论著

微信式延续护理对真菌性外耳道炎患者心理及治疗效果的影响

WeChat continuous nursing intervention on mental state and therapeutic efficacy of fungal external auditory meatus

:100-103
 
目的 观察实施微信式延续护理干预对真菌性外耳道炎患者心理状态及治疗效果的影响。方法 选取我院2018 年12月—2019年12 月期间门诊治疗的110例真菌性外耳道炎患者为观察对象,将所选患者随机分为常规组和干预组,常规组55例,采取常规护理;干预组55例,在常规护理的基础上实施微信式延续护理干预。观察两组患者的心理状态及治疗依从性、治疗效果的变化。结果 干预组患者心理状态的改善、治疗依从性、治疗效果均优于常规组,差异有统计学意义(P<0.05)。结论 在给予真菌性外耳道炎患者实施护理干预的过程中,加入微信式延续护理干预,患者的心理状态得到改善、治疗依从率增加及患者治疗的总有效率提高。因此微信式延续护理干预值得在临床护理中进一步推广。
Objective To observe WeChat continuous nursing intervention on mental state and therapeutic efficacy of fungal external auditory meatus. Methods 110 cases of fungal external auditory meatus treated in our hospital from December 2018 to December 2019 were selected as the observation objects,The selected patients were randomly divided into the conventional group and the intervention group,There were 55 cases in the conventional group,taking regular care; there were 55 cases in the intervention group,on the basis of routine nursing,WeChat continuous nursing intervention was implemented. The psychological status and treatment compliance of the two groups were observed,also changes in treatment outcomes. Results The improvement of psychological state,treatment compliance and treatment effect in the intervention group were better than that in the conventional group.The difference was statistically significant(P<0.05). Conclusion In the course of nursing intervention for patients with fungal external auditory meatus,WeChat continuous nursing intervention was added.The psychological state of the patients has been improved,the rate of treatment compliance is increased and the total effective rate of treatment is increased greatly.Therefore,WeChat continuous nursing intervention is worthy of further promotion in clinical nursing.
论著

PAD方案治疗初发多发性骨髓瘤的疗效及安全性

Efficacy and safety analysis of PAD regimen in the treatment of newly diagnosed multiple myeloma

