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Objective:To evaluate the effect of dexamethasone combined with aminophylline on perioperative airway responses in COVID-19 convalescent patients undergoing gynecological laparoscopic surgery.Methods:Sixty-eight COVID-19 convalescent patients, aged 25-57 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing gynecological laparoscopic surgery, were divided into experimental group ( n=34) and control group ( n=34). In experimental group, dexamethasone 10 mg was intravenously injected at the beginning of anesthesia induction, and aminophylline 0.25 g (in 100 ml of normal saline) was intravenously infused for 10 min starting from 15 min before the end of surgery. In control group, the equal volume of normal saline was administrated instead at the same time point. Airway secretions, laryngospasm and bronchospasm were recorded from the time point before operation to 24 h after operation, and coughing was also recorded from emergence to 3 min after extubation. The blood eosinophils (EOS) count, percentage of EOS (EOS%), and neutrophil to lymphocyte ratio were determined, and plasma C reactive protein level was measured by enzyme-linked immunosorbent assay before operation and at 24 h after operation. The serum levels of interleukin-6, tumor necrosis factor-α and interferon-γ were measured before operation, at 5 and 10 min after extubation and at 24 h after operation. Results:Compared with control group, the incidence of coughing, severity of coughing, incidence of increased airway secretion, and grade of airway secretion were significantly decreased, the levels of EOS, EOS%, neutrophil to lymphocyte ratio and plasma C reactive protein in peripheral blood and serum levels of interferon-γ, interleukin-6 and tumor necrosis factor-α were significantly decreased after operation ( P<0.05), and no significant change was found in the incidence of bronchial spasm in experimental group ( P>0.05). No laryngeal spasm occurred in both groups. Conclusions:Dexamethasone combined with aminophylline can relieve the perioperative airway responses by inhibition of inflammatory responses in COVID-19 convalescent patients undergoing gynecological laparoscopic surgery.
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@#Introduction: The estimation of drug competence using Artificial Intelligence is presented in various literature for the adult population, but it is still new for drug dosage optimization in neonates. Aminophylline, a methylxanthine is administered as central nervous system stimulant for reducing Apnea episodes in neonates. Methods: The paper describes comparative evaluation of Support Vector Machine (SVM), K Nearest Neighbour (KNN), Decision Tree (DT) and Artificial Neural Network (ANN) for predicting drug effectiveness of Aminophylline. The models were evaluated using 100 Aminophylline cases based on various metrics such as sensitivity, specificity, and accuracy. The data used for the analysis was collected from the population pharmacokinetic study conducted at Kasturba Medical College, Neonatal Intensive Care Unit (NICU). Results: The evaluation result seemed to favour Multi-Layer Perceptron (MLP) with accuracy of 0.92 Area Under the Curve (AUC) followed by 0.85 (AUC) for Support Vector Machine (SVM). The input parameters in particular maternal, pharmacokinetics, demographic and physiological that were identified in literature as predictor variable played an important role in estimating effectiveness of Aminophylline regimens. Conclusion: Artificial Intelligence approach was potentially helpful in analysing drug dosage of Aminophylline and its effectiveness in diagnosing neonatal Apnea.
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Theophylline is one of the most widely prescribed drugs worldwide for the treatment of asthma and chronic obstructive pulmonary disease(COPD),and it has been used clinically for more than 80 years. Due to the many adverse reactions and narrow therapeutic window,theophylline and its derivatives have gradually become the third or fourth options in clinical treatment of asthma,especially after the application of inhaled glucocorticoids and β2-ceptor agonists in asthma with good therapeutic effect. However,with the further elucidation of asthma pathogenesis and the in-depth study of theophylline's mechanism of action,as well as the development of specific drug formulations of theophylline such as sustained-release and controlled-release dosage forms,the therapeutic position of theophylline in asthma treatment has been consolidated and understood in a new way. In this paper,the pharmacology and pharmacokinetic parts of "Expert Consensus on the Safe and Rational Use of Aminophylline in Children" are explained in detail,so as to provide reference for rational application of aminophylline in pediatrics.
