小儿智力糖浆联合盐酸哌甲酯片治疗儿童注意缺陷多动障碍的疗效观察

目的探讨小儿智力糖浆联合盐酸哌甲酯片治疗儿童注意缺陷多动障碍的临床疗效。方法选择2012年1月—2014年12月重庆市开县人民医院儿科收治儿童注意缺陷多动障碍患者90例,随机分为对照组和治疗组,每组45例。对照组患者口服盐酸哌甲酯片,2片/次,1次/d。治疗组患者在对照组的治疗基础上口服小儿智力糖浆,10 m L/次,2次/d。3周为1个疗程,全部患者均治疗3个疗程。观察两组的临床疗效,同时比较两组治疗前后Conner行为评定量表各因子评分及不良反应情况。结果治疗后,对照组和治疗组总有效率分别为77.78%、88.89%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者冲动多动、多动指数、学习问题、品行问题、焦虑、身心问题评分均较较治疗前显著降低,同组治疗前后差异有统计学意义(P0.05);且治疗组治疗后各评分均显著低于对照组,两组比较差异有统计学意义(P0.05)。两组不良反应发生率比较差异无统计学意义。结论小儿智力糖浆联合盐酸哌甲酯片治疗儿童注意缺陷多动障碍,能够显著提高临床疗效,且无严重不良反应,具有一定的临床推广价值。     

盐酸哌甲酯缓释片联合经颅磁刺激治疗对儿童注意缺陷多动障碍疗效的研究

目的探讨盐酸哌甲酯缓释片联合经颅磁刺激治疗对儿童注意缺陷多动障碍的临床效果。方法选取我院2019年1～12月60例注意缺陷多动障碍患儿,随机将其分为观察组(n=30)和对照组(n=30)。对照组采用盐酸哌甲酯缓释片进行治疗,观察组在对照组基础上联合经颅磁刺激治疗。观察两组治疗2个疗程后的Conner’s儿童行为量表评分、视听整合持续性操作测试结果及不良反应发生率。结果治疗2个疗程后,Conner’s儿童行为量表评分均较治疗前降低,且两组间差异有统计学意义(P 0.05);两组的听觉平均反应时间、视觉平均反应时间均降低,且两组间差异有统计学意义(P 0.05);两组的听觉正确反应数、视觉正确反应数均升高,且两组间差异有统计学意义(P 0.05);观察组的依从性高于对照组且不良反应例数少于对照组,差异均有统计学意义(均P 0.05)。结论盐酸哌甲酯缓释片联合经颅磁刺激治疗儿童注意缺陷多动障碍的临床效果比单用盐酸哌甲酯缓释片进行治疗的效果好,不良反应少,对儿童注意缺陷多动障碍的临床治疗具有积极意义。     

小儿黄龙颗粒对注意缺陷多动障碍亚型的疗效分析

目的:探讨小儿黄龙颗粒对注意缺陷多动障碍(ADHD)不同亚型的治疗效果。方法:回顾性分析2018年12月至2020年10月江西省儿童医院诊治的90例注意缺陷多动障碍患儿临床资料,根据注意缺陷多动障碍亚型不同进行分类,将注意力障碍为主型的患儿纳入A组(n=30)、将多动/冲动型患儿纳入B组(n=30)、将混合型患儿纳入C组(n=30)。比较三组治疗前、治疗8周后症状(采用SNAP-Ⅳ评定量表)、临床疗效[采用Conners简明症状问卷(ASQ)]及中医证候主症积分。结果:治疗后,三组SNAP-Ⅳ症状评分、ASQ评分均较治疗前降低,差异有统计学意义(P<0.05);三组神思涣散、多动不宁、性急易怒、多言多语评分均较治疗前降低,差异有统计学意义(P<0.05)。结论:小儿黄龙颗粒对各分型ADHD患儿均有一定疗效,可显著改善患儿临床症状,降低中医证候主症积分。     

哌甲酯治疗注意力缺陷多动障碍的临床效果及对患儿心率变异性的影响

目的 观察哌甲酯治疗注意力缺陷多动障碍的临床效果及对患儿心率变异性的影响。方法 回顾性分析2021年1月—2022年7月湖北省荆门市妇幼保健院精神科及武汉大学人民医院收治的82例注意力缺陷多动障碍患儿临床资料。根据治疗方法不同分为研究组(42例)和对照组(40例)。对照组予心理干预、行为矫治等非药物治疗,研究组在对照组治疗基础上联合药物(哌甲酯)治疗,疗程为3个月。比较2组患儿治疗效果,治疗前后相关评分及心率变异性指标。结果 研究组患儿治疗总有效率为95.24%,高于对照组的80.00%(χ²=4.443,P=0.035);治疗3个月后,2组患儿缺陷多动障碍筛查量表(SNAP-Ⅳ)、Conners简明症状问卷(ASQ)、Weiss功能缺陷量表(WFIRS-P)评分均较治疗前降低,且研究组低于对照组(P均<0.01);2组心率(HR)、RR间期标准差(SDNN)均较治疗前下降,相邻RR间期差的均方根(RMMSD)、高频(HF)较治疗前上升,组内及组间比较差异均有统计学意义(P<0.05或P<0.01);2组总频率(TP)、低频(LF)、极低频(VL...     

