急性出血坏死性胰腺炎肝损伤中TLR2/4mRNA的表达及氯喹的干预效应

目的： 研究急性出血坏死性胰腺炎（AHNP）肝损伤中Toll-样受体(TLR)2/4mRNA表达的变化及氯喹的干预效应。 方法：采用逆行胰胆管牛磺胆酸钠（TAC）注射造成大鼠AHNP肝损伤动物模型。动物分为假手术组（S组）、胰腺炎组和氯喹（CQ）治疗组。后2组于术后3，6，12 h分批剖杀，S组于术后6 h剖杀。观察血清淀粉酶、ALT和AST及肝组织NO和TNF-α的变化，RT-PCR方法检测各组不同时点肝组织TLR2和TLR4mRNA的表达。 结果：相对于S组，胰腺炎组大鼠3 h肝组织TLR2和TLR4mRNA表达开始增高，术后6～12 h肝组织TLR2和TLR4mRNA表达迅速达到峰值（P<0.05），肝损伤加重，血清淀粉酶升高，肝组织TNF-α浓度升高，NO浓度逐渐降低（P<0.05）；相对胰腺炎组，CQ治疗组TLR2/4mRNA表达降低（P<0.05），肝损伤程度减轻，血清淀粉酶降低，肝组织TNF-α浓度降低，NO浓度显著升高（P<0.05）。 结论：AHNP大鼠肝组织内TLR2和TLR4的基因表达上调；其表达增高可能在AHNP肝损伤的发生、发展中起重要作用。氯喹对大鼠AHNP过程中肝损伤可能有保护作用。     

特异性血小板抗体检测的实验研究

目的　建立一种简易、特异性强的血小板抗体检测方法。方法　利用磷酸氯喹溶液对血小板进行处理 ,去掉血小板相关抗原 (HLA抗原 ) ,用只含特异性抗原的血小板包被聚乙烯板来捕获血小板抗体。结果　与常用的SEPSA和淋巴细胞毒实验 (LCT)比较 ,该方法只表现血小板特异性抗体反应。结论　本方法能够鉴别血小板相关抗原的抗体和血小板特异性抗原的抗体 ,为临床血小板减少疾病的鉴别诊断、非溶血性发热反应和血小板输注无效的原因提供有用的参考依据     

氯喹对全肝缺血再灌注大鼠肺损伤的保护作用

目的 探讨氯喹对全肝缺血再灌注大鼠急性肺损伤（Au）的保护作用及其机制。方法 健康SD大鼠90只，雌雄不拘，体重300～350g，随机分为3组：假手术组（A组）、全肝缺血再灌注组（B组）、全肝缺血再灌注＋氯喹组（C组），每组30只。阻断肝门及肝上、肝下下腔静脉20min时开放血流，建立大鼠全肝缺血再灌注模型。C组于缺血前即刻经股静脉注射氯喹10mg／kg，A、B组给予等量生理盐水。于缺血20min、再灌注4h时每组分别处死10只大鼠，抽取门静脉血，测定血浆D-乳酸、内毒素（ETX）、肿瘤坏死因子-a（TNF-a）浓度，另外10只用于观察再灌注48h时大鼠生存率，并在电镜下观察肺组织超微结构的改变。结果 缺血再灌注可导致大鼠缺血期和再灌注期门静脉血D-乳酸、ETX、TNF-a浓度升高，大鼠生存率降低，肺组织超微结构严重受损，氯喹可减弱全肝缺血再灌注导致的上述改变。结论 氯喹对全肝缺血再灌注大鼠ALI有一定的保护作用，通过抑制磷脂酶A2激活，降低肠粘膜屏障通透性升高，降低肠黏膜内毒素移位。     

Chloroquine blood concentrations and malaria prophylaxis in Tanzanian women during the second and third trimesters of pregnancy

