丙酸氟替卡松气雾剂联合扎鲁司特治疗支气管哮喘临床观察

目的探讨丙酸氟替卡松气雾剂联合扎鲁司特治疗支气管哮喘临床效果。方法将140例支气管哮喘患者分成两组,治疗组采用丙酸氟替卡松气雾剂联合扎鲁司特治疗;对照组采用吸入丙酸氟替卡松气雾剂治疗,对比两组治疗效果。结果治疗前和治疗4周后PEF、FEV1值治疗组明显优于对照组(P<0.05);有效率治疗组明显优于对照组(P<0.05)。结论丙酸氟替卡松气雾剂联合扎鲁司特治疗支气管哮喘疗效显著,值得推广。     

两种方法治疗支气管哮喘伴过敏性鼻炎疗效比较

目的 比较采用丙酸氟替卡松气雾剂联合鼻喷剂与单纯丙酸氟替卡松气雾剂治疗支气管哮喘伴过敏性鼻炎的疗效.方法 50例支气管哮喘伴过敏性鼻炎患者随机分成观察组和对照组各25例,观察组吸入丙酸氟替卡松气雾剂加丙酸氟替卡松鼻喷剂,对照组吸入丙酸氟替卡松吸入气雾剂.随访6个月,分别于1、3、6个月检测两组治疗后肺功能:1s用力呼气量占正常预计值的百分比(FEV1％)、哮喘急性发作次数、无症状天数.结果 观察组治疗后1、3、6个月FEV1％分别为(107.2±15.3)％、(115.3±11.9)％、(131.3±10.9)％,均明显高于对照组的(98.6±13.6)％、(102.6±13.6)％、(126.5±9.7)％(t=2.306、3.355、3.714,均P＜0.05).观察组治疗期间发生支气管哮喘次数(0.13±0.11)次、无症状天数(150.2±14.3)d、鼻炎发作次数(0.25±0.31)次,对照组分别为(0.30±0.44)次、(116.5±23.1)d、(0.65±0.24)次,两组差异均有统计学意义(t =2.413、3.435、3.734,均P＜0.05).结论 丙酸氟替卡松气雾剂联合鼻喷剂治疗支气管哮喘伴过敏性鼻炎疗效显著,值得临床推广应用.     

丙酸氟替卡松联合布地奈德治疗小儿支气管哮喘的临床研究

目的探讨丙酸氟替卡松吸入气雾剂联合吸入用布地奈德混悬液治疗小儿支气管哮喘的临床疗效。方法选取2015年1月—2016年1月在第四军医大学第一附属医院治疗的支气管哮喘患儿96例作为研究对象,利用随机数字表法将患儿分为对照组和治疗组,每组各48例。对照组雾化吸入吸入用布地奈德混悬液,0.5 mg/次,2次/d。治疗组在对照组基础上吸入丙酸氟替卡松吸入气雾剂,2揿/次,2次/d。两组患儿均连续治疗12周。观察两组的临床疗效,比较两组肺功能、血气指标和炎性因子情况。结果治疗后,对照组和治疗组总有效率分别为83.3%、95.8%,两组比较差异有统计学意义(P0.05)。治疗后,两组呼气峰流速值(PEF)、1 s用力呼气容积(FEV1)、呼气高峰流量(PEFR)和FEV_1/用力肺活量(FVC)均明显上升,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血氧分压(Pa O_2)和酸碱度(p H)值均显著上升,二氧化碳分压(Pa CO2)均显著下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组肿瘤坏死因子α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素4(IL-4)、白细胞介素8(IL-8)和白细胞介素13(IL-13)水平均明显下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论丙酸氟替卡松吸入气雾剂联合吸入用布地奈德混悬液治疗小儿支气管哮喘具有较好的疗效,可改善肺功能,缓解炎症反应,具有一定临床推广应用价值。     

