铋剂在幽门螺杆菌治疗中的合理应用

目的 观察铋剂控制幽门螺杆菌的临床疗效及药物不良反应.方法 64例幽门螺杆菌阳性的消化性溃疡患者,分别应用铋剂联合抗生素治疗及单用抗生素治疗,观察临床疗效及药物不良反应.结果 两组患者治疗2周幽门螺杆菌根除率分别为:90.63%(29/32),71.88%(23/32),药物不良反应轻微.结论铋剂联合抗生素治疗幽门螺杆菌的临床疗效比单用抗生素效果好,不良反应轻微可以耐受,值得临床推广.     

序贯疗法和四联疗法治疗根治失败的幽门螺杆菌感染疗效评价

目的评价含左氧氟沙星序贯疗法和含铋剂四联疗法治疗根除失败的幽门螺杆菌感染的疗效以及发生不良反应,并复习相关文献。方法将58例经传统标准三联疗法(7d)根除幽门螺杆菌失败的患者,随机分成治疗组和对照组。治疗组(序贯疗法)方案为前5d雷贝拉唑+左氧氟沙星,后5d雷贝拉唑+克拉霉素+呋喃唑酮,疗程10d。对照组(四联疗法)方案为质子泵抑制剂+克拉霉素+甲硝唑+铋剂,疗程7d。治疗结束至少4周后,通过13C-尿素呼吸试验判断根除幽门螺杆菌效果,并评价耐受性。结果序贯疗法(治疗组)幽门螺杆菌根除率为81.2%,四联疗法(对照组)幽门螺杆菌根除率为73.1%,两组间比较差异有统计学意义(P<0.05)。不良反应发生率相似,无严重的不良反应病例。结论含左氧氟沙星序贯疗法(10d)和含铋剂四联疗法(7d)均是治疗根除幽门螺杆菌感染失败患者有效的补救措施,而不良反应均不明显。但含左氧氟沙星序贯疗法疗效更为满意,为幽门螺杆菌补充治疗方案提供新的思路。     

不同治疗方案对幽门螺杆菌初次根除效果对比

目的对比不同治疗方案对幽门螺杆菌初次根除效果。方法选取在我院行幽门螺杆菌初次根除患者720例,按照随机数字表法分为A、B、C组,每组240例。A组采用7d不含铋剂四联疗法,B组采用7d标准三联疗法,C组采用10d标准三联治疗法,比较三组患者的幽门螺杆菌根除效果及不良反应。结果 A组意向性治疗(ITT)根除率显著高于B组与C组,差异有统计学意义(P<0.05),A组符合方案集(PP)根除率显著高于B组与C组(P<0.05)。三组不良反应发生率比较,差异无统计学意义(P>0.05)。结论采用7d不含铋剂四联疗法可有效提高幽门螺杆菌根除效果,用药安全性较高,值得在幽门螺杆菌初次根除治疗中推广。     

泮托拉唑、铋剂联合抗生素治疗幽门螺杆菌阳性的消化性溃疡临床疗效观察

目的观察泮托拉唑、铋剂联合抗生素治疗幽门螺杆菌阳性的消化性溃疡临床疗效。方法观察52例幽门螺杆菌阳性的消化性溃疡患者应用泮托拉唑、铋剂联合抗生素治疗的临床疗效。结果 52例患者治疗2周幽门螺杆菌根除率为82.69%(43/52),治疗4周消化性溃疡愈合率为59.62%(31/52),不良反应轻微。结论泮托拉唑、铋剂联合抗生素治疗幽门螺杆菌阳性的消化性溃疡临床疗效好,不良反应轻微可以耐受,值得临床推广。     

抗幽门螺杆菌药物的临床研究进展

目前用于根除幽门螺杆菌（Helicobacter pylori, HP）感染的药物主要有质子泵抑制剂、相关抗生素、铋剂、益生菌及中医药等。要提高HP的根除率,就必须坚持个体化治疗,选择最佳组合。本文对根除幽门螺杆菌的临床药物研究进展进行综述。     