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Objective To compare the clinical effects of aminophylline and doxofylline in the treatment of bronchial asthma , thus to provide guidance for clinical practice .Methods 130 patients with bronchial asthma admitted in Zhejiang Rongjun Hospital from January 2015 to January 2017 were selected as the objects of observation , and they were randomly divided into two groups according to the digital table ,with 65 cases in each group .The control group was given aminophylline treatment ,the observation group was given doxofylline treatment .The clinical curative effect,pulmonary function index[forced vital capacity (FVC),forced expiratory volume in one second(FEV1),FEV1/FVC],quality of life scores and the incidence rate of adverse reactions were observed in the two groups .Results The total effective rate of observation group was 92.31％,which was higher than 70.77％of the control group ,the difference was statistically significant(χ2 =10.015,P<0.05).After treatment,the FEV1 [(2.72 ±0.64)L],FVC[(2.96 ± 0.67)L],FEV1/FVC[(89.35 ±7.77)％] in the observation group were significantly better than those in the control group[(2.05 ±0.35)L,(2.41 ±0.52)L,(80.58 ±7.69)％] (t=7.405,5.228,6.467,all P<0.05).The quality of life score in the observation group was (87.87 ±5.31) points,which was significantly higher than (75.35 ± 5.40)points in the control group (t=13.328,P<0.05).The incidence rate of adverse reactions in the observation group was 9.23％,which was lower than 27.69％ in the control group,there was statistically significant difference between the two groups (χ2 =7.358,P <0.05).Conclusion Aminophylline and doxofylline in the treatment of bronchial asthma can obtain certain curative effect ,but the effect of doxofylline is better ,and with less adverse reactions .
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Objective To evaluate the effect of aminophylline on the efficacy of extubation under ultra-fast track anesthesia ( UFTA) in pediatric patients with congenital heart disease ( CHD) undergoing surgical correction of anomaly. Methods Ninety American Society of Anesthesiologists physical status Ⅰor Ⅱ pediatric patients, aged<6 yr, undergoing surgical correction of anomaly, were randomized into 3 groups ( n=30 each) using a random number table method: group Ⅰ, group Ⅱ and group Ⅲ. After the end of surgery, normal saline was given in groupⅠ, 1 mg∕kg aminophylline was given in groupⅡ, and 2 mg∕kg aminophylline was given in groupⅢ. The condition of extubation in the operating room and respirato-ry rate at extubation were recorded. Mean arterial pressure, heart rate and bispectral index value were re-corded at the end of surgery, and at 9 and 15 min after administration. Results Compared with groupⅠ, the rate of successful extubation in the operating room, BIS value at 9 min after administration and respira-tory rate at extubation were significantly increased inⅡand Ⅲ groups ( P<0. 05) . There was no significant difference in the parameters mentioned above between group Ⅱand group Ⅲ ( P>0. 05 ) . Conclusion Aminophylline can increase the efficacy of extubation under UFTA in pediatric patients with CHD undergoing surgical correction of anomaly, and 1 mg is the recommended dose.
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Objective To compare the effects of caffeine citrate and aminophylline combined with naloxone in the treatment of premature infants with apnea.Methods From March 2015 to March 2017,140 premature infants with apnea who were treated in neonatal intensive care unit in Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou were selected in the research.The children were randomly divided into the study group and the control group according to the digital table,with 70 cases in each group.The control group was treated with aminophyl-line combined with naloxone,and the observation group was treated with caffeine citrate.The adverse reaction of children during the treatment was recorded,and the level of apnea was evaluated after treatment.The blood gas index of children before and after 48h treatment was compared,the mortality rate of the children was counted,and the incidence of brain injury during the 1 year follow -up was analyzed.Results After treatment for 48h,the level of PaO2in the two groups was significantly higher [study group: (10.54 ±0.41) kPa,control group: (9.66 ± 0.39) kPa] than those before treatment[study group: (7.18 ±0.26) kPa,control group: (7.21 ±0.24) kPa],and the level of PaCO2[study group: (5.31 ±0.24) kPa,control group: (5.82 ±0.25) kPa]was significantly lower than those before treatment[study group: (6.83 ±0.28) kPa,control group: (6.77 ±0.30) kPa](t＝19.153,13.624,11.271,7.304;P＝0.000,0.000,0.000,0.000),and the level of PaO2in the study group