氧启动雾化吸入博利康尼、沐舒坦在慢性阻塞性肺部疾病急性加重期治疗中的应用

目的探讨氧启动雾化吸入博利康尼、沐舒坦在慢性阻塞性肺部疾病急性加重期的治疗效果.方法慢性阻塞性肺部疾病急性加重期患者90例,随机分为治疗组和对照组两大组.治疗组64例分为A、B、C 3个方案组,用氧启动雾化吸入治疗,药物配伍分别为博利康尼雾化液5mg/2ml;沐舒坦注射液30mg/4ml;博利康尼雾化液2.5mg/ml+沐舒坦注射液15mg/2ml.对照组26例给予α-糜蛋白酶2000U/5ml.结果在治疗组中,A、B方案组的总有效率分别为76.19%和73.68%,A、B两组疗效无显著差异(P＞0.05).C方案组的总有效率为91.67%,与A、B方案组比较有显著差异(P＜0.05).对照组的总有效率为69.23%,治疗组中C方案组与对照组比较,也有显著差异(P＜0.05);从临床缓解所需平均时间比较,A、B方案组和对照组三者之间无显著差异(P＞0.05),但与C方案组比较却有显著差异(P＜0.05).结论在慢性阻塞性肺部疾病急性加重期的治疗中,采用氧启动雾化吸入博利康尼、沐舒坦疗效更好.     

沐舒坦治疗慢性阻塞性肺病加重期疗效观察

目的:探讨沐舒坦治疗慢性阻塞性肺病(COPD)急性加重期的治疗作用.方法:90例患者随机分为治疗组和对照组.治疗组接受沐舒坦针剂治疗,对照组接受必嗽平针剂治疗.结果:治疗组在改善咳嗽、咳痰等方面有效率达90.75%,明显高于对照组(P<0.05).治疗组动脉血气改善情况明显高于对照组.结论:沐舒坦针剂为一种安全性高,疗效确切的祛痰剂,能较快地控制病情,缩短疗程,值得临床推广应用.     

慢性镉中毒致肌萎缩侧索硬化症样改变1例报道

<正>镉是一种毒性较大的重金属,含镉的食物及空气对身体危害极其严重,它主要通过呼吸道、消化道和皮肤吸收进入人体。长期处于含镉量较高的环境中会导致慢性镉中毒,引起肺、肾及骨骼等器官的损害。尽管动物实验证实镉是一种强有力的神经毒素~([1]),其对人类神经系统的损害尚不明确。我院收治一例慢性镉中毒致肌萎缩侧索硬化症样改变的患者,现复习相关文献,报道如下。1病例资料患者男性,49岁,四肢麻木、无力半年,加重伴全身肌肉萎缩3个     

沐舒坦联合普米克令舒治疗COPD急性加重期的临床观察

目的探讨沐舒坦联合普米克令舒治疗COPD急性加重期的疗效。方法 94例COPD急性加重期患者随机分为治疗组和对照组,除常规抗感染、平喘,吸氧、化痰,维持水电解质酸碱平衡等综合治疗外,对照组应用沐舒坦,治疗组应用沐舒坦和普米克令舒,疗程1周。结果治疗组的总有效率93.6%,显著高于对照组78.7%(P<0.05);治疗后FEV1、FVC与对照组相比差异有统计学意义(P<0.05),且无明显不良反应。结论沐舒坦联合普米克令舒治疗COPD急性加重期具有协同作用,可促进排痰、祛痰,改善肺功能,且无明显不良反应,值得临床推广应用。     

