大剂量静注丙种球蛋白治疗重症病毒性脑炎

目的探讨采用大剂量静注丙种球蛋白(IVIG)治疗小儿急性重症病毒性脑炎(ASMEP)的疗效.方法将39例ASMEP患儿随机分成两组:治疗组(n=20)用IVIG、干扰素(IFN)、病毒唑及对症等综合治疗,对照组(n=19)用IFN、病毒唑及对症等综合治疗,IVIG按0.4g/kg.d,连用3～5天.结果治疗组痊愈17例,有效3例,治愈率85%,有效率100%;对照组痊愈10例,有效6例,无效3例,治愈率5 3%,有效率84%,两组治愈率对比有显著性的差异(x2=5.23,P＜0.05).两组症状控制时间方面,治疗组在退热、解痉、神志转清、脑膜刺激征消失方面均较对照组为短且有显著性差异(p＜0.001～0.01).结论应用IVIG、IFN、病毒唑及对症等综合治疗ASMEP的疗效优于IFN、病毒唑及对症治疗的疗效.     

病毒唑雾化吸入治疗50例毛细支气管炎疗效观察

目的　观察病毒唑雾化吸入治疗毛细支气管炎的疗效。方法　采用病毒唑超雾化吸入治疗毛细支气管炎 5 0例 ,并与同期采用静脉应用病毒唑治疗的 45例毛细支气管炎患儿进行临床对照研究。结果　治疗组总有效率98% ,人均住院日为 (6 .6 5± 2 .3) d,对照组总有效率为 73% ,人均住院日为 (8.75± 2 .2 5 ) d,两组总有效率差异有非常显著性 (χ2 值 =12 .2 ,P<0 .0 1) ,治疗组人均住院日短于对照组 ,差异有非常显著性 (t值 =4,72 ,P<0 .0 1)。结论　病毒唑雾化吸入治疗毛细支气管炎可以取得比对照组更加满意疗效 ,且可缩短病程 ,减少不良反应。     

咪唑斯汀、组织胺人免疫球蛋白治疗慢性荨麻诊

目的观察咪唑斯汀、组织胺人免疫球蛋白联合治疗慢性荨麻疹的疗效。方法采用随机对照,以口服咪唑斯汀皮下注射组织胺人免疫球蛋白为治疗组,以口服咪唑斯汀为对照组,疗程28天,进行对比观察。结果治疗组有效率为95.8%,对照组有效率为91.7%,两组有效率比较无显著性差异(P>0.05);治疗组治愈率为85.4%,对照组治愈率为60.4%,两组治愈率比较有显著性差异(P<0.05);两组痊愈患者随访3个月,治疗组痊愈患者复发率12.5%,对照组痊愈患者复发率41.4%,两组比较有显著性差异(P<0.05)。结论咪唑斯汀、组织胺人免疫球蛋白联合治疗慢性荨麻疹的疗效好,复发度低,安全可靠,是治疗慢性荨麻疹的有效方法。     

中西医结合治疗神经性皮炎69例

目的探讨神经性皮炎的中西医治疗疗效。方法随机将齐齐哈尔市碾子山区疾病预防控制中心门诊2008年1月至2009年11月收治的135例神经性皮炎患者分为观察组69例、对照组66例,对照组进行西医对症治疗,观察组进行中西医结合治疗,对两组临床疗效进行分析比较。结果观察组临床治愈率为75.36%,治疗总有效率为91.30%;对照组临床治愈率为59.09%,治疗总有效率为77.27%。观察组临床治愈率、总有效率与对照组相比有显著性差异(χ2=4.07,P<0.05;χ2=5.10,P<0.05)。治疗前后监测两组血常规、肝肾功未见明显异常。所有患者均随访8~12个月,两组复发率比较有显著性差异(χ2=4.53,P<0.05)。结论中西医结合治疗神经性皮炎临床疗效显著,远期复发率低,值得临床进一步应用。     

丙种球蛋白治疗AIDP临床疗效观察

目的探讨静脉注射丙种球蛋白(IVIG)在急性炎症性脱髓鞘性多发性神经病(AIDP)治疗中的临床疗效。方法选取72例AIDP患者随机分为治疗组和对照组各36例,对照组给予地塞米松10 mg静脉滴注,每天1次,连用5 d;治疗组给予免疫球蛋白0.4 g/(kg.d)静脉滴注,连用5 d。5 d后两组患者均改口服泼尼松5 mg/(kg.d),并同时给予神经营养药及对症支持治疗,分别于治疗2周和4周末进行Hughes评分,4周末评定治愈情况。结果 2周和4周末Hughes评分,治疗组明显低于对照组,两组比较,差异有统计学意义(t=2.58、2.60,P<0.05);4周末痊愈率评定,治疗组患者痊愈率和显著进步率分别为27.78%(10/36)和41.67%(15/36),对照组痊愈率和显著进步率分别为5.56%(2/36)和25.00%(9/36),治疗组明显优于对照组(χ2=12.38,P<0.01)。结论 IVIG治疗AIDP可有效改善患者症状和体征,提高治愈率和显著进步率,临床疗效明显,建议推广应用。     

