Background and purpose To date,no large cohort study has investigated the effects of intravenous thrombolysis(IVT)in Chinese patients aged over 80 years who had a stroke.This study aimed to assess the trends in the us...Background and purpose To date,no large cohort study has investigated the effects of intravenous thrombolysis(IVT)in Chinese patients aged over 80 years who had a stroke.This study aimed to assess the trends in the use of alteplase,the clinical characteristics and the outcomes of Chinese patients aged above 80 years who had an acute ischaemic stroke.Methods Data for this analysis were obtained from the China Stroke Center Alliance programme,a nationwide,multicentre,prospective registry encompassing 1751 hospitals across 31 provinces,covering the period from 1 January 2018 to 14 December 2022.The primary outcome was defined as a modified Rankin Scale(mRS)Score of 0-2 at discharge.Secondary outcomes included an mRS Score of 0-1 and independent ambulation on discharge.Safety outcomes assessed were in-hospital mortality and symptomatic intracranial haemorrhage(sICH).Results Out of 30902 patients over 80 years old who qualified for thrombolysis,8673(median age(IQR),84(82-87)years)received alteplase treatment.Patients administered alteplase demonstrated improved short-term functional outcomes,such as an mRS Score of 0-2(adjusted OR(aOR)1.12,95%CI,1.06 to 1.18,p<0.001),an mRS Score of 0-1(aOR 1.14,95%CI,1.08 to 1.19,p<0.001)and independent ambulation at discharge(aOR 1.14,95%CI,1.08 to 1.20,p<0.001).Moreover,no significant increase was observed in the risk of in-hospital mortality(aOR 1.12,95%CI,0.93 to 1.35;p=0.23).However,the risk of sICH was significantly higher among patients treated with alteplase(aOR 3.22,95%CI,2.77 to 3.75;p<0.001).Conclusions IVT with alteplase in elderly patients who had a stroke resulted in improved short-term functional outcomes without elevating the risk of in-hospital mortality.Nonetheless,this population remains at a higher risk of sICH.展开更多
The primary intravenous anesthetics employed in clinical practice encompass dexmedetomidine(Dex),propofol,ketamine,etomidate,midazolam,and remimazolam.Apart from their established sedative,analgesic,and anxiolytic pro...The primary intravenous anesthetics employed in clinical practice encompass dexmedetomidine(Dex),propofol,ketamine,etomidate,midazolam,and remimazolam.Apart from their established sedative,analgesic,and anxiolytic properties,an increasing body of research has uncovered neuroprotective efects of intravenous anesthetics in various animal and cellular models,as well as in clinical studies.However,there also exists conficting evidence pointing to the potential neurotoxic efects of these intravenous anesthetics.The role of intravenous anesthetics for neuro on both sides of protection or toxicity has been rarely summarized.Considering the mentioned above,this work aims to ofer a comprehensive understanding of the underlying mechanisms involved both in the central nerve system(CNS)and the peripheral nerve system(PNS)and provide valuable insights into the potential safety and risk associated with the clinical use of intravenous anesthetics.展开更多
Osteomyelitis is a bone infection that requires prolonged antibiotic treatment and potential surgical intervention.If left untreated,acute osteomyelitis can lead to chronic osteomyelitis and overwhelming sepsis.Early ...Osteomyelitis is a bone infection that requires prolonged antibiotic treatment and potential surgical intervention.If left untreated,acute osteomyelitis can lead to chronic osteomyelitis and overwhelming sepsis.Early treatment is necessary to prevent complications,and the standard of care is progressing to a shorter duration of intravenous(Ⅳ) antibiotics and transitioning to oral therapy for the rest of the treatment course.We systematically reviewed the current literature on pediatric patients with acute osteomyelitis to determine when and how to transition to oral antibiotics from a short Ⅳ course.Studies have shown that switching to oral after a short course(i.e.,3-7 d) of Ⅳ therapy has similar cure rates to continuing long-term Ⅳ therapy.Prolonged Ⅳ use is also associated with increased risk of complications.Parameters that help guide clinicians on making the switch include a downward trend in fever,improvement in local tenderness,and a normalization in C-reactive protein concentration.Based on the available literature,we recommend transitioning antibiotics to oral after 3-7 d of Ⅳ therapy for pediatric patients(except neonates) with acute uncomplicated osteomyelitis if there are signs of clinical improvement,and such regimen should be continued for a total antibiotic duration of four to six weeks.展开更多
Objective We aimed to compare the clinical outcomes of intravenous urography-assisted fluoroscopy-guided shockwave lithotripsy for radiolucent ureteral stones and standard shockwave lithotripsy for radiopaque ureteral...Objective We aimed to compare the clinical outcomes of intravenous urography-assisted fluoroscopy-guided shockwave lithotripsy for radiolucent ureteral stones and standard shockwave lithotripsy for radiopaque ureteral stones.Methods We retrospectively reviewed 734 patients with ureteral stones treated by fluoroscopy-guided shockwave lithotripsy between March 2014 and March 2021.The primary outcome was a stone-free rate with one session within 30 days,defined as no residual stones without auxiliary treatment.The multivariate analysis was used to examine whether the intravenous urography use predicted treatment success.Furthermore,we compared the outcomes using propensity score matching.Results Ninety-eight patients underwent the intravenous urography use protocol(Group I),and the remaining 636 patients underwent the non-intravenous urography protocol(Group N).Stone-free rates with one session within 30 days were 38%and 32%in groups I and N,respectively(p=0.3).No statistical differences were observed in the conversion rate to ureteroscopy(p=0.3)or complication rate(p=0.7)between Group I and Group N.One patient who developed skin redness was considered a complication of the contrast medium.Propensity score matching examined 88 matched pairs.Treatment success was obtained in 31(35%)patients in Group I and 33(38%)patients in Group N(p=0.9)within 30 days with one session.Conclusion Radiolucent stones can be safely and effectively treated by shockwave lithotripsy with intravenous urography.展开更多
The pharmacokinetics of milbemycin oxime was investigated in dogs following oral(per os, PO) and intravenous(IV) administration. Three groups of dogs received milbemycin oxime tablets as a single PO dose equal to 0.25...The pharmacokinetics of milbemycin oxime was investigated in dogs following oral(per os, PO) and intravenous(IV) administration. Three groups of dogs received milbemycin oxime tablets as a single PO dose equal to 0.25, 0.5 and 1.0 mg · kg-1 of milbemycin oxime, respectively, another group received a single IV dose of 0.5 mg · kg-1. Blood samples were collected at predetermined times after drug administration and the milbemycin oxime concentrations in plasma were determined by LC-MS/MS. The drug protein binding in dog plasma in vitro was determined by equilibrium dialysis at concentrations spanning the range of values observed in vivo in dog plasma. After PO administration at doses of 0.25, 0.5 and 1.0 mg · kg-1, milbemycin oxime was slowly absorbed and eliminated, the time to reach the maximum plasma concentration(Tmax) was 4.14±0.20, 4.27±0.14 and 4.06±0.13 h, the mean absorption time(MAT) was 19.06, 13.67 and 11.77 h, the terminal rate half-life(t1/2λz) was 15.06±0.37, 11.09±0.54 and 9.76±0.89 h and the total body clearance(Cl) was 1.15±0.05, 1.18±0.03 and 1.17±0.07 m L · min-1 · kg-1, respectively. The maximum plasma concentration(Cmax, 36.50±1.40, 76.11±2.77 and 182.05±7.20 ng · m L-1, respectively) and the area under the first-moment curve(AUC-10→∞, 985.83±49.46, 1 663.12±51.42 and 3 558.04±197.88 mg · h · L, respectively) increased accordingly to the administered dose rates; the oral bioavailabilities were estimated to be 88.61%, 74.75% and 79.96%, respectively. The values of fu were 0.12%, 0.14% and 0.13% in dog plasma, respectively. In conclusion, the pharmacokinetics of milbemycin oxime in dogs following oral administration revealed its higher oral bioavailability and advantageous pharmacokinetic properties, such as its lower total body clearance and longer elimination half-life, and indicated that the single oral dose of 0.50 mg · kg-1 of milbemycin oxime which was recommended in all the parasitological efficacy studies allowed an adequate concentration of the drug.展开更多