托莫西汀与哌甲酯治疗注意缺陷多动障碍患儿的疗效和安全性比较

目的:比较托莫西汀与哌甲酯治疗注意缺陷多动障碍患儿的疗效和安全性。方法:选择我院收治的注意缺陷多动障碍患儿共52例,随机分为托莫西汀组与哌甲酯组各26例,治疗结束后观察两组患儿的治疗有效率、ADHDRS-IV-Parent:Inv评分以及CPRS-R:S评分。结果:托莫西汀组与哌甲酯组的治疗有效率相近。治疗后托莫西汀组与哌甲酯组的ADHDRS-IV-Parent:Inv各项评分均明显下降,与治疗前比较差异均有统计学意义(P<0.05)。治疗后托莫西汀组与哌甲酯组CPRS-R:S评分的分数均明显下降,与治疗前比较差异均有统计学意义(P<0.05)。托莫西汀组的多动分变化值大于哌甲酯组,差异有统计学意义(P<0.05),两组患儿在治疗过程中均未发现严重的药物不良反应。结论:托莫西汀的疗效与哌甲酯相近,都具有良好的安全性,值得临床推广。     

托莫西汀和阿立哌唑治疗儿童注意缺陷多动障碍的疗效比较

目的比较托莫西汀和阿立哌唑治疗儿童注意缺陷多动障碍的临床疗效。方法收集2015年1月—2016年1月在大连市第七人民医院诊治的88例注意缺陷多动障碍患者,根据用药方案的不同分为对照组和治疗组,每组各44例。对照组患儿口服阿立哌唑片,1片/次,每晚1次。治疗组患儿口服盐酸托莫西汀胶囊,初始剂量为每天0.5 mg/kg,治疗过程中根据临床反应及耐药性进行剂量调整,每天最大剂量为1.4 mg/kg。两组患儿均连续治疗6周。比较两组患儿临床效果、SNAP-IV量表评分、数字划消失误率和Conners父母量表测验结果。结果治疗后,对照组和治疗组的总有效率分别为81.82%、97.73%,两组总有效率比较差异具有统计学意义(P0.05)。治疗后,两组患儿SNAP-IV量表评分、数字划消失误率和Conners父母量表测验结果均显著改善,同组治疗前后比较差异具有统计学意义(P0.05);且治疗后治疗组患儿上述观察指标比对照组的改善更明显,两组比较差异有统计学意义(P0.05)。结论托莫西汀治疗注意缺陷多动障碍临床效果显著,有利于患者认知功能的改善,具有一定的临床推广应用价值。     

儿童注意缺陷多动障碍患儿应用盐酸哌甲酯治疗对其依从性的影响

目的 分析儿童注意缺陷多动障碍患儿应用盐酸哌甲酯治疗的临床效果及对其用药依从性的影响。方法 选取本院收治的60例注意缺陷多动障碍患儿,按随机数字表法分为观察组与对照组,各30例。对照组服用速释盐酸哌甲酯片治疗,观察组服用盐酸哌甲酯缓释片治疗。比较两组治疗效果、依从性、用药前后的中文版评定量表父母版(SNAP-Ⅳ)评分(注意力不足评分、多动/冲动评分、对立违抗评分)、用药前后的血清学指标[泌乳素(PRL)、中枢神经特异性蛋白(S100β)]、不良反应发生情况。结果 两组治疗总有效率比较无差异(P>0.05)。两组用药1个月的依从性比较无差异(P>0.05)。观察组用药3、6、12个月时的依从性分别为93.33%、90.00%、90.00%,高于对照组的66.67%、60.00%、60.00%(P<0.05)。用药后,两组患儿的注意力不足、多动/冲动、对立违抗评分均有所降低,且观察组注意力不足、多动/冲动、对立违抗评分分别为(10.36±1.24)、(9.86±1.12)、(8.14±1.04)分,低于对照组的(13.41±1.38)、(12.93±1.20)、(10.0...     

