,nausea and vomiting,and breast tenderness),sex hormones[estradiol(E2),luteinizing hormone(LH),and follicle-stimulating hormone(FSH)],lumbar spine(L1-4)and bilateral femoral bone mineral density(BMD),and sleep quality(sleeping time and frequency of awakenings from sleep).RESULTS Compared with the control group,the observation group had statistically higher total effective rates of treatment;lower overall incidence of adverse events;higher post-treatment E2 levels and L1-4 and bilateral femoral BMD;and lower LH and FSH levels,sleeping time,and frequency of awakenings from sleep after treatment.CONCLUSION Therefore,for the treatment of PMS,γ-oryzanol combined with Femoston is significantly better than Femoston alone in terms of clinical effectiveness,exhibiting more pronounced clinical advantages in improving safety,sex hormone levels,BMD,and sleep quality.

Appropriateness of Amikacin Dose Prescription, Monitoring and Safety during Hospitalization as an Impact of Clinical Pharmacologist Intervention, in the Israeli Regional Hospital

Background: Use of inappropriate amikacin dose is one of the most important factors in inducing toxicity, prolonged hospitalization as well as in increasing patient’s mortality. Objective: The aims of this study are the analysis of amikacin dose, serum level and the examination of the effectiveness of the clinical pharmacologist (CP) therapeutic drug monitoring (TDM) intervention to guarantee the safety of amikacin use. Methods: This is a one-year retrospective observational chart review study, which evaluates amikacin dose, serum drug level, development of adverse effects in patients on amikacin with or without CP TDM consultation. Results: Amikacin was prescribed for 393 complex patients, with median age 83. Amikacin group (AG) included 140 (32%) courses with CP consultation (AG1) and 292 (68%) courses without CP consultation (AG2). The distribution of most study characteristics in both groups was similar including amikacin dose (9-10 mg/kg/day), renal failure (14%) and mortality (12%). Acceptance for CP consultation was in 46% of amikacin courses and dose changes were done in 63% after CP intervention. Prolonged antibiotic course (4.6 ± 1.5 vs 3.8 ± 1.6 days, p < 0.0001) and the patient’s hemodynamic instability (15% vs 7%, p = 0.01) were more frequent in the AG1 compared to the AG2. There was a strong association between CP consultation and prolonged hospitalization (p = 0.005), while no association between it and amikacin adverse effects, renal failure or mortality. Conclusions: There was no trend to reducing amikacin toxicity, days of hospitaliza tion or mortality in patients with CP consultation. CP TDM intervention was more in the management of complicated clinical situations. However, it is necessary to optimize it.

Clinical Application Analysis of Andrographolide Total Ester Sulfonate Injection,a Traditional Chinese Medicine Licensed in China

Andrographolide total ester sulfonate（ATES） injection is one of the products of traditional Chinese medicine（TCM） currently used against viral infection in China.ATES injection was approved for manufacturing and marketing in January 2002.It is indicated for acute respiratory infections,tonsillitis,chronic obstructive pulmonary disease,influenza,foot and mouth disease,bronchiolitis,herpangina,mumps,infectious mononucleosis and psychosis.However,its usage also carries risk.We investigated the use of ATES at the Wuhan Union Hospital from January 2014 to December 2014 and evaluated its real-world clinical application using the hospital centralized monitoring method.A total of 848 cases were enrolled in this study.In these cases,it was mainly used for postoperative anti-inflammation and treating upper respiratory infection,pneumonia and bronchitis.Among them,39.86% were contraindicated.Irregular medication of adults and children accounted for 1.91% and 23.38%,respectively.Improper choice of solvent accounted for 3.18%.The choice of intravenous drip versus aerosol inhalation was reasonable.A case of adverse events（AEs） was observed in the monitoring period,and the incidence of adverse drug reaction（ADR） of ATES injection was 0.12%.ATES injection in our hospital is relatively safe with a low incidence of adverse reactions.The study assesses the clinical usage and adverse reactions of ATES injection,and provides suggestions for rational use in clinical practice.