The intravenous formulation of levetiracetam (LEV)has been available in clinical practice worldwide for several years,but not in China.In the present study,we aimed to evaluate the bioequivalence of intravenous and or...The intravenous formulation of levetiracetam (LEV)has been available in clinical practice worldwide for several years,but not in China.In the present study,we aimed to evaluate the bioequivalence of intravenous and oral LEV (tablet), an antiepileptic drug,in healthy Chinese volunteers.Two randomized,single-dose (1500mg),open-label,2-period crossover trials were conducted as follows:study A,15-min infusion;study B,45-min infusion.A total of 22healthy men participated in study A,and 24healthy men and woman were enrolled in study B.In study A,blood samples were collected after termination of each treatment.In study B,samples were collected after oral or after the start of the intravenous administration.Safety and the ratio of intravenous/oral LEV for AUC 0-t and Cmax were evaluated.The 90% confidence intervals of Cmax and AUC0-t ratios for LEV 1500-mg tablets versus 15-min intravenous administration were outside the bioequivalence limits (80.00%-125.00%). For LEV 45-min intravenous administration,bioequivalence versus 1500-mg tablets was within the range for Cmax and AUC 0-t. The most frequently adverse event (AE)was somnolence.A total of eight subjects experienced nine mild AEs in study A, and 19subjects experienced 29mild AEs in study B.Intravenous infusions (15 and 45 min)of 1500-mg LEV were as well tolerated as the oral tablet.Bioequivalence was demonstrated by 45-min infusions.Therefore,direct conversion from oral to intravenous LEV 1500 mg (45-min infusion),or vice versa,was possible.展开更多
BACKGROUND Stress hyperglycemia(SH)is a common phenomenon that is present in about 50%of patients with acute ischemic stroke(AIS).It is thought to be a main risk factor for poor functional outcome among patients with ...BACKGROUND Stress hyperglycemia(SH)is a common phenomenon that is present in about 50%of patients with acute ischemic stroke(AIS).It is thought to be a main risk factor for poor functional outcome among patients with AIS undergoing intravenous thrombolysis(IVT).AIM To investigate the predictive value of glycemic indicators for early neurological outcomes(ENOs)in patients with AIS treated with IVT.METHODS We retrospectively reviewed a prospectively collected database of patients with AIS who underwent IVT at the Department of Neurology,Second Affiliated Hospital of Xuzhou Medical University,between January 2017 and June 2022.ENO included early neurological improvement(ENI)and early neurological deterioration(END),defined as a decrease or increase in the National Institutes of Health Stroke Scale(NIHSS)score between baseline and 24 hours after IVT.We analyzed the associations between glycemic indicators[including admission hyperglycemia(AH),fasting blood glucose(FBG),and SH ratio(SHR)]and ENO in all patients and in subgroups stratified by diabetes mellitus(DM).RESULTS A total of 819 patients with AIS treated with IVT were included.Among these,AH was observed in 329 patients(40.2%).Compared with patients without AH,those with AH were more likely to have a higher prevalence of DM(P<0.001)and hypertension(P=0.031)and presented with higher admission NIHSS scores(P<0.001).During the first 24 hours after IVT,END occurred in 208 patients(25.4%)and ENI occurred in 156 patients(19.0%).Multivariate mixed logistic regression analyses indicated that END was independently associated with AH[odds ratio(OR):1.744,95%confidence interval(CI):1.236-2.463;P=0.002].Subjects were classified into four groups representing quartiles.Compared with Q1,patients in the higher quartiles of SHR(Q2:OR:2.306,95%CI:1.342-3.960;P=0.002)(Q3:OR:2.284,95%CI:1.346-3.876;P=0.002)(Q4:OR:3.486,95%CI:2.088-5.820;P=0.001)and FBG(Q3:OR:1.746,95%CI:1.045-2.917;P=0.033)(Q4:OR:2.436,95%CI:1.476-4.022;P=0.001)had a significantly higher risk of END in the overall population.However,none of the glycemic indicators were found to be associated with ENI in patients with or without DM.CONCLUSION Our study demonstrated that glycemic indicators in patients with stroke treated with IVT were associated with the presence of END rather than ENI during the first 24 hours after admission.展开更多
AIM： To compare the effect of intravenous and oral omeprazole in patients with bleeding peptic ulcers without high-risk stigmata.METHODS： This randomized study included 211 patients [112 receiving iv omeprazole prot...AIM： To compare the effect of intravenous and oral omeprazole in patients with bleeding peptic ulcers without high-risk stigmata.METHODS： This randomized study included 211 patients [112 receiving iv omeprazole protocol （Group 1）, 99 receiving po omeprazole 40 mg every 12 h （Group 2）] with a mean age of 52.7. In 144 patients the ulcers showed a clean base, and in 46 the ulcers showed fiat spots and in 21 old adherent clots. The endpoints were re-bleeding, surgery, hospital stay, blood transfusion and death. After discharge, re-bleeding and death were reevaluated within 30 d.RESULTS： The study groups were similar with respect to baseline characteristics. Re-bleeding was recorded in 5 patients of Group 1 and in 4 patients of Group 2 （P = 0.879）. Three patients in Group 1 and 2 in Group 2 underwent surgery （P = 0.773）. The mean length of hospital stay was 4.6 ± 1.6 d in Group 1 vs 4.5 ± 2.6 d in Group 2 （P = 0.710）; the mean amounts of blood transfusion were 1.9 ±1.1 units in Group 1 vs 2.1 ±1.7 units in Group 2 （P = 0.350）. Four patients, two in each group died （P = 0.981）. After discharge, a new bleeding occurred in 2 patients of Group 1 and in 1 patient of Group 2, and one patient from Group 1 died.CONCLUSION： We demonstrate that the effect of oral omeprazole is as effective as intravenous therapy in terms of re-bleeding, surgery, transfusion requirements, hospitalization and mortality in patients with bleeding ulcers with low risk stigmata. These patients can be treated effectively with oral omeprazole.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)pneumonia with severe septic shock and acute respiratory distress syndrome(ARDS)are critical illnesses for patients following transplant.Intravenous immunoglobulin(IVIG)pla...BACKGROUND Coronavirus disease 2019(COVID-19)pneumonia with severe septic shock and acute respiratory distress syndrome(ARDS)are critical illnesses for patients following transplant.Intravenous immunoglobulin(IVIG)plays a role in both immune support and inflammation control,especially in immunocompromised patients.This case report describes the first successful experience using IVIG and pulse steroids to manage this critical condition following lung transplantation.CASE SUMMARY A 65-year-old male patient reported a history of chronic obstructive pulmonary disease and poor lung function and received bilateral sequential lung transplantations.Postoperatively,he developed COVID-19 pneumonia,severe septic shock,and ARDS.He recovered from this critical condition after empirical antibiotics administration and veno-venous extracorporeal membrane oxygenation,in addition to IVIG and pulse steroids.CONCLUSION IVIG is a valuable adjunct in managing severe sepsis in lung transplant recipients after COVID-19 infection.We aim,for the first time,to report the success of such a management approach for COVID-19 ARDS and sepsis in the post-lung transplant setting.With further investigations,this is a starting point for wider analysis of such an approach in this setting and consequently helps guide clinical practice for such a challenging patient population moving forward.展开更多