was significantly higher than that in the control group,and the level of PaCO 2in the study group was significantly lower than that in the control group(t＝6.029,4.327;P＝0.000,0.000).The overall effective rate of apnea therapy in the study group (92.86%) was significantly higher than 77.14%in the control group (χ2＝4.509,P＝0.034).The mortality rate(1.43%) and the incidence rate of brain injury (0.00%) of the study group were significantly lower than those of the control group (10.00%and 7.14%)(χ2＝4.773,5.185;P＝0.029,0.023).The incidence rate of adverse reactions (30.00%) of the study group was significantly lower than 50.00%of the control group (χ2＝5.833,P＝0.016).The endometri-al thickness of the study group was significantly lower than that of the control group (P＜0.05).The rate of ovulation success(87.84%) and pregnancy success rate (45.94%) of the study group were significantly higher than those of the control group(72.97%and 28.39%)(χ2＝5.189,4.890;P＝0.023,0.027).The rate of abortion(8.82%) of the study group was significantly lower than 33.33%of the control group (χ2＝5.242,P＝0.022).During the period of treatment,the incidence rate of adverse drug reactions (6.77%) of the study group was not significantly different from 8.11%of the control group (χ2＝0.098,P＝0.754).Conclusion Compared with aminophylline combined with naloxone treatment,caffeine citrate can significantly improve the blood gas status of apnea preterm infants,improve the overall curative effect of apnea,prevent the occurrence of neonatal death and brain injury,and reduce the adverse reactions of the children during the treatment.It is worthy of clinical application.
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Objective To compare the clinical effect of Doxofylline and aminophylline in the treatment of bronchial asthma.Methods The clinical data of 112 patients with bronchial asthma treated in Jiaxing Second Hospital from February 2015 to December 2016 were retrospectively analyzed.The patients were divided into two groups: the treatment group(56 cases), the use of doxofylline treatment, and the control group(56 cases), the use of aminophylline treatment.After 1 w treatment, the curative effect and adverse reactions were compared between the two groups to observe the changes of lung function before and after treatment.Results The total effective rate of the treatment group and the control group were 91.07% and 76.79% respectively(P<0.05).After treatment, the FVC of the treatment group was(2.24±0.63)L, FEV1 was(1.59±0.47)L, VC was(2.94±0.77)L, the incidence of adverse reactions was 10.71%, which was superior to the control group, the difference was statistically significant(P<0.05).Conclusion Doxofylline treatment of bronchial asthma clinical efficacy is remarkable, worthy of clinical promotion.
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Objective To study the role of aminophylline in COPD patients undergoing abdominal surgery under general anesthesia.Methods A total of 60 COPD patients who received the upper abdominal surgery under general anesthesia were randomly assigned as regular treatment group (control,n=30) and aminophylline group (aminophylline,n=30).The aminophylline group was intravenously injected aminophylline (2mg/kg) after intubation,and the same volume of saline was injected for the control group.The respiratory mechanics,serum cytokines including tumor necrosis factor-α(TNF-α),interleukin-8 (IL-8) and interleukin-10(IL-10),recovery time and adverse cardiovascular events were measured.Results The general conditions,including gender,age,weight,smoking status,lung function,GOLD standard,surgical site,operation time and anesthetic time had no statistically significant differences between the two groups.During general anesthesia,aminophylline decreased the peak airway pressure(15 minutes,t=9.220,P=0.047),the plate airway pressure(15 minutes,t=5.906,P=0.025) and the airway resistance(15 minutes,t=10.438,P=0.04).Aminophylline increased the respiratory compliance(15 minutes,t=-7.431,P=0.001).Aminophylline attenuated the increase of inflammatory cytokines,such as TNF-α(8 hours,t=6.374,P=0.000),IL-8(8 hours,t=7.716,P=0.000) and hsCRP(8 hours,t=6.665,P=0.000).Aminophylline shortened the time to spontaneous ventilation(t=3.439,P=0.001),opening eyes(t=3.516,P=0.001),limb movement(t=6.249,P=0.000) and extubation (t=3.159,P=0.003).Administration of aminophylline had no obvious adverse effects on blood pressure and heart rate.Conclusion Administration of aminophylline for COPD patients undergoing abdominal surgery under general anesthesia can improve respiratory mechanics,downregulate inflammatory cytokines,accelerate recovery after general anesthesia and possess no obvious adverse cardiovascular effects,which is worthy of popularization.