喘嗽宁片联合丙酸氟替卡松治疗咳嗽变异性哮喘的临床研究

目的研究喘嗽宁片联合丙酸氟替卡松吸入气雾剂治疗咳嗽变异性哮喘的临床疗效。方法选取2017年3月—2019年1月宝鸡市中医院收治的100例咳嗽变异性哮喘患者为研究对象,采用随机对照组法将所有患者随机分为对照组和治疗组,每组各50例。对照组患者雾化吸入丙酸氟替卡松吸入气雾剂,2揿/次,2次/d;治疗组患者在对照组的基础上口服喘嗽宁片,4片/次,3次/d。两组患者持续治疗4周。观察两组的临床疗效,比较两组的肺功能指标、嗜酸性粒细胞(EOS)计数、嗜酸性粒细胞阳离子蛋白(ECP)水平和炎性因子水平。结果治疗后,对照组和治疗组的总有效率分别为78.00%、92.00%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者用力肺活量(FVC)、第一秒用力呼气容积(FEV1)和FEV1/FVC均明显升高,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组患者肺功能指标明显高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者EOS计数和ECP水平均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组患者EOS计数和ECP水平明显低于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患者高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平均显著降低,白细胞介素-10(IL-10)水平显著升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组患者hs-CRP、TNF-α、IL-10水平明显优于对照组,两组比较差异有统计学意义(P0.05)。结论喘嗽宁片联合丙酸氟替卡松吸入气雾剂治疗咳嗽变异性哮喘具有较好的临床疗效,能改善肺功能,降低血清炎性因子水平,具有一定的临床推广应用价值。     

屏风生脉胶囊联合沙美特罗替卡松气雾剂治疗支气管哮喘的临床研究

目的探讨屏风生脉胶囊联合沙美特罗替卡松气雾剂治疗支气管哮喘的临床疗效。方法选取2015年9月—2016年9月在杭州师范大学附属医院进行治疗的支气管哮喘患者84例,根据治疗方案的差别分为对照组(42例)和治疗组(42例)。对照组吸入沙美特罗替卡松气雾剂,1吸/次,2次/d。治疗组在对照组的基础上口服屏风生脉胶囊,3粒/次,3次/d。两组患者均治疗4周。观察两组患者临床疗效,同时比较两组患者治疗前后临床症状消失的时间、第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气流速(PEF)等肺功能指标、血清学指标的变化。结果治疗后,对照组和治疗组总有效率分别为80.95%、95.24%,两组总有效率比较差异有统计学意义(P0.05)。两组患者喘憋、咳嗽、肺部啰音消失的时间较对照组均显著缩短,两组比较差异具有统计学意义(P0.05)。两组患者FEV1、FVC、PEF均较同组治疗前明显升高,同组治疗前后差异具有统计学意义(P0.05);且治疗组升高程度优于对照组,两组比较差异有统计学意义(P0.05)。两组患者血清IL-4、IL-6、TNF-α和NO水平明显低于同组治疗前,而IL-10、SOD水平明显高于同组治疗前(P0.05);且治疗组上述指标的改善程度更显著(P0.05)。结论屏风生脉胶囊联合沙美特罗替卡松气雾剂治疗支气管哮喘效果显著,可有效改善患者临床症状和肺功能,并可降低机体炎性反应,具有一定的临床推广应用价值。     

沙美特罗替卡松气雾剂治疗儿童支气管哮喘的效果观察

目的探讨沙美特罗替卡松气雾剂治疗儿童支气管哮喘的临床效果。方法选取我院收治的84例支气管哮喘患儿作为研究对象,将其随机均分为实验组和对照组,对照组采用氟替卡松气雾剂治疗,实验组采用沙美特罗替卡松气雾剂治疗,比较两组临床疗效及治疗前后肺功能指标。结果分别接受治疗后有效率比较χ2=5.61,有显著性差异,比较有统计学意义(P<0.05);相比于治疗前,两组治疗后PEF预计值及FEV1预计值显著升高(P<0.05);相比于对照组治疗后,实验组治疗后PEF预计值及FEV1预计值均显著升高,比较差异显著(P<0.05)。结论采用沙美特罗替卡松气雾剂治疗儿童支气管哮喘能显著改善患儿肺功能,临床疗效显著,可作为治疗支气管哮喘的有效方法。     

