复明胶囊联合聚乙二醇滴眼液治疗白内障术后干眼症的临床研究

目的 探讨复明胶囊联合聚乙二醇滴眼液治疗白内障术后干眼症的临床疗效。方法 选取2017年8月—2019年12月濮阳市人民医院收治的93例白内障术后干眼症患者（142眼）。根据信封法将所有患者分为对照组（46例,69眼）和治疗组（47例,73眼）。对照组患者滴眼聚乙二醇滴眼液,3次/d。治疗组在对照组治疗的基础上口服复明胶囊,5粒/次,3次/d。两组连续治疗8周。观察两组的临床疗效,比较两组泪液肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、超敏C反应蛋白（hs-CRP）、角膜荧光素染色（FL）评分、泪液分泌试验（Sit）长度、泪膜破裂时间（BUT）和干眼症状评分。结果 治疗后,治疗组总有效率为89.04%,显著高于对照组的73.91%,差异有显著性意义（P<0.05）。治疗后,两组FL评分下降,BUT、Sit长度升高（P<0.05）;且治疗组FL评分低于对照组,BUT、Sit长度高于对照组（P<0.05）。治疗4、8周后,两组干眼症状评分均显著下降（P<0.05）,并且治疗组干眼症状评分低于同期对照组（P<0.05）。治疗后,两组泪液TNF-α、IL-6、hs-CRP水平均明显下降（P<0.05）,并且治疗组泪液TNF-α、IL-6、hs-CRP水平低于对照组（P<0.05）。结论 复明胶囊联合聚乙二醇滴眼液治疗白内障术后干眼症疗效确切,可有效改善其临床症状,有效降低泪液TNF-α、IL-6、hs-CRP水平,安全性较好。     

鱼腥草滴眼液联合夫西地酸滴眼液治疗急性细菌性结膜炎的临床研究

目的 探讨鱼腥草滴眼液联合夫西地酸滴眼液治疗急性细菌性结膜炎的临床效果。方法 选取2019年1月—2020年12月河南科技大学第一附属医院收治的160例急性细菌性结膜炎患者，随机分成对照组和治疗组，每组各80例。对照组患眼眼睑内滴入夫西地酸滴眼液，1滴/次，2次/d。在对照组基础上，治疗组给予鱼腥草滴眼液，1滴/次，6次/d。两组均连续治疗7 d。观察两组患者临床疗效，比较治疗前后两组患者典型表现缓解时间，Schirmer I试验（SIt）值和泪膜破裂时间（BUT），及血清肿瘤坏死因子-α（TNF-α）、白细胞介素-18（IL-18）和超敏C反应蛋白（hs-CRP）水平。结果 治疗后，治疗组临床有效率为97.50%，较对照组的88.75%显著提高（P＜0.05）。与对照组相比，治疗组灼热感、异物感、结膜分泌物和结膜充血的缓解时间均显著缩短（P＜0.05）。治疗后，治疗组SIt值显著增加，BUT显著延长（P＜0.05）；而对照组SIt值显著减小，BUT显著缩短（P＜0.05）。治疗后，治疗组SIt值和BUT均显著优于对照组（P＜0.05）。治疗后，两组患者血清TNF-α、IL-18和hs-CRP浓度较治疗前均显著下降（P＜0.05），且治疗组较对照组更低（P＜0.05）。结论 鱼腥草滴眼液联合夫西地酸滴眼液治疗急性细菌性结膜炎的整体疗效确切，可安全有效，且迅速地改善患者眼部表现。     