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Objective To investigate the clinical effect of methylprednisolone and aminophylline on bronchial asthma patients, so as to improve the level of clinical treatment. Methods Selected form August 2014 to June 2016 in our hospital diagnosed with bronchial asthma in 90 patients as the research object, for the normal group and the treatment group in accordance with the double blind method standard for sharing, the former the latter with aminophylline treatment; Methylprednisolone Treatment on the basis of the former treatment. After treatment, the statistical comparison of two groups and the clinical symptoms and quality of life to improve the situation. Results the total efficiency of the treatment group was 97.8％, significantly higher than that of the control group 77.8％(P<0.05). The treatment group of clinical symptoms and signs scores were lower than those of the reference group; improving the quality of life was better than the reference group, there were significant differences between groups of data comparison, statistical significance was established(P<0.05). Conclusion Patients with bronchial asthma by aminophylline combined with methylprednisolone treatment, the effect is considerable, not only can improve the treatment effect, rapidly relieve symptoms, improve the quality of life of patients, suggest further promotion.
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Objective To observe the clinical nursing effect of doxofylline in the treatment of bronchial asthma and intervention. Methods 98 cases of bronchial asthma patients in our hospital from June 2014 to November 2016 received as the object of nursing, the patients were divided into control group and treatment group, 49 cases in each group, using multiple theophylline treatment, the control group was given routine care, the treatment group on the basis of the comprehensive nursing, the clinical effects of two groups were compared before and after, adverse reactions and treatment of pulmonary function. Results The total effective rate of treatment group was 89.80％, control group total effective rate was 73.47％, the total effective rate of treatment group was significantly better than the control group (P<0.05), the difference was statistically significant; the treatment group adverse reaction rate was 6.12％, the control group adverse reaction rate was 18.37％, incidence of adverse reaction in treatment group was significantly better than the control group (P<0.05), the difference was statistically significant; two groups of patients after treatment of FEV1, FFV1/FVC and PEF indexes were improved, but the treatment group was significantly better than the control group (P<0.05), the difference was statistically significant. Conclusion Doxofylline the treatment of bronchial asthma in the process of the comprehensive nursing has a good effect, and less adverse reactions. It is worthy of clinical application.
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Objective To investigate the clinical effects and safety of Aminophylline and Caffeine citrate in the treatment of preterm infants with primary apnea. Methods 130 preterm infants with primary apnea were chosen and randomly divided into both group including the Aminophylline group (65 children) with aminophylline and the Caffeine citrate group (65 children) with Caffeine citrate on the basis of conventional intervention; and the total oxygen inhalation time, mechanical ventilation time, hospitalization time, the complications incidence with follow-up and the levels of development quotient for short-term of both groups were compared. Results The total oxygen inhalation time, the mechanical ventilation time and the hospitalization time of Caffeine citrate group were significantly shorter than aminophylline group(P<0.05). The incidence of PDA, BPD and ROP of Caffeine citrate group were significantly lower than aminophylline group(P<0.05). There was no significant difference in the incidence of intracranial hemorrhage, PVL and NEC between two groups. The development quotient levels in 24 weeks and 48 weeks after treatment of Caffeine citrate group were significantly higher than aminophylline group(P<0.05). Conclusion Compared with Aminophylline, Caffeine citrate on the basis of conventional intervention in the treatment of preterm infants with primary apnea could efficiently shorten the oxygen inhalation time, the mechanical ventilation time and clinical disease course, reduce the related complications risk and be helpful to promote the intellectual development.
