儿童肺炎支原体肺炎耐药情况及阿奇霉素临床疗效观察

目的：了解儿童肺炎支原体肺炎（MPP）对大环内酯类抗生素的耐药情况，观察阿奇霉素治疗耐药MPP的临床疗效。方法：于2012年10月至2014年3月采集儿科病房疑似MPP患儿咽拭子标本共100例，应用巢式PCR扩增及DNA测序检测红霉素作用靶位23SrRNA基因。在此基础上将患儿分为敏感组（MS-MPP）及耐药组（MR-MPP），比较两组患儿对阿奇霉素治疗反应的差异。结果：经PCR扩增，100例咽拭子标本中91例阳性，26例无点突变，65例存在点突变，其中58例为2063位A→G点突变，7例为2064位A→G点突变，耐药率65.7%。32例MR-MPP患儿与17例MS-MPP患儿比较，阿奇霉素治疗后敏感组发热时间、总热程、住院时间均短于耐药组，差异有统计学意义（P<0.05）。结论：儿童MPP耐药情况严重，对阿奇霉素治疗反应性降低，发热时间、总热程、住院时间延长。     

阿奇霉素联合强的松治疗支原体肺炎临床效果观察

目的:探讨阿奇霉素联合强的松治疗支原体肺炎临床效果.方法:选取我院2014年5月~2016年7月收治的83例支原体肺炎患者,随机分组,对照组41例,观察组42例,对照组予以阿奇霉素治疗,观察组予以阿奇霉素、强的松联合治疗,观察比较两组临床疗效、止咳时间、体温恢复正常时间、肺啰音消失时间及不良反应发生情况.结果:观察组总有效率为95.24%,高于对照组的78.05%,差异有统计学意义(P<0.05);观察组止咳、体温恢复正常及肺啰音消失时间均低于对照组,差异具有统计学意义(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).结论:对支原体肺炎实施阿奇霉素、强的松联合治疗,疗效显著,可有效缩短患者体温恢复正常、肺啰音消失及止咳时间,安全性高.     

乙酰半胱氨酸与阿奇霉素联用治疗肺炎支原体肺炎患儿的疗效观察

目的：探究乙酰半胱氨酸与阿奇霉素联用治疗肺炎支原体肺炎患儿的临床疗效。方法：选取2019年10月—2020年12月洛阳市妇幼保健院收治的86例肺炎支原体肺炎患儿作为研究对象,根据治疗方法的不同将其分为阿奇霉素组（n=41）和联用组（n=45）,阿奇霉素组患儿给予阿奇霉素治疗,联用组患儿在阿奇霉素组基础上加用乙酰半胱氨酸雾化吸入治疗;比较2组患儿治疗后的临床疗效、用药期间不良反应的发生情况,以及治疗前后咳嗽症状量表评分、乳酸脱氢酶和D-二聚体水平的变化情况。结果：联用组患儿治疗后的总有效率高于阿奇霉素组（93.33%vs 75.61%,P<0.05）;2组患者治疗后的咳嗽症状评分值均低于治疗前（P<0.05）,但联用组患儿的改善幅度大于阿奇霉素组（P<0.05）;2组患者治疗后的乳酸脱氢酶和D-二聚体水平测得值均显著低于治疗前（P<0.05）,但联用组患儿的下降幅度明显大于阿奇霉素组（P<0.05）;2组患者用药期间不良反应的发生率经比较其差异无统计学意义（7.32%vs 8.89%,P>0.05）。结论：乙酰半胱氨酸与阿奇霉素联用治疗肺炎支原体肺炎患...     

利福平辅助治疗耐药肺炎支原体肺炎疗效观察

目的：观察利福平联合阿奇霉素治疗耐药肺炎支原体肺炎疗效。方法将110例耐药肺炎支原体肺炎患儿随机分为观察组58例和对照组52例,对照组给予阿奇霉素治疗,观察组在治疗组基础上加用利福平治疗,观察临床症状、体征、X 线、住院时间及临床效果。结果观察组临床症状、体征减轻和消失、胸片或肺 CT 阴影减轻或消失的时间明显少于对照组,平均住院天数短与对照组,差异有统计学意义（P ﹤0.05）。观察组总有效率为96.6%明显优于对照组的84.6%,差异有统计学意义（P ﹤0.05）。结论利福平联合阿奇霉素治疗耐药肺炎支原体肺炎,对缩短发热时间、减轻咳嗽等症状、促进啰音消失、降低平均住院日,有明显疗效,且用药安全,不良反应小,患儿及家长易接受,值得临床推广应用。     

阿奇霉素联合热毒宁治疗儿童支原体肺炎的临床研究

目的研究阿奇霉素联合热毒宁治疗小儿支原体肺炎的疗效及安全性,为临床合理应用抗菌药物提供参考。方法采用随机对照方法将2010年3月至2012年1月入我院治疗的支原体肺炎患儿164例进行研究,随机分为治疗组和对照组各82。治疗组患儿应用阿齐霉素加热毒宁静脉滴注,疗程5～10 d;对照组患儿单用阿奇霉素静脉滴注,疗程7～13 d。结果治疗组总有效率为98.86%,对照组治疗总有效率为89.77%,2组比较差异有统计学意义(P<0.05);治疗组患儿退热时间、咳嗽好转时间、啰音消失时间、平均治愈时间均较对照组短,差异有统计学意义(P<0.05);胃肠道反应、皮疹、ALT增高等不良反应,二者相比差异无统计学意义(P>0.05)。结论阿奇霉素联合热毒宁治疗小儿支原体肺炎临床疗效显著,临床症状消失更迅速,不良反应少,好于阿奇霉素单一治疗,值得临床推广应用。     

