重症胰腺炎的早期非手术治疗临床分析

目的总结重症急性胰腺炎非手术治疗体会。方法收集我院1995年1月～2004年10月我院收治的66例重症胰腺炎，回顾分析非手术治疗重症胰腺炎的诊治经验。结果本组非手术治疗54例，51例治愈，死亡3例，治愈率81．8％；手术治疗12例，8例治愈，死亡4例。治愈率66．7％。结论早期以非手术为主的综合治疗措施能提高重症胰腺炎治疗效果。     

急性重症胰腺炎45例诊治分析

目的观察非手术治疗重症急性胰腺炎的临床疗效。方法回顾分析2005年12月-2011年12月在本院治疗的急性胰腺炎患者45例。结果非手术治疗组23例,临床治愈19例,治愈率为82．6％,手术治疗组22例,临床治愈16例,治愈率为72．3％。结论应根据患者的具体病因及病情,准确掌握非手术和手术的治疗时机,提高治疗急性重症胰腺炎的疗效。     

重症胰腺炎非手术治疗体会

目的急性重症胰腺炎（SAP）的早期治疗以非手术治疗为主，手术治疗对患者创伤较大，并发症较多，增加了患者病死率。本研究探讨了急性重症胰腺炎早期非手术治疗的必要性及优越性。方法本研究对56例急性重症胰腺炎采用非手术或是手术治疗。结果对56例急性重症胰腺炎采用非手术治疗与手术治疗的治愈率分别为89．5％（43／48）、62．5％（5／8），病死率分别为10．4％（5／48）、37．5％（3／8）。结论对于急性重症胰腺炎（SAP）的治疗，非手术治疗的治愈率明显高于手术治疗。     

谈重症胰腺炎的早期非手术治疗

目的 总结重症急性胰腺炎非手术治疗体会.方法 回顾分析河南中医学院第一附属医院2003年5月～2006年10月收治的45例重症胰腺炎病例.结果 本组非手术冶疗37例,死亡2例,治愈率94.6%;手术治疗8例,死亡2例,治愈率75%.结论 早期以非手术为主的综合冶疗措施能提高重症胰腺炎治疗效果.     

重症急性胰腺炎临床治疗对比分析

目的探讨重症急性胰腺炎(SAP)的合理治疗方案和临床效果。方法对32例重症急性胰腺炎患者,分为手术治疗组和非手术治疗组。对两组的平均病程及死亡率进行回顾分析,观察手术组与非手术组的治疗效果。结果非手术治疗23例,治愈21例,死亡2例;手术治疗9例,治愈6例.死亡3例;非手术治疗组死亡率显著低于手术治疗组。结论重症急性胰腺炎早期应采取非手术治疗为主,若出现手术指征时,应及时手术。手术时机的掌握和手术方式的选择对手术治疗重症急性胰腺炎很重要。理性选择重症急性胰腺炎的手术适应证及手术时机是提高重症急性胰腺炎疗效的关键。     

手术与非手术治疗急性重症胰腺炎60例临床观察

目的:探讨分析急性重症胰腺炎患者非手术治疗方法的临床效果。方法:选取急性重症胰腺炎患者60例,采取非手术治疗34例,手术治疗26例,比较两组患者的治愈率、好转率和病死率。结果:非手术治疗患者中,治愈28例,好转5例,死亡1例;手术治疗患者中,治愈6例,好转12例,死亡8例。两种治疗方式疗效比较,差异有统计学意义(P<0.05)。结论:非手术治疗急性重症胰腺炎优于手术治疗,中药治疗、营养支持和血液净化是非手术治疗的重要环节。     

重症急性胰腺炎的非手术治疗

目的探讨重症急性胰腺炎非手术治疗效果。方法通过对早期手术为主的A组1992年以前的53例和以早期非手术为主的B组(1992年以前8例,1992年以后32例）40例患者的并发症和病死率,进行回顾性分析。结果B组并发症（ARDS、肾衰、心衰）的发生率和病死率明显低于A组（P＜0．05）。对重症急性胰腺炎的治疗采取早期非手术治疗明显优于早期手术治疗。结论大多数重症急性胰腺炎可经非手术治疗治愈,经早期保守治疗而行延期手术者可简化手术方法,可减少术后并发症,提高手术耐受性。     

重症急性胰腺炎早期手术与非手术治疗效果观察

目的探讨重症急性胰腺炎的早期手术与非手术治疗效果.方法本院1998年1月至2005年6月收治的76例重症胰腺炎分为手术治疗组46例、非手术治疗组30例,两组结果进行比较分析.结果手术组死亡18例,病死率为39.13%,非手术死亡2例病死率6.67%,两组病死率比较差异有显著性(χ2=4.93,P＜0.05).结论重症急性胰腺炎的早期非手术治疗优于手术治疗效果,同时应根据患者具体情况选择手术治疗.     

非手术综合治疗急性重症胰腺炎临床疗效观察

目的探讨急性重症胰腺炎非手术治疗的方法和疗效。方法回顾分析2004年4月至2008年4月32例急性重症胰腺炎的非手术治疗的诊治经验。结果32例患者经内科综合治疗治愈28例,转手术治疗者4例,术后死亡3例,病死率为9.3%,治愈率为90.7%。结论急性重症胰腺炎的非手术综合治疗疗效较好,应注意及时诊断,早期应用生长抑素,合理选用抗生素,积极配合中药治疗,加强营养,必要时转手术治疗。     

急性重症胰腺炎早期治疗的临床分析

目的 探讨急性重症胰腺炎的治疗。方法 对我院1996年1月－2001年12月间收治的43例急性重症胰腺炎病人的早期治疗方法进行分析。结果 43例病人均首先采取非手术疗法，28例经非手术治愈，2例死亡；13例中转手术，12例治愈，1例死亡。结论 多数急性重症胰腺炎病人可经非手术治愈，但病情恶性者应及时中转手术。     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

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.