沐舒坦和普米克令舒联合治疗COPD急性加重期的疗效分析

目的探讨沐舒坦联合普米克令舒治疗慢性阻塞性肺疾病(COPD)急性加重期的临床疗效。方法60例COPD患者随机分为治疗组和对照组各30例,治疗组用沐舒坦15mg+普米克令舒1mL+生理盐水20mL。对照组采用生理盐水20mL+糜蛋白酶2000U+普米克令舒1mL以空气压缩泵雾化吸入,2次/d,疗程1周。观察比较两组的临床疗效。结果治疗组的总有效率为93.3%,明显高于对照组的总有效率60.0%,经统计学处理,两组总有效率比较,差异有显著性(χ2=8.363,P<0.05)。两组在缓解喘憋,消除喘鸣音,肺部ā音,咳嗽方面,治疗组比对照组有明显差异(P<0.01)。结论沐舒坦、普米克令舒联合雾化吸入治疗治疗COPD急性加重期有协同作用,疗效显著,可以缩短病程,提高治愈率,值得临床推广。     

26例肌萎缩侧索硬化症的护理

肌萎缩侧索硬化症(ALS)是运动神经元疾病中最常见的类型,为主要累及脊髓前角细胞、脑干运动神经核及锥体束的神经系统慢性变性疾病,临床特征为隐袭起病,慢性进行性发展,并存上下运动神经元同时受损的症状和体征[1].迄今为止,病因仍不十分明了,有研究认为与自身免疫[2]、兴奋性氨基酸的毒性作用、神经营养障碍及其氧化损害、生化及病毒感染等有关.患者最终因呼吸衰竭致死.通过密切观察病情,维持有效通气,保证营养支持,加强功能锻炼及心理护理,可促使患者症状得到改善,有效地防止并发症的发生,提高生活质量.我科对26例ALS患者按照上述方法进行精心护理,取得了良好的效果,现报道如下.     

肌萎缩侧索硬化症患者长期机械通气1例护理体会

肌萎缩侧索硬化症(ALS)是运动神经元病最常见的类型,由脊髓前角细胞、脑干和额叶皮质运动神经元的进行性变性所致。我科于2002年10月29日收治了1例ALS患者,至今机械通气达5年,未出现压疮、泌尿系感染、误肺部严重感染等并发症。维持有效的机械通气、保证可靠的营养支持、满足不     

沐舒坦雾化结合体位引流促进排痰效果观察

1临床资料 1．1一般资料132例观察对象均为2005年9月-2006年5月我院呼吸科收治慢性肺部感染患者，其中9例肺脓肿，42例支气管扩张，81例慢性阻塞性肺疾病，年龄42-65岁，平均49岁．给予低流量吸氧、抗感染、止咳平喘治疗，患者均有发热、大量脓痰，痰液黏稠不易咳出，以急性发作期和中度病情患者为主。     

沐舒坦雾化吸入对胸外科患者术后恢复的影响

胸外科患者术后常出现胸闷、气急等主观呼吸功能障碍症状,常并发肺不张、肺部感染、急性呼吸衰竭.并发症的发生率达43.6%[1],其发生主要与患者呼吸功能及排痰障碍有关.我们对胸外科患者术后采用盐酸氨溴索(沐舒坦)雾化吸入,观察其对患者术后呼吸功能恢复的影响.     

临床药师参与1例COPD合并肺部感染患者的治疗实践

目的：探讨临床药师对COPD合并肺部感染患者抗感染药物的选择及药学监护的意义。方法：对1例COPD合并肺部感染患者,临床药师从抗感染药物选择、疗程、药物相互作用及不良反应等方面进行药学监护。结果：临床药师通过对该患者实施药学监护,及时发现和解决了患者药物治疗的问题,为临床合理用药提供了意见。结论：临床药师通过参与临床实践,可协助医师提高药物治疗的安全性和有效性,使患者获得优良的药学服务。     

Immune-mediated Mechanisms in the Pathoprogression of Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease with selective loss of upper and lower motor neurons. At sites of motor neuron injury, neuroinflammation is a prominent pathological finding and is characterized by microglial activation, astrogliosis, and infiltration of monocytes and T-cells. Both innate and adaptive immune responses actively influence disease progression in animal models and in ALS patients, and promote neuroprotection or neurotoxicity at different stages of disease. The early immune reaction to signals from injured motor neurons is to rescue and repair damaged tissue. As disease accelerates, a shift occurs from beneficial immune responses (involving M2 microglia and regulatory T-cells) to deleterious immune responses (involving M1 microglia and Th1 cells). In this review, we underscore the importance of immune-mediated mechanisms in the pathogenesis of ALS and discuss the alterations and distinct phenotypes of immune cells at the different stages of disease. The better we understand the dynamic changes that occur within the immune system over the course of disease, the better we will be able to develop effective therapeutic regimens in ALS.     