Objective: Routine malaria prophylaxis with chloroquine (CQ) is recommended to pregnant semi-immune women in several countries in Africa. The dosage is empirically based. We investigated whether blood CQ concentrations and apparent oral blood clearance (CL/F) change during the course of pregnancy. We also studied whether malaria parasites could be detected together with low CQ blood levels. Methods: Forty nine semi-immune Tanzanian women were recruited in the 16th week of pregnancy. They were given 310 mg oral CQ base once per week as prophylaxis during the whole pregnancy. Capillary blood samples were taken for analysis of CQ before treatment and at weeks 26 and 36. Blood samples were dried on filter paper and analysed by HPLC. Blood was also drawn to detect occurrence of malaria parasites. Results: A total of 25 women fulfilled the sampling schedule. CL/F increased significantly from 160 ml ·  min⁻¹ at week 26 to 180 ml · min⁻¹ at week 36. In 7 of 25 women, CL/F increased >20%. Trough blood CQ concentrations, determined on four occasions at week 26 and at week 36 varied between 200 and 900 nmol · l⁻¹. No statistically significant differences between occasions were seen. Malaria parasites were seen in two individuals early in pregnancy. Conclusion: Blood CQ CL/F showed a small increase during the course of pregnancy. The estimated mean blood CL/F values of 160 and 180 ml · min⁻¹ (week 26 and 36, respectively) were higher than the mean CL/F of 125 ml · min⁻¹ in non-pregnant individuals, published previously. Efficacy of higher dosages of CQ in malaria prophylaxis in pregnant women could, therefore, be evaluated in controlled trials in high-risk malaria areas. Received: 3 July 1996 / Accepted in revised form: 5 November 1996     

复方萘酚喹治疗间日疟的疗效观察

目的 :观察复方萘酚喹与氯喹治疗间日疟的临床疗效。方法 :以显微镜血检单纯间日疟原虫阳性患者为观察对象 ,药物为复方萘酚喹 (萘酚喹 40 0mg 青蒿素 1 0 0 0mg) ,1次顿服 ,服药后按时测量体温和血检原虫 ,随访 42天 ,观察治疗效果。结果 :复方萘酚喹治疗 1 0 9例 ,平均退热时间为 ( 1 3 0± 5 5 )h ,原虫转阴时间为 ( 1 8 1± 5 7)h,治愈率为 1 0 0 %。药后无明显不良反应。结论 :复方萘酚喹治疗间日疟具有良好的效果。     

伯氏疟原虫对青蒿素抗药性的研究

仿Peters剂量递增法用伯氏疟原虫ANKA株及N株对QHS进行了抗药性的研究。经14个月的培育至第58代,QHS im注射“4日抑制性实验”的ED₅₀在RQ/ANKA系及RQ/N系分别为其亲代系的53.4及54.6倍,但经蚊传未获成功。在第40代(I₅₀=25)时,其50%的治愈剂量为其亲代系的5.4倍。停药传代其抗性会逐渐消失。该虫系对青蒿酯钠及蒿甲醚有明显的交叉抗性,其ED₅₀分别为其亲代系的13.1及11.7倍,对伯喹的抗性为2.9倍,对氯喹未见明显交叉抗性。     

Hydroxychloroquine for the treatment of COVID-19 and its potential cardiovascular toxicity: Hero or villain?

A variety of treatment modalities have been investigated since the beginning of the Coronavirus Disease-19 (COVID-19) pandemic. The use of antimalarials (hydroxychloroquine and chloroquine) for COVID-19 treatment and prevention has proven to be a cautionary tale for widespread, off-label use of a medication during a crisis. The investigation of antimalarials for COVID-19 has also been a driver for a deluge of scientific output in a short amount of time. In this narrative review, we detail the evidence for and against antimalarial use in COVID-19, starting with the early small observational studies that influenced strategies worldwide. We then contrast these findings to later published larger observational studies and randomized controlled trials. We detail the emerging possible cardiovascular risks associated with antimalarial use in COVID-19 and whether COVID-19-related outcomes and cardiovascular risks may differ for antimalarials used in rheumatic diseases.     

Antipalúdicos en dermatología: mecanismo de acción,indicaciones y efectos secundarios

Antimalarial drugs have been in common use in dermatology since the 1950s. Their mechanism of action is complex, and it is now known that they act through various pathways. We review the indications for antimalarials in dermatology, their adverse effects, and some less well-known effects, such as their antithrombotic and hypolipidemic action. The most recent recommendations concerning ophthalmological screening in patients on antimalarials are also reviewed.     

Case report of chloroquine therapy and hypoglycaemia in type 1 diabetes: What should we have in mind during the COVID-19 pandemic?

A type 1 diabetes patient experienced remission associated with chloroquine therapy while travelling to a malaria-endemic area. Chloroquine has immunomodulatory and hypoglycaemic effects and may become more frequently used due to the COVID-19 pandemic. Patients with type 1 diabetes treated with chloroquine should be monitored for hypoglycaemia, even after recovery.