特布他林与布地奈德雾化吸入对支气管哮喘急性发作患者肺功能的改善及其血清IL-4和IFN-γ水平的影响

目的:研究硫酸特布他林和布地奈德雾化吸入对支气管哮喘急性发作期患者肺功能的善改作用及其血清IL-4和干扰素-γ(IFN-γ)水平的影响。方法:选取2014年6月—2015年6月间收治的支气管哮喘急性发作患者120例,将其随机分为治疗组和对照组,每组60例;对照组患者均给予布地奈德雾化吸入治疗,治疗组患者在对照组的基础上加用硫酸特布他林雾化吸入治疗,比较两组患者治疗后的总有效率以及治疗前后肺功能各项指标及血清IL-4和IFN-γ水平的变化情况。结果:治疗组患者治疗后的总有效率为91.67%显著高于对照组为78.33%(P<0.05);治疗后用力肺活量(FVC)、用力1 s呼气量(FEV1)、FEV1/FVC比值和峰值呼气流速(PEF)等肺功能指标均显著优于对照组(P<0.05),治疗后血清IL-4水平为(42.98±6.21)ng/L低于对照组为(48.45±5.89)ng/L(P<0.05),治疗后血清IFN-γ水平为(75.56±10.62)ng/L高于对照组为(71.08±9.84)ng/L(P<0.05)。结论:采用硫酸特布他林和布地奈德雾化吸入治疗支气管哮喘急性发作患者,可改善患者肺功能和调节患者血清IL-4和IFN-γ水平,纠正体内免疫功能失调,其疗效优于单用布地奈德雾化吸入的疗效     

硫酸特布他林联合布地耐德对支气管扩张合并支气管哮喘患者的临床反应性

目的观察硫酸特布他林联合布地耐德雾化吸入治疗对支气管扩张合并支气管哮喘的临床反应性。方法选择98例经HRCT明确诊断为支气管扩张,并且在临床同时有可逆性气道反应-支气管哮喘的患者随机分为两组。治疗组48例给予硫酸特布他林联合布地耐德雾化吸入;对照组50例给予常规治疗。观察用药后两组患者的症状改善、肺功能指标{第1秒最大呼气量(FEV1)、FEV1/FVC%、峰流速(PEF)}的变化。结果治疗组前后症状记分由12.13分下降至5.06分,对照组有11.26分下降至10.21分。治疗4个月后治疗组肺功能各指标(FEV1、FEV1/FVC%、PEF)明显改善(P<0.01)。结论支气管扩张合并支气管哮喘患者在常规治疗基础上,硫酸特布他林联合布地耐德雾化吸入治疗,能有效改善患者临床症状及通气功能,缩短病程。     

双歧杆菌对支气管哮喘儿童肺功能及血清IFN-γ、IL-4的影响

目的:探讨双歧杆菌辅助治疗儿童支气管哮喘的临床疗效及其对肺功能、血清IFN-γ、IL-4的影响。方法:选取2018年7月～2020年2月某院收治的72例支气管哮喘急性发作期患儿为研究对象,随机分为对照组和观察组。对照组予常规治疗,观察组联用双歧杆菌三联活菌片,观察并比较两组患儿症状、体征消失时间、肺功能以及血清IFN-γ、IL-4水平。结果:治疗后两组患儿肺功能指标FEV1、FEV1/FVC、MEF25%及MEF50%均有明显改善(P0.05),且观察组优于对照组(P0.05);两组患儿临床症状、体征消失时间无明显差异(P0.05);治疗后两组患儿血清IFN-γ水平明显升高、IL-4水平明显下降(P0.05);但两组组间比较无明显差异(P0.05)。结论:与哮喘常规治疗相比,双歧杆菌联合治疗方案能够有效改善哮喘患儿肺功能,但对哮喘急性发作症状体征持续时间及血清IFN-γ、IL-4水平无明显影响。     

特布他林与布地奈德雾化吸入对支气管哮喘患儿的疗效及其对血清TNF-α、IL-6水平及肺功能的影响

目的:评价特布他林与布地奈德雾化吸入对儿童支气管哮喘患者的疗效及其对血清TNF-α、IL-6水平和肺功能的影响。方法:选取2012年6月—2016年5月间收治的支气管哮喘儿童患者82例,将其分为对照组40例和观察组42例;对照组患者给予吸氧、抗过敏、消炎、止咳等常规治疗,观察组患者则在对照组基础上给予特布他林及布地奈德雾化吸入治疗,7 d为1疗程,比较两组患儿治疗后的总有效率的差异和肺功能、炎症各指标以及喘息、咳嗽、咳痰等症状评分值的改善情况。结果:治疗后,两组患者喘息、咳嗽、咳痰等症状评分值、TNF-α、IL-6、Hs-CRP测得值低于治疗前(P<0.05);观察组患者治疗后用力肺活量(FVC)、第1秒用力呼气量(FEV1)、FEV1/FVC等肺功能指标高于对照组(P<0.05),总有效率为95.24%高于对照组为77.50%(P<0.05)。结论:特布他林与布地奈德联用雾化吸入治疗儿童支气管哮喘的疗效较为显著,可有效地改善肺功能和炎症指标。     

