沙美特罗替卡松粉吸入剂引起皮疹的分析与思考

1例7岁女童,诊断为支气管哮喘,应用沙美特罗替卡松粉吸入剂3 d后出现全身皮疹,既往无药物过敏史,之后检查过敏原发现牛奶过敏为4级,最终判断为沙美特罗替卡松粉吸入剂中的辅料乳糖引起的过敏反应。     

沙美特罗氟替卡松联合孟鲁司特钠治疗慢性支气管炎临床观察

目的：对在慢性支气管炎治疗中,运用沙美特罗氟替卡松粉吸入剂与孟鲁司特钠的效果进行观察。方法：通过随机对照研究,对比观察组采用沙美特罗氟替卡松联合孟鲁司特钠治疗,对照组采用沙美特罗氟替卡松治疗的临床效果及肺功能改善情况。结果：观察组总有效率为92.59%,对照组总有效率为70.37%;观察组肺功能各项指标改善效果更加显著。结论：在慢性支气管炎治疗中,采用沙美特罗氟替卡松粉吸入剂与孟鲁司特钠进行联合治疗效果显著。     

沙美特罗氟替卡松粉吸入剂在儿童哮喘治疗中的临床疗效观察

目的观察沙美特罗氟替卡松粉吸入剂（舒利迭）在治疗儿童哮喘中的临床疗效。方法将130例患有哮喘的儿童随机分为研究组和对照组,每组65例,所有患儿均停用原来治疗哮喘的药物,研究组给予沙美特罗氟替卡松粉吸入剂,对照组给予氟替卡松（辅舒酮）进行治疗。结果患儿在接受药物治疗后的肺功能有明显的改善,且研究组改善更为明显。研究组患者的有效率明显高于对照组。两组差异均具有统计学意义（P〈0.05）。结论沙美特罗氟替卡松粉吸入剂能够很好地治疗儿童哮喘,对缓解症状和改善肺功能均能起到良好效果。     

药品行政保护品种介绍：其他类药物(七)(续完)

<正>沙美特罗羟萘甲酸盐/氟替卡松丙酸酯粉吸入剂通用名：沙美特罗羟萘甲酸盐/氟替卡松丙酸酯粉吸入剂(salmeterol xinafonate/fluticasone propionate)。商品名：舒利迭准纳器粉吸入剂。沙美特罗羟萘甲     

噻托溴铵联合沙美特罗/丙酸氟替卡松治疗COPD稳定期患者的疗效观察和护理

目的观察沙美特罗替卡松（舒利迭）联合噻托溴铵粉吸入剂（思力华）对慢性阻塞性肺疾病（COPD）的治疗效果。方法采用随机、双盲的方法将48例COPD患者分为观察组和对照组,观察组A组给予噻托溴铵和沙美特罗/丙酸氟替卡松治疗,对照组B组给予沙美特罗/丙酸氟替卡松治疗。分别对两组患者治疗前后的呼吸困难的评分、肺功能的检测和6 min步行距离（6MWT）的情况进行比较。结果治疗3个月后,与对照组比较,观察组肺功能指标FEV1、FEV1/FVC%、生活质量评分及6MWT,差异有统计学意义（P〈0.05）。结论噻托溴铵与沙美特罗替卡松联合吸入治疗COPD,疗效优于沙美特罗替卡松单药治疗。     