明目蒺藜丸联合玻璃酸钠滴眼液治疗干眼症的临床研究

目的 探讨明目蒺藜丸联合玻璃酸钠滴眼液治疗干眼症的临床疗效。方法 选取2021年7月—2023年1月在中国人民解放军中部战区总医院诊治的78例干眼症患者，根据用药方案的不同将所有患者分为对照组和治疗组，每组各39例。对照组给予玻璃酸钠滴眼液，1滴/次，3次/d；治疗组在对照组治疗基础上口服明目蒺藜丸，9 g/次，2次/d。两组均治疗8周。观察两组的临床疗效和临床症状改善时间，比较两组治疗前后视功能相关生命质量量表（NEI-VFQ-25）评分、视功能损害眼病患者生存质量量表（SQOL DVI）评分、眼表疾病量表（OSDI）评分、眼表功能指标、泪液细胞因子的变化情况。结果 治疗后，治疗组的总有效率是97.44%，显著高于对照组的79.49%（P＜0.05）。治疗后，治疗组眼睛干涩感、异物感、疲劳感、畏光、灼烧感改善时间上均显著短于对照组（P＜0.05）。治疗后，两组NEI-VFQ-25评分、SQOL DVI评分均显著升高，而中国干眼问卷量表评分、OSDI量表评分均显著降低（P＜0.05）；治疗后，治疗组患者相关量表评分改善均优于对照组（P＜0.05）。治疗后，两组患者泪膜破裂时间（FBUT）、SⅠt均较治疗前显著升高，而角膜荧光素染色（FL）评分显著降低（P＜0.05）；治疗后，治疗组眼表功能指标改善均优于对照组（P＜0.05）。治疗后，两组泪液中白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）均显著降低，而溶菌酶、表皮生长因子（EGF）、乳铁蛋白（LF）均显著显著升高（P＜0.05）；治疗后，治疗组泪液细胞因子改善均优于对照组（P＜0.05）。结论 明目蒺藜丸联合玻璃酸钠滴眼液治疗干眼症可有效改善临床症状，改善眼表功能及泪液分泌，下调泪液细胞因子水平，提高生活质量，有着良好的临床应用价值。     

复方小活络丸联合托法替布治疗类风湿关节炎的临床研究

目的 探讨复方小活络丸联合托法替布治疗类风湿关节炎的临床疗效。方法 选取2021年7月—2023年7月天津市北辰医院骨科收治的128例类风湿关节炎患者,按照随机数字法分为对照组和治疗组,每组各64例。对照组口服枸橼酸托法替布片,1片/次,2次/d。治疗组在对照组治疗基础口服复方小活络丸,温开水送服1丸/次,2次/d。两组均连续治疗7周。观察两组的临床疗效和症状改善时间,比较两组治疗前后视觉模拟评分法（VAS）评分、白细胞介素-6（IL-6）、抗环瓜氨酸肽抗体（anti-CCP）、B细胞趋化因子CXC配体13（CXCL13）、肿瘤坏死因子-α（TNF-α）的变化情况。结果 治疗后,治疗组总有效率是98.44%,显著高于对照组的84.38%（P＜0.05）。治疗后,治疗组关节疼痛、关节肿胀、关节晨僵、关节屈伸不利改善时间均显著短于对照组（P＜0.05）。治疗后,两组VAS疼痛评分均较同组治疗前显著降低（P＜0.05）;治疗后,治疗组VAS疼痛评分低于对照组（P＜0.05）。治疗后,两组血清IL-6、anti-CCP、CXCL13、TNF-α水平均较同组治疗前显著降低（P＜0.05）;治疗后,治疗组IL-6、anti-CCP、CXCL13、TNF-α水平均低于对照组（P＜0.05）。结论 复方小活络丸联合托法替布治疗类风湿关节炎具有较好的临床疗效,能缩短症状改善时间,降低VAS疼痛评分和血清炎性因子水平,值得借鉴应用。     

贝复舒滴眼液联合玻璃酸钠滴眼液治疗白内障术后角膜水肿的临床效果

目的 观察贝复舒滴眼液联合玻璃酸钠滴眼液治疗白内障术后角膜水肿的临床效果。方法 2014年1月-2016年1月选择在北京市顺义区妇幼保健院诊治的白内障术后角膜水肿患者78例,根据随机信封抽签原则分为观察组与对照组各39例,对照组给予玻璃酸钠滴眼液治疗,观察组给予贝复舒滴眼液联合玻璃酸钠滴眼液治疗,两组都连续治疗观察4周。比较两组临床疗效、治疗前后视力状况、并发症情况及炎症因子白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）水平。结果 治疗后观察组的有效率（98.7%）明显高于对照组（88.5%）,差异有统计学意义（P<0.05）。治疗后观察组与对照组的视力明显好于治疗前,同组治疗前后比较差异有统计学意义（P<0.05）;同时观察组治疗后的视力明显好于对照组,差异有统计学意义（P<0.05）。观察组治疗期间的新生血管性青光眼、瞳孔区模性渗出、玻璃体积血等并发症发生率为7.7%,对照组为9.0%,两组对比无明显差异。治疗后观察组的泪液IL-6和TNF-α含量明显低于治疗前,同组治疗前后比较差异有统计学意义（P<0.05）;同时治疗后观察组的泪液IL-6和TNF-α含量明显低于对照组,差异有统计学意义（P<0.05）。结论 贝复舒滴眼液联合玻璃酸钠滴眼液治疗白内障术后角膜水肿能抑制泪液中炎症因子的表达,具有很好的安全性,从而提高治疗疗效与改善视力。     

