阿昔洛韦与更昔洛韦治疗成人水痘的疗效比较

目的:比较阿昔洛韦与更昔洛韦治疗成人水痘的疗效。方法:将我院140例水痘患者,按住院单双日随机均分为阿昔洛韦组与更昔洛韦组,分别给予阿昔洛韦与更昔洛韦10mg.kg-1,bid,静脉滴注。观察并记录2组患者的退热时间、皮疹结痂时间、总有效率和不良反应。结果:更昔洛韦组患者的退热时间明显短于阿昔洛韦组,2组比较差异有统计学意义(P<0.05);2组的皮疹结痂时间比较,差异无统计学意义(P>0.05);更昔洛韦组的总有效率明显高于阿昔洛韦组(P<0.05)。2组治疗过程中,均未见不良反应发生。结论:更昔洛韦治疗成人水痘的疗效显著优于阿昔洛韦,且退热时间短于阿昔洛韦。     

蓝芩口服液联合更昔洛韦治疗成人水痘疗效观察

目的观察蓝芩口服液联合更昔洛韦治疗成人水痘的临床疗效。方法将44例成人水痘患者分为两组,治疗组给予蓝芩口服液+更昔洛韦注射液,对照组给予更昔洛韦注射液,两组疗程均为7d。结果治疗组患者体温开始下降时间、体温恢复正常时间、咽喉疼痛时间、皮损痊愈时间均短于对照组(P<0.05),但水疱结痂时间与对照组比较差异无统计学意义(P>0.05)。结论蓝芩口服液联合更昔洛韦治疗成人水痘患者疗效显著。     

重组干扰素α-2a、更昔洛韦、阿昔洛韦治疗小儿水痘疗效观察

目的：比较重组干扰素α-2a、更昔洛韦、阿昔洛韦治疗小儿水痘的疗效。方法：将152例患儿随机分3组,分别为重组干扰素α-2a治疗组、更昔洛韦治疗组、阿昔洛韦对照组。结果：重组干扰素α-2a组分别与更昔洛韦组、阿昔洛韦组比较总有效率均有显著差异,而更昔洛韦组与阿昔洛韦组总有效率比较无明显差异。结论：重组干扰素α-2a治疗小儿水痘疗效优于更昔洛韦、阿昔洛韦,不良反应少,更昔洛韦治疗小儿水痘疗效与阿昔洛韦相似,更昔洛韦不良反应相对多。     

成人水痘61例临床疗效观察

目的探讨成人水痘的临床治疗效果,为临床治疗提供依据。方法选取具有水痘的成人患者122例,随机分为对照组和治疗组,各61例,对照组患者应用阿昔洛韦治疗,治疗组在应用核苷类抗病毒药阿昔洛韦的基础上,联合盐酸伐昔洛韦颗粒治疗,进行疗效比较观察。结果治疗组在治疗后的退热时间(d)和结痂时间(d)结果分别是(1.74±0.26)和(2.67±0.33);对照组在治疗后的退热时间(d)和结痂时间(d)结果分别是(2.26±0.22)和(3.81±0.26)。治疗组显效37例(60.66%),有效18例(29.51%),总有效率90.17%;对照组显效28例(45.90%),有效17例(27.87%),总有效率73.77%。两个结果显示治疗组明显优于对照组,经统计学处理差异有显著性(P<0.05)。结论应用核苷类抗病毒药阿昔洛韦的基础上,联合盐酸伐昔洛韦颗粒治疗,不仅可以降低药物依赖性,而且可以明显地提高治疗效果,缩短退热时间和结痂时间,加快斑疹和丘疹的消退情况,降低新皮疹的出现率等临床症状,值得临床推广。     

阿昔洛韦软膏辅助治疗水痘34例

目的:观察阿昔洛韦软膏辅助治疗水痘的疗效。方法:34例水痘住院患儿,随机分为对照组和治疗组。对照组予一般常规治疗,治疗组除一般常规治疗外,加阿昔洛韦软膏外涂治疗。结果:两组平均止痒时间(t=3.41,P<0.01)、皮疹结痂时间(t=5.82,P<0.01)均有显著性差异,治疗组皮疹止痒时间及结痂时间明显短于对照组。结论:阿昔洛韦软膏辅助治疗水痘,简便有效。     