吸入沙美特罗与氟替卡松复合制剂治疗慢性阻塞性肺疾病疗效观察

目的探讨联合吸入沙美特罗与氟替卡松治疗慢性阻塞性肺疾病（COPD）在控制症状、改善肺功能、改善健康状况等方面的作用及安全性。方法450例COPD患者采用完全随机设计方法分为3组：沙美特罗与氟替卡松组150例，在常规治疗基础上给予沙美特罗与氟替卡松复合制剂，50μg／250ixg，2次／d；氟替卡松组150例，在常规治疗基础上给予氟替卡松，250μg／次，2次／d；对照组150例，只给予常规治疗。测量用力肺活量、第一秒用力呼气容积（FEV1）等肺功能参数，观察症状控制情况、急性发作次数以及患者健康状况的改变情况。结果试验周期为12个月，沙美特罗与氟替卡松组和氟替卡松组FEV1均显著高于对照组[（1173±10）ml和（1110±11）m1对比（1084±10）ml，P〈0．05]；沙美特罗与氟替卡松组在症状的控制、健康状况的改善方面亦明显好于对照组。各组发生药物不良反应情况无统计学意义。结论吸入沙美特罗与氟替卡松复合制剂治疗COPD可以良好控制临床症状、改善肺功能状况，药物不良反应发生率低。     

沙美特罗氟替卡松粉吸入剂治疗慢性阻塞性肺疾病的疗效观察

目的:观察沙美特罗氟替卡松粉吸入剂治疗慢性阻塞性肺疾病(COPD)的疗效。方法:将348例患者随机分为试验组(180例)和对照组(168例),试验组在综合治疗的基础上加用沙美特罗氟替卡松粉吸入剂,每次1吸(50μg沙美特罗、250μg丙酸氟替卡松),bid;对照组仅采用综合疗法,15d为1个疗程。结果:试验组临床症状、肺功能改善明显优于对照组(P<0.05)。结论:沙美特罗氟替卡松粉吸入剂适用于治疗COPD患者,有良好的辅助疗效。     

沙美特罗氟替卡松吸入治疗对COPD稳定期患者肺功能影响

目的探讨沙美特罗氟替卡松吸入治疗对COPD稳定期患者肺功能影响。方法回顾性分析100例COPD稳定期患者沙美特罗氟替卡松治疗组同非沙美特罗氟替卡松组治疗前后通过对肺功能检查变化讨论沙美特罗氟替卡对稳定期COPD患者肺功能影响。结果沙美特罗氟替卡松组治疗前后肺功能变化差异有显著性,非沙美特罗氟替卡松组大部分肺功能指标差异无显著性。结论沙美特罗氟替卡松吸入治疗对COPD稳定期患者显著改善肺功能,减少急性发作频率和改善症状。可作为COPD稳定期治疗的一线药物。     

沙美特罗氟替卡松粉吸入剂治疗慢性阻塞性肺疾病急性加重期的疗效观察

目的观察沙美特罗氟替卡松粉吸入剂治疗慢性阻塞性肺疾病急性加重期（AECOPD）的临床疗效。方法将70例AECOPD患者随机分为对照组和治疗组各35例。对照组仅予以常规内科治疗,治疗组在对照组治疗基础上加用沙美特罗氟替卡松粉吸入剂治疗。比较2组临床疗效及不良反应发生率。结果治疗组显效率和总有效率分别为57.1%、91.4%,高于对照组的28.6%、71.4%,差异均有统计学意义（P〈0.05）。治疗组不良反应发生率为8.6%,对照组为5.7%,2组比较差异无统计学意义（P〉0.05）。结论沙美特罗氟替卡松粉吸入剂治疗AECOPD疗效显著。     

沙美特罗替卡松粉吸入剂治疗支气管哮喘的疗效研究

目的：探讨沙美特罗替卡松粉吸入剂治疗支气管哮喘的临床疗效。方法选取我院2011年1月—2014年1月收治的支气管哮喘患者76例,随机分为观察组38例和对照组38例,观察组给予沙美特罗替卡松粉吸入剂治疗,对照组给予丙酸氟替卡松吸入治疗。观察比较治疗前后两组支气管哮喘患者肺功能的改变及治疗效果。结果两组临床有效率、用力肺活量（FVC）、最大呼气峰流速（PEF）和第1秒末用力呼气容积（FEV1）比较,差异均有统计学意义（P 〈0.05）。结论沙美特罗替卡松粉吸入剂治疗支气管哮喘疗效确切。     

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.     

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.