固尔苏联用经鼻持续气道正压通气治疗早产儿肺透明膜病的疗效观察

目的：探讨固尔苏（肺表面活性物质）治疗新生儿肺透明膜病的临床疗效。方法：随机选取2005—01～2008—12我科新生儿病房入院确诊肺透明膜病早产儿32例，对照组14例在常规治疗同时单给与经鼻持续气道正压通气（nCPAP），治疗组18例在给与nCPAP前给与气管插管内应用固尔苏治疗，观察治疗组用药前、用药后0.5、2h血气分析指标的变化及治疗组、对照组临床症状改善情况。结果：治疗组在应用固尔苏8h内紫绀、呼吸急促、呻吟、三凹征等临床表现明显减轻或消失，在应用固尔苏治疗后0.5、2h检测动脉血血气分析血PaO2明显升高，血PaCO2显著降低，血pH值显示酸中毒明显好转，差异有显著性（P＜0.01）。结论：固尔苏与nCPAP联合治疗新生儿肺透明膜病疗效显著，可缩短病程。     

固尔苏预防早产儿肺透明膜病的效果观察

目的观察固尔苏（猪肺磷脂）预防早产儿肺透明膜病（HMD）的效果。方法将胎龄≤32周,体质量≤1500g的同条件早产儿64例分为预防组31例和对照组33例。预防组在出生后6h内经气管内滴人固尔苏,对照组不应用固尔苏。结果预防组并发HMD、肺炎、需要机械通气、死亡及放弃治疗的发生率均少于对照组,差异有统计学意义（P〈0．05或P〈0．01）。结论早产儿预防性应用固尔苏可降低HMD的发病率,减轻病情,改善早产儿预后。     

固尔苏治疗27例新生儿肺透明膜病临床疗效分析和体会

目的探讨固尔苏治疗新生儿肺透明膜病的临床效果。方法选择2008年至2009年常州妇幼保健医院早产儿肺透明膜病27例,在出生后6h内经气管插管,应用固尔苏(100mg/kg)按不同体位各1/2量缓慢滴入气道,效果不明显者可重复使用一次。结果 27例肺透明膜病应用固尔苏后16例立即好转,5例重复使用固尔苏后明显好转,6例效果不明显。结论固尔苏治疗新生儿肺透明膜病有明显疗效。     

固尔苏联合CPAP治疗新生儿肺透明膜病疗效分析

目的探讨固尔苏联合CPAP治疗新生儿肺透明膜病的临床疗效。方法 38例新生儿肺透明膜病随机分为对照组(19例)与观察组(19例),对照组采用常规加CPAP呼吸机治疗,观察组在对照组治疗的基础上联合气管内滴注固尔苏治疗,统计分析两组患儿疗效及治疗1h、12h后动脉血pH、PaO2、PaCO2对比情况及疗效情况。结果观察组患儿用固尔苏治疗1h和12h以后,pH得以纠正,PaO2显著提高,而PaCO2降低,与对照组比较差异均有统计学意义(P<0.05);观察组的总有效率治疗组为89.47%,而对照组为63.16%,两组对照差别有统计学意义(P<0.05)。结论固尔苏联合CPAP治疗新生儿肺透明膜病能改善患儿氧和功能,提高疗效,值得临床推广应用。     

猪肺磷脂治疗早产儿肺透明膜病25例疗效观察

目的：观察猪肺磷脂（固尔苏）治疗早产儿肺透明膜病的疗效。方法：25例肺透明膜病的早产儿，根据体质量不同给予不同剂量的猪肺磷脂注射液，气管内缓慢推注。结果：给药后10min～2h呼吸困难、皮肤青紫减轻，三凹征明显改善，给药后血气、呼吸参数等各项指标也逐渐改善。结论：猪肺磷脂治疗早产儿肺透明膜病有效。     

固尔苏早期应用治疗新生儿肺透明膜病疗效观察

目的探讨猪肺磷脂注射液（固尔苏）早期应用治疗新生儿肺透明膜病（NHMD）疗效。方法将51例NHMD随即分为两组：治疗组29例出生后6h内应用固尔苏气管内给药,对照组22例未应用固尔苏,对两组患儿并发症、持续正压通气（CPAP）或机械通气用氧时间、血气分析参数等方面进行比较。结果治疗组并发症、CPAP或机械通气用氧时间少于对照组,血气分析改善较对照组明显,差异有统计学意义（P〈0.05）。结论早期应用固尔苏可减少NHMD并发症的发生,改善呼吸功能。     

肺表面活性物质治疗新生儿肺透明膜病的临床体会

目的：探讨早使用肺表面活性物质治疗新生儿肺透明膜病与晚使用的疗效区别。方法：对应用肺表面活性物质治疗的28例早产儿肺透明膜病,按用药时间即用药于出生后3～12h、12～24h分组进行临床观察,比较两组低流量（每分氧流量〈40％）吸氧血氧饱和度达90％以上所需时间和总用氧时间。结果：生后3～12h用药者低流量（每分氧流量〈40％）吸氧血氧饱和度达90％以上所需时间和总用氧时间比生后12-24h用药者明显缩短。结论：对于早产儿,尤其是极低体重儿,及时诊断新生儿肺透明膜病．尽可能在出生3～12h之前应用肺表面活性物质进行治疗．能发挥肺表面活性物质的最佳治疗效果。     

固尔苏治疗早产儿肺透明膜病128例临床观察

目的观察固尔苏治疗早产儿肺透明膜病(HMD)的方法,剂量及疗效。方法用药前两组患者均接受呼吸机及常规治疗。治疗组使用的PS(固尔苏)本品规格为1.5mL含120mg,避光,保存于2～8℃。观察项目为血气分析、X线胸片、呼吸机参数,并记录两组患儿上呼吸机时间、住院时间及转归情况。结果治疗组128例使用PS后,PaO2、PaO2/FiO2明显上升,说明PS能迅速有效改善HMD患儿的氧合功能。治疗组病死率3.91%,对照组病死率21.79%,治疗组HMD病死率较对照组明显下降。结论 PS替代疗法将成为早产儿肺透明膜病的主要治疗方法。     

猪肺磷脂预防早产儿肺透明膜病48例的疗效观察

目的 观察固尔苏(猪肺磷脂)预防早产儿肺透明膜病(HMD)的效果.方法 将胎龄≤32周,体重质量≤1500g的同条件早产儿48例分为预防组25例和对照组23例.预防组在出生后6h内经气管内滴入固尔苏,对照组不应/11固尔苏.结果 预防组并发HMD、肺炎、需要机械通气,死亡及放弃治疗的发生率均少于对照组,差异有统计学意义...     

应用固尔苏治疗新生儿呼吸窘迫综合征临床研究

目的：探讨肺表面活性物质（PS）治疗新生儿呼吸窘迫综合征（NRDs）的临床疗效。方法：观察26例NRDS患儿给予外源性PS（固尔苏，curosurf），治疗前后肺氧舍功能、机械通气参数变化。结果：应用PS后患儿呼吸困难减轻、青紫改善，用药后2h、6h、12h患儿动脉血PaO2升高、pH值升高、PaCO2下降，与用药前比较，二者之间差异均有显著性意义（P〈0．05）；机械通气参数FiO2、PIP、PEEP、RR在用药后2h逐渐降低，12h显著下降，与用药前比较，差异均有显著性意义（P〈0．05）。结论：PS能有效改善患儿的肺氧合功能，降低机械通气参数，减少机械通气时间、住院天数、病死率。     

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.