A 1-year follow-up after a pilot study with Doloteffin for low back pain.

OBJECTIVE: To complete a year's follow-up on patients from a 6-week double-blind pilot comparison between 44 Doloteffin patients and 44 rofecoxib patients being treated for acute exacerbations of chronic low back pain. METHODS: 38 "ex-Doloteffin" (ex-D) and 35 "ex-rofecoxib" (ex-R) received Doloteffin containing 60 mg harpagoside per day for up to 54 weeks. Pain, additional analgesics, mobility, general health and adverse events were assessed from diary records and at 6-week visits. RESULTS: 53 patients remained in the follow-up at 24 weeks and 43 at 54 weeks. There was never any convincing difference between ex-D and ex-R patients in the number of patients remaining in follow-up, diary pain scores, additional analgesics, Arhus Index and health assessment questionnaire scores (HAQ). Individual fluctuations notwithstanding, the follow-up showed a slight overall improvement on the improvements in Arhus and HAQ scores achieved in the pilot study (MANOVA p = 0.016). Of the 21761 patient-days, the respective percentages with no, mild, moderate, severe and excruciating pain were 28%, 39%, 22%, 8.5% and 1.5%, respectively. Few patients requested additional treatments for their pain. Three patients suffered from minor adverse drug reactions. CONCLUSION: Long-term treatment with Doloteffin was well tolerated. Ex-R and ex-D patients behaved similarly during the follow-up.     

Nifedipine and atenolol singly and combined for treatment of essential hypertension: comparative multicentre study in general practice in the United Kingdom

A randomised double blind parallel group study was performed to compare the efficacy and acceptability of slow release nifedipine (maximum dose 40 mg twice a day) with those of atenolol (maximum dose 100 mg once a day) as single agents for the treatment of essential hypertension. Of 410 patients recruited almost exclusively from general practices in 22 centres in the United Kingdom 210 received nifedipine and 200 atenolol. Both drugs significantly reduced blood pressure, and control—a reduction of the diastolic pressure to less than 95 mm Hg—was obtained in about 65% of patients. Those who received nifedipine had more pronounced reductions in systolic pressure than those who received atenolol. One hundred and forty nine patients who failed to respond adequately to either atenolol or nifedipine in low doses were given both drugs once daily for eight weeks in a fixed combination capsule that contained atenolol 50 mg and nifedipine 20 mg. All patients showed further reductions in blood pressure, although those who were taking β atenolol before the combination capsule had more pronounced reductions in systolic pressures. Twenty six patients (12%) were withdrawn because of adverse effects while taking nifedipine compared with 19 (10%) taking atenolol. Flushing and oedema were more common after the calcium antagonist, whereas diarrhoea and dyspepsia were more common after atenolol. The frequencies of headaches, dizziness, fatigue, and dyspnoea were equally distributed between the two groups. When the fixed combination capsule was taken side effects such as flushing and oedema continued.Nifedipine was more effective than atenolol in lowering systolic blood pressure, although neither drug used alone controlled the pressure of more than two thirds of the patients studied. When used in a fixed combination slightly better control of blood pressure was achieved with a lower dose of each drug.     

舌下含服卡托普利用于院前急救高血压急症的临床疗效及对患者血清sCD40L、sPECAM-1、PDGF-BB水平的影响

目的:探讨舌下含服卡托普利用于院前急救高血压急症的临床疗效及对患者血清可溶性CD40L(sCD40L)、可溶性血小板内皮细胞黏附分子1(sPECAM-1)、血小板衍生生长因子-BB(PDGF-BB)水平的影响。方法:选择2015年5月到2017年5月我院院前急救高血压急症患者65例作为研究对象,按照随机数表法分为观察组(n=35)和对照组(n=30)。对照组给予硝苯地平舌下含化治疗,观察组采用舌下含服卡托普利治疗。比较两组治疗后的疗效,治疗前后血清s CD40L、sPECAM-1、PDGF-BB水平、收缩压(SBP)、舒张压(DBP)、心率(HR)的变化及不良反应的发生情况。结果:治疗后,观察组临床疗效总有效率为94.29%,显著高于对照组(73.33%,P0.05);两组血清s CD40L、sPECAM-1、PDGF-BB、SBP、DBP及HR水平均较治疗前明显下降,且观察组以上指标均显著低于对照组(P0.05);观察组患者不良反应发生率为17.14%,明显低于对照组(56.67%,P0.05)。结论:舌下含服卡托普利用于院前急救高血压急症患者的临床效果显著优于硝苯地平舌下含化治疗,其可更有效改善患者血清sCD40L、sPECAM-1、PDGF-BB水平。     

