摘要:目的:探討肝素在預防過敏性紫癜性腎炎中的療效及安全性。方法:采用隨機對照的方法,將98例過敏性紫癜患兒分為肝素治療組(49例)和對照組(49例),肝素組給予肝素鈉100～150 Ｕ加入5%葡萄糖100～200 mL中靜脈點滴,每日1次,連用5～7天,以后每兩周查尿常規1次,至少觀察3個月或以上。結果:肝素治療組發生腎炎3例(6.1%),對照組發生腎炎11例(22.4%),肝素治療組腎炎發生率低于對照組(0.01lt;P≤0.05)。結論:肝素對預防紫癜性腎炎的發生有效,且不良反應少。Abstract: Objective: To investigate the heparin in the prevention of allergic purpura nephritis in the efficacy and safety. Methods:A randomizedcontrolled method, 98 cases of allergic purpura patients were divided into heparin in the treatment group (49 cases) and control group (49 cases), heparin group received heparin, 100150 u in 5% glucose 100 ~ 200 mL in the intravenous drip, day 1, used in conjunction 57 days, after a routine urine check every two weeks times, at least for 3 months or more.Results: The results of heparin treatment group occurred nephritis in 3 cases (6.1%), glomerulonephritis in 11 cases in control group (22.4%), glomerulonephritis incidence of heparin in the treatment group than the control group (0.01lt;P ≤ 0.05). Conclusion: heparin in preventing the occurrence of HenochSchonlein purpura nephritis and effective, and less adverse reactions.
Objective To explore the effects of propofol and thiopental sodium injection on convulsive seizure in electro-convulsive therapy(ECT) and to provide evidence to help the selection of intravenous anaesthetics in improved ECT. Methods Total of 111 patients who received ECT in the 3rd Pepole’s Hospital of Panzhihua from July to December 2005 were divided into a thiopental sodium group (n =62) and a propofol group (n =49). These patients received intravenous anaesthesia with suxamethonium plus thiopental sodium or propofol for the implementation of ECT, respectively. The status of convulsive seizure was compared between the two groups. Results There were no significant differences between the two groups in terms of main demographic data, disease category and ECT parameters (Pgt;0.05). Motor seizure and electricity discharge lasted significantly longer in the propofol group than in the thiopental sodium group (Plt;0.01). Conclusion Thiopental sodium can increase the excitation threshold of brain cortical neurons and decrease the level of convulsive seizure induced by ECT. Propofol may decrease the excitation threshold, and increase the level of convulsive seizure under the same ECT parameters, but may have the potential to induce epileptic seizure.
【摘要】 患者為老年男性,反復出現惡心、嘔吐、乏力、低鈉、低鉀血癥, 3次住院。對其惡心嘔吐原因,曾考慮是否有抗高血壓藥物吲噠帕胺所引起,或是老年人攝入不足,電解質紊亂所致低鈉低鉀血癥。最后考慮該患者低鈉血癥系垂體前葉功能減退所致。MRI檢查顯示空蝶鞍。空鞍的原因尚不清楚,空鞍綜合征也是垂體前葉功能減退的因素之一。此癥盡管很少見,但隨著CT、MRI這些高新設備的普遍使用及人口老齡化,會發現更多的病例,也對我們診斷治療提供了有力的依據。【Abstract】The patient’s condition: old male patient with repeat nausea, vomitus, hypodynamia, low sodium and kaliopenia. Three times to be in hospital. First, we consider that indapamide resuted low sodium and Kaliopemia,but we discovered that the anterior pituitay gland hypofunction. MRI show that empty sella turcica. The reason of empty is not clear,the saddle syndrome is also a factor of pituitary function before the leaves falling off. The disease was rare,but with common use of CT,MRI and aging,we will discover many more cases to provide power evidence for diagnosis and treatment.
