糖皮质激素雾化吸入治疗重症甲型H1N1流感患儿疗效及其对单核细胞、嗜碱性粒细胞、嗜酸性粒细胞的影响

目的:探究重症甲型H1N1流感患儿应用糖皮质激素雾化吸入治疗的疗效,并分析患儿单核细胞(MONO)、嗜碱性粒细胞(嗜碱性粒细胞,BASO)、嗜酸性粒细胞(EOS)的状况.方法:选取298例2019年2月—2021年2月期间在本院接受治疗的重症甲型H1N1流感患儿,随机抽签的方法将患儿均分到对照组(常规治疗)、研究组(糖皮质激素),每组149例患儿.比较两组治疗前后身体状况变化、治疗研究炎症细胞状况.结果:治疗前后相比,两组体温(T)、心率(HR)以及第1秒用力呼气容积(FEV1)均明显改善,但研究组T、HR更低,FEV1更大(t=12.82、1.85、5.59,P<0.05).研究组MONO、BASO以及EOS百分比均比对照组更低,且研究组EOS计数更小(t=6.96、10.06、13.54、8.00,P<0.05).结论:采取雾化吸入糖皮质激素的方式给予重症甲型H1N1流感患儿治疗,可以明显改善患儿身体状况,降低炎症细胞水平,治疗效果良好.     

布地奈德混悬液联合纤支镜用于儿童甲型H1N1/H3N2感染合并塑型性支气管炎的病例分析

目的:探讨甲型H1N1/H3N2感染合并塑型性支气管炎(PB)的病理特征及诊治方法。方法:报告3例我院收治的甲型H1N1/H3N2感染合并PB儿童的病例资料,总结布地奈德混悬液雾化吸入联合纤支镜灌洗的治疗经验,并结合文献内容对该少见病种进行分析。结果:3例患儿中有2例甲型H1N1、1例甲型H3N2感染合并PB,其中2例有基础疾病,分别为支气管哮喘与原发性肾病综合征。3例患儿均诊断为重症肺炎、呼吸衰竭、肺不张,其中2例伴有纵膈气肿、皮下气肿。经纤支镜检查均取出树枝状异物,病理检查均为纤维素性渗出,伴有中性粒细胞、嗜酸性粒细胞及淋巴细胞浸润,确诊为PB。3例患儿经过辅助呼吸、呼吸道管理、抗感染等对症支持治疗,并采用布地奈德混悬液雾化吸入联合纤支镜灌洗后均痊愈出院。结论:PB是甲型流感的合并症之一,病情危重。临床上一旦考虑该病,应在布地奈德混悬液雾化治疗基础上尽快行纤支镜检查,以明确诊断并及时治疗。     

小儿甲型H1N1流感68例临床分析

摘要目的探讨小儿甲型H1N1流感的临床特点。方法对2009年9月-11月我院收治的68例确诊为甲型H1N1流感患儿临床资料进行分析和总结。结果经治疗68例全部治愈出院。结论今年我科收治的68例甲型H1N1流感以单纯型为主，未发现重症和危重症。早预防、早发现、早确诊与早治疗是应对甲型H1N1流感的关键。     

甲型H1N1流感确诊病例C反应蛋白和白细胞计数的变化及意义

目的 探讨甲型H1N1流感确诊病例C反应蛋白(CRP)、白细胞计数(WBC)、中性粒细胞(NE)和中性粒细胞比率(NE%)的变化及意义.方法 200例患者分为2组,甲型H1N1流感组(H1N1组)91例、非甲型H1N1流感组(非H1N1组)109例.分别检测CRP、血常规和体温.结果 H1N1组WBC、NE和CRP水平...     

重症甲型H1N1流感1例临床分析

甲型H1N1流感为一种新型呼吸道传染病,其病原菌为新甲型H1N1流感病毒株,病毒基因中包含有猪流感、禽流感和人流感3种流感病毒的基因片段。2009年12月我院收治了重症甲型H1N1流感患儿1例,现将该病的救治与药学监护报道如下。     

南京地区儿童甲型H1N1流感(重症)61例临床分析

目的 探讨儿童甲型H1N1流感(重症)的临床表现、诊断与治疗.方法 对61例儿童甲型H1N1流感(重症)的临床表现和实验室资料进行回顾分析.结果 61例甲流患儿均为本地流行病例,合并有肺炎者52例,支气管炎6例.最常见的症状是发热58例(95.1%);咳嗽52例(85.2%);喘息3例(0.4%);实验室检查显示白细胞...     

