丙种球蛋白联合西咪替丁治疗小儿过敏性紫癜的临床研究

目的探讨丙种球蛋白联合西咪替丁治疗小儿过敏性紫癜的疗效。方法纳入过敏性紫癜患儿90例,随机分为3组,A、B、C组各30例。A组常规对症治疗,B组在A组基础上加用西咪替丁治疗,C组在B组基础上加用丙种球蛋白治疗。结果 B组总有效率明显高于A组(P<0.05),症状缓解时间和住院时间明显短于A组(P<0.05)。C组总有效率明显高于A组和B组(P<0.05),症状缓解时间、住院时间、复发率明显低于A组和B组(P<0.05)。结论丙种球蛋白联合西咪替丁治疗小儿过敏性紫癜治愈率高,恢复快,疗效确切。     

重组血小板生成素与小剂量人血丙种球蛋白治疗特发性小儿血小板减少性紫癜的疗效比较

目的：观察重组血小板生成素（rhTPO）与小剂量人血丙种球蛋白治疗特发性小儿血小板减少性紫癜的临床疗效。方法将300例特发性小儿血小板减少性紫癜（ITP）患儿随机分为3组,每组100例。A 组皮下注射rhTPO,B 组给予糖皮质激素,C 组在 B 组的基础上给予小剂量人血丙种球蛋白,比较3组临床疗效及血小板动态变化情况。结果 A、C 组总有效率均高于 B 组（P ﹤0.05）;A 组与 C 组总有效率比较差异无统计学意义（P ﹥0.05）。A、C组各项血小板动态指标均较 B 组有显著改善（P ﹤0.05）。除出血停止时间外,C 组其他指标均优于 A 组（P ﹤0.05）。结论 rhTPO 和糖皮质激素联合小剂量人血丙种球蛋白对小儿血小板减少性紫癜均有良好的治疗效果,后者治疗方案治疗效果更佳。     

环孢素A治疗难治性特发性血小板减少性紫癜疗效分析

目的 探讨环孢素A治疗难治性特发性血小板减少性紫癜的临床疗效.方法 将46例患者随机分为治疗组和对照组各23例,治疗组应用环孢素A,对照组应用长春新碱.结果 治疗组总有效率为82.6%明显高于对照组的60.8%,差异有统计学意义(P<0.05).结论 环孢素A治疗难治性特发性血小板减少性紫癜的疗效优于长春新碱,值得临床推广应用.     

不同剂量丙种球蛋白联合地塞米松治疗小儿中重症特发性血小板减少性紫癜

摘 要 目的： 探讨不同剂量丙种球蛋白联合地塞米松治疗小儿中重症特发性血小板减少性紫癜(ITP)的疗效。方法: 96例ITP患儿随机分为A组(标准大剂量丙种球蛋白+地塞米松)、B组(中剂量丙种球蛋白+地塞米松)和对照组(地塞米松)3组,均连续治疗2周后,比较3组疗效、药品不良反应和治疗前后患儿血小板参数变化情况。结果: A、B 两组患儿治疗后Plt、PCT、PDW水平均明显高于对照组(P＜0.05),治疗后血小板恢复正常时间和出血停止时间均明显短于对照组(P＜0.05),治疗总有效率均明显高于对照组(P＜0.05)。A、B 两组患儿间治疗后血小板恢复正常时间和出血停止时间,以及治疗总有效率比较,差异均无统计学意义(P＞0.05)。三组患儿药品不良反应发生率比较,差异无统计学意义(P＞0.05)。结论:中剂量丙种球蛋白治疗ITP效果显著,能够达到标准大剂量丙种球蛋白的疗效,且有效减少丙种球蛋白使用剂量,值得临床推广应用。     

大剂量丙种球蛋白联合干扰素辅助治疗儿童重症病毒性脑炎的疗效观察

目的：探讨大剂量丙种球蛋白（IVIG）、干扰素（IFN）辅助治疗儿童重症病毒性脑炎（SVE）的临床疗效。方法选取2008年1月～2012年12月收治的99例重症病毒性脑炎患儿99例,并将患儿随机分为3组,其中观察A组33例,观察B组34例,观察C组32例。另选取2006年2月～2007年10月间住院,未使用大剂量丙种球蛋白和干扰素治疗的重症病毒性脑炎患儿31例作为对照组。观察组和对照组都按原则进行常规治疗。对照组除常规治疗外不给予任何处理措施,A组在常规治疗基础上应用大剂量丙种球蛋白辅助治疗,B组在常规治疗基础上应用大剂量干扰素,C组在常规治疗基础上同时另给予大剂量丙种球蛋白和干扰素。观察治疗前后各组的疗效。结果 A组总有效率为93.94%（31/33）,B组总有效率为94.12%（32/34）,C组总有效率为93.75%（30/32）,对照组总有效率为80.65%（25/31）,A、B、C三组分别与对照组比较,差异均有统计学意义（P均＜0.05）,A、B组和C组之间两两比较,差异无统计学意义（P＞0.05）。结论大剂量丙种球蛋白或干扰素辅助治疗小儿重症病毒性脑炎可以提高临床疗效,大剂量丙种球蛋白与干扰素联合应用临床疗效并非优于单一用药。     