康复新液与他克莫司联合沙利度胺治疗口腔扁平苔藓的疗效及安全性分析

目的:探讨康复新液与他克莫司联合沙利度胺治疗口腔扁平苔藓(oral lichen planus,OLP)的临床疗效及安全性。方法:选择2017年12月-2020年1月就诊于我院的80例OLP患者,采用随机数字表法将其分为联合组和对照组,每组40例。两组均进行常规治疗,对照组使用0.1%的他克莫司软膏与康复新液治疗,联合组在对照组的基础上加用沙利度胺片,比较两组的临床疗效、治疗前后糜烂面大小、疼痛程度的变化以及不良反应的发生情况。结果:治疗后,联合组总有效率为90.00%,显著高于对照组(72.5%,P0.05);与治疗前相比,两组口腔糜烂面积和疼痛程度均显著降低(P 0.05),且联合组口腔糜烂面积和疼痛程度显著低于对照组(P 0.05);治疗期间,对照组出现1例不良反应,具体表现为轻微的黏膜烧灼痛,停药后两天后症状消失,不良反应发生率为2.5%,联合组出现2例不良反应,其中1例病变部位出现黏膜萎缩,1例出现色素沉着,不良反应发生率为5.0%,两组不良反应的发生率比较无显著差异(P0.05)。结论:康复新液与他克莫司联合沙利度胺治疗口腔扁平苔藓的临床疗效明显优于康复新液与他克莫司治疗,其能明显降低粘膜糜烂面积和疼痛程度,且安全性高。     

赖氨酸维B12合剂联合西沙比利对功能性消化不良腹痛患儿肠道菌群及胃肠功能的影响

探讨赖氨酸维B₁₂合剂联合西沙比利对功能性消化不良（FD）腹痛患儿肠道菌群及胃肠功能的影响,以期为临床提供参考。

选取2022年5月至2023年6月于本院收治的90例FD伴腹痛患儿,采用简单随机分组将患儿分为单一组（n=45）和联合组（n=45）,单一组患儿采用西沙比利治疗,联合组患儿采用赖氨酸维B₁₂合剂联合西沙比利治疗。比较两组患儿的疗效,治疗前后患儿的肠道菌群、胃肠功能和疼痛程度,记录两组患儿治疗期间的不良反应发生情况。

联合组患儿治疗的有效率为95.56%,单一组为82.22%,差异有统计学意义（χ²=4.050,P＜0.05）。治疗后,联合组患儿的乳杆菌和双歧杆菌数量较单一组高,大肠埃希菌数量较单一组低,差异均有统计学意义（t=11.065,17.829,7.985,均P＜0.05）。治疗后,联合组患儿的粪便性质分级量表评分较单一组高,克利夫兰便秘评分量表和视觉模拟评分量表评分较单一组低,差异均有统计学意义（t=4.395,4.414,10.302,均P＜0.05）。治疗后,联合组患儿的胃动素和胃泌素水平较单一组高,生长抑素水平较单一组低,差异均有统计学意义（t=6.102,10.743,10.908,均P＜0.05）。联合组患儿的不良反应发生率为6.67%,单一组为13.33%,差异无统计学意义（χ²=0.485,P＞0.05）。

赖氨酸维B₁₂合剂联合西沙比利治疗FD伴腹痛患儿具有较好的临床疗效且无明显不良反应,可以缓解腹痛,改善肠道菌群和胃肠功能。

     

