还原型谷胱甘肽辅助强化期治疗初治肺结核患者的效果及对血清GPX、XOD、MDA、SOD、GST水平的影响

目的探讨还原型谷胱甘肽辅助强化期治疗初治肺结核患者的效果及对血清谷胱甘肽过氧化物酶(GPX)、黄嘌呤氧化酶(XOD)、丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽转移酶(GST)水平的影响。方法选取2015年12月—2016年6月衡水市第三人民医院收治的初治肺结核90例,随机分为观察组和对照组两组各45例,对照组给予常规抗结核治疗(异烟肼、利福平、吡嗪酰胺及乙胺丁醇),观察组在对照组治疗基础上强化期加用还原型谷胱甘肽。观察比较两组治疗前及治疗后2、4、8周血清GPX、XOD、MDA、SOD和GST水平及治疗后治疗有效率、药物性肝损伤情况。结果治疗后2周,观察组GST水平高于对照组,差异有统计学意义(P0.05)。治疗后4和8周,观察组XOD、MDA水平明显低于治疗前,GPX、SOD、GST水平明显高于治疗前,差异有统计学意义(P0.05);观察组XOD、MDA水平较对照组显著下降,GPX、SOD、GST水平较对照组升高,差异有统计学意义(P0.05)。治疗后1和2个月,观察组治疗有效率均高于对照组,差异有统计学意义(P0.05)。治疗后2、4及8周观察组药物性肝损伤发生率均低于对照组,差异有统计学意义(P0.05)。结论常规抗结核治疗基础上强化期加用还原型谷胱甘肽可通过增强抗氧化能力提高初治肺结核患者治疗效果。     

胸腺因子D与黄芪治疗老年肺结核30例疗效分析

目的探讨胸腺因子D与黄芪在初治老年肺结核治疗中的疗效和安全性。方法　采用随机配对法 ,将 6 0例初治涂阳老年肺结核患者分为观察组 (30例 )和对照组 (30例 )。观察组化疗方案为 2HRZE/ 4HR加用胸腺因子D与黄芪 ;对照组化疗方案 2HRZE/ 4HR ,不加用胸腺因子D与黄芪。结果　观察组治疗的前3个月痰涂片阴转率 ,显著高于对照组 (P <0 .0 5 ) ,疗程满 6个月后 ,两组痰涂片阴转率无显著差异(P >0 .0 5 ) ,病灶明显好转及空洞关闭率观察组优于对照组。观察组的细胞免疫功能显著改善。结论　胸腺因子D与黄芪能改善初治老年肺结核患者的细胞免疫功能 ,利于痰菌阴转、病灶吸收、空洞关闭 ,而且不良反应少且较轻微 ,可作为初治老年肺结核的免疫治疗和短程化疗的辅助治疗。     

兰索拉唑对胃溃疡患者血浆MDA、SOD、NO及ET-1表达的影响

目的观察兰索拉唑对胃溃疡患者血浆多种因子表达的影响。方法将185例胃溃疡患者随机分成奥美拉唑组(90例)和兰索拉唑组(95例),另外选择同期健康体检人员90例作为对照组。观察对照组及胃溃疡患者治疗前和治疗4周后血浆丙二醛(MDA)、超氧化物歧化酶(SOD)、一氧化氮(NO)及内皮素-1(ET-1)水平。结果治疗前奥美拉唑与兰索拉唑两组患者血浆MDA、SOD、NO及ET-1水平无统计学差异(P0.05);与健康对照组比较,两组患者SOD与NO水平均明显降低,而MDA与ET-1水平则显著升高(P均0.01)。治疗4个疗程后兰索拉唑组与健康对照组血浆MDA及ET-1水平明显低于奥美拉唑组,而SOD及NO水平则显著高于奥美拉唑组(P均0.05)。结论兰索拉唑对胃溃疡患者血浆MDA、SOD、NO及ET-1水平的影响大于奥美拉唑,表明其在该病中有更高的治疗价值,值得临床应用及推广。     