脉血康胶囊联合桂哌齐特治疗急性脑梗死的临床研究

目的研究脉血康胶囊联合马来酸桂哌齐特注射液治疗急性脑梗死的临床疗效。方法选取2016年8月—2018年8月北京市房山区良乡医院收治的134例急性脑梗死患者作为研究对象,采用照抽签方式将所有患者分为对照组和治疗组,每组各67例。对照组静脉滴注马来酸桂哌齐特注射液,4支/次,溶于10%的葡萄糖注射液500 mL中,100 mL/h,1次/d;治疗组在对照组治疗的基础上口服脉血康胶囊,3粒/次,3次/d。两组均持续治疗2周。观察两组患者的临床疗效,同时比较两组治疗前后的美国国立卫生研究院卒中量表(NIHSS)评分、改良的Rankin残障量表(MRS)评分、Barthel指数(BI)和血液流变学指标。结果治疗后,对照组和治疗组患者的总有效率分别为85.07%、95.52%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者NIHSS评分、MRS评分显著降低,BI指数显著升高,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组NIHSS评分、MRS评分均显著低于对照组,治疗组BI指数显著高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组红细胞压积(HCT)、全血黏度(WBV)和纤维蛋白原(FIB)水平显著降低,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组血液流变学指标显著低于对照组,两组比较差异具有统计学意义(P0.05)。结论脉血康胶囊联合马来酸桂哌齐特注射液治疗急性脑梗死具有较好的临床疗效,能够降低血液黏度,改善日常活动能力,促进神经功能恢复,具有一定的临床推广应用价值。     

盐酸哌甲酯缓释片联合感觉统合训练治疗儿童注意缺陷多动障碍的临床观察

目的评价儿童注意缺陷多动障碍行盐酸哌甲酯缓释片、感觉统合训练(SIT)联合治疗的可行性,为儿童注意缺陷多动障碍患儿临床治疗工作提供参考。方法 66例儿童注意缺陷多动障碍患儿,采取随机法分为对照组和试验组,每组33例。对照组口服盐酸哌甲酯控释片治疗,试验组在对照组用药基础上配合感觉统合训练。比较两组患儿治疗前后智力状况评分及治疗后行为状况评分。结果治疗后,两组患儿的全量表智商、言语量表智商及操作量表智商评分均高于本组治疗前,且试验组改善情况优于对照组,差异具有统计学意义(P<0.05)。治疗后,试验组患儿的学习因子、行为因子、心身因子、焦虑因子、冲动因子、多动因子评分分别为(1.55±0.40)、(1.55±0.35)、(0.90±0.23)、(1.45±0.30)、(1.26±0.30)、(1.80±0.35)分,均低于对照组的(1.93±0.43)、(1.78±0.40)、(1.10±0.25)、(1.68±0.33)、(1.82±0.33)、(2.10±0.33)分,差异均具有统计学意义(P<0.05)。结论盐酸哌甲酯缓释片联合感觉统合训练治疗儿童注意缺陷多动障碍在改善患儿的智力状况以及行为状况等方面均有积极意义,建议联合推行应用。     

气滞胃痛颗粒联合复方阿嗪米特治疗肠易激综合征的临床研究

目的探讨气滞胃痛颗粒联合复方阿嗪米特肠溶片治疗肠易激综合征的临床疗效。方法选取海洋石油总医院2016年11月—2017年11月收治的肠易激综合征患者94例为研究对象,随机将入组者分为对照组和治疗组,每组各47例。对照组口服复方阿嗪米特肠溶片,2片/次,3次/d;治疗组在对照组治疗的基础上口服气滞胃痛颗粒,1袋/次,3次/d。两组患者均连续治疗4周。观察两组临床疗效,比较治疗前后两组患者临床症状积分、肠易激综合征生活质量指数评分量表(IBS-QOL)评分、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分和血清学指标。结果治疗后,对照组和治疗组的临床总有效率分别为80.85%、95.74%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者腹痛积分、腹胀积分、腹泻积分和便秘积分均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组症状积分比对照组降低更显著,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者HAMD量表评分、HAMA量表评分均显著降低,IBS-QOL评分显著升高,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组量表评分明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清血管活性肽(VIP)、5-羟色胺(5-HT)、生长抑素(SS)水平均显著降低,神经肽Y(NPY)水平均显著升高,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组血清学指标水平明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论气滞胃痛颗粒联合复方阿嗪米特肠溶片治疗肠易激综合征具有较好的临床疗效,可改善临床症状,提高患者生活质量,促进机体胃肠激素和神经肽水平改善,具有一定的临床推广应用价值。     

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.     

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.     

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.