注射用盐酸头孢甲肟治疗急性细菌感染的临床评价

目的：考察注射用盐酸头孢甲肟治疗急性细菌感染的临床疗效、细菌学疗效和安全性。方法：将126名入选患者随机分为两组：试验组（n=62）和对照组（n=64），分别接受同剂量注射用盐酸头孢甲肟和头孢噻肟钠静脉滴注治疗（2g，bid），疗程为7—14d。结果：试验组和对照组的临床痊愈率分别为74．19％和68．75％（P=0．8844），有效率分别为95．16％和95．31％（P=0．9020），均无显著差异；两组细菌清除率分别为90．57％和86．54％（P〉0．05），无显著差异；两组不良反应发生率分别为1．61％和4．69％（P〉0．05），无显著差异，且不良反应大多轻微并为一过性。结论：注射用盐酸头孢甲肟可安全、有效地用于治疗急性细菌感染。     

头孢地尼胶囊治疗呼吸系统和泌尿系统急性细菌感染的多中心随机对照研究

目的通过治疗急性呼吸系统和泌尿系统细菌性感染,评价头孢地尼胶囊安全性和有效性。方法采用多中心、区组随机化、双盲双模拟、随机平行对照的试验方法。观察对象为符合人组条件的138例急性呼吸系统和泌尿系统细菌性感染的患者。试验组予试验用头孢地尼胶囊及已上市头孢地尼胶囊模拟药各1粒,po,tid。对照组予已上市头孢地尼胶囊及试验用头孢地尼胶囊模拟药各1粒,po,tid;疗程7。14d。结果本临床试验共入组138例,可进行疗效评价分析的病例共137例,试验组69例,对照组68例,2组总痊愈率分别为75．36％和77．94％,总有效率分别为92．75％和95．59％。呼吸系统试验组痊愈率和有效率分别为69．44％和91．67％,对照组分别为73．53％和94．12％;泌尿系统试验组痊愈率和有效率分别为81．82％和93．94％,对照组分别为82．35％和97．06％;2组总细菌阳性率分别为91．30％和80．88％,细菌清除率分别为88．89％和94．55％。2组比较差异均无统计学意义（P〉0．05）。试验组不良事件发生率为8．70％（6／69）,对照组为13．04％（9／69）,主要不良反应为轻至中度的恶心、上腹不适、皮疹、ALT和AST升高等,2组比较差异均无统计学意义（P〉0．05）。结论试验用头孢地尼胶囊治疗细菌引起的呼吸系统和泌尿系统感染,临床疗效明显,细菌清除率高,不良反应较少,与已上市头孢地尼胶囊疗效相当。     

玉屏风胶囊治疗过敏性鼻炎随机双盲平行对照多中心临床研究

目的观察玉屏风胶囊治疗过敏性鼻炎的临床疗效和安全性。方法用随机双盲平行对照多中心临床试验方法,共入选288例过敏性鼻炎患者,随机分成试验组和对照组(3∶1),分别服用玉屏风胶囊和辛芩颗粒,疗程为20d。结果治疗20 d后,疾病疗效总有效率,试验组为81.34%,对照组为67.14%,试验组总有效率明显高于对照组(P<0.01);中医证候疗效总有效率,试验组为80.38%,对照组为65.71%,试验组总有效率明显高于对照组(P<0.01)。结论玉屏风胶囊具有疗效好,不良反应发生率低,复发率低等优点,是治疗过敏性鼻炎的理想药物。     

中西药联合治疗过敏性鼻炎临床观察

目的观察中西药联合治疗过敏性鼻炎的临床疗效。方法将120例过敏性鼻炎患者随机分为试验组和对照组各60例。试验组予玉屏风散联合西替利嗪治疗，对照组单用西替利嗪治疗。观察2组临床疗效。结果试验组总有效率为98．3％高于对照组的71．7％，差异有统计学意义（P〈0．05）。结论中西药联合治疗过敏性鼻炎疗效显著，具有标本兼治的效果，值得临床推广应用。     

盐酸非索非那定片治疗变应性鼻炎多中心随机双盲对照临床试验

目的 评价国产盐酸非索非那定片治疗变应性鼻炎的有效性和安全性。方法 用多中心随机双盲双模拟平行对照临床试验，实际纳入对照组72例，试验组68例；试验组（盐酸非索非那定片，120mg）及对照组（盐酸西替利嗪，10mg），2组均每天服药1次、模拟片1片，均连服14天。在服药第7天、第14天时，经询问、专科检查等方法，评价患者疾病严重程度及改善情况，并给出相应评分。结果 2组均能有效控制和改善病情，试验组与对照组的有效率分别为93．06％，98．53％，2组间差别无统计学意义。2组药物不良反应发生率分别为25．00％，20．59％，2组间差异无统计学意义。2组均未见严重不良反应发生。结论 盐酸非索非那定片治疗变应性鼻炎的有效性与安全性和盐酸西替利嗪相当。     

