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.

Clinical efficacy of tocilizumab combined with leflunomide in the treatment of rheumatoid arthritis

Objective:To study the clinical efficacy of tocilizumab combined with leflunomide in the treatment of rheumatoid arthritis.Methods:114 patients with rheumatoid arthritis admitted from May 2015 to April 2018 were randomly divided into control group(n=57)and observation group(n=57).The control group was treated with leflunomide.On the basis of this,the observation group was treated with tocilizumab for 12 weeks.Functional indicators,erythrocyte sedimentation rate(ESR),rheumatoid factor and inflammatory factors were evaluated and adverse reactions were recorded.Results:The total treatment efficiency of the observation group(89.47%)was significantly higher than that of the control group(75.44%)(P<0.05).Morning stiffness time,joint pain score,joint swelling score,ESR,serum C-reactive protein(CRP),rheumatoid factor(RF),tumor necrosis factor(TNF-α),and interleukin-1 were observed in the observation group and the control group.The levels of IL-1),IL-6,IL-8 and other indicators were lower than those before treatment.The indexes of the observation group were significantly lower than those before treatment(P<0.05),and after treatment The morning stiffness time,joint pain score,joint swelling score,ESR,CRP,RF,TNF-α,IL-1,IL-6,IL-8 and other indicators in the observation group were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was 14%,and the incidence of adverse reactions in the control group was 17.54%.Toltuzumab combined with leflunomide in the treatment of rheumatoid arthritis did not increase the probability of adverse reactions.Conclusion:The use of tocilizumab combined with leflunomide in the treatment of rheumatoid joints has good efficacy and safety.This may be related to a significant reduction in inflammatory factors TNF-α,IL-1,IL-6,IL-8 and the like.

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.

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).

An Evaluation of the Clinical Efficacy and Safety of Ixazomib for Relapsed/Refractory Multiple Myeloma

Objective:To investigate the clinical efficacy and safety of ixazomib in the treatment of relapsed/refractory multiple myeloma(RRMM).Methods:The clinical data of 20 patients with RRMM admitted to the hospital from January 2020 to January 2022 were analyzed retrospectively.All patients were treated with ixazomib-based chemotherapy regimen(IRD regimen 13 cases;ID regimen 7 cases).The objective response rate(ORR)and adverse events(AEs)were observed.Results:All 20 patients received two to seven courses of treatment,in which the median was three courses.One patient had CR,four patients had VGPR,seven patients had PR,two patients had SD,and six patients had PD.The ORR was 60.00%(12/20),and 25.00%(5/20)of them had VGPR or more.The ORR of patients with previous treatment lines≥3,ISS stage III,and high-risk cytogenetic was lower than that of patients with previous treatment lines<3,ISS stage I/II,and low-risk cytogenetics.The main AEs include anemia,thrombocytopenia,neutropenia,nausea and vomiting,diarrhea,constipation,and respiratory tract infection,most of which are grade I/II.Conclusion:Ixazomib is effective in the treatment of RRMM in some patients,and the AEs are controllable.Patients who had received less than 3 lines of treatment in the past,with ISS stage I to II and low-risk cytogenetics had better treatment effect.

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。

Systematic review of long-term Xingnao Kaiqiao needling efficacy in ischemic stroke treatment

OBJeCTIve：To systematically evaluate the long-term effect and safety ofXingnao Kaiqiao nee-dling method in ischemic stroke treatment. DATA ReTRIevAL： We retrieved relevant random and semi-random controlled trials that used theXingnao Kaiqiao needling method to treat ischemic stroke compared with various control treatments such as conventional drugs or other acupuncture therapies. Searched databases included China National Knowledge Infrastructure, Weipu Information Resources System, Wanfang Medical Data System, Chinese Biomedical Literature Database, Cochrane Library, and PubMed, from May 2006 to July 2014. SeLeCTION CRITeRIA： Two authors independently conducted literature screening, quality evaluation, and data extraction. The quality of articles was evaluated according to the Cochrane Reviewers’ Handbook 5.1, and the study was carried out using Cochrane system assessment methods. RevMan 5.2 was used for meta-analysis of the included studies. MAIN OUTCOMe MeASUReS： Mortality rate, recurrence rate, and disability rate were observed. ReSULTS：Nine randomized and semi-randomized controlled trials treating 931 cases of ischemic stroke were included in this review. Meta-analysis results showed that there were no sig-niifcant differences in mortality reduction （risk ratio （RR） = 0.58, 95% conifdence interval （CI）： 0.17–1.93,Z = 0.89,P = 0.37） or recurrence rate （RR = 0.55, 95%CI： 0.18–1.70,Z = 1.04,P = 0.30） of ischemic stroke patients between theXingnao Kaiqiao needling and control treatment groups. However, theXingnao Kaiqiao needling method had a tendency towards higher efifcacy in mor-tality reduction and recurrence rates. TheXingnao Kaiqiao needling method was signiifcantly better than that of the control treatment in reducing disability rate （RR = 0.51, 95%CI： 0.27–0.98, Z = 2.03,P 〈 0.05）. CONCLUSION：TheXingnao Kaiqiao needling method has a better effect than control treatment in reducing disability rate. The long-term effect ofXingnao Kaiqiao needling against ischemic stroke is better than that of control treatment. However, the limitations of this study limit the strength of the conclusions. Randomized controlled trials with a strict, reasonable design, and multi-center, large-scale samples and follow-up are necessary to draw conclusions aboutXingnao Kaiqiao needling.

