Zhonghua nei ke za zhi
-
Zhonghua nei ke za zhi · May 2017
Meta Analysis[Levofloxacin-based triple therapy versus bismuth-based quadruple therapy in the treatment of Helicobacter pylori as the rescue therapy: a meta analysis].
Objective: To evaluate the efficacy of levofloxacin-based triple therapy and bismuth-based quadruple therapy in the treatment of Helicobacter pylori (Hp) infection as rescue regimens. Methods: Related randomized controlled trials assessing the efficacy and safety of levofloxacin-based triple therapy eradicating Hp as salvage treatment were retrieved from Pubmed, Cochrane Library, SPRINGER, VIP database, WanFang database and CKNI database. The literature quality was evaluated by the improved Jadad criterion. ⋯ The adverse effects were significantly lesser(19.1% vs 29.5%, OR=0.47, 95%CI 0.26-0.82, P<0.05), whereas the compliance rate was significantly higher in levofloxacin group (96.0% vs 89.9%, OR=2.27, 95%CI 1.33-3.87, P<0.05). Conclusions: Comparing with bismuth-based quadruple therapy, levofloxacin-based triple therapy has higher eradication rate, compliance rate and lesser side effects, so we recommend it as a second-line rescue therapy after front-line Hp eradication failure. The optimal second-line alternative scheme might differ among countries depending on quinolone resistance.
-
Zhonghua nei ke za zhi · May 2017
Observational Study[The predictive value of dynamic arterial elastance in arterial pressure response after norepinephrine dosage reduction in patients with septic shock].
Objective: To assess whether dynamic arterial elastance(Ea(dyn))can be used to predict the reduction of arterial pressure after decreasing norepinephrine (NE) dosage in patients with septic shock. Methods: A prospective observational cohort study was conducted. Thirty-two patients with septic shock and mechanical ventilationwere enrolledfrom January 2014 to December 2015 in ICU of Wuxi People's Hospital of Nanjing Medical University. ⋯ Ea(dyn)≤0.97 predicted a decrease of MAP when decreasing NE dose, with an area under the receiver-operating characteristic curve of 0.85. The sensitivity was 100.0% and specificity was 73.7%. Conclusions: In septic shock patients treated with NE, Ea(dyn) is an index to predict the decrease of arterial pressure in response to NE dose reduction.