影响急性有机磷农药中毒抢救成功率的非治疗性因素分析

目的:探讨影响急性有机磷农药中毒(AOPP)抢救成功率的非治疗性因素,提高群众的防范意识。方法:回顾性分析75例我院2012年1月-2013年12月收治的口服AOPP患者的年龄、毒物的种类与剂量、服毒到就诊的时间、中毒的程对抢救成功率的影响。结果:在相同的治疗措施下,患者的年龄越大,就诊时间越晚,中毒程度越重,抢救成功率越低,死亡率越高。结论:除治疗性因素外,患者的年龄、毒物的种类与剂量、服毒到就诊的时间、中毒的程度这些非治疗性因素对急性有机磷农药中毒的抢救成功率也有影响。     

口服农药自杀未遂者一般情况的病例对照研究

采用医院为基础的病例－对照研究方法，以山东省某市中心人民医院和河北省某市中心人民医院为研究现场，通过１：１病例－对照研究，于１９９９年５￣８月对１１９对口服农药自杀未遂者及对照者的个人一般情况及与家庭有关的一般状况进行了调查分析。结果显示，病例和对照经济状况、社会支持程度有显著性差异，文化程度和宗教信仰无显著性差异。结果提示，经济状况差、社会支持程度低可能是口服农药自杀行为的危险因素，文化程度和宗教信仰可能不是口服农药自杀行为的危险因素。     

血液灌流救治重度有机磷农药中毒患者的疗效与护理

目的探讨血液灌流救治重度有机磷农药中毒患者的临床疗效及护理方法。方法将48例重度有机磷农药中毒患者随机分为血液灌流组和常规治疗组。常规治疗组22例接受洗胃、补液、利尿、导泻、解磷定及阿托品等药物治疗；血液灌流组26例在常规治疗的基础上给予血液灌流1—3次，并给予相应观察与护理。结果与常规治疗组比较，血液灌流组的昏迷至清醒时间和住院天数均缩短，阿托品总用量少，治愈率高，差异均有统计学意义（P〈0．05）。结论血液灌流配合常规内科治疗抢救重度有机磷农药中毒患者的效果好，治疗过程中应给予患者相应的护理。     

大黄加芒硝导泻治疗有机磷农药中毒的效果观察

目的 观察鼻饲大黄水溶液、芒硝敷脐导泻救治重度急性有机磷农药中毒(AOPP)患者的效果.方法 采用回顾性分析方法,选择80例重度AOPP患者,按治疗方法不同分为两组,每组40例.所有患者给予彻底洗胃、正确使用胆碱酯酶复能剂及阿托品等综合治疗,在此基础上,一组鼻饲大黄水溶液200 ml、芒硝100 g敷脐治疗(大黄芒硝组),另一组鼻饲20％甘露醇200 ml作为对照(甘露醇组).观察两组患者首次排便时间、导泻期间排便次数、胆碱酯酶(ChE)活性恢复正常时间、阿托品化时间、阿托品化用量、阿托品总用量、不良反应发生率、住院时间,并进行统计学分析.结果 大黄芒硝组各指标改善情况均好于甘露醇组[首次排便时间(min):134.13±31.31比154.35±34.78,导泻期间排便次数(次/d):2.60±0.81比2.14±0.63,ChE活性恢复正常时间(d):9.65±1.42比10.66±1.74,阿托品化时间(h):3.00±0.73比3.56±1.02,阿托品化用量(mg):51.43±7.03比57.65±7.74,阿托品总用量(mg):229.78±28.96比248.41±31.45,不良反应发生率:腹痛0比17.5％、腹胀0比20.0％,住院时间(d):10.43±1.68比11.59±2.12],差异均有统计学意义(均P＜0.01).结论 联用大黄水溶液和芒硝敷脐导泻治疗重度AOPP患者,能及时清除肠内毒物,减少不良反应,缩短住院时间.     

