白藜芦醇联合乌司他丁治疗急性胰腺炎的疗效分析

目的：观察白藜芦醇联合乌司他丁对大鼠急性胰腺炎（AP）的治疗效果。方法：将250只雄性Wister大鼠随机分为5组,分别为假手术（A）组、急性胰腺炎组（B组）、白藜芦醇组（C组）、乌司他丁组（D组）和白藜芦醇联合乌司他丁治疗组（C＋D组）。制备各组AS大鼠模型,观察各组腹水量及血淀粉酶、脂肪酶、TNF-α、NF—κB、丙二醛（MDA）及超氧化物歧化酶（SOD）水平,并观察胰腺病理改变。结果：B组与A组相比,SOD水平明显降低（P〈0．05）,MDA水平明显升高（P〈0．05）;C、D及C＋D组与B组相比,血清SOD水平明显升高（P〈0．05）,MDA水平明显降低（P〈0．05）;C＋D组与C组、D组相比,血清SOD水平明显升高（P〈O．05）,血清MDA水平明显降低（P〈0．05）。与B组比较,C和D组血淀粉酶、脂肪酶、TNF-α、病理学评分均降低,细胞超微结构损伤减轻,有显著性差异（P〈0．05或P〈0．01）。C＋D组上述指标改善较C组和D组更明显,差异有显著性（P〈0．05）。结论：乌司他丁、白藜芦醇通过升高SOD保护性因子、降低MDA损伤性因子,对急性胰腺炎有治疗作用,尤其在乌司他丁与白藜芦醇合用时效果更显著。     

染料木黄酮对哮喘豚鼠肺部炎症和气道重塑的预防作用

目的：研究蛋白酪氨酸激酶（PTK）抑制剂染料木黄酮对哮喘豚鼠肺部炎症和气道重塑的作用。方法：成年雄性豚鼠30只,随机分成3组（n=10）：对照组（C组）、哮喘组（A组）和染料木黄酮干预组（B组）,以腹腔内注射联合雾化吸入卵蛋白复制哮喘模型。测支气管肺泡灌洗液（BALF）中细胞总数及其分类数,测细支气管炎症细胞浸润及支气管重塑指标,免疫纽化方法测磷酸化酪氨（p-tyrosine）在肺组织中的表达。结果：A组BALF中细胞总数、嗜酸性粒细胞分类与C组比较明显增加,B组与A组比较明显降低,差异有统计学意义（P〈0．01）;A组细支气管嗜酸性粒细胞（E）数和淋巴细胞（L）数较C组明显增多,B组与A组比较明显降低,差异有统计学意义（P〈0．01）;B组细支气管重塑较A组明显减轻（P〈0．01）,与C组比较,差异无统计学意义（P〈0．05）;免疫组化显示p-tyrosine在支气管平滑肌、支气管上皮、血管滑平滑肌及炎性细胞均有表达,尤其以支气管和血管平滑肌及炎性细胞明显,A组比C组表达明显增高,差异有统计学意义（P〈0．01）,而B组与C组比较,无明显差别（P〉0．05）。结论：PTK对哮喘豚鼠肺部炎症和支气管重塑具有促进作用：PTK抑制剂染料木黄酮对哮喘豚鼠肺炎症和支气管重塑具有预防和抑制作用。     

呼吸道合胞病毒感染促进豚鼠产生气道高反应性及其机制研究

目的：通过检测气道反应性和M2受体功能,研究呼吸道合胞病毒（RSV）感染与哮喘发病的关系及机制。方法：34只豚鼠随机分为4组：Hep-2滴鼻＋生理盐水雾化（Hep-2／NS,A）组,RSV滴鼻＋生理盐水雾化（RSV／NS,B）组,Hep-2滴鼻＋鸡卵蛋白（OVA）雾化（Hep-2／OVA,C）组和RSV滴鼻＋OVA雾化（RSV／OVA,D）组,其中A和B纽各9只,C和D组各8只,以A组为对照组。21d通过电刺激迷走神经检测各组气道反应性和M2受体功能,行嗜酸性粒细胞计数以及病理学观察。结果：B组气道内压力（mmH2O）与A组无明显差异（P〉0．05）,给予匹罗卡品,IP下降幅度高于A组,但差别无显著性（P〉0．05）。C组IP明显高于A且（P〈0．05）,且给予匹罗卡品,IP下降幅度明显低于A组,差别有显著性（P〈0．05）。D组IP明显高于C组（P〈0．05）,给予匹罗卡品后IP下降幅度明显低于C组（P〈0．05）。结论：RSV感染可促进过敏原引起的M2R功能障碍,从而促进AHR发生。     

