力尔凡致呼吸困难1例

力尔凡是利用现代生物技术生产的抗肿瘤药,对原发性、转移性肿瘤有较强的杀灭及抑制作用,并且能改善和增强机体的免疫功能.长期使用无毒性,有少数患者出现注射部位疼痛,偶见有皮疹,但发热反应发生率达30%～50%[1],致过敏性休克2例[2],致呼吸困难未见报道.     

服用拉米夫定出现锥体外系症状1例

拉米夫定(lamivudine)是一种治疗慢性乙型肝炎(乙肝)的药物,其成分是硫代脱氧胞嘧定,一种核苷类似物,抑制病毒作用较强,我国食品药品监督管理局及美国FDA在1998年底批准该药治疗慢性乙肝,其疗效已得到普遍认可,且不良反应少.曾有报道拉米夫定致急性肌张力障碍2例[1]及拉米夫定致精神障碍1例[2],现报道致锥体外系症状的不良反应1例如下.     

氟喹诺酮类药物致不良反应56例分析

氟喹诺酮类药物抗菌作用广泛,疗效好,但是用药后所导致的不良反应(药源性疾病)不断上升[1],对患者的肝、肾以及血液系统的损害比较严重。笔者收集56例氟喹诺酮类药物致不良反应病例的资料进行分析,报道如下:     

利培酮和氯氮平及其代谢产物对体外培养大鼠胰岛分泌功能的影响

近年来关于非典型抗精神病药(AAPDs)对糖代谢影响的报道和临床研究很多.AAPDs中氯氮平对糖代谢影响最大[1],利培酮影响较小,介于氯氮平、奥氮平和传统抗精神病药之间[2].     

静脉药瘾者继发败血症致脑出血1例

败血症和脑出血都是临床常见病,但两者同时存在的病例却较罕见[1-9],现将本院收治静脉药瘾者继发败血症致脑出血1例报道如下:1临床资料患者,曾某,男,37岁。因"反复发热7d,意识欠清2d"于2011年9月20日入本院感染科。患者于2011年9月13日无明显诱因出现发热,体温达39.7℃,伴有乏力感,不伴头     

应用氯氮平致发热反应的重复性

氯氮平为二苯并二氮杂卓类的衍生物,结构类似三环抗抑郁药[1],是一种新型的抗精神病药物.但是,随着在临床的广泛应用,其副反应也逐渐显露出来,其中,发热和白细胞改变是较为严重的副反应.而临床上最常见的、出现频度最高的即为发热反应.一般情况下,经减药、停药和对症处理后,症状即可消失.但是,对于首次应用氯氮平出现发热反应的患者,可否再次应用氯氮平,还没有文献报道.我们在临床上遇到三例应用氯氮平出现发热反应于二次住院再次应用氯氮平而又出现发热反应,其中一例于第三次住院未用氯氮平而未出现发热.现报告如下:     

超声诊断腹腔脏器穿孔致腹膜炎32例

超声诊断大网膜病变国内外报道较少[1],而腹腔脏器穿孔后引发腹膜炎是外科常见病.本文收集1999年6月～2003年7月我院超声诊断各类腹腔脏器穿孔致腹膜炎32例,现报告如下.     

腰-硬联合麻醉后伴发颅内积气致意识丧失一例并文献复习

腰-硬联合麻醉(CSEA)广为临床应用,其常见并发症亦已得到重视和有所降低[1,2],但对其少见和严重并发症,却少见报道.现将本院1例CSEA后伴发颅内积气致意识丧失病例进行报道,并结合文献分析如下.     

更昔洛韦联合病毒唑治疗手足口病疗效观察

手足口病(HFMD)是1957年首次在新西兰发现的一种新型传染病.近年来,HFMD在东南亚流行并呈上升趋势,2008年5月2日我国将之纳入丙类传染病管理.HFMD是由肠道病毒感染引起,表现为手、足、臀、口腔粘膜等部位斑丘疹和发热,一般预后良好,轻型可自愈,HFMD流行时伴较高的死亡率[1],该病亦可引起心肌损害[2]、肺水肿、脑炎、脑膜炎等严重并发症,严重者可致死亡.目前,对该病治疗尚缺乏特异性药物,我院应用更昔洛韦联合病毒唑治疗手足口病患儿,取得良好效果,现报道如下.     

舒芬太尼用于高血压老年患者全麻诱导插管的临床分析

舒芬太尼是选择性μ受体激动药,具有脂溶性高,血浆蛋白结合率达92.5％,易穿透血脑屏障,可选择性作用于μ受体,亲和力强,是芬太尼家族中镇痛作用最强的人工合成类阿片药物[1],有文献报道:舒芬太尼镇痛持续时间为芬太尼的5～10倍[2],舒芬太尼用于高血压老年患者全麻诱导插管的临床应用的有关报道少见,因而作者就此问题进行了有关的临床研究.     

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.     

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.