富氢水干预对耐力训练大鼠氧化-抗氧化能力的影响

目的:观察自由饮用富氢水8周,中等强度耐力训练大鼠氧化应激损伤指标、抗氧化指标的变化,分析富氢水对运动性氧化应激损伤的保护作用。方法:将40只110—140g SD雄性大鼠随机分为4组:安静对照组(N=8,C组);运动对照组(N=12,CS组);补充富氢水组(N=8,H组);补充富氢水运动组(N=12,HS组)。C组、CS组大鼠自由进食,饮水。H组、HS组大鼠自由进食,饮用富氢水,实验共持续8周。自第5周开始,CS组、HS组大鼠进行中等强度耐力跑台训练,训练4周。训练结束后次日,全部大鼠在24h内心尖取血,分离血清。测定血清氧化应激指标(MDA、8-OHdG、3-NT);抗氧化指标(TAOC、T-SOD、CAT、GSH-Px)。结果:①大鼠血清8-OHdG、3-NT指标无组间差异;运动对照组大鼠血清MDA含量显著高于安静对照组(P0.05);补充富氢水运动组大鼠血清MDA含量显著低于运动对照组(P0.05)。②大鼠血清T-SOD活性水平无组间差异;运动对照组大鼠血清CAT活性极显著高于安静对照组(P0.01);补充富氢水运动组大鼠血清CAT活性、GSH-Px活性、T-AOC水平均显著高于运动对照组(P0.05)。结论:4周中等强度耐力训练引起大鼠脂质过氧化损伤,8周自由饮用富氢水显著降低运动性氧化应激引起的脂质过氧化损伤并显著提高大鼠的抗氧化能力。     

五酯胶囊、水飞蓟素防治药物性肝损害的疗效评价

目的:评价五酯胶囊、水飞蓟素对抗结核药物所致肝损害的预防和治疗效果。方法:112例住院HB-sAg( )初治浸润型肺结核随机分为两组,均以2HRZE(S)/4HR方案抗结核治疗,治疗组于强化期加用五酯胶囊、水飞蓟素(西利宾胺或利加隆)。结果:治疗组47例发生可逆性中度转氨酶升高7例(14.9%);对照组65例,发生可逆性中度转氨酶升高25例(38.5%),两组差异显著(P<0.05)。同时观察HBsAg(-)住院初治浸润型肺结核102例,发生可逆性中度转氨酶升高9例(8.8%)。结论:HBsAg( )病例接受抗结核治疗易发生药物性肝损害,五酯胶囊、水飞蓟素只对部分药物性肝损害有预防和治疗作用,而对药物过敏反应在抗结核药所致药物性肝损害中起一定作用。     

两种化疗方案治疗肺结核空洞病例的疗效研究

目的:了解短程化疗方案每日用药和全程间歇短程化疗方案对初治涂阳肺结核空洞病例的近期疗效.方法:2HRZE/4HR方案,随机选择初治涂阳肺结核患者81例,A组(治疗组)肺结核空洞病例40例,B组(对照组):肺结核无空洞病例41例.2H3R3Z3E3/4H3R3,方案,随机选择初治涂阳肺结核患者82例,C组(治疗组)肺结核空洞病例41例,D组(对照组):肺结核无空洞病例41例.两组患者年龄、性别构成差异无显著性.结果:2HRZE/4HR方案,A组化疗2、3个月末痰菌阴转率分别为92.5%和95.0%,B组阴转率分别为95.1%和97.6%,差异无统计学意义(P=0.65、0.55).治愈77例,治愈率95.1%,其中,A组治愈率92.5%,B组治愈率97.6%,差异无统计学意义(P=0.30).2H3R3Z3E3/4H3R3方案,C组化疗2、3个月末痰菌阴转率分别为82.9%和87.8%,D组阴转率均为95.1%,差异无统计学意义(P=0.08,0.075).治愈69例,治愈率84.1%,其中,C组治愈率75.6%,D组治愈率92.7%,差异有统计学意义(P=0.03).比较两种化疗方案的总治愈率和对肺结核空洞病例治愈率,均以2HRZE/4HR方案为优(P=0.02,0.03),对肺结核无空洞病例治愈率差异无统计学意义(P=0.30).结论:2H3R323E/4H3R3方案用于初治涂阳肺结核无空洞病例是适宜的,初治涂阳肺结核空洞病例应首选2HRZE/4HR方案.     

