氨溴索序贯治疗慢性阻塞性肺疾病急性加重期的疗效观察

目的探讨氨溴索序贯治疗慢性阻塞性肺疾病急性加重期的临床效果。方法入选的慢性阻塞性肺疾病患者110例随机分为观察组和对照组。两组患者均给予持续性低流量吸氧、给予抗生素类药物抗感染、给予扩张支气管类药物、根据患者营养状况给予营养支持、给予糖皮质激素类药物。观察组患者同时给予氨溴索治疗,采用序贯疗法。观察两组疗效和肺功能改变情况。结果观察组治疗后的用力肺活量和对照组治疗后的的用力肺活量比较,前者高于后者,差异有统计学意义(P<0.05)。观察组治疗的第1秒用力呼气量、用力呼气流速峰值分别和对照组治疗后的第1秒用力呼气量、用力呼气流速峰值比较,差异有统计学意义(P<0.05)。观察组总有效率高于对照组,差异有统计学意义(P<0.05)。结论氨溴索序贯治疗能够有效提高慢性阻塞性肺疾病加重期患者临床治疗效果,改善患者肺功能显著,值得借鉴。     

沙美特罗替卡松粉吸入剂治疗慢性阻塞性肺疾病50例疗效观察

目的 观察沙美特罗替卡松粉吸入剂(舒利迭)治疗慢性阻塞性肺疾病(COPD)的临床疗效.方法 将100例慢性阻塞性肺疾病患者治疗随机分为观察组和对照组各50例.2组均给予抗感染、祛痰、平喘等常规治疗,观察组在此基础上给予舒利迭吸入治疗;对照组采用布地奈德雾化吸入,并口服茶碱缓释片治疗.疗程均为3个月.观察2组临床症状及肺功能改善情况.结果 观察组总有效率为96%高于对照组的78%,差异有统计学意义(P<0.05).2组治疗后肺功能改善情况与治疗前比较,差异有统计学意义(P<0.05或P<0.01);观察组治疗后肺功能改善情况与对照组比较,差异有统计学意义(P<0.05).结论 舒利迭吸入治疗COPD,能够显著改善患者肺功能,明显缓解临床症状,显著提高患者生活质量,值得临床推广应用.     

肺舒配方颗粒治疗慢性阻塞性肺疾病的疗效观察

目的研究肺舒配方颗粒治疗慢性阻塞性肺疾病的效果。方法选择来我院治疗慢性阻塞性肺疾病的患者80例,随机将其分成两组,每组40例。对照组患者给予口服金水宝胶囊,治疗组在对照组治疗基础上加用肺舒配方颗粒,观察两组患者治疗效果、肺功能指标、血清炎性因子和T淋巴细胞亚群值变化情况。结果治疗组总有效率高于对照组,差异有统计学意义(P<0.05);治疗组肺功能指标水平高于对照组,差异有统计学意义(P<0.05);对照组血清炎性因子水平高于治疗组,差异有统计学意义(P<0.05);对照组CD~+_3、CD~+_8低于治疗组,差异有统计学意义(P<0.05);对照组CD~+_4高于治疗组,差异有统计学意义(P<0.05)。结论采用肺舒配方颗粒治疗慢性阻塞性肺疾病可以提高患者治疗效果,改善肺功能,值得推广。     

联合应用左旋氧氟沙星和头孢呋辛治疗慢性阻塞性肺疾病急性发作的疗效观察

目的:观察联合应用左旋氧氟沙星和头孢呋辛治疗慢性阻塞性肺疾病急性发作的临床疗效。方法:选取2011年1月—2013年12月期间救治的90例慢性阻塞性肺疾病急性发作患者,随机分成观察组和对照组,各45例。对照组给予左旋氧氟沙星治疗,观察组给予左旋氧氟沙星和头孢呋辛联合治疗,对两组治疗前后肺功能、血气分析实验室指标以及治疗后临床疗效进行观察对比。结果:观察组总有效率显著优于对照组,差异有统计学意义(P<0.05)。两组患者治疗后1 s内用力呼吸量(FEV1)、FEV1与预计值内的比值(FEV1%)、FEV1与用力肺活量(FVE)的比值(FEV1/FVE)、动脉血氧分压(Pa O2)、动脉血二氧化碳分压(Pa CO2)以及血白细胞计数(WBC)均得到一定改善,治疗前后相比差异有统计学意义(P<0.05)。且观察组改善情况显著优于对照组,差异有统计学意义(P<0.05)。结论:联合应用左旋氧氟沙星和头孢呋辛治疗慢性阻塞性肺疾病急性发作,临床疗效显著,可显著改善患者肺功能、血气等实验室指标。     

中西医结合治疗老年慢性阻塞性肺疾病急性发作期的疗效观察

目的观察中西医结合治疗急性发作期老年慢性阻塞性肺疾病的治疗效果。方法选取2012年9月~2015年5月到院就诊治疗的84例老年慢性阻塞性肺疾病急性发作期患者,随机法分为观察组和对照组各42例,对照组实施常规西医治疗(口服盐酸氨溴索、抗感染治疗和氧疗);观察组在此基础上应用清肺化痰汤,观察比较两组患者治疗2周后效果、肺功能改善、血氧饱和度、二氧化碳和氧分压。结果观察组总有效率显著比对照组高,肺功能、氧分压以及二氧化碳分压改善情况明显优于对照组,差异有统计学意义(P<0.05)。结论中西医结合治疗老年慢性阻塞性肺疾病急性发作期患者,效果显著,可有效改善患者肺功能。     