Objective To develop a diclofenac sodium-loaded gelatin scaffold with anti-inflammatory activity and provide a new avenue for alleviating the inflammatory response and enhancing cartilage regeneration in vivo. Methods Diclofenac sodium was homogeneously mixed with gelatin to prepare a diclofenac sodium-loaded porous gelatin scaffold by freeze-drying method as the experimental group, and a pristine porous gelatin scaffold was served as a control group. The general morphology of the scaffold was observed, the pore size of the scaffold was measured by scanning electron microscopy, the porosity of the scaffold was calculated by drainage method, the loading of diclofenac sodium into the gelatin scaffold was detected by fourier transform infrared spectrometer and X-ray diffraction examinations, and the release kinetics of diclofenac sodium from gelatin scaffold was tested using an in vitro release assay. The two scaffolds were co-cultured with lipopolysaccharide-predisposed RAW264.7 in vitro, and the expressions of interleukin 1β (IL-1β) and tumor necrosis factor α (TNF-α) were detected by reverse transcription polymerase chain reaction (RT-PCR), enzyme-linked immuno sorbent assay, and Western blot, to detect the in vitro anti-inflammatory effect of the drug-loaded scaffold. Thereafter, the second generation chondrocytes of New Zealand white rabbits were inoculated on the two groups of scaffolds for in vitro culture, and the cytocompatibility of the scaffold was tested by live/dead staining and cell counting kit 8 assay, the feasibility of in vitro cartilage regeneration of the scaffold was evaluated via gross observation, HE staining, Safranin-O staining, and immunohistochemical collagen type Ⅱ staining, as well as biochemical quantitative analyses. Finally, the two groups of chondrocyte-scaffolds were implanted subcutaneously into New Zealand white rabbits, and after 4 weeks, the general observation, HE staining, safranin O staining, immunohistochemical collagen type Ⅱ staining, and biochemical quantitative analyses were performed to verify the cartilage regeneration in vivo, and the expression of inflammation-related genes CD3 and CD68 was detected by RT-PCR to comprehensively evaluate the anti-inflammatory performance of the scaffolds in vivo. Results The two scaffolds exhibited similar gross, microporous structure, pore size, and porosity, showing no significant difference (P>0.05). Diclofenac sodium was successfully loaded into gelatin scaffold. Data from in vitro anti-inflammatory assay suggested that diclofenac sodium-loaded gelatin scaffold showed alleviated gene and protein expressions of IL-1β and TNF-α when compared with gelatin scaffold (P<0.05). The evaluation of cartilage regeneration in vitro showed that the number of living cells increased significantly with the extension of culture time, and there was no significant difference between the two groups at each time point (P>0.05). White cartilage-like tissue was regenerated from the scaffolds in both groups, histological observation showed typical cartilage lacuna structure and specific cartilage extracellular matrix secretion. There was no significant difference in the content of cartilage-specific glycosaminoglycan (GAG) and collagen type Ⅱ between the two groups (P>0.05). In vivo experiments showed that the samples in the experimental group had porcelain white cartilage like morphology, histologic staining showed obvious cartilage lacuna structure and cartilage specific extracellular matrix, the contents of GAG and collagen type Ⅱ were significantly higher than those in the control group, and the protein and mRNA expressions of CD3 and CD68 were significantly lower than those in the control group, with significant differences (P<0.05). ConclusionThe diclofenac sodium-loaded gelatin scaffold presents suitable pore size, porosity, and cytocompatibility, as well as exhibited satisfactory anti-inflammatory ability, providing a reliable scheme for alleviating the inflammatory reaction of regenerated cartilage tissue after in vivo implantation and promoting cartilage regeneration in vivo.