Background: Puffy hand syndrome (PHS) is a rare complication primarily associated with intravenous drug use (IVDU), characterized by chronic swelling and fibrosis of the hands due to lymphatic damage. Concurrent pulmo...Background: Puffy hand syndrome (PHS) is a rare complication primarily associated with intravenous drug use (IVDU), characterized by chronic swelling and fibrosis of the hands due to lymphatic damage. Concurrent pulmonary complications, such as pneumonia and pneumothorax, significantly contribute to increased morbidity in this population. Case Presentation: We report the case of a 28-year-old female who injects drugs, and presents with fever, bilateral hand edema, and respiratory symptoms. Clinical evaluation revealed erythema and edema of both hands, elevated inflammatory markers, and a left lower lobe infiltration that progressed to pneumothorax. A diagnosis of PHS and left lower lobe pneumonia complicated by pneumothorax was established. Management and Outcomes: The patient was treated with broad-spectrum antibiotics, including ceftriaxone, levofloxacin, dexamethasone, and oxygen supplementation, as well as antipyretics. She demonstrated partial clinical improvement and was referred to another hospital’s thoracic surgery department for specialized care. Conclusions: This case underscores the importance of early recognition and multidisciplinary management of rare but serious complications in IVDU patients. Further research is necessary to elucidate the interplay between lymphatic dysfunction and pulmonary pathophysiology in this demographic.展开更多
This study investigated the factors contributing to intravenous admixture preparation errors(IAPEs)within Pharmacy Intravenous Admixture Services(PIVAS).A retrospective analysis was conducted on IAPEs documented in th...This study investigated the factors contributing to intravenous admixture preparation errors(IAPEs)within Pharmacy Intravenous Admixture Services(PIVAS).A retrospective analysis was conducted on IAPEs documented in the PIVAS unit of a large multi-specialty hospital in China,which houses over 2000 beds,covering the period from January 1,2015 to December 31,2022.Drug preparation records were examined using a generalized linear mixed model(GLMM)to identify both univariate and multivariate factors associated with IAPE occurrences.A total of 824 IAPE cases were recorded during the study period,yielding an overall error rate of 0.018%.Univariate analysis identified drug categories(general drugs,anti-infective drugs,and antineoplastic drugs),preparation time(workdays),and years of work experience as significant determinants(P<0.05).Multivariate analysis further confirmed that drug categories(general and antineoplastic drugs),preparation time(workdays),and work experience remained statistically significant predictors of IAPE incidence(P<0.05).IAPEs in PIVAS were influenced by multiple factors,predominantly those related to personnel and drug characteristics.Targeted interventions,informed by multivariate analysis,are essential to mitigating these errors and enhancing medication safety.展开更多
The Interpretation of Nursing Guidelines for Intravenous Thrombolysis in Acute Ischemic Stroke offers comprehensive recommendations across five key domains:hospital organizational management,patient condition monitori...The Interpretation of Nursing Guidelines for Intravenous Thrombolysis in Acute Ischemic Stroke offers comprehensive recommendations across five key domains:hospital organizational management,patient condition monitoring,complication observation and management,positioning and mobility away from the bed,and quality assurance.These Guidelines encompass all the phases of intravenous thrombolysis care for patients experiencing acute ischemic stroke.This article aims to elucidate the Guidelines by discussing their developmental background,the designation process,usage recommendations,and the interpretation of evolving perspectives,thereby providing valuable insights for clinical practice.展开更多
This study aimed to explore the specific application effect of specialist nursing intervention in intravenous therapy on elderly patients with peripherally inserted central catheters(PICC).From November 2023 to Novemb...This study aimed to explore the specific application effect of specialist nursing intervention in intravenous therapy on elderly patients with peripherally inserted central catheters(PICC).From November 2023 to November 2024,a total of 60 elderly patients with PICC admitted to Guiqian International General Hospital were selected as research subjects.Using a digital random table method,these patients were randomly divided into a control group and an experimental group,with 30 patients in each.The control group received routine nursing care,while the experimental group received specialized intravenous therapy nursing intervention in addition to routine care.The nursing effects of both groups were comprehensively evaluated,including treatment compliance,psychological state,quality of life,incidence of complications,and satisfaction with nursing care.The results showed that after the intervention,the treatment compliance in the experimental group was significantly higher than that of the control group(P<0.05).Additionally,scores on the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)were markedly lower in the experimental group compared to the control group(P<0.05),indicating improved psychological well-being.The experimental group also scored higher in all dimensions of quality of life(P<0.05),and had a lower complication rate and higher satisfaction with nursing care(P<0.05).In conclusion,the application of specialized intravenous therapy nursing intervention in the care of elderly patients with PICC can significantly enhance treatment compliance,improve psychological status,elevate quality of life,and reduce complications,demonstrating strong clinical value and providing important guidance for future treatment and nursing of such patients.展开更多
Background Postoperative pain,if not effectively controlled,can trigger sympathetic activation and stress responses that increase the risk of cardiovascular complications.Oxycodone,a semisynthetic opioid acting on bot...Background Postoperative pain,if not effectively controlled,can trigger sympathetic activation and stress responses that increase the risk of cardiovascular complications.Oxycodone,a semisynthetic opioid acting on bothμ-andκ-receptors,may provide stable analgesia with less hemodynamic fluctuation compared with the pureμ-agonist sufentanil.This study aimed to compare the efficacy and cardiovascular safety of oxycodone-based versus sufent anil-based intravenous patient-controlled analgesia(IV-PCA)after laparoscopic abdominal surgery.Methods This single-center retrospective comparative study included patients who underwent laparoscopic abdominal surgery between March 2024 and March 2025.According to their postoperative PCA regimen,patients were divided into an oxycodone group and a sufentanil group.The primary endpoint was the incidence of cardiovascular adverse events(CVAE)within 48 h after surgery,including hypotension,bradycardia,and arrhythmia.Logistic regression was used to identify independent predictors of CVAE,and receiver operating characteristic(ROC)analysis assessed discriminative performance.Results A total of 356 patients were analyzed(oxycodone n=197;sufentanil n=159).The incidence of CVAE was significantly lower in the oxycodone group than in the sufentanil group(5.2%vs.12.1%,P=0.021).Oxycodone provided comparable analgesic intensity with fewer PCA bolus attempts(36±15 vs.52±17,P<0.001)and higher patient satisfaction scores(4.3±0.5 vs.4.1±0.5,P=0.002).Multivariate logistic regression identified sufentanil use(OR:2.53,95%CI:1.16-5.84,P=0.018)as independent predictors of CVAE.Conclusions Oxycodone-based IV-PCA provided effective postoperative analgesia with a lower incidence of cardiovascular adverse events compared with sufentanil-based PCA.The results suggested that oxycodone offered a favorable balance between analgesic efficacy and hemodynamic stability,making it a safer alternative for postoperative pain management in patients at cardiovascular risk.展开更多
