正清风痛宁联合四妙汤加减治疗痛风性关节炎的疗效

目的 观察正清风痛宁联合四妙汤加减治疗痛风性关节炎的疗效。方法 痛风性关节炎患者60例随机分为两组，每组30例。对照组采用四妙汤加减治疗，观察组采用正清风痛宁联合四妙汤加减治疗。比较两组临床疗效及中医症候积分。采用尿酸氧化酶法检测治疗前后血清尿酸(SUA)水平，免疫比浊法检测治疗前后血清超敏C反应蛋白(hsCRP)水平，酶联免疫吸附法检测血清IL-1β、IL-6、IL-8、TNF-α、丙二醛(MDA)、3-硝基酪氨酸修饰蛋白(3-NT)、8-羟基脱氧鸟苷(8-OHdG)水平。结果 观察组治疗总有效率高于对照组(96.67%vs.76.67%)(P<0.05)。与治疗前比较，两组治疗后SUA水平、中医症候主症积分和次症积分、血清hsCRP、TNF-α、IL-1β、IL-6、IL-8、MDA、3-NT和8-OHdG水平均降低(P<0.05);且观察组治疗后上述各观察指标较对照组降低更为明显(P<0.05)。结论 正清风痛宁联合四妙汤加减治疗痛风性关节炎有较为明显的治疗效果，能改善临床症状，并可降低SUA水平，减轻炎症反应及氧化应激反应。     

痛风性关节炎利用解毒泄浊益肾汤治疗的疗效观察

目的研究痛风性关节炎利用解毒泄浊益肾汤治疗的疗效。方法选取我院2014年8月至2016年2月收治的痛风性关节炎患者98例为研究对象,分为两组,给予对照组患者痛风定胶囊口服,给予观察组患者解毒泄浊益肾汤治疗,对比两组临床疗效。结果观察组患者的临床治疗总有效率为95.92%,显著高于对照组的79.59%(P<0.05)。观察组治疗后的Cr、BUN、UA显著优于对照组(P<0.05)。结论痛风性关节炎利用解毒泄浊益肾汤治疗的疗效显著,在临床上值得广泛推广。     

中药熏洗治疗膝骨关节炎的疗效观察

目的 观察中药熏洗治疗膝骨关节炎的疗效。方法 选取2020年1月—2021年7月株洲市中医伤科医院收治的膝骨关节炎患者80例,采用双盲法分为对照组和中药治疗组,各40例。对照组采用塞来昔布胶囊,中药治疗组采用中药熏洗,2组均持续治疗28 d。比较2组临床疗效,治疗前及治疗28 d后血清炎性因子[C反应蛋白(CRP)、白介素-6(IL-6)、白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)]、中医症状(关节疼痛、关节怕冷、晨僵)积分、Lysholm膝关节评分(Lysholm评分)、视觉模拟评分法(VAS)评分。结果 中药治疗组总有效率为95.00%,高于对照组的77.50%(χ²=5.165,P=0.023)。治疗28 d后,2组血清CRP、IL-6、IL-1β、TNF-α水平及关节疼痛、关节怕冷、晨僵症状积分和VAS评分低于治疗前,Lysholm评分高于治疗前,且中药治疗组降低/升高幅度大于对照组(P<0.01)。结论 采用中药熏洗治疗膝骨关节炎的效果明显,可有效地减轻机体炎性损伤,提高膝关节功能,进而缓解患者关节疼痛及肿胀、晨僵等症状。     