热毒宁注射液不良反应325例分析

目的探讨热毒宁注射液不良反应发生的规律及特点,为临床合理用药提供依据。方法对2012年1月至2022年12月武汉市药品不良反应监测中心数据库中收集的325例热毒宁注射液药物不良反应(ADR)报告进行统计分析。结果325例热毒宁注射液ADR报告中,6岁以下儿童发生ADR居多,多数为联合用药(52.62%);不合理用药导致ADR的影响因素为用药剂量不合理(14.77%)、超适应证用药(1.54%)、溶媒不合理(1.54%);ADR主要发生在用药30 min内,累及系统-器官与临床表现主要为皮肤及其附件损害(52.71%),全身性损害次之(21.26%)。结论临床上需加强儿童病人(尤其是6岁以下)使用热毒宁注射液的ADR风险管理,应尽量避免循证医学证据不足的超剂量用药、超适应证及联合用药等不合理使用,避免增加ADR发生风险,保障热毒宁注射液的安全有效使用。

麻杏石甘汤联合阿莫西林钠克拉维酸钾对肺部感染患儿炎症指标的影响

目的观察麻杏石甘汤联合阿莫西林钠克拉维酸钾治疗肺部感染患儿的临床疗效以及对炎症等指标影响。方法研究总计纳入肺部感染患儿85例,患儿均由医院儿科2020年12月—2023年2月收治,符合肺部感染诊断,以随机数字表法将患儿分为对照组(42例)与观察组(43例),给予对照组患儿阿莫西林钠克拉维酸钾治疗,给予观察组患儿阿莫西林钠克拉维酸钾结合麻杏石甘汤治疗,治疗过程中对照组脱落1例,观察组脱落2例,观察各组患儿数据:患儿治疗效果、发热消失时间、肺部感染吸收时间、止咳时间、心率呼吸复常时间与肺部啰音消失时间、治疗前后患儿中医证候(咳嗽、气喘、咳痰、发热、烦躁不安等)积分变化、炎症因子指标变化与肺功能指标变化、氧合指数与肺部感染评分变化、住院时间与医疗费用、治疗不良反应。结果观察组患儿治疗效果优于对照组患儿(P<0.05);较对照组患儿,观察组患儿的发热消失时间、肺部感染吸收时间、止咳时间、心率呼吸复常时间与肺部啰音消失时间均更短(P<0.05);治疗前各组患儿中医证候(咳嗽、气喘、咳痰、发热、烦躁不安等)积分、肿瘤坏死因子α(Tumour necrosis factor-α,TNF-α)与白介素-6(Interleukin 6,IL-6)、白介素-8(Interleukin 8,IL-8)等炎症因子指标、用力肺活量(Forced vital capacity,FVC)与第1秒用力呼气容积(Forced expiratory volume in one second,FEV1)等肺功能指标、氧合指数与肺部感染评分比较,P>0.05,治疗后各组患儿中医证候(咳嗽、气喘、咳痰、发热、烦躁不安等)积分、炎症因子指标(TNF-α、IL-6及IL-8)、肺功能指标(FVC及FEV1)、氧合指数与肺部感染评分等指标均改善,观察组患儿治疗后中医证候(咳嗽、气喘、咳痰、发热、烦躁不安等)积分、炎症因子指标(TNF-α、IL-6及IL-8)、肺功能指标(FVC及FEV1)、氧合指数与肺部感染评分等指标均优于对照组患儿(P<0.05);观察组患儿住院时间短于对照组患儿,住院费用少于对照组患儿(P<0.05);各组患儿不良反应率均较低(P>0.05)。结论麻杏石甘汤联合阿莫西林钠克拉维酸钾治疗肺部感染患儿疗效确切,患儿症状改善,恢复快,肺功能好转,治疗不良反应较少,治疗安全可靠,值得应用。

八珍化积汤联合卡瑞利珠单抗治疗晚期食管癌的临床效果

目的:探讨八珍化积汤联合卡瑞利珠单抗治疗晚期食管癌的临床效果。方法:回顾性分析2022年5月-2023年7月于中国科学院合肥肿瘤医院和安徽省中医院西区就诊的104例晚期食管癌患者临床资料,依据治疗方法分组,其中52例采用卡瑞利珠单抗治疗,纳入常规组,52例采用八珍化积汤联合卡瑞利珠单抗治疗,纳入联合组。对比两组患者的中医证候积分、血清程序性死亡受体1(PD-1)、程序性死亡受体配体(PD-L1)、鳞状细胞癌抗原(SCC-Ag)、癌胚抗原(CEA)、卡氏功能状态(KPS)评分、T细胞亚群CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、树突状细胞(DC)、临床疗效、不良反应发生情况。结果:治疗后,联合组患者中医证候积分低于常规组(P<0.01);联合组PD-1、PD-L1水平低于常规组(P<0.01);联合组SCC-Ag及CEA水平均低于常规组(P<0.01);联合组KPS评分高于常规组(P<0.01);联合组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、DC水平均高于常规组(P<0.05);联合组患者治疗总有效率高于常规组(P<0.05);两组1~2级不良反应总发生率差异无统计学意义(P>0.05)。结论:八珍化积汤联合卡瑞利珠单抗能够改善晚期食管癌患者血清学指标及肿瘤标志物水平,降低中医证候积分,提高患者免疫功能及临床疗效,延长患者生存期,安全性较高。