红霉素和阿奇霉素治疗支原体肺炎的疗效及耐药情况

目的比较红霉素和阿奇霉素对支原体肺炎的疗效及耐药情况。方法回顾性分析有支原体工gM检查阳性的85例患者：A组采用红霉素静脉滴注治疗;B组采用阿奇霉素静脉滴注治疗;5d后无效改用红霉素静脉滴注治疗,有效者改为阿奇霉素口服序贯治疗。结果两组在发热、咳喘、肺部音消失方面均有统计学差异。结论红霉素在支原体肺炎的发热、咳喘、肺部啰音的消失方面均优于阿奇霉素,阿奇霉素治疗肺炎支原体有耐药现象。     

甲砜霉素甘氨酸酯对肺炎支原体肺炎的疗效分析

目的观察甲砜霉素甘氨酸酯治疗肺炎支原体肺炎的疗效。方法将肺炎支原体肺炎患者120例随机分为甲砜霉素甘氨酸酯组60例(观察组)和阿奇霉素组60(对照组),观察组使用甲砜霉素甘氨酸酯治疗,对照组使用阿奇霉素治疗,疗程为10~14 d。结果观察组有效率为93.34%,高于对照组68.34%,差异具有统计学意义。结论由于阿奇霉素耐药菌株的出现,甲砜霉素甘氨酸酯对肺炎支原体肺炎的有效率明显超过了阿奇霉素,为大环内酯类耐药的肺炎支原体肺炎患者增加了一种可供选择的抗生素。     

儿童支原体肺炎耐药性与大环内酯类抗生素应用的关联性研究

目的：探讨不规律使用大环内酯类抗生素与肺炎支原体（MP）耐药的相关性及规律使用阿奇霉素序贯疗法治疗儿童支原体肺炎（MPP）的有效性。方法：选取431例MP感染患儿,根据患儿MP感染次数分为观察组217例和对照组214例,观察组咽拭子标本培养结果阳性且对阿奇霉素敏感者与对照组培养结果阳性且对阿奇霉素耐药者提取DNA进行23s rRNA V区基因突变位点检测,对细菌培养阳性者进行药敏试验,根据药敏试验结果选择观察组中对大环内酯类抗菌药物敏感及23s rRNA V区无突变的患儿进行阿奇霉素序贯治疗,观察治疗效果。结果：观察组与对照组患儿MP培养阳性者分别为56例和49例,两组MP对大环内酯类药物耐药率为19.6% vs 75.5%,差异有统计学意义（χ2=32.868,P<0.01）。对照组患儿不规范使用大环内酯类药物次数与肺炎支原体耐药率呈正相关（χ2=22.056,P<0.01;r=0.321,P<0.01）。观察组对阿奇霉素敏感且23s rRNA V区基因位点无突变的26例患儿行阿奇霉素序贯治疗2２周和4周时ＭＰ培养阴性率分别为73.1%和92.3%,基因测序结果显示培 养阳性菌株仍未发现23s rRNA V区基因位点突变。结论：不规律应用大环内酯类抗生素可增加ＭＰ耐药率,MP耐药性与23s rRNA V区基因位点突变有关;对儿童MP感染在没有药敏结果情况下,规律使用阿奇霉素抗感染治疗,不会诱导耐药菌株出现。     

阿奇霉素联合丙种球蛋白治疗重型支原体肺炎

目的探讨阿奇霉素联合丙种球蛋白治疗小儿重型支原体肺炎的临床效果。方法选择2009年5月至2011年5月我院收治的64例重型支原体肺炎患儿作为临床观察对象。将其随机均分为观察组和对照组。观察组患儿给予实施阿奇霉素联合丙种球蛋白疗法,对照组仅用阿奇霉素进行治疗,主要观察两组患儿退烧、肺部落音消失时间的长短、咳嗽减轻等情况,治疗一个疗程后,进行胸片复查。结果治疗2周后,两组患儿的症状均得到控制,临床治疗效差异比较无统计学意义(P>0.05),但是观察组在热退的时间、咳嗽减轻的时间、肺部啰音消失的时间都比对照组短,比较差异显著(P<0.05)。结论阿奇霉素联合丙种球蛋白治疗重型支原体肺炎,临床症状控制良好,治疗时间缩短,值得在临床上推广应用。     

阿奇霉素联合氨溴特罗对小儿支原体肺炎的疗效评价

目的探讨阿奇霉素联合氨溴特罗对小儿支原体肺炎的效果及安全性。方法 120例进行小儿支原体肺炎治疗的患者,随机分为阿奇霉素组、阿奇霉素联合氨溴特罗组,分别给予相应的小儿支原体肺炎治疗,治疗后观察患者患儿发热、咳嗽和肺部啰音的改变情况,并进行疗效评价和不良反应观察。结果阿奇霉素联合氨溴特罗组的发热、咳嗽、肺部啰音明显低于阿奇霉素治疗的结果,具有统计学意义(P<0.05)。对照组中有治疗效果占总的48.3%,治疗组中治疗效果占总的80%,两组比较具有统计学意义(P<0.05)。结论阿奇霉素联合氨溴特罗组比单用阿奇霉素在小儿支原体肺炎的治疗方面效果好。     

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.