Xiyanping is used to treat infectious diseases with antibiotics in clinic. The aim of this study is to investigate the mechanism of Xiyanping through studying the effect of the combination of Xiyanping with Cefazolin on the chemotaxis and phagocytic function of peripheral blood neutrophils in mice. Ten healthy mice were in control group. Forty healthy mice in experimental group were infected with staphylococcus aureus, and were randomly divided further into four groups, i.e. model group, Xiyanping group, Cefazolin group and combination group (Xiyanping with Cefazolin). Mice in the control group and model group were given normal saline (NS) through abdomen while those in other groups were given Xiyanping, Cefazolin, and Xiyanping with Cefazolin, respectively. The chemotaxis of peripheral blood neutrophils was detected with the transwell method, and the phagocytic function of peripheral blood neutrophils was analyzed with flow cytometry (FCM). In the present study, there was no significance on the chemotactic index of peripheral blood neutrophils in all the groups (P>0.05). The actual phagocytotic rate and index of peripheral blood neutrophils in the blank group, Xiyanping group, and the combination group were significantly higher than those of the model group and Cefazolin group (P<0.05). However, those were not significant in the blank group, Xiyanping group, and the combination group (P>0.05) or between the model group and Cefazolin group (P>0.05). Our results suggested the combination of Xiyanping and Cefazolin could enhance the therapeutic effect by improving the phagocytic function of peripheral blood neutrophils.
Objective To study the clinical efficacy of topiramate combined with carbamazepine combined with phenytoin in elderly seizures. Methods A total of 105 elderly patients with epilepsy were enrolled in this study from August 2014 to July 2016 in Fuzhou Chinese and Western Medicine Hospital. The patients were aged 61 to 80 years. There were 42 males and 63 females with epilepsy. The course were 1 to 5 years; 55 cases were partial onset, 50 cases were systemic attack. According to the different treatment methods, the patients were divided into A, B, C three groups, each group were 35 patients. Group A was daily treated with 4 to 8 mg/kg topiramate; Group B was treated with 0.3 g carbamazepine combined with 250 to 300 mg phenytoin per day. Group C was daily treated with 4 to 8 mg/kg topiramate and 0.3 g carbamazepine combined with 250 to 300 mg phenytoin. The total effective rate, the incidence of adverse reactions, the number of seizures before and after treatment were compared among the three groups. Results The total effective rate of group C was higher than that of group A and B, and the difference was statistically significant (P<0.05). There were no significant differences in the number of epileptic seizures between the three groups before treatment (P>0.05). The number of seizures in group C was significantly lower than that in group A and B (P<0.05). Conclusions The treatment of topical epilepsy patients with topiramate and carbamazepine combined with phenytoin can significantly improve the total effective rate of treatment, protect the safety of medication, reduce the number of patients with epilepsy, so that patients can quickly return to normal life. It would be worthy for clinical promotion and use.
Hypernatremia is one of the commonly syndromes in critically ill patients. Severe hypernatremia has a low incidence (0.6%–1.0%) but with a very high mortality (58%–87%). Conventional treatments include the limitation of sodium intake and the supplement of sodium free liquid according to the assessed water lost. The reduction rates of conventional treatments are commonly not effective enough to decrease the serum sodium concentration in severe euvolemic or hypervolemic hypernatremia patients. Continuous renal replacement therapy (CRRT) has been reported to be effective on the reduction of sodium level in severe hypernatremia patients. However, the evidences on the use of CRRT for hypernatremia are limited. Our present review summarizes the current evidences on the prevalence of hypernatremia, the outcome of hypernatremia patients, the conventional treatment of hypernatremia, and the advantages and indications of CRRT for the management of hypernatremia. Additionally, we introduce our experiences on the management of hypernatremia using CRRT as well.
The effects on rat’s liver preservation using HX solation with high potassium and low sodium or HXm solution with high sodium and low potassium were studied with isolated perfusion of rat livers (IPRL). Sixty inbred Wistar rats were randomly divided into group HX (preserved with HX solution, n=30) and group HXm (preserved with HXm solution,n=30). The preservation effects of the storage solutions were assessed by measuring the sinunoidal lining cell mortality (SLCM), the Krebs-hense-leit perfusate ketone bidy ratio (PKBR), the hepatic sugar release (SL), and the hepatic tissue water content (HTWC). The results showed that there no significant differences between the two storage solutions after 6 hours preservation. If the preserved time was prolonged to 12 hours or more, the effect of rat’s liver preservation using HX solution were much superior to those using HXmsolutin.
