磷酸肌酸钠在新生儿缺氧缺血性心肌损害中的疗效分析

目的探讨磷酸肌酸钠在新生儿缺氧缺血性心肌损害中的疗效。方法选择我院2010年4月至2012年4月缺氧缺血性心肌损伤新生儿共60例,上述患儿随机分为观察组和对照组。对照组给予常规治疗,观察组在常规治疗中给予磷酸肌酸钠。两组患儿在治疗前和治疗后测定心肌酶谱的改变情况,测定天冬氨酸转氨酶、肌酸激酶、肌酸激酶同工酶水平。结果观察组治疗前天冬氨酸转氨酶、肌酸激酶、肌酸激酶同工酶水平分别与对照组治疗前比较,差异无统计学意义(P>0.05);观察组治疗后天冬氨酸转氨酶、肌酸激酶、肌酸激酶同工酶水平分别与对照组治疗后比较,差异有统计学意义(P<0.05)。结论磷酸肌酸钠在新生儿缺氧缺血性心肌损害中的疗效显著,能够显著改善心肌损伤,值得借鉴。     

鼠神经生长因子对新生儿缺氧缺血性脑病患儿血清神经肽Y和神经元特异性烯醇化酶水平的影响及疗效观察

摘 要 目的： 探讨鼠神经生长因子对新生儿缺氧缺血性脑病(HIE)患儿血清神经肽Y(NPY)和神经元特异性烯醇化酶(NSE)水平的影响及疗效观察。方法: 采用随机数字表法将70例新生儿HIE患儿分成观察组和对照组。两组患儿均予以吸氧、控制颅内压、血压和血糖,抗惊厥、保持水电解质平衡等常规治疗。观察组患儿加用鼠神经生长因子20 μg, im,qd。对照组患儿加用胞磷胆碱注射液100 mg,ivd,qd,均连用10～14 d。观察两组患儿治疗前后血清NPY 和NSE水平变化,比较两组疗效及药品不良反应,随访1年内神经系统后遗症的发生率。结果: 治疗2周后,两组血清NPY和NSE水平较前均明显下降(P<0.05和P<0.01),且观察组下降幅度明显大于对照组(P<0.05);观察组临床总有效率为94.28%,明显高于对照组的68.57%(P<0.01),两组患儿治疗中未出现明显药品不良反应。随访观察1年,观察组后遗症的发生率明显低于对照组(P<0.05)。结论: 鼠神经生长因子治疗新生儿HIE的疗效肯定,安全性好,可促进受损神经元细胞的修复,减少神经系统后遗症的发生率,其作用与降低血清NPY和NSE水平密切相关。     

磷酸肌酸钠治疗新生儿缺氧缺血性心肌损害的疗效观察

目的观察磷酸肌酸钠治疗新生儿缺氧缺血性心肌损害治疗效果。方法对72例新生儿缺氧缺血性心肌损害患儿随机分为对照组及治疗组,对照组采用常规治疗措施,治疗组在常规治疗措施基础上加用磷酸肌酸钠。观察两组患儿治疗前后心肌酶谱变化。结果治疗组心肌酶谱下降水平优于对照组,差异有统计学意义(P0.05)。结论磷酸肌酸钠在治疗对新生儿缺氧缺血性心肌损害的患儿疗效显著,值得应用。     

磷酸肌酸钠辅助治疗高血压并发急性左心衰竭患者的临床研究

摘 要 目的：探讨磷酸肌酸钠辅助治疗原发性高血压所致的急性左心衰患者心功能疗效,并观察血清细胞色素C（Cyt C）及心肌营养素 1（CT 1）的变化。方法: 选取原发性高血压并发急性左心衰竭患者73例,随机分为对照组（n=35）和观察组（n=38）,对照组患者给予吸氧、利尿、降血压、扩张血管治疗,观察组患者在对照组基础上加用磷酸肌酸钠1.0 g,ivd,qd治疗;观察患者治疗前、治疗3 d及治疗7 d NYHA心功能分级改变、6 min步行距离、左心室射血分数（LVEF）变化;比较两组患者治疗前、治疗3 d、7 d血清中N端脑钠肽前体（NT proBNP）、人基质裂解素2（ST2）、Cyt C及CT 1含量变化。结果:两组患者治疗3 d、7 d后心功能指标均较前治疗前明显改善,血清NT proBNP、ST2、Cyt C及CT 1含量均较前显著降低（P＜0.05）。观察组治疗3 d、7 d心功能指标明显优于对照组,血清NT proBNP、ST2、Cyt C及CT 1含量明显低于对照组（P＜0.05）。结论:磷酸肌酸钠辅助治疗高血压并发急性左心衰竭有较好临床疗效,其机制可能为增强心肌细胞能量代谢,减少心肌细胞凋亡有关。     