阿泰宁治疗冷凉、喝酒性腹泻35例疗效观察

目的观察和评价阿泰宁（酪酸梭菌CGMCC0313．1制剂）治疗冷凉、喝酒性腹泻的临床疗效。方法选择受凉、吃凉食和喝酒后就腹泻的患者,口服阿泰宁胶囊,一次3粒,一天2～3次,疗程14～60d。治疗期间观察患者的临床症状、服药情况,治疗结束后评价药物的疗效。结果35例冷凉、喝酒性腹泻患者治疗后腹泻、腹痛和腹部不适等症状有显著的改善（P〈0．01或P〈0．001）;治愈率为97．14％（34／35）,总有效率为100％（35／35）,治疗中未见不良反应或副作用。结论阿泰宁治疗冷凉、喝酒性腹泻疗效显著。     

Comparison of enalapril and nifedipine in treating non-insulin dependent diabetes associated with hypertension: one year analysis.

OBJECTIVES--To compare the efficacy, safety, and tolerance of enalapril and nifedipine in hypertensive patients with non-insulin dependent diabetes. DESIGN--One year double blind follow up of patients randomly allocated to either enalapril or nifedipine with matching placebos for the alternative drug. SETTING--Metabolic Investigation Unit, Hong Kong. SUBJECTS--102 patients were randomised: 52 to nifedipine and 50 to enalapril. At baseline 44 patients had normoalbuminuria, 36 microalbuminuria, and 22 macroalbuminuria. MAIN OUTCOME MEASURES--Blood pressure, albuminuria, and parameters of renal function and glycaemic control. RESULTS--In patients who completed one year''s treatment the median dose required by the nifedipine group (n = 49) was 60 mg/day; seven (14%) required additional diuretics. Of 41 patients given enalapril, 37 required the maximum dose (40 mg/day) and 27 (76%) required diuretics. At one year mean arterial blood pressures were similar in both groups. Albuminuria fell by 54% in the enalapril group and 11% in the nifedipine group (p = 0.006). Fractional albumin clearance ratio fell by 47% in the enalapril group and increased by 3% in the nifedipine group (p = 0.009). Creatinine clearance fell similarly in both groups but plasma creatinine concentration was increased by 20% in the enalapril group versus 8% in the nifedipine group (p = 0.001). CONCLUSION--Patients taking enalapril often required diuretics to control blood pressure. Enalapril reduced proteinuria significantly more than nifedipine in the microalbuminuric and macroalbuminuric patients but increased plasma creatinine concentrations. Longer follow up is required to clarify the importance of enalapril''s antiproteinuric effect.     

Patients as a direct source of information on adverse drug reactions.

To determine whether patients should participate directly in detecting adverse reactions to drugs their ability to provide written reports of symptoms experienced during treatment with amoxycillin or trimethoprim-sulphamethoxazole was investigated. When compared with telephone interviews forms on which patients reported events were reliable (the observed agreement with the same statements posed during telephone calls was 85%, kappa = 0.56) and valid (sensitivity = 54%, specificity = 94%). Patients were also supplied with forms that invited them to report adverse reactions, and their perceptions were compared with those of a panel of experts, who were informed of all clinical events that had been reported during the detailed telephone interviews. Patients were more conservative than the experts in attributing clinical events to drug treatment. The extent of agreement varied and was notably poor for skin and bowel complaints (kappa = 0.13 in each case). The performance of event report forms and reaction report forms as instruments of detection was compared in a hypothetical situation in which the experts'' views represented the "truth" about adverse reactions to a new drug. Event reporting had a higher sensitivity than reaction reporting (42% v 24%) but a lower specificity (58% v 98%). National centres monitoring adverse drug reactions should probably resist pressure to accept reports of reactions directly from the public, but a system based on large scale reporting of events might be valuable in aiding the early detection of symptomatic reactions to new drugs.     

Factors associated with anti-tuberculosis medication adverse effects: a case-control study in Lima, Peru

Background

Long-term exposure to anti-tuberculosis medication increases risk of adverse drug reactions and toxicity. The objective of this investigation was to determine factors associated with anti-tuberculosis adverse drug reactions in Lima, Peru, with special emphasis on MDR-TB medication, HIV infection, diabetes, age and tobacco use.

