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Objective:To investigate the clinical efficacy of multiple colostrum feedings in reducing the incidence of neonatal jaundice.Methods:We randomly selected 100 full-term neonates delivered in Xiaoshan Hospital from January 2018 to January 2019 and randomly allocated them into control and observation groups ( n = 50/group). The control group was administered colostrum < 4 times/day, and the observation group was administered colostrum > 12 times/day. The incidence of neonatal jaundice, the severity of jaundice, the duration of jaundice, serum bilirubin level 7 days after birth, and the satisfaction of neonatal close relatives were compared between the two groups. Results:Neonatal jaundice was significantly milder in the observation group than in the control group ( P < 0.05). The proportion of healthy neonates was significantly higher in the observation group than in the control group ( P < 0.05). The duration of jaundice was shorter in the observation group than in the control group [(2.10 ± 0.35) days vs. (4.25 ± 1.53) days, t = 8.66, P < 0.001]. There was a significant difference in serum bilirubin level 1-5 days after birth between the two groups (all P < 0.05). The satisfaction of the close relatives of neonates was significantly higher in the observation group than in the control group (96.00% vs. 84.00%, χ2 = 4.00, P = 0.045). All neonates with jaundice healed after multiple short-term blue light phototherapies and had no obvious adverse reactions. Conclusion:Multiple colostrum feedings can greatly reduce the incidence of neonatal jaundice, improve the satisfaction of the close relatives of neonates, play a positive role in promoting maternal and infant health, and thereby are worthy of popularization.
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Objective To investigate the clinical effect of montelukast sodium in the treatment of cough vari-ant asthma in children,to provide reference for clinical treatment.Methods 128 cases of children with cough variant asthma were randomly divided into observation group and control group of 64 cases.The control group with routine measures for the treatment of asthma in children for treatment,the observation group in the control group based on the treatment regimen,plus montelukast sodium chawing treatment.The changes of the two groups were compared after 12 weeks of treatment,the clinical efficacy and lung function indexes before and after treatment.Through 6 months of follow -up,the recurrence of the disease between the two groups after treatment.Results The effective rate in the observation group was 43.75%,the total effective rate was 93.75%,which were significantly higher than those of the control group (χ2 =4.53,P <0.05);the two groups after treatment of FEV1 ,FVC,FEV1 /FVC,PEF and PEF during the day at night were significantly higher than those before treatment (t =4.11,3.23,3.82,5.12,3.12,5.54,4.31, 4.98,6.22,4.45,all P <0.05);After treatment,the FEV1 [(3.08 ±0.43)L],FVC[(3.89 ±0.52)L],FEV1 /FVC [(75.95 ±6.51)%],PEF day[(3.24 ±0.91 )L/s],PEF for the night[(3.51 ±1.01 )L/s]of the observation group were significantly higher than those of the control group (t =3.67,3.10,3.43,2.92,3.01,all P <0.05);The recurrence rate of the observation group was 3.13%,which was significantly lower than that of the control group (χ2 =4.82,P <0.05).Conclusion The clinical efficacy of montelukast can significantly improve cough variant asthma in children,improve children's lung function,reduce the recurrence rate of cough variant asthma.
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Objective To study the clinical efficacy and safety of Yanhuning injection in the treatment of bronchial pneumonia in children.Methods 102 cases of bronchial pneumonia were randomly divided into the observation group and the control group,51 cases in each group.The control group was given conventional treatment, the observation group was given Yanhuning injection on the basis of the treatment of control group.The clinical efficacy after treatment,clinical symptoms and signs disappeared time and adverse drug reaction were compared between the two groups.Results In the observation group after treatment,the cured,improvement,invalid cases were 27 cases, 23 cases,1 case,the total effective rate was 98.04%,which in the control group were 18 cases,25 cases,8 cases,the total effective rate was 84.31%.The total effective rate of the observation group was significantly higher than that of the control group (χ2 =5.97,P 0.05).Conclusion Yan-huning injection for the treatment of children with bronchial pneumonia can significantly improve the clinical curative effect,shorten the disappearance time of the clinical symptoms and signs,the curative effect is reliable,high security.
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ObjectiveTo study the pharmacokinetics of sufentanil in patients undergoing different cardiac surgeries with or without CPB.MethodsSixteen ASA Ⅱ or Ⅲ patients aged 56-64 yr weighing 52-78 kg undergoing cardiac surgery were divided into 2 groups ( n ＝ 8 each):group Ⅰ off-pump coronary artery bypass grafting and group Ⅱ valve replacement.Radial artery and peripheral vein were cannnlated.A bolus of sufentanil 5μg/kg was administered iv after induction of anesthesia.Blood samples were obtained from radial artery at 1,3,5,10,20,30,60,120,180,240,360 min after sufentanil injection.Plasma was immediately separated and stored at - 80 C for determination of plasma sufentanil concentration by liquid c hromatography-mass spectrometry.Pharmacokinetic parameters were calculated by 3P97 pharmacological program.ResultsThe pharmacokinetic profile of sufentanil was best described by a three-compartment open model.The 3 exponential equations in group Ⅰ,before and during CPB in group Ⅱ were:Cp(t) ＝ 11.7 e-0.47t + 1.9 e0.043t + 0.27 e-0.0032t ; Cp(t) ＝ 33.4 e-1.87t + 7.1e-0.103t +2.0 e-0.0248t and Cp(t) ＝ 23.8 e-0.54t + 5.2 e0.054t + 0.15 e-0.0017t respectively.There was significant difference in most of the pharmacokinetic parameters between the 2 groups.ConclusionsThe pharmacokinetics of sufentanil in patients undergoing different cardiac surgeries can be described by ~compartment open model.Low cardiac function and CPB can reduce its drug metabolism rate and prolong the duration of action.