Background Kawasaki disease(KD)is a common acute systemic vasculitis in children,with coronary artery injury being its most serious complication.Currently,intravenous immunoglobulin(IVIG)serves as the standard first l...Background Kawasaki disease(KD)is a common acute systemic vasculitis in children,with coronary artery injury being its most serious complication.Currently,intravenous immunoglobulin(IVIG)serves as the standard first line treatment.However,approximately 10%-20%of patients do not respond to initial IVIG therapy,leading to difficulties in inflammation control,increased risk of coronary artery lesions,and a lack of reliable early predictive indicators.Existing scoring systems(such as the Kobayashi and Egami scores)for predicting IVIG nonresponse are predominantly based on clinical features and conventional inflammatory markers,and thus have limited ability to specifically reflect the extent of myocardial involvement and cardiac functional impairment.Therefore,identifying biomarkers capable of predicting IVIG responsiveness is of significant importance for clinical decision making and improving patients'outcomes.Brain natriuretic peptide(BNP)and cardiac troponin I(cTnI),which reflect cardiac function and myocardial injury respectively,may serve as potential indicators for evaluating IVIG treatment response.Combining these two cardiac specific biomarkers with traditional scoring systems could provide a more comprehensive and accurate tool for early identification of IVIG nonresponsive patients.Methods A retrospective analysis was conducted on the clinical data of 80 children with KD who were admitted to Longyan First Hospital from January 2024 to October 2025.All patients received IVIG therapy.Based on treatment response,they were divided into an IVIG-responsive group and an IVIG-nonresponsive group.General information and laboratory parameters were collected from both groups.Univariate and multivariate logistic regression analyses were employed to screen for independent risk factors affecting the efficacy of IVIG in KD patients.Additionally,receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of BNP and cTnI for IVIG treatment response.Results After standard IVIG treatment,all KD children were categorized based on treatment response into an IVIG-responsive group(n=68,85.00%)and an IVIG-nonresponsive group(n=12,15.00%).The Kobayashi score,ESR,BNP,and cTnI levels were significantly higher in the IVIG-nonresponsive group compared to the IVIGresponsive group(P<0.05).Multivariate logistic regression analysis identified Kobayashi score,BNP,and cTnI as independent risk factors affecting IVIG treatment efficacy.Furthermore,ROC curve analysis demonstrated that both BNP and cTnI exhibited predictive value for IVIG treatment outcomes.Conclusions The Kobayashi score,serum BNP level,and serum cTnI level were all independent risk factors influencing the efficacy of IVIG therapy in children with KD.Both serum BNP and cTnI levels demonstrated certain predictive value for IVIG treatment outcomes.展开更多
Objective:To evaluate the therapeutic effects of intravenous infusion using intravenous indwelling needles(IIN)versus peripherally inserted central catheters(PICC)in patients with acute leukemia during maintenance tre...Objective:To evaluate the therapeutic effects of intravenous infusion using intravenous indwelling needles(IIN)versus peripherally inserted central catheters(PICC)in patients with acute leukemia during maintenance treatment.Methods:Eighty-six patients with acute leukemia admitted to the First Affiliated Hospital of Baotou Medical College from July 2022 to March 2023 were randomly divided into the IIN group and the PICC group,with 43 patients in each group.Results:Significant differences were observed between the two groups in terms of the number of punctures and puncture time(P<0.05).Although the intubation cost was lower in the IIN group than in the PICC group,the maintenance treatment duration was shorter in the IIN group(P<0.05).There were no significant differences between the two groups in terms of disease symptoms,treatment-related toxicity,and side effects(P>0.05).However,anxiety,treatment compliance,and patient satisfaction were significantly lower in IIN group compared to the PICC group(P<0.05).Additionally,the incidence of vein-related complications in the IIN group was higher than in the PICC group(P<0.05).Conclusion:Compared with intravenous indwelling needles,PICCs demonstrate superior application outcomes.Although the cost of PICC placement is relatively high,its ability to prolong maintenance treatment,alleviate patient anxiety,reduce vein-related complications,and improve treatment compliance makes it a valuable method worth promoting.展开更多
A recently published study(Xin et al.,Prog Biochem Biophys,2026,53(2):431-441.DOI:10.3724/j.pibb.2025.0508)addresses the therapeutic challenges of pancreatic ductal adenocarcinoma(PDAC)by innovatively developing an or...A recently published study(Xin et al.,Prog Biochem Biophys,2026,53(2):431-441.DOI:10.3724/j.pibb.2025.0508)addresses the therapeutic challenges of pancreatic ductal adenocarcinoma(PDAC)by innovatively developing an orally administered nanogene delivery system.Designed to achieve in situ,efficient delivery of chimeric antigen receptor(CAR)genes to tumor sites,this approach offers a novel strategy for CAR-macrophage(CAR-M)based immunotherapy.Its key highlights are as follows.展开更多
BACKGROUND Managing sudden deafness(SD)in patients with diabetes mellitus(DM)is partic-ularly challenging due to the heightened risk of adverse effects associated with systemic drug administration.This study explores ...BACKGROUND Managing sudden deafness(SD)in patients with diabetes mellitus(DM)is partic-ularly challenging due to the heightened risk of adverse effects associated with systemic drug administration.This study explores the potential of retroauricular subperiosteal injection as a localized drug delivery method for a more effective and safe treatment.AIM To compare the efficacy of retroauricular subperiosteal injection vs systemic intravenous glucocorticoid(GC)administration for SD in patients with DM and assess the effects on blood glucose levels.METHODS A total of 128 cases of type 2 DM(T2DM)with SD diagnosed and treated in Zibo Central Hospital from February 2021 to July 2023 were divided into two groups:An observation group(66 cases receiving retroauricular subperiosteal injection of methylprednisolone)and a control group(62 cases receiving systemic intravenous administration of methylprednisolone).The two groups were compared in terms of therapeutic efficacy,hearing recovery,blood glucose level changes,and incidence of adverse reactions.Binary logistic regression was used to analyze the factors affecting therapeutic efficacy.RESULTS The observation group showed a significantly higher total effective rate(90.91%)compared with the control group(75.81%,P<0.05).Additionally,pure-tone hearing threshold,fasting plasma glucose,and 2-hour postprandial blood glucose were significantly lower in the observation group compared with the control group(P<0.05).The incidence of adverse reactions was also lower in the observation group than in the control group(7.58%vs 22.58%,P<0.05).A T2DM course longer than 5 years and systemic intravenous GC administration were identified as independent risk factors for treatment inefficacy(P<0.05).INTRODUCTION Sudden deafness(SD)is a clinical emergency characterized by rapid-onset hearing loss that is often accompanied by clinical symptoms such as tinnitus and vertigo[1].Although its pathogenesis remains unclear,it is supposedly associated with factors,including inner ear microcirculation disorders,autoimmune diseases,and viral infections[2,3].Patients with diabetes are particularly susceptible to microvascular complications due to poor long-term glycemic control,affecting the ear’s microcirculation,subsequently increasing the risk of SD[4].Type 2 diabetes mellitus(T2DM),a chronic metabolic disease,causes multiple microvascular damages throughout the body,complicating SD treatment in patients with diabetes[5,6].Inner ear microcirculation disturbances in patients with diabetes may exacerbate the risk of SD,and its pathological process may be related to vascular endothelial dysfunction,inflammatory reactions,and hemorrhological changes caused by diabetes mellitus(DM)[7].Current SD treatments include glucocorticoids(GCs),vasodilators,and hyperbaric oxygen therapy[8].GCs are widely used due to their anti-inflammatory and immunosuppressive effects[9].However,systemic GCs may cause blood glucose(BG)fluctuations and even increase the risk of complications in patients with DM,limiting their clinical use in this population[10].Therefore,there is a compelling and immediate need for a local alternative solution that minimally affects the metabolic mechanisms.In recent years,retroauricular subperiosteal injection has emerged as a localized administration modality for treating SD[11].This method allows drugs to directly act on the inner ear,avoiding the side effects of systemic administration and having a minor impact on BG levels,providing a potentially effective treatment for patients with diabetes[12].However,there is limited clinical evidence to compare the efficacy and glycaemic effects of retroauricular subperiosteal injection vs systemic intravenous GC administration in patients with SD and diabetes.This study aimed to explore the efficacy of retroauricular subperiosteal injection and systemic intravenous GC administration for treating patients with SD and DM and their effects on BG,providing a safer and more effective clinical treatment approach.展开更多