Methodology and Results

A case-control study was performed using information from Peruvian TB Programme. A case was defined as having reported an anti-TB adverse drug reaction during 2005–2010 with appropriate notification on clinical records. Controls were defined as not having reported a side effect, receiving anti-TB therapy during the same time that the case had appeared. Crude, and age- and sex-adjusted models were calculated using odds ratios (OR) and 95% confidence intervals (95%CI). A multivariable model was created to look for independent factors associated with side effect from anti-TB therapy. A total of 720 patients (144 cases and 576 controls) were analyzed. In our multivariable model, age, especially those over 40 years (OR = 3.93; 95%CI: 1.65–9.35), overweight/obesity (OR = 2.13; 95%CI: 1.17–3.89), anemia (OR = 2.10; IC95%: 1.13–3.92), MDR-TB medication (OR = 11.1; 95%CI: 6.29–19.6), and smoking (OR = 2.00; 95%CI: 1.03–3.87) were independently associated with adverse drug reactions.

Conclusions

Old age, anemia, MDR-TB medication, overweight/obesity status, and smoking history are independent risk factors associated with anti-tuberculosis adverse drug reactions. Patients with these risk factors should be monitored during the anti-TB therapy. A comprehensive clinical history and additional medical exams, including hematocrit and HIV-ELISA, might be useful to identify these patients.     

埃索美拉唑治疗幽门螺杆菌阳性十二指肠球部溃疡疗效观察

目的：比较埃索关拉唑与兰索拉唑、奥美拉唑三联疗法治疗幽门螺杆菌（Hp）阳性十二指肠球部渍疡疗效观察。方法：将84例Hp阳性的十二指肠球部溃疡随机分为三组。埃索美拉唑组（28例）：埃索美拉唑20mg＋阿莫西林1g＋呋喃唑酮100mg,每日2次,共7日,后服用埃索美拉唑20mg,每日一次,共21天;兰索拉唑组（28例）：兰索拉唑15mg＋阿莫西林1g＋呋喃唑酮100mg,每日2次,共7日,后服用兰索拉唑15mg,每日一次,共21天;奥美拉唑组（28例）：奥美拉唑20mg＋阿莫西林1g＋呋喃唑酮100mg,每日2次,共7日,后服用奥美拉唑20mg,每日一次,共21天。疗效结束4周后复查胃镜并检测Hp,观察腹痛缓解率、溃疡愈合率,Hp根治率及药物不良反应。结果：埃索美拉唑组、兰索拉唑组和奥关拉唑组溃疡愈合率分别为100％,85．7％,82．1％,HP根治率为85．7％,60．7％,64.3％,埃索美拉唑组溃疡愈合率及Hp根除率高于兰索拉唑组及奥美拉唑组,差异具有统计学意义（P〈0．05）。兰索拉唑组及奥美拉唑组溃疡愈合率及Hp根除率无明显差异（P〉0．05）。三组用药后不良反应少,具较好的安全性。结论：埃索关拉唑三联疗法治疗Hp阳性的消化性溃疡疗效优于兰索拉唑及奥美拉唑三联疗法,值得临床广泛应用。     

Percentage of patients with preventable adverse drug reactions and preventability of adverse drug reactions--a meta-analysis

Background

Numerous observational studies suggest that preventable adverse drug reactions are a significant burden in healthcare, but no meta-analysis using a standardised definition for adverse drug reactions exists. The aim of the study was to estimate the percentage of patients with preventable adverse drug reactions and the preventability of adverse drug reactions in adult outpatients and inpatients.

Methods

Studies were identified through searching Cochrane, CINAHL, EMBASE, IPA, Medline, PsycINFO and Web of Science in September 2010, and by hand searching the reference lists of identified papers. Original peer-reviewed research articles in English that defined adverse drug reactions according to WHO’s or similar definition and assessed preventability were included. Disease or treatment specific studies were excluded. Meta-analysis on the percentage of patients with preventable adverse drug reactions and the preventability of adverse drug reactions was conducted.