:13-17
 
目的 探讨PAD方案治疗初发多发性骨髓瘤(MM)有效性及安全性。方法 统计54例接受PAD方案治疗的初发MM患者临床资料,采用回顾性分析方法。PAD方案:P(硼替佐米)1.3 mg/m2,第1、4、8、11天皮下注射,A(脂质体阿霉素)25~30 mg/m2,第1天静脉滴注,D(地塞米松)40 mg,第1~4 天静脉滴注或口服,每21天为1个疗程。采用IMWG疗效标准判定疗效,按NCICTCAE(第3版)标准判断不良反应。结果 ①总体疗效:平均4(2~8)个疗程后,47例(87.0%)患者获部分缓解(PR)以上疗效,其中完全缓解(CR)20例(37.0%),很好的部分缓解(VGPR)19例(35.2%),部分缓解(PR)8例(14.9%),疾病稳定(SD)5例(9.3%),病情进展率(PD)2例(3.7%)。②亚组疗效:54例患者中,35例治疗4个以上疗程,19例小于4个疗程,ORR分别为97.1%(34/35)、68.4%(13/19)(P=0.003)。按照年龄、肾功能、骨破坏数目、骨髓浆细胞比例、ALB、LDH、β2-MG、细胞遗传学、ISS分期、临床分型进行队列亚组疗效比较,结果提示亚组疗效差异无统计学意义(P>0.05);③总体安全性:中性粒细胞减少8例(14.8%),血小板减少8例(14.8%),周围神经病变16例(29.6%),腹泻2例(3.7%),便秘2例(3.7%),带状疱疹4例(7.4%),细菌感染5例(9.3%),以上不良反应经对症治疗后症状减轻或消失。④亚组安全性:按照年龄和疗程数进行亚组比较,年龄大于60岁患者和年龄小于60岁患者总不良反应发生率和3/4级不良反应发生率分别是47.4% vs 60.0% 和15.8% vs 20.1%,(P=0.404和P=1.00);治疗4个以上疗程患者和小于4个疗程患者总不良反应发生率和3/4级不良反应发生率分别是57.9% vs 54.3%和21.2% vs 17.1%,(P=1.00和P=0.728)。结论 PAD方案治疗初发MM效果显著,缓解率和疗程数有相关性,疗效与传统的生存预后因素无关,可作为MM诱导治疗的一线方案。脂质体阿霉素心脏毒性小,替代传统蒽环类药物阿霉素,不良反应可控,耐受性良好,更适用于老年MM患者。
Objective To investigate the efficacy and safety of PAD regimen in previously untreated patients with multiple myeloma(MM). Methods We retrospectively analyzed 54 patients with newly-diagnosed MM,who were treated with PAD regimen: Bortezomib 1.3mg/m2 subcutaneously on day 1,4,8,11. Liposomal doxorubicin 25~30 mg/m2 intravenously on the first day. Dexamethasone 40 mg/d intravenously or orally on days 1~4. Treatment was repeated every 21 days. Response was evaluated according to the International Uniform Response Criteria for MM.Adverse events were graded according to the National Cancer Institute Common Toxicity Criteria,version 3.0. Results ①Overall response:after median 4(2~8) courses of PAD,47patients(87.0%)responsed,including complete response (CR) in 20 (37.0%),very good partial response (VGPR) in 19 (35.2%),partial response (PR) in 8 (14.9%),stable disease (SD) in 5 (9.3%) and progressive disease (PD) in 2 (3.7%). ②Subgroups efficacy: among the 54 patients,35 patients received more than 4 therapeutic courses,and 19 patients received less than 4 courses.The ORR was 97.1% (34/35) and 68.4% (13/19) respectively (P=0.003). Subgroups efficacy were compared according to age,renal function,number of bone destruction,proportion of bone marrow plasma cells,ALB,LDH,β2-MG,cytogenetics,ISS staging and clinical classification. The results indicated that there was no statistical difference(P>0.05). ③Overall safety: adverse events included neutropenia in 8 (14.8%),thrombocytopenia in 8 (14.8%),peripheral neuropathy in 16 (29.6%),diarrhea in 2 (3.7%),constipation in 2 (3.7%),herpes zoster in 4 (7.4%) and bacterial infection in 5 (9.3%). The adverse events relieved or disappeared after symptomatic treatment. ④Subgroups safety: compared by age and courses of treatment,the incidence of overall adverse events and grade 3/4 adverse events in patients older than 60 years and ones younger than 60 were 47.4% vs 60.0% and 15.8% vs 20.1% respectively,(P=0.404,P=1.00). The incidence of overall adverse events and grade 3/4 adverse events in patients with more than 4 therapeutic courses and ones with less than 4 courses were 57.9% vs 54.3% and 21.2% vs 17.1% respectively,(P=1.00和P=0.728). Conclusion PAD regimen has really curative effect in treating patients with newly diagnosed MM. There is a correlation between remission rate and therapeutic courses. It can be used as the first selected protocol for the induction therapy of MM. Its efficacy is independent of traditional prognostic factors.Liposomal doxorubicin has almost no cardiotoxicity. Replacing traditional anthracycline doxorubicin,the adverse events are controllable and the tolerance is generally well. PAD regimen is more proper to be applied to older patients with MM.
论著

镇痛活络酊和外用非甾体抗炎药治疗肱骨外上髁炎的短期疗效对比研究

Short-term effects comparison between analgesic tincture and topical nonsteroidal anti-inflammatory drugs in the treatment of lateral epicondylitis

