干扰素佐治新生儿轮状病毒肠炎临床疗效观察

目的:探讨干扰素治疗新生儿轮状病毒性肠炎的疗效.方法:2008年6月至2010年10月住院的新生儿轮状病毒肠炎患儿140例,按随机数表法分为治疗组与对照组各70例.所有病例根据脱水程度、性质给予口服或静脉补液,并口服双歧杆菌乳杆菌嗜热链球菌三联活菌片、蒙脱石散,合理喂养,治疗组在此基础上给予人重组干扰素α-1b注射液10 U/kg皮下注射,1次/d,连用3d,比较两组有效率、止泻时间、住院时间.结果:显效率治疗组71.4％,对照组41.4％,两组比较差异有统计学意义(X2=12.81,P＜0.01),治疗组平均止泻时间(3.1±1.6)d,平均住院时间(5.6±1.3)d,对照组平均止泻时间(4.2±1.7)d,平均住院时间(8.3±2.4)d,两组比较差异均有统计学意义(u=3.9及8.85,P均＜0.01).结论:干扰素佐治新生儿轮状病毒性肠炎显效快,止泻效果好,无明显不良反应.     

干扰素治疗婴幼儿轮状病毒肠炎120例

目的:观察干扰素治疗轮状病毒肠炎的疗效.方法:轮状病毒肠炎患儿250例,随机分为治疗组120例,给予干扰素50万U•d 1,im,3～5 d为1个疗程;对照组130例口服矽碳银、促菌生片.对两组疗效进行回顾性分析.结果:治疗组显效率80.8%,止泻时间(2.31±0.74) d;对照组显效率62.3%,止泻时间(3.74±2.41) d.两组比较,差异均有极显著性(P＜0.01).结论:干扰素治疗婴幼儿轮状病毒肠炎,能减少大便次数和水分,缩短病程.     

莪术油葡萄糖注射液治疗小儿轮状病毒性肠炎60例疗效观察

目的 观察莪术油葡萄糖注射液治疗小儿轮状病毒性肠炎的疗效.方法 将120例小儿轮状病毒性肠炎随机分为治疗组、对照组各60例,对照组采用病毒唑治疗,治疗组在此基础上加用莪术油葡萄糖注射液治疗,两组均未用抗生素,有脱水分别给予口服补液盐(ORS)口服或静脉补液纠正水电解质紊乱.结果 治疗组止泻时间(2.5±1.2)d与对照组(3.5±1.6)d比较,止泻时间明显缩短(P<0.05),两组总病程差异有统计学意义(P<0.01).结论 莪术油葡萄糖注射液治疗小儿轮状病毒性肠炎有良好的疗效.     

热毒宁与小儿氨基酸合用治疗轮状病毒肠炎的疗效观察

目的:探讨热毒宁和小儿氨基酸联合治疗轮状病毒肠炎的疗效.方法:将120名轮状病毒肠炎患儿随机分为治疗组和对照组各60例,对照组进行补液、维持肠道微生态平衡及保护胃肠粘膜等综合治疗,治疗组在对照组综合治疗的基础上加用热毒宁和6%的小儿氨基酸治疗,治疗期间观察体温、大便次数及性状改变,观察两组总有效率、止泻时间和总病程.结果:止泻时间、总病程治疗组分别为(2.21±0.62)d、(5.18±1.32)d,对照组分别为(3.96±2.46)d、(6.98±1.92)d,两组比较差异均有统计学意义(P<0.01).显效率和总有效率治疗组分别为55.0%、88.3%,对照组分别为30.0%、68.3%,两组比较差异均有统计学意义(P<0.01).结论:热毒宁和小儿氨基酸合用治疗轮状病毒肠炎的疗效确切,能迅速改善临床症状,缩短病程,避免或减轻腹泻所致的生长停滞,有利于患儿的生长发育.     

消旋卡多曲颗粒佐治小儿轮状病毒肠炎疗效观察

目的:观察消旋卡多曲佐治小儿轮状病毒肠炎的临床疗效。方法:将确诊为小儿轮状病毒肠炎的58例患儿随机分为治疗组30例和对照组28例。对照组予补液、口服蒙脱石散和微生态制剂等常规治疗,治疗组在常规治疗的基础上口服消旋卡多曲颗粒,每次1.5 mg/kg,每天3次,治疗3 d后比较两组疗效。结果:治疗组平均退热时间(2.1±1.0)d,短于对照组的(3.7±1.2)d(P<0.01);治疗组平均止泻时间(3.5±0.5)d,短于对照组的(4.2±1.2)d(P<0.01);治疗组总有效率93.33%,高于对照组的78.57%(P<0.05)。结论:治疗组临床疗效优于对照组,消旋卡多曲佐治小儿轮状病毒肠炎疗效显著。     