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Objective To investigate the therapeutic effect of aminophylline on the treatment of patients with thoracic surgery perioperative. Methods 230 cases with thoracic surgery were selected as the research objects and divided into the research group and the control group randomly, and there was 15 cases in each group. the control group were ginven closed drainage of thoracic cavity during the surgery, continued to 3 days after surgery. The control group were given intravenous drip of ciprofloxacin lactate injection at 12 h after operation, and the treatment lasted for 7 days. At this basis, the research group were given aminophylline 0.5 mg/d by intravenous injection at the beginning of anesthesia induction and continued for 3 days. The levels of lung and respiratory inflammation related factor (White blood cells, PCT, hs-CRP, TNF-α, IL-6, IL-8 and IL-10), blood gas index in the two groups pre- and post–surgery were detected, and the complications and adverse drug reactions were observed. Results 24h after surgery, TNF alpha, IL-6, IL-8 were significantly lower than those in the control group (P<0.05), and IL-10 level was significantly higher than that in the control group (P<0.05). And PaO2 in the research groupwas significantly higher than that in the control group patients (P<0.05). After treatment, arterial carbon dioxide partial pressure (PaCO2) in the two groups were significantly lower than preoperative (P<0.05). The complication rate in the research group was significantly lower than that in the control group within ten days(P<0.05). There were no adverse reactions in both groups. Conclusion During the perioperative period in thoracic surgery, aminophylline intervention can effectively improve the prognosis. .
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According to the points and difficulties of aminophylline monitoring experiments, oriented by problems, specific teaching case was designed to practice case teaching. The analysis of the results of classroom performance, teaching effect evaluation, peer evaluation and students' feedback showed that case teaching promoted the initiatives of students' learning as well as improved the teaching effect compared with the traditional teaching method. Furthermore, it improved their clinical thinking ability through theory and practical cases and helped the teachers to learn while teaching.
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Objective To investigate the effects of caffeine citrate and aminophylline in treatment of primary apnea of premature infants and its related complications. Methods A total of 152 preterm infants who were diagnosed primary apnea within 10 days after birth were randomly divided into caffeine citrate group(n=77) and aminophylline group(n =75). The changes in the time of the apnea disappeared after treating,needing oxygen,non-invasive and invasive mechanical ventilation,and the incidence of bronchopul-monary dysplasia ( BPD ) , necrotizing enterocolitis, retinopathy of prematurity, patent ductus arteriosus (PDA),intercranial hemorrhage(ICH)were compared between the two groups. Results The time of the apnea disappeared after treating[(47. 4 ± 5. 3) h],needing oxygen[(20. 5 ± 7. 6) d],non-invasive mechani-cal ventilation[(8. 7 ± 4. 2) d] and invasive mechanical ventilation[(1. 0 ± 1. 3) d] in the caffeine citrate group were significantly lower than those in the aminophylline group [ ( 54. 8 ± 6. 2 ) h, ( 24. 4 ± 8. 5 ) d, (10.4±5.3)d,(10.4±5.3)d,respectively](P0. 05). Conclusion The caffeine citrate has a better efficacy in the treating primary apnea of preterm infants than aminophylline. It can also decrease the incidence of BPD,PDA and ICH in premature infants.
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Objective Discuss the clinical efficacy of caffeine citrate and aminophylline in treatment of primary apnea of prematurity.Methods 80 cases of primary apnea of prematurity were selected.They were divided into two groups randomly.The control group (40 cases) received aminophylline treatment and the observation group (40 cases) received caffeine citrate therapy.The efficacy of caffeine citrate and aminophylline in treatment of primary apnea ofprematudty was evaluated by efficacy,primary apnea episodes and disappeared time,adverse reaction during treatment.Results The effective rate of observation group was 85％,the effective rate of control group was 75％.The observation group had higher efficiency (P ＜ 0.05).The frequency of apnea of observation group was less than that of the control group.The disappearance time of observation group was shorter than that of the control group (P ＜ 0.05).During the treatment,the tachycardia,feeding intolerance,bronchopulmonary dysplasia and other adverse reactions rate of observation group was lower than that of the control group (P ＜ 0.05).Conclusion Compared with aminophylline,caffeine citrate had a good therapeutic effect of primary apnea of prematurity.It can reduce apnea frequency,eliminate clinical symptoms with high safety.It was an ideal drug for treatment of primary apnea.