Therapeutic Effectiveness of Sustained Low‐Efficiency Hemodialysis Plus Hemoperfusion and Continuous Hemofiltration Plus Hemoperfusion for Acute Severe Organophosphate Poisoning

There is no report on the effects of sustained low‐efficiency dialysis (SLED) plus hemoperfusion (HP) (SLED + HP) in patients with acute severe organophosphate (OP) poisoning (ASOPP). This study was designed to compare the therapeutic effectiveness between SLED + HP and continuous hemofiltration (CHF) plus HP (CHF + HP) in patients with ASOPP. In order to assess the two treatment methods, 56 patients with ASOPP were divided into CHF + HP group and SLED + HP group. The biochemical indicators, in‐hospital duration, hemodynamic parameters, Acute Physiology, and Chronic Health Evaluation (APACHE II) score, and survival and mortality rates were compared. In both groups after treatment, the levels of serum creatine kinase isozyme MB, creatine kinase, creatinine, glutamic‐oxalacetic transaminease, and glutamate‐pyruvate transaminase, and the APACHE II scores on the first, second, and seventh day decreased (P < 0.05), whereas the levels of serum acetylcholinesterase increased. The two groups showed no statistical differences in in‐hospital duration, biochemical indicators, APACHE II score, hemodynamic parameters, survival rate, or the mortality rate (P > 0.05). In conclusion, SLED has similar hemodynamic stability to CHF and the two treatment methods have similar effects on ASOPP patients. More importantly, SLED plus HP is relatively economical and convenient for patients with ASOPP in clinical practice.     

Oral Treatment of Organophosphate Poisoning in Mice

OBJECTIVE: Organophosphates are used as pesticides, herbicides, and chemical warfare agents. Treatment of organophosphate poisoning is with intravenous atropine and pralidoxime in addition to supportive care. This study determined the efficacy of oral agents in preventing death from organophosphate poisoning. METHODS: The organophosphate paraoxon (8 mg/kg) was used in a murine model with lethality at four and 24 hours as an end point. For oral treatment, 15 male Balbc mice were given either atropine sulfate (4 mg/kg), or a combination of atropine sulfate (4 mg/kg) with pralidoxime (100 mg/kg), by oral gavage. A control group of 22 mice received water by oral gavage. Chi-square analysis was used to compare results in the different groups. RESULTS: Of the control group, six of 22 survived to four hours after paraoxon exposure. Of the exposed animals treated with oral atropine, eight of 15 survived to four hours. Of the exposed animals treated with a combination of atropine and pralidoxime, 13 of 15 survived to four hours. All animals surviving to four hours survived to 24 hours. The increased survival of animals in the atropine group relative to the control group was not significant (p = 0.09). Survival was significant in the group treated with atropine and pralidoxime relative to atropine alone (p = 0.02) and to the control group (p = 0.0002). All treated mice surviving at four hours were alive at 24 hours. CONCLUSIONS: Both oral atropine and a combination of oral atropine and pralidoxime improved survival, and combination therapy achieved statistical significance. Generalization of this result to other organophosphate pesticides, other doses of paraoxon, and other species cannot be made without further investigations.     

中药抗肿瘤活性成分纳米递送系统的研究进展

与传统化疗药物相比,中药抗肿瘤活性成分具有多靶点、多层次及协同干预等独特的优势。然而,大部分中药抗肿瘤活性成分往往水溶性差、生物利用度低等,限制了其临床应用。纳米递送系统有望改善中药抗肿瘤活性成分的应用限制,与游离药物相比,纳米载药系统表现出改善的生物利用度、增强的组织靶向性、减轻的脱靶不良反应及更大的体内稳定性。综述了目前最常用的2种中药抗肿瘤活性成分纳米递送系统即包载递送系统和共价结合前药递送系统,并对其中存在的问题及未来发展进行讨论,旨在为促进中药抗肿瘤活性成分纳米递送系统在临床上的实际应用提供参考。     

How to improve CHMs quality: enlighten from CHMs ecological cultivation

Chinese herbal medicines (CHMs) are one of the important bioresources of medicine, which works by unlocking nature''s ability to prevent diseases and recover from illnesses. Recently, it has ascended to the world stage and become a global icon. Nowadays, a considerable of researches have focused on the quality evaluation of CHMs. However, it is difficult to meet the reasonable needs of human beings for safe drug use to evaluate the quality of a huge number of inferior goods for the CHMs contaminated by pesticides and heavy metals. Hence to explore an eligible medicinal plant cultivation pattern, which can provide high quality CHMs sustainably, is most promising. This review analyzed the situation and characteristics of medicinal plant resources in different periods, including wild-harvested resources and domestic cultivation during different stages, putting forward that ecological cultivation must be the way to develop medicinal plant cultivation and to obtain high quality CHMs.     

山东道地药材瓜蒌中无机元素及农药残留量的检测

目的 检测山东道地药材瓜蒌中无机元素和农药残留量.方法 用原子吸收光谱法、原子荧光光谱法测定无机元素,以气相色谱法测定农药残留量.结果 与结论 6个栽培品种15个瓜萎样本的重金属和农药残留均符合国内外的相关标准,并拟订了瓜蒌药材中有害物质的限量.