OBJECTIVE Influence of irradiation and phenytoin sodium on modulatory activities of wound fluid on proliferation of fibroblasts and collagen synthesis was studied. METHODS The male Wistar rats were used in this study. The rats were divided into irradiated and non-irradiated groups, and in each of them it was subdivided into phenytoin group and control. A 7 cm long incisional wound was made on the back of each rat, in which a polyvinyl alcohol sponge (PVAS) with a size of 1.0 cm x 0.4 cm was implanted into the wound and the wound was sutured up. The PVAS was prepared by rinsing in running water over night and then was boiled for 30 minutes. Before implantation, the sponge was immersed in phenytoin sodium solution (10 mg/l ml) or normal saline (as control). From each wound the wound fluid and fibroblasts were collected. The methods of incorporation of 3H were adopted to assess the proliferation of fibroblasts and synthesis of collagen. RESULTS It was shown that proliferation of fibroblasts and collagen synthesis were stimulated by wound fluid remarkably on 5 to 8 days after wounding, and that 6 Gy to total-body irradiation wound decrease this effect. It was also noted that topical phenytoin sodium increased the modulatory activity of wound fluid irrespective of being irradiated or not. CONCLUSION It could be drawn that, after total-body irradiation, stimulation of hyperplasia of fibroblasts and collagen synthesis by wound fluid was markedly lowered indicating the total-body irradiation resulted in changes of local conditions of the wound which was unbenefitted to repair of tissue cells, while phenytoin sodium could enhance the stimulating action of wound fluid on proliferation of fibroblasts and synthesis of collagen which was beneficial to wound healing.
Objective To systematically evaluate the efficacy and safety of injected cyclooxygenase-2 inhibitor for acute postoperative pain. Methods We electronically searched PubMed, EBSCO, Springer, Ovid and CNKI databases from 1999 through Jan. 2009 to identify randomized controlled trials (RCTs) about cyclooxygenase-2 inhibitor or parecoxib sodium for acute postoperative pain. The methodological quality of included RCTs were assessed, and the data was extracted by two reviewers independently according to the Cochrane Handbook. The homogeneous RCTs were pooled using RevMan software, and the non-homogeneous studies evaluted using descriptive qualitative analysis. Results Seven RCTs involving 1939 patients met the inclusion criteria. The results of meta-analyses showed that: ① Efficacy: The comparison of PCA combined parecoxib sodium (successively injected less than 3 days) i.v. with PCA alone: after 24, 48, and 72 hours of the initial dose of parecoxib 40 mg i.v., the percentage of the patients’ global evaluation of study medication (PGESM) described effective (excellent and good) was higher than that of the control group [RR (95%CI) were 1.41 (1.13, 1.75), 1.25 (1.15, 1.35), and 1.30 (1.21, 1.40) respectively]; the percentage of the PGESM described ineffective (fair and poor) was lower than that of the control group [RR (95%CI) were 0.43 (0.26, 0.72), 0.44 (0.34, 0.57), and 0.33 (0.23, 0.48) respectively]. ② Safety: Combination of PCA with parecoxib sodium could lessen the incidence of postoperative fever (RR=0.34, 95%CI 0.22 to 0.53) and nausea and vomiting (RR=0.69, 95%CI 0.57 to 0.83), but not statistically decrease of respiratory depression (RR=0.84, 95%CI 0.38 to 1.83), pruritus (RR=0.91, 95%CI 0.54 to 1.52), and headache (RR=0.77, 95%CI 0.47 to 1.28). Conclusion The combination of PCA with parecoxib sodium successively injected less than 3 days can significantly increase the scores of PGESM, and does not increase the incidence of adverse effects or postoperative complications, and also has the advantage of decreasing postoperative fever, nausea and vomiting.