Varicose veins are enlarged, protuberant superficial veins that are palpable beneath the skin. The causes of such a venous pathology may be primary, secondary, or congenital. The major agents leading to the developmen...Varicose veins are enlarged, protuberant superficial veins that are palpable beneath the skin. The causes of such a venous pathology may be primary, secondary, or congenital. The major agents leading to the development of varicose veins include: Hereditary, prolonged standing, Increasing age, Heavy lifting, Prior superficial or deep vein clots, Female gender and Multiple pregnancies. In this manuscript, we report a case of inguinal varicose vein in connection with femoral vein, resulted from direct intravenous injection of drug. The diagnosis was made based on Doppler sonography.展开更多
基金grants 2022YFC2504902,2022YFC2504904 from the Ministry of Science and Technology of the People’s Republic of China,grant Z200016 from the Beijing Natural Science。
文摘Background and purpose To date,no large cohort study has investigated the effects of intravenous thrombolysis(IVT)in Chinese patients aged over 80 years who had a stroke.This study aimed to assess the trends in the use of alteplase,the clinical characteristics and the outcomes of Chinese patients aged above 80 years who had an acute ischaemic stroke.Methods Data for this analysis were obtained from the China Stroke Center Alliance programme,a nationwide,multicentre,prospective registry encompassing 1751 hospitals across 31 provinces,covering the period from 1 January 2018 to 14 December 2022.The primary outcome was defined as a modified Rankin Scale(mRS)Score of 0-2 at discharge.Secondary outcomes included an mRS Score of 0-1 and independent ambulation on discharge.Safety outcomes assessed were in-hospital mortality and symptomatic intracranial haemorrhage(sICH).Results Out of 30902 patients over 80 years old who qualified for thrombolysis,8673(median age(IQR),84(82-87)years)received alteplase treatment.Patients administered alteplase demonstrated improved short-term functional outcomes,such as an mRS Score of 0-2(adjusted OR(aOR)1.12,95%CI,1.06 to 1.18,p<0.001),an mRS Score of 0-1(aOR 1.14,95%CI,1.08 to 1.19,p<0.001)and independent ambulation at discharge(aOR 1.14,95%CI,1.08 to 1.20,p<0.001).Moreover,no significant increase was observed in the risk of in-hospital mortality(aOR 1.12,95%CI,0.93 to 1.35;p=0.23).However,the risk of sICH was significantly higher among patients treated with alteplase(aOR 3.22,95%CI,2.77 to 3.75;p<0.001).Conclusions IVT with alteplase in elderly patients who had a stroke resulted in improved short-term functional outcomes without elevating the risk of in-hospital mortality.Nonetheless,this population remains at a higher risk of sICH.
基金supported by the National Key Research and Development Program of China(2018YFC2001802)the National Natural Science Foundation of China(82303765 and 82071251)+4 种基金Hubei Province Key Research and Development Program(2021BCA145)Open Foundation of Hubei Key Laboratory of Regenerative Medicine and Multi-disciplinary Translational Research(2022zsyx008)Program of Scientifc and Technological Project in Guizhou Province(Qian Ke He Ji Chu ZK[2022]Yi Ban 516 and Qian Ke He Ji Chu ZK[2021]Yi Ban 559)the Science and Technology Talents Growth Project in Education Department of Guizhou Province(Qian Jiao He KY Zi[2021]4Y211)Research project of Guizhou Administration of Traditional Chinese Medicine(QZYY-2021-082).
文摘The primary intravenous anesthetics employed in clinical practice encompass dexmedetomidine(Dex),propofol,ketamine,etomidate,midazolam,and remimazolam.Apart from their established sedative,analgesic,and anxiolytic properties,an increasing body of research has uncovered neuroprotective efects of intravenous anesthetics in various animal and cellular models,as well as in clinical studies.However,there also exists conficting evidence pointing to the potential neurotoxic efects of these intravenous anesthetics.The role of intravenous anesthetics for neuro on both sides of protection or toxicity has been rarely summarized.Considering the mentioned above,this work aims to ofer a comprehensive understanding of the underlying mechanisms involved both in the central nerve system(CNS)and the peripheral nerve system(PNS)and provide valuable insights into the potential safety and risk associated with the clinical use of intravenous anesthetics.
文摘Osteomyelitis is a bone infection that requires prolonged antibiotic treatment and potential surgical intervention.If left untreated,acute osteomyelitis can lead to chronic osteomyelitis and overwhelming sepsis.Early treatment is necessary to prevent complications,and the standard of care is progressing to a shorter duration of intravenous(Ⅳ) antibiotics and transitioning to oral therapy for the rest of the treatment course.We systematically reviewed the current literature on pediatric patients with acute osteomyelitis to determine when and how to transition to oral antibiotics from a short Ⅳ course.Studies have shown that switching to oral after a short course(i.e.,3-7 d) of Ⅳ therapy has similar cure rates to continuing long-term Ⅳ therapy.Prolonged Ⅳ use is also associated with increased risk of complications.Parameters that help guide clinicians on making the switch include a downward trend in fever,improvement in local tenderness,and a normalization in C-reactive protein concentration.Based on the available literature,we recommend transitioning antibiotics to oral after 3-7 d of Ⅳ therapy for pediatric patients(except neonates) with acute uncomplicated osteomyelitis if there are signs of clinical improvement,and such regimen should be continued for a total antibiotic duration of four to six weeks.
文摘Objective We aimed to compare the clinical outcomes of intravenous urography-assisted fluoroscopy-guided shockwave lithotripsy for radiolucent ureteral stones and standard shockwave lithotripsy for radiopaque ureteral stones.Methods We retrospectively reviewed 734 patients with ureteral stones treated by fluoroscopy-guided shockwave lithotripsy between March 2014 and March 2021.The primary outcome was a stone-free rate with one session within 30 days,defined as no residual stones without auxiliary treatment.The multivariate analysis was used to examine whether the intravenous urography use predicted treatment success.Furthermore,we compared the outcomes using propensity score matching.Results Ninety-eight patients underwent the intravenous urography use protocol(Group I),and the remaining 636 patients underwent the non-intravenous urography protocol(Group N).Stone-free rates with one session within 30 days were 38%and 32%in groups I and N,respectively(p=0.3).No statistical differences were observed in the conversion rate to ureteroscopy(p=0.3)or complication rate(p=0.7)between Group I and Group N.One patient who developed skin redness was considered a complication of the contrast medium.Propensity score matching examined 88 matched pairs.Treatment success was obtained in 31(35%)patients in Group I and 33(38%)patients in Group N(p=0.9)within 30 days with one session.Conclusion Radiolucent stones can be safely and effectively treated by shockwave lithotripsy with intravenous urography.