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.

Analysis of Ornidazole Injection in Clinical Use at Post-marketing Stage by Centralized Hospital Monitoring System

This study aims to analyze the clinical use of ornidazole injection at the post-marketing stage by centralized hospital monitoring system method,and investigate its widespread use in patients,in order to regulate and guide the rational drug use,improve the drug specificity and provide a basis for drug therapy.The study adopts a prospective,multi-center,large sample size,centralized hospital monitoring system.We selected five leading hospitals in Hubei province,and observed the inpatients who received the ornidazole injection from July 1,2015 to October 31,2015.The basic information of patients was recorded,as well as the drug use and adverse events.The statistical analysis was performed based on these data.A total of 4396 individuals were enrolled in this study,most of them were middle-aged female patients and the ornidazole injection was mainly used as prophylactic prior to surgery to prevent the infections,and surgical treatment of anaerobic infections,abdominal infections and pelvic infections.The irrational drug use existed mainly in the prescribing and administration process,including unreasonable dosing frequency,rapid intravenous drip speed and extended duration of drug use.Eleven cases of adverse reactions were collected during the monitoring,incidence rate of adverse reactions was 2.5‰;adverse drug reactions occurred within 30 min.The study results fully reflected the usage of ornidazole injection in the real world.Based on the study,we calculated the adverse reaction incidence of ornidazole and identified the risk factors which may affect the safety of ornidazole injection.Study results strongly recommend that the manufacturers should publish standards for inpatient use and doctors should prescribe with caution accordingly.

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.

Clinical decision support for drug related events: Moving towards better prevention

Clinical decision support(CDS) systems with automated alerts integrated into electronic medical records demonstrate efficacy for detecting medication errors(ME) and adverse drug events(ADEs). Critically ill patients are at increased risk for ME, ADEs and serious negative outcomes related to these events. Capitalizing on CDS to detect ME and prevent adverse drug related events has the potential to improve patient outcomes. The key to an effective medication safety surveillance system incorporating CDS is advancing the signals for alerts by using trajectory analyses to predict clinical events, instead of waiting for these events to occur. Additionally, incorporating cutting-edge biomarkers into alert knowledge in an effort to identify the need to adjust medication therapy portending harm will advance the current state of CDS. CDS can be taken a step further to identify drug related physiological events, which are less commonly included in surveillance systems. Predictive models for adverse events that combine patient factors with laboratory values and biomarkers are being established and these models can be the foundation for individualized CDS alerts to prevent impending ADEs.

Analysis on the Clinical Therapeutic Effect of Hepatic Artery Chemoembolization in the Treatment of Advanced Liver Cancer