注射用丹参多酚酸盐联合苯溴马隆治疗痛风性关节炎的临床研究

目的探讨注射用丹参多酚酸盐联合苯溴马隆胶囊治疗痛风性关节炎的临床疗效。方法选取2019年7月—2020年9月在河南省洛阳正骨医院就诊的92例痛风性关节炎患者,按照随机数字表法分为对照组和治疗组,每组各有46例。对照组口服苯溴马隆胶囊,50mg/次,1次/d。治疗组在对照组基础上静脉滴注注射用丹参多酚酸盐,200mg/次,1次/d。两组患者连续治疗4周。观察两组的临床疗效,比较两组的疼痛消失时间、红肿消失时间,检测两组血清中白细胞介素-8(IL-8)、白细胞介素-1β(IL-1β)、转化生长因子-β1(TGF-β1)、血尿酸、血沉水平。结果治疗后,治疗组的总有效率为93.48%,对照组的总有效率为78.26%,两组对比有明显差异(P0.05)。治疗后,两组患者的视觉模拟评分法(VAS)评分显著降低(P0.05);治疗组VAS评分降低更明显(P0.05)。治疗后,治疗组的疼痛消失时间、红肿消失时间短于对照组,差异有统计学意义(P0.05)。治疗后,两组的IL-8、IL-1β、血尿酸、血沉显著降低,TGF-β1显著升高(P0.05);治疗后,治疗组的IL-8、IL-1β、血尿酸、血沉低于对照组,TGF-β1高于对照组(P0.05)。结论注射用丹参多酚酸盐联合苯溴马隆胶囊可提高痛风性关节炎的临床疗效,减轻疼痛程度,降低炎症因子水平。     

注射用丹参多酚酸盐联合苯溴马隆治疗痛风性关节炎的临床研究

目的探讨注射用丹参多酚酸盐联合苯溴马隆胶囊治疗痛风性关节炎的临床疗效。方法选取2019年7月—2020年9月在河南省洛阳正骨医院就诊的92例痛风性关节炎患者,按照随机数字表法分为对照组和治疗组,每组各有46例。对照组口服苯溴马隆胶囊,50mg/次,1次/d。治疗组在对照组基础上静脉滴注注射用丹参多酚酸盐,200mg/次,1次/d。两组患者连续治疗4周。观察两组的临床疗效,比较两组的疼痛消失时间、红肿消失时间,检测两组血清中白细胞介素-8(IL-8)、白细胞介素-1β(IL-1β)、转化生长因子-β1(TGF-β1)、血尿酸、血沉水平。结果治疗后,治疗组的总有效率为93.48%,对照组的总有效率为78.26%,两组对比有明显差异(P<0.05)。治疗后,两组患者的视觉模拟评分法(VAS)评分显著降低(P<0.05);治疗组VAS评分降低更明显(P<0.05)。治疗后,治疗组的疼痛消失时间、红肿消失时间短于对照组,差异有统计学意义(P<0.05)。治疗后,两组的IL-8、IL-1β、血尿酸、血沉显著降低,TGF-β1显著升高(P<0.05);治疗后,治疗组的IL-8、IL-1β、血尿酸、血沉低于对照组,TGF-β1高于对照组(P<0.05)。结论注射用丹参多酚酸盐联合苯溴马隆胶囊可提高痛风性关节炎的临床疗效,减轻疼痛程度,降低炎症因子水平。     

化浊解毒方对黄褐斑患者血清白细胞介素1、白细胞介素6、肿瘤坏死因子α的影响

目的观察化浊解毒法对黄褐斑患者血清白细胞介素1（IL-1）、白细胞介素6（IL-6）、肿瘤坏死因子α（TNF—α）水平的影响。方法选择80例黄褐斑患者作为治疗组,30例健康女性作为对照组。治疗纽采用化浊解毒方口服加颜面熏蒸方法治疗,对照组不予任何药组干预。观察治疗组患者临床疗效及治疗前后空腹静脉血清IL-1,IL-6,TNF～d水平变化情况。结果治疗组患者血清IL-1,IL-6,TNF-理含量与对照组比较均显著升高（均P〈0．01）;治疗组患者治疗后血清IL-1,IL-6,TNF—d含量与治疗前相比,显著降低（均P〈0．01）。结论化浊解毒方可能是通过降低黄褐斑患者体内IL-1,IL-6,TNF—d含量,从而抑制黑素细胞的合成达到治疗黄褐斑的作用。     