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Objective To assess the effect of different ages on sufentanil pharmacokinetics in patients undergoing cardiac valve replacement.Methods Sixteen NYHA Ⅱ or Ⅲ patients undergoing selective cardiac valve replacement were randomly divided into two groups:elderly group (aged 65-69 years,group Ⅰ,n =8) and young adult group (aged 36-45 years,group Ⅱ,n =8).Intravenous and intra-arterial cannulae were placed.Sufentanil 5 μg/kg injected intravenously during anesthesia induction.Blood samples from the radial artery were obtained at 1,3,5,10,20,30,60,120,180,240 and 360 min after sufentanil injection (3 ml each).Then 1 ml plasma was immediately separated from the 3 ml blood sample and stored at - 80 ℃ until being assayed.Plasma sufentanil concentration was determined with liquid chromatography mass spectrometry and pharmacokinetic parameters were calculated with 3P97 pharmacologicl program.Results Plasma sufentanil concentration versus the time decay curve in patients undergoing cardiac valve replacement before cardiopulmonary bypass (CPB) was fitted to a twocompartment model and could be expressed by bi-exponential equations:Cp (t) =27.4 e-0.41t + 3.2 e-0.029t in group Ⅰ and Cp (t) =14.4 e-0.51t +3.4 e-0.032t in group Ⅱ,respectively.There were significant differences in t 1/2 α,t1/2 β and CL between the two groups ( P ＜ 0.05 or 0.0l ).During CPB,plasma sufentanil concentration versus the time decay curve in patients undergoing cardiac valve replacement was fitted to a three-compartment model and could be expressed by tri-exponential equations:Cp(t) =22 e-0.51t + 3.5 e-0.045t + 0.21 e-0.0029 t in group Ⅰand Cp(t) =15 e-0.52t + 3.9 e-0.048t + 0.32 e-0.004t in group Ⅱ,respectively.There were no significant differences in pharmacokinetic parameters between the two groups ( P ＞ 0.05).Conclusion There are significant differences in sufentanil phannacokinetic characteristics before CPB but different ages have no obvious influence on sufentanil pharmaco-kinetics during CPB.
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Objective To study pharmacokinetics of domestic sufentanil as a single intravenous injection in Chinese patients undergoing abdominal surgery. Methods Ten patients undergoing abdominal surgery, ASA Ⅰ-Ⅱ grade,age from 51 to 65 years old,weighing from 58～68 kg were studied. Intravenous and intra-arterial cannulae were placed in advance. After general anesthesia, sufentanil 2 μg/kg was administered as a rapid bolus intravenously. Blood samples were obtained at 1,3,5,10,20,30,60,120,180,240 and 360 min after sufentanil injection. Plasma was separated from blood samples immediately and stored at -80 ℃ until assayed. Plasma concentration of sufentanil were determined by liquid chromatography mass spectrometry, pharmacokinetic parameters were calculated by 3P97 pharmacology program:central volume of distribution(Vc), apparent volume of distribution (Vd), rapid distribution half-life(t1/2 π), slow distribution half-life(t1/2 α), terminal elimination half-life(t1/2 β),speed constant(P, A, B, π, α, β, k10, k12, k21, k13, k31), clearance(CL)and area under curve(AUC)and so on. Results Pharmacokinetics of sufentanil in patients ndergoing gastrectomy was best fitted to three-compartment open model,the tri-exponential equation :Cp(t)= 2. 86e-0.8241t + 0.75e-0.0604t + 0.14e-0.0050t. Main pharmacokinetic parameter t1/2π =(1.29 ± 0.81)min, t1/2α =(12.20 ± 2.84)min, t1/2β =(150.50 ±48.71)min,Vc =(0.552 ±0.104)L/kg,Vd =(9.008 ±0. 754)L/kg,CL =(0.044 ±0. 011)L/(kg · min)and AUC =(47.58 ±11.88)ng/(ml · min). Conclusions Pharmacokinetics of domestic sufentanil in patients undergoing abdominal surgery was best fitted to three-compartment open model, and the pharmacokinetic characteristics of sufentanil were consistent with its clinical pharmacology.
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Cardiac valve replacement was applied to treat congenital/acquired valve deformity or distortion, which can solve the dynamics changes and ameliorate life quality of valvular disease patients. During the cardiac valve replacement, anaesthesia was more important due to the poor compensation and cardiorespiratory function, especially the decline of myocardial contractile force and energy charge. Thus, the individuated selection of anesthetic should attract more attention. Here, the announcements of anaesthesia during cardiac valve replacement were explored.