中西医结合治疗慢性盆腔炎132例疗效分析

目的观察中西医结合治疗慢性盆腔炎的临床疗效。方法选择2010年6月～2011年6月在笔者所在医院进行治疗的慢性盆腔炎患者132例,随机分为观察组和对照组各66例。观察组实施中西医结合治疗,对照组实施西医常规治疗,比较两组患者的治愈率、总有效率和复发率。结果观察组痊愈48例,有效13例,痊愈率为72.72%,总有效率为92.42%;对照组痊愈32例,有效21例,痊愈率为48.48%,总有效率为80.30%。两组治愈率(x2=8.123,P<0.05)和总有效率(x2=4.117,P<0.05)比较,均有统计学意义。结论中西医结合治疗慢性盆腔炎可以显著提高临床疗效,降低复发率,值得临床推广使用。     

磺胺嘧啶银和双氧水联合治疗褥疮疗效分析

目的探讨磺胺嘧啶银和双氧水联合治疗褥疮的疗效。方法采用随机对照进行临床试验,将通榆县第一人民院收治的压疮30例患者分为治疗组(n=14例)和对照组(n=16例)。对两组患者治愈率、有效率、治疗天数、愈合时间进行对比。结果治疗组治愈率和有效率,明显高于对照组,治疗天数和愈合时间明显少于对照组(P<0.01)。结论联合治疗法疗程短,治愈率高,操作简单,疗效显著,值得推广。     

红霉素加小剂量氨茶碱治疗小儿毛细支气管炎疗效观察

目的观察红霉素与小剂量氨茶碱联合治疗小儿毛细支气管炎的临床效果。方法 98例毛细支气管炎患儿随机分为治疗组54例,对照组44例。治疗组采用红霉素与小剂量氨茶碱联合治疗,对照组采用病毒唑、常量氨茶碱治疗。两组均给予常规吸氧、局部雾化、对症支持治疗。观察两组症状、体征、胸部X线的改变,进行疗效评定。结果治疗组与对照组总有效率分别为96．3％、79．5％,两组比较有显著性差异(P<0．05)。结论红霉素与小剂量氨茶碱联合治疗小儿毛细支气管炎疗效显著,值得临床推广应用。     

无环鸟苷治疗小儿疱疹性口腔炎的临床观察

目的观察无环鸟苷与病毒唑治疗小儿疱疹性口腔炎的疗效比较。方法对208例小儿疱疹性口腔炎患儿随机分成观察组150例,对照组58例。观察组用无环鸟苷静滴,对照组用病毒唑静滴治疗。一般对症治疗,抗感染治疗两组相同。治疗4天后判断疗效进行比较。结果观察组显效122例(81.3%)有效28例(18.7%),总有效率100%,对照组显著性意义(P<0.05)及总有效率的优越性。结论无环鸟苷用于治疗小儿疱疹性口腔炎明显优于病毒唑,且疗效显著安全。     

地氯雷他定联合胎盘多肽注射剂治疗慢性荨麻疹疗效观察

目的:研究抗组胺药联合胎盘多肽治疗慢性荨麻疹的近期及远期疗效。方法:选取慢性荨麻疹患者68例,按随机分配方案隐匿的方法(按顺序编号法)随机分成治疗组33例及对照组35例,两组同时服用地氯雷他定5 mg,qd,连服4周,其中治疗组加用胎盘多肽注射剂2 mL,im,qd,连用8周。结果:治疗4周时,治疗组有效率为93.3%、治愈率为73.3%,对照组有效率为87.1%、治愈率为67.7%,两组比较差异无显著性(P>0.05);停用地氯雷他定2周后,治疗组基本痊愈患者的复发率为36.36%、对照组基本痊愈患者的复发率为71.43%,两组比较差异有显著性(P<0.01);停用地氯雷他定4周后,治疗组基本痊愈患者的复发率为40.91%、对照组基本痊愈患者的复发率为76.19%,两组比较差异有显著性(P<0.01);停用地氯雷他定24周后,治疗组基本痊愈患者的复发率为40.91%、对照组基本痊愈患者的复发率为80.95%,两组比较差异有显著性(P<0.01)。结论:抗组胺药联合胎盘多肽治疗慢性荨麻疹的近期疗效好,近期及远期复发率低。     

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.

---

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.