异甘草酸镁联合还原型谷胱甘肽治疗化疗药物性肝损伤临床疗效观察

探讨异甘草酸镁联合还原型谷胱甘肽治疗化疗药物性肝损伤临床疗效。选取2014年3月~2016年3月在本科室就诊的100例化疗药物性肝损伤患者。按照就诊顺序分为对照组和观察组各50例。对照组采用还原型谷胱甘肽治疗,观察组采用异甘草酸镁联合还原型谷胱甘肽治疗。观察两组患者治疗有效情况、血清谷草转氨酶(ALT)和谷丙转氨酶(AST)变化水平等。观察组患者有效率明显高于对照组,差异有统计学意义(P0.05);治疗后两组患者ALT水平、AST水平水平显著低于治疗前,且观察组患者改善情况显著优于对照组,差异有统计学意义(P0.05)。应用异甘草酸镁联合还原型谷胱甘肽治疗化疗药物性肝损伤,疗效显著,可有效改善患者ALT水平和AST水平,值得在临床推广应用。     

初治结核病患者预防使用保肝药物对药物性肝损伤的价值研究

目的研究初治结核病患者预防使用保肝药物对抗结核药物引起的药物性肝损伤(drug-induced liver injury,DILI)的临床价值。方法选取2015年12月—2017年12月我院收治226例出现DILI的初治肺结核,依据治疗方法不同,分为观察组(n=122)与对照组(n=104)。观察组予规范抗结核及预防性保肝药物治疗,对照组予规范抗结核治疗。两组发生DILI后均停用所有药物,并且予以相应治疗,直至DILI恢复正常1周后停药。检测治疗前、出现DILI时、治疗后肝功能相关指标变化,记录DILI分型、分级、发生时间及肝功能恢复正常时间,比较CD4+T淋巴细胞计数及合并疾病。结果与对照组比较,观察组出现DILI时总胆红素水平及治疗后碱性磷酸酶水平均下降,差异有统计学意义(P 0. 05)。两组DILI分型比较差异无统计学意义(P 0. 05);两组DILI分级仅1级损伤比较差异有统计学意义(P=0. 004)。观察组、对照组发生3级及以上DILI的概率分别为9. 02%(11/122)、18. 27%(19/104),比较差异有统计学意义(P=0. 04)。观察组DILI发生时间为8～75(17. 40±13. 43) d,对照组DILI发生时间为2～55(10. 28±11. 92) d,比较差异有统计学意义(P=0. 008)。两组肝功能未完全恢复情况比较差异有统计学意义(P=0. 002),但3级及以上DILI患者肝功能未完全恢复情况比较差异无统计学意义(P=0. 85)。两组CD4+T淋巴细胞计数、发生3级及以上DILI患者CD4+T淋巴细胞计数比较差异均无统计学意义(P 0. 05)。两组3级及以上DILI合并疾病比较差异无统计学意义(P=0. 72)。结论预防性给予保肝药物对初治结核病患者的肝功能无明显保护作用,但对部分具有肝损伤高危因素或免疫力低下的患者来说,预防性使用保肝药物对抗结核药物引起的DILI有一定益处。     

依帕司他对糖尿病周围神经病变患者SOD、MDA水平的影响及疗效分析

目的探讨依帕司他对糖尿病周围神经病变患者超氧化物歧化酶(SOD)、丙二醛(MDA)水平的影响及疗效。方法选取某院2016年4月至2018年3月收治的糖尿病周围神经病变患者60例进行研究。按照治疗方案不同,分为对照组(31例)和观察组(29例)。两组患者均在药物控糖的基础上,对照组采用甲钴胺口服治疗,观察组采用依帕司他口服治疗,两组患者治疗时长均为3个月。3个月后,对比两组患者临床疗效、治疗前后SOD、MDA水平、不良反应发生情况。结果治疗后,观察组总有效率(93.10%)与对照组(67.71%)比较显著更高(P0.05)。两组患者治疗后SOD水平较治疗前均明显升高,且观察组显著高于对照组;MDA水平较治疗前明显降低,且观察组显著低于对照组(P0.05)。两组患者在治疗期间均有不良反应发生,其中对照组发生率(35.48%)明显高于观察组(10.34%),P0.05。结论依帕司他治疗糖尿病周围神经病变,可显著改善患者SOD、MDA水平,提高临床疗效。     