儿童重症甲型H1N1流感59例临床分析

目的 分析儿童重症甲型H1N1流感的临床特点及治疗效果.方法 对2009年12月在本院甲流病房集中收治的重症甲型H1N1流感59例进行回顾性分析.全部病例入院前均取咽拭子标本进行了甲型H1N1流感病毒的病原核酸检测,观察记录患儿住院期间的临床表现、合并症特点、实验室检查、疗效及转归.结果 本组患儿均不同程度出现持续高热不退,呼吸系统、血液系统、神经系统等多系统损害表现以及原有基础性疾病加重等情况.59例中发热57例,咳嗽54例,其中经X线诊断肺炎40例,诊断支气管炎14例.外周血白细胞尤其中性粒细胞数最下降56例.少数患儿有嗜睡、乏力、烦躁等神经系统症状,但均无脑脊液及头颅CT的异常.用奥司他韦口服57例,此外根据各自病情给与抗感染、输注丙种球蛋白支持治疗及其他对症治疗.57例中,1例自动出院,其余患儿均治愈或好转出院.结论 儿童重症甲型H1N1流感主要以呼吸系统症状为主,口服奥司他韦以及适当的抗感染、输注丙种球蛋白等综合性治疗有确切的疗效.     

甲型H1N1流感重症患者的护理

目的研究甲型H1N1流感重症患者的护理,为今后类似患者护理提供经验。方法对本院2009年10月至12月收治的9例甲型H1N1流感重症患者的治疗、护理情况进行总结、分析、评估。结果经过精心的治疗、系统、个体化的护理,9例甲型H1N1流感重症患者无一例死亡,平均住院日为（8．7±1．2）d。结论正确认识甲型H1N1流感重症患者疾病的重要和危险性,在精心的治疗下,进行系统和个体化结合的护理,是保证患者尽早康复的重要手段。     

苏州地区儿童重症甲型H1N1流感与重症呼吸道合胞病毒感染的比较

目的 比较苏州地区新甲型H1N1流感病毒与呼吸道合胞病毒(RSV)引起小儿重症感染的特点.方法 比较分析24例甲型H1N1流感患儿(甲型H1N1组)与42例的RSV感染患儿(RSV组)的临床特征及其预后.结果 与RSV组比较,甲型H1N1组平均年龄大,危重病例评分(PCIS)低,死亡风险评分(PRISMⅢ)高,住院时间和机械通气时间长,发热、急性呼吸窘迫综合征发生率高,喘息发生率低,肌钙蛋白、谷氨酸氨基转移酶、乳酸脱氢酶和C反应蛋白异常升高比例高(P＜0.05).甲型H1N1组影像学主要表现为两肺大范围实变影,肺气漏征象多见;RSV组主要表现为两肺门纹理改变及弥漫气肿.结论 了解上述不同特点有利于儿童甲型H1N1流感和RSV感染的鉴别和早期进行针对性治疗.     

重症甲型H1N1流感15例临床分析

目的：探讨重症甲型H1N1流感的临床特点。方法：对本院确诊的15例重症甲型H1N1流感临床特点和治疗进行回顾性分析。结果：所有确诊重症甲型H1N1流感患者均有发热等流感样症状,均继发肺部感染,可有白细胞（WBC）和淋巴细胞（L）减低及心肌酶异常,早期给予抗病毒等综合治疗,效果良好。结论：重症甲型H1N1流感发病以年轻群体为主,传染性高于季节性流感。早期给予奥司他韦等抗病毒治疗,疗效肯定。     

The aminomethylation of 1-cyano-isochromane and 1-cyano-isothiochromane

The Aminomethylation of 1-Cyano-isochromane and 1-Cyano-isothiochromane Aminomethylation of 1-cyano-isochromane (1a) and 1-cyano-isothiochromane (1i) can be achieved via reaction of carbanions 2 with α-haloamines 3 . Dialkylaminomethyl and dialkylaminobenzyl compounds 4 are formed.     

Preferential induction of CYP1A1 and CYP1B1 in CCSP-positive cells.

