泮托拉唑抑制胃溃疡胃酸分泌的临床疗效

目的：探讨泮托拉唑抑制胃溃疡胃酸分泌的临床疗效。方法选取2013年1月—2014年9月桂林中西医结合医院收治的胃溃疡患者70例,按随机数字表法将患者分为研究组与对照组,各35例。研究组患者予以泮托拉唑治疗,对照组患者予以法莫替丁治疗。观察两组患者临床疗效、治疗前后视觉模拟评分法（VAS）评分、幽门螺杆菌（HP）感染情况及不良反应发生情况。结果研究组患者总有效率高于对照组,差异有统计学意义（ P ﹤0.05）;治疗前两组患者 VAS 评分比较,差异无统计学意义（P ﹥0.05）,治疗后研究组患者 VAS 评分低于对照组,差异有统计学意义（P ﹤0.05）;治疗前两组患者 HP 感染率比较,差异无统计学意义（ P ﹥0.05）,治疗后研究组患者 HP 感染率低于对照组,差异有统计学意义（P ﹤0.05）;两组患者不良反应发生率比较,差异无统计学意义（P ﹥0.05）。结论泮托拉唑抑制胃溃疡胃酸分泌的临床疗效显著,可降低患者疼痛程度,减少 HP 感染的发生,且不良反应小。     

氟康唑与伊曲康唑治疗甲真菌病的疗效对比

目的：比较氟康唑与伊曲康唑治疗甲真菌病的疗效。方法选取2012年2月—2014年2月贺州市广济医院收治的甲真菌病患者60例,根据患者入院顺序将其随机分为治疗组与对照组,各30例。对照组患者予以伊曲康唑治疗,治疗组患者予以氟康唑治疗。观察两组患者近、远期临床疗效（停药3个月后观察两组近期疗效,停药6个月后观察两组远期疗效）、真菌学检查结果、住院费用及不良反应发生情况。结果停药3个月后两组患者总有效率比较,差异无统计学意义（P ﹥0.05）;停药6个月后两组患者总有效率比较,差异无统计学意义（ P ﹥0.05）;两组患者治疗后真菌转阴率比较,差异无统计学意义（ P ﹥0.05）;治疗组患者治疗费用低于对照组,差异有统计学意义（P ﹤0.05）;两组患者不良反应发生率比较,差异无统计学意义（P ﹥0.05）。结论伊曲康唑与氟康唑治疗甲真菌病的疗效相当,但氟康唑的不良反应少,价格低。     

谷维素联合马来酸曲美布汀治疗肠易激综合征的临床疗效

目的：探讨谷维素联合马来酸曲美布汀治疗肠易激综合征（ IBS）的临床疗效。方法选取2012年5月—2014年8月株洲市三三一医院收治的 IBS 患者67例,按治疗方法不同将患者分为治疗组（35例）与对照组（32例）。对照组患者予以马来酸曲美布汀治疗,治疗组患者在对照组基础上加用谷维素治疗。观察两组患者临床疗效、治疗前后症状评分和症状频率评分、不良反应发生情况。结果治疗组患者总有效率高于对照组,差异有统计学意义（P ﹤0.01）;治疗前两组患者症状评分和症状频率评分比较,差异无统计学意义（ P ﹥0.05）,治疗后治疗组患者症状评分和症状频率评分低于对照组,差异有统计学意义（ P ﹤0.05）;两组患者不良反应发生率比较,差异无统计学意义（P ﹥0.05）。结论谷维素联合马来酸曲美布汀治疗 IBS 的临床疗效显著,可改善患者肠道功能,且不良反应小。     