阿昔洛韦联合西咪替丁治疗小儿水痘的疗效观察

目的:观察阿昔洛韦联合西咪替丁治疗小儿水痘的临床效果。方法:收集2009年1月-2010年12月在我院就诊的水痘患儿60例,将其随机均分为2组。研究组使用阿昔洛韦联合西咪替丁治疗,对照组使用利巴韦林治疗,分析比较2组患者的疗效、痊愈时间并观察2组不良反应。结果:研究组的治疗总有效率(93.3%)明显优于对照组(76.7%)(χ2=12.48,P<0.05);患儿疱疹痊愈时间明显短于对照组(χ2=13.26,P<0.05);患儿退热、止痒、结痂时间均明显短于对照组(P均<0.05)。2组均未见明显不良反应。结论:采用阿昔洛韦联合西咪替丁治疗小儿水痘,疗效较好,能明显缩短患儿治疗时间,且安全性较好。     

更昔洛韦与阿昔洛韦治疗带状疱疹的临床及安全性对比

目的观察更昔洛韦与阿昔洛韦治疗带状疱疹的临床疗效与安全性。方法临床纳入50例带状疱疹患者,分别给予更昔洛韦(研究组)与阿昔洛韦(对照组)治疗,每组25例。观察给药后7 d内患者症状、体征变化。结果研究组治疗有效率为96.0%,高于对照组的76.0%(P<0.05);研究组平均止痛、止疱以及结痂时间均较对照组短(P<0.05)。结论更昔洛韦带状疱疹,其临床有效率更高,患者症状恢复快,且无不良反应,值得推广。     

Kaposi 水痘样疹23例临床分析

目的：探讨kaposi水痘样疹患者的临床特征、易感因素及合理治疗。方法对本院收治的23例kaposi水痘样疹患者的临床资料进行回顾性分析。结果更昔洛韦联合静脉用人免疫球蛋白（ IVIg）治疗在病情控制（新发皮疹控制时间、退热、皮疹消退结痂等）上要明显优于单用更昔洛韦治疗。结论更昔洛韦联合IVIg有利于及时控制kaposi水痘样疹的病情。     

更昔洛韦治疗小儿水痘34例临床观察

目的:探讨更昔洛韦对小儿水痘的临床疗效及安全性。方法:66例水痘患儿随机分为2组,治疗组34例用更昔洛韦注射液5mg/(kg·d),对照组32例用利巴韦林注射液10mg/(kg·d),两组均每日一次静脉滴注,疗程5d,其他治疗方法相同。结果:治疗组热退及结痂时间较对照组缩短(P<0.05),且两组治疗前后周围血白细胞和中性粒细胞比较均无明显差异(P>0.05)。结论:更昔洛韦对小儿水痘有显著疗效,而且安全。     

银翘解毒汤治疗小儿水痘的临床观察

目的:观察银翘解毒汤治疗小儿水痘的临床疗效及不良反应。方法:76例水痘患儿随机分为两组,治疗组42例采用中药银翘解毒汤治疗,1日1剂,分三次内服并外擦患处;对照组34例给予重组人干扰素-α2b(莱福隆)5万IU/(kg.d)肌肉注射,1次/d,同时予阿昔洛韦20 mg/(kg.d)分4次口服,两组均5 d为一疗程。结果:两组止痒时间、疱疹结痂时间及总有效率比较无显著差异(p>0.05);但退热时间,治疗组和对照组分别为(2.38±0.91)d、(3.65±1.20)d,差异有显著意义(t=5.25,P<0.01)。不良反应治疗组为0,对照组为20.6%,有显著差异(χ2=5.78,P=0.0025)。结论:银翘解毒汤治疗小儿水痘疗效好,无明显不良反应,患儿依从性较好。     

Interaction of estrone and estradiol with DNA and protein of liver and kidney in rat and hamster in vivo and in vitro

