Search

Efficacy and Safety of Desloratadine in Chronic Urticaria: A Systematic Review

Objectives　To evaluate the efficacy and safety of desloratadine in the patients with chronic urticaria(cu). Methods　We searched PubMed, Blackwell, BIOSIS Preview, The Cochrane Library, VIP and CNKI electronically from January 1, 2000 to April, 2008. Relevant journals and conference proceedings were also handsearched. Randomized controlled trials (RCTs) and quasi-RCTs comparing desloratadine with other medicines in the patients with CIU were considered eligible. The quality of the included trials was assessed by the Jadad scale, and meta-analysis was conducted using RevMan 5.0 software. Results　Nineteen trials involving 3,448 participants contributed to the meta-analysis. The results of the meta-analysis indicated that desloratadine showed similar effect on the improvement of signs and symptoms compared with loratadine RR 1.04 and 95%CI 0.99 to 1.09, mizolastine in RR 0.99 and 95%CI 0.92 to 1.07, cetirizine RR 1.05 and 95%CI 0.97 to 1.13 and terfenadine RR 1.10 and 95%CI 0.84 to 1.44. And desloratadine had similar safety to mizolastine RR 0.84 and 95%CI 0.45 to 1.58, ceririzine RR 0.67 and 95%CI 0.67 and 0.39 to 1.15 and terfenadine RR 0.44 and 95%CI 0.17 to 1.10. Desloratadine was safer than loratadine RR 0.74 and 95%CI 0.55 to 1.00. Conclusions　Desloratadine, the active metabolite of loratadine, is an oral, once-daily, non-sedating antihistamine that is effective in the treatment of CIU. Desloratadine provides rapid and sustained relief of CIU symptoms.

Clinical Analysis of 196 Cases of Adult Measles

目的:探討成人麻疹的流行病學與臨床特征。方法:回顧性分析196例成人麻疹的臨床資料。結果:患者以外來流動人員及本地農村人口多見,平均年齡26.78歲,多數患者未接種麻疹疫苗或麻疹疫苗史不詳。成人麻疹患者臨床癥狀重,皮疹典型,為充血性斑丘疹,麻疹黏膜斑(Koplik’s spots)明顯,且持續時間長,可合并肝臟和心肌損傷,但并發癥以肺炎和支氣管炎為主。結論:有必要加強成人的免疫接種,尤其是外來的務工人員,強化醫務人員對麻疹的認識,避免麻疹的流行。

496例慢性蕁麻疹患者變應原皮膚點刺試驗結果分析

目的分析慢性蕁麻疹患者常見變應原分布情況。 方法對2012年6月-2013年3月收治的496例慢性蕁麻疹患者進行皮膚點刺試驗。將患者分為≥16歲組和＜16歲組，分別觀察兩組患者皮膚點刺試驗后各變應原陽性率。 結果496例患者中共442例（89.11%）檢出陽性結果。屋塵螨與粉塵螨變應原陽性率明顯高于其他變應原（P＜0.05）；海蝦和大豆變應原陽性率在≥16歲組和＜16歲組間差異有統計學意義（χ2=8.191、4.748，P＜0.05），其余變應原陽性率不同年齡組間比較差異無統計學意義（P＞0.05）；91.40%的患者存在≥4種變應原陽性反應，93.21%的患者同時存在吸入性和食入性變應原陽性反應。 結論塵螨是慢性蕁麻疹患者最主要的變應原。

Analysis on Measles Epidemic Characteristic and Control Efficacy in Jinan in 2009

Objective　To analyze the measles epidemic characteristic, so as to provide scientific evidence for the strategy of controlling and eliminating measles. Methods　The data of measles cases was collected from the national epidemiological investigation and surveillance report system, and the measles epidemiological characteristic as well as the efficacy of measles control strategy were analyzed through descriptive studies. Results　The total number of the reported measles cases reached 309 in 2009, the incidence rate was 5.1 per 100 000 population and declined by 71.26% compared with the year of 2008. Seasonal peak in 2009 appeared from January to April. The infants less than eight months old as well as the patients more than 15 years old were the main suffering population, which accounted for 33.98% (105/309) and 49.51% (153/309) of the total, respectively. The patients having no or having unclear measles vaccination history accounted for 93.2% (288/309). The cases of floating population accounted for 9.71% (30/309). Conclusion　It has been demonstrated that vaccine immunization activities are important measures to eliminate measles. To achieve the goal of measles elimination, not only does the children routine immunization have to be performed, but also the strengthened immunization has to be carried out for the key crowd in key areas.