止咳平喘方辅助治疗支气管哮喘疗效观察及对肺功能、细胞因子的影响

目的观察止咳平喘方治疗支气管哮喘患儿的效果及对肺功能、细胞因子的影响。方法 185例支气管哮喘患儿随机分为治疗组95例和对照组90例,对照组给予西医常规治疗,治疗组在对照组治疗方法的基础上给予止咳平喘方。治疗28 d后观察2组患儿的临床疗效以及肺功能[第1秒最大呼气量(FEV1)、峰流速值(PEF)、第1秒最大呼气量占用力肺活量的比值(FEV1/FVC)]、辅助性T细胞亚群(Th1/Th2)型细胞因子[γ-干扰素(IFN-γ)、白细胞介素(IL)-4、IL-6、IL-8]的变化。结果治疗组总有效率为97.89%,对照组为93.33%,2组比较差异有统计意义(P0.05);治疗后2组患儿肺功能指标FEV1,PEF,FEV1/FVC及细胞因子IFN-γ,IL-4,IL-6,IL-8均显著改善,与同组治疗前比较差异有统计意义(P0.05),且治疗组作用显著优于对照组(P0.05)。结论止咳平喘方可提高支气管哮喘患儿的临床疗效,有助于改善肺功能、纠正Th1/Th2型细胞因子水平,值得临床推广。     

龙香平喘胶囊联合噻托溴铵治疗老年支气管哮喘的临床研究

目的探讨龙香平喘胶囊联合噻托溴铵喷雾剂治疗老年支气管哮喘的临床疗效。方法选取2017年10月—2019年10月在平煤神马医疗集团总医院治疗的80例老年支气管哮喘患者,随机分为对照组(40例)和治疗组(40例)。对照组患者吸入噻托溴铵喷雾剂,2揿/次,1次/d。治疗组在对照组的基础上口服龙香平喘胶囊,3粒/次,3次/d。两组患者治疗10 d。观察两组患者临床疗效,比较治疗前后两组患者临床症状消失时间,肺功能指标第1秒用力呼气量(FEV1)、用力肺活量(FVC)、FEV1/FVC和最大呼气流速峰值(PEFR),血清白细胞介素4(IL-4)、IL-18、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)和干扰素γ(INF-γ)水平及不良反应情况。结果治疗后,治疗组临床总有效率明显高于对照组(P0.05)。治疗后,治疗组患者临床症状消失时间均显著早于对照组(P0.05)。治疗后,两组患者FEV1、FVC、FEV1/FVC、PEFR指标均显著升高(P0.05),且治疗组明显高于对照组(P0.05);治疗后,两组患者IL-4、IL-18、TNF-α、CRP水平显著降低,而INF-γ水平显著升高(P0.05),且治疗组患者血清炎性因子水平明显好于对照组(P0.05)。治疗后,治疗组患者药物不良反应总发生率明显低于对照组(P0.05)。结论龙香平喘胶囊联合噻托溴铵喷雾剂治疗老年支气管哮喘临床效果显著,可有效减轻患者症状,改善肺功能状态及降低炎性因子反应。     

布地奈德与特布他林雾化吸入联用对支气管哮喘患者的临床疗效及其对肺功能的影响

目的:探究布地奈德与特布他林雾化吸入联用对支气管哮喘患者的临床疗效及其对肺功能的影响。方法:选取2017年9月—2018年9月间收治的支气管哮喘患者102例资料,按治疗方法的不同将其分为对照组和联用组,每组51例;对照组患者在常规治疗基础上给予布地奈德雾化吸入治疗,联用组患者在对照组患者基础上加用特布他林雾化吸入治疗,比较两组患者治疗后的总有效率差异,以及治疗前后血清炎症因子如血清白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和肺功能指标(FVC、FEV1、PEF)水平测得值的变化情况。结果:两组患者治疗后IL-1、L-6、TNF-α水平测得值均低于治疗前(P<0.05),联用组患者治疗后IL-1、L-6、TNF-α水平测得值低于对照组(P<0.05);治疗后两组患者用力肺活量(FVC)、第1秒用力呼吸容积(FEV1)和呼气风流速(PEF)均高于治疗前(P<0.05),联用组患者治疗后FVC、FEV1、PEF水平值均高于对照组(P<0.05);联用组患者治疗后的总有效率高于对照组(P<0.05)。结论:采用布地奈德与特布他林雾化吸入联用治疗支气管哮喘患者的疗效优于单用布地奈德雾化吸入,有效降低了其炎症因子水平,改善了肺功能。     