[6,7-³H] Estrone (E) and [6,7-³H]estradiol-17 (E₂) have been synthesized by reduction of 6-dehydroestrone and 6-dehydroestradiol with tritium gas. Tritiated E and E₂ were administered by oral gavage to female rats and to male and female hamsters on a dose level of about 300 g/kg (54 mCi/kg). After 8 h, the liver was excised from the rats; liver and kidneys were taken from the hamsters. DNA was purified either directly from an organ homogenate or via chromatin. The radioactivity in the DNA was expressed in the units of the Covalent Binding Index, CBI = (mol chemical bound per mol DNA-P)/(mmol chemical administered per kg b.w.). Rat liver DNA isolated via chromatin exhibited the very low values of 0.08 and 0.09 for E and E₂, respectively. The respective figures in hamster liver were 0.08 and 0.11 in females and 0.21 and 0.18 in the males. DNA isolated from the kidney revealed a detectable radioactivity only in the female, with values of 0.03 and 0.05 for E and E₂, respectively. The values for male hamster kidney were < 0.01 for both hormones. The minute radioactivity detectable in the DNA samples does not represent covalent binding to DNA, however, as indicated by two sets of control experiments. (A) Analysis by HPLC of the nucleosides prepared by enzyme digest of liver DNA isolated directly or via chromatin did not reveal any consistent peak which could have been attributed to a nucleoside-steroid adduct. (B) All DNA radioactivity could be due to protein contaminations, because the specific activity of chromatin protein was determined to be more than 3,000 times higher than of DNA. The high affinity of the hormone to protein was also demonstrated by in vitro incubations, where it could be shown that the specific activity of DNA and protein was essentially proportional to the concentration of radiolabelled hormone in the organ homogenate, regardless of whether the animal was treated or whether the hormone was added in vitro to the homogenate.Carcinogens acting by covalent DNA binding can be classified according to potency on the basis of the Covalent Binding Index. Values of 10³–10⁴ have been found for potent, 10² for moderate, and 1–10 for weak carcinogens. Since estrone is moderately carcinogenic for the kidney of the male hamster, a CBI of about 100 would be expected. The actually measured limit of detection of 0.01 places covalent DNA binding among the highly unlikely mechanisms of action. Similar considerations can be made for the liver where any true covalent DNA binding must be below a level of 0.01. It is concluded that an observable tumor induction by estrone or estradiol is unlikely to be due to DNA binding.Paper presented at the Satellite Symposium of the European Society of Toxicology, Rome, March 29, 1983     

Arsenic induced changes in growth development and apoptosis in neonatal and adult brain cells in vivo and in tissue culture

Arsenic at a nonlethal level in drinking water consumed over a period of time has been reported to produce chronic toxicity and various types of health problems ranging from skin cancer to disturbance in memory. Neurotoxic effects have been reported in clinical cases with chronic exposure to arsenic. Physiological detoxication of arsenic occurs partially through methylation. Arsenic and its methylated derivatives are distributed in different organs and systems. The present study examined the possible interference in the neuronal development and differentiation due to the exposure to arsenic during gestation. The experiments were carried out to examine short and long term effects of arsenic on brain explants and cells grown and maintained in tissue culture system. The effects of arsenic exposure showed changes in brain cell membrane function indicated by generation and release of reactive oxygen-nitrogen intermediates. On the morphological aspect the explants' growth was reduced, ground matrix was lost and neural networking was inhibited. Cells showed signs of apoptotic changes. Arsenic toxicity may induce damage to brain cells prior to more visible clinical conditions. The deleterious effects also pass from the maternal to fetal tissue across the transplacental barrier.     

Metabolic interaction between imipramine and carbamazepine in vivo and in vitro in rats

Summary The pharmacokinetic consequences of the combination of carbamazepine with imipramine in male Wistar rats have been investigated. It was found that a 2-week treatment with the combination resulted in the increase of the concentrations of the parent compounds and a simultaneous decrease in their metabolites in blood plasma i.e. carbamazepine inhibited imipramine demethylation in the side chain while imipramine inhibited carbamazepine 10,11-epoxidation. The velocity of imipramine 2-hydroxylation and 10,11-epoxy-carbamazepine hydration did not seem to be changed by the combination. On the basis of studies in vitro it is concluded that the observed metabolic interaction between carbamazepine and imipramine is due to the competition of the drugs for the active centre of cytochrome P 450 and to a certain qualitative alteration of the enzyme by imipramine as can be deducted from the decrease of carbamazepine binding to the cytochrome. Send offprint requests to K. J. Netter     

Nicotine metabolism and urinary elimination in mouse: in vitro and in vivo

This study aimed at elucidating the in vivo metabolism of nicotine both with and without inhibitors of nicotine metabolism. Second, the role of mouse CYP2A5 in nicotine oxidation in vitro was studied as such information is needed to assess whether the mouse is a suitable model for studying chemical inhibitors of the human CYP2A6. The oxidation of nicotine to cotinine was measured and the ability of various inhibitors to modify this reaction was determined. Nicotine and various inhibitors were co-administered to CD2F1 mice, and nicotine and urinary levels of nicotine and four metabolites were determined. In mouse liver microsomes anti-CYP2A5 antibody and known chemical inhibitors of the CYP2A5 enzyme blocked cotinine formation by 85-100%, depending on the pre-treatment of the mice. The amount of trans-3-hydroxycotine was five times higher than cotinine N-oxide, and ten times higher than nicotine N-1-oxide and cotinine. Methoxsalen, an irreversible inhibitor of CYP2A5, significantly reduced the metabolic elimination of nicotine in vivo, but the reversible inhibitors had no effect. It is concluded that the metabolism of nicotine in mouse is very similar to that in man and, therefore, that the mouse is a suitable model for testing novel chemical inhibitors of human CYP2A6.     