特應性皮炎與慢性蕁麻疹患者血清白細胞介素-4的檢測

目的　了解特應性皮炎與慢性蕁麻疹患者外周血白細胞介素-4的水平。 方法　采用雙夾心酶聯免疫吸附試驗法（ELASA）對2010年5月－2012年6月皮膚科門診及變態反應門診收治的31例特應性皮炎患者與30例IgE介導慢性蕁麻疹患者進行血清白細胞介素-4檢測。 結果　特應性皮炎與慢性蕁麻疹患者血清白細胞介素-4明顯高于正常人對照組（P＜0.001）。 結論　特應性皮炎與慢性蕁麻疹患者存在循環白細胞介素-4水平明顯異常。

西替利嗪滴劑治療慢性蕁麻疹近期療效觀察

【摘要】　目的　觀察西替利嗪滴劑治療慢性蕁麻疹的療效。　方法　選擇2011年4月-2011年8月間80例慢性蕁麻疹患者為研究對象，試驗組40例給予西替利嗪滴劑1次/d，10 mg/次；對照組40例給予氯雷他定1次/d，10 mg/d，均連續服用28 d。分別于用藥后第7、28天隨訪，觀察療效和不良反應。　結果　試驗組治療7、28 d有效率分別為72.5%、87.5%，對照組有效率分別為67.5%、85.0%，兩組比較差異無統計學意義（χ2=0.060，0.081；Pgt;0.05）。　結論　口服西替利嗪滴劑或氯雷他定10 mg/d治療慢性蕁麻疹療效相似，但滴劑劑量調整更準確，在慢性蕁麻疹緩解期的維持減量階段應用更方便。

罕見腹型蕁麻疹伴高淀粉酶血癥一例分析

Effects of Mass Immunization Campaign on the Epidemiological Characteristics of Measles

Objective　To evaluate the effects of mass immunization campaign on the epidemiological characteristics of measles. Methods　Comparison was made between the incidences of measles before and after the mass immunization campaign in 2007 in Shunqing prefecture of Nanchong city. Results　The total number of the reported measles cases reached 460 during 2004 to 2007 in Shunqing prefecture of Nanchong city, and the respective annual rates of incidence were 4.04, 23.53, 11.84, and 33.57, respectively per 100 000 heads. Cases reported from April to July accounted to 73.91% of the total (340/460). Children under 15 were reported to have the highest incidence rate and accounted to 83.70% of the total (385/460), of which incidences of children under 1 accounted to 0%, 10.81%, 13.51% and 25.82%, respectively. Only 20.00% of the subjects (92/460) in this study had a definite history of measles vaccination. After the mass immunization campaign in September, 2007, only 10 cases were reported in 2008 and the incidence rate was 1.58 per 100 000 heads, a 95.29% decrease in incidence rate in comparison with that of the last year. Conclusion　The mass immunization campaign has achieved substantial results.

Health technology assessment of four non-sedating antihistamines for allergic diseases

Objective　This review compared clinical effectiveness, cardiac safety and economics of astemizole, loratadine, cetirizine and terfenadine to provide evidence for adjustment of Essential Drug List in China. Search strategy　We searched Medline, Cochrane Library, Embase and Chinese Biomedical Database. Fourteen databases for drug safety and pharmaceutical economics were additionally searched. Selection Criteria　Randomized controlled trials and systematic reviews, published in English and Chinese and comparing two or more of these four antihistamines for allergic rhinitis and urticaria were included for study of effectiveness. Non-randomized clinical trials were additionally included for economic evaluation. Cardiac safety studies of antihistamines for allergic diseases of any type were included. Quality Appraisal　Jadad scale was primarily applied to randomized controlled trials. Allocation concealment and intention-to-treat analysis were also appraised. The QUOROM statement was applied to systematic reviews and meta-analysis. Data extraction and analyses　For the study of effectiveness, composite data were primarily extracted and analyzed by fixed effect model. Sensitivity analysis was done to explore the heterogeneity. For the study of cardiac safety, cases of adverse drug reactions and death were summarized. Difference of occurrence rate in sex and age were analyzed if possible.Electrocardiography and clinical symptoms were summarized. Results　No studies on economic evaluation were identified. 27 and 6 randomized controlled trials, including 3 227 participants, for allergic rhinitis and urticaria were identified. Cetirizine was superior to loratadine (n=709) in symptom score and onset of action, superior to terfenadine (n=645) in Quality of Life and superior to astemizole (n=498) in patient satisfaction and onset of action. 73 h-ADR cases were identified in astemizole, 27 cases in terfenadine, 1 case in loratadine and none in cetirizine. No deaths were identified. Combination of terfenadine plus grapefruit juice (n=l8), itraconazole (n=6), nefazodone (n=67), and loratadine administration concomitant with cemitidine (n=30) significantly prolonged QTc interval. Conclusions　Cetirizine was superior to other three antihistamines in terms of clinical effectiveness and drug safety. Astemizole and terfenadine could cause significantly more cardiac-related adverse reactions than cetirizine and loratadine.

一起醫務人員院內麻疹聚集性疫情的流行病學調查

目的 對一起醫務人員院內感染麻疹疫情的流行病學特征進行分析，為制定麻疹控制措施提供依據。 方法 對 2015 年 5 月發生在某醫院醫務人員中的一起麻疹疫情的資料進行流行病學分析。 結果 2015 年 5 月 20 日—25 日相繼有 6 名醫務人員發生院內麻疹感染，且均與同一麻疹確診病例有直接接觸史。 結論 應及時辨別和隔離麻疹病例和麻疹疑似病例，做好消毒防護工作，及時接種麻疹疫苗，以避免麻疹疫情的發生。