:123-129
 
目的 对比中成药镇痛活络酊和非甾体抗炎药(Nonsteroidal Anti-inflammatory Drugs,NSAIDs)治疗肱骨外上髁炎(lateral epicondylitis,LE)的短期临床疗效差异。方法 筛选后符合纳入标准的LE患者60例,随机分为镇痛活络酊组(n=30)和NSAIDs组(n=30)。镇痛活络酊组外用镇痛活络酊,NSAIDs组外用法斯通凝胶(酮洛芬),两组均连续用药3周,3次/d。用药后3 周、6 周和12 周连续随访,主要观测指标包括视觉模拟评分(visual analog scale,VAS);肩、肘和手的功能评分(Disabilities of the arm, Shoulder And Hand,DASH);无痛握力(Pain-free grip strength,PFGS)。VAS评分分别测量患者1周前用力活动时的VAS评分和正常休息时的VAS评分,记为VAS(活动时)和VAS(休息时)。运用统计学方法对比分析两组患者在VAS评分(活动时)、VAS评分(休息时)、DASH评分和PFGS上的差异。结果 两组患者在VAS评分(活动时)、VAS评分(休息时)和DASH评分上均未见组间差异(P>0.05)。两组患者在用药前、用药后3周、用药后6周的PGFS对比同样无组间差异(P=0.91,P=0.42,P=0.13)。但是,在用药后12周,镇痛活络酊组的PFGS高于NSAIDs组(P=0.02)。结论 镇痛活络酊缓解LE疼痛的效果与外用NSAIDs相当,对提升伸肌力效果则更优。
Objective To compare the short-term clinical effects difference between analgesic tincture and topical nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of lateral epicondylitis (LE). Methods 60 cases of LE patients were randomly divided into an analgesic tincture group (n=30) and a NSAIDs group (n=30). Analgesic tincture was chosen for the analgesic tincture group and topical ketoprofen gel for the NSAIDs group to treat LE. Two groups were treated continuously for 3w, 3 times/day. Clinical results of each drug were followed-up at the time point of 3w, 6w and 12w after usage. Observational indexes included the visual analogue scale (VAS), disabilities of the arm, shoulder and hand questionnaire (DASH) and pain-free grip strength (PFGS). The inter-group difference of VAS (at activity), VAS (at rest), DASH score and PFGS were compared subsequently. Results No difference of the VAS (at activity), VAS (at rest), DASH score were ascertained (P> 0.05) between groups. Inter-group difference of PGFS was also not discerned at the time points of pre-treatment and 3 weeks and 6 weeks (P=0.91, P=0.42, P=0.13) post-treatment. However, PFGS of the analgesic tincture group was found to be higher than that of the NSAIDs group (P=0.02) after 12 weeks post-treatment. Conclusion Effect of analgesic tincture in releasing pain is almost the same to that of tropical NSAIDs, but a better effect in improving muscle strength.
论著

AngioJet血栓抽吸联合髂静脉支架置入治疗下肢深静脉血栓合并髂静脉压迫的疗效分析

Analysis of the efficacy of AngioJet thrombus aspiration combined with iliac vein stent implantation in the treatment of lower extremity deep venous thrombosis with iliac vein compression

:119-122
 
目的 分析AngioJet血栓抽吸联合髂静脉支架在下肢深静脉血栓合并髂静脉压迫的临床疗效。方法 2016年1月—2019年6月在揭阳市人民医院普外一科收治的首发髂股DVT并在AngioJet吸栓或联合导管溶栓后置入支架的患者,比较吸栓后直接支架置入和溶栓再分期支架置入的治疗效果。结果 本研究共纳入50例接受支架手术的DVT患者,其中治疗组29例,分期置入组21例。治疗组临床症状缓解率和住院时间优于对照组,差异有统计学意义(P<0.05),且出血风险更低。 而置入支架长度和直径无差异,治疗组的3个月、6个月和12个月的通畅率、静脉返流时间和 Villalta评分均无差异(P>0.05)。结论 AngioJet血栓清除后直接支架置入术是治疗合并髂静脉压迫的下肢深静脉血栓的有效方法,临床改善更快,住院时间显著缩短。
Objective To analyze the clinical effect of AngioJet thrombus aspiration combined with iliac vein stent in deep vein thrombosis of the lower extremity with iliac vein compression. Methods From January 2016 to June 2019, patients with first iliofemoral DVT and stent implantation after AngioJet thrombolysis or combined catheter thrombolysis were treated in the first department of general surgery, Jieyang People's Hospital. The therapeutic effects of direct stent implantation and stent implantation after thrombolysis were compared. Results A total of 50 patients with DVT who underwent stent surgery were included in this study, including 29 in the treatment group and 21 in the staging group. The clinical symptom relief rate and length of stay in the treatment group were better than those in the control group, the difference was statistically significant (P<0.05), and the risk of bleeding was lower. There was no significant difference in stent length and diameter. There were no significant differences in patency rate, venous reflux time, and Villalta score in the treatment group at 3 months, 6 months, and 12 months (P>0.05). Conclusion Direct stent placement after AngioJet thrombectomy is an effective method for treating deep venous thrombosis of lower limbs with iliac vein compression. The clinical improvement is faster and the length of hospital stay is significantly shortened.
论著

