莫西沙星与左氧氟沙星治疗耐多药肺结核的疗效比较

目的：比较莫西沙星与左氧氟沙星治疗耐多药肺结核病的安全性及临床疗效。方法将2010年6月～2013年5月收治的98例耐多药肺结核病患者根据治疗方法不同随机分为治疗组（49例）和对照组（49例）,治疗组用莫西沙星0.4 g,1次/d;对照组用左氧氟沙星0.4 g,1次/d,疗程18个月,两组均联合其他抗结核药物治疗。观察两组痰菌转阴率、病灶吸收率、空洞闭合率、不良反应发生率等情况。结果治疗总有效率：莫西沙星组为93.88%,左氧氟沙星组为75.51%;痰菌转阴率：莫西沙星组为83.67%,左氧氟沙星组为61.22%,差异有统计学意义（P＜0.05）;病灶吸收率：莫西沙星组为81.63%,左氧氟沙星组为67.35%,差异无统计学意义（P＞0.05）;空洞闭合率：莫西沙星组为48.98%,左氧氟沙星组为22.45%,差异有统计学意义（P＜0.05）;不良反应发生率：莫西沙星组为24.49%,左氧氟沙星组为30.61%,差异无统计学意义（P＞0.05）。结论相对左氧氟沙星而言,莫西沙星联合常规抗结核药物用于治疗耐多药肺结核病的疗效、痰菌转阴率较好,不良反应发生率较低。     

左氧氟沙星与莫西沙星治疗老年耐多药肺结核临床疗效对比分析

目的：对比分析左氧氟沙星与莫西沙星治疗耐多药肺结核临床疗效和药物不良反应。方法采用计算机随机分组的方式将本院收治的100例耐多药肺结核患者对照组和观察组,两组患者均给予基础抗结核药物治疗,对照组患者联合左氧氟沙星,观察组患者联合莫西沙星,比较两组患者临床疗效和用药安全性。结果观察组患者治疗总有效率为98.00%,对照组患者治疗总有效率为80.00%,差异有统计学意义（P〈0.05）。两组患者在不良反应发生方面差异无统计学意义（P〉0.05）。结论左氧氟沙星与莫西沙星联合基础抗结核药物治疗耐多药肺结核均取得较为满意的效果,但是,莫西沙星组患者治疗效果优于左氧氟沙星者。     

联合莫西沙星治疗耐多药肺结核临床观察

目的：观察对比联合莫西沙星与联合左氧氟沙星治疗复治耐多药肺结核的疗效及安全性。方法采用随机分组的方法将138名复治耐多药肺结核患者分成治疗组（T组）69例,对照组（C组）69例,治疗组选用联合莫西沙星方案,对照组选用联合左氧氟沙星方案。结果治疗2个月以上痰菌阴转率治疗组明显优于对照组,两者差异有统计学意义（P〈0.05）。不良反应发生率治疗组与对照组差异无统计学意义（P〉0.05）。结论莫西沙星是一种安全、有效的抗结核药物,方案中联合莫西沙星较左氧氟沙星效果更好。     

含莫西沙星方案和左氧氟沙星不同方案在老年耐多药肺结核病中效果比较

目的探讨含莫西沙星方案和左氧氟沙星不同方案在老年耐多药肺结核病中的临床效果。方法选择我院中心肺结核患者共100例,随机分为观察组和对照组。观察组给予含莫西沙星方案治疗,对照组给予含左氧氟沙星方案治疗。观察两组治疗效果。结果观察组患者治疗3个月末痰转阴所占比例大于对照组（P〈0.05）,6个月末、12个月末及18个月末痰转阴所占比例与对照组相同（P〉0.05）。观察组空洞闭合和缩小所占比例与对照组差异无统计学意义（P〉0.05）;观察组不良反应发生率与对照组相同（P〉0.05）。结论含莫西沙星方案和左氧氟沙星不同方案在老年耐多药肺结核病均有较好临床效果,但莫西沙星在痰菌阴转速度上优于左氧氟沙星。     

利福布丁联合莫西沙星方案治疗耐多药结核病的疗效分析

目的观察含利福布丁联合莫西沙星方案治疗耐多药结核病的药物疗效判定。方法将我院2010年5月至2012年5月期间收治的100例耐多药结核病患者平均分为两组,治疗组用利福布丁(0.3g/d)联合莫西沙星(400 mg/d)方案治疗,对照组用左氧氟沙星(0.4 g/d)联合丁胺卡那霉素(0.6 g/d)方案治疗,两组疗程均为12个月。观察临床症状改善情况、痰菌、X线病变、空洞改变及药物不良反应。结果治疗组,显效30例(60.00%),总有效率92.00%;对照组,显效18例(36.00%),总有效率72.00%。治疗组明显优于对照组,经统计学处理,P<0.05,差异显著有统计学意义。结论对耐多药结核病适宜采用利福布丁联合莫西沙星方案治疗在临床上适用于治疗多耐药肺结核病。     

莫西沙星与左氧氟沙星治疗耐多药肺结核的临床疗效对比

目的对比莫西沙星与左氧氟沙星治疗耐多药肺结核的临床疗效。方法选取我院就诊的84例耐多药肺结核患者,随机分为观察组(莫西沙星)和对照组(左氧氟沙星)各42例。对比两组临床疗效。结果观察组总有效率95.24%显著高于对照组总有效率83.33%(P>0.05)。观察组痰菌转阴时间和症状改善时间显著短于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论莫西沙星治疗耐多药肺结核的临床疗效优于左氧氟沙星,能较快改善患者临床症状及痰菌转阴时间,安全性良好,值得临床推广。     