早期大剂量乌司他丁治疗急性肺挫伤的疗效观察

目的：探讨早期大剂量乌司他丁治疗急性肺挫伤的临床疗效。方法：选择102例在湖南中医药大学第一附属医院胸外科治疗的急性肺挫伤患者,随机分为A组（对照组）、B组（常规剂量组）和C组（大剂量组）,每组各34例。A组患者给予常规治疗;B组在对照组治疗基础上给予乌司他丁10万单位加入0．9％氯化钠100mL静脉滴注,每8h1次,连用7d;C组在对照组治疗基础上给予乌司他丁40万单位加入0．9％氯化钠100mL静脉滴注,每8h1次,连用7d。分别测定和比较3组患者在治疗前、治疗第1天、治疗第4天、治疗第7天的动脉血氧分压（PaO2）、动脉二氧化碳分压（PaCO2）、氧合指数（PaO2／FiO2、血清肿瘤坏死因子-α（TNF—α）、白细胞介素-6（IL-6）的水平以及治疗期间3组患者急性呼吸窘迫综合征（ARDS）T2．肺部感染的发生率。结果：治疗后,B组的PaO2水平在第7天较A组升高,C组的PaO2水平在第1、4、7天较A组均有升高,在第1、4天较B组亦有升高（P〈0．05）;B、C两组PaCO：水平在第4天较A组均有升高（P〈0．05）;B组的PaO2／FiO2水平在第7天较A组升高,C组的PaO/FiO2水平在第4、7天较A、B两组均有升高（P〈0.05）。B组的TNF—α水平在第7天较A组降低,C组的TNF-α水平在第4、7天较A组降低,在第4天较B组降低（P〈0．05）;B组的IL-6水平在第7天较A组降低,C组的IL-6水平在第4、7天较A、B组均降低（P〈0．05）。各组ARDS及肺部感染的发生率比较无统计学差异（P〉0．05）。结论：早期大剂量乌司他丁对急性肺挫伤具有明显的临床疗效。     

早期吸入不同浓度布地奈德对哮喘大鼠气道炎症和重构的干预

目的：研究早期吸入不同浓度布地奈德对哮喘大鼠气道炎症和气道重构的干预情况。方法i32只Wistar大鼠随机分为4组：A对照组8只,B卵蛋白（OVA）致哮喘组8只,C卵蛋白致哮喘后吸入低浓度布地奈德治疗组8只,D卵蛋白致哮喘后吸入高浓度布地奈德治疗组8只。分别测定各组大鼠血中肿瘤坏死因子-α（TNF-α）及肺泡灌洗液（BALF）中内皮素．1（ET-1）的水平,计数BALF中细胞总数及分类。各组大鼠行肺组织切片HE染色,再行胶原染色、免疫组化NGF、TGF-β1染色,借助计算机图象分析软件测量单位气道面积炎性细胞数目,基底膜周径（Pbm）、平滑肌面积（WArn）、气道内壁面积（WAi）、胶原面积（Wcol）,NGF及TGF-β1阳性信号积分吸光度。结果：B组BALF中细胞总数、嗜酸细胞分类及TNF—α、ET-1水平与A组比较均明显增加,差异有统计学意义（P〈0．01）,C组及D组较B组均明显降低,差异有统计学意义（P〈0．01）。B组NGF及TGF-β1的表达、气道壁炎性细胞计数、气道内壁面积、平滑肌面积、胶原面积与A组比较均明显增加,差异有统计学意义（P〈0．01）,C组及D组与B组比较均明显降低,差异有统计学意义（P〈0．01）,C组及D组与A组比较差异有统计学意义（P〈0．05,P〈0．01）,C组与D组差异均有统计学意义（P〈0．05,P〈0．01）。结论：早期吸入不同浓度的布地奈德均可明显抑制气道炎症和气道重构,高浓度较低浓度对气道炎症和气道重构的影响更明显。     

