泮托拉唑联合加贝酯治疗急性胰腺炎的临床研究

目的考察注射用泮托拉唑钠联合注射用甲磺酸加贝酯治疗急性胰腺炎的临床疗效。方法选取2016年2月—2017年3月在三二〇一医院就诊的急性胰腺炎患者68例作为研究对象,将所有患者随机分为对照组和治疗组,每组各34例。对照组患者静脉滴注注射用甲磺酸加贝酯,200 mg/d,1次/d。治疗组患者在对照组治疗的基础上静脉滴注注射用泮托拉唑钠,40mg/d,1次/d。两组患者均持续治疗7d。观察两组患者的临床疗效,同时比较两组患者治疗前后的生化指标和血清炎症因子水平。结果治疗后,治疗组总有效率为94.12%,显著高于对照组的79.41%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者的血淀粉酶(AMY)、尿淀粉酶(UAMY)和血尿素氮(BUN)水平均显著降低(P0.05);治疗后治疗组的生化指标水平显著低于对照组(P0.05)。治疗后,两组患者的血清白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平均显著降低(P0.05);治疗后治疗组炎症因子水平明显低于对照组(P0.05)。结论注射用泮托拉唑钠联合注射用甲磺酸加贝酯治疗急性胰腺炎具有较好的临床疗效,可改善患者的生化指标和炎症因子水平,且安全性高,具有一定的临床推广应用价值。     

胰胆炎合剂联合乌司他丁治疗急性胰腺炎的临床研究

目的研究胰胆炎合剂联合注射用乌司他丁治疗急性胰腺炎的临床疗效。方法选取2017年1月—2017年12月西安交通大学第一附属医院收治的急性胰腺炎患者120例为研究对象,所有患者随机分为对照组和治疗组,每组各60例。对照组静脉滴注注射用乌司他丁,10万单位加入到0.9%氯化钠注射液500 m L中,静滴时间2 h,1次/d。治疗组在对照组治疗的基础上口服胰胆炎合剂,1袋/次,2次/d。两组患者持续治疗7 d。观察两组的临床疗效,比较两组的临床症状恢复时间和生化指标水平。结果治疗后,对照组和治疗组的总有效率分别为85.00%、96.67%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组腹痛缓解时间、胃肠功能恢复时间、血尿淀粉酶正常时间、白细胞计数恢复时间均显著短于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组C反应蛋白(CRP)、白细胞(WBC)、淀粉酶(AMY)和乳酸脱氢酶(LDH)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);且治疗组生化指标水平明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论胰胆炎合剂联合注射用乌司他丁治疗急性胰腺炎具有较好的临床疗效,能改善患者临床症状,调节CRP、WBC、AMY和LDH水平,安全性较好,具有一定的临床推广应用价值。     

参麦注射液联合甲磺酸加贝酯治疗急性胰腺炎的疗效观察

目的探究参麦注射液联合甲磺酸加贝酯治疗急性胰腺炎的临床疗效。方法选取2014年1月—2016年7月重庆市巴南区第二人民医院收治的急性胰腺炎患者96例,随机分为对照组和治疗组,每组各48例。对照组在常规治疗的基础上静脉滴注注射用甲磺酸加贝酯,前3 d 300 mg/d,3 d后100 mg/d。治疗组患者在对照组的基础上静脉滴注参麦注射液40 m L/d,两组均治疗2周。观察两组的临床疗效,比较两组的临床症状改善及住院时间和血淀粉酶、尿淀粉酶、血白细胞(WBC)和血门冬氨酸氨基转移酶(AST)及其不良反应情况。结果治疗后,对照组和治疗组的总有效率分别为79.41%、91.67%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组的腹痛缓解时间、腹部压痛消失时间、住院时间和血淀粉酶恢复正常时间均短于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者的血淀粉酶、尿淀粉酶、血WBC和血AST均较治疗前显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组患者的上述观察指标均明显低于对照组,两组比较差异具有统计学意义(P0.05)。两组不良反应发生情况比较差异无统计学意义。结论参麦注射液联合甲磺酸加贝酯治疗急性胰腺炎的疗效显著,安全性较高,具有一定的临床推广应用价值。     

