奥美拉唑治疗急性重型颅脑损伤并发应激性溃疡及胃酸变化

目的　探讨奥美拉唑 (洛赛克 )和雷尼替丁对重型颅脑损伤并发上消化道出血患者胃酸分泌的影响。方法　 78例患者随机分组 :洛赛克组、雷尼替丁组 ;所有病例均于应用抑酸药前、用药后 3,12 ,2 4 ,72h监测胃液 pH及消化道出血情况。 结果　重型颅脑损伤并发上消化道出血时胃液 pH值低 ,洛赛克组较雷尼替丁组能显著升高胃内 pH(P <0 .0 5 )。 结论　重型颅脑损伤并发上消化道出血胃酸呈高分泌状态。洛赛克对应激性溃疡的胃酸抑制和止血效果均优于雷尼替丁。     

奥美拉唑治疗急性重型脑出血并发应激性溃疡及胃酸变化

目的：探讨奥美拉唑和雷尼替丁对重型脑出血并发上消化道出血患者胃酸分泌的影响。方法：60例患者随机分组：奥美拉唑组、雷尼替丁组;所有病例均于应用抑酸药前、用药后3,12,24,72h监测胃液pH及消化道出血情况。结果：重型脑出血并发上消化道出血时胃液pH值低,奥美拉唑组较雷尼替丁组能显著升高胃内pHP〈0．05。结论：重型脑出血并发上消化道出血胃酸呈高分泌状态。奥美拉唑对应激性溃疡的胃酸抑制和止血效果均优于雷尼替丁。     

重型颅脑损伤并上消化道出血的治疗

目的 探讨重型颅脑损伤并上消化道出血的防治。方法 对GCS评分≤8分，去大脑强直，中枢性高热，高血糖等上消化道出血相关的危险因素行胃液pH监测，应用洛赛克等制酸剂及肠外营养等预防和治疗上消化道出血。结果 24例成功止血，但其中6例最终死于脑干功能衰竭或全身多脏器功能衰竭。1例于出血后4天未能止血死亡。结论维持胃液pH≥4.5-6是预防、治疗重型颅脑损伤并上消化道出血的有效方法，H^ K^ ATP酶抑制剂-洛赛克是迅速增加胃液pH值的有效药物，上消化道出血明显影响重型颅脑损伤的预后。     

奥美拉唑预防重型颅脑损伤并发应激性溃疡出血的临床分析

目的总结使用奥美拉唑预防重型颅脑损伤并发应激性溃疡出血的临床效果及相关临床经验。方法回顾性分析本院2000年1月至2007年12月间收治重型颅脑损伤患者救治情况,随机分为治疗组和对照组,治疗组入院后较对照组增加预防性使用奥美拉唑40mg/次,3次/d,并于治疗前及治疗后第3天、第7天,分别取胃液测定pH值,进行比较。结果对照组应激性溃疡出血发生率及持续时间均显著高于治疗组（P〈0.05）,同时,治疗组采用输血治疗及大量输血治疗比例均低于对照组（P〈0.05）;两组患者胃液pH值入院当日无显著性差异,治疗组经奥美拉唑治疗后胃液pH值在入院后第3天及第7天时显著高于对照组（P〈0.05）。结论对重型颅脑损伤患者早期给予奥美拉唑进行预防性治疗,安全有效,可以降低应激性溃疡发生率,减少发生应激性溃疡患者上消化道出血量,改善预后。     

胃酸测定在预防和治疗重型颅脑损伤患者应激性溃疡中的应用

应激性溃疡所导致的上消化道出血在颅脑损伤中是最常见的并发症之一,尤其是在重型颅脑损伤患者中更为突出,并有逐年升高趋势,严重影响患者的预后,出血病死率可高达30％ ～50％[1],因此预防和治疗应激性溃疡所导致的上消化道出血是提高重型颅脑损伤救治成功率的重要步骤之一.我院于2007年6月至2010年6月共收治重型颅脑外伤354例,均采用测定胃液pH值的办法预防和治疗应激性溃疡患者,取得了良好效果.报告如下.     

重型颅脑损伤并上消化道应激性溃疡出血的治疗

目的 探讨重型颅脑损伤并上消化道应激性渍疡出血的防治方法。方法 对GCS评分≤8分,去大脑强直,中枢性高热,高血糖等上消化道出血相关的危险患者行胃液PH监测,应用洛赛克等制酸剂及肠外营养等预防和治疗上消化道出血。结果 25例符合诊断中24例成功止血,但其中6例最终死于脑干功能衰竭或全身多脏器功能衰竭。1例未能止血于出血后第4天死亡;结论 维持胃液PH≥4．5～6是预防、治疗重型颅脑损伤并上消化道出血的有效方法,H^＋-K^＋-ATP酶抑制剂-洛赛克是迅速增加胃液PH值的有效方法,上消化道出血明显影响重型颅脑损伤的预后。     

奥美拉唑雷尼替丁预防颅脑损伤术后应激性胃出血比较

目的：探讨奥美拉唑,雷尼替丁预防颅脑损伤手术后应激性胃出血的效果。方法;将中,重型颅脑损伤（GCS12－4分）的手术后患者随机分为3组,各30例,奥美拉唑组,雷尼替丁组在对照组用药的基础上分别静脉滴注奥美拉唑40mg,qd,和雷尼替丁150mg,bid,观察临床出血程度,结果：奥美拉唑组,雷尼替丁组的预防效果分别为96．7％,93．3％,与对照组（76．7％）比较差异有统计学意义（P＜0．05）,在使用额外剂量后,奥美拉唑组的5例出血均停止,雷尼替丁组7例出血中仍有4例不能止血,结论：奥美拉唑,雷尼替丁均有预防颅脑损伤手术后应激性胃出血的作用,且预防效果几乎相等,但奥美拉唑较雷尼替丁的止血作用强。     

洛赛克预防重型颅脑损伤后上消化道出血的疗效观察

目的:观察洛赛克对重型颅脑损伤后上消化道出血的预防作用。方法:对120例重型颅脑损伤的患者随机分为治疗组、对照组,治疗组给予洛赛克40 m g,每日2次静脉注射,对照组给予雷尼替丁150 m g,每日2次静脉注射,两组均在积极治疗原发病的基础上采取上述措施。结果:治疗组发生上消化道出血3例,出血率5.0%,对照组12例,出血率20%,两组比较P<0.05。结论:洛赛克对预防重型颅脑损伤后上消化道出血有显著作用。     

鼻饲生大黄粉辅治重型颅脑损伤后上消化道出血的临床观察

重型颅脑损伤并发急性上消化道出血是常见的严重并发症之一，在重型颅脑损伤患者中占40％～80％，严重影响患者的治疗和预后。防治上消化道出血是颅脑外科的重要环节之一，也是提高重型颅脑损伤患者救治成功率的重要步骤之一。笔者采用鼻饲生大黄粉辅治重型颅脑伤并发上消化道出血，收到较好疗效，现报道如下。     

重型颅脑损伤合并上消化道出血31例报告

重型颅脑损伤合并上消化道出血３１例报告莆田市医院王国锋林秋泉我院１９９３年６月至１９９６年６月收治的重型颅脑损伤合并上消化道出血３１例，占我院同期入院的２２０例重型颅脑损伤的１４．０９％，现就本病情况报告如下。一、临床资料本组３１例中，男２２例，女９...     

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.