融合功能训练在大龄人群斜视矫正术后疗效的评价

Evaluation of the effect of fusion training on strabismus correction in the elderly

:58-61
 
目的 分析融合功能训练在大龄人群行斜视矫正术后建立双眼三级视功能及巩固术后效果的可能性。方法 回顾性研究2008年10月—2016年12月在广州爱尔眼科医院被诊断为共同性斜视并进行手术矫正的患者174例,术后进行融合功能训练。根据术前诊断斜视的类型分成共同性内斜视组、共同性外斜视组、间歇性外斜视组,根据两眼最佳矫正视力差别分为>2行、≤2行组,训练时对单眼抑制及交叉抑制者先采用脱抑制训练再扩大融合功能训练,具有较小融合范围的矫正术后的患者直接从扩大融合功能开始训练,对比观察斜视手术矫正前和矫正后进行融合训练后融合功能及双眼视情况。结果 斜视矫正术后128例建立了正常的融合范围,随访1年斜视无复发,无视疲劳症状发生。其中共同性外斜视组、共同性内斜视组、间歇性外斜视组进行训练后治疗的有效率分别为32.35%、28.57%、100%,两眼最佳矫正视力相差>2行和≤2行的有效率分别为11.54%、100%。结论 大龄斜视患者尤其是间歇性外斜视或双眼最佳矫正视力相差在2行以内的患者,经过融合训练均获得良好的双眼视,视疲劳得到改善,斜视手术效果得到巩固。
Objective To analyze the possibility of fusion function training to establish binocular tertiary vision function and consolidate the effect of postoperative strabismus correction in elderly people. Methods Conduct a retrospective study about 174 patients who were diagnosed with common strabismus and had corrective surgery at Guangzhou Aier Eye Hospital from October 2008 to December 2016, and those patients was performed after the fusion function training. According to the type of preoperative diagnosis of strabismus, they were divided into common esotropia group, common exotropia group, intermittent exotropia group. According to the difference of the best corrected visual acuity between the two eyes, they were divided into>2 lines group and ≤2 lines group. Monocular-suppression and cross-suppression patients firstly used de-inhibition training and then expand the fusion-range training. Patients with a smaller fusion range started training directly by expanding the fusion function. We compared and observed the fusion function and binocular condition between before and after strabismus surgery. Results The normal fusion range was established in 128 cases after strabismus correction, and there was no recurrence of strabismus and visual fatigue symptoms after 1 year of follow-up. Among them, the effective treatment rates of the common exotropia group, the common esotropia group, and the intermittent exotropia group after training are 32.35%, 28.57%, and 100%, respectively. The two groups which are divided into>2 lines group and ≤2 lines group are 11.54% and 100%, respectively. Conclusion Elderly patients with strabismus, especially those with intermittent exotropia or within two lines of best corrected visual acuity, have achieved good binocular vision after fusion training, have been improved visual fatigue, and the effect of strabismus surgery is consolidated.
论著

运用李可老中医学术思想从“中气”论治术后肠梗阻的疗效观察

Curative effect of treating postoperative ileus with Li Ke's academic idea of traditional Chinese medicine: by mediating the Qi in the middle energizer(stomach and spleen)