不同血透方式对糖尿病肾病患者氧化应激及微炎症状态的影响

目的探讨不同血液透析方式对糖尿病肾病(DN)患者氧化应激及微炎症状态的影响。方法选取2017年6月—2018年6月在本院接受维持性血液透析治疗(MHD)的70例患者为研究对象,将其按照随机数字表法分为观察组和对照组,每组各35例;对照组接受普通血液透析(HD)治疗,观察组接受高通量血液透析(HFHD);对比两组治疗前后的超敏C反应蛋白(hs-CRP)、丙二醛(MDA)、过氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)水平。结果观察组治疗后,MDA水平较治疗前明显降低(P0.05),SOD、GSH-Px水平均较治疗前明显上升(P0.05);治疗后,观察组MDA、SOD、GSH-Px水平均明显优于对照组(P0.05);观察组治疗后hs-CRP、IL-6、TNF-α水平较治疗前明显降低(P0.05);观察组治疗后hs-CRP、IL-6、TNF-α水平均明显低于对照组,差异有统计学意义(P0.05)。结论 HFHD有助于缓解DN患者的氧化应激与微炎症状态,提高患者生活质量,可在临床推广。     

Cellular uptake and efflux of azithromycin, erythromycin, clarithromycin, telithromycin, and cethromycin

Macrolide antibiotics have an outstanding ability to concentrate within host cells, particularly phagocytes. In the study described in this paper five different macrolide antibiotics were compared regarding the uptake and release kinetics in human peripheral blood polymorphonuclear neutrophils (PMNs) and three different cell lines, two phagocytic cell lines (RAW 264.7 and THP-1) and an epithelial cell line (MDCK). Based on the results obtained, the substances tested could be clustered into different groups. Azithromycin constituted the first group, characterized by rapid and nonsaturable uptake into phagocytic cells and a high degree of retention in the preloaded cells. The second group included erythromycin and clarithromycin. These two substances do not exhibit cell specificity; consequently, they are taken up to a similar extent and are released by all cell types studied. Ketolides constituted the last group. Their uptake was saturable in cells of monocytic lineage as well as in nondifferentiated cells of myeloid lineage, and they were rapidly released from all the cell lines studied. However, in PMNs, ketolide uptake was not saturable; and unlike telithromycin, cethromycin rapidly egressed from the loaded cells.     

Comparative Activities of Clinafloxacin, Grepafloxacin, Levofloxacin, Moxifloxacin, Ofloxacin, Sparfloxacin, and Trovafloxacin and Nonquinolones Linozelid, Quinupristin-Dalfopristin, Gentamicin, and Vancomycin against Clinical Isolates of Ciprofloxacin-Resistant and -Susceptible Staphylococcus aureus Strains

The activities of eight fluoroquinolones and linezolid, quinupristin-dalfopristin (Synercid), gentamicin, and vancomycin were tested against 96 ciprofloxacin-susceptible and 205 ciprofloxacin-resistant Staphylococcus aureus strains. Overall, clinafloxacin, followed by moxifloxacin and trovafloxacin, was the most active quinolone tested. For all isolates, linezolid and quinupristin-dalfopristin showed activities that were at least comparable to vancomycin, with no cross-resistance to any other test compound.     

Attributional,life-event,and affective predictors of onset of depression,anxiety, and negative attributional style

This investigation examined (1) the extent to which negative attributional style and life events predict the development of depression and anxiety, and (2) the extent to which measures of life events, depression, and anxiety predict the development of negative attributional style. Sets of questionnaires, including the Attributional Style Questionnaire (ASQ), the Multiple Affect Adjective Check List (MAACL), the Beck Depression Inventory (BDI), the Stimulus-Response Inventory of General Trait Anxiousness (SR-GTA), and the Life Experiences Survey (LES), were administered to 80 undergraduate students on two occasions separated by a 1-month interval, between midterm and final examination periods of an academic semester. Results of hierarchical multiple regression analyses indicated that (1) composite negative attributional style predicted the onset of anxiety, measured by the MAACL anxiety scale, and (2) depression, measured by the MAACL depression scale, and low amounts of desirable life events each predicted the onset of composite negative attributional style.This research was partially supported by the Temple University Research Incentive Fund to the second author. We thank Edward Gracely for his assistance in the data-analytic process.     

Worry, Procrastination, and Perfectionism: Differentiating Amount of Worry, Pathological Worry, Anxiety, and Depression

This study investigates features that differentiate worry from somatic anxiety and depression. Theoretical models of the worry process suggest that worry is closely related to procrastination. In addition, research on worry and elevated evidence requirements proposes a relationship between worry and perfectionism. Perfectionism, however, is multidimensional in nature. Moreover, previous research has linked procrastination and perfectionism mainly to anxiety and depression. Therefore, the relationship among worry, procrastination, and dimensions of perfectionism was investigated in a sample of 180 students, controlling for anxiety and depression. Results show that worry had substantial correlations with procrastination and perfectionism, particularly with perfectionist concern over mistakes and doubts. Moreover, worry was related to parental criticism and expectations, but unrelated to excessively high personal standards. Instead, high-worriers reported to lower standards under stress. Partial correlations indicated that these correlations were specific for amount of worry, thus differentiating amount of worry, pathological worry, anxiety, and depression.     