重组人干扰素α-1b治疗婴幼儿轮状病毒肠炎疗效观察

目的:观察干扰素α-1b治疗轮状病毒肠炎的临床疗效。方法:选择2011年10月至2012年2月我院门诊就诊的轮状病毒肠炎患儿86例,按随机数表法分成治疗组45例和对照组41例。两组病例根据脱水程度及性质给予口服或静脉补液,并口服双歧杆菌三联活菌、蒙脱石散、腹泻奶粉;治疗组在此基础上给予肌肉注射重组人干扰素α-1b,6月～1岁,每次6μg,每天1次,>1岁～2岁,每次10μg,每天1次,连续3 d;对照组给予利巴韦林注射液10 mg/(kg.d)静脉滴注,每天1次,连续3 d。比较两组的有效率、止泻时间和退热时间。结果:经72 h治疗后,治疗组总有效率93.3%,对照组73.2%,两组比较差异有统计学意义(χ2=5.005,P<0.05);治疗组平均退热时间(1.47±0.46)d,平均止泻时间(3.14±0.68)d,对照组平均退热时间(2.74±1.16)d,平均止泻时间(4.12±1.26)d,两组比较差异均有统计学意义(t=6.791,t=4.537,P均<0.01)。结论:干扰素治疗轮状病毒肠炎可显著提高疗效,缩短病程。     

杜迪思密达大剂量乳酶生治疗轮状病毒肠炎

目的探讨杜迪联合思密达及大剂量乳酶生治疗轮状病毒肠炎的临床疗效.方法将360例轮状病毒肠炎患儿随机分为杜迪治疗组(DBS组)206例和对照组154例,两组均给予大剂量乳酶生[0.6～0.8/(kg·d)和思密达0.3/(kg·d)]在此基础上,DBS组加用新型抗病毒药-杜迪10mg/(kg·d)治疗轮状病毒肠炎206例,进行疗效观察.结果①3d治愈率DBS组91.7%(189/206),对照组52.6%(81/154).②平均止泻时间DBS组2.60±0.24d,对照组3.26±0.15d.③从发病到止泻天数DBS组5.10±0.23d,对照组5.96±0.35d,两组比较有非常显著性差异(P＜0.01).结论杜迪联合思密达及大剂量乳酶生治疗轮状病毒肠炎能明显有效地缩短病程,疗效确切,治愈率高,值得临床推广应用.     

西咪替丁治疗轮状病毒性肠炎40例

目的：观察西咪替丁治疗轮状病毒性肠炎的临床疗效.方法：轮状病毒性肠炎患儿79例,随机分为两组,治疗组40例,给予西咪替丁10 mg&;#8226;kg 1&;#8226;d 1,加入10%葡萄糖注射液100 mL;对照组给予利巴韦林10 mg&;#8226;kg 1&;#8226;d 1,加入10%葡萄糖注射液100 mL,两组均静脉滴注,连用2或3 d.结果：治疗组有效率90.0%,平均止泻时间为(5.8±4.6) d.对照组有效率为38.5%.平均止泻时间为(8.8±4.3) d.两组有效率差异有极显著性(P＜0.01);治疗组平均止泻时间比对照组短(P＜0.05).结论：西咪替丁治疗轮状病毒性肠炎疗效较好,无明显副作用.     

培菲康胶囊联合锌制剂治疗小儿轮状病毒肠炎疗效评价

目的探讨培菲康胶囊联合锌剂治疗小儿感染轮状病毒引起肠炎的临床效果。方法选取2010年5月至2013年5月间我院所接收治疗的感染轮状病毒并已至肠炎的患儿160例,按照就诊顺序均分为A、B、C、D 4组,每组40例。四组患儿均给予常规基础治疗,A组作为对照组,不再做其他处理;B组给予口服培菲康胶囊散剂;C组口服葡萄糖酸锌;D组给予培菲康胶囊联合葡萄糖酸锌治疗。比较四组患儿腹泻治疗总有效率、症状恢复平均时间。结果 D组治疗有效率显著高于A、B、C组(P<0.01、P<0.05、P<0.05);A、B、C、D组患儿恢复正常所需时间分别为(4.18±1.12)d、(3.42±1.06)d、(3.42±1.53)d、(1.95±0.98)d。平均止泻时间D组显著短于A、B、C组(P<0.01、P<0.05、P<0.05)。结论培菲康胶囊联合锌剂治疗小儿轮状病毒肠炎效果显著优于单独使用培菲康胶囊及锌剂,临床疗效显著,值得推广。     

