两组药物雾化吸入治疗慢性阻塞性肺疾病急性加重期的疗效观察及护理

目的沐舒坦联合布地奈德超声雾化吸入治疗慢性阻塞性肺疾病急性加重期（AECOPD）的疗效观察。方法54例AECOPD患者随机分为观察组和对照组，各27例，两组均在常规治疗的基础上加用超声雾化吸入，观察组用沐舒坦加布地奈德雾化吸入，对比两组治疗效果。结果观察组的疗效（92．5％）优于对照组（77．7％），两组比较差异有统计意义（P〈0．05）。结论沐舒坦联合布地奈德超声雾化吸入能够快速缓解AECOPD患者症状，缩短病程，副作用小，患者易于接受。     

博利康尼、普米克令舒及沐舒坦雾化吸入治疗慢性阻塞性肺疾病急性加重期的疗效观察

目的：探讨博利康尼、普米克令舒与沐舒坦联合吸入治疗慢性阻塞性肺疾病急性加重期（AECOPD）的疗效。方法：人选64例患者,随机分为治疗组和对照组,治疗组给予博利康尼、普米克令舒及沐舒坦雾化液以6-8L／min氧气驱动雾化吸入,2次／d;对照组给予常规雾化吸入。7-10d为1个疗程,比较两组治疗后的疗效。结果：两组临床疗效比较.差异具有统计学意义。结论：博利康尼、普米克令舒及沐舒坦氧气驱动雾化吸入治疗AECOPD疗效好,不良反应少,经济实用。     

沐舒坦联合利巴韦林治疗小儿支气管肺炎疗效观察

目的观察沐舒坦联合利巴韦林治疗小儿支气管肺炎的临床疗效。方法将我院收治的支气管肺炎患儿25例,随机分为试验组15例和对照组10例。对照组采用常规超声雾化吸入,试验组除采用抗感染、抗病毒治疗外,还加用沐舒坦联合利巴韦林氧气雾化吸入。观察2组的临床疗效。结果试验组总有效率为93.3%高于对照组的80.0%,差异有统计学意义（P〈0.01）。结论沐舒坦联合利巴韦林雾化吸入治疗小儿支气管肺炎不良反应小,疗效确切,有一定的临床推广价值。     

盐酸氨溴索雾化吸入防治术后肺部并发症 50 例及护理观 察简

目的探讨盐酸氨溴索雾化吸入对预防术后肺部并发症的作用。方法分析2010年至2012年医院收治的胸部及腹部手术患者100例,随机均分成试验组和对照组,各50例,试验组给予盐酸氨溴索注射液（沐舒坦）雾化吸入治疗,对照组给予常规的α-糜蛋白酶、地塞米松、庆大霉素雾化吸入治疗,比较两组患者术后肺部并发症的发生情况及症状疗效。结果患者肺部术后并发症的发生率,试验组肺部感染为4．00％、肺不张为6．00％,对照组肺部感染为16．00％、肺不张为18．00％,试验组并发症的发生率明显低于对照组（P〈0．05）;手术后第3天患者咳嗽的频率,试验组明显低于对照组（P〈0．05）;手术1周后症状总有效率,试验组明显高于对照组（19〈0．05）。结论盐酸氨溴索雾化吸入治疗用于胸、腹部手术患者防治肺部并发症,比传统的雾化吸入药物具有显著优势。     

氧驱动雾化吸入沙丁胺醇和沐舒坦治疗毛细支气管炎疗效观察

目的：探讨沙丁胺醇和沐舒坦氧驱动雾化吸入辅助治疗毛细支气管炎的效果。方法：随机将126例毛细支气管炎患儿分为治疗组（64例）和对照组（62例）,治疗组给予沙丁胺醇和沐舒坦氧驱动雾化吸入,对照组给予α-糜蛋白酶、庆大霉素、地塞米松超声雾化吸入。结果：治疗组治愈率、好转率、无效率及总有效率分别为82．81％、10．93％、6．25％、93．75％,对照组分别为45．16％、27．42％、27．42％、72．58％,有显著性差异（P〈0．05）。结论：应用沙丁胺醇和沐舒坦氧驱动雾化吸入辅助治疗婴儿毛细支气管炎效果满意,未见不良反应。     