:55-57
 
目的 探讨运用李可老中医学术思想,从“中气”论治术后肠梗阻的疗效。方法 采用前瞻性临床观察队列研究方法,选择82例术后肠梗阻患者,按照随机化原则平均分为两组:观察组为西医治疗基础上,联合从“中气”论治应用方剂,对照组为单纯西医治疗。结果 观察组的有效率为95.12%,首次排气时间为(12.46±2.75)h,首次排便时间为(31.52±5.38)h,腹痛腹胀完全消失时间为(15.71±3.57)h,平均住院时间为(18.69±3.82)d;对照组的有效率为73.17%,首次排气时间为(36.57±2.75)h,首次排便时间为(62.39±5.73)h,腹痛腹胀完全消失时间为(42.58±8.27)h,平均住院时间为(25.95±5.84)d;有效率对比,观察组高于对照组(P<0.05),观察组症状改善时间较对照组明显缩短(P<0.05)。结论 对于术后肠梗阻的治疗,西医联合从“中气”论治疗效优于单纯西医治疗。
Objective To explore the therapeutic effect on postoperative ileus with Li Ke's academic thought of traditional Chinese medicine: by mediating the Qi in the middle energizer(Stomach and Spleen). Methods Using prospective clinical observation cohort study, 82 patients with postoperative ileus were randomly divided into two groups on average: the observation group was treated with Western medicine and Chinese medicine decoction in which prescribed by the principle of mediating the Qi in the middle energizer(stomach and spleen). while the control group was treated with Western medicine only. Results The effective rate of the observation group was 95.12%, the average time of first farting of the patients was(12.46±2.75) h, the average time of first defecation was (31.52±5.38)h, the average time of complete disappearance of abdominal pain and abdominal distension was (15.71±3.57) h, and the average hospital stays was (18.69±3.82) d. In the control group, the effective rate was 73.17%, the average time of first farting of the patients was (36.57±2.75)h, the average time of first defecation was (62.39±5.73)h, the average time of complete disappearance of abdominal pain and abdominal distension was (42.58±8.27)h, and the average hospital stays was (25.95±5.84)d. Compared with the control group, the effective rate was higher in the observation group (P <0.05), and the symptom improvement time in the observation group was shorter than that in the control group (P <0.05). Conclusion For the treatment of postoperative ileus, western medicine combined with Chinese medicine decoction in which prescribed by the principle of mediating the Qi in the middle energizer(stomach and spleen) is better than Western medicine only.
论著

四金石灵膏配合间苯三酚治疗输尿管结石伴肾绞痛的疗效观察

Analysis of curative effect of four-gold-stone-ling confection combined with phloroglucinol in the treatment of ureteral calculus with renal colic