基金Supported by Natural Science Fund of Heilongjiang Province(C201424)
文摘The pharmacokinetics of milbemycin oxime was investigated in dogs following oral(per os, PO) and intravenous(IV) administration. Three groups of dogs received milbemycin oxime tablets as a single PO dose equal to 0.25, 0.5 and 1.0 mg · kg-1 of milbemycin oxime, respectively, another group received a single IV dose of 0.5 mg · kg-1. Blood samples were collected at predetermined times after drug administration and the milbemycin oxime concentrations in plasma were determined by LC-MS/MS. The drug protein binding in dog plasma in vitro was determined by equilibrium dialysis at concentrations spanning the range of values observed in vivo in dog plasma. After PO administration at doses of 0.25, 0.5 and 1.0 mg · kg-1, milbemycin oxime was slowly absorbed and eliminated, the time to reach the maximum plasma concentration(Tmax) was 4.14±0.20, 4.27±0.14 and 4.06±0.13 h, the mean absorption time(MAT) was 19.06, 13.67 and 11.77 h, the terminal rate half-life(t1/2λz) was 15.06±0.37, 11.09±0.54 and 9.76±0.89 h and the total body clearance(Cl) was 1.15±0.05, 1.18±0.03 and 1.17±0.07 m L · min-1 · kg-1, respectively. The maximum plasma concentration(Cmax, 36.50±1.40, 76.11±2.77 and 182.05±7.20 ng · m L-1, respectively) and the area under the first-moment curve(AUC-10→∞, 985.83±49.46, 1 663.12±51.42 and 3 558.04±197.88 mg · h · L, respectively) increased accordingly to the administered dose rates; the oral bioavailabilities were estimated to be 88.61%, 74.75% and 79.96%, respectively. The values of fu were 0.12%, 0.14% and 0.13% in dog plasma, respectively. In conclusion, the pharmacokinetics of milbemycin oxime in dogs following oral administration revealed its higher oral bioavailability and advantageous pharmacokinetic properties, such as its lower total body clearance and longer elimination half-life, and indicated that the single oral dose of 0.50 mg · kg-1 of milbemycin oxime which was recommended in all the parasitological efficacy studies allowed an adequate concentration of the drug.
文摘The intravenous formulation of levetiracetam (LEV)has been available in clinical practice worldwide for several years,but not in China.In the present study,we aimed to evaluate the bioequivalence of intravenous and oral LEV (tablet), an antiepileptic drug,in healthy Chinese volunteers.Two randomized,single-dose (1500mg),open-label,2-period crossover trials were conducted as follows:study A,15-min infusion;study B,45-min infusion.A total of 22healthy men participated in study A,and 24healthy men and woman were enrolled in study B.In study A,blood samples were collected after termination of each treatment.In study B,samples were collected after oral or after the start of the intravenous administration.Safety and the ratio of intravenous/oral LEV for AUC 0-t and Cmax were evaluated.The 90% confidence intervals of Cmax and AUC0-t ratios for LEV 1500-mg tablets versus 15-min intravenous administration were outside the bioequivalence limits (80.00%-125.00%). For LEV 45-min intravenous administration,bioequivalence versus 1500-mg tablets was within the range for Cmax and AUC 0-t. The most frequently adverse event (AE)was somnolence.A total of eight subjects experienced nine mild AEs in study A, and 19subjects experienced 29mild AEs in study B.Intravenous infusions (15 and 45 min)of 1500-mg LEV were as well tolerated as the oral tablet.Bioequivalence was demonstrated by 45-min infusions.Therefore,direct conversion from oral to intravenous LEV 1500 mg (45-min infusion),or vice versa,was possible.
基金Supported by the Foundation of Jiangsu Provincial Commission of Health and Family Planning,No.QNRC2016353the Commission of Health and Family Planning Xuzhou,No.KC22206.
文摘BACKGROUND Stress hyperglycemia(SH)is a common phenomenon that is present in about 50%of patients with acute ischemic stroke(AIS).It is thought to be a main risk factor for poor functional outcome among patients with AIS undergoing intravenous thrombolysis(IVT).AIM To investigate the predictive value of glycemic indicators for early neurological outcomes(ENOs)in patients with AIS treated with IVT.METHODS We retrospectively reviewed a prospectively collected database of patients with AIS who underwent IVT at the Department of Neurology,Second Affiliated Hospital of Xuzhou Medical University,between January 2017 and June 2022.ENO included early neurological improvement(ENI)and early neurological deterioration(END),defined as a decrease or increase in the National Institutes of Health Stroke Scale(NIHSS)score between baseline and 24 hours after IVT.We analyzed the associations between glycemic indicators[including admission hyperglycemia(AH),fasting blood glucose(FBG),and SH ratio(SHR)]and ENO in all patients and in subgroups stratified by diabetes mellitus(DM).RESULTS A total of 819 patients with AIS treated with IVT were included.Among these,AH was observed in 329 patients(40.2%).Compared with patients without AH,those with AH were more likely to have a higher prevalence of DM(P<0.001)and hypertension(P=0.031)and presented with higher admission NIHSS scores(P<0.001).During the first 24 hours after IVT,END occurred in 208 patients(25.4%)and ENI occurred in 156 patients(19.0%).Multivariate mixed logistic regression analyses indicated that END was independently associated with AH[odds ratio(OR):1.744,95%confidence interval(CI):1.236-2.463;P=0.002].Subjects were classified into four groups representing quartiles.Compared with Q1,patients in the higher quartiles of SHR(Q2:OR:2.306,95%CI:1.342-3.960;P=0.002)(Q3:OR:2.284,95%CI:1.346-3.876;P=0.002)(Q4:OR:3.486,95%CI:2.088-5.820;P=0.001)and FBG(Q3:OR:1.746,95%CI:1.045-2.917;P=0.033)(Q4:OR:2.436,95%CI:1.476-4.022;P=0.001)had a significantly higher risk of END in the overall population.However,none of the glycemic indicators were found to be associated with ENI in patients with or without DM.CONCLUSION Our study demonstrated that glycemic indicators in patients with stroke treated with IVT were associated with the presence of END rather than ENI during the first 24 hours after admission.
文摘AIM： To compare the effect of intravenous and oral omeprazole in patients with bleeding peptic ulcers without high-risk stigmata.METHODS： This randomized study included 211 patients [112 receiving iv omeprazole protocol （Group 1）, 99 receiving po omeprazole 40 mg every 12 h （Group 2）] with a mean age of 52.7. In 144 patients the ulcers showed a clean base, and in 46 the ulcers showed fiat spots and in 21 old adherent clots. The endpoints were re-bleeding, surgery, hospital stay, blood transfusion and death. After discharge, re-bleeding and death were reevaluated within 30 d.RESULTS： The study groups were similar with respect to baseline characteristics. Re-bleeding was recorded in 5 patients of Group 1 and in 4 patients of Group 2 （P = 0.879）. Three patients in Group 1 and 2 in Group 2 underwent surgery （P = 0.773）. The mean length of hospital stay was 4.6 ± 1.6 d in Group 1 vs 4.5 ± 2.6 d in Group 2 （P = 0.710）; the mean amounts of blood transfusion were 1.9 ±1.1 units in Group 1 vs 2.1 ±1.7 units in Group 2 （P = 0.350）. Four patients, two in each group died （P = 0.981）. After discharge, a new bleeding occurred in 2 patients of Group 1 and in 1 patient of Group 2, and one patient from Group 1 died.CONCLUSION： We demonstrate that the effect of oral omeprazole is as effective as intravenous therapy in terms of re-bleeding, surgery, transfusion requirements, hospitalization and mortality in patients with bleeding ulcers with low risk stigmata. These patients can be treated effectively with oral omeprazole.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)pneumonia with severe septic shock and acute respiratory distress syndrome(ARDS)are critical illnesses for patients following transplant.Intravenous immunoglobulin(IVIG)plays a role in both immune support and inflammation control,especially in immunocompromised patients.This case report describes the first successful experience using IVIG and pulse steroids to manage this critical condition following lung transplantation.CASE SUMMARY A 65-year-old male patient reported a history of chronic obstructive pulmonary disease and poor lung function and received bilateral sequential lung transplantations.Postoperatively,he developed COVID-19 pneumonia,severe septic shock,and ARDS.He recovered from this critical condition after empirical antibiotics administration and veno-venous extracorporeal membrane oxygenation,in addition to IVIG and pulse steroids.CONCLUSION IVIG is a valuable adjunct in managing severe sepsis in lung transplant recipients after COVID-19 infection.We aim,for the first time,to report the success of such a management approach for COVID-19 ARDS and sepsis in the post-lung transplant setting.With further investigations,this is a starting point for wider analysis of such an approach in this setting and consequently helps guide clinical practice for such a challenging patient population moving forward.
