雷公藤片致面部色素沉着2例

<正> 自1989年10月至1991年11月,我们用雷公藤片(湖北省黄石市制药厂生产,批号900803)治疗类风湿关节炎187例,其中2例发生面部色素沉着,现报道如下。 例1,女性,35a,因全身关节游走性疼痛8a,双手指关节变形、肿胀2a余,于1990年6月20日入院。经实验室检查,X线摄片等检查,诊断为类风湿关节炎,经服用吲哚美辛、吡罗昔康片,症状未控制。改用雷公藤片(停服其它药物),每次1片tid,于服药     

雷公藤多苷致功能失调性子宫出血1例

雷公藤多苷片具有祛风解毒、除湿、消肿、舒筋通络和较强的抗炎及抑制细胞免疫和体液免疫等作用。目前广泛应用于类风湿性关节炎、肾病综合症及自身免疫性疾病。有文献报道,长期大量服用雷公藤多苷片致月经周期延长、闭经、肠溃疡性出血、血小板减少等副作用。本文报道较小剂量( 1mg·kg-1,tid ,po)短期服用致功能失调性子宫出血(简称:功血)一例报道如下。患者,女,34岁,因患寻常型进行期银屑病就诊,T36 .8℃,Bp 135 / 80mmHg及血常规检查均正常,给予雷公藤多苷片(批号:2 0 0 110 0 2 ) 2 0mgtid ,复方青黛丸6 gtid ,迪维霜外用。5d后患者…     

雷公藤药酒治疗类风湿关节炎392例

目的 :评价雷公藤药酒治疗类风湿关节炎(RA)的有效性与安全性。方法 :5 88例病人分为治疗组 392例 ,男性 10 1例 ,女性 2 91例 ,年龄 (4 2±s8)a ,单用雷公藤药酒 10mL ,po ,bid ;对照组 196例 ,男性 4 7例 ,女性 14 9例 ,用吲哚美辛 2 5mg ,po ,tid ,布洛芬 2粒 ,po ,tid ,治疗 ,0 .5a评价疗效。结果 :治疗 0 .5a关节疼痛、肿胀、压痛、握力、晨僵症状治疗组均优于对照组 (P <0 .0 1)。 2组临床治愈、显效、无效例数分别为 3,15 1,4 2例和 2 1,341,30例(P <0 .0 1)。治疗组不良反应发生率 30 .5 %。结论 :雷公藤药酒治疗RA有肯定的控制病情的缓解症状的作用     

雷公藤多苷片致过敏反应1例

1　临床资料潘玉珍 ,女 ,60岁 ,因双手各指关节晨僵、肿胀、疼痛半年余 ,于 2 0 0 0年 5月 10日来我院就诊。既往有高血压病史 10余年。查体 :双手各指关节肿胀、压痛。检验 :类风湿因子 ( ) ,血沉 10ｍｍ/ｈ ,抗“Ｏ” <4 0 0Ｕ ,诊断为 :“类风湿性关节炎”。给予雷公藤多苷     

长期应用雷公藤治疗类风湿关节炎的不良反应

雷公藤多甙治疗类风湿关节炎具有一定疗效,但亦有不良反应。以往曾报道用药6个月内不良反应,近2年对我院一些长期应用雷公藤多甙治疗类风湿关节炎的病人进行     

长期应用雷公藤多甙治疗类风湿关节炎的不良反应

目的：观察长期用雷公藤多甙类风湿关节炎的不良反应，方法；对８６例类风湿关节炎病人长期服用雷公藤多甙的不良反应了调查，剂量１０～３０ｍｇ／ｄ不等，结果：５０例服用雷公藤多甙６ｍｏ～２ａ者不良反应为４４％，３６例服用２ａ以上者５３％，不良反应主要表现为月经紊乱，闭经和皮肤色纱沉着，调查显示雷公藤多甙服用时间短似与不良反应发生率有关，剂量较大，不良反应也较严重，不良反应对性别无选择性，对不同年龄影响不同     