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Objective To establish a method for detection of aminophylline in blood samples of preterm infants . Methods A molecularly imprinted electrochemical sensing film on the glassy carbon electrode surface was prepared by electropolymerization using aminophylline as the template molecule and pyrrole as the functional monomer in 0.2 mol/L HAc-NaAc buffer solution ( pH 4.0).The surface morphology and properties of molecularly imprinted sensing films were characterized by three dimensional laser scanning microscopy , differential pulse voltammetry ( DPV) and electrochemical impedance spectroscopy ( EIS) while the effects of scanning cycle number and incubation time were investigated by square wave voltammetry(SWV) method in 5 mmol/L K3[Fe(CN)6] -0.1 mol/L KCl solution.Results Under optimized experimental conditions ,the SWV peak current difference was linear to the negative logarithm of aminophylline concentration in the range from 1.0 ×10 -7 to 1.0 ×10 -3mol/L with a detection limit (S/N=3) of 0.5 ×10 -8mol/L.The recovery rate was 92.2% -101.4%.Also, the molecularly imprinted electrochemical sensor for aminophylline had good selectivity , stability and reproducibility .Conclusion The molecularly imprinted electrochemical sensor for aminophylline can be used for rapid and accurate detection of clinical blood concentrations of aminophylline molecules in preterm infants in the future .
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Objective To investigate the effect of histone deacetylase 2(HDAC2) expression by aminophylline on glucocorticoid sensitivity of guinea pigs with lipopolysaccharide -induced sudden hearing loss .Methods Fifty guinea pigs were randomly divided into five groups :control/artificial perilymph(AP) group (n=10) in which both the ears were administrated 5μl sterile artificial perilymph fluid by means of drilling the scala tympani of the cochle‐ar basal turn ;whereas 5 μl of 5 mg/ml LPS was transferred into the cochlea of both the ears of other groups in the same way ,which were model(LPS) group(n=10) ,lipopolysaccharide+ dexamethasone(LPS+ DEX) group(n=10) ,lipopolysaccharide+ aminophylline(LPS+ AMI) group(n= 10) ,and lipopolysaccharide+ dexamethasone+aminophylline(LPS+DEX+AMI) group(n=10) .Guinea pigs with normal hearing tested by auditory brain stem response (ABR) before treatment were included in this study .ABRs were recorded in all guinea pigs 48 hours after surgery .The immunofluorescence staining was used to detect for the HDAC2 in the inner ear .The HDAC2 levels in the cochlea of guinea pigs were detected by ELISA test .Results ABR results showsed that hearing loss in AP group was mild ,the threshold shifts were less than 10 dB at 4 kHz ,8 kHz ,16 kHz frequencies ,at 32 kHz the threshold shift was 11 .50 dB ,respectively .However ,the hearing loss was obvious in LPS group ,especially at the high frequency (the threshold shift was 60 .75 ± 6 .02 dB SPL) .Compared to AP group ,hearing loss in LPS group was statistically significant at all frequencies (P<0 .01) .The hearing improvement was obvious at frequeniies of 16 kHz and 32 kHz in group of LPS+DEX and LPS+AMI (P<0 .05) .The LPS+DEX+ AMI treatment for LPS -induced acute hearing loss was the most remarkable at all frequencies compared with glucocorticoid or aminophylline treatment alone ,especially at 16 kHz (P<0 .05) .The immunofluorescence staining showed positive expression of HDAC2 in the cochlea in the inner and outer hair cells ,stria vascularis ,spiral ganglion and spiral ligament .The correlation analysis showed negative correlations between the expression of HDAC2 and threshold shift of ABR at 8 kHz ,16 kHz ,and 32 kHz (P<0 .05) .Conclusion It is effective for dexamethasone and aminophylline treatment in induced hearing loss in guinea pigs .Aminophylline can elevate HDAC2 expression and improve the effect of glu‐cocorticoid .In conclusion ,HDAC2 plays a critical role in restoring glucocorticoid sensitivity in the inner ear .