儿童急性免疫性血小板减少症骨髓巨核细胞数与临床疗效的关系研究

目的:观察儿童免疫性血小板减少症(immunethrombocytopenia,ITP)初诊时骨髓巨核细胞数量改变与疗效的关系,探讨巨核细胞数量的改变对急性ITP预后的估计及对治疗的指导作用。方法:将70例急性重度免疫性血小板减少症患儿,治疗前行骨髓细胞涂片检查,根据巨核细胞数量将其分为A、B、C三组,A组骨髓涂片巨核细胞数<7个/4.5 cm2,B组骨髓涂片巨核细胞为7～35个/4.5 cm2,C组>35个/4.5 cm2,分析三组激素治疗的疗效并进行比较分析。结果:三组患儿对激素冲击治疗反应不同,A组有效率25.0%,B组有效率76.5%,C组有效率93.3%,B、C两组分别与A组比较差异有统计学意义(P<0.05),C组有效率高于B组,两组比较差异有统计学意义(P<0.05)。结论:ITP患儿发病时骨髓细胞涂片,巨核细胞增殖明显者对激素、丙种球蛋白等治疗敏感,疗效好,恢复快;骨髓涂片巨核细胞不增多或减少者对激素、丙种球蛋白等治疗反应性差,应与家属沟通,及早采取其他联合治疗方法。     

环孢素A治疗难治性特发性血小板减少性紫癜疗效分析

目的探讨环孢素A治疗难治性特发性血小板减少性紫癜的临床疗效。方法将46例患者随机分为治疗组和对照组各23例,治疗组应用环孢素A,对照组应用长春新碱。结果治疗组总有效率为82.6%明显高于对照组的60.8%,差异有统计学意义（P〈0.05）。结论环孢素A治疗难治性特发性血小板减少性紫癜的疗效优于长春新碱,值得临床推广应用。     

不同剂量丙种球蛋白治疗儿童重症特发性血小板减少性紫癜

目的:探讨不同剂量丙种球蛋白治疗儿童重症特发性血小板减少性紫癜(ITP)的临床效果,为临床治疗提供参考。方法:选取广西壮族自治区南溪山医院2018年3月至2019年2月收治的110例ITP患儿,按随机数表法分为观察组和对照组各55例,两组患儿均给予泼尼松口服治疗,对照组给予大剂量丙种球蛋白,观察组给予中小剂量丙种球蛋白,比较两组患儿治疗前后血小板参数变化情况、血小板恢复正常时间及出血停止时间、临床疗效、不良反应发生情况。结果:两组患儿治疗后各血小板参数较治疗前明显改善(P<0.05),两组治疗前后各指标比较差异无统计学意义(P>0.05);观察组患儿血小板恢复正常时间及出血停止时间较对照组有所延长,对照组患儿治疗第2、3、5天的治疗有效率均高于观察组,两组患儿治疗第5天的治疗有效率均高于治疗第2、3天,但上述差异均无统计学意义(P>0.05)。观察组临床总有效率为90.91%,低于对照组的94.55%,但差异无统计学意义(P>0.05);两组不良反应发生率比较差异无统计学意义(P>0.05);观察组治疗费用低于对照组,差异有统计学意义(P<0.05)。结论:中小剂量丙种球蛋白与大剂量丙种球蛋白治疗儿童重症特发性血小板减少性紫癜疾病的临床疗效相当,可减轻患儿家庭经济负担。     

重组人干扰素α2b雾化吸入联合开喉剑喷雾剂治疗小儿疱疹性咽峡炎的疗效

目的 观察重组人干扰素α2b雾化吸入联合开喉剑喷雾剂治疗小儿疱疹性咽峡炎的疗效。方法 选取2021年1月—2022年6月黄冈市妇幼保健院收治的疱疹性咽峡炎患儿132例,按照随机数字表法分为A组、B组、C组、D组,每组33例。A组入院后接受常规治疗,在此基础上,B组予以注射用重组人干扰素α2b雾化吸入治疗,C组予以开喉剑喷雾剂治疗,D组则予以注射用重组人干扰素α2b联合开喉剑喷雾剂治疗,患儿均持续治疗5 d。比较4组患儿症状改善时间、住院时间及治疗后免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平,不良反应。结果 D组总有效率均高于A组、B组、C组(χ²/P=10.185/<0.001、3.995/0.046、5.121/0.024)。B组、C组、D组退热时间、流涎缓解时间、咽痛缓解时间、溃疡及疱疹消退时间、住院时间均短于A组,且D组短于B组及C组(P<0.05)。B组、C组、D组治疗后血清IgA、IgG、IgM水平均高于A组,且D组高于B组及C组(P<0.05)。4组不良反应总发生率比较,差异无统计学意义(χ^2...     

静脉丙种球蛋白治疗川崎病的临床疗效分析

目的 探讨不同剂量丙种球蛋白治疗小儿川崎病的临床疗效.方法 我院2006年10月至2010年12月收治的120例川崎病患儿,随机分为A、B、C三组,每组40例,三组患者均采用静脉注射内种球蛋白进行治疗,A组静脉滴注丙种球蛋白 2g/kg,B组静脉滴注丙种球蛋白1g/(kg·d)×2d;C组静脉滴注丙种球蛋白0.4 g/(kg·d)×5d,其他治疗相同.观测患儿退热、淋巴结肿大消退、粘膜充血消退、皮疹消退、手足症状消退时间及冠状动脉损害发生率(CAL).结果 A组患儿退热、淋巴结肿大消退、粘膜充血消退、皮疹消退、手足症状消退时间明显短于B、C两组,差异有显著性(P＜0.05);B组患儿淋巴结肿大消退、粘膜充血消退、皮疹消退、手足症状消退时间与C组比较,差异无显著性(P＞0.05).A、B、C 三组CAL发生率分别为27.5％、30.0％、27.5％,差异无显著性(P＞0.05),三组均未见明显不良反应.结论 静脉丙种球蛋白2 g/kg单次给药治疗川崎病,能更好地退热,并有效预防冠状动脉并发症的发生,疗效满意,值得临床推广.     

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.