伏立康唑治疗血液病肺部真菌感染的疗效观察

目的观察国产伏立康唑治疗血液病肺部侵袭性真菌感染的疗效和安全性。方法以国产伏立康唑治疗40例发生于血液病的肺部侵袭性真菌感染,观察疗效及不良反应。结果 40例患者中,有效32例(其中完全缓解20例,部分缓解12例),无效8例(其中稳定4例,进展2例,死亡2例),总有效率为80%。40例患者不良反应轻,无因不良反应不能耐受而停药的病例。结论国产伏立康唑是治疗血液病患者肺部侵袭性真菌感染安全有效的药物。     

伏立康唑对白血病患儿伴侵袭性肺部真菌感染的疗效评价

目的:评价伏立康唑对患儿白血病伴侵袭性肺部真菌感染的临床疗效。方法:选取2014年1月—2016年1月期间收治的白血病伴有侵袭性肺部真菌感染患儿30例,患儿经诊断为白血病伴有侵袭性肺部真菌感染后给予伏立康唑治疗,临床症状较轻的患儿给予口服伏立康唑治疗,临床症状较重的患儿给予伏立康唑注射液静脉滴注治疗,治疗时间为2周~3月不等;评价患儿治疗后的总有效率以及不良反应的发生率。结果:30例患儿给予伏立康唑治疗后的总有效率为85.33%,用药期间不良反应症状较轻,具有良好的难受性。结论:采用伏立康唑治疗儿童白血病侵袭性肺部真菌感染的疗效较显著,具有较高的安全性。     

伏立康唑治疗血液病并发肺部侵袭性真菌感染13例

目的观察探讨伏立康唑治疗血液系统疾病并发肺部侵袭性真菌感染的效果及不良反应。方法回顾性分析13例血液系统疾病合并肺部侵袭性真菌感染患者的临床资料,7例患者初治即使用常规剂量伏立康唑,5例在氟康唑无效情况下改用伏立康唑,1例患者联合使用卡泊芬净及伏立康唑。结果 13例患者有效10例(其中治愈7例,改善3例),无效2例,死亡1例。副反应:肝功能异常2例,1例为谷丙转氨酶及谷氨酰转肽酶轻度升高,1例出现轻度黄疸,2例出现一过性低钾血症,未出现一次性视觉障碍,不需要停止伏立康唑进行治疗。肺部侵袭性真菌感染患者有效率为76.9%。结论伏立康唑治疗血液系统疾病并发肺部侵袭性真菌感染安全有效,副作用小。     

伏立康唑治疗儿童血液系统恶性肿瘤伴发侵袭性真菌感染的临床分析

目的 评价伏立康唑治疗儿童血液系统恶性肿瘤伴发侵袭性真菌感染的疗效及安全性。方法 46例血液系统恶性肿瘤伴发侵袭性真菌感染的患儿,给予伏立康唑治疗。重症者首日予以负荷剂量6 mg/(kg·次),q.12 h.,次日起给予维持剂量4 mg/(kg·次),q.12 h.;轻症者给予伏立康唑片口服,剂量为200 mg,q.12 h.,序贯治疗14~42 d。观察疗效。结果 伏立康唑有效率为67.4%,只有少数患儿出现轻度肝功能损害、胃肠道反应、视觉异常等不良反应。结论 伏立康唑治疗儿童血液系统恶性肿瘤伴发侵袭性真菌感染效果好,毒副作用少,是一种安全高效的抗真菌药物,值得临床推广。     

伏立康唑联合卡泊芬净治疗儿童白血病合并侵袭性真菌病疗效分析

目的:研究伏立康唑和卡泊芬净联合治疗儿童白血病化疗期间侵袭性真菌病(IFD)的临床疗效和安全性。方法:选取2015-2018年在我院接受抗侵袭性真菌感染治疗的41例白血病患儿,分为联合治疗组22例和伏立康唑组19例,其中联合治疗组患儿采用卡泊芬净联合伏立康唑治疗,伏立康唑组采用伏立康唑单独治疗,比较两组患儿用药后的治疗效果、感染死亡的风险因素和不良反应发生率。结果:联合治疗组与伏立康唑组临床有效率分别为77.3% 和36.9%,差异有统计学意义(P<0.05);联合治疗组死于感染相关因素的患儿少于伏立康唑组(P<0.05),治疗方式是IFD致死的风险因素(P<0.05);联合治疗组患儿出现肾功能和消化系统损伤的概率小于伏立康唑组(P<0.05)。结论:泊芬净和伏立康唑联合治疗儿童白血病合并侵袭性真菌感染的临床效果较好,可降低病死率和不良反应发生率。     