胺碘酮联合美托洛尔治疗心律失常的临床疗效观察

目的：探讨胺碘酮联合美托洛尔治疗心律失常的临床疗效。方法选取2011年4月—2014年4月屯留县人民医院收治的心律失常患者85例,随机分为观察组（42例）与对照组（43例）。对照组患者予以胺碘酮治疗,观察组患者予以胺碘酮联合美托洛尔治疗。观察两组患者转复率、有效率、药物起效时间、治疗前后心率、血压变化情况及不良反应发生情况。结果观察组患者窦性心律转复率和有效率明显高于对照组,药物起效时间短于对照组,差异有统计学意义（P ﹤0.05）;治疗前两组患者收缩压、舒张压及心率比较,差异无统计学意义（ P ﹥0.05）;治疗后观察组患者收缩压、舒张压及心率低于对照组,差异有统计学意义（ P ﹤0.05）;两组患者不良反应发生率比较,差异无统计学意义（P ﹥0.05）。结论胺碘酮联合美托洛尔治疗心律失常的临床疗效显著,可缩短药物起效时间,改善患者心率、血压,且不良反应小。     

不同剂量米非司酮治疗子宫肌瘤的临床效果比较

目的：探讨不同剂量米非司酮治疗子宫肌瘤的临床效果。方法选取2013年1月～2014年2月在本院就诊的子宫肌瘤患者85例,随机分为观察组42例和对照组43例。对照组给予米非司酮片12.5 mg,观察组给予米非司酮片25 mg,比较两组的临床疗效、子宫肌瘤体积、不良反应发生率及血清FSH、LH、E2、P水平。结果观察组的总有效率为95.24%,明显高于对照组的83.72%,两组比较差异有统计学意义（P〈0.05）。两组治疗后的子宫肌瘤体积明显小于治疗前,差异有统计学意义（P〈0.05）。两组治疗后的子宫肌瘤体积比较,差异无统计学意义（P〉0.05）。两组治疗前后的血清FSH、LH、E2、P水平比较,差异有统计学意义（P〈0.05）。观察组治疗后的血清FSH、LH、E2、P水平明显低于对照组（P〈0.05）。观察组的不良反应发生率为21.43%,明显高于对照组的9.30%,两组比较差异有统计学意义（P〈0.05）。结论25 mg/（次·d）的米非司酮是治疗子宫肌瘤的有效剂量,可以提高临床疗效,但不良反应发生率高于小剂量组。     

亮丙瑞林联合来曲唑治疗绝经前期子宫肌瘤的临床效果

目的：探讨亮丙瑞林联合来曲唑治疗绝经前期子宫肌瘤的临床效果。方法选取2010—2014年曲阳仁济医院收治的子宫肌瘤患者86例,随机分为对照组（41例）与观察组（45例）。对照组患者给予亮丙瑞林治疗,观察组患者在对照组基础上加用来曲唑治疗。观察两组患者症状改善情况、临床疗效、性激素水平及不良反应发生情况。结果治疗后两组患者闭经、贫血症状均得到纠正,头晕、乏力、下腹痛等症状均得到缓解;观察组患者临床疗效优于对照组,差异有统计学意义（ P<0.05）;治疗前两组患者黄体生成素（ LH）、促卵泡激素（ FSH）、雌二醇（E2）及孕酮（P）水平比较,差异无统计学意义（P>0.05）,治疗后观察组患者LH、FSH、E2水平低于对照组（P<0.05）,两组患者P水平比较,差异无统计学意义（P>0.05）;观察组患者颜面潮红、出汗、易躁、阴道干燥发生率低于对照组（ P<0.05）。结论亮丙瑞林联合来曲唑治疗绝经前期子宫肌瘤的临床效果显著,能降低性激素水平,减少不良反应的发生。     

腹腔镜手术治疗子宫肌瘤的疗效观察

目的：探讨开腹手术和腹腔镜手术治疗子宫肌瘤的临床疗效。方法选取医院收治的子宫肌瘤患者130例,根据手术方式的不同分为 A、B 组各65例,A 组行腹腔镜子宫肌瘤剔除术,B 组行传统开腹手术,比较2组手术疗效、手术时间、住院时间等。结果 A 组患者的手术时间、排气时间、住院时间均显著短于 B 组,术中出血量显著少于 B 组（P ﹤0.05）;2组患者症状缓解率、子宫异常发生率及复发率比较,差异均无统计学意义（P ﹥0.05）;A 组患者的术后并发症发生率为7.69%显著低于 B 组的26.15%,差异均有统计学意义（P ﹤0.05）。结论与传统开腹手术相比,腹腔镜手术治疗子宫肌瘤对机体的创伤更小,术后并发症更少,住院时间更短,是一种安全、有效的微创治疗手段,值得推广应用。     