沐舒坦超声雾化吸入佐治小儿肺炎66例疗效观察

目的观察沐舒坦超声雾化吸入佐治小儿肺炎的临床疗效及不良反应。方法选择本院近年来诊治的小儿肺炎患者66例,按前瞻性／随机化原则分为观察组和对照组各33例,两组均给予抗感染、补液、维持电解质及酸碱平衡等常规综合治疗,观察组在常规治疗基础上加用沐舒坦7．5～15mg超声雾化吸入,2次／d。对照组给予α糜蛋白酶4mg雾化吸入,2次／d。疗程均为5—7d。结果观察组治愈率69．7％,总有效率93．9％;对照组治愈率42．4％,总有效率75．7％。观察组治愈率和总有效率均明显高于对照组,差异有统计学意义（P〈0．05）。两组患儿研究观察期心率、呼吸等生命体征稳定,耐受性好,均未出现明显不良反应。结论沐舒坦可促进呼吸道内黏稠分泌物的排出及减少黏液的滞留,显著促进排痰,改善呼吸状况,佐治小儿肺炎能明显提高临床疗效。     

沐舒坦佐治新生儿肺炎疗效观察

目的探讨沫舒坦不同给药途径治疗新生儿肺炎的疗效。方法将2007年1月-2008年12月我科确诊为新生儿肺炎180例,随机分成4组,其中对照组采用吸氧,青霉素或头抱三嗪抗感染,补液等常规处理;（静脉静滴）治疗组1在对照组基础上加用沐舒坦静滴;（雾化）治疗组2在对照组基础上加用沐舒坦用氧气作驱动力雾化吸入;（静脉静滴＋雾化）治疗组3在对照组基础上加用沐舒坦静滴及沐舒坦用氧气作驱动力雾化吸入。结果治疗组在临床症状、体征及住院日均短于对照组（P〈0．01及P〈0．05）,治疗组疗效优干对照组,差异有统计学意义。结论沐舒坦无论是静脉滴注还是雾化吸入治疗新生儿肺炎具有疗效显著．安全．基层医院可以应用。     

早期应用外源性肺表面活性物质预防早产儿呼吸窘迫综合征疗效观察

目的：观察早产儿生后早期（2h内）使用肺表面活性物质（PS）预防早产儿呼吸窘迫综合征（RDS）的疗效。方法：我院出生的58例早产儿，其中治疗组28例于2h内气管内滴或注入PS预防早产儿RDS，剂量为100mg／kg，对照组30例常规给予氨茶碱、氨溴索治疗。结果：治疗组仅3例发生RDS，其中1例并发气胸放弃治疗，发生率10．7％。对照组有13例并发RDS，共5例因颅内出血、肺出血、气胸等放弃治疗。发生率43．4％。结论：早产儿早期使用PS可以有效减少及减轻RDS发生率及临床症状，有效提高早产儿存活率，安全性好。     

沐舒坦联合万托林雾化吸入辅助治疗毛细支气管炎疗效观察

目的探讨沐舒坦联合万托林雾化吸入辅助治疗毛细支气管炎疗效。方法124例急性毛细支气管炎患儿随机分为2组,治疗组予沐舒坦＋万托林雾化吸入：对照组予a-糜蛋白酶＋地塞米松镇雾化吸入。结果治疗组在显效率和总有效率方面高于对照组．差异有统计学意义（P〈0．05）症状消失时间和住院时间明显少于对照组,经t检验差异有显著意义（P〈0．05）。两组患者均未见明显不良反应。讨论沐舒坦联合万托林雾化吸入辅助治疗毛细支气管炎疗效显著。     

雾化吸入易坦静对预防早产儿呼吸窘迫综合征的影响

目的研究雾化吸入易坦静预防早产儿呼吸窘迫综合征(RDS)的临床疗效。方法将126例早产儿随机分为实验组63例和对照组63例。均给予一般治疗,实验组再给予雾化吸入易坦静2.5ml,q12h,疗程3～4d。结果实验组早产儿RDS 发生率为4.7%(3/63),对照组早产儿 RDS 发生率为17.4%(11/63)。结论雾化吸入易坦静对预防早产儿呼吸窘迫综合征(RDS)有一定疗效。     

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.     

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.