:53-56
 
目的 探讨四金石灵膏联合间苯三酚治疗输尿管结石伴肾绞痛的应用价值。方法 随机将76例输尿管结石伴肾绞痛患者分为两组,以接受中药安慰剂联合间苯三酚治疗者为对照组,以接受四金石灵膏联合间苯三酚治疗者为观察组,每组38例。对比两组临床治疗效果,并分析尿液相关指标的变化情况。结果 两组7 d治疗过程中VAS评分及尿Ga水平呈降低趋势、WHOQL-BREF评分及尿OPN水平呈升高趋势(P<0.05),而治疗3 d及7 d后,治疗组VAS评分及尿Ga水平低于对照组、WHOQL-BREF评分及尿OPN水平高于对照组(P<0.05)。同时,治疗7 d后,观察组排石率高于对照组(P<0.05),而观察组排石时间及止痛时间短于对照组(P<0.05)。此外,治疗7 d后,治疗组治疗总有效率高于对照组(P<0.05),而两组间治疗不良反应发生率比较未见差异有统计学意义(P>0.05)。结论 四金石灵膏联合间苯三酚可有效的提高输尿管结石伴肾绞痛的临床治疗效果,具有较为理想的应用价值。
Objective To explore the application value of four-gold-stone-ling confection and phloroglucinol in the treatment of ureteral calculus with renal colic. Methods 76 patients with ureteral calculus with renal colic were randomly divided into two groups, with those receiving traditional Chinese medicine placebo combined with phloroglucinol as the control group, and those receiving four-gold-stone-ling confection combined with phloroglucinol as the observation group,38 cases in each group. The clinical treatment effects of the two groups were compared, and the changes of urine-related indicators were analyzed. Results The VAS score and urine Ga level of the two groups showed a decreasing trend during 7d treatment, and the WHOQL-BREF score and urine OPN level showed an increasing trend(P<0.05). After 3d and 7d treatment, the VAS score and urine Ga level of the treatment group were lower than that of control group, the WHOQL-BREF score and urine OPN level were higher than that of control group(P<0.05). Meanwhile, After 7d of treatment, the rate of stone drainage in the observation group was higher than that of control group(P<0.05), while the time of stone drainage and pain relief in the observation group was shorter than control group(P<0.05). In addition, after 7d treatment, the total effective rate of the treatment group was higher than control group (P<0.05), while the difference of incidence of adverse reactions between the two groups was not significant(P>0.05). Conclusion Four-gold-stone-ling confection combined with phloroglucinol may effectively improve the clinical effect of ureteral calculi with renal colic, and have ideal application value.
论著

高压氧治疗面部填充术后血管并发症62例疗效分析

Effect of hyperbaric oxygen therapy on 62 cases of vascular complications after facial filling

:50-52
 
目的 分析高压氧治疗对面部填充术后血管并发症的疗效。方法 将62例面部填充剂注射后并发症患者根据高压氧介入时机分为A组和B组,A组在在常规治疗的基础上,48小时内进行高压氧治疗,B组在在常规治疗的基础上,48小时后进行高压氧治疗,在治疗结束后对两组患者进行疗效分析。结果 A组患者的治疗疗效较B组患者治疗疗效好,差异有统计学意义(P<0.05)。结论 高压氧治疗对面部填充剂注射后并发症疗效是肯定的,且高压氧介入时间越早效果越好。
Objective To analysie effect of hyperbaric oxygen therapy on vascular complications after facial filling. Methods 62 patients with complications after injection of facial filler according to the timing of hyperbaric oxygen intervention were divided into group A and group B.Group A was treated with hyperbaric oxygen within 48 hours on the basis of conventional treatment.Group B was treated with hyperbaric oxygen 48 hours later on the basis of conventional treatment to analysie the efficacy of the two groups of patients after the end of treatment. Results The efficacy of group A patients was better than that of group B, the difference was statistically significant P<0.05. Conclusion Hyperbaric oxygen therapy is effective in the treatment of complications after facial filler injection, and the earlier the hyperbaric oxygen intervention time is taken, the better the effect is.
论著

尼洛替尼治疗伊马替尼疗效欠佳的慢性髓性白血病慢性期患者的回顾性临床分析

Retrospective clinical analysis of switching nilotinib to patients with chronic myeloid leukemia in chronic phase with suboptimal response to imatinib