营养支持治疗对老年慢阻肺合并呼衰患者疗效评价

目的：评价营养支持治疗老年慢性阻塞性肺疾病合并呼吸衰竭患者的临床疗效。方法将80例老年慢性阻塞性肺疾病合并呼吸衰竭患者随机分为试验组40例和对照组40例,对照组患者给予常规的综合治疗,试验组在对照组的基础上给予营养支持。观察两组患者治疗后的临床疗效,测量两组患者治疗前后营养状况指标的改善情况,观察两组患者治疗前后的肺功能指标和动脉血气指标改善情况。结果试验组患者总有效率（95.0%）明显高于对照组总有效率（75.0%）,差异有统计学意义（χ2=6.27,P<0.05）;两组患者治疗前相关肺功能指标和血气指标比较,差异均无统计学意义（P>0.05）;治疗后显著改善（P<0.05）;且试验组患者治疗后的改善情况明显优于对照组患者（P<0.05）,治疗前两组患者营养状况指标比较,差异均无统计学意义（P>0.05）;治疗后试验组显著改善,而对照组上述指标无明显变化（P>0.05）。结论营养支持治疗对老年慢性阻塞性肺疾病合并呼吸衰竭有更好的辅助治疗效果,可以较快的缓解老年患者临床症状。     

复方异丙托溴铵治疗急性加重期慢性阻塞性肺疾病的临床分析

目的分析复方异丙托溴铵对急性加重期慢性阻塞性肺疾病的治疗效果。方法选取76例急性加重期慢性阻塞性肺疾病患者为研究对象,将76例研究对象随机分为对照组与观察组,各38例。对照组给予布地奈德雾化吸入治疗,观察组在对照组基础上加用复方异丙托溴铵治疗,对两组患者临床治疗效果进行对比分析。结果观察组总有效率显著高于对照组,两组比较差异具有统计学意义(P<0.05);治疗前,两组患者FEV_1(第1秒用力呼气容积)、FEV_1/FVC(第1秒用力呼气容积与用力肺活量比值)、PEF(最大呼气流量)等肺功能指标比较,差异无统计学意义;治疗后,观察组患者FEV_1、FEV_1/FVC、PEF等肺功能指标均优于对照组,数据比较差异具有统计学意义(P<0.05)。结论复方异丙托溴铵在急性加重期慢性阻塞性肺疾病中的治疗效果理想,建议在临床上推广。     

阿托伐他汀在慢性阻塞性肺疾病中的治疗作用探讨

目的 探讨阿托伐他汀在慢性阻塞性肺疾病(COPD)中的治疗作用.方法 将50例COPD患者随机分为治疗组和对照组各25例.对照组给予常规治疗,治疗组在对照组治疗基础上给予阿托伐他汀治疗.1个月后比较2组肺功能变化情况,包括第1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)及FEV1占预计值(%),并观察2组疗效.结果 治疗组总有效率为96%高于对照组的84%,差异有统计学意义(P<0.05).2组治疗后FEV1、FEV1/FVC及FEV1占预计值均升高,差异均有统计学意义(P<0.05),且治疗组改善情况优于对照组,差异均有统计学意义(P<0.05).结论 他汀类药物可能在慢性阻塞性肺疾病的病理生理进程中产生有利的影响,改善肺功能及COPD患者的生活质量.     

肺呼吸康复治疗在慢性阻塞性肺疾病缓解期患者中的应用

目的研究肺呼吸康复治疗对慢性阻塞性肺疾病缓解期患者的作用。方法观察110例慢性阻塞性肺疾病缓解期患者进行治疗的疗效。结果治疗后观察组肺功能较对照组强,且生活质量评分高于对照组,两组差异有统计学意义(P<0.05)。结论肺呼吸康复治疗可改善慢性阻塞性肺疾病缓解期患者肺功能,提高生活质量。     

慢性阻塞性肺疾病的临床治疗探讨

目的探讨慢性阻塞性肺疾病的临床治疗方法及效果。方法从我院2012年9月至2014年3月接收并治疗的慢性阻塞性肺疾病患者中选取68例进行回顾性分析,随机分为观察组与对照组,每组34例,对照组行常规治疗,观察组在对照组治疗基础上行舒利迭联合金水宝胶囊治疗,观察两组患者治疗效果及肺功能恢复情况。结果观察组治疗总有效率为94.12%,对照组总有效率为73.53%,观察组治疗效果明显优于对照组,观察组肺功能恢复显著优于对照组,差异具有统计学意义(P<0.05)。结论在慢性阻塞性肺疾病的临床治疗中,选用舒利迭联合金水宝胶囊,可有效缓解病症,促进患者血气改善,实现肺功能恢复,值得临床应用及推广。     

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.     

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.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.