醋酸奥曲肽联合甲磺酸加贝酯治疗急性胰腺炎患者的临床疗效分析

目的 探讨醋酸奥曲肽联合甲磺酸加贝酯治疗急性胰腺炎的效果.方法 选择本院2014年1月至12月收治的急性胰腺炎患者50例为对照组,在常规对症治疗的基础上给予醋酸奥曲肽静脉滴注;另选择本院2015年1月至12月收治的急性胰腺炎患者50例为观察组,在对照组治疗基础上给予甲磺酸加贝酯静脉滴注,观察两组治疗效果.结果 观察组和对照组的总有效率分别为90.0％和70.0％,观察组明显高于对照组,组间比较差异有统计学意义(P＜0.05);两组治疗前CRP、IL-6水平比较差异无统计学意义(P＞0.05);治疗2d后,两组CRP、IL-6水平均明显下降,观察组CRP为(4.3±0.5)mg/L、IL-6为(29.7±3.9)μg/L,对照组CRP为(19.2±3.8) mg/L、IL-6为(55.8±6.8)μg/L,观察组改善效果更加明显(P＜0.05);观察组腹痛、腹胀缓解时间分别为(3.9±0.5)d、(2.1±0.3)d,对照组分别为(8.6±1.5)d、(6.6±1.2)d,观察组明显短于对照组(P＜0.05);观察组血淀粉酶水平为(3.8±0.3)U,对照组为(6.9±1.1)U,观察组较对照组明显下降,组间比较差异有统计学意义(P＜0.05).结论 醋酸奥曲肽联合甲磺酸加贝酯治疗急性胰腺炎可提高治疗效果,改善血清炎症因子和血淀粉酶水平,在较短的时间内缓解患者腹痛、腹胀症状,效果显著.     

清胰利胆丸联合加贝酯治疗急性胰腺炎的临床研究

目的 探讨清胰利胆丸联合加贝酯治疗急性胰腺炎的临床效果.方法 选取2020年1月—2020年12月河南科技大学第一附属医院收治的80例急性胰腺炎患者,使用随机数字表法将80例患者分成治疗组与对照组各40例.对照组静脉滴注注射用甲磺酸加贝酯,治疗开始3 d内,0.1 g/次,3次/d,之后调整为0.1 g/次,1次/d;...     

醋酸奥曲肽联合甲磺酸加贝酯治疗对急性胰腺炎患者血清炎症因子水平的影响

目的:探讨醋酸奥曲肽联合甲磺酸加贝酯治疗对急性胰腺炎患者血清炎症因子水平的影响。方法:选取我院消化内科住院部急性胰腺炎患者99例,随机分为3组,其中A组32例,给予醋酸奥曲肽治疗;B组33例,给予甲磺酸加贝酯治疗;C组34例,给予醋酸奥曲肽联合甲磺酸加贝酯治疗。治疗前、后对全部患者均采用酶联免疫吸附试验法检测血清炎症因子C-反应蛋白、α-肿瘤坏死因子和白介素-6的水平。结果:治疗后,与A组和B组相比,C组患者的治疗有效率显著更高,至腹痛缓解时间、腹胀缓解时间和排便恢复时间均显著更短,血淀粉酶水平也显著更低(P均<0.05),而A组和B组患者的上述各指标值比较差异均无统计学意义。治疗前,比较3组患者的3种血清炎症因子水平,差异均无统计学意义;治疗后,C组患者的上述血清炎症因子水平均显著低于A组和B组,且3组患者的这些血清炎症因子水平均显著低于治疗前(P均<0.05)。结论:醋酸奥曲肽联合甲磺酸加贝酯治疗急性胰腺炎的疗效较好,并能显著降低患者的血清炎症因子水平。     

甲磺酸加贝酯联合参芎葡萄糖注射液治疗重症胰腺炎的临床疗效分析

目的：探究甲磺酸加贝酯联合参芎葡萄糖注射液在治疗重症胰腺炎上的临床治疗效果。方法将我院收治的68例重症胰腺炎患者按照入院治疗的先后顺序分为联合用药组和对照组,对照组患者采用奥曲肽进行治疗,联合用药组则采用甲磺酸加贝酯和参芎葡萄糖注射液进行联合治疗。治疗结束后对比两组患者的临床疗效。结果治疗后,联合用药组的总有效率为94．12％,对照组为82．35％,比较两组患者的临床疗效,差异显著有统计学意义（ P＜0．05）。而联合用药组的腹痛缓解时间、血淀粉酶恢复正常时间、胰腺炎痊愈时间均明显少于对照组,1年内复发率低于对照组,两组患者比较差异有统计学意义（P＜0．05）。结论甲磺酸加贝酯联合参芎葡萄糖注射治疗重症胰腺炎,二者能够相互作用,其症状及临床指标恢复时间均少于常规治疗,疗效显著,可以将其作为治疗重症胰腺炎的首选方案在临床上积极推广。     