国产铋剂三联疗法治疗胃幽门螺杆菌感染的疗效观察

幽门螺杆菌感染与不同严重程度的多种胃、十二指肠组织病理学改变相关，包括慢性活动性胃炎、萎缩性胃炎、消化性溃疡、胃癌及胃粘膜相关淋巴样组织(MALT)淋巴瘤等。对上述疾病进行根除幽门螺杆菌治疗已得到国内外学者的广泛公识。铋剂在根除幽门螺杆菌治疗的应用中具有独特的优势。本临床研究旨在考察苏州东瑞制药有限公司生产的先瑞牌枸橼酸铋钾(以下简称先瑞)在三联疗法中对幽门螺杆菌(HP)的根除率，同时评价先瑞三联疗法在治疗HP感染过程中的安全性。     

含铋剂四联疗法根除2型糖尿病患者幽门螺杆菌感染的临床研究

目的探讨含铋剂四联疗法治疗2型糖尿病患者幽门螺杆菌(Hp)感染的有效性和安全性。方法将165例2型糖尿病幽门螺杆菌感染初治患者随机分为LAC(兰索拉唑、阿莫西林和克拉霉素,n=84)组和LACB(兰索拉唑、阿莫西林、克拉霉素和胶体果胶铋,n=81)组,2组疗程均为10 d,治疗结束后6周对根除Hp疗效进行观察。结果 LACB组Hp根除率90.1%,LAC组Hp根除率53.6%,LACB组Hp根除率明显高于LAC组(P<0.001);2组不良反应率比较差异无统计学意义(13.6%vs 8.3%,P=0.280)。结论相比标准三联疗法,含铋剂四联疗法能显著提高2型糖尿病患者幽门螺杆菌感染的初治成功率,不良反应少,安全有效。     

抗幽门螺杆菌的用药研究进展

幽门螺杆菌(Helicobacter pylori,Hp)感染不仅与胃炎、消化性溃疡、胃癌等消化系统疾病关系密切,还与缺血性心脑血管疾病、脑出血、糖尿病等多种非消化系统疾病有关.目前用于根除幽门螺杆菌感染的药物主要有质子泵抑制剂、抗生素、铋剂、益生菌及中药等.然而,面对我国基数庞大的感染人口,幽门螺杆菌的根除率却在逐年...     

含铋剂四联疗法治疗消化性溃疡幽门螺杆菌感染的疗效分析

目的 探讨含铋剂四联疗法治疗消化性溃疡幽门螺杆菌感染的临床疗效.方法 收集本院2013年7月至2015年4月收治的消化性溃疡幽门螺杆菌感染患者208例前瞻性研究且随机分为两组,每组104例,实验组患者给予阿莫西林+泮托拉唑+呋喃唑酮+胶体果胶铋四联疗法治疗,对照组患者则给予阿莫西林+泮托拉唑+克拉霉素三联疗法治疗,比较两组患者胃溃疡与十二指肠溃疡治疗效果评价、幽门螺杆菌根除率与药物不良反应情况等.结果 实验组患者胃溃疡(95.00％)与十二指肠溃疡(98.44％)治疗效果评价显著优于对照组(75.00％,83.33％),差异具有统计学意义(P＜0.01);实验组患者胃溃疡(90.00％)与十二指肠溃疡(95.31％)幽门螺杆菌根除率显著高于对照组(68.18％,71.67％),差异具有统计学意义(P＜0.01);两组患者药物不良反应情况比较(6.72％ vs.3.84％),差异无统计学意义(P＞0.05).结论 含铋剂四联疗法治疗消化性溃疡幽门螺杆菌感染的临床疗效显著,且安全性较好,具有借鉴性.     

奥美拉唑及胶体果胶铋四联疗法根除幽门螺杆菌感染的研究

目的探讨奥美拉唑及胶体果胶铋的四联疗法根除幽门螺杆菌感染的疗效。方法本研究以60例幽门螺杆菌感染患者为研究对象,随机平均分为3组,Ⅰ组采用奥美拉唑、胶体果胶铋、阿莫西林和克拉霉素四联疗法治疗;Ⅱ组采用奥美拉唑、阿莫西林和克拉霉素三联疗法治疗;Ⅲ组采用胶体果胶铋、阿莫西林和克拉霉素三联疗法治疗,对比分析三组患者治疗效果。结果奥美拉唑和胶体果胶铋的四联疗法与另外两种三联疗法相比,幽门螺杆菌感染的患者症状显著改善(改善率95%)、根除情况显著较好(根除率(95%),药物不良反应情况少(5%)(P<0.05)。结论含奥美拉唑和胶体果胶铋的四联疗法相比三联疗法根除幽门螺杆菌的临床效果安全、可靠,值得临床推广应用。     

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.