文摘Background: Puffy hand syndrome (PHS) is a rare complication primarily associated with intravenous drug use (IVDU), characterized by chronic swelling and fibrosis of the hands due to lymphatic damage. Concurrent pulmonary complications, such as pneumonia and pneumothorax, significantly contribute to increased morbidity in this population. Case Presentation: We report the case of a 28-year-old female who injects drugs, and presents with fever, bilateral hand edema, and respiratory symptoms. Clinical evaluation revealed erythema and edema of both hands, elevated inflammatory markers, and a left lower lobe infiltration that progressed to pneumothorax. A diagnosis of PHS and left lower lobe pneumonia complicated by pneumothorax was established. Management and Outcomes: The patient was treated with broad-spectrum antibiotics, including ceftriaxone, levofloxacin, dexamethasone, and oxygen supplementation, as well as antipyretics. She demonstrated partial clinical improvement and was referred to another hospital’s thoracic surgery department for specialized care. Conclusions: This case underscores the importance of early recognition and multidisciplinary management of rare but serious complications in IVDU patients. Further research is necessary to elucidate the interplay between lymphatic dysfunction and pulmonary pathophysiology in this demographic.
基金The National Natural Science Foundation of China(Grant No.72474013)the Beijing Health Technology Promotion Project(Grant No.BHTPP2024007)。
文摘This study investigated the factors contributing to intravenous admixture preparation errors(IAPEs)within Pharmacy Intravenous Admixture Services(PIVAS).A retrospective analysis was conducted on IAPEs documented in the PIVAS unit of a large multi-specialty hospital in China,which houses over 2000 beds,covering the period from January 1,2015 to December 31,2022.Drug preparation records were examined using a generalized linear mixed model(GLMM)to identify both univariate and multivariate factors associated with IAPE occurrences.A total of 824 IAPE cases were recorded during the study period,yielding an overall error rate of 0.018%.Univariate analysis identified drug categories(general drugs,anti-infective drugs,and antineoplastic drugs),preparation time(workdays),and years of work experience as significant determinants(P<0.05).Multivariate analysis further confirmed that drug categories(general and antineoplastic drugs),preparation time(workdays),and work experience remained statistically significant predictors of IAPE incidence(P<0.05).IAPEs in PIVAS were influenced by multiple factors,predominantly those related to personnel and drug characteristics.Targeted interventions,informed by multivariate analysis,are essential to mitigating these errors and enhancing medication safety.
文摘The Interpretation of Nursing Guidelines for Intravenous Thrombolysis in Acute Ischemic Stroke offers comprehensive recommendations across five key domains:hospital organizational management,patient condition monitoring,complication observation and management,positioning and mobility away from the bed,and quality assurance.These Guidelines encompass all the phases of intravenous thrombolysis care for patients experiencing acute ischemic stroke.This article aims to elucidate the Guidelines by discussing their developmental background,the designation process,usage recommendations,and the interpretation of evolving perspectives,thereby providing valuable insights for clinical practice.
文摘This study aimed to explore the specific application effect of specialist nursing intervention in intravenous therapy on elderly patients with peripherally inserted central catheters(PICC).From November 2023 to November 2024,a total of 60 elderly patients with PICC admitted to Guiqian International General Hospital were selected as research subjects.Using a digital random table method,these patients were randomly divided into a control group and an experimental group,with 30 patients in each.The control group received routine nursing care,while the experimental group received specialized intravenous therapy nursing intervention in addition to routine care.The nursing effects of both groups were comprehensively evaluated,including treatment compliance,psychological state,quality of life,incidence of complications,and satisfaction with nursing care.The results showed that after the intervention,the treatment compliance in the experimental group was significantly higher than that of the control group(P<0.05).Additionally,scores on the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)were markedly lower in the experimental group compared to the control group(P<0.05),indicating improved psychological well-being.The experimental group also scored higher in all dimensions of quality of life(P<0.05),and had a lower complication rate and higher satisfaction with nursing care(P<0.05).In conclusion,the application of specialized intravenous therapy nursing intervention in the care of elderly patients with PICC can significantly enhance treatment compliance,improve psychological status,elevate quality of life,and reduce complications,demonstrating strong clinical value and providing important guidance for future treatment and nursing of such patients.
基金supported by the Health and Health Development Promotion Project-Anesthesia and Critical Care Research Project(No.KM-20240219-01)。
文摘Background Postoperative pain,if not effectively controlled,can trigger sympathetic activation and stress responses that increase the risk of cardiovascular complications.Oxycodone,a semisynthetic opioid acting on bothμ-andκ-receptors,may provide stable analgesia with less hemodynamic fluctuation compared with the pureμ-agonist sufentanil.This study aimed to compare the efficacy and cardiovascular safety of oxycodone-based versus sufent anil-based intravenous patient-controlled analgesia(IV-PCA)after laparoscopic abdominal surgery.Methods This single-center retrospective comparative study included patients who underwent laparoscopic abdominal surgery between March 2024 and March 2025.According to their postoperative PCA regimen,patients were divided into an oxycodone group and a sufentanil group.The primary endpoint was the incidence of cardiovascular adverse events(CVAE)within 48 h after surgery,including hypotension,bradycardia,and arrhythmia.Logistic regression was used to identify independent predictors of CVAE,and receiver operating characteristic(ROC)analysis assessed discriminative performance.Results A total of 356 patients were analyzed(oxycodone n=197;sufentanil n=159).The incidence of CVAE was significantly lower in the oxycodone group than in the sufentanil group(5.2%vs.12.1%,P=0.021).Oxycodone provided comparable analgesic intensity with fewer PCA bolus attempts(36±15 vs.52±17,P<0.001)and higher patient satisfaction scores(4.3±0.5 vs.4.1±0.5,P=0.002).Multivariate logistic regression identified sufentanil use(OR:2.53,95%CI:1.16-5.84,P=0.018)as independent predictors of CVAE.Conclusions Oxycodone-based IV-PCA provided effective postoperative analgesia with a lower incidence of cardiovascular adverse events compared with sufentanil-based PCA.The results suggested that oxycodone offered a favorable balance between analgesic efficacy and hemodynamic stability,making it a safer alternative for postoperative pain management in patients at cardiovascular risk.
