Objective To review and summarize the latest development of the therapy for the Duchenne muscular dystrophy (DMD). Methods Therecentlypublished articles related to the therapies for DMD were extensively reviewed and briefly summarized. Results The therapeutic approaches for DMD included the gene therapy, the cell therapy, and the pharmacological therapy. The gene therapy and the cell therapy were focused on the treatment for the cause of DMD by the delivery of the missing gene, the modification of the mutated gene, and the transfer of the normal cells including the stem cells, while the pharmacological therapy dealt with the downstream events caused by the dystrophin gene defect, slowed down the pathologic progress of DMD, and improved the DMD patient’s life quality and life span, by medication and other factor treatments. Conclusion There is still no cure for DMD because of various difficulties in replacing or repairing thedefected gene and of the multifaceted nature of the severe symptoms. Therefore,it is imperative for us to find out a more effective treatment that can solve these problems.
Objective Making an individualized pharmacological treatment plan for a patient of acute respiratory distress syndrome after operation. Methods First, six clinical problems were put forward after assessing the patient’ s health state. Then we searched OVID versions of the ACP Journal Club (1991~2009), CENTRAL (1st Quarter 2009), CDSR (1st Quarter 2009), and MEDLINE (1991~2009) databases. Systematic reviews, meta-analyses, and randomized clinical trials about treatment of acute respiratory distress syndrome were included. The pharmacological treatment plan was made accordingly.Results After evaluation, 13 studies were eligible. The evidence indicated that the restrictive strategy of fluid management, corrected hypoproteinaemia, diuresis, and low-dose corticosteroids given in the early phase could improve oxygenation and prognosis; inhaled nitric oxide, exogenous surfactant supplement, other pharmacological drugs were associated with limited improvement in oxygenation in patients with ARDS but confer no mortality benefit and may cause harm, so we did not recommend their routine use in ARDS patients. The individual treatment plan was made based on the evidence found. After 8 days of treatment, the patient was out the ICU. He recovered and was discharged after 1 month. Conclusions The individual treatment plan, which was made based on high quality evidence and patient’s condition, improved treatment efficacy, shortened the stay in ICU, reduced mortality, and decreased adverse reactions.
Based on literatures on Meta-analysis and randomized controlled trial, drug use and some geriatrics syndromes such as cognitive impairment and depression, in elderly diabetic patients were reviewed. Insulin plus oral hypoglycemic drugs was more rational therapy for insulin resistance and islet dysfunction in type 2 diabetes mellitus. We should pay more attention to cognitive impairment and depression in elderly type 2 diabetic patients.