阿加曲班治疗下肢深静脉血栓形成的效果观察

目的：观察阿加曲班治疗下肢深静脉血栓形成（LDVT）的临床效果。方法将200例 LDVT 患者随机分为观察组和对照组各100例。对照组采用低分子肝素联合尿激酶治疗。观察组采用阿加曲班联合尿激酶治疗。治疗后,比较2组临床疗效、治疗前后凝血酶原时间（PT）、凝血酶时间（TT）和部分活化凝血酶时间（APTT）、血小板计数（PLT）以及小腿周径和股静脉血流速度。结果观察组总有效率和完全再通率均高于对照组,差异均有统计学意义（P ﹤0.05）。2组治疗前后 PT、TT、APTT、PLT 水平差异无统计学意义（P ﹥0.05）。治疗前2组患者小腿周径差和患肢股静脉血流速度差异无统计学意义（P ﹥0.05）。治疗后,2组小腿周径差均小于治疗前,股静脉血流速度均高于治疗前,且观察组优于对照组,差异均有统计学意义（ P ﹤0.05）。结论阿加曲班治疗 LDVT 疗效较好,血管再通率高,能避免血小板减少症,值得临床推广应用。     

硬化疗法在下肢静脉曲张治疗中的应用效果研究

目的：探讨硬化疗法在下肢静脉曲张治疗中的应用效果。方法选取2010年3月—2013年3月某院收治的下肢静脉曲张患者90例,随机分为观察组和对照组,各45例。对照组患者予以传统大隐静脉高位结扎术＋剥脱术治疗,观察组患者予以硬化疗法治疗。观察两组患者的手术住院情况、临床疗效、随访6个月复发率及不良反应发生情况。结果观察组患者手术时间、住院时间短于对照组,术中出血量少于对照组,差异有统计学意义（ P ﹤0.05）;两组患者总有效率比较,差异无统计学意义（P ﹥0.05）;两组患者随访6个月复发率比较,差异无统计学意义（P ﹥0.05）;观察组患者不良反应发生率低于对照组,差异有统计学意义（ P ﹤0.05）。结论硬化疗法在下肢静脉曲张治疗中的应用效果显著,可缩短患者手术时间及住院时间,减少术中出血量,且不良反应小,安全性高。     

口服补液盐Ⅲ联合金双歧治疗肺癌化疗相关腹泻的疗效观察

目的：观察口服补液盐Ⅲ联合金双歧治疗肺癌化疗相关腹泻的疗效。方法：60例肺癌化疗相关性腹泻患者随机分成观察组和对照组各30例,两组均口服金双歧,4片／次,3次／ d;观察组在对照组基础上加用口服补液盐Ⅲ5.125 g／次,1次／ d。两组疗程均为5d。观察两组患者治疗前后的腹泻总有效率、肺癌的 Karnofsky 评分（KPS 评分）、大便性状改善时间及总腹泻病程。结果：观察组和对照组总有效率分别为96.7%和70.0%,差异有统计学意义（P ﹤0.05）。两组患者治疗前后 KPS 评分均明显改善（P ﹤0.05）,但治疗后两组比较无统计学意义（P ﹥0.05）。观察组患者大便性状改善时间及总腹泻病程明显优于对照组,差异有统计学意义（P ﹤0.05）。观察组和对照组不良反应发生率分别为6.7%和3.3%,差异无统计学意义（P ﹥0.05）。结论：口服补液盐Ⅲ联合金双歧可以有效地治疗和改善肺癌化疗相关性腹泻,且安全性好,可用于临床。     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.