咳露口服液联合酮替芬治疗咳嗽变异性哮喘的疗效观察

目的探讨咳露口服液联合酮替芬治疗咳嗽变异性哮喘的临床疗效和安全性。方法选取2016年11月—2017年11月于洛阳市中心医院就诊的咳嗽变异性哮喘患者120例,随机分成对照组和治疗组,每组各60例。对照组口服富马酸酮替芬片,1片/次,2次/d;治疗组患者在对照组的基础上口服咳露口服液,15 mL/次,3次/d。两组患者均连续治疗2个月。观察两组患者临床疗效,同时比较治疗前后两组患者哮喘控制测试(ACT)评分、日常生活活动(ADL)评分、咳嗽症状积分、嗜酸性粒细胞(EOS)绝对值、肺功能和不良反应。结果治疗后,对照组和治疗组临床有效率分别为81.67%和95.00%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者ACT和ADL评分显著升高(P0.05),咳嗽症状积分显著降低(P0.05),且治疗组患者ACT、ADL及咳嗽症状积分水平明显好于对照组(P0.05)。治疗后,两组EOS绝对值显著降低(P0.05),肺功能指标用力肺活量(FVC)和第1秒钟用力呼吸容积(FEV1)显著升高(P0.05),且治疗组患者EOS绝对值及肺功能较对照组患者改善更明显(P0.05)。治疗期间,治疗组患者不良反应发生率为3.33%,显著低于对照组的15.00%,两组比较差异具有统计学意义(P0.05)。结论咳露口服液联合酮替芬治疗咳嗽变异性哮喘疗效显著,安全性好,具有一定的临床推广应用价值。     

吸入糖皮质激素联合阿斯美、酮替芬治疗咳嗽变异型哮喘的疗效观察

目的 探讨吸入性糖皮质激素联合阿斯美、酮替芬治疗咳嗽变异型哮喘临床疗效.方法 对64 例咳嗽变异型哮喘患者随机分成2 组,对照组应用吸入性糖皮质激素,治疗组应用吸入性糖皮质激素联合阿斯美、酮替芬进行治疗,将其疗效进行对比.比较两组临床症状的改善程度和药物不良反应发生情况.结果 治疗组咳嗽症状痊愈率和总有效率(25.00%,84.38%)均明显优于对照组(6.25%,56.25%)(P＜ 0.05).结论 阿斯美加酮替芬可迅速缓解咳嗽变异型哮喘的咳嗽症状,且不良反应少,安全性好.     

博利康尼加酮替芬治疗咳嗽变异性哮喘61例临床观察

目的 探讨博利康尼和酮替芬治疗咳嗽变异性哮喘的临床疗效及安全性.方法 将117例咳嗽变异性哮喘患者随机分为治疗组61例,对照组56例.治疗组口服博利康尼及酮替芬片治疗,对照组给予舒喘灵加服异丙嗪,同时予抗感染、止咳祛痰等治疗,疗程均为2w.结果 治疗2w末,治疗组显效率为72.13%,总有效率为95.08%,对照组显效率为35.71%,总有效率为73.21%,两组比较有极显著性差异(P＜0.005).结论 博利康尼和酮替芬治疗咳嗽变异性哮喘疗效显著.     

博利康尼加酮替芬治疗咳嗽变异性哮喘61例临床观察

目的 探讨博利康尼和酮替芬治疗咳嗽变异性哮喘的临床疗效及安全性.方法 将117例咳嗽变异性哮喘患者随机分为治疗组61例,对照组5 6例.治疗组口服博利康尼及酮替芬片,对照组给予舒喘灵加服异丙嗪,同时予抗感染、止咳祛痰等治疗,疗程均为2w.结果 治疗2w末,治疗组显效率为72.13%,总有效率为95.08%,对照组显效率为35.71%,总有效率为73.21%,两组比较有极显著性差异(P＜0.005).结论 博利康尼和酮替芬治疗咳嗽变异性哮喘疗效显著.     