玻璃酸钠滴眼液联合重组人表皮生长因子滴眼液治疗白内障术后干眼症的疗效观察

摘 要 目的：观察玻璃酸钠滴眼液联合重组人表皮生长因子（rhEGF）滴眼液治疗白内障术后干眼症的临床疗效。方法：白内障术后干眼症患者80例（80眼）随机分为观察组和对照组,每组40例（40眼）。对照组给予玻璃酸钠滴眼液治疗,观察组在对照组基础上加用rhEGF滴眼液治疗,两组疗程均为4周。比较两组患者用药前及用药2周、4周的干眼症状评分,两组泪膜破裂时间（BUT）、泪液分泌试验（SIt）及角膜荧光素染色（FL）情况,评价两组疗效和药品不良反应。结果：观察组总有效率为97.5%,显著性高于对照组的75.0%(P<0.05)。治疗2周、4周后,两组干眼症状评分均较前显著下降（P<0.05）;且观察组评分明显低于对照组（P<0.05）。治疗后,两组BUT、SIt均较前显著上升,FL较前显著降低（P<0.05）;且观察组BUT、SIt明显高于对照组,FL明显低于对照组（P<0.05）。对照组药品不良反应发生率显著高于观察组（P<0.05）。结论：玻璃酸钠滴眼液联合rhEGF滴眼液可以显著改善白内障术后干眼症患者的临床症状,促进泪膜的稳定性,减少泪液分泌与角膜损伤,值得临床推广应用。     

疗癣卡西甫丸联合卡泊三醇乳膏治疗寻常型银屑病的临床研究

目的 探讨疗癣卡西甫丸联合卡泊三醇乳膏治疗寻常型银屑病的临床疗效。方法 选择2019年6月—2021年6月南阳市中心医院收治的106例寻常型银屑病患者,随机分为对照组和治疗组,每组各53例。对照组外涂卡泊三醇乳膏,取适量均匀涂在患处,2次/d。在对照组基础上,治疗组口服疗癣卡西甫丸,10 g/次,2次/d。所有连续治疗7 d。观察两组患者临床疗效,比较治疗前后两组症状缓解时间,血清因子白细胞介素-2（IL-2）、干扰素-γ（INF-γ）、肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）水平及不良反应情况。结果 治疗后,治疗组临床有效率明显高于对照组（98.11%vs 84.91%,P＜0.05）。治疗后,治疗组中瘙痒、红斑丘疹、鳞屑、皮损缓解时间均明显短于对照组（P＜0.05）。治疗后,两组患者血清因子IL-2、INF-γ、TNF-α、IL-6水平明显降低（P＜0.05）,且治疗组明显低于对照组（P＜0.05）。治疗期间,治疗组不良反应发生率为7.54%,明显低于对照组的16.98%（P＜0.05）。结论 疗癣卡西甫丸联合卡泊三醇乳膏治疗寻常型银屑病效果明显,可改善机体免疫系统,降低炎症反应。     