支气管哮喘急性发作期超敏C-反应蛋白、白细胞、中性粒细胞比例检测的意义及比较

探讨超敏C-反应蛋白（hs-CRP）、血白细胞总数（WBC）、中性粒细胞比例（N％）在支气管哮喘（简称哮喘）急性发作期诊治中的临床意义。方法：分析60例患者治疗前及自觉症状缓解时hs—CRP、WBC、N％动态变化情况,观察上述指标在急性发作期的阳性率以及自觉症状缓解时的阴性率。结果：①hs-CRP、N％、WBC在自觉症状缓解时均明显低于哮喘急性发作期（P〈0．05）;②哮喘患者急性发作期hs—CRP、N％阳性率均高于WBC阳性率,且与后者比较均具有统计学差异（P〈0．05）;③哮喘患者经治疗自觉症状缓解时hs-CRP、WBC阴性率均高于N％阴性率,且与后者比较均具有统计学差异（P〈0．05）。结论-血清hs-CRP既可作为哮喘患者急性发作期感染的敏感指标,又是反映急性发作期治疗效果的早期评判指标,比WBC、N％更迅速、敏感。     

布地奈德混悬液雾化吸入治疗小儿急性喉炎的临床观察

目的：观察布地奈德混悬液雾化吸入治疗小儿急性喉炎的临床疗效。方法：选择2010年6月~2012年12月我院收治的急性喉炎患儿67例为研究对象,并将其随机分为对照组和观察组,两组均给予相同的综合性治疗。在此基础上,对照组仅通过静脉给予地塞米松,观察组在地塞米松静脉给药的同时,加用布地奈德混悬液雾化吸入治疗。治疗后,观察和比较两组患儿的症状、体征缓解时间及住院时间。结果：观察组声音嘶哑、犬吠样咳嗽、喉喘呜、吸气性呼吸困难的缓解时间及住院时间均明显短于对照组,观察组雾化吸入布地奈德4h、24h时的临床疗效明显优于对照组,差异有统计学意义（P〈0．05）,两组均无不良反应的发生。结论：布地奈德混悬液雾化吸入治疗小儿急性喉炎起效快,病程短,方法简单,不良反应少。     

补骨脂抑制人工关节假体周围骨溶解的研究

目的：探讨中药补骨脂对人工关节置换术后假体周围骨溶解,假体无菌性松动的核因子KB受体活化因子配体-核因子KB受体活化因子受体-骨保护素（RANKL-RANK-OPG）信号通路的作用。方法：取24只200＋5g雌性SD大鼠。随机分为A、B、C组,均注射钛颗粒溶液建立骨溶解模型,术后A组采用中药补骨脂水溶液腹腔注射,B组采用外源性OPG腹腔注射作为阳性对照,C组采用生理盐水腹腔注射作为阴性对照。给药4周后,通过免疫组化及反转录聚合酶链反应（RT-PCR）检测各组动物体内RANKL／RANK的表达水平变化。结果：用药4周后,3组12只大鼠背部气囊均为厚壁囊腔,骨溶解模型成功建立,免疫组化及RT-PCR检测RANKIJRANK均呈阳性表达。免疫组化RANKL平均光密度（AOD）值A组（0．168±0．017）、B组（0．147±0．009）明显低于C组（0．314±0．011）,差异有统计学意义（P〈0．05）;A组、B组之间比较无明显差异。RANKAOD值测定A组（0．172±0．015）、B组（0．193±0．045）明显低于C组（0．342±0．007）,差异有统计学意义（P〈0．05）;A组、B组之间比较无明显差异。RT-PCR检测RANKL相对量A组（0．575±0．143）、B组（0．543±0．174）明显低于C组（0．951±0．362）,差异有统计学意义（P〈0．05）;A组、B组之间比较无明显差异。RANK相对量A组（0．433±0．025）、B组（0．611±0．209）明显低于C组（0．871±0．211）,差异有统计学意义（P〈0．05）;A组、B组之间比较无明显差异。结论：中药补骨脂对人工关节置换术后假体周围骨溶解,假体无菌性松动具有抑制作用。     