孟鲁司特联合酮替芬治疗儿童咳嗽变异性哮喘的疗效观察

目的：观察孟鲁司特联合酮替芬治疗儿童咳嗽变异性哮喘的疗效及安全性。方法：80例咳嗽变异性哮喘患儿随机分为观察组与对照组。两组患儿均予以特布他林5 mg雾化吸入,bid,急性期后停止使用,并予以酮替芬片0.5～1 mg,po bid,连用4周。观察组在此基础上加用孟鲁司特钠咀嚼片2.5～5 mg,qd,连用4周。观察两组患儿咳嗽缓解及消失时间、肺功能改善情况,评价两组疗效及安全性。结果：观察组患儿咳嗽缓解时间及消失时间均短于对照组（P〈0.05）。两组患儿治疗前肺功能比较,差异无统计学意义（P〉0.05）。治疗4周后,两组患儿肺功能均较治疗前改善（P〈0.05或0.01）,且观察组改善幅度明显优于对照组（P〈0.05或0.01）;观察组治疗总有效率明显优于对照组,两组患儿均未出现药品不良反应。结论：孟鲁司特联合酮替芬治疗儿童变异性哮喘能迅速的缓解患儿的咳嗽症状,改善肺功能,提高疗效,且安全性好。     

孟鲁斯特防治儿童咳嗽变异性哮喘临床观察

目的观察孟鲁斯特治疗儿童咳嗽变异性哮喘的临床疗效。方法将62例咳嗽变异性哮喘（CVA）患儿随机分为治疗组32例,对照组30例,所有患儿均给予特步他林口服,至症状消失后停药,治疗组同时给予孟鲁斯特口服,对照组给予酮替芬口服,两药总疗程均为4周,分别记录咳嗽明显缓解的时间和咳嗽消失的时间。结果治疗组与对照组疗效差异有非常显著意义（P〈0．01）。结论孟鲁斯特治疗儿童咳嗽变异性哮喘的临床疗效疗效显著,且不良反应少,值得临床推广。     

34例小儿过敏性咳嗽的临床分析

目的探讨小儿过敏性咳嗽的临床特点及疗效观察,观察舒喘灵联合酮替芬治疗咳嗽变异性哮喘的临床效果及安全性。方法34例患者均给予舒喘灵0.1mg/(次?kg),口服,3次/d;酮替芬0.5～lmg,2次/d,疗程2～4周,所有患者均给予对症治疗,适当应用抗生素及止咳治疗。结果小儿过敏性咳嗽患儿的临床表现不典型,误诊率高。本组显效23例,有效8例,无效3例,总有效率为91.18%。其中6例出现心率增快,3例出现头疼、面部潮红,均不影响治疗,停药后消失。结论舒喘灵联合酮替芬治疗咳嗽变异性哮喘可迅速降低气道高反应性,抑制迟发哮喘反应,抑制气道炎性反应,促进过敏性咳嗽症状消失,临床效果理想。     

盐酸丙卡特罗联合酮替芬治疗小儿咳嗽变异性哮喘临床观察

目的探讨盐酸丙卡特罗联合酮替芬治疗小儿咳嗽变异性哮喘的短期临床疗效。方法将86例咳嗽变异性哮喘患儿随机分为治疗组及对照组各43例,治疗组口服盐酸丙卡特罗和酮替芬片,对照组口服沙丁胺醇片,同时两组均给予抗感染及综合对症治疗。结果治疗组总有效率88.37%,对照组总有效率46.51%,两组比较差异有统计学意义(P<0.05)。结论盐酸丙卡特罗联合酮替芬治疗小儿咳嗽变异性哮喘疗效显著。     

氯蕾他定联合酮替芬治疗小儿咳嗽变异性哮喘85例临床观察

目的观察氯蕾他定联合酮替芬治疗咳嗽变异性哮喘的临床疗效。方法将85例咳嗽变异性哮喘患儿分为治疗组45例和对照组40例,观察组给予氯蕾他定合酮替芬,其中氯蕾他定5～10mg/次,1次/d;酮替芬0.5mg/次,2次/d。对照组只给予酮替芬0.5mg/次,2次/d。结果观察组患儿经治疗后总有效率与对照组比较差异有统计学意义（P〈0.01）;复发例数两组比较差异有统计学意义（P〈0.01）。结论口服氯蕾他定联合酮替芬治疗咳嗽变异性哮喘临床效果优于单纯酮替芬治疗,且不良反应发生率低。     

舒喘灵联合酮替芬治疗咳嗽变异型哮喘临床观察

目的观察舒喘灵联合酮替芬治疗咳嗽变异性哮喘的临床效果及安全性。方法34例患者均给予舒喘灵0.1 mg/（次·kg）,口服,3次/d;酮替芬0.5-1 mg,2次/d,疗程2-4周,所有患者均给予对症治疗,适当应用抗生素及止咳治疗。结果本组显效23例,有效8例,无效3例,总有效率为91.18%。其中6例出现心率增快,3例出现头疼、面部潮红,均不影响治疗,停药后消失。结论舒喘灵联合酮替芬治疗咳嗽变异性哮喘可迅速降低气道高反应性,抑制迟发哮喘反应,抑制气道炎性反应,促进过敏性咳嗽症状消失,临床效果理想。     

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.     

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.     

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.