车前番泻颗粒治疗老年慢性功能性便秘的临床疗效研究

目的 观察车前番泻颗粒治疗老年慢性功能性便秘患者的疗效和安全性.方法 选择80例慢性功能性便秘老年患者,随机均分为治疗组和对照组.治疗组选用车前番泻颗粒治疗,疗程2周;观察组选用乳果糖治疗,疗程2周.观察排便次数、大便性状的变化及伴随症状的情况.结果 车前番泻颗粒和乳果糖均可使多数老年慢性功能性便秘患者大便的次数、性状恢复至正常或缓解,且车前番泻颗粒的疗效明显高于乳果糖,有显著性差异(P<0.05).药物不良反应发生率差异无显著性(P>0.05).结论 车前番泻颗粒为一种治疗老年功能性便秘安全、非常有效的药物.     

替加色罗片对慢性便秘患者的消化不良症状、胃电活动、胃肠传输和肛管直肠功能的影响

目的:研究口服替加色罗对慢性便秘患者伴随的消化不良症状、胃电活动、胃肠传输和肛管直肠功能的影响。方法:43例慢性便秘患者进行口服4周替加色罗6mg每日两次或安慰剂随机双盲治疗。治疗前后用消化不良症状问卷、不透X线标记物法、胃电图和直肠肛管测压法评估患者消化不良症状、胃电活动、胃肠传输和肛管直肠功能的变化。结果:与安慰剂组相比,替加色罗组慢性便秘患者伴随的消化不良症状总积分治疗后较治疗前显著降低(11.57±3.24vs5.29±1.18,P=0.024)。替加色罗组治疗后空腹-餐后胃电正常节律百分比变化较治疗前显著减小(6.58%±1.29%vs11.80%±3.85%,P=0.044)。替加色罗组患者胃内残余钡条数较治疗前显著减少(5.95±1.65vs4.57±1.65,P=0.036);结肠内残余标记物数量(7.50±2.02vs5.89±1.94,P=0.029)较治疗前显著减少,其中右半结肠(1.06±0.50vs0.67±0.23,P=0.035)和直肠乙状结肠(3.33±1.28vs1.50±1.01,P=0.017)残余标记物数显著减少。替加色罗治疗后直肠排便窘迫阈值[(25.2±1.8)mmHgvs(22.9±2.0)mmHg,P=0.028,1mmHg=0.133kPa]和最大容量感觉阈值[(32.1±2.5)mmHgvs(29.3±2.3)mmHg,P=0.043]显著降低。替加色罗治疗后初次排便感觉阈值和肛管直肠压力较治疗前无统计学差异(P>0.05)。结论:替加色罗能改善慢性便秘患者的消化不良症状,改善餐后胃电活动,加速胃肠传输,降低直肠感觉阈值,提高直肠敏感性。     

聚乙二醇4000治疗老年患者慢性功能性便秘的疗效分析

目的观察聚乙二醇4000治疗老年患者慢性功能性便秘的疗效和安全性。方法选择慢性功能性便秘老年患者72例,随机平分为治疗组和对照组。治疗组选用聚乙二醇4000治疗,每次10g,bid,疗程2周;对照组选用乳果糖治疗,每次15ml,bid。疗程2周。观察排便次数、性状的变化及伴随症状的情况。结果聚乙二醇4000和乳果糖均可使多数老年慢性功能性便秘患者的大便次数、大便性状及伴随症状恢复正常或缓解,总有效率分别为72．2％和67．7％,两组无显著性差异(P＞0．05),药物不良反应发生率分别为5．6％、11．1％,差异无显著性(P＞0．05)。结论聚乙二醇4000是一种治疗老年患者慢性功能性便秘有效而安全的药物。     

肠舒通栓治疗慢性功能性便秘的疗效观察

目的评价肠舒通栓治疗成人慢性功能性便秘的疗效。方法采用随机交叉试验设计,患者先后接受2种药物治疗,分别为肠舒通栓和开塞露治疗,疗程2周。中间间歇5~7d(洗脱期)。分别观察用药前后排便次数和大便性状的变化。结果40例纳入试验,33例完成治疗。治疗2周后平均每周排便次数分别为:5.55±1.92与4.58±2.06,二者比较有统计学意义;大便形状正常率分别为78.8%与63.6%,二者比较无统计学意义;其2周的有效率分别为84.8%、69.7%,二者比较无统计学意义。说明肠舒通栓与开塞露均能有效地缓解慢性功能性便秘患者的便秘症状,肠舒通栓在改善患者的大便次数方面更明显。通过2周治疗,乙状结肠镜检未见药物损伤局部黏膜。结论肠舒通栓短期治疗成人功能性便秘安全、有效。     