乙醚吸入与戊巴比妥钠腹腔注射联合麻醉的应用

目的探讨乙醚吸入与戊巴比妥钠联合麻醉应用效果。方法随机将20只受肝大鼠分成两组,每组10只。A组为单纯的乙醚吸入麻醉对照组,B组先用乙醚吸入作麻醉诱导,再腹腔注射2％戊巴比妥钠作麻醉维持。观察手术时间、术中追加麻醉次数、术后苏醒时间和死亡率。结果与B组相比,A组手术时间明显延长（P〈0．05）,术中平均需要重复吸入乙醚5±1．63次,以维持麻醉状态。B组术中麻醉平稳,不需要继续给药．两组术后苏醒时间无显著性差异（P〉0．05）。结论乙醚吸入与戊巴比妥钠联合麻醉,可延长麻醉的有效时间,加强麻醉效果,有效地保证手术的顺利进行。     

益生菌预防自发性腹膜炎再发的临床研究

目的探讨益生菌药物对自发性腹膜炎（SBP）再发的预防效果。方法51例肝硬化并SBP治疗后,在综合护肝治疗的基础上随机分为3组：A组18例,除外综合治疗外无其他用药;B组20例,予益生菌口服;C组13例,予喹诺酮类药物口服。观察其自发性腹膜炎再发生率。结果A组与B组比较,SBP再发生率高（x2=3．99,P〈o．05）。A组与B、C组比较,SBP再发生率高,差异有统计学意义（x2=5．26,P〈0．05）。B组与C组比较,x2=0．001,P〉0．05,两治疗组间差异无统计学意义。结论益生菌对预防自发性腹膜炎再发有效。     

沙丁胺醇雾化吸入辅助治疗小儿支气管哮喘急性发作的疗效观察

目的:观察沙丁胺醇雾化吸入辅助治疗小儿支气管哮喘急性发作的疗效。方法:将纳入研究的170例处于支气管哮喘急性发作期的患儿随机分为A组和B组,各85例。A组给予常规西医治疗,B组在常规治疗的基础上给予沙丁胺醇雾化吸入治疗。治疗1周后观察疗效,并复查肺功能。结果:B组总有效率90.59%显著优于A组总有效率69.41%,比较有显著性差异(x2=11.912P0.05);治疗后,B组各肺功能指标改善幅度明显优于A组,比较均有显著性差异(P0.05)。结论:沙丁胺醇雾化吸入辅助治疗可迅速缓解小儿哮喘急性发作,且有助于改善肺功能,临床效果满意。     

Pitfalls associated with the therapeutic reference pricing practice of asthma medication

ABSTRACT: BACKGROUND: Therapeutic reference pricing (TRP) based on the WHO daily defined dose (DDD) is frequently employed method for the cost-containment of pharmaceuticals. Our objective was to compare average drug use in real world to DDD and to evaluate whether TRP based on DDD could result in cost savings in the maintenance medication and the total direct health expenditures for asthma patients treated with Symbicort Turbuhaler (SYT) and Seretide Diskus (SED) in Hungary. METHODS: Real-world data was derived from the NHIF database. Average doses and costs were compared between the high-dose and medium dose SYT and SED groups. Multiple linear regressions were employed to adjust the data for differences in the gender and age distribution of patients. RESULTS: 27,779 patients with asthma were included into the analysis. Average drug use was lower than DDD in all groups, 1.38-1.95 inhalations in both SED groups, 1.28-1.97 and 1.74-2.49 inhalations in the medium and high-dose SYT groups, respectively. Although the cost of SED based on the DDD would be much lower than the cost of SYT in the medium-dose groups, no difference was found in the actual cost of the maintenance therapy. No significant differences were found between the groups in terms of total medical costs. CONCLUSIONS: Cost-containment initiatives by payers may influence clinical decisions. TRP for inhalation asthma drugs raises special concern, because of differences in the therapeutic profile of pharmaceuticals and the lack of proven financial benefits. Our findings indicate that the presented TRP approach of asthma medications based on the daily therapeutic costs according to the WHO DDD do not result in reduced public health care spending in Hungary. Further analysis is required to answer whether TRP generates even additional expenditures by inducing switching costs and reducing patient compliance. Potential confounding factors may limit the generalizability of our conclusions.     