Objective:To analyze the clinical efficacy of hepatic artery chemoembolization in the treatment of advanced liver cancer.Methods:124 patients with advanced liver cancer admitted to our hospital from September 2019 to November 2020 were selected as the research subjects of this paper.The patients with advanced liver cancer were divided into experimental group and control group.The control group was treated with radiofrequency ablation alone,and the experimental group was administered hepatic arterial chemoembolization.The improvement in physical indicators and the incidence of adverse reactions between the two groups were compared.Results:The alpha-fetoprotein(AFP)index and serum total bilirubin(TBIL)index of the experimental group were lower than those of the control group,and the alanine aminotransferase(ALT)index was higher than that of the control group.There were differences in the comparison of liver function indices between the two groups which were statistically significant.After treatment,there were 3 cases of fever,4 cases of vomiting,8 cases of bone marrow transplantation,4 cases of abdominal pain,2 cases of proteinuria,and 1 case of diarrhea occurred in the experimental group;whereas there were 6 cases of fever,8 cases of vomiting,14 cases of bone marrow transplantation,7 cases of abdominal pain,5 cases of proteinuria,and 6 cases of diarrhea occurred in the control group.The difference in incidence of adverse reactions between patients after different treatment interventions was statistically significant.Analyzing the remission rate of tumor diseases in patients,the remission rate of the experimental group was higher than that of the control group,and the difference in the remission rate between the two groups of patients was statistically significant.Conclusion:The implementation of hepatic arterial chemoembolization for patients with advanced liver cancer can promote the improvement of the patient's short-term treatment efficacy,enhance the liver functions of the patient,reduce the incidence of adverse reactions,improve the efficiency of the patient's body rehabilitation,and enhance the quality of life of the patient after treatment.

Efficacy and safety of adalimumab in comparison to infliximab for Crohn's disease:A systematic review and meta-analysis

BACKGROUND Adalimumab(ADA)and infliximab(IFX)are the cornerstones of the treatment of Crohn’s disease(CD).It remains controversial whether there is a difference in the effectiveness and safety between IFX and ADA for CD.AIM To perform a meta-analysis to compare the effectiveness and safety of ADA and IFX in CD.METHODS Pub Med,Embase,Cochrane Library,and Web of Science databases were searched.Cohort studies were considered for inclusion.The primary outcomes were induction of response and remission,maintenance of response and remission,and secondary loss of response.Adverse events were secondary outcomes.RESULTS Fourteen cohort studies were included.There was no apparent difference between the two agents in the induction response[odds ratio(OR):1.27,95%confidence interval(CI):0.93-1.74,P=0.14]and remission(OR:1.11,95%CI:0.78–1.57,P=0.57),maintenance response(OR:1.08,95%CI:0.76–1.53,P=0.67)and remission(OR:1.26,95%CI:0.87–1.82,P=0.22),and secondary loss of response(OR:1.01,95%CI:0.65–1.55,P=0.97).Subgroup analysis revealed ADA and IFX had similar rates of response,remission,and loss of response either in anti-tumor necrosis factor-αna?ve or non-na?ve patients.Further,there was a similar result regardless of whether CD patients were treated with optimized therapy,including dose intensification,shortening interval,and combination immunomodulators.However,ADA had a fewer overall adverse events than IFX(OR:0.62,95%CI:0.42–0.91,P=0.02).CONCLUSION ADA and IFX have similar clinical benefits for anti-tumor necrosis factor-αna?ve or non-na?ve CD patients.Overall adverse events rate is higher in patients in the IFX group.

Clinical Effect of Photodynamic Therapy Combined Cryotherapy on Nonmelanoma Skin Cancer

The purpose of this study was to investigate the clinical efficacy of photodynamic combined freezing in patients with non-melanoma skin cancer(NMSC).First,according to the treatment regimen,96 patients with NMSC were divided into study group(n=50)and control group(n=46).The control group was treated with 5-amino-ketovalic acid photodynamic therapy(ALAPDT),while the study group was treated with ala-PDT combined with cryotherapy.Visual analogue scale(VAS)scores,visual satisfaction,clinical efficacy,adverse reactions,and progression-free survival were compared between the two groups.The results showed that VAS score in the study group was slightly higher than that in the control group,but the difference was not statistically significant(P>0.05).The appearance satisfaction and total effective rate of patients in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the study group was slightly higher than that in the control group,but the difference was not statistically significant(P>0.05).3 years progressionfree survival time and 3 years progression-free survival rate were compared between the two groups,and the difference was not statistically significant(P>0.05).Therefore,the combination of PDT and cryotherapy for non-melanoma skin cancer has a good clinical effect,which is conducive to the recovery of skin lesions,high patient satisfaction,fewer adverse reactions,and longer progression-free survival.In addition,the combined therapy can provide a new treatment idea for non-melanoma skin cancer patients who are not suitable for surgical treatment.