胰胆炎合剂联合生长抑素治疗急性胰腺炎的临床研究

目的 探讨胰胆炎合剂联合注射用生长抑素治疗急性胰腺炎的临床疗效。方法 选取2019年4月—2021年6月在南阳市中心医院就诊的83例急性胰腺炎患者,根据随机数字表法将所有患者分为对照组（40例）和治疗组（41例）。对照组静脉滴注注射用生长抑素,3 mg加入50 mL生理盐水中,静脉持续泵注,速度为250 μg/h,1次/d。治疗组在对照组基础上口服胰胆炎合剂,1袋/次,2次/d。两组患者连续治疗7 d。观察两组患者临床疗效,比较两组症状消失时间,血清脂肪酶、淀粉酶、高迁移率族蛋白B1（HMGB1）、二胺氧化酶（DAO）、白细胞介素-35（IL-35）水平。结果 治疗后,治疗组总有效率为92.68%,对照组总有效率为75.00%,组间有明显差异（P<0.05）。治疗后,治疗组的高热、腹痛、腹胀、恶心、呕吐消失时间短于对照组,差异有统计学意义（P<0.05）。治疗后,两组的脂肪酶、淀粉酶水平显著降低（P<0.05）,且以治疗组脂肪酶、淀粉酶水平降低更明显（P<0.05）。治疗后,两组的HMGB1、DAO、IL-35水平明显减少（P<0.05）;且治疗组治疗后的HMGB1、DAO、IL-35水平低于对照组,差异有统计学意义（P<0.05）。结论 胰胆炎合剂联合注射用生长抑素治疗急性胰腺炎的疗效确切,可改善临床症状,促进胰酶分泌,缓解炎症反应程度,药物安全性良好。     

清胰利胆颗粒联合异甘草酸镁治疗急性胰腺炎的临床研究

目的探讨清胰利胆颗粒联合异甘草酸镁注射液治疗急性胰腺炎的临床疗效。方法选取2015年12月—2017年12月东台市人民医院收治的120例急性胰腺炎患者作为研究对象,将患者随机分为对照组和治疗组,每组各60例。对照组患者静脉滴注异甘草酸镁注射液,将10 mg溶于10%葡萄糖注射液250 m L中,1次/d。治疗组在对照组治疗的基础上口服清胰利胆颗粒,1袋/次,3次/d。两组患者均持续治疗14 d。观察两组患者的临床疗效,比较两组的临床症状缓解时间、血清炎性因子水平和生化指标水平。结果治疗后,对照组和治疗组的总有效率分别为76.67%、93.33%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组患者腹水消失时间、腹痛消失时间、排气恢复时间、尿淀粉酶恢复时间和血淀粉酶恢复时间显著短于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血清C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组血清炎性因子水平明显低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血清淀粉酶(AMS)、血清脂肪酶(LPS)水平均显著降低,对氧磷酶1(PON1)水平显著升高,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组生化指标明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论清胰利胆颗粒联合异甘草酸镁注射液治疗急性胰腺炎疗效显著,能有效缓解患者临床症状,改善血清炎性因子水平和相关生化指标,具有一定的临床推广应用价值。     

胰胆舒颗粒联合兰索拉唑治疗急性胰腺炎的临床研究

目的研究胰胆舒颗粒联合注射用兰索拉唑治疗急性胰腺炎的临床疗效。方法选取2018年12月—2019年12月郑州大学附属洛阳中心医院收治的100例急性胰腺炎患者为研究对象,将所有患者随机分为对照组和治疗组,每组各50例。对照组患者静脉注射注射用兰索拉唑,30 mg溶于0.9%氯化钠注射液100 m L中,2次/d。治疗组在对照组基础上口服胰胆舒颗粒,10 g/次,3次/d。两组患者持续治疗10 d。观察两组患者临床疗效,比较两组的临床症状缓解时间、胰腺炎床旁严重度指数(BISAP)评分、血清学指标、血清炎性因子水平。结果治疗后,治疗组总有效率94.00%,显著高于对照组的80.00%(P0.05)。治疗后,治疗组排气恢复正常时间、腹水消失时间、血淀粉酶恢复正常时间、排气恢复正常时间、腹痛消失时间、尿淀粉酶恢复正常时间明显短于对照组(P0.05)。治疗后,两组胰腺炎床旁严重度指数(BISAP)评分显著降低(P0.05);并且治疗组BISAP评分降低较明显(P0.05)。治疗后,两组血清淀粉酶(AMS)、脂肪酶(LPS)水平显著降低(P0.05);并且治疗组血清AMS、LPS水平明显低于对照组(P0.05)。治疗后,两组患者血清肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)和白细胞介素-6(IL-6)水平显著降低(P0.05);并且治疗组血清TNF-α、CRP和IL-6水平明显低于对照组(P0.05)。结论胰胆舒颗粒联合注射用兰索拉唑治疗急性胰腺炎具有较好的治疗效果,能够改善临床症状,降低血清AMS和LPS、炎性因子水平,值得在临床上推广应用。     

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.     

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.