小儿肺热咳喘口服液联合三联吸入雾化治疗法对哮喘急性发作的影响

目的:探讨小儿肺热咳喘口服液联合三联吸入雾化治疗方案对哮喘患儿的治疗效果以及对肺功能的影响作用。方法:将我院自2017年1月至2018年11月间收治的哮喘患儿210例作为研究对象,按照随机数字表法分为两组各105例,研究组患儿在布地奈德、沙丁胺醇、异丙托溴铵三联吸入雾化治疗的基础上给予小儿肺热咳喘口服液进行治疗,对照组患儿仅给予三联雾化吸入治疗,对比观察两组患儿的疗效和预后。结果:研究组临床治疗后总有效率为95.24%,明显高于对照组77.14%(P0.05);治疗后研究组咳嗽消失时间、呼吸困难消失时间和急性发作随诊时间均明显短于对照组(P0.05),两组肺部喘鸣音消失时间比较差异无统计学意义(P0.05);治疗前患儿第一秒用力呼气量(forced expiratory volume in one second,FEV1)、最大肺活量(forced vital capacity,FVC)及FEV1/FVC值、呼气峰流速值(peak expiratory flowrate,PEF)对比无统计学意义(P0.05),治疗后1 d、3 d、7 d以上指标水平均明显升高,且在治疗后7 d,研究组明显高于对照组(P0.05)。治疗期间研究组有1例出现轻度腹泻,3例食欲减退,并发症的发生率为3.81%(4/105),对照组治疗期间2例出现轻度腹泻,4例食欲减退,并发症的发生率为5.71%(6/105),两组比较无统计学意义(P0.05)。结论:使用小儿肺热咳喘口服液联合三联吸入雾化法治疗儿童哮喘急性发作,可改善患儿临床症状和肺功能,疗效显著,可推广使用。     

头孢曲松+小剂量糖皮质激素联合肺泡灌洗术治疗儿童大叶性肺炎疗效分析

摘要 目的：探讨头孢曲松+小剂量糖皮质激素联合肺泡灌洗术对儿童大叶性肺炎的治疗效果。方法：选取我院2019年10月到2022年10月收治的270例大叶性肺炎儿童作为研究对象,依据治疗方法将患儿分为A、B、C三组,每组90例。所有患儿均采取常规维持水电解质、酸碱平衡、吸痰、清热、平喘、止咳等治疗,A组患儿在常规治疗基础上应用头孢曲松治疗,B组应用头孢曲松+小剂量糖皮质激素治疗,C组应用头孢曲松+小剂量糖皮质激素联合肺泡灌洗术治疗,对比三组患儿体征消失时间、影像学恢复时间,治疗前后白细胞计数（WBC）、中性粒细胞百分比（GRA）、降钙素原（PCT）、C反应蛋白（CRP）、血沉（ESR）表达水平,临床疗效以及不良反应发生率。结果：三组患儿肺啰音/哮鸣音消失时间、咳嗽消失时间、发热总天数、影像学恢复时间对比差异显著,且C组明显低于B组和A组（P＜0.05）;三组患儿治疗前WBC、GRA、PCT、CRP、ESR表达水平对比无明显差异（P＞0.05）,治疗后三组患儿WBC、GRA、PCT、CRP、ESR表达水平均降低,且C组明显低于B组和A组（P＜0.05）;三组患儿治疗效果对比差异显著,C组明显高于B组和A组（P<0.05）;三组患儿不良反应发生率对比无明显差异（P＞0.05）。结论：采用头孢曲松+小剂量糖皮质激素联合肺泡灌洗术治疗儿童大叶性肺炎能够快速减轻患儿临床症状,降低炎症因子反应,提升治疗效果,且安全性较高,能够让患儿早日康复出院。     