文摘Background Kawasaki disease(KD)is a common acute systemic vasculitis in children,with coronary artery injury being its most serious complication.Currently,intravenous immunoglobulin(IVIG)serves as the standard first line treatment.However,approximately 10%-20%of patients do not respond to initial IVIG therapy,leading to difficulties in inflammation control,increased risk of coronary artery lesions,and a lack of reliable early predictive indicators.Existing scoring systems(such as the Kobayashi and Egami scores)for predicting IVIG nonresponse are predominantly based on clinical features and conventional inflammatory markers,and thus have limited ability to specifically reflect the extent of myocardial involvement and cardiac functional impairment.Therefore,identifying biomarkers capable of predicting IVIG responsiveness is of significant importance for clinical decision making and improving patients'outcomes.Brain natriuretic peptide(BNP)and cardiac troponin I(cTnI),which reflect cardiac function and myocardial injury respectively,may serve as potential indicators for evaluating IVIG treatment response.Combining these two cardiac specific biomarkers with traditional scoring systems could provide a more comprehensive and accurate tool for early identification of IVIG nonresponsive patients.Methods A retrospective analysis was conducted on the clinical data of 80 children with KD who were admitted to Longyan First Hospital from January 2024 to October 2025.All patients received IVIG therapy.Based on treatment response,they were divided into an IVIG-responsive group and an IVIG-nonresponsive group.General information and laboratory parameters were collected from both groups.Univariate and multivariate logistic regression analyses were employed to screen for independent risk factors affecting the efficacy of IVIG in KD patients.Additionally,receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of BNP and cTnI for IVIG treatment response.Results After standard IVIG treatment,all KD children were categorized based on treatment response into an IVIG-responsive group(n=68,85.00%)and an IVIG-nonresponsive group(n=12,15.00%).The Kobayashi score,ESR,BNP,and cTnI levels were significantly higher in the IVIG-nonresponsive group compared to the IVIGresponsive group(P<0.05).Multivariate logistic regression analysis identified Kobayashi score,BNP,and cTnI as independent risk factors affecting IVIG treatment efficacy.Furthermore,ROC curve analysis demonstrated that both BNP and cTnI exhibited predictive value for IVIG treatment outcomes.Conclusions The Kobayashi score,serum BNP level,and serum cTnI level were all independent risk factors influencing the efficacy of IVIG therapy in children with KD.Both serum BNP and cTnI levels demonstrated certain predictive value for IVIG treatment outcomes.
基金supported by the Medical and Health Science and Technology Plan Project of Health and Health Commission of Inner Mongolia Autonomous Region(202201427).
文摘Objective:To evaluate the therapeutic effects of intravenous infusion using intravenous indwelling needles(IIN)versus peripherally inserted central catheters(PICC)in patients with acute leukemia during maintenance treatment.Methods:Eighty-six patients with acute leukemia admitted to the First Affiliated Hospital of Baotou Medical College from July 2022 to March 2023 were randomly divided into the IIN group and the PICC group,with 43 patients in each group.Results:Significant differences were observed between the two groups in terms of the number of punctures and puncture time(P<0.05).Although the intubation cost was lower in the IIN group than in the PICC group,the maintenance treatment duration was shorter in the IIN group(P<0.05).There were no significant differences between the two groups in terms of disease symptoms,treatment-related toxicity,and side effects(P>0.05).However,anxiety,treatment compliance,and patient satisfaction were significantly lower in IIN group compared to the PICC group(P<0.05).Additionally,the incidence of vein-related complications in the IIN group was higher than in the PICC group(P<0.05).Conclusion:Compared with intravenous indwelling needles,PICCs demonstrate superior application outcomes.Although the cost of PICC placement is relatively high,its ability to prolong maintenance treatment,alleviate patient anxiety,reduce vein-related complications,and improve treatment compliance makes it a valuable method worth promoting.
文摘A recently published study(Xin et al.,Prog Biochem Biophys,2026,53(2):431-441.DOI:10.3724/j.pibb.2025.0508)addresses the therapeutic challenges of pancreatic ductal adenocarcinoma(PDAC)by innovatively developing an orally administered nanogene delivery system.Designed to achieve in situ,efficient delivery of chimeric antigen receptor(CAR)genes to tumor sites,this approach offers a novel strategy for CAR-macrophage(CAR-M)based immunotherapy.Its key highlights are as follows.
文摘BACKGROUND Managing sudden deafness(SD)in patients with diabetes mellitus(DM)is partic-ularly challenging due to the heightened risk of adverse effects associated with systemic drug administration.This study explores the potential of retroauricular subperiosteal injection as a localized drug delivery method for a more effective and safe treatment.AIM To compare the efficacy of retroauricular subperiosteal injection vs systemic intravenous glucocorticoid(GC)administration for SD in patients with DM and assess the effects on blood glucose levels.METHODS A total of 128 cases of type 2 DM(T2DM)with SD diagnosed and treated in Zibo Central Hospital from February 2021 to July 2023 were divided into two groups:An observation group(66 cases receiving retroauricular subperiosteal injection of methylprednisolone)and a control group(62 cases receiving systemic intravenous administration of methylprednisolone).The two groups were compared in terms of therapeutic efficacy,hearing recovery,blood glucose level changes,and incidence of adverse reactions.Binary logistic regression was used to analyze the factors affecting therapeutic efficacy.RESULTS The observation group showed a significantly higher total effective rate(90.91%)compared with the control group(75.81%,P<0.05).Additionally,pure-tone hearing threshold,fasting plasma glucose,and 2-hour postprandial blood glucose were significantly lower in the observation group compared with the control group(P<0.05).The incidence of adverse reactions was also lower in the observation group than in the control group(7.58%vs 22.58%,P<0.05).A T2DM course longer than 5 years and systemic intravenous GC administration were identified as independent risk factors for treatment inefficacy(P<0.05).INTRODUCTION Sudden deafness(SD)is a clinical emergency characterized by rapid-onset hearing loss that is often accompanied by clinical symptoms such as tinnitus and vertigo[1].Although its pathogenesis remains unclear,it is supposedly associated with factors,including inner ear microcirculation disorders,autoimmune diseases,and viral infections[2,3].Patients with diabetes are particularly susceptible to microvascular complications due to poor long-term glycemic control,affecting the ear’s microcirculation,subsequently increasing the risk of SD[4].Type 2 diabetes mellitus(T2DM),a chronic metabolic disease,causes multiple microvascular damages throughout the body,complicating SD treatment in patients with diabetes[5,6].Inner ear microcirculation disturbances in patients with diabetes may exacerbate the risk of SD,and its pathological process may be related to vascular endothelial dysfunction,inflammatory reactions,and hemorrhological changes caused by diabetes mellitus(DM)[7].Current SD treatments include glucocorticoids(GCs),vasodilators,and hyperbaric oxygen therapy[8].GCs are widely used due to their anti-inflammatory and immunosuppressive effects[9].However,systemic GCs may cause blood glucose(BG)fluctuations and even increase the risk of complications in patients with DM,limiting their clinical use in this population[10].Therefore,there is a compelling and immediate need for a local alternative solution that minimally affects the metabolic mechanisms.In recent years,retroauricular subperiosteal injection has emerged as a localized administration modality for treating SD[11].This method allows drugs to directly act on the inner ear,avoiding the side effects of systemic administration and having a minor impact on BG levels,providing a potentially effective treatment for patients with diabetes[12].However,there is limited clinical evidence to compare the efficacy and glycaemic effects of retroauricular subperiosteal injection vs systemic intravenous GC administration in patients with SD and diabetes.This study aimed to explore the efficacy of retroauricular subperiosteal injection and systemic intravenous GC administration for treating patients with SD and DM and their effects on BG,providing a safer and more effective clinical treatment approach.
文摘Varicose veins are enlarged, protuberant superficial veins that are palpable beneath the skin. The causes of such a venous pathology may be primary, secondary, or congenital. The major agents leading to the development of varicose veins include: Hereditary, prolonged standing, Increasing age, Heavy lifting, Prior superficial or deep vein clots, Female gender and Multiple pregnancies. In this manuscript, we report a case of inguinal varicose vein in connection with femoral vein, resulted from direct intravenous injection of drug. The diagnosis was made based on Doppler sonography.