Both benzo[a]pyrene (BaP) and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) are potent ligands of aryl hydrocarbon receptors (AhR). Although animal studies indicate that both compounds induce pathological changes in the peripheral lung, the specific cell type involved remains unclear. Clara cells, expressing Clara cell specific protein (CCSP) and abundant in cytochrome P450, are nonciliated bronchiolar epithelial cells in the peripheral lung. Here we explore the hypothesis that CCSP-positive Clara cells are highly responsive to AhR ligands and are the primary cell type involved in BaP- and TCDD-induced toxicities. The responsiveness to AhR ligands was evaluated by measuring the respective mRNA and protein levels of cytochrome P450 1A1 (CYP1A1) and 1B1 (CYP1B1) using real-time RT-PCR and immunocytochemistry assays. Two in vitro models were used: primary cultures of human small airway epithelial (SAE) cells and rat lung slice cultures. In the presence of calcium, human SAE cells differentiated into CCSP-positive cells. BaP- and TCDD-induced mRNA and protein levels of CYP1A1 and CYP1B1 levels were significantly elevated in CCSP-positive cell cultures. Similarly, AhR mRNA and protein levels were increased in CCSP-positive cell cultures, as determined by real-time RT-PCR and Western blot analysis. When rat lung slice cultures were treated with BaP or TCDD for 24 h, CYP1A1 and CYP1B1 proteins were strongly induced in Clara cells. These results indicate that, in the peripheral lung of both rats and humans, CCSP-positive cells (Clara cells) may be more sensitive to AhR ligands than other cell types.     

Influence of genetic polymorphisms of CYP1A1 and GSTM1 on the urinary levels of 1-hydroxypyrene

The aim of the present study is to evaluate the influence of the genetic polymorphism of two enzymes involved in the biotransformation of xenobiotics, cytochrome P450 1A1 (CYP1A1) and glutathione-S-transferase M1 (GSTM1), on the urinary levels of 1-hydroxypyrene (1-OH-P) in workers exposed to polycyclic aromatic hydrocarbons (PAHs) and in unexposed workers (controls). The study group consisted of 30 controls recruited among employees of a service company and 171 PAHs-exposed workers from two electric steel plants and an iron foundry (all males, ranging between 18 and 60 years of age). Determination of airborne PAHs and urinary 1-OH-P was performed by high-performance liquid chromatography (HPLC) with fluorimetric detection. Polymerase chain reaction (PCR)-based restriction fragment length polymorphism (RFLP) was used to determine the genetic polymorphisms of CYP1A1 (CYP1A1*2A and CYP1A1*2B) and GSTM1. No influence of the genetic polymorphism of CYP1A1 and GSTM1 on the urinary levels of 1-OH-P was observed in this study.     

Toxicokinetics and Bioavailability of Oral and Intravenous 1, 1 -Dichloroethylene

Toxicokinetics and Bioavailability of Oral and Intravenous 1,1-Dichloroethylene.PUTCHA, L., BRUCKNER, J. V., D'SOUZA, R., DESAI, F., AND FELDMAN,S. (1986). Fundam. Appl. Toxicol. 6, 240–250. Althoughaliphatic halocarbons have been identified as contaminants ofdrinking water supplies, little definitive information is availableon their gastrointestinal (G.1) absorption and toxicokinetics.Therefore, a study of a representative halocarbon, 1,1-dichloroethylene(1,1-DCE), was undertaken to contrast the kinetics of the chemicalfollowing iv injection with that following oral administration.Four dosage-levels of 1,1-DCE (10, 25, 50, and 100 mg/kg BW)in 50% aqueous polyethylene glycol 400 were given iv and poto fasted and nonfasted male Sprague—Dawley rats. Serialblood samples were taken from the tail artery of the lightlyetherized animals for up to 490 min after dosing. 1,1-DCE concentrationsin the whole blood were determined by gas chromatographic head-spaceanalysis. Evaluation of the iv data revealed that disappearanceof 1,1-DCE from the systemic circulation followed a triexponentialpattern. Light ether anesthesia did not appear to alter thepharmacokinetics of iv-injected 1,1-DCE. There was no differencebetween nonfasted and fasted iv rats in biological half-life(t) or in any other pharmacokinetic parameter. Total body clearance,t apparent volume of distribution and volume of distributionin the central compartment did show increases with increasingdose in these animals. Oral dosing experiments revealed that1,1-DCE was absorbed very rapidly and completely from the G.I.tract. Peak blood levels were reached 2 to 8 min following oraladministration of 1,1-DCE as an aqueous suspension. The t of1,1-DCE in orally dosed rats was somewhat longer than in theiriv counterparts The t values for nonfasted, orally dosed ratswere longer than for their fasted counterparts, suggesting delayedabsorption due to the presence of food in the G.I. tract. Bioavailabilityof 1,1-DCE, as determined by comparing areas under blood concentrationversus time curves (AUCs), was equivalent in animals given thesame dose of 1,1-DCE iv and po. AUCs increased with increasingdose in iv and po groups, but the increases were not proportionalto dose.