雷公藤联合甲氨蝶呤治疗类风湿关节炎的疗效观察

目的 探讨雷公藤联合甲氨蝶呤治疗类风湿关节炎(RA)的临床疗效.方法 将126例RA患者采用数字表法随机分为治疗组(76例)和对照组(50例).治疗组采用雷公藤联合甲氨蝶呤治疗,对照组采用甲氨蝶呤治疗.两组均以治疗1个月为1个疗程,治疗3个疗程.比较两组ACR20/50、关节肿胀数、关节压痛数、晨僵时间、红细胞沉降率(ESR)、类风湿因子(RF)、C反应蛋白(CRP).结果 治疗组ACRS0改善率为69.74％,明显优于对照组的48.00％(x2=6.001,P＜0.05);经过治疗后,治疗组在关节肿胀数、关节压痛数、晨僵时间、ESR、RF、CRP的降低程度上均优于对照组(P＜0.05或P＜0.01).结论 雷公藤联合甲氨蝶呤治疗类风湿关节炎疗效确切,可缓解类风湿关节炎的进展,值得临床上推广.     

长期应用雷公藤多甙治疗类风湿关节炎的不良反应

目的：观察长期用雷公藤多甙治类风湿关节炎的不良反应。方法：对８６例类风湿关节炎病人长期服用雷公藤多甙的不良反应作了调查，剂量１０～３０ｍｇ／ｄ不等。结果：５０例服用雷公藤多甙６ｍｏ～２ａ者不良反应为４４％，３６例服用２ａ以上者５３％，不良反应主要表现为月经紊乱、闭经和皮肤色素沉着。调查显示雷公藤多甙服用时间长短似与不良反应发生率有关，剂量较大，不良反应也较严重。不良反应对性别无选择性，对不同年龄影响不同，与病程长短无直接关系。结论：长期服用雷公藤多甙可对病人产生不同程度的不良反应。     

雷公藤多苷对类风湿关节炎患者血清细胞因子水平的影响

目的探讨雷公藤多苷对类风湿关节炎患者血清细胞因子水平的影响。方法收集滨州市中心医院2008年6月至2011年10月门诊就诊的初治类风湿关节炎患者38例,设为观察组,给予雷公藤多苷片30 mg/d,疗程3个月;对照组为同期健康体检者35例。采用放免法测定血清细胞因子白细胞介素4(IL-4)、白细胞介素6(IL-6)、白细胞介素8(IL-8)、白细胞介素10(IL-10)的水平,并结合血沉、C反应蛋白及临床表现等进行分析。结果类风湿关节炎患者治疗前血清IL-6及IL-8水平明显高于对照组(P<0.01),IL-4及IL-10水平与对照组相似(P>0.05);雷公藤多苷治疗3个月后患者血清IL-6及IL-8水平较治疗前明显降低(P<0.01),IL-4及IL-10水平较治疗前明显升高(P<0.01);38例观察组患者中,显效16例,有效16例,无效6例,总有效率为84.21%,治疗3个月后患者血沉、C反应蛋白水平均较治疗前明显降低(P<0.01)。结论类风湿关节炎患者血清IL-4,IL-6,IL-8,IL-10水平的失衡可能与其发病有关;雷公藤多苷可有效调节类风湿关节炎患者血清IL-4,IL-6,IL-8,IL-10的水平,从而发挥治疗作用。     

雷公藤的临床应用

雷公藤 (TripterygiumWilfordiiHook ,F)系卫矛科属植物 ,俗名黄藤 ,黄腊藤。《本草纲目》记载 ,其性苦辛温 ,有大毒。具有活血通络、祛风除温、消炎镇痛、清热解毒作用。近 10a来 ,雷公藤在临床上应用十分广泛。实验研究表明 ,雷公藤是一种应用广泛、效果良好的中草药。1　肾病1.1　肾小球肾炎　采用雷公藤多苷片治疗肾小球肾炎 3 0例。口服雷公藤多苷片 1～ 1.5mg·kg 1 ·d 1 ,3 0d为 1个疗程。经过 1～ 3个疗程治疗 ,显效 2 3例 ,有效 4例 ,无效 3例[1 ] 。1.2　紫癜性肾炎　采用雷公藤多苷片治疗紫癜性肾炎 3 4例。每次 2 0mg ,tid ,…     

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.     

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.