多索茶碱联合布地奈德气雾剂雾化对支气管哮喘急性发作患者肺功能的影响

目的:探究多索茶碱联合布地奈德气雾剂雾化对支气管哮喘急性发作患者治疗效果.方法:回顾性选取104例我院支气管哮喘急性发作患者(2019-01～ 2020-01),52例采用布地奈德气雾剂雾化治疗列为对照组,52例采用多索茶碱联合布地奈德气雾剂雾化治疗列为实验组,两组均给予常规治疗.比较两组疗效、治疗前后哮喘控制评分(ACT)、肺功能[呼气峰值流速(PEF)、用力肺活量(FVC)、一秒用力呼气容积(FEV1)]、炎性因子[干扰素-γ(IFN-γ)、白介素-4(IL-4)]水平.结果:实验组总有效率90.38％(47/52)高于对照组75.00％ (39/52) (P＜0.05);治疗后两组ACT评分均较治疗前升高,且实验组高于对照组(P＜0.05);治疗后两组FVC、FEV1、PEF水平均较治疗前改善,且实验组高于对照组(P＜0.05);治疗后两组血清IFN-γ、IL-4含量均较治疗前改善,且实验组IL-4低于对照组,IFN-γ高于对照组(P＜0.05).结论:支气管哮喘急性发作患者采用多索荼碱联合布地奈德气雾剂雾化治疗效果显著,可有效提高患者肺功能,控制哮喘发作,通过调节血清IFN-γ、IL-4水平,改善患者免疫功能.     

复方鲜竹沥液联合特布他林治疗儿童喘息性支气管炎的临床研究

目的研究复方鲜竹沥液联合硫酸特布他林雾化吸入用溶液治疗儿童喘息性支气管炎的临床疗效。方法选取2017年10月—2018年10月来天津市第三中心医院分院进行治疗的120例喘息性支气管炎患儿为研究对象,将所有患儿采用照抽签方式分为对照组和治疗组,每组各60例。对照组患儿雾化吸入硫酸特布他林雾化吸入用溶液,20kg以上患儿,5mg溶于生理盐水2 mL中,20 kg以下患儿,2.5 mg溶于生理盐水1 mL中,吸入时间10～15 min/次,2次/d。治疗组在对照组治疗的基础上口服复方鲜竹沥液,20 mL/次,3次/d。两组持续治疗14 d。观察两组的临床疗效,比较两组的临床症状缓解时间、肺功能指标、血清炎性因子水平。结果治疗后,对照组和治疗组的总有效率分别为81.67%、95.00%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组患儿咳嗽消失时间、喘息消失时间、肺部啰音消失时间显著短于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患儿第1秒用力呼气容积(FEV1)、峰值呼气流速(PEF)和FEV1/用力肺活量(FVC)均显著升高,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组患儿FEV1、PEF和FEV1/FVC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,两组患儿白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和C反应蛋白(CRP)水平均显著降低,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组患儿hs-CRP、IL-6、IL-8水平明显低于对照组,两组比较差异有统计学意义(P0.05)。结论复方鲜竹沥液联合硫酸特布他林雾化吸入用溶液治疗儿童喘息性支气管炎具有较好的治疗效果,能改善患儿临床症状和肺功能,降低血清炎性因子水平,安全性较高,具有一定的临床推广应用价值。     

氧驱动雾化吸入普米克令舒治疗小儿支气管哮喘急性发作的疗效及对肺功能的影响

目的:探讨氧驱动雾化吸入普米克令舒治疗小儿支气管哮喘急性发作的疗效及对肺功能的影响.方法:90例支气管哮喘患儿,随机分为对照组和研究组各45例.两组给予常规治疗,对照组予万托林吸入治疗,研究组予普米克令舒氧气驱动雾化吸入治疗.结果:两组FEV1/FVC(％)及PEF在治疗前比较,无显著差异(P>0.05),两组FEV1/FVC(％)及PEF在治疗后比较,研究组明显优于对照组(P<0.05).两组有效率比较,观察组优于对照组(P<0.05).结论:氧驱动雾化吸入普米克令舒治疗小儿支气管哮喘急性发作可有效改善症状及肺功能,效果显著.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.