- ISSN 1008-5734
- CN 11-4015/R
- 1999年创刊
- 主管: 中国科学技术协会
- 主办: 中华医学会
Objective: To assess the efficacy and safety of homemade bezafibrate in treatment of hypertriglyceridemia. Methods: Form May 2006 to July 2007, 132 patients with hypertriglyceridemia were enrolled in the study and randomly divided into the following three groups: the bezafibrate group (59 cases), the fenofibrate group (55 cases), and the control group (18 cases). The bezafibrate group comprised 45 male and 14 female patients with an average age of (51.4±15.4) years. The fenofibrate group comprised 42 male and 13 female patients with an average age of (51.5±15.5) years. The control group comprised 13 male and 5 female patients with an average age of (52.7±16.0) years. The bezafibrate group was administered bezafibrate 200 mg orally thrice daily, the fenofibrate group was administered fenofibrate 100 mg orally thrice daily, the control group received nondrug therapy. The duration of treatment was 3 months. The blood levels of triglyceride, total cholesterol , low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were measured before and after therapy and compared among the three groups. The adverse reactions were observed. Results: In the bezafibrate and fenofibrate groups, the levels of TG, TC and LDL-C were respectively（3.16±0.60）,（5.25±0.56）,（2.76±0.45）and（3.13±0.55）,（5.28±0.52）,（2.82±0.41）mmol/L before treatment and deceased respectively to （2.42±0.43）,（4.93±0.47）,（2.55±0.44）and（2.43±0.43）,（4.97±0.47）,（2.48±0.45）mmol/L after treatment, and the differences were statistically significant (all P<0.01); the levels of HDL-C were respectively (1.09±0.18) and (1.10±0.16) mmol/L before treatment and increased respectively to (1.23±0.13) and (1.22±0.18) mmol/L after treatment, and the differences were statistically significant (all P<0.01). In the control groups, after treatment, the levels of TG, TC, and LDL-C were respcetively (3.10±0.40), (5.22±0.42), and (2.81±0.57)mmol/L, which were higher than those in the bezafibrate group (P＜0.05, P＜0.01); and the levels of TG and LDL-C were markedly higher than those in the fenofibrate group (P<0.05, P<0.01); HDL-C level was (1.10±0.13)mmol/L, which was markedly lower than that in the bezafibrate and fenofibrate groups(all P<0.05). There was no statistically significant difference in the indices between the two treatment groups (all P> 0.05). In the bezafibrate and fenofibrate groups, gastrointestinal symptoms occurred in 11 cases (18.6%) and 9 cases (16.4%), respectively; there was no statistically significant difference (P> 0.05); Transient elevation of ALT, AST, and CK levels occurred. There were no statistically significant differences in rash and some other adverse reactions between the two treatment groups (all P> 0.05). Conclusion: Homemade bezafibrate is a safe and effective lipidlowering agent.
Objective: To assess the efficacy and safety of homemade lipoprostagladin E1 injection in the treatment of peripheral arterial occlusive disease. Methods:A randomized, controlled study was conducted by Xuanwu Hospital of Capital Medical University. From September 2006 to September 2007, 207 patients with peripheral arterial occlusive disease were enrolled in the study and divided into two groups: the homemade lipoprostagladin E1 group (101 cases) and the non-homemade lipoprostagladin E1 group (106 cases ). The homemade lipoprostagladin E1 group comprised 72 males and 29 females with an average age of (63.8±9.3) years. The non-homemade lipoprostagladin E1 group comprised 67 males and 39 females with an average age of (63.7±8.4) years. The patients in both groups were administered an IV infusion of the homemade lipoprostagladin E1 10 μg and nonhomemade lipoprostagladin E110 μg via Murphy’s dropper once daily for 2 weeks, respectively. Rest pain score, anklebrachial index, maximal painless walking distance, and the area of ischemic ulceration were recorded before treatment and on the day of treatment end , and adverse reactions were observed during treatment. Results: In the homemade lipoprostagladin E1 and nonhomemade lipoprostagladin E1 groups, the rest pain scores were (1.30±1.54) and (1.52±1.74) after 2 weeks of treatment as well as (2.37±2.17) and (2.38±2.29) before treatment; the differences were statistically significant (P<0.01, P<0.001), but there was no statistically significant difference between the two groups(P>0.05); the anklebrachial indexes were (0.76±0.22) and (0.74±0.22) after treatment as well as (0.68±0.20) and (0.66±0.21) before treatment, respectively; the differences were statistically significant (P<0.05, P< 0.01), but there was no statistically significant difference between the two groups (P> 0.05). The improvement rate of the walking distance of patients with claudication was 10.34% and 16.13% before and after treatment, respectively; there was no statistically significant difference between the two groups(P>0.05). The difference in the area of ischemic ulceration was not statistically significant before and after treatment (P>0.05). In the homemade lipoprostagladin E1 group, 9 patients developed adverse reactions including elevated liver aminotransferase (3 cases), phlebitis (3 cases), dermatitis (1 case), abnormal WBC count (1 case), elevated INR (1 case); the incidence was 8.9%. In the non-homemade lipoprostagladin E1, 8 patients developed adverse reactions including phlebitis (2 cases), dermatitis (1 case), gastrointestinal uncomfort (1 case), palpitation (1 case), chest distress (1 case), abnormal WBC count (1 case), and fatigue (1 case); the incidence was 7.5%. The difference in the incidence of adverse reactions was not statistically significant between the two groups (P>0.05). Conclusion: The homemade lipoprostagladin E1 injection is a safe and effective agent for treatment of peripheral arterial occlusive disease.