Results

Data were analysed from 16 original studies on outpatients with 48797 emergency visits or hospital admissions and from 8 studies involving 24128 inpatients. No studies in primary care were identified. Among adult outpatients, 2.0% (95% confidence interval (CI): 1.2–3.2%) had preventable adverse drug reactions and 52% (95% CI: 42–62%) of adverse drug reactions were preventable. Among inpatients, 1.6% (95% CI: 0.1–51%) had preventable adverse drug reactions and 45% (95% CI: 33–58%) of adverse drug reactions were preventable.

Conclusions

This meta-analysis corroborates that preventable adverse drug reactions are a significant burden to healthcare among adult outpatients. Among both outpatients and inpatients, approximately half of adverse drug reactions are preventable, demonstrating that further evidence on prevention strategies is required. The percentage of patients with preventable adverse drug reactions among inpatients and in primary care is largely unknown and should be investigated in future research.     

布比卡因局部阻滞治疗输尿管结石所致肾绞痛60 例的临床观察

目的:比较药物治疗与布比卡因局部阻滞治疗输尿管上段结石所致的肾绞痛的临床疗效。方法:选择输尿管结石患者共120例。随机分成药物治疗组(M组)与局部阻滞组(B组)各60例,其中药物治疗组采用杜冷丁加阿托品治疗,局部阻滞组采用布比卡因行痛区局部阻滞,两组年龄、性别均无统计学差异,比较两组患者治疗的总有效率、不良反应、镇痛起效时间、缓解时间等疗效指标。结果:局部阻滞组治疗的总有效率大于药物治疗组,不良反应也比药物治疗组少。疼痛起效时间及缓解时间,局部阻滞组均明显短于药物治疗组。结论:布比卡因局部阻滞治疗输尿管上段结石所致的肾绞痛临床疗效明显优于以杜冷丁加阿托品为代表的药物治疗。     

Public involvement in pharmacogenomics research: a national survey on patients’ attitudes towards pharmacogenomics research and the willingness to donate DNA samples to a DNA bank in Japan

To assess the attitude of Japanese patients towards pharmacogenomics research and a DNA bank for identifying genomic markers associated with adverse drug reactions (ADRs) and their willingness to donate DNA samples, we conducted a survey of 550 male and female patients. The majority of the respondents showed a positive attitude towards pharmacogenomics research (87.6%) and a DNA bank (75.1%). The willingness to donate DNA samples when experiencing severe ADRs (55.8%) was higher than when taking medications (40.4%). Positive attitudes towards a DNA bank and organ donation were significantly associated with an increased willingness to donate. Though the level of positive attitude in the patient population was higher than that in the general public in our former study (81.0 and 70.4%, respectively), the level of the willingness of patients to donate was 40.4% when taking medications and 55.8% when experiencing severe ADRs which was lower than that of the general public in our former study (45.3 and 61.7%). The results suggested that the level of true willingness in the patient population was lower than that of the general public considering the fictitious situation presented to the public (to suppose that they were patients receiving medication). It is important to assess the willingness of patients who are true potential donors, not the general public.     

Mutation in the ITPA gene predicts intolerance to azathioprine

Inosine triphosphate pyrophosphatase (ITPase) deficiency occurs with polymorphic frequencies in Caucasians and results in the benign accumulation of the inosine nucleotide ITP. In 62 patients treated with azathioprine for inflammatory bowel disease, the ITPA 94C>A deficiency-associated allele was significantly associated with adverse drug reactions (OR 4.2, 95% CI 1.6-11.5, p = 0.0034). Significant associations were found for flu-like symptoms (OR 4.7, 95% CI 1.2-18.1, p = 0.0308), rash (OR 10.3, 95% CI 4.7-62.9, p = 0.0213) and pancreatitis (OR 6.2, CI 1.1-32.6, p = 0.0485). Polymorphism in the ITPA gene thus predicts AZA intolerance. Alternative immunosuppressive drugs, particularly 6-thioguanine, should be considered for AZA-intolerant patients with ITPase deficiency.     