脑苷肌肽对缺血缺氧性脑病患儿血浆炎症因子影响及疗效

摘 要 目的:观察脑苷肌肽对缺血缺氧性脑病(HIE)患儿血浆炎症因子影响及疗效。方法: 65例HIE患儿分为观察组和对照组。两组均常规予以吸氧,控制颅内压、血压和血糖,抗惊厥,维持水、电解质及酸碱平衡等基础治疗。对照组在此基础上加用脑活素注射液2.5 ml,ivd,qd,连用10 d;观察组在此基础上加用脑苷肌肽注射液2 ml,ivd,qd,连用10 d。观察两组治疗前后血浆hs-CRP、IL-18和TNF-α水平变化,并比较两组疗效。结果:治疗后,两组患儿血浆hs-CRP、IL-18和TNF-α水平均有明显下降(P<0.05或0.01),且观察组的下降幅度比对照组更显著(P<0.05);观察组总有效率高于对照组(P<0.05;两组患儿治疗期间均未发生明显药物不良反应。结论:脑苷肌肽治疗新生儿HIE安全、有效,能降低新生儿HIE血浆hs-CRP、IL-18和TNF-α水平,具有抑制炎症反应作用。     

磷酸肌酸钠联合果糖二磷酸钠治疗新生儿窒息后心肌损伤的疗效观察

目的 研究注射用磷酸肌酸钠联合果糖二磷酸钠注射液对新生儿窒息患儿心功能的影响。方法 选择2015年1月—2018年6月宝鸡市人民医院收治的70例新生儿窒息后心肌损伤患儿作为研究对象,采用抽签法将患儿随机分为两组。对照组将果糖二磷酸钠注射液250 mg/（kg·d）溶于30 mL的10%葡萄糖溶液中静脉滴注。观察组在对照组治疗的基础上,将注射用磷酸肌酸钠0.5 g溶于30 mL的10%葡萄糖溶液中静脉滴注。两组均治疗2周。观察两组患者的临床疗效,同时比较两组治疗前后的肌酸激酶同工酶（CK-MB）、肌钙蛋白T（CTnT）、肌酸激酶（CK）和乳酸脱氢酶（LDH）水平及左室射血分数（LVEF）。结果 治疗后,观察组的总有效率为94.29%,明显高于对照组的71.43%（P<0.05）。治疗后,两组CKMB、CTnT、CK和LDH水平均明显降低（P<0.05）;且观察组血清学指标显著低于对照组（P<0.05）。治疗后,两组LVEF均明显升高（P<0.05）,且观察组显著高于对照组（P<0.05）。结论 注射用磷酸肌酸钠联合果糖二磷酸钠注射液可以提高新生儿窒息后心肌损伤的疗效,有效改善心功能,具有临床推广应用价值。     

孟鲁司特钠联合糠酸莫米松鼻喷雾剂治疗过敏性鼻炎的疗效观察

摘 要 目的：探讨孟鲁司特钠与糠酸莫米松联合治疗过敏性鼻炎患儿的临床疗效及其安全性。方法: 过敏性鼻炎门诊患儿91例随机分为观察组46例和对照组45例。对照组采用糠酸莫米松喷雾剂治疗,观察组在对照组基础上加用孟鲁司特钠治疗。两组疗程均为2周。比较两组患儿治疗前后鼻塞、喷嚏、鼻痒、流涕等症状积分,以及血清IL-4、IL-12、IgE水平变化;评价两组疗效及药品不良反应。结果: 观察组总有效率为93.48%,高于对照组的75.56%（P＜0.05）。治疗后,两组鼻塞、喷嚏、鼻痒、流涕积分均较治疗前降低（P＜0.05）;且观察组各项症状积分均低于对照组（P＜0.05）。治疗后,两组患儿血清IL-4、IgE水平较治疗前降低,IL-12水平较前增加（P＜0.05）;观察组患儿上述指标明显优于对照组（P＜0.05）。两组患儿均未发生药品不良反应。结论:孟鲁司特钠联合糠酸莫米松喷雾剂治疗过敏性鼻炎疗效显著,安全性好。     