不同类型喹诺酮类药物治疗老年耐多药结核的临床疗效对比分析

目的探讨不同类型喹诺酮类药物治疗老年耐多药结核的疗效和安全性。方法收集2014年12月~2015年12月我院诊断为耐多药结核的老年患者作为研究对象,按患者接受喹诺酮类的药物种类分为:莫西沙星组60例、环丙沙星组56例和左氧氟沙星组58例。对比(1)莫西沙星组、环丙沙星组与左氧氟沙星组治疗多耐药结核的临床疗效。(2)莫西沙星组、环丙沙星组与左氧氟沙星组对结核杆菌清除率。(3)莫西沙星组、环丙沙星组与左氧氟沙星组不良反应发生率。结果 (1)莫西沙星组、环丙沙星组、左氧氟沙星组临床有效率分别为88.5%、76.8%、70.7%。莫西沙星组与环丙沙星、左氧氟沙星组有效率比较,差异有统计学意义(P<0.05)。环丙沙星、左氧氟沙星组有效率比较,差异无统计学意义(P>0.05)。(2)莫西沙星组、环丙沙星组、左氧氟沙星组在治疗4、8、12周时对结核杆菌清除率分别为59.2%、75%、90.6%、(21.4%、55.4%、87.5%)、(20%、53.3%、77.8%),以莫西沙星清除率最高,差异有统计学意义(P<0.05)。(3)莫西沙星组、环丙沙星组与左氧氟沙星组不良反应发生率比较,差异无统计学意义(P>0.05)。结论相对于环丙沙星、左氧氟沙星,莫西沙星对老年多耐药结核的清除率更高,疗效肯定,而且安全性好。     

含依替米星方案治疗耐多药肺结核病的临床研究

目的：探讨应用含依替米星方案对耐多药肺结核病进行治疗的临床效果。方法：选择2013年3月～2015年3月在我院接受治疗的124例耐多药肺结核病患者随机平分为对照组、观察组。在常规抗结咳治疗基础上,对照组给予左氧氟沙星治疗,观察组给予莫西沙星联合依替米星治疗,并对比疗效。结果：观察组治疗总有效率（91.94%）明显高于对照组（77.42%）,接受治疗后痰菌转阴率明显高于对照组,组间差异显著（P＜0.05）;观察组不良反应发生率为4.83%,显著低于对照组的11.29%（P＜0.05）。结论：应用莫西沙星联合依替米星对耐多药肺结核病治疗可促进患者痰菌转阴率得到明显提高,不良反应较少。     

左氧氟沙星和莫西沙星治疗耐多药肺结核病的临床效果比较

目的研究左氧氟沙星和莫西沙星在对耐多药肺结核病进行治疗时的临床效果比较。方法84例耐多药肺结核病患者,按照入院挂号尾数的奇偶数分为观察组和对照组,每组42例。观察组患者通过左氧氟沙星联合卷曲霉素、对氨基水杨酸钠、丙硫异烟胺肠溶片、吡嗪酰胺胶囊治疗;对照组通过莫西沙星联合卷曲霉素、对氨基水杨酸钠、丙硫异烟胺肠溶片、吡嗪酰胺胶囊治疗。比较两组患者治疗效果、不良反应发生生情况、病灶吸收情况以及24个月后痰菌转阴情况。结果观察组的治疗总有效率为92.86%与对照组的95.24%比较,差异无统计学意义(P<0.05)。观察组的不良反应发生率为9.52%(4/42),与对照组的9.52%(4/42)比较,差异无统计学意义(P>0.05)。观察组患者的病灶总吸收率为88.10%与对照组的85.71%比较,差异无统计学意义(P>0.05)。24个月后,观察组的痰涂片转阴率为83.33%(35/42)与对照组的80.95%(34/42)比较,差异无统计学意义(χ²=0.081,P=0.776>0.05)。结论临床对耐多药肺结核病进行治疗时通过左氧氟沙星和莫西沙星进行用药均能够获取理想的治疗效果,在治疗方面不会产生明显的差异,因此可以根据患者实际情况合理的选择这两种药物进行治疗。     

含莫西沙星方案和左氧氟沙星不同方案在老年耐多药肺结核病中的临床效果观察

目的对比分析含莫西沙星方案与含左氧氟沙星不同方案治疗老年耐多药肺结核病的临床效果。方法随机将2016年1月至2016年10月本院收治的98例老年耐多药肺结核病患者分到A组、B组,每组49例。A组治疗方案:莫西沙星、阿米卡星、对氨基水杨酸钠、利福喷丁、丙硫异烟胺、吡嗪酰胺、帕司烟肼治疗3个月,然后使用莫西沙星、利福喷丁、丙硫异烟胺、吡嗪酰胺、帕司烟肼继续治疗6个月,最后使用莫西沙星、吡嗪酰胺、利福喷丁、帕司烟肼治疗9个月。B组治疗方案中除了将左氧氟沙星代替莫西沙星外,其他药物用法用量及疗程均与A组一致。两组患者的治疗周期均为18个月。对比分析两组患者的痰菌阴转率。结果 A组、B组的痰菌转阴率分别为89.80%(44/49)、71.43%(35/49),两组比较,P <0.05。结论含莫西沙星方案治疗老年耐多药肺结核病的痰菌阴转率明显高于含左氧氟沙星方案。     

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.