肌萎缩性侧索硬化症运动神经传导速度和F波改变特征

目的：研究肌萎缩性侧索硬化症（ALS）的运动神经传导速度（MCV）和F波改变特点及诊断价值。方法：50例ALS患者（肯定ALS 41例，很可能ALS 9例）和正常对照组进行MCV和F波测定。结果：患者组正常中神经、尺神经、胫神经和腓神经的末端运动潜伏期（DML）分别与对照组比较明显延长。患者组正中神经、尺神经、胫神经和腓神经的F波出现率明显低于对照组。肯定组和很可能组的正中神经左右往返脊髓的中枢潜伏期增大，与对照组比较均有显著性差异。患者组正中神经和尺神经往返脊髓的中枢潜伏期与对照组比较均有非常显著性差异，而腓神经有显著性差异。结论：这些参数的改变特点对ALS的电生理诊断有一定的参考价值。     

Diversity of Ion Channels in Human Bone Marrow Mesenchymal Stem Cells from Amyotrophic Lateral Sclerosis Patients

Human bone marrow mesenchymal stem cells (hBM-MSCs) represent a potentially valuable cell type for clinical therapeutic applications. The present study was designed to evaluate the effect of long-term culturing (up to 10^th passages) of hBM-MSCs from eight individual amyotrophic lateral sclerosis (ALS) patients, focusing on functional ion channels. All hBM-MSCs contain several MSCs markers with no significant differences, whereas the distribution of functional ion channels was shown to be different between cells. Four types of K⁺ currents, including noise-like Ca⁺²-activated K⁺ current (IK_Ca), a transient outward K⁺ current (I_to), a delayed rectifier K⁺ current (IK_DR), and an inward-rectifier K⁺ current (K_ir) were heterogeneously present in these cells, and a TTX-sensitive Na⁺ current (I_Na,TTX) was also recorded. In the RT-PCR analysis, Kv1.1, heag1, Kv4.2, Kir2.1, MaxiK, and hNE-Na were detected. In particular, I_Na,TTX showed a significant passage-dependent increase. This is the first report showing that functional ion channel profiling depend on the cellular passage of hBM-MSCs     

Immunomodulatory Properties of Bone Marrow Mesenchymal Stem Cells from Patients with Amyotrophic Lateral Sclerosis and Healthy Donors

Journal of Neuroimmune Pharmacology - Pathogenesis of amyotrophic lateral sclerosis (ALS) involves several mechanisms resulting in a shift from a neuroprotective to a neurotoxic immune reaction. A...     

Plant-Derived Natural Compounds for the Treatment of Amyotrophic Lateral Sclerosis: An Update

BackgroundAmyotrophic lateral sclerosis (ALS) is a motor neuron disease (MND) that typically causes death within 3-5 years after diagnosis. Regardless of the substantial scientific knowledge accrued more than a century ago, truly effective therapeutic strategies remain distant. Various conventional drugs are being used but are having several adverse effects. Objective/AimThe current study aims to thoroughly review plant-derived compounds with well-defined ALS activities and their structure-activity relationships. Moreover, the review also focuses on complex genetics, clinical trials, and the use of natural products that might decrypt the future and novel therapeutics in ALS. MethodsThe collection of data for the compilation of this review work was searched in PubMed Scopus, Google Scholar, and Science Direct. ResultsResults showed that phytochemicals like-Ginkgolides, Protopanaxatriol, Genistein, epigallocatechingallate, resveratrol, cassoside, and others possess Amyotrophic lateral sclerosis (ALS) activity by various mechanisms. ConclusionThese plant-derived compounds may be considered as supplements for conventional (ALS). Moreover, further preclinical and clinical studies are required to understand the structure-activity relationships, metabolism, absorption, and mechanisms of plant-derived natural agents.     