不同剂量氯吡格雷治疗急性ST段抬高心肌梗死的临床研究

目的:观察标准治疗基础上联合不同剂量氯吡格雷治疗急性ST段抬高心肌梗死的疗效及安全性。方法:2004年9月至2008年3月就诊我院的124例12小时以内发病的ST段抬高型心肌梗死患者,随机分为3组,3组均在入院后前3天给予阿司匹林300mg/d,此后给予阿司匹林100mg/d,A组常规不给予氯吡格雷治疗,B组给予氯吡格雷75mg/d,C组入院即刻给予氯吡格雷300mg,继之75 mg/d治疗,随访30天。观察溶栓血管再通率、梗死后心绞痛发作、心力衰竭事件及死亡、再发心肌梗死、或脑卒中的联合终点。结果:与A组相比,B组、C组患者溶栓成功率提高、梗死后心绞痛发作减少。P<0.05:进一步分析发现C组与B组差异无统计学意义,P>0.05。三组均无主要和次要出血事件发生,轻微出血发生率无统计学差异,P<0.05。结论:ST段抬高的急性心肌梗死患者在标准治疗的基础上早期加用氯吡格雷75 mg/d或先予300 mg负荷量,继之75 mg/d口服,均可提高溶栓成功率,降低梗死后心绞痛发生,而氯吡格雷负荷剂量组并不优于普通剂量组,且两组安全耐受性好。     

Unequal Day-Night Terbutaline I.V. Dosing in Acute Severe Asthma: Effect on Nocturnal Bronchial Patency,Heart Rate,and Arterial Pressure

Our study investigated the differential effects of continuous or unequal day-night terbutaline dosing on circadian bronchial patency, heart rate, and arterial pressure in severe acute asthma. Forty-five hospitalized asthmatic patients (19 women and 26 men, mean age 45.4 years, mean weight 63.5 kg) were included in this multicenter study. Three groups of patients (corresponding to three dosing schedules) were randomized; the three groups were comparable, since no statistically significant difference was detected in the age, weight, or peak expiratory flow values at the beginning of the study. In order to reach immediately the concentrations of terbutaline corresponding to the desired unequal day-night concentrations, a theoretical pharmacokinetic simulation was done to predict the outcome in terms of the plasma concentrations after the three dosing regimens; the results of this simulation allowed us to calculate the initial bolus dose to be given over 5 min to groups A, B, and C, i.e., 1.47, 2.94, and 4.41 Mg/kg, respectively. This bolus was given to all patients at 0700 h, the beginning of the study. The patients were randomly divided into three groups (A, B, C) receiving one of these treatments: 0.0111 mg/kg of terbutaline i.v. from 0700 to 1900 h at a constant rate delivered by an electrical pump and 0.0222 mg/kg of terbutaline i.v. from 1900 to 0700 h at a constant rate (A) (one third the total daily dose during the day and the remaining two thirds at night), 0.0166 mg/kg of terbutaline i.v. from 0700 to 1900 h at a constant rate and 0.0166 mg/kg of terbutaline i.v. from 1900 to 0700 h at a constant rate (B) (one half the total daily dose during the day and the remaining one half at night), or 0.0222 mg/kg of terbutaline i.v. from 0700 to 1900 h at a constant rate and 0.0111 mg/kg of terbutaline i.v. from 1900 to 0700 h at a constant rate (C) (two thirds the total daily dose during the day and the remaining one third at night). Since acute severe asthma could not be treated without steroids, a 40 mg dose of SoluMedrol was injected into all patients at 0700. Peak expiratory flow rate, heart rate, systolic arterial pressure, and possible side effects were recorded at different times during the 24-h scale: 0700, 1000, 1300, 1600, 1900, 2300, 0300, and 0700 h. Our results have shown a significant therapeutic effect of terbutaline i.v. dosing in severe acute asthma whatever the unequal daynight dosing, but did not demonstrate the efficacy of one of the three dosing schedules over the others.     

连续肾脏替代疗法治疗重症急性胰腺炎时机的探讨

目的:探讨连续肾脏替代疗法(CRRT)治疗重症急性胰腺炎的最佳时机。方法:选取我院收治的30例重症急性胰腺炎(SAP)患者为研究对象,按发病后行CRRT的时间分将患者随机为A、B两组,A组发病后72小时内治疗,B组发病后72小时后治疗,分析和比较两组治疗后的临床转归及生命体征变化、APACHEⅡ评分变化急性生理与慢性健康状况、住院费用、平均住院时间。结果:经CRRT治疗后,A组死亡率(14.3%)低于B组(43.7%),差异有统计学意义(P0.05);A、B两组治疗后体温、心率、呼吸、平均动脉压平稳,A组优于B组,差异有统计学意义(P0.05);A组的平均住院时间(15.7±8.9)d、住院费用(107000±65000)万元均明显优于B组,差异有统计学意义(P0.05);两组患者治疗后APACHEⅡ评分均明显优于治疗前,治疗后A组APACHEⅡ评分明显优于B组,差异显著有统计学意义(P0.05)。结论:早期行CRRT能明显改善重症急性胰腺炎患者的疗效和预后,最佳治疗时机可能为发病后72小时内。     