Absorption, distribution, metabolic fate, and elimination of pefloxacin mesylate in mice, rats, dogs, monkeys, and humans

Pefloxacin mesylate is well absorbed by the oral route. The antimicrobial activity in dog, cynomolgus monkey, and human plasma was essentially due to unchanged drug which respectively accounted for 64, 94, and 84% of the total activity (ratios derived from relative area under the curve [AUC] values). Half-lives ranged from 1.9 h in mice to 8.6 h in humans. Protein binding was weak, about 20% in plasma. Except in brain, concentrations in most of the organs and tissues tested in rats and dogs were higher than the plasma levels. Microbiological activity in urine was mainly due to pefloxacin and norfloxacin, the N-desmethyl metabolite. The norfloxacin/pefloxacin ratios were 0 in mice, ca. 1 in rats and dogs, 1.6 in cynomolgus monkeys, and 2.3 in humans. The principal urinary compounds were unchanged drug in mice, pefloxacin glucuronide and pefloxacin N-oxide in rats and dogs, norfloxacin and pefloxacin in monkeys, and pefloxacin N-oxide and norfloxacin in humans. The urinary recovery of identified metabolites was 29.5% of the dose in mice, 37.8% in rats, 36.3% in dogs, 26.5% in monkeys, and 58.9% in humans. Biliary excretion occurred and was extensive in rats and dogs, mainly as a glucuronide conjugate of the drug. In rat and human bile, the main active compound was unchanged pefloxacin.     

Cancers of the prostate, penis, and testicles: epidemiology, prevention, and treatment

Cancer is a disease that most people fear. Nurses are required to provide information on how to avoid cancer, and, once the diagnosis is made, how to cope with it. Prevention and early detection of the cancers described in this article are in the very early stages of knowledge development, but general health promotion guidance can be offered on how to avoid most cancers (ie, no tobacco use, a high-fiber and low fat diet, exercise, and maintaining a normal weight). Nurses also can advise patients to be screened for colorectal cancer at the appropriate ages and time intervals and to be aware as new developments occur in the scientific base for screenings in the areas of prostate, penile, and testicular cancer. Finally, coping with these forms of cancer often requires the patient to make major lifestyle and psychological changes, especially if surgery in the genital area occurs. Decreased libido, incontinence, and impotence are major complications that can occur with these illnesses. The male cancers described vary tremendously in their prevalence, incidence, mortality, treatment, and survival rates. Within this group, there are remarkably positive outcomes and outcomes much in need of improvement. Penile and testicular cancers are the bright spots in this picture; both are uncommon, and both are eminently treatable. Prostate cancer, on the other hand, is quite common, difficult to screen, difficult to treat without major sexual problems, and yet receives relatively little funding from the NIH. Although as many men die from prostate cancer as women die from breast cancer, NIH funds breast cancer research at much higher levels than prostate cancer. According to the latest data available at the NIH Web site, during the 1990s, the amount of NIH funding varied from four times more for breast cancer (1993) to 2.9 times more in 1999. For fiscal year 2002, NIH is providing $522 million in funding for breast cancer and $278 million for prostate cancer. Private foundation funds for prostate cancer are much smaller than those available for breast cancer. Both types of cancer are extremely important to address, and both should receive adequate research attention. Nurses can advocate for more funding for prostate cancer, from basic science approaches to behavioral science strategies.     

Effect of 5-fluorouracil, mitoxantrone, methotrexate, and vincristine on the antibacterial activity of ceftriaxone, ceftazidime, cefotiam, piperacillin, and netilmicin

Using the checkerboard agar dilution technique, antibacterial activity and in vitro interactions of 4 antineoplastic agents and 5 antimicrobial drugs were examined against 56 strains of 7 bacterial species. 5-fluorouracil was found to inhibit all strains of Staphylococcus aureus and of Staphylococcus epidermidis at a concentration of 0.8 micrograms/ml or less. 84% of all gram-negative strains were inhibited synergistically when 5-fluorouracil was combined with beta-lactam antibiotics. Methotrexate and cefotiam were antagonistic in 42% of all combinations, especially when tested against Escherichia coli and Klebsiella pneumoniae.