Amyotrophic Lateral Sclerosis, 2016: existing therapies and the ongoing search for neuroprotection

Introduction: Amyotrophic lateral sclerosis (ALS), one in a family of age-related neurodegenerative disorders, is marked by predominantly cryptogenic causes, partially elucidated pathophysiology, and elusive treatments. The challenges of ALS are illustrated by two decades of negative drug trials.

Areas covered: In this article, we lay out the current understanding of disease genesis and physiology in relation to drug development in ALS, stressing important accomplishments and gaps in knowledge. We briefly consider clinical ALS, the ongoing search for biomarkers, and the latest in trial design, highlighting major recent and ongoing clinical trials; and we discuss, in a concluding section on future directions, the prion-protein hypothesis of neurodegeneration and what steps can be taken to end the drought that has characterized drug discovery in ALS.

Expert opinion: Age-related neurodegenerative disorders are fast becoming major public health problems for the world’s aging populations. Several agents offer promise in the near-term, but drug development is hampered by an interrelated cycle of obstacles surrounding etiological, physiological, and biomarkers discovery. It is time for the type of government-funded, public-supported offensive on neurodegenerative disease that has been effective in other fields.     

弥散张量成像对早期肌萎缩侧索硬化症上运动神经元损害的诊断意义

目的:探讨弥散张量成像(DTI)在发现早期肌萎缩侧索硬化症(ALS)上运动神经元损害中的临床意义.方法:21例ALS患者在行DTI检查时,8例无明显上运动神经元(UMN)受累体征,但在病程后期均出现了临床锥体束征的ALS患者作为A组,13例有明确UMN损害体征的ALS患者作为B组,20例健康人作为对照组.对所有研究对象行轴位DTI扫描,选取感兴趣区(ROI)测量部分各向异性分数(FA)和平均弥散系数(MD).结果:与对照组比较,A组内囊后肢(u=3.974,P<0.01)、大脑脚(u=3.580,P<0.01)、延髓锥体(u=2.402,P<0.05)处的FA值明显减低,内囊后肢(u=2.168,P<0.05)处的MD值增高,A、B 2组间该3个ROI处的FA、MD值差异无统计学意义.结论:DTI可发现ALS早期UMN损害,有助于ALS的早期诊断.     

Neuroprotective Effects of Genistein in a SOD1-G93A Transgenic Mouse Model of Amyotrophic Lateral Sclerosis

Oxidant toxicity has been implicated in the pathogenesis of amyotrophic lateral sclerosis (ALS), an insidiously progressive neurodegenerative disorder involving upper and lower motor neurons. Here, we investigated the cellular and molecular mechanisms underlying the neuroprotective effects of an anti-oxidant genistein in SOD1-G93A transgenic mouse model of ALS. Rotarod test, hanging wire test and hindlimb clasping test were used to determined disease onset and assess motor performance. Immunostaining together with neuronal size measurement were used to count viable motor neurons. In addition, immunostaining procedure and ELISA kit were used to assess the inflammatory response in the spinal cord. Our results showed that Genistein administration suppressed the production of pro-inflammatory cytokines and alleviated gliosis in the spinal cord of SOD1-G93A mice. In addition, genistein administration induced autophagic processes and enhanced the viability of spinal motor neurons. As a result, genistein alleviated ALS-related symptoms and slightly prolonged the lifespan of SOD1-G93A mice. Taken together, our results indicate that genistein is neuroprotective in SOD1-G93A mice, suggesting genistein could be a promising treatment for human ALS.

Genistein protects impariments in SOD1-G93A transgenic mouse model.