秋水仙碱与乳果糖治疗老年功能性便秘的临床研究

目的：观察秋水仙碱与乳果糖治疗老年功能性便秘的疗效及不良反应。方法84例老年功能性性便秘患者随机分为乳果糖组41例,联用秋水仙碱与乳果糖组(联用组)43例。乳果糖组口服乳果糖口服液20 ml,3次/d;联用组3次/d同时口服秋水仙碱1 mg、乳果糖口服液20 ml。观察两组患者用药后首次排便时间(h),用药后第1、2周平均排便次数和大便形态及其不良反应。结果用药后首次排便时间两组比较差异有统计学意义(P<0.05);每周排便次数和大便形态治疗后第1周与治疗前同组比较差异有统计学意义(P<0.05),联用组差异具有统计学意义(P<0.05);第1、2周同组比较差异无统计学意义(P>0.05);组间比较差异有统计学意义(P<0.05)。结论秋水仙碱和乳果糖均可用于老年功能性便秘,2种药物联用能更好地改善排便次数及大便性状;因用药时间短,没有发现明显的副作用。便秘是一个慢性过程,但不宜长期用药。     

六味能消胶囊治疗老年人功能性便秘的临床研究

目的评价六味能消胶囊治疗老年人慢性功能性便秘的临床治疗效果.方法采用随机双盲对照方法,观察66例老年人功能性便秘患者治疗前后排便次数、大便性状、排便困难症状评分、胃肠传输时间.结果六味能消胶囊组排便困难症状人均评分由治疗前基线期(11.15±0.65)下降为治疗后(3.45±0.48)(P＜0.05),对照组分别为(10.45±0.55)和(8.6±0.28)(P＞0.05);六味能消胶囊组治疗前后平均钡条残留率分别为(68±6)%和(40±3)%(P＜0.05),对照组治疗前后平均钡条残留率分别为(69±5)%和(46±6)%(P＜0.05).结论六味能消胶囊能增加老年人功能性便秘患者的排便次数、改变大便性状、加快胃肠传输时间,有较好的安全性和耐受性.     

普芦卡必利治疗功能性便秘的临床观察

目的:观察普芦卡必利治疗功能性便秘的疗效及安全性。方法:选取功能性便秘女性患者87例,给予普芦卡必利2 mg,qd,总疗程为4周,采用前瞻性自身对照研究,观察患者治疗前后排便次数、大便性状、排便困难程度的变化情况以及服药期间出现的相关不良反应。结果:治疗后患者每周大便次数逐渐增加,大便性状逐渐趋于正常,排便费力情况明显缓解。各观察指标在治疗前后比较差异均有统计学意义(P<0.01)。研究过程中未见严重不良反应发生。结论:普芦卡必利治疗功能性便秘安全、有效。     

中医药辨证治疗老年功能性便秘疗效分析

目的探讨中医药辨证治疗老年功能性便秘的临床效果。方法将122例确诊为老年功能性便秘患者分为两组,其中治疗组78患者采用芪术润肠汤辨证施治,对照组44例患者应用杜秘克与莫沙比利联合治疗。疗程3周,治疗后随访3个月,观察患者大便次数、大便性状、排便时间及排便困难症状的改善情况。结果治疗组总有效率为91.0%,对照组总有效率为72.7%,治疗组总有效率显著高于对照组,差异有统计学意义(χ2=7.16,P<0.01)。结论中医药辨证治疗老年功能性便秘临床效果好,不良反应轻微,值得在临床应用。     

乳果糖合用金双歧胶囊治疗老年功能性便秘临床观察

目的:联合应用乳果糖和金双歧胶囊治疗老年功能性便秘。通过与对照组的比较,即单用乳果糖的治疗方案,观察疗效和不良反应。方法:采用随机、平行对照研究,将老年功能性便秘患者随机分为治疗组(50例)、对照组(50例)。入选患者年龄大于或等于65周岁,患者及其家属能准确完成治疗过程中大便改变及不良反应等记录。入选排除标准为对乳果糖和金双歧胶囊等过敏、半乳糖败血症。治疗组同时服用乳果糖和金双歧胶囊,对照组服用乳果糖。治疗组口服溶液起始剂量每日30ml,维持剂量每日10～25ml,连用6周,金双歧胶囊一天两次,一次2片,连服6周;对照组口服溶液起始剂量每日30ml,维持剂量每日10～25ml,连用6周。患者及其家属每日记录内容包括服药剂量、腹痛、腹胀或腹部不适感、是否排便或排便次数、大便性状、其他不良反应等。其中大便性状根据患者及其家属记录按Bristal粪便分级评分。疗效标准:患者大便次数和性状均恢复正常为显效;患者大便次数和性状较前改善或其中一项较前改善,不影响正常生活为有效;治疗后大便次数和性状均改善不明显为无效。结果:两组经治疗后,对照组显效率52%,总有效率88%;治疗组显效率60%,总有效率96%,两组有显著差异(P<0.05),具有统计学意义。结论:乳果糖合用金双歧胶囊治疗老年功能性便秘比单用乳果糖有更高的有效率,能更好的改善患者病况,金双歧胶囊能增加乳果糖的疗效,减少副作用。     

双歧四联活菌片治疗老年慢性功能性便秘疗效分析

目的:分析双歧四联活菌片治疗老年慢性功能性便秘的临床效果。方法:56例老年慢性功能性便秘患者随机分成两组,一组口服双歧四联活菌片,另一组口服酚酞片。在连续治疗2周后和停药第八周对其大便次数和性状进行临床效果的评估并观察药物不良反应。结果:在停药第八周两组的临床效果差异有显著性。结论:双歧四联活菌片对改善老年人慢性功能性便秘有较显著疗效,不良反应小,值得推广使用。     

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.     

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.     

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.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

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.