A 40-year-old man received ibuprofen 50 mg thrice daily for pain in his right lower limb. About 2 months later, the patient developed palpitations, nausea, vomiting, and decreased urinary output (300 ml/d), then presented to hospital. Routine urine testing revealed 2 + protein and renal function tests showed a BUN level of 51.7 mmol/L, a SCr level of 1490.4 μmol/L. Reducing blood pressure and blood purification treatments were given. One months later, his renal function gradually normalized. -
Objective: To investigate the distribution and drug resistance of 1103 strains of bacteria isolated from urine culture in order to provide a basis for appropriate selection of antibacterials in clinical practice. Methods:The urine samples from the outpatients and inpatients in our hospital from September 2006 to August 2008 were cultured and 1103 strains of bacteria were isolated. The identification of bacteria and antibacterial sensitivity tests of the isolates were performed by a routine method and VITEK 32 automatic measurement system. The results were evaluated according to NCCLS/CLSI 2006. Results: Among 1103 strains of bacteria, 647(58.7%) strains were Gramnegative bacilli and 456(41.2%) were Gram-positive coci. The first 5 bacteria isolation rates were Escherichia coli (427 strains, 38.7%), Coagulase negative staphylococcus (154 strains, 14.0%), Enterococcus faecalis (137 strains, 12.4%), Staphylococcus aureus (75 strains, 6.8%), and Enterococcus faecium (63 strains, 5.7%). Among the 1103 cases of patients whose urine culture was positive for bacteria, 448 (40.6%) cases were males and 655 (59.4%) were females; 1014 (91.9%) cases were inpatients and 89(81%) cases were outpatients. The first three wards to bacteria isolation rates were the ICU (41.6%), general geriatric wards (116%), and internal neuropathic wards (10.9%). ESBLsproducing strains of E. coli were 44.7% (191/427) of E. coli and ESBLsproducing strains of K. pneumonia were 65% (39/60) of K. pneumonia. The drug resistance rate of ESBLsproducing strains to 15 antibacterials was higher than that of ESBLsnon-producing strains, but both were sensitive to imipenem. Oxacillin-resistant strains of Coagulase negative staphylococci(ORCNS) were 76.0% (117/154) and oxacillin-resistant strains of staphyococcus aureus(ORSA) were 57.3% (43/75) . Antibacterial sensitivity tests revealed that E. coli and K. pneumonia were sensitive to imipenem (resistance rate was zero). The resistance rate of acinetobacter to imipenem was the lowest and it was 26.7%. The resistance rate of Pseudomonas aeruginosa to piperacillintazobactam was the lowest and it was 7.4%. The resistance rate of Proteus mirabilis to cepholosporines was 0～2.9%; ORSA and ORCNS were all sensitive to vancomycin(resistance rate was zero); the resistance rate of Enterococcus faecalis to nitrofurantoin was 2.2%. Conclusion: Resistant strains isolated from urine culture is tending increasingly. Appropriate drug selection in clinical practice should be based on the results of antibacterial sensitivity tests in order to avoid the development of resistant strains.
A 65yearold man with mycoplasma pneumonia received an IV infusion of cefpiramide 1.0 g twice daily. On day 1 of therapy, the patient developed lightning pain in his right cheek; the pain radiated to the left cheek and forehead, which occurred once every 10 minutes and lasted for 10 seconds. Thirteen days later, he presented with dozens of red papules in different sizes on his skin. Cefpiramide was stopped and switched to clindamycin. Two days later, the pain in his cheek subsided.
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