Efficacy and Safety of 30% Supramolecular Salicylic Acid Peeling Combined with Isotretinoin Erythromycin Gel in the Treatment of Moderate-to-Severe Acne Vulgaris: A Comparative Study

Background: Both 30% supramolecular salicylic acid (SA) and isotretinoin erythromycin gel (IEG) have proven efficacy with good safety profiles in the treatment of acne vulgaris. Objectives: This study compared the clinical efficacy and safety of 30% SA peeling and IEG in the treatment of moderate-to-severe acne vulgaris. Methods: Patients with moderate-to-severe acne vulgaris were randomized into 3 groups of 30 persons each, and treated with SA peel, or IEG, or SA combine with IEG (SA + IEG group). Evaluation of acne was done by effective rate and individual lesion counts. And the adverse effects and recurrence were recorded. Results: The SA + IEG group was better in clinical efficacy and treating noninflammatory and inflammatory lesions than that of single treatment group (P 0.05). Conclusion: 30% SA combined with IEG had a significant effect in the treatment of moderate-to-severe acne lesions.

CYP3A4基因位点多态性对托法替布治疗类风湿关节炎临床疗效及药品不良反应的影响

目的探讨CYP3A4*4,CYP3A4*18,CYP3A4*1G基因位点多态性对托法替布治疗类风湿关节炎(RA)临床疗效及药品不良反应(ADR)的影响。方法选取医院风湿免疫科2020年2月至2022年8月收治的RA患者309例作为RA组,予枸橼酸托法替布片,每日2次,每次5 mg,共治疗6个月;选取同期的健康人群165例作为对照组。采用荧光聚合酶链反应(PCR)法检测CYP3A4*4,CYP3A4*18,CYP3A4*1G基因位点多态性;根据美国风湿病学学会(ACR)制订的ACR20标准评价托法替布的临床疗效,以是否符合ACR20标准,将RA患者分为改善组(181例)和未改善组(128例);统计治疗期间RA患者与托法替布相关的ADR,采用Karch和Lasagna评定法判定因果关系,以因果关系是否判定为肯定、很可能和可能,将RA患者分为ADR组(58例)和无ADR组(251例)。结果RA组和对照组患者的CYP3A4*4,CYP3A4*18,CYP3A4*1G基因位点多态性均无显著差异(P>0.05)。改善组和未改善组患者的疾病活动度差异显著(P<0.05),CYP3A4*4,CYP3A4*18,CYP3A4*1G基因位点多态性均无显著差异(P>0.05)。ADR累及系统为实验室检验异常、皮肤系统、消化系统、呼吸系统、血液系统,分别发生27例、11例、7例、5例、3例;ADR严重程度为轻度51例,中度7例。ADR组和无ADR组患者的CYP3A4*1G基因位点多态性差异显著(P<0.05),CYP3A4*4和CYP3A4*18基因位点多态性均无显著差异(P>0.05)。结论CYP3A4*1G基因位点多态性与托法替布治疗RA的ADR有相关性。使用托法替布时,应监测患者的CYP3A4*1G基因位点多态性,必要时调整剂量,保证用药安全。

吗啉硝唑临床应用的研究进展

从结构特点、抗菌机制、抗菌活性、药动学、药物相互作用及临床应用等方面全面介绍吗啉硝唑的研究进展,为深入研究提供参考。吗啉硝唑作为新型硝基咪唑类抗菌药,抗菌活性强,不易产生耐药性,临床应用日益增多。多项研究证实吗啉硝唑疗效显著,安全性高。吗啉硝唑具有科研和临床应用价值,值得深入研究。

Observation on the Clinical Effect of Stereotactic Body Radiotherapy in Patients with Oligometastatic Tumors

Objective:To observe the efficacy and safety of stereotactic body radiotherapy(SBRT)in the treatment of extracranial oligometastases.Method:A retrospective analysis of 70 patients with extracranial oligometastasis of malignant tumors who underwent SBRT in our hospital(Shaanxi Provincial People’s Hospital)from January 2019 to December 2021 with≤5 metastases,≤3 metastatic organs,and metastases with diameters of≤5 cm.According to the clinical data of patients,the dose-fractionation mode of SBRT is mainly determined according to the pathology of the primary tumor,the location of the metastatic tumor,and the important structures around the tumor.The local control,survival and adverse reactions were observed.Results:A total of 219 oligometastatic lesions in 70 patients were treated with SBRT.The median follow-up time was 24 months(12-40 months).The local control rate(LCR)of all target lesions assessed 3 months after radiotherapy was 94.1%;the 1-,2-,and 3-year LCRs were 88.6%,74.6%,and 64.9%,respectively.The median progression-free survival(PFS)was 11.8 months(95%CI,8.9-14.7 months),and the 1-and 2-year PFS rates were 48.6%and 32.6%,respectively;the median overall survival(OS)was 31.9 month(95%CI 26.0-37.8 months),the 1-year OS rate was 84.3%.The local control time,PFS,and OS of patients with metastases≤3 cm were significantly better than those with metastases>3 cm,and the differences were statistically significant(P<0.05).Acute adverse reactions after SBRT treatment in oligometastatic patients were mainly bone marrow suppression and gastrointestinal reactions,with incidence rates of 48.98%and 30.61%,respectively;chronic adverse reactions were mainly pain(bone,muscle),radiation enteritis,and radiation pneumonitis,with incidence rates of 38.57%,30.00%,and 24.29%,respectively.The treatment-related adverse reactions were mainly grade 1,which were all improved after symptomatic treatment,except for one patient with bone metastases from lung cancer who had grade 4 myelosuppression.No grade 4 or 5 adverse events occurred in the other patients.Conclusion:The application of SBRT in the treatment of extracranial oligometastases is safe,effective,and has high tolerability.