:33-37
 
目的 比较一线伊马替尼疗效欠佳的慢性髓性白血病慢性期(CML-CP)患者,继续伊马替尼原方案或转换为尼洛替尼治疗后的疗效及安全性。方法 收集伊马替尼疗效欠佳的 45 例患者,分为伊马替尼组22例及尼洛替尼转换组23例,22例伊马替尼组患者继续接受原方案伊马替尼治疗,剂量均为400 mg qd,又将尼洛替尼转换组分为早期尼洛替尼转换组7例,晚期尼洛替尼组转换有16例。尼洛替尼转换组的23例患者接受尼洛替尼的剂量均为400 mg,q12h。所有入组患者首诊时测定 Sokal 评分,在治疗过程中随访观察定期监测血液学、细胞遗传学及分子学缓解情况(FISH 和 RQ-PCR),并对患者用药后的基本情况、临床表现及不良反应进行记录。结果 转换尼罗替尼治疗3个月时,早期尼洛替尼转换组中国际标准化 BCR-ABL1融合基因转录本水平(BCR-ABL1IS)<10%的患者有 5 例(71.4%),晚期尼洛替尼转换组BCR-ABL1IS<10%的患者有6例(37.5%),差异无统计学意义(P>0.05)。中位观察6(3~12)个月,尼罗替尼组中有17例(73.9%)获得部分细胞遗传学反应,9例(39.1%)患者获得主要分子学反应。伊马替尼组中有9例(40.9%)获得部分细胞遗传学反应,2例(9.1%)患者获得主要分子学反应,尼洛替尼组部分细胞遗传学反应、主要分子学反应患者优于伊马替尼组(P值分别为0.027、0.020)。45例患者中达到完全细胞遗传学反应的患者与未达到完全细胞遗传学反应相比,Sokal 评分偏低(P=0.032)。结论 尼洛替尼可使伊马替尼疗效欠佳的 CML-CP 患者达到更好的疗效,因此需要及时对伊马替尼疗效欠佳的 CML-CP 患者进行评估后及时更换为尼洛替尼等二代酪氨酸激酶抑制剂。
Objective To assess the clinical efficacy and safety of original scheme or switching to nilotinib in patients with chronic myeloid leukemia in chronic phase(CML-CP)with suboptimal response of first-line imatinib. Methods 45 patients with suboptimal response of imatinib were collected and divided into 22 patients who continued to use original scheme and 23 patients who switched to nilotinib therapy. All the 22 patients of imatinib group received imatinib 400 mg once a day. And the 23 patients of nilotinib group were divided into early switch group and late switch group. Early switch group had 7 patients, late switch group had 16 patients. Both early and late switch to nilotinib group were subsequently to nilotinib 400 mg q12h. Sokal scores of all the enrolled patients were measured at the first diagnosis. Hematology, cytogenetics and molecular remission (FISH and RQ-PCR)were monitored, and the patients' basic information, clinical manifestations and adverse reactions were recorded regularly during the treatment. Results After switching to nilotinib for 3 months,there were 5 patients (71.4%)whose BCR-ABL1IS<10% in the early nilotinib switch group, while 6 patients (37.5%)in the late nilotenib switch group.There was no statistical difference(P>0.05).With a median observation period of 6(3~12)months,there were 17 (73.9%)patients achieved partial cytogenetic response and 9 (39.1%)patients achieved major molecular response in the nilotinib group,there were 9 patients (40.9%)achieved partial cytogenetic response and 2 patients (9.1%)achieved major molecular response in the imatinib group. Patients who achieved partial cytogenetic response and major molecular response in the nilotinib group were more than those in the imatinib group (P values were 0.027 and 0.020, respectively).Sokal scores of 45 patients who had achieved complete cytogenetic response were lower than those who had achieved it (P=0.032). Conclusion Early switch to nitotinib is feasible and effective to patients who didn't have optimal response to imatinib. It is necessary to assess patients regularly in order to have the proper timing switching patients to nilotinib therapy.
临床诊疗

雾化吸入布地奈德对急性支气管炎患者疗效及相关指标的影响

:86-88
 
目的 探究雾化吸入布地奈德对急性支气管炎患者疗效及相关指标的影响。方法 选取2016年7月—2018年6月在我院接受治疗的120例急性支气管炎患者作为研究对象,随机分为两组:常规组(60例)和综合组(60例)。常规组实施常规治疗,综合组在常规治疗基础上实施雾化吸入布地奈德治疗,比较两组的整体治疗效果。结果 综合组的治疗总有效率为95.0%,常规组的治疗总有效率为83.3%,综合组要高于常规组,差异有统计学意义(P<0.05);在PEF、FVC、FEV1等肺功能指标的比较中,综合组和常规组治疗前不存在差异(P>0.05),治疗后综合组要高于常规组,差异有统计学意义(P<0.05)。结论 急性支气管炎患者实施雾化吸入布地奈德治疗,疗效显著,有利于改善肺功能。
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