沙美特罗替卡松粉吸入剂治疗支气管哮喘的疗效研究

目的：探讨沙美特罗替卡松粉吸入剂治疗支气管哮喘的临床疗效。方法选取我院2011年1月—2014年1月收治的支气管哮喘患者76例,随机分为观察组38例和对照组38例,观察组给予沙美特罗替卡松粉吸入剂治疗,对照组给予丙酸氟替卡松吸入治疗。观察比较治疗前后两组支气管哮喘患者肺功能的改变及治疗效果。结果两组临床有效率、用力肺活量（FVC）、最大呼气峰流速（PEF）和第1秒末用力呼气容积（FEV1）比较,差异均有统计学意义（P 〈0.05）。结论沙美特罗替卡松粉吸入剂治疗支气管哮喘疗效确切。     

吸入布地奈德气雾剂与沙美特罗丙酸氟替卡松干粉剂治疗支气管哮喘的疗效比较

目的探讨吸入布地奈德气雾剂与沙美特罗丙酸氟替卡松干粉剂治疗支气管哮喘的疗效比较。方法选取44例支气管哮喘疾病患者随机分配到A、B两个小组,A组给予吸入布地奈德气雾剂进行治疗;B组给予定量每日吸入沙美特罗丙酸氟替卡松干粉剂进行治疗。分别对治疗前、治疗1个月后、治疗3个月后等时间段进行临床指标评价和心率、血氧饱和度指标分析。结果吸入布地奈德气雾剂与沙美特罗丙酸氟替卡松干粉剂在治疗支气管哮喘病方面均能迅速起效;治疗1个月后、治疗3个月后A组与B组临床指标评价和心率、血氧饱和度指标改善情况差值均无统计学意义。结论吸入沙美特罗丙酸氟替卡松干粉剂和吸入布地奈德气雾剂与在治疗支气管哮喘疗效相当。     

玉屏风口服液联合沙美特罗替卡松气雾剂治疗小儿哮喘37例临床观察

目的观察玉屏风口服液联合沙美特罗替卡松气雾剂治疗小儿哮喘的临床疗效。方法选取2012年6月至2014年6月在我院就诊的74例哮喘患儿作为研究对象,按照随机数字表法分为治疗组和对照组。对照组吸入沙美特罗替卡松气雾剂,治疗组给予玉屏风口服液联合沙美特罗替卡松气雾剂,观察哮喘的复发和控制情况。结果与同组治疗前比较,患儿肺功能指标均明显改善(P0.05);治疗组治疗后和停药6月后与对照组比较,患儿肺功能改善显著(P0.05)。治疗组在治疗后以及停药6月后,有效控制率高于对照组,复发率低于对照组,差异有统计意义(P0.05)。结论沙美特罗替卡松气雾剂联合玉屏风口服液治疗小儿哮喘的疗效较单用沙美特罗替卡松气雾剂治疗效果更好,且复发率低。     

长期吸入小剂量丙酸氟替卡松气雾剂防治婴幼儿哮喘的疗效观察

目的观察长期吸入小剂量丙酸氟替卡松气雾剂防治婴幼儿哮喘的疗效。方法 108例哮喘婴幼儿,随机分成对照组和观察组,各54例。对照组给予常规综合治疗,观察组在此基础上吸入小剂量丙酸氟替卡松气雾剂,观察比较两组患儿的疗效。结果观察组治疗总有效率为92.59%,高于对照组的68.52%,差异有统计学意义(P<0.05);观察组的门诊就诊次数、住院时间、治疗总费用均少于对照组(P<0.05)。结论长期吸入小剂量丙酸氟替卡松气雾剂防治婴幼儿哮喘安全有效、方便、经济,值得推广。     

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.     

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.     

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.     

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.