纤维支气管镜对支气管结核的诊治价值

目的探讨和评价纤维支气管镜在支气管结核早期诊断及治疗中的价值。方法分析54例支气管结核患者的纤维支气管镜下表现及经纤维支气管镜局部灌注抗结核药治疗气管结核。结果纤维支气管镜表现:炎性侵润型22.22%,溃疡型51.85%,增殖型(包括瘢痕狭窄)25.92%。治疗结果,51例菌阳患者全部转阴,纤维支气管镜所见病灶完全吸收或明显吸收、管腔通畅,总有效率为100%。结论支气管结核临床及X线、CT表现特异性不强,纤维支气管镜检查为支气管结核早期诊断的主要措施,且经纤维支气管镜局部灌注抗结核药治疗支气管结核疗效显著、副作用少、安全可靠,值得广泛推广应用。     

纤维支气管镜检查对支气管结核的诊断价值

目的 探讨纤维支气管镜检查对支气管结核的诊断价值.方法 通过纤维支气管镜活检和细菌学的检查对56例支气管结核进行回顾性分析.结果 纤维支气管镜检查支气管异常发现率100%,纤维支气管镜下主要表现为充血水肿病变36例,占64%;病检、刷检与灌洗液检查找抗酸杆菌阳性率可达91%.结论 支气管结核的临床表现缺乏特异性,支气管镜检查在确诊支气管结核,减少漏诊、误诊率方面确实具有重要的临床意义.     

痰热清注射液治疗小儿支气管肺炎临床分析

目的:观察痰热清注射液对儿童支气管肺炎的疗效。方法:将124例支气管肺炎患儿随机分成两组。治疗组64例给予痰热清注射液1mg/(kg.d)静脉滴注,1次/d;对照组60例给予头孢噻肟100￣150mg/(kg.d)或氨氯西林50￣100mg/(kg.d)加利巴韦林10￣15mg/(kg.d)分两次静脉滴注,疗程均为7￣10d。结果:治疗组总有效率95.31%,对照组总有效率98.33%,两组总有效率比较,差异无统计学意义(P>0.05)。结论:痰热清注射液是治疗儿童支气管肺炎的有效药物。     

纤支镜在支气管内膜结核诊断中的应用

目的 探讨纤维支气管镜在支气管内膜结核的诊断价值。方法 采用目标Olympus P30型纤维支气管镜,按纤支镜常规方法局庥和镜检,观察各肺段支气管黏膜情况,钳取及刷检病变部位,行病理组织学检查及涂片找抗酸杆菌,并通过纤支镜对病变部位的支气管进行冲洗,对冲洗液涂片作抗酸染色和培养结核杆菌。结果 60例患者支气管黏膜活检刷检经病理或抗酸染色诊断结核病者51例(85.0％),镜检后痰涂片或冲洗液中找到抗酸杆菌9例。结论 纤维支气管镜可早期发现支气管内膜结核并给予及时的抗结核治疗,有效防止了支气管内膜结核造成的支气管狭窄。     

拉莫三嗪和丙戊酸钠联合治疗儿童难治性癫痫临床研究

目的:了解丙戊酸钠(VPA)和拉莫三嗪(LTG)治疗儿童难治性癫痫的疗效.方法:收集儿童难治性癫痫21例,已在使用VPA且血药浓度在有效范围内(50～100 μg/mL)者,即从0.15 mg/(kg·d)、1次/d开始加LTG,第1个月每周增加0.2 mg/(kg·d),第2个月每周增加0.3 mg/(kg·d),以后每周增加0.5～1 mg/(kg·d),直至发作控制或剂量迭10 mg/(kg·d).未使用VPA者,从20 mg/(kg·d)开始加VPA,并调整血药浓度至50～100 μg/mL,再逐渐减停其它抗癫痫药物,加LTG,方法同上.随访发作情况,监测不良反应.结果:治疗9个月时10例(47.6%)完全控制,5例(23.8%)有效,6例(28.6%)无效,治疗后发作频率减少,差异有统计学意义(P<0.005),5例(23.8%)脑电图恢复正常,8例(38.1%)出现不良反应.结论:LTG和VPA联用为一种有效、安全而经济的治疗小儿难治性癫痫的方法.     