参松养心胶囊治疗室性早博的疗效观察

目的比较中药参松养心胶囊与西药慢心律治疗室性早搏的疗效与安全性。方法80例室性早搏患者被随机分为两组,参松养心胶囊治疗组40例和慢心律对照组40例。治疗组口服参松养心胶囊4粒,3次／d;对照组口服慢心律150mg,3次／d,疗程4周,观察两组临床疗效。结果治疗组总有效率为80％,症状改善率为90％;对照组总有效率为82．5％,症状改善率70％。两组比较差异无统计学意义（P〉0．05）,两组治疗室性早搏临床疗效相当。结论参松养心胶囊与慢心律有相近的治疗室性早搏作用,且不良反应少。     

甲磺酸帕珠沙星注射液治疗急性细菌感染的多中心随机对照研究

目的评价甲磺酸帕珠沙星注射液治疗呼吸系统和泌尿系统急性细菌性感染的临床疗效和安全性。方法采用多中心、随机双盲、平行阳性药对照试验方法。试验组用甲磺酸帕珠沙星注射液500mmg,ivgtt,bid;对照组用左氧氟沙星200mg,iv gtt,bid,疗程7。14d。结果本研究共入组287例,试验组144例,对照组143例。细菌培养阳性病例193例,试验组94例,对照组99例,试验组总痊愈率和有效率分别为59．57％和90．43％,对照组分别为59．60％和87．88％。其中呼吸系统感染试验组的痊愈率和有效率分别为57．45％和91．49％,对照组分别为61．22％和83．67％;泌尿系统感染试验组的痊愈率和有效率分别为61．70％和89．36％,对照组分别为58．00％和92．00％,2组比较差异均无统计学意义（P〉0．05）。试验组细菌清除率为95．74％（90／94）,对照组为93．94％（93／99）,2组比较差异无统计学意义（P〉0．05）。试验组和对照组不良反应发生率分别为10．42％（15／144）和13．29％（19／143）,主要表现为轻至中度的恶心、腹泻、头痛、皮疹、注射部位疼痛、静脉炎、ALT升高、BUN升高、Cr升高等,2组比较差异无统计学意义（P〉0．05）。结论甲磺酸帕珠沙星注射液治疗呼吸系统和泌尿系统急性细菌感染,临床疗效明显,安全性较好。     

苍耳子鼻炎胶囊在鼻内镜术后的疗效观察

目的：探讨慢性鼻窦炎鼻息肉经鼻内镜鼻窦开放术后应用苍耳子鼻炎胶囊治疗的疗效。方法：采用随机对照试验．60例患者分为试验组（术后应用苍耳子鼻炎胶囊）和对照组,每组30例,观察随访半年。结果：术后疗效比较：治疗组总有效率为93．3％．对照组总有效率为86．7％,经卡方检验,P〈0．05。结论：苍耳子鼻炎胶囊可明显改善术后患者症状与体征。     

不同用药方案治疗细菌性阴道病临床疗效和安全性评价

目的：观察奥硝唑、乳酸杆菌活菌胶囊以及合并用药治疗细菌性阴道病（BV）的疗效。方法：将门诊150名BV患者随机分为3组。A组口服奥硝唑6d，13组阴道用乳酸杆菌活菌胶囊10d，C组口服奥硝唑6d，随后用乳酸杆菌活菌胶囊10d，评定疗效。结果：A、B、C3组治愈率分别为70．00％，60．00％，76．00％，有效率分别为88．00％，82．00％，96．00％，C组有效率明显高于B组（P〈0．05）；2个月内复发率3组分别是14．00％，6．00％和0，C组明显低于A组，差异显著（P〈0．05）；不良反应率分别是10．00％，0．00％，8．00％，3组间差异无显著性（P〉0．05）。结论：奥硝唑合并乳酸杆菌活菌胶囊治疗BV疗效高，不良反应发生率低。     

中西医结合治疗儿童常年性变应性鼻炎112例疗效观察

目的 探讨中西医结合治疗儿童常年性变应性鼻炎的疗效。方法 300例患儿随机分三组。治疗组（A组）：常规药物点鼻，注射气管炎菌苗，结合辨证论治口服中药；对照组（B组）：常规药物点鼻，注射气管炎菌苗；对照组（C组）：单纯口服中药。随访一年，观察其症状、体征进行评分计算改善率。结果 A组显效率51．79％（58／112），总有效率85．71％（96／112）；B组显效率44．44％（40／90），总有效率70．00％（63／90）；C组显效率41．83％（41／98），总有效率67．35％（66／98）。经统计学处理差异有显著性意义（P〈0．05），治疗中无不良反应发生。结论 中西医结合治疗儿童常年性变应性鼻炎具有疗效好、无副作用等特点。     

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.     

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.