富马酸伏诺拉生联合阿莫西林治疗幽门螺杆菌感染的临床效果

目的观察富马酸伏诺拉生联合阿莫西林治疗幽门螺杆菌感染的临床效果。方法选取2023年1月—2024年1月临沂市中心医院收治的幽门螺杆菌感染患者62例,采用随机数字表法分为研究组和对照组,每组31例。对照组采用常规四联疗法治疗,研究组采用富马酸伏诺拉生联合阿莫西林治疗,2组均治疗1个月。比较2组临床疗效,治疗前后症状积分、炎性指标[白介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、C反应蛋白(CRP)]水平,幽门螺杆菌根除率、复发率及不良反应。结果研究组总有效率(96.77%)高于对照组(80.65%)(χ^(2)=4.026,P=0.045)。治疗1个月后,2组上腹痛、反酸嗳气、恶心呕吐积分均低于治疗前,且研究组低于对照组(P<0.05或P<0.01);2组IL-2、TNF-α、IL-6及CRP水平均低于治疗前,且研究组低于对照组(P<0.01)。研究组幽门螺杆菌根除率为96.77%(30/31),高于对照组的80.65%(25/31)(χ^(2)=4.026,P=0.045);研究组疾病复发率为3.33%(1/30),低于对照组的28.00%(7/25)(χ^(2)=4.838,P=0.028)。研究组不良反应总发生率(3.23%)低于对照组(19.35%)(χ^(2)=4.026,P=0.045)。结论富马酸伏诺拉生联合阿莫西林治疗幽门螺杆菌感染的疗效较好,安全性较高,可改善患者症状,降低血清炎性指标,提升幽门螺杆菌根除率,降低疾病复发率。

吸入用盐酸氨溴索溶液联合孟鲁司特钠咀嚼片治疗小儿喘息性支气管肺炎的临床效果

目的观察吸入用盐酸氨溴索溶液联合孟鲁司特钠咀嚼片治疗小儿喘息性支气管肺炎的临床效果。方法选取2021年8月—2022年10月萍乡市妇幼保健院接诊的喘息性支气管肺炎患儿60例,利用随机数字表法分为观察组和对照组,每组30例。对照组给予布地奈德、特布他林雾化吸入等常规治疗,观察组在对照组基础上加用吸入用盐酸氨溴索溶液联合孟鲁司特钠咀嚼片治疗,2组均治疗7 d。比较2组治疗效果、临床症状改善时间、住院时间,治疗前后白细胞计数、中性粒细胞计数、C反应蛋白(CRP)水平及不良反应。结果观察组治疗总有效率为100.00%,高于对照组的76.67%(χ^(2)=7.925,P=0.005);观察组喘息、哮鸣音、咳嗽、发热改善时间及住院时间短于对照组(P<0.01)。治疗7 d后,2组白细胞计数、中性粒细胞计数、CRP水平均低于治疗前,且观察组低于对照组(P<0.01)。观察组与对照组不良反应总发生率比较差异无统计学意义(3.33%vs.6.67%,P=1.000)。结论吸入用盐酸氨溴索溶液联合孟鲁司特钠咀嚼片治疗小儿喘息性支气管肺炎的疗效显著,能缩短患儿康复时间,改善炎性指标水平,且安全性较高。