卡马西平和左乙拉西坦单药治疗儿童部分发作性癫痫的对照研究

目的:比较卡马西平和左乙拉西坦单药治疗儿童部分发作性癫痫的疗效.方法:53例在我院新诊断的部分发作性癫痫儿童,根据就诊顺序按单双号顺序分成两组,分别给予卡马西平和左乙拉西坦单药治疗,左乙拉西坦起始剂量10 mg/(kg·d),每周加量一次,逐渐加量至20～30 mg/(kg·d),最大剂量40 mg/(kg·d);卡马西平起始剂量5 mg/(kg·d),每周增加5 mg/(kg·d),逐渐增加剂量至10～20 mg/(kg·d).血药浓度6～10 mg/L.随访6月后评价疗效及不良反应.结果:53例全部完成观察和随访,卡马西平组26例,左乙拉西坦组27例.卡马西平组15例完全控制发作(57.7%),4例部分控制(15.4%),总有效率为73.1%;左乙拉西坦组10例完全控制发作(37.0%),5例部分控制(18.5%),总有效率为55.5%.两组总有效率比较差异无统计学意义(P>0.05).两组均未见严重不良反应.结论:左乙拉西坦和卡马西平单药治疗儿童部分发作性癫痫均有很好疗效和耐受性.     

支气管内膜结核23例报告

目的探讨经纤维支气管镜确诊的支气管内膜结核的临床特征,为早期诊断提供临床帮助。方法回顾性分析确诊的23例支气管内膜结核患者的临床资料并复习相关的文献知识。结果本组患者纤维支气管镜显示瘢痕狭窄为主11例,溃疡坏死为主6例,黏膜炎性病变为主4例。全部病例经纤维支气管镜病理活检或刷检找到抗酸杆菌确诊。结论支气管内膜结核临床表现无特异性,影像学表现复杂多样,纤维支气管镜检查是确诊EBTB最重要的手段。     

护理干预对支气管内膜结核患者支气管镜下注药治疗依从性的影响

目的 探讨护理干预对支气管内膜结核患者支气管内注药治疗依从性的影响.方法 将68例支气管内膜结核患者经纤维支气管镜注药治疗的患者随机分为实验组和对照组各34例,实验组进行全程、系统的护理干预,对照组予常规的健康教育.6个月后,分别对两组患者治疗依从性为进行评定、比较.结果 实验组有27例支气管内膜结核患者能完全遵医,79.41%,对照组有15例支气管内膜结核患者能完全遵医,占44.12%,两组病人的遵医程度有显著差异(P＜0.05).结论 护理干预能提高支气管内膜结核患者支气管镜下注药治疗的依从性.     

纤维支气管镜诊断支气管结核72例临床分析

目的：分析在临床上使用纤维支气管镜诊断支气管结核时所起的主要作用。方法对2010年3月-2013年6月本院使用纤维支气管镜检查的72例支气管内膜结核患者的临床资料进行了回顾性分析,对纤维支气管镜的具体表现特点进行了总结。结果经检查72例患者均呈阳性。在镜下表现为炎症浸润型24例,增殖型15例,溃疡型4例,另外29例为瘢痕狭窄型。痰涂片检查阳性率明显低于纤维支气管镜刷检,差异具有统计学意义（P〈0.01）。结论纤维支气管镜是临床上诊断支气管结核的有效辅助手段。     

痰热清注射液联合更昔洛韦治疗161例小儿手足口病疗效观察

目的探讨痰热清注射液联合更昔洛韦治疗161例小儿手足口病的临床疗效.方法 在对症治疗的基础上,治疗组(85例)给予痰热清注射液0.5～0.8mL/(kg?d),更昔洛韦注射液5mg/(kg?d)分别加入5%葡萄糖液静脉滴注,1日1次;对照组(76例)给予炎琥宁5～10mg/(kg?d),更昔洛韦注射液5mg/(kg?d)静滴,1日1次,疗程3～7d.结果 治疗组总有效率高于对照组(分别为96.47%和88.16%),退热、疱疹消退时间短于对照组,差异有统计学意义.结论 痰热清注射液联合更昔洛韦治疗小儿手足口病疗效佳,副作用小.     

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.     

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.