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ObjectiveTo explore the efficacy and predictive indicators of stellate ganglion block （SGB） as an adjunctive intervention for chronic subjective tinnitus and accumulate experience for the application of SGB in the clinical treatment of tinnitus. MethodsA retrospective review was conducted on the data of chronic subjective tinnitus patients who received SGB intervention， with unsatisfactory outcomes otherwise. Pure tone audiometry （PTA）， tinnitus loudness evaluation and Pittsburgh sleep quality index （PSQI） were used. The tinnitus handicap inventory （THI） scores were compared before and after SGB intervention. Correlation analysis and linear regression equations were employed to identify the potential indicators predicting the effectiveness of SGB intervention. Statistical analysis was performed by SPSS 24.0 software. ResultsBy April 2023， a total of 107 patients with chronic subjective tinnitus had undergone SGB intervention， including 67 male and 40 female， with a mean age of （45.32±11.40） years old and an average tinnitus history of （20.32±24.64） months ［16 （12~20）］. Only 7 patients （6.54%） quitted the intervention for personal reasons， which demonstrated good compliance with the intervention. No patients experienced adverse reactions such as infection at the injection site， hematoma， nerve injury， local anesthetic intoxication and so on， which revealed good safety. After SGB intervention， THI scores decreased to below 36 points in 77 patients and decrease by 10 points or more in 12 of the remaining patients， with a total effective rate of 89%. A paired sample t-test showed a significant difference in THI scores before and after SGB intervention （t=15.575， P<0.001）， indicating good improvement. Pearson correlation analysis suggested that pre-intervention THI scores and subjective tinnitus loudness were significantly positively correlated with the improvement level of THI scores （P<0.05）. Further stepwise linear regression analysis found that "pre-intervention THI scores" had statistical significance （P<0.001）， with a regression coefficient of 0.308， predicting a 17.4% improvement level in THI scores. ConclusionsDue to its good and safe short-term effects， SGB intervention can be used as a supplementary option for chronic subjective tinnitus when other interventions are not ideal， especially for patients with higher THI scores. However， further research is needed to clarify the long-term efficacy and underlying mechanisms， in order to establish a more solid theoretical basis for SGB intervention in the treatment of subjective tinnitus.
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Objective A discussion of practical models for auditing the prescription of parenteral nutrition by clinical pharmacists of nutrition.Methods A three-dimensional approach to prescription audit of parenteral nutrition by clinical pharmacists,focusing on the stability of the nutritional solution,its pharmacological rationality and the patient's individual need.Results Establishment of this three-dimensional approach.Conclusion This three-dimensional approach ensures the safety and rationality of parenteral nutrition and gives play to clinical pharmacists.
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Objective To determine serum concentration of methotrexate in children with acute lymphoblastic leukemia by HPLC and explore the application practice.Methods The separation was performed in a Wondasil C18-WR column (4.6 mm ×150 mm, 5 μm) with a mobile phase of methanol-0.15%phosphoric acid solution(21:79 ) and determined at 306 nm.The sample of serum was centrifuged after protein precipitation with perchloric acid.Detected results for children to establish monitoring files.ResuIts The linearity was well at 0.02 ~50 μg/mL of methotrexate ( r =0.9990,n=6).The average recovery was 96.50%, RSD of within day and between days were less than 15%.Established monitoring files for six children and after 3 courses of treatment, the blood concentration of methotrexate in 4 children were small and they were in a safe range , which could reduce the frequency of monitoring.ConcIusion This method is simple, sensitive and accurate for methotrexate detection in serum.The children with stable concentration and within safety range, can reduce monitioring frequency.It could bring the children less pain and relieve the burden of family.
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Objective To investigate effect of glucose and lipid metabolism on acute cerebral infarction patients by Rhodiola injection. Methods 201 cases of acute cerebral infarction patients were selected,and divided into experiment group and control group.The control group of 101 cases were treated by clinical routine therapy,the experiment group 100 cases were treated with Rhodiola injection.The clinical efficacy, blood rheology and blood lipids, blood glucose index were compared before and after treatment.Results After 2 weeks of treatment, the total effective rate in experimental group was significantly higher than the control group(χ2 =12.596, P<0.05), with statistical difference.Patients in the experimental group,FBG was significantly lower than the control group, the difference was statistically significant (t=8.830, P<0.05).Patients in the experimental group TG, TC, LDL-C were significantly lower than that of control group, HDL-C was significantly higher than control group (P<0.05).Blood rheology indexes decreased significantly better than the control group ( P<0.05 ) .Conclusion Rhodiola injection on patients with acute cerebral infarction has good clinical curative effect, and can effectively improve the blood lipid, blood glucose level, reduce blood viscosity, is of great significance to the clinical treatment of cerebral infarction.