CRRT中不同治疗剂量对血小板数量的影响

目的探讨在CRRT治疗中不同治疗剂量对血小板数量的影响。方法对36例需行CRRT治疗的患者分为传统治疗剂量组和低治疗剂量组,选择相同的滤器,观察治疗前后血小板的数量、肾功能的指标及C-反应蛋白的变化,应用统计学方法进行分析不同治疗剂量对上述指标的影响有否差异。结果低治疗剂量组对血小板数量影响比传统治疗剂量组小,且能降低肌酐及尿素氮,但不能降低C-反应蛋白。结论 CRRT中低治疗剂量对血小板数量影响小,可用于肾功能衰竭伴血小板减少需行CRRT治疗的危重症患者。

小剂量低压力灌洗法治疗急性中毒所致上消化道出血的效果研讨

目的:探讨用小剂量低压力灌洗法治疗急性中毒所致上消化道出血的临床效果。方法:选取2019年4月至2020年4月期间云南省景洪市第一人民医院收治的62例急性中毒所致上消化道出血患者作为研究对象。采用双盲法将这些患者分为对照组和观察组,每组各有31例患者。两组患者入院后,均对其进行常规治疗。在此基础上,对观察组患者进行小剂量低压力灌洗治疗。比较两组患者治疗的效果。结果:治疗后,观察组患者治疗的有效率高于对照组患者,P<0.05;其并发症的发生率低于对照组患者,P<0.05;其胃液潜血试验结果转阴的时间短于对照组患者,P<0.05。观察组中死亡危险程度为高危、中危的患者所占的比例均低于对照组中相应患者的占比,P<0.05;观察组中死亡危险程度为低危的患者所占的比例高于对照组中相应患者的占比,P<0.05。结论:用小剂量低压力灌洗法对急性中毒所致上消化道出血患者进行治疗的效果较为理想,安全性较高。

Aspirin-induced small bowel injuries and the preventive effect of rebamipide

AIM:To evaluate the influence of taking low-dose aspirin for 4 wk on small intestinal complications and to examine the preventive effect of rebamipide.METHODS:This study was conducted as a single-center,randomized,double-blind,cross-over,placebo-controlled study.Eleven healthy male subjects were enrolled.Each subject underwent video capsule endos-copy after 1 and 4 wk of taking aspirin and omepra-zole,along with either rebamipide or placebo therapy.The primary endpoint was to evaluate small bowel damage in healthy subjects before and after taking low-dose aspirin for 4 wk.RESULTS:The number of subjects with mucosal breaks(defined as multiple erosions and/or ulcers)were 1 at 1 wk and 1 at 4 wk on the jejunum,and 6 at 1 wk(P = 0.0061)and 7 at 4 wk on the ileum(P =0.0019).Rebamipide significantly prevented mucosal breaks on the ileum compared with the placebo group(P = 0.0173 at 1 wk and P = 0.0266 at 4 wk).CONCLUSION:Longer-term,low-dose aspirin adminis-tration induced damage in the small bowel.Rebamipide prevented this damage,and may be a candidate drug for treating aspirin-induced small bowel complications.

The effects of low-dose splenic irradiation and radiotherapy on immune system of patients with locally advanced non-small cell lung cancer