石斛夜光丸联合玻璃酸钠滴眼液及维生素AD软胶囊治疗干眼症临床评价

目的探讨石斛夜光丸联合玻璃酸钠滴眼液及维生素AD软胶囊治疗干眼症的临床疗效。方法选取医院2016年3月至2018年8月收治的干眼症患者101例,按随机数字表法分为对照组(50例)和研究组(51例)。两组患者均予玻璃酸钠滴眼液及维生素AD软胶囊治疗,研究组患者加服石斛夜光丸。两组患者均治疗1个月。结果研究组总有效率为83.53%,显著高于对照组的60.00%(P<0.05);治疗后,两组患者眼表疾病指数(OSDI)及角膜荧光染色(FL)评分均明显降低,且研究组明显低于对照组(P<0.05),泪膜破裂时间(BUT)均明显延长,基础泪液分泌试验Ⅰ(Sit)数据均明显升高,且研究组明显高于对照组(P<0.05);治疗后,两组患者泪液中肿瘤坏死因子-α(TNF-α)、白细胞介素1β(IL-1β)、基质金属蛋白酶9(MMP-9)水平均明显下降,且研究组明显低于对照组(P<0.05);研究组不良反应发生率与对照组相当(21.57%比16.00%,P>0.05)。结论石斛夜光丸联合玻璃酸钠滴眼液及维生素AD软胶囊治疗干眼症,可有效改善患者眼部症状及泪液中IL-1β,TNF-α,MMP-9水平。     

当归苦参丸联合克林霉素磷酸酯凝胶治疗玫瑰痤疮的临床研究

目的 探讨当归苦参丸联合克林霉素磷酸酯凝胶治疗玫瑰痤疮的临床疗效。方法 选择2019年11月—2022年8月天津市北辰医院收治120例玫瑰痤疮者,随机分为对照组（60例）和治疗组（60例）。对照组患者外涂克林霉素磷酸酯凝胶,2次/d。在对照组的基础上,治疗组口服当归苦参丸,6 g/次,2次/d。两组服药8周。观察两组患者临床疗效,比较治疗前后两组患者症状缓解时间,皮肤病生活质量量表（DLQI）,血清炎性因子肿瘤坏死因子-α（TNF-α）、抗菌肽-37（LL-37）、白细胞介素-6（IL-6）和干扰素-γ（INF-γ）水平及不良反应情况。结果 治疗后,治疗组患者临床有效率为98.33%,明显高于对照组（83.33%,P＜0.05）。治疗后,治疗组患者症状缓解时间均早于对照组（P＜0.05）。治疗后,两组患者DLQI评分均明显下降（P＜0.05）,且治疗组的DLQI评分低于对照组（P＜0.05）。治疗后,两组患者LL-37、IL-6、TNF-α水平均低于治疗前,而IFN-γ水平高于治疗前（P＜0.05）,且治疗组血清炎性因子水平明显好于对照组（P＜0.05）。治疗后,治疗组不良反应发生率（5.00%）明显低于对照组（11.67%,P＜0.05）。结论 当归苦参丸联合克林霉素磷酸酯凝胶治疗玫瑰痤疮效果确切,可显著改善症状,有效降低炎性反应。     

蠲痹抗生丸联合美洛昔康治疗膝骨关节炎的临床研究

目的 探讨蠲痹抗生丸联合美洛昔康治疗膝骨关节炎的临床疗效。方法 选择2019年3月—2021年3月平煤神马医疗集团总医院接诊的78例骨关节炎患者,随机分为对照组和治疗组,每组各39例。对照组口服美洛昔康片,1片/次,1次/d。在对照组基础上,治疗组口服蠲痹抗生丸,2丸/次,2次d。两组患者治疗7周为1个疗程。观察两组患者临床疗效,比较治疗前后两组患者症状缓解时间,视觉模拟评分法（VAS）和西大略湖和麦克马斯特骨性关节炎指数（WOMAC）评分,血清因子白细胞介素-1（IL-1）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和转移生长因子-β（TGF-β）水平,及不良反应情况。结果 治疗后,对照组总有效率为76.92%,显著低于治疗组的97.44%（P＜0.05）。治疗后,治疗组关节肿胀、关节活动受限、关节晨僵、关节疼痛缓解时间明显早于对照组（P＜0.05）。治疗后,两组患者VAS评分、WOMAC评分比治疗前均明显下降（P＜0.05）,且治疗组评分均显著低于对照组（P＜0.05）。治疗后,两组患者血清因子IL-1、IL-6、TNF-α水平均明显降低,而TGF-β明显升高（P＜0.05）,且治疗组各血清因子水平明显好于对照组（P＜0.05）。治疗组患者不良反应发生率为7.69%,明显低于对照组的15.38%（P＜0.05）。结论 蠲痹抗生丸联合美洛昔康治疗膝骨关节炎,症状改善明显,局部炎症反应明显降低,且药物安全有效。     

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.