胡氏益胃汤结合针刺疗法治疗慢性萎缩性胃炎临床观察

目的观察胡氏益胃汤结合针刺疗法治疗慢性萎缩性胃炎临床效果和安全性。方法纳入104例慢性萎缩性胃炎患者(2021年1月—2023年6月收治)进行分组研究,分组方法为随机数字表法,将其随机分为对照组与中医组,给予对照组患者(52例)西药(呋喃唑酮片、西沙比利片)治疗,中医组在对照组西药治疗基础上结合胡氏益胃汤以及针刺疗法治疗,研究过程中中医组脱落3例,对照组脱落1例。观察各组患者临床数据情况:疗效、治疗前后中医证候积分(胃脘痞闷及反酸嗳气、腹痛胀满)变化及胃镜指标(肠化程度、胃黏膜特征以及胃萎缩程度)评分变化、血清胃肠激素指标(胃动力素以及生长抑制素胃泌素)变化、白介素-6(Interleukin-6,IL-6)及白介素-8(Interleukin-8,IL-8)、肿瘤坏死因子α(Tumour necrosis factor-α,TNF-α)等血清炎性因子水平变化、治疗前后幽门螺杆菌(HP)阳性率变化、T淋巴细胞(Human lymphocyte CD_(4)^(+),human lymphocyte CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))变化、不良反应。结果中医组患者治疗效果优于对照组(P<0.05);治疗前各组患者中医证候积分(胃脘痞闷及反酸嗳气、腹痛胀满)、胃镜指标(肠化程度、胃黏膜特征以及胃萎缩程度)评分、血清胃肠激素指标(胃动力素以及生长抑制素、胃泌素)、血清炎性因子水平(IL-6、IL-8及TNF-α)、HP阳性率、免疫功能指标(CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))比较,P>0.05,治疗后各组患者中医证候积分(胃脘痞闷及反酸嗳气、腹痛胀满)及胃镜指标(肠化程度、胃黏膜特征以及胃萎缩程度)评分、胃泌素水平、IL-6、IL-8及TNF-α水平、HP阳性率、CD_(8)^(+)指标均下降,胃动力素以及生长抑制素水平、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)指标均上升,中医组治疗后各项指标上升及下降程度均大于对照组患者(均P<0.05);中医组与对照组不良反应率均较低(P>0.05)。结论胡氏益胃汤结合针刺疗法治疗慢性萎缩性胃炎临床效果显著,可有效改善患者症状,缓解患者病情,改善患者胃肠功能及免疫功能,降低HP阳性率,治疗不良反应少,安全可靠。

伢典微创凝胶治疗小儿乳牙龋齿的临床效果研究

目的探讨小儿乳牙龋齿施以伢典微创凝胶治疗的价值。方法80例龋齿患儿,随机分为研究组和对照组,每组40例。对照组采用常规磨牙去龋治疗,研究组采用伢典微创凝胶治疗。比较两组临床效果,龈沟液炎症因子[白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)]水平,疼痛和配合度评分,并发症发生情况。结果研究组总有效率92.5%较对照组的75.0%高(P<0.05)。治疗后,研究组龈沟液IL-6(2.0±0.3)ng/L、TNF-α(3.0±0.2)ng/L均较对照组的(5.8±0.5)、(4.5±1.0)ng/L低(P<0.05)。研究组疼痛评分(3.4±0.6)分较对照组的(6.5±1.0)分低,配合度评分(5.1±0.4)分较对照组的(3.3±0.5)分高(P<0.05)。研究组并发症发生率5.0%较对照组的20.0%低(P<0.05)。结论在小儿乳牙龋齿治疗中采用伢典微创凝胶的效果好,且并发症少,值得应用和推广。

帕拉米韦与奥司他韦治疗流行性感冒患儿的效果比较

目的:比较帕拉米韦与奥司他韦治疗流行性感冒(简称流感)患儿的效果。方法:回顾性分析2022年6月至2023年6月该院收治的88例流感患儿的临床资料,按照治疗方法不同将其分为对照组和观察组各44例。两组均给予常规治疗,在此基础上,对照组给予奥司他韦治疗,观察组给予帕拉米韦治疗。比较两组临床症状(发热、咳嗽、流涕、咽喉肿痛、关节酸痛)持续时间,治疗前后炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]、T细胞亚群指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平,以及不良反应发生率。结果:观察组发热、咳嗽、流涕、咽喉肿痛、关节酸痛等临床症状持续时间均短于对照组,差异有统计学意义(P<0.05);治疗后,观察组TNF-α、IL-6、CRP水平均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组,CD8^(+)水平低于对照组,差异均有统计学意义(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:帕拉米韦治疗流感患儿可缩短临床症状持续时间,降低炎性因子水平,改善T细胞亚群指标水平,效果优于奥司他韦治疗。