益生菌辅助四联疗法对H. pylori感染患者根治效果及肠道菌群的影响

研究益生菌辅助四联疗法对H. pylori感染患者根治效果及肠道菌群的影响。

选择2019年1月至2020年6月在我院接受治疗的160例H. pylori感染患者为研究对象,用随机数字表法分为对照组（n = 80）和观察组（n = 80）。对照组患者给予标准铋剂四联药物治疗,观察组加用双歧杆菌四联活菌片治疗。比较两组患者的H. pylori根除率、复发率、不良反应发生率、临床症状（上腹痛、上腹胀、嗳气、纳差）、肠道菌群（双歧杆菌、乳杆菌）和炎性因子[白细胞介素-6（IL-6）、白细胞介素-8（IL-8）及肿瘤坏死因子-α（TNF-α）]水平。

观察组患者的H. pylori根除率（95.00%）高于对照组（82.5%）,复发率和不良反应发生率低于对照组（均P＜0.05）。治疗后两组患者的临床症状积分均显著下降,同时观察组患者上腹痛、上腹胀、嗳气、纳差等临床症状积分低于对照组（均P＜0.05）。治疗后观察组患者肠道双歧杆菌和乳杆菌数量升高,而对照组降低,同时观察组患者肠道双歧杆菌和乳杆菌数量高于对照组（均P＜0.05）。治疗后观察组患者IL-6、IL-8和TNF-α水平均低于对照组（均P＜0.05）。

双歧杆菌四联活菌片辅助标准铋剂四联疗法治疗可显著提高H. pylori感染患者H. pylori根除率,降低复发率和不良反应的发生率,改善肠道菌群分布,减轻患者的临床症状和炎症状态。

     

阿片类药物滴定法治疗癌痛的疗效及不良反应分析

目的:探讨阿片类药物滴定法治疗癌痛的疗效及不良反应分析,为临床治疗提供依据。方法:采用回顾性分析选择2012年1月~2015年12月我院收治的肿瘤患者共110例,采用数字评定量表(NRS)和面部表情疼痛分级量表(FRS)进行疼痛评价,采用滴定法从小剂量开始给药,并记录患者的疼痛状况和不良反应发生状况。结果:患者总用药时间为28~170 d,平均用药时间(45.7±19.4)d,中位时间为48d。阿片类药物使用剂量(换算成吗啡剂量计算)40~500 mg,中位剂量74 mg。110例患者中有101例(91.82%)达到中度以上缓解。发生不良反应63(57.27%)例,消化道副反应为最常见的不良反应,主要有便秘48例(43.64%)例和恶心呕吐25例(22.73%)、其次依次为嗜睡15例(13.64%)、头晕9例(8.18%)、排尿困难5例(4.55%)、皮肤瘙痒3例(2.73%)和呼吸抑制2例(1.82%)。结论:阿片类药物能够有效缓解癌症患者的中重度癌痛,其主要不良反应是便秘和恶心呕吐。应合理、安全的使用阿片类药物,从小剂量开始,规范剂量滴定。     

Faster onset of action with topical levocabastine than with oral cetirizine

This international multicentre, open-label, parallel-group trial was undertaken to compare the therapeutic efficacy and tolerability of topical levocabastine and oral cetirizine in patients with perennial allergic rhinoconjunctivitis, with particular reference to the comparative onset of action of the two drugs. A total of 207 patients were randomized to receive either levocabastine nasal spray (0.5 mg/ml, two sprays in each nostril twice daily) plus levocabastine eye drops as required (0.5 mg/ml, one drop in each eye twice daily p.r.n.) or cetirizine orally (10 mg once daily) with a treatment duration of 2 weeks. Onset of action was found to be significantly more rapid with levocabastine than with cetirizine for both nasal and ocular symptoms (p < 0.001). Within 15 min of study drug administration, 36% of levocabastine-treated patients reported relief from nasal symptoms and 32% relief from ocular symptoms compared with 10% and 17% of patients on cetirizine, respectively. At 1 h, the percentages of patients reporting relief were 76% and 38% for nasal symptoms, and 81% and 48% for ocular symptoms in the levocabastine and cetirizine treatment groups, respectively. At 8 h there were no differences between the two treatments. Overall therapeutic efficacy was found to be comparable in the two treatment groups over the 2-week study period with no significant intergroup differences in symptom severity or global therapeutic efficacy. Both drugs were well tolerated with no significant differences in the incidence or type of adverse reactions between the two groups. In conclusion, levocabastine eye drops and nasal spray are as effective and well tolerated as oral cetirizine for the treatment of perennial allergic rhinoconjunctivitis with the advantage of a significantly faster onset of action for both nasal and ocular symptoms.     