干扰素治疗儿童轮状病毒肠炎的临床疗效观察

目的 探讨干扰素在儿童轮状病毒肠炎的临床应用价值,优化临床治疗效果.方法 选择轮状病毒肠炎儿童112例,按随机数字表分为观察组56例和对照组56例.对照组进行常规对症治疗,观察组进行常规对症治疗联合干扰素治疗,两组均治疗3d.治疗前后观察患儿症状改善情况,记录退热时间、止呕时间、止泻时间、粪便排毒时间及总病程,评判3d的临床总有效率,并详细记录临床不良反应.结果 观察组与对照组退热时间、止泻时间、止呕时间、总病程分别为(1.86±1.42)d比(2.96±1.47)d,(3.12±1.52)d比(4.66±1.37)d,(2.08±1.28)d比(3.82±1.53)d,(7.26±1.15)d比(15.32±1.35)d,(6.11±1.42)d比(8.13±2.41)d,各项指标差异均有显著统计学意义；观察组与对照组总有效率分别为96.43％比78.57％,差异具有显著统计学意义(x2 =8.693,P＜0.05).结论 干扰素能够明显缩短轮状病毒肠炎儿童的症状缓解时间,具有更强更快的排毒效果,缩短总病程,临床总有效率显著提高,且安全性良好,是治疗轮状病毒肠炎的理想药物.     

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.

     

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.     

2-(Acetoxyphenyl)-(Z)-styryl sulfides as cyclooxygenase inhibitors

2-(Acetoxyphenyl)-(Z)-styryl sulfides are described as selective cyclooxygenase-2 (COX-2) inhibitors, useful for treating inflammation and COX-2-mediated disorders including neoplasia. 2-(Acetoxyphenyl)-(Z)-styryl sulfide is claimed to be the most potent COX inhibitor in the series with a COX-2 selectivity ratio of 33. This compound is also claimed to be superior to celecoxib (Celebrex^®, Pfizer) in inhibiting cell growth of colorectal carcinoma cells. In this evaluation, the COX inhibitory activity of this compound is compared to that previously disclosed for diarylheterocycles and 2-(acetoxyphenyl)alkyl sulfides. The validity of the DLD-1 cell line in the growth inhibition studies is questioned based on recent literature reports indicating the lack of COX-2 expression in this cell line.     

Sleep-disordered breathing with chronic opioid use

Chronic opioid use for pain relief or as substitution therapy for illicit drug abuse is prevalent in our societies. In the US, retail distribution of methadone and oxycodone has increased by 824 and 660%, respectively, between 1997 and 2003. μ-Opioids depress respiration and deaths related to illicit and non illicit chronic opioid use are not uncommon. Since 2001 there has been an emerging literature that suggests that chronic opioid use is related to central sleep apnoea of both periodic and non-periodic breathing types, and occurs in ～ 30% of these subjects. The clinical significance of these sleep-related abnormalities are unknown. This review addresses the present knowledge of control of ventilation mechanisms during wakefulness and sleep, the effects of opioids on ventilatory control mechanisms, the sleep-disordered breathing found with chronic opioid use and a discussion regarding the future research directions in this area.     

Drug targets for cognitive enhancement in neuropsychiatric disorders

The investigation of novel drug targets for treating cognitive impairments associated with neurological and psychiatric disorders remains a primary focus of study in central nervous system (CNS) research. Many promising new therapies are progressing through preclinical and clinical development, and offer the potential of improved treatment options for neurodegenerative diseases such as Alzheimer's disease (AD) as well as other disorders that have not been particularly well treated to date like the cognitive impairments associated with schizophrenia (CIAS). Among targets under investigation, cholinergic receptors have received much attention with several nicotinic agonists (α7 and α4β2) actively in clinical trials for the treatment of AD, CIAS and attention deficit hyperactivity disorder (ADHD). Both glutamatergic and serotonergic (5-HT) agonists and antagonists have profound effects on neurotransmission and improve cognitive function in preclinical experiments with animals; some of these compounds are now in proof-of-concept studies in humans. Several histamine H3 receptor antagonists are in clinical development not only for cognitive enhancement, but also for the treatment of narcolepsy and cognitive deficits due to sleep deprivation because of their expression in brain sleep centers. Compounds that dampen inhibitory tone (e.g., GABA_A α5 inverse agonists) or elevate excitatory tone (e.g., glycine transporter inhibitors) offer novel approaches for treating diseases such as schizophrenia, AD and Down syndrome. In addition to cell surface receptors, intracellular drug targets such as the phosphodiesterases (PDEs) are known to impact signaling pathways that affect long-term memory formation and working memory. Overall, there is a genuine need to treat cognitive deficits associated with many neuropsychiatric conditions as well as an increasingly aging population.