乌灵胶囊联合针灸治疗肝郁脾虚证腹泻型肠易激综合征的临床疗效及安全性

目的探讨乌灵胶囊联合针灸治疗肝郁脾虚证腹泻型肠易激综合征(irritable bowel syndrome with diarrhea,IBS-D)的临床疗效及安全性。方法选取肝郁脾虚证IBS-D患者140例。按随机数字表法将所有患者分为对照组和观察组,各70例。对照组给予水疗基础治疗+口服马来酸曲美布汀胶囊和乌灵胶囊治疗,观察组在对照组的治疗基础之上联合针灸治疗。评价两组患者的综合疗效和总体证候疗效,采用肠易激综合征生活质量量表(irritable bowel syndrome quality of life scale,IBS-QOL)对肝郁脾虚证IBS-D患者治疗前和疗程结束后生活质量变化情况进行评估,采用汉密顿焦虑量表(hamilton anxiety scale,HAMA)评估患者治疗前与疗程结束后焦虑程度,采用汉密顿抑郁量表(hamilton depression scale,HAMD)评估患者治疗前与疗程结束后的抑郁程度。采用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)检测患者血清二胺氧化酶(diamine oxidase,DAO)、D-乳酸和肠脂肪酸结合蛋白(intestinal fatty acid binding protein,IFBP)、5-羟色胺(5-hydroxyteyptamine,5-HT)、降钙素基因相关肽(calcitonin gene related peptide,CGRP)水平。结果观察组的综合疗效97.14%(68/70)高于对照组85.71%(60/70),差异有统计学意义(χ^(2)=5.833,P<0.05);观察组的总体证候疗效98.57%(69/70)高于对照组82.86%(58/70),差异有统计学意义(χ^(2)=10.260,P<0.05);观察组疗程结束后IBS-QOL评分高于对照组,差异有统计学意义(t=4.272,P<0.05),观察组疗程结束后HAMA、HAMD评分低于对照组,差异有统计学意义(t=8.535,10.534,P<0.05);观察组疗程结束后DAO、D-乳酸、IFABP水平低于对照组,差异有统计学意义(t=7.229,13.046,7.016,P<0.05);观察组疗程结束后HT、CGRP表达水平低于对照组,差异有统计学意义(t=4.620,2.027,P<0.05);观察组患者不良反应发生率8.57%(6/70)高于对照组5.71%(4/70)(χ^(2)=0.431,P>0.05)。结论乌灵胶囊联合针灸可提升临床疗效,可有效改善IBS-D患者的生活质量和焦虑抑郁状态,同时对降低DAO、D-乳酸、IFABP、5-HT、CGRP水平,缓解胃肠道症状效果显著,且安全性较高。

不同剂量糖皮质激素冲击治疗风湿病患者的临床疗效分析

目的分析不同剂量糖皮质激素冲击治疗风湿病的临床疗效。方法80例风湿病患者,采取随机形式分为对照组和研究组,每组40例。对照组接受小剂量甲泼尼龙琥珀酸钠治疗,研究组接受大剂量甲泼尼龙琥珀酸钠治疗。比较两组患者治疗效果、不良反应发生情况。结果研究组疾病治疗总有效率90.0%高于对照组的60.0%,对比存在显著差异(P<0.05)。研究组治疗期间不良反应发生率为37.5%,与对照组的25.0%对比不存在显著差异(P>0.05)。结论临床中为风湿病患者提供大剂量糖皮质激素进行冲击治疗,能够提高疾病临床疗效,且不会引发严重不良反应。