氨溴索联合阿奇霉素对肺炎患儿血清炎性因子及肺功能的影响

目的探讨盐酸氨溴索联合阿奇霉素对肺炎患儿血清炎性因子及肺功能的影响。方法选取在我院进行治疗的肺炎患儿78例,按抽签顺序分为两组,各39例。两组患儿均行常规治疗,对照组在上述基础上实施阿奇霉素治疗,观察组在对照组基础上加用盐酸氨溴索治疗,比较两组血清炎性因子水平及肺功能情况。结果对照组治疗前后PCT、hs-CRP、TNF-α水平比较,P均<0.0005。观察组治疗前后PCT、hs-CRP、TNF-α水平比较,P均<0.0005。两组治疗后PCT、hs-CRP、TNF-α水平比较,P均<0.0005。对照组治疗前后PEF、MMF、PEmax、Pimax变化比较,P均<0.0005。观察组治疗前后PEF、MMF、PEmax、Pimax变化比较,P均<0.0005。两组治疗后PEF、MMF、PEmax、Pimax变化比较,P均<0.0005。结论给予肺炎患儿盐酸氨溴索联合阿奇霉素治疗效果确切,可降低患儿血清炎性因子水平,改善肺功能。

Improvement of lenvatinib-induced nephrotic syndrome after adaptation to sorafenib in thyroid cancer:A case report

BACKGROUND Target therapy is licensed by United States Food and Drug Administration on certain cancers.Both sorafenib and lenvatinib are tyrosine kinase inhibitor and indicated on radioactive iodine(RAI)-refractory differentiated thyroid cancer(DTC).Lenvatinib is more effective in cancers'control than sorafenib,but causes more nephrotoxicity than sorafenib does.This case is the second published case about the serial adaptions from lenvatinib to sorafenib for improving the proteinuria and,meanwhile,achieving the therapeutic goal.CASE SUMMARY A 56-year-old man suffered from bilateral edematous lower extremities after 1-mo prescription of lenvatinib of 20 mg/d for RAI-refractory DTC.Aside from this symptom,he also developed hypertension.His laboratory showed grade-3 proteinuria(estimated 24-h urine protein:9993 mg),hypoalbuminemia and hypercholesterolemia.Anti-vascular endothelial growth factor(VEGF)therapyinduced nephrotic syndrome was impressed.After reduced dosage of lenvatinib of 10 mg/d and related symptomatic drugs,limited improvement was observed in both adverse effects and caner control.Under this condition,we substituted sorafenib of 400 mg/d for lenvatinib of 10 mg/d.After a 5-mo prescription,not only hypertension and peripheral edema were greatly improved,but also proteinuria was improved from grade three to grade one(estimated 24-h urine protein:962 mg).At the same time the cancer control was achieved,judged from computed tomography and laboratory evidence[thyroglobulin(Tg)before prescription of sorafenib:354.7 ng/m L;Tg after prescription of sorafenib:108.9 ng/m L].CONCLUSION Adaption from lenvatinib to sorafenib is a feasible method to improve the antiVEGF therapy-induced nephrotic syndrome and achieve the therapeutic goal at the same time.

Application of recombinant human granulocyte colony stimulating factor in children with acute myeloid leukemia

Objective To evaluate the effect of recombinant human granulocyte colon y stimulating factor (rhGCSF) on accelerating neutrophil recovery and decrease fatal infections for childhood acute myeloid leukemia (AML) Methods From November 1992 to March 1997, 45 patients wer e enrolled into our study and 15 were newly diagnosed All were treated with hi gh dose chemotherapy combined with rhGCSF Results Of 15 newly diagnosed patients, 13 achieved complete remission (CR) after one course of therapy and 2 achieved CR after two courses of therapy For newly diagnosed patients, the durations of absolute neutrophil counts (ANC ) <05109/L were 5 days and 10 days in rhGCSF group and control group res p ectively ( P <005) The incidences of infection of these two groups w ere 40% and 60% respectively ( P <005) As for patients who receive d intensive therapy, the durations of ANC <05109/L were 5 days and 8 days i n rhGCSF group and control group, respectively ( P <005), and the i ncidences of infection were 25% and 444% respectively ( P <005) Conclusions The application of rhGCSF in children with AML after chem otherapy may hasten the hematopoietic recovery The duration of neutropenia wa s shortened by 3-4 days, and the incidence of fatal infection was reduced rhG CSF does not stimulate AML growth in vivo

Advancing drug delivery to articular cartilage:From single to multiple strategies

Articular cartilage(AC) injuries often lead to cartilage degeneration and may ultimately result in osteoarthritis(OA) due to the limited self-repair ability. To date, numerous intra-articular delivery systems carrying various therapeutic agents have been developed to improve therapeutic localization and retention, optimize controlled drug release profiles and target different pathological processes. Due to the complex and multifactorial characteristics of cartilage injury pathology and heterogeneity of the cartilage structure deposited within a dense matrix, delivery systems loaded with a single therapeutic agent are hindered from reaching multiple targets in a spatiotemporal matched manner and thus fail to mimic the natural processes of biosynthesis, compromising the goal of full cartilage regeneration. Emerging evidence highlights the importance of sequential delivery strategies targeting multiple pathological processes. In this review, we first summarize the current status and progress achieved in single-drug delivery strategies for the treatment of AC diseases. Subsequently, we focus mainly on advances in multiple drug delivery applications, including sequential release formulations targeting various pathological processes, synergistic targeting of the same pathological process, the spatial distribution in multiple tissues, and heterogeneous regeneration. We hope that this review will inspire the rational design of intraarticular drug delivery systems(DDSs) in the future.