磷酸肌酸钠治疗新生儿缺氧缺血性心肌损伤临床观察

目的观察静脉滴注磷酸肌酸钠对于新生儿缺氧缺血性心肌损伤治疗的临床疗效。方法选择2012年9月一2013年12月,本院新生儿科收治的78例缺氧缺血性心肌损伤的患儿,随机分为治疗组40例,对照组38例。2组均给予常规及能量合剂营养支持对症治疗;治疗组在此基础上另给予静脉滴注磷酸肌酸钠,0．5g／次,1次／d,10d为1个疗程,观察2组患儿治疗前后临床表现、体征及心肌酶谱的改变。结果总有效率对照组为78．94％,治疗组为92．50％,治疗组明显高于对照组;2组治疗后心肌酶谱比较,差异有统计学意义（P〈0．05）。结论新生儿缺氧缺血性心肌损害检测指标特异敏感;对于新生儿缺氧缺血性心肌损伤给予静脉滴注磷酸肌酸钠疗效显著,无明显不良反应。     

神经节苷酯辅助治疗急性脑梗死患者的疗效及对其血清hs-CRP、TNF-α的影响

摘 要 目的： 探讨神经节苷脂钠治疗急性脑梗死患者的疗效及对其血清高敏C反应蛋白（hs-CRP）、肿瘤坏死因子α（TNF-α）的影响。方法: 急性脑梗死患者216例随机分为观察组与对照组,每组108例。对照组患者予常规治疗,观察组患者在对照组基础上加用神经节苷脂注射液100 mg加入0.9%氯化钠注射液250 ml,ivd,qd。两组疗程均为14 d。评价两组临床疗效,比较两组患者治疗前后神经功能缺损程度评分（NDS）、日常生活活动量评分,以及血清hs-CRP和TNF-α水平变化。观察两组药品不良反应发生情况。结果: 观察组治疗总有效率为90.7%,明显高于对照组的71.3%（P＜0.05）。治疗后,观察组NDS评分较前明显降低,而ADL评分较前明显提高（P＜0.05）,且与对照组比较,差异均有统计学意义（P＜0.05）;而对照组患者治疗前后NDS及ADL评分无明显变化（P＞0.05）。两组患者治疗后血清hs-CRP和TNF-α水平均较治疗前明显降低（P＜0.05）,且观察组血清hs-CRP和TNF-α水平明显低于对照组（P＜0.05）。治疗期间两组患者均未见药品不良反应发生。结论: 神经节苷脂钠辅助治疗急性脑梗死疗效良好,能显著降低患者血清hs-CRP和TNF-α水平,改善患者NDS及ADL评分,且安全性好,值得在临床上进一步推广应用。     

阿奇霉素与头孢呋辛治疗儿童呼吸道感染疗效比较

摘 要 目的： 比较阿奇霉素与头孢呋辛治疗儿童呼吸道感染的疗效及对患儿血清前白蛋白（PA）、C反应蛋白（CRP）与降钙素原（PCT）水平的影响。方法: 120例呼吸道感染患儿随机分为两组各60例。观察组采用阿奇霉素（10 mg·kg^-1·d^-1 ivd）治疗,对照组采用头孢呋辛钠(30 mg·kg^-1, ivd,q8h)治疗,疗程均为5d。比较两组患儿治疗前后CRP、PA、PCT水平变化,以及临床症状消失时间和疗效。结果: 治疗后,两组患儿的CRP和PCT均明显降低,PA明显升高(P<0.05),但组间差异无统计学意义(P>0.05)。观察组患儿咳嗽消失、退热、肺啰音消失和气急消失时间均明显短于对照组(P<0.05)。两组疗效和药品不良反应发生率差异无统计学意义(P>0.05)。结论:阿奇霉素治疗儿童呼吸道感染的疗效与头孢呋辛钠相当,但症状消失较快。     

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.     

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.     

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.     

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.