膝关节腔内注射玻璃酸钠联合复方倍他米松对高原地区膝关节滑膜炎患者疼痛症状及膝关节功能的影响

目的 观察膝关节腔内注射玻璃酸钠联合复方倍他米松对高原地区膝关节滑膜炎患者的疼痛症状及膝关节功能的影响。方法 高原地区膝关节滑膜炎患者118例随机分为观察组（n=59）和对照组（n=59）。对照组膝关节腔内注射复方倍他米松1 mL+0.9%氯化钠注射液2 mL,观察组用相同方法注射复方倍他米松1 mL+玻璃酸钠注射液2 mL。两组均为1周1次,共治疗4周。分别于治疗前、治疗第2、第4周用视觉模拟评分法（VAS）评估患者膝关节疼痛情况,对膝关节功能情况进行Lysholm评分,测定滑膜厚度和关节腔积液量;比较两组临床疗效,以及治疗前后两组患者膝关节积液中白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的水平变化,观察药品不良反应发生情况。结果 观察组治疗总有效率为91.53%,明显优于对照组（P <0.05）。治疗后第2、第4周,两组患者膝关节VAS评分、滑膜厚度和关节腔积液量均较前明显降低,Lysholm评分则较前明显升高（P <0.01）;且观察组上述指标均优于同时点的对照组（P <0.01）。治疗后,两组患者膝关节积液中TN...     

电针联合等速肌力训练治疗老年早期膝关节骨性关节炎的临床观察

目的 探讨电针联合等速肌力训练治疗老年早期膝关节骨性关节炎(KOA)的应用价值。方法 选择我院2019年6月至2020年9月入住的100例老年早期KOA患者作为研究对象,采用随机数字表法分为观察组(n=50)和对照组(n=50)。对照组采用等速肌力训练治疗,观察组采用电针联合等速肌力训练治疗。统计比较两组的疗效、血清炎症因子、KOA症状、膝关节功能和生活质量(SF-36)。结果 观察组的疗效明显优于对照组(P 0.05)。与治疗后对照组比较,观察组的白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)浓度和WOMAC评分均明显低,Lysholm评分和SF-36评分均明显高(P 0.05)。与治疗前比较,两组治疗后的IL-6、TNF-α浓度和WOMAC评分均明显低于治疗前,Lysholm评分和SF-36评分均明显高于治疗前(P 0.05)。结论 电针联合等速肌力训练治疗老年早期KOA可提高疗效,降低炎症因子浓度,改善膝关节功能、KOA症状和患者生活质量。     

健膝汤联合关节镜治疗膝关节慢性滑膜炎的临床研究

目的探讨健膝汤联合关节镜治疗膝关节慢性滑膜炎的效果。方法膝关节慢性滑膜炎患者136例采用随机数字表法分为两组,68例患者采用关节镜治疗为对照组,68例患者采用健膝汤联合关节镜治疗为观察组,于治疗前后行VAS评分、Lysholm评分,比较两组治疗前后炎症因子改变、相关指标改善、临床疗效、并发症。结果治疗后,两组炎症因子(IL-6,TNFα,CRP)、浮髌试验阳性率、VAS评分降低。两组膝关节屈曲度、Lysholm评分增加。观察组炎症因子(IL-6,TNFα,CRP)、浮髌试验阳性率、VAS评分、并发症发生率低于对照组。观察组膝关节屈曲度、Lysholm评分、总有效率高于对照组(P<0.05)。结论健膝汤联合关节镜是治疗膝关节慢性滑膜炎的有效方法,可降低炎症水平,缓解疼痛,改善临床病症,疗效显著且安全性高。     

泄浊解毒方结肠透析治疗慢性肾脏病4期患者短期疗效观察

目的观察泄浊解毒方结肠透析治疗对慢性肾脏病(chronickidneydisease,CKD)4期患者的短期疗效。方法纳入2017年1月-2018年1月CKD 4期住院患者,应用泄浊解毒方结肠透析治疗的65例患者为治疗组,未应用的60例为对照组。观察2组临床症状及血生化指标的变化。结果与对照组比较,治疗组食欲不振、体倦乏力、便秘、皮肤瘙痒症状显著改善(P<0.05或P<0.01)。与治疗前及对照组比较,治疗组血肌酐、尿酸氮、血磷(P3-)均显著下降(P<0.05)。治疗组总有效率(67.7%)显著高于对照组(48.3%)(P<0.05)。结论泄浊解毒方结肠透析可有效改善CKD 4期患者临床症状及生化指标,短期疗效显著。     

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.