A comparative evaluation of the effects on the crystallogenic properties of the rat blood serum for prolonged inhalations of nitric oxide or reactive oxygen species

The objective of this work was to study how a prolonged course of inhalations of nitric oxide or singlet oxygen modify crystallization of the blood serum in rats. Experiments were performed with 50 adult Wistar rats, which were divided into five equal groups. The control group (n = 10) included intact rats, which were not exposed to any manipulation other than a single blood drawing. Rats of groups 2, 3, and 4 received inhalations of nitric oxide at 20, 50, and 100 ppm, respectively, daily for 30 days. Group 5 rats (n = 10) received a similar course of inhalations of singlet oxygen for 30 days. Blood samples were drawn from the sublingual vein in rats of the test groups immediately after completion of the inhalation course (day 30 of the experiment) and in the recovery period (day 60 of the experiment) and tested for crystallogenic activity. Dried samples were evaluated visually for crystallizability, structure index, facia destruction degree, and marginal zone clarity, using respective scales. A prolonged course of NO inhalations was found to modulate the crystallogenic properties of the rat serum. An optimal response was recorded at the lowest nitric oxide concentration (20 ppm). Higher NO concentrations caused more adverse changes in serum crystallization after the end of the inhalation course and hindered the recovery processes. Singlet oxygen inhalations for 30 days did not exert a considerable adverse effect on the crystallogenic properties of the rat serum.     

布地奈德雾化吸入联合系统护理干预治疗儿童哮喘急性发作

为了探讨布地奈德雾化吸入联合系统护理干预治疗儿童哮喘急性发作的临床效果,本研究选取2016年2月至2017年12月在我院治疗的哮喘急性发作患儿84例,采用随机数字表法将患儿随机分为观察组(n=44)和对照组(n=40),均给予地奈德雾化吸入,其中对照组给予常规护理,观察组在对照组基础上增加系统护理干预,观察两组治疗疗效、临床症状消失时间、治疗依从性、肺功能等。研究结果表明观察组治疗疗效优于对照组(p<0.05),其治疗总有效率为93.18%;观察组和对照组喘息、咳嗽和肺部哮鸣音消失时间比较差异无统计学意义(p>0.05);观察组治疗后用力肺活量(FVC)、第一秒用力呼气容积(FEV1)和呼气流量峰值(PEF)分别为(3.30±1.03) L、(2.70±0.81) L和(6.10±0.90) L/s,明显高于对照组(p<0.05);观察组治疗依从性好的比例为86.36%,明显高于对照组(p<0.05);观察组和对照组治疗期间未发生不良反应。研究结果初步说明布地奈德雾化吸入联合系统护理干预治疗儿童哮喘急性发作能提高治疗效果,同时提高患儿治疗依从性。     

Driving and timing components of the breathing pattern during hypoxia in anaesthetized cats

The effects of acute hypoxic hypoxia elicited by N2 inhalation on the driving and timing components of the breathing pattern were studied in 18 adult anaesthetized cats. Two phases could be distinguished in the ventilatory response to acute hypoxia. During the first phase, mean inspiratory flow (VT/TI) increased exponentially up to 240% of the initial value. During the second phase, VT/TI gradually decreased, reaching the control values in the last preapnoeic breaths during the first exposure and remained higher than normal with earlier respiratory arrest in three repeated N2 inhalations. No significant changes could be observed in the timing component of breathing pattern (TI/TT) in the course of the first hypoxic exposure, and the changes in TI/TT did not exceed 7% in repeated attacks. This suggests that the shortening of both inspiratory and expiratory durations increased the breathing frequency up to 130% of its resting value. Moreover, tachypnoea was preserved until respiratory arrest. Accordingly, it is concluded that the decrease in ventilation with the appearance of apnoea during the second phase of N2 inhalation in anaesthetized cats is not due to a failure of respiratory timing, but to a depression of the driving mechanisms which are responsible for this phenomenon.