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Objective To study the mental development and efficacy of caffeine citrate and aminophylline in treating primary apnea in premature infants. Methods Preterm infants who were diagnosed as primary apnea, received caffeine citrate therapy and recovered in the neonatal ward of our Hospital from December 2013 to December 2014, and followed-up in the high-risk infants outpatient clinic of our Hospital after discharge were recruited in the caffeine group. Preterm infants of aminophylline group were recruited randomly by number method. They were diagnosed as primary apnea, received aminophylline therapy and recovered in our neonatal ward from December 2011 to December 2013, and followed-up regularly in the high-risk infants outpatient clinic of our Hospital after discharge. The treatment effect and mental development at 6 and 12 months of corrected age between the two groups were compared. Results Each group included 150 cases of premature infants. The time (h) of oxygen therapy, noninvasive mechanical ventilation, and invasive mechanical ventilation in the caffeine group were all significantly shorter than that in the aminophylline group [(119. 1 ± 100. 2) vs. (156. 5 ± 134. 1), (107. 4 ± 100. 2) vs. (156. 7 ± 139. 8), (146. 4 ± 122. 6) vs. (270. 9 ± 257. 2), P < 0. 05]. The incidence of patent ductus arteriosus and bronchopulmonary dysplasia in the caffeine group were significantly lower than that in the aminophylline group (24. 0% vs. 45. 3% , 9. 3% vs. 21. 3% , P <0. 05). The scores of gross motor, fine motor and social intercourse in caffeine group were significantly higher than aminophylline group at 6 months of corrected age ( P < 0. 05). The scores of gross motor, fine motor, language and adaptability of infants at 12 months of corrected age from caffeine group were significantly higher than that of infants from aminophylline group ( P < 0. 05). Conclusions Caffeine citrate treatment of primary apnea in preterm infants is more effective than aminophylline. Caffeine citrate treatment can improve mental development of premature infants.
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Objective To investigate the effects of serum brain natriuretic peptide(BNP), procalcitonin (PCT) and lung function by tiotropium bromide combined with aminophylline in the treatment of senile chronic obstructive pulmonary disease.Methods A total of 82 cases of elderly patients with chronic obstructive pulmonary disease ( COPD) were collected and randomly divided into experimental group and control group with 41 cases in each group.Patients in the control group were treated by conventional treatment; patients in the experimental group were treated on the basis of the control group with tiotropium bromide combined with aminophylline.The lung function, respiratory condition and serum levels of PCT, BNP before and after treatment were determined, and the clinical efficacy and safety was compared.Results The effective rate of the control group (68.29%) was lower than the experimental group (87.80%) , with statistical significance ( P<0.05 ); compared with the control group after treatment, the forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and FEV1%pre of the experimental group significantly increased, dyspnea score decreased, 4 min walking test increased, serum PCT and BNP levels decreased in the experimental group, with statistical significance ( P<0.05 ). Conclusion Tiotropium bromide combined with aminophylline in the treatment of senile chronic obstructive pulmonary disease could reduce the serum BNP and PCT levels and improve lung function.
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Objective To study the efficacy and safety of different doses of caffeine citrate and aminophylline treatment for apnea of prematurity. Methods Preterm infants who met the inclusive criteria were admitted to NICU of JingZhou Central Hospital from October 1st, 2013 to October 1st, 2015. They were randomly assigned to three groups. Infants assigned to high dose caffeine group were received a loading dose of 40 mg / kg daily, followed by the maintaining dose of 20 mg / kg daily. Neonates in low dose caffeine group were administered with the loading dose of 20 mg / kg daily, followed by maintaining dose of 10 mg / kg daily. Infants in the aminophylline group received a loading dose of 5 mg / kg, then with maintaining dose of 2 mg / kg every 12 hours. Caffeine citrate or aminophylline therapy were continued until the infants were free from apnea for a period of 7 days or when the gestational age of 34 weeks were reached. Extubation failure rate, frequency of apnea, duration of apnea, mechanical ventilation, as well as oxygen therapy, length of hospital stay, mortality, and the adverse effects were compared among three groups. Results 90 infants were enrolled for study, with 30 in each group. Extubation failure rate, frequency of apnea, apnea duraion and oxygen therapy duration of infants in high dose caffeine groups were all significantly lower than those of infants in low dose caffeine group and aminophylline group (P 0. 05). Duration of mechanical ventilation and CPAP, length of hospital stay, incidence of complications (BPD, ROP, IVH, PVL, NEC ), mortality were of no significant difference among three groups ( P > 0. 05 ) . Conclusions High dose caffeine therapy for apnea of prematurity is more effective in decreasing incidence of extubation failure and apnea, as well as decreasing duration of apnea and oxygen therapy. Tachycardia is the only adverse effect of high dose caffeine therapy discovered by this study.