Penetration and action of edoxudine in vitro and in vivo

The penetration of 5-ethyl-2'-deoxyuridine (edoxudine, Aedurid) from gel base with and without the addition of urea and other adjuvant has been studied in an in vitro model using guinea pig skin. The formulation of 3% edoxudine gel with 5% urea showed the best results. In vivo experiments on hairless mice infected intracutaneously with herpes simplex virus type 1 also showed this formulation's good efficacy as compared to other formulations.     

Buprenorphine and naloxone alone and in combination in opioid-dependent humans

Subjective, physiological and behavioral effects of subcutaneously administered hydromorphone (6 mg), naloxone (0.2 mg), buprenorphine (0.2 and 0.3 mg), and two buprenorphine-naloxone combinations (buprenorphine 0.2 mg plus naloxone 0.2 mg and buprenorphine 0.3 mg plus naloxone 0.2 mg) were assessed under double-blind conditions in six opioid-dependent volunteers. Physiologic measures and subject- and observer-rated behavioral responses were measured before dosing and for 120 min after drug administration. Hydromorphone decreased pupil diameter and respiration, increased blood pressure and increased scores on subjective measures indicating opioid-like effects. Buprenorphine given alone had no significant effect on any variable measured. Naloxone given alone produced opioid abstinence-like effects which were measurable on subject- and observer-rated behavioral measures and physiological measures. Buprenorphine in combination with naloxone somewhat attenuated the naloxone-precipitated withdrawal response. Overall, the naloxone-buprenorphine combinations produced effects which were qualitatively similar to the effects of naloxone alone, suggesting a low potential for abuse of the combination product by opioid-dependent individuals.Supported by a grant from Reckitt and Colman Pharmaceutical Division and USPHS Grants DA-00050 and DA-04089 from the National Institute on Drug Abuse     

Cadmium in milk and mammary gland in rats and mice

The purpose of the present investigation was to study the uptake of cadmium in mammary tissue, effects on milk secretion and composition, and lactational transport of cadmium to the sucklings. Cadmium exposure during lactation resulted in retention of cadmium in the mammary tissue in mice and rats. The uptake of cadmium in the mammary tissue was rapid, as shown in lactating mice by whole-body autoradiography 4 h after an intravenous injection of a tracer dose of (109)CdCl(2). Retention of cadmium in kidneys of suckling pups was observed in the autoradiograms at 7 days after exposure of the dams. Lactating rats were intravenously infused with (109)CdCl(2) in 0.9% saline via osmotic minipumps from day 3 to day 16 after parturition. The cadmium dose given was 0, 8.8, 62 and 300 microg Cd/kg body wt. per day. Plasma and milk were collected at day 10 and 16 after parturition. Plasma cadmium levels in dams increased from day 10 to day 16. Cadmium levels were higher in milk than in plasma, with milk/plasma ratios varying from 2 to 6. Zinc levels in milk were positively correlated to cadmium levels in milk (r(2)=0.26; P=0. 03). In milk, (109)Cd was distributed in fat (46-52%), casein fraction (40-46%), and whey fraction (6-8%). There was a high correlation between cadmium concentrations in pups' kidney and cadmium concentrations in dam's milk (r(2)=0.98; P < 0.001). Of the cadmium dose given to the dams <0.05% was retained in the litters on day 16 of lactation. No effects were observed due to cadmium exposure on body weight in pups or dams. Cadmium treatment did not cause any effect on the lactose or protein concentration in milk, the concentrations of DNA, RNA or the ratio RNA/DNA in the mammary gland. Histological evaluation of mammary tissue did not reveal any abnormalities at any dose level. (109)Cd was bound to metallothionein in mammary tissue. The fraction of radiolabelled cadmium bound to metallothionein increased in a dose-dependent manner in both the liver (88-98%) and mammary tissue (57-80%). The present results indicate a low transfer of cadmium to the suckling pup, which might be due to binding of cadmium to metallothionein in the mammary tissue. However, during the susceptible developmental period even a low cadmium exposure may be of concern.