Objective： The aim of the research was to study the effects of low-dose splenic irradiation and radiotherapy on immune system of patients with locally advanced non-small cell lung cancer （NSCLC）. Methods： Twelve cases of stage III NSCLC in Tumor Radiotherapy Center of our hospital （the Affiliated Hospital of Medical College Qingdao University, China） were collected from July 2011 to July 2012; all patients were under 75 years old with clear pathology, measurable lesions and good personal statement. They were randomly divided into combined treatment group （D1 ＋ D2） and control group （D1）. The control group （D1） only received radiotherapy to the chest; combined treatment group （D1 ＋ D2） received low-dose splenic irradiation plus conventional dose irradiation. Flow cytometry was used to detect the peripheral blood T lymphocyte immune indexes of patients before, during and after the treatment, classification by five blood cell analyzer was used to determine white blood cells, neutrophils, hemoglobin and platelet count. The radiation induced toxicity including esophagitis, pneumonia and gastrointestinal reaction was observed, as well as the dose when it happened. Results： There was no significant difference in the ratio between two groups in cells CD4＋, CD8＋ and CD4＋/CD8＋ after radiotherapy （P 〉 0.05）. There was no change in these indicators in combined treatment group after treatment （P 〉 0.05）, but it decreased in control group （P 〈 0.05）. There was no significant difference in the incidences of radiation esophagitis, pneumonia, gastrointestinal reactions and bone marrow suppression between two groups （P 〉 0.05）, but the patients in combined treatment group seemed to tolerate high dose well （P 〈 0.05）. Conclusion： Low-dose splenic irradiation combined with radiotherapy to the chest can alleviate the injury degree of acute radiation induced the toxicity of locally advanced NSCLC patients, through affect the patient＇s immune function.

Analysis and comparison of two low-dosage warfarin regimens in Chinese patients

Oral anticoagulation therapy with warfarin is used to prevent and treat venous and arterial thrombosis and embolism. Its narrow therapeutic index should be monitored carefully in order to reach the desired outcomes. The complexity of the pharmacokinetic and pharmacodynamics profile of warfarin makes it a challenge to use during treatment. Its manufacturing characteristics play a key role in its dosage. The aim of this study is to examine and evaluate the effect of two different warfarin regimens in Chinese patients. A cross-sectional study design was adopted. Medical records of all patients （n = 368） who received warfarin therapy in cardio-thoracic surgery wards between Sep. 2008 and Dec. 2009 were reviewed. Details of antithrombotic results of international normalized ratio （INR） monitoring were obtained. Statistical analysis was performed to assess factors predictive of INR therapeutic range at patients＇ discharge time according to different warfarin regimens （2.5 mg in China and 3.0 mg in USA）. The patients＇ mean age was （48.23~12.96） years. The percentage of patients within the INR therapeutic range in the group treated with 2.5 mg warfarin （35.17%） was much lower than that in group treated with 3.0 mg warfarin （47.72%）. Therefore, a significance difference was observed （P = 0.032〈0.05）. In this study, statistical values have shown that most of the patients were related to medical case requesting INR target range of 1.8-2.2 and 2.0-2.5, respectively. There was a statistically significant difference between the two groups. The study showed that the 2.5 mg-warfarin regimen was less suitable than the 3.0 mg-warfarin regimen. Medication regimen should be simplified as much as possible, especially during different treatment period.

Clinical efficacy and safety of Gandouling plus low-dose D-penicillamine for treatment of Wilson's disease with neurological symptoms

OBJECTIVE： To investigate the effect and safety of Gandouling plus low-dose D-penicillamine for treating patients with Wilson＇s disease （WD） who have neurological symptoms. METHODS： WD patients with neurological symptoms were divided into two groups： a treatment group （n = 53） and a control group （n = 50）. The treatment group received anti-copper therapy with a combination of Gandouling and low-dose D-peni- cillamine （10 mglkg）, whereas the control group was with conventional dose D-penicillamine （20 rag/ kg） monotherapy. The clinical efficacies, adverse re- actions, and results of the various hematological and biochemical investigations were recorded and analyzed statistically. RESULTS： Overall, 98.11% of the WD patients treated with the combined therapy experienced alleviation of their neurological condition （paralleled by a significantly improved Global Assessment Scale score or remained stable）. Their white blood cell and platelet counts stabilized, and their liver function was improved or remained stable. The combined therapy also obviously promoted improved 24-h urinary copper excretion. Only 15.09% of the WD patients with the combined therapy experienced adverse reactions, including neurological deterioration in one case （1.89%） and hepatic worsening in one case （1.89%）, which was less frequent than that in the control group given conventional-dose D-penicillamine monotherapy. CONCLUSION： Treating WD patients with neurological symptoms using Gandouling plus low-close D-penicillamine is effective and safe.