替罗非班联合双联抗血小板治疗伴H型高血压的急性脑梗死患者对神经功能及预后的影响

目的探讨替罗非班联合双联抗血小板在伴H型高血压的急性脑梗死(ACI)患者中的治疗效果。方法选取2021年8月至2024年4月莒南县中医医院收治的112例伴H型高血压的ACI患者资料,按不同治疗方法分为两组,各56例。对照组给予双联抗血小板治疗,观察组在对照组基础上加用替罗非班治疗。对比两组临床疗效、美国国立卫生研究院卒中量表(NIHSS)及改良Rankin量表(mRS)评分、血液流变学指标及不良反应。结果观察组总有效率94.64%,高于对照组的82.14%(P<0.05);治疗后NIHSS(8.78±1.73)分、mRS(1.24±0.29)分、全血高切黏度(HBV)为(4.23±0.72)mPa·s、血浆黏度(PV)为(1.58±0.11)mPa·s、低切黏度(LBV)为(8.15±1.16)mPa·s、纤维蛋白原(FIB)为(2.87±0.35)g/L,低于对照组的(10.92±2.04)分、(1.59±0.23)分、(5.62±1.14)mPa·s、(1.68±0.13)mPa·s、(9.54±1.34)mPa·s、(3.34±0.46)g/L(P<0.05);两组不良反应相比无统计学差异(P>0.05)。结论替罗非班联合双联抗血小板可增强伴H型高血压的ACI患者临床治疗效果,减轻神经损伤,改善血液流变学等指标,安全性高。

Meta-analysis of single strain probiotics for the eradication of Helicobacter pylori and prevention of adverse events

AIM:To assess the efficacy and safety of single strain probiotics for the:(1) eradication of Helicobacter pylori(H.pylori);(2) prevention of adverse events;and(3) prevention of antibiotic-associated diarrhea associated with eradication therapy.METHODS:We searched Pub Med(1960-2014),EMBASE(1974-2014),Cochrane Database of Systematic Reviews(1990-2014),and ISI Web of Science(2000-2014).Additionally,we conducted a grey literature search including contact with National Institutes of Health Clinical Trials Registry,abstracts from annual infectious disease and gastroenterology meetings,experts in the field and correspondence with authors.Randomized controlled trials of H.pylori positive adults or children treated with eradication therapy and assessing the adjunctive therapy with a single strain of probiotics were included.The primary outcomes were the rates of eradication of H.pylori and frequency of patients with adverse events or antibiotic-associated diarrhea.Outcomes were pooled using fixed or random-effects models to calculate the relative risk and corresponding 95%CI and weighted on study size.To explore possible explanations for heterogeneity,a priori subgroup analyses were conducted on daily probiotic dose,study population,and quality of the study.The overall quality of the evidence for each probiotic strain was assessed using the GRADE criteria.RESULTS:A total of 25 randomized controlled trials(28 treatment arms,with a total of 3769 participants) assessed one of six single probiotic strains as adjunctive treatments to standard eradication therapy.Only one probiotic strain significantly improved H.pylori eradication rates:Saccharomyces boulardii(S.boulardii) CNCM I-745 [pooled relative risks(p RR) = 1.11,95%CI:1.07-1.16].Only one probiotic strain(S.boulardii CNCM I-745) significantly prevented any adverse events(p RR = 0.42,95%CI:0.28-0.62).Both S.boulardii CNCM I-745 and Lactobacillus rhamnosus GG significantlyreduced antibiotic-associated diarrhea(p RR = 0.47,95%CI:0.37-0.60 and p RR = 0.29,95%CI:0.17-0.48,respectively) associated with H.pylori eradication therapy.Meta-regression of sub-groups did not detect significant differences by dose,adult vs pediatric,symptom status,or study quality,but did find significant differences by the strain of probiotic.Potential mild publication bias was found for antibiotic-associated diarrhea,but not for eradication or adverse event outcomes.Analysis of the study quality illuminated areas for improvement in future studies(use of placebos,study size calculations,attrition reasons and discussion of limitations and generalizability).CONCLUSION:The pooled evidence suggests that the adjunctive use of a few probiotic strains may improve H.pylori eradication rates and prevent the development of adverse events and antibiotic-associated diarrhea in those treated with standard eradication therapies.The type of probiotic strain was the most important factor in predicting efficacy.