伏立康唑对白血病患者化疗期间肺部侵袭性真菌感染的临床疗效与安全性评价

目的:评价伏立康唑对白血病患者化疗期间肺部侵袭性真菌感染的临床疗效与安全性。方法:选取2013年11月—2018年11月期间收治的白血病患者化疗期间肺部侵袭性真菌感染60例资料,按治疗方法的不同将其分为对照组和治疗组,每组30例;对照组患者给予两性霉素B治疗,治疗组患者给予伏立康唑治疗;比较两组患者治疗后的总有效率和用药期间不良反应的发生率差异,以及治疗后症状体征(体温、全身疼痛、咳嗽、肺部湿啰音)复常时间的差异。结果:治疗组患者治疗后体温、全身疼痛、咳嗽、肺部湿啰音复常时间均早于对照组(P<0.05),总有效率高于对照组(P<0.05),用药期间不良反应发生率低于对照组(P<0.05)。结论:对白血病化疗期间肺部侵袭性真菌感染患者,采用伏立康唑治疗的疗效优于两性霉素B,加快了症状的恢复,且安全性高。     

伏立康唑治疗肺部侵袭性真菌感染的有效性与安全性分析

目的:探讨伏立康唑治疗肺部侵袭性真菌感染的有效性与安全性.方法:选取2014年8月~2016年11月我院接收的82例肺部侵袭性真菌感染患者,所有患者实施伏立康唑治疗,观察临床疗效、不良反应、安全性及体征状况并进行分析.结果:经治疗,伏立康唑对肺部侵袭性真菌感染的清除率为85.37%、痊愈率为47.56%,有效率为73.17%;不良反应发生率为9.76%(8/82),且经治疗均恢复正常;治疗后患者谷丙转氨酶、谷草转氨酶水平明显低于治疗前,总胆红素、尿素氮明显高于治疗前,差异有统计学意义(P<0.05).结论:伏立康唑应用于肺部侵袭性真菌感染治疗效果显著、安全性高.     

国产伏立康唑与两性霉素B治疗急性白血病合并侵袭性真菌感染的临床分析

目的:比较国产伏立康唑与两性霉素B治疗急性白血病合并侵袭性真菌感染的疗效及不良反应.方法:回顾性分析急性白血病合并侵袭性真菌感染患者27例临床资料,分为治疗组14例和对照组13例,治疗组静脉滴注伏立康唑4mg/kg,1次/12h,对照组静脉滴注两性霉素B从5mg开始逐渐增加剂量为1mg/kg,1次/d,两组均于用药2周后评价疗效及不良反应.结果:治疗组及对照组有效率分别为78.57%和46.15%,差异有统计学意义(P<0.05),不良反应发生率分别为28.57%、69.23%,治疗组明显低于对照组,差异有统计学意义(P<0.05).结论:国产伏立康唑治疗急性白血病合并侵袭性真菌感染较两性霉素B疗效好,不良反应少.     

伏立康唑对白血病患者合并肺部侵袭性真菌感染的临床疗效

目的:分析伏立康唑对白血病患者合并肺部侵袭性真菌感染的临床疗效。方法:选取2018年2月—2019年3月经我院收治的66例白血病合并肺部侵袭性真菌感染患者,随机分为观察组和对照组,每组33例。对照组常规给予两性霉素B治疗,观察组给予伏立康唑治疗。观察两组治疗4周后的临床疗效和症状消失时间。结果:观察组临床治疗总有效率为96.97%(32/33),显著高于对照组的78.79%(26/33)(P<0.05),观察组体温恢复正常时间(6.32±0.93)d、全身疼痛消失时间(5.31±0.89)d、咳嗽消失时间(10.14±1.04)d、肺部湿啰音消失时间(12.24±1.37)d均少于对照组(P<0.05)。结论:白血病合并肺部侵袭性真菌感染接受伏立康唑治疗效果显著,可明显改善症状,促进康复,值得推广。     

伏立康唑治疗血液病合并侵袭性真菌感染 42 例简

目的评价伏立康唑治疗血液病合并侵袭性真菌感染（IFI）的疗效和安全性。方法收集医院心血管中心血液病合并侵袭性真菌感染患者42例,均给予伏立康唑（汇德力康）,从临床表现、影像学和病原学3个方面评价其疗效和安全性,同时观察药品不良反应。结果伏立康唑治疗IFI总有效率为70．00％。单变量分析显示,延长伏立康唑治疗疗程和患者基础病稳定能显著提高疗效,其不良反应主要有神经精神症状、视觉异常和皮疹。结论伏立康唑治疗血液病侵袭性真菌感染高效广谱,安全性高,不良反应小,值得临床推广。     

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.

     

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.     

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.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

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.