重组人表皮生长因子凝胶联合赛肤润对慢性伤口患者疼痛评分及不良反应的影响

摘要 目的：探讨重组人表皮生长因子(Recombinant human epidermal growth factor,rhEGF)凝胶联合赛肤润对慢性伤口患者疗效及对疼痛评分与不良反应的影响。方法：2017年3月-2019年9月选择在本院进行诊治的胃肠外科术后慢性伤口患者108例,根据治疗方法分为联合组与对照组各54例。对照组给予赛肤润治疗,联合组在对照组治疗的基础上给予rhEGF凝胶治疗,两组都持续给药观察14 d,记录患者疼痛与不良反应情况。结果：联合组治疗第3 d、第7 d、第14 d的疼痛VAS评分都低于对照组(P<0.05)。联合组治疗期间的皮肤坏死、伤口感染、发热等不良反应发生率为3.7 %,低于对照18.5 %(P<0.05)。联合组治疗后第3 d伤口愈合率为83.3 %,高于对照组的59.3 %(P<0.05),治疗后第7 d、第14 d的联合组伤口愈合率稍高于对照组,对比无统计学意义（P>0.05）。两组治疗后的血清血管内皮生长因子(vascular endothelial growth factor,VEGF)含量高于治疗前(P<0.05),联合组高于对照组(P<0.05)。结论：rhEGF凝胶联合赛肤润在慢性伤口患者的应用能促进缓解疼痛评分,减少不良反应的发生,促进VEGF的表达,从而加快伤口愈合。     

Pre-Treatment with Amifostine Protects against Cyclophosphamide-Induced Disruption of Taste in Mice

Cyclophosphamide (CYP), a commonly prescribed chemotherapy drug, has multiple adverse side effects including alteration of taste. The effects on taste are a cause of concern for patients as changes in taste are often associated with loss of appetite, malnutrition, poor recovery and reduced quality of life. Amifostine is a cytoprotective agent that was previously shown to be effective in preventing chemotherapy-induced mucositis and nephrotoxicity. Here we determined its ability to protect against chemotherapy-induced damage to taste buds using a mouse model of CYP injury. We conducted detection threshold tests to measure changes in sucrose taste sensitivity and found that administration of amifostine 30 mins prior to CYP injection protected against CYP-induced loss in taste sensitivity. Morphological studies showed that pre-treatment with amifostine prevented CYP-induced reduction in the number of fungiform taste papillae and increased the number of taste buds. Immunohistochemical assays for markers of the cell cycle showed that amifostine administration prevented CYP-induced inhibition of cell proliferation and also protected against loss of mature taste cells after CYP exposure. Our results indicate that treatment of cancer patients with amifostine prior to chemotherapy may improve their sensitivity for taste stimuli and protect the taste system from the detrimental effects of chemotherapy.     

2009 年-2010 年我院212 例不良反应报告分析

目的:总结医院药品不良反应(ADR)发生的特点。方法:通过ADR网上检索工具统计2009年1月～2010年12月不良反应报告表,采用回顾性分析全院不良反应分布情况。结果:60岁以上老年人ADR发生率较高(27.36%);静脉滴注方式导致的不良反应例数最多(75.00%);导致不良反应的药品以抗微生物药物最多(45.28%);临床表现以皮肤及其附件损害和全身性损害为主(44.35%)。结论:全院不良反应工作有所提高,但仍应加强全院用药监测工作,确保患者用药安全。