90例吸入型糖皮质激素治疗哮喘疗效观察

目的：观察吸入型糖皮质激素对哮喘患者的治疗效果。方法：将我院收治的90例哮喘患者随机分为3组,对照组（万托林组）、丙酸氟替卡松组（辅舒酮组）和沙美特罗替卡松组（舒利迭组）。对照组使用万托林,1日3次,1次2喷;丙酸氟替卡松组患者吸入辅舒酮,500μg,1日3次;沙美特罗替卡松组使用舒利迭,1次1吸,1日2次。3组均连续治疗6个月。结果：舒利迭组总有效率高于辅舒酮组,对照组总有效率最低;3组咳嗽症状评分、诱导痰嗜酸细胞计数方面,辅舒酮组（0.7±0.2、6.3±1.5）优于对照组（1.3±0.3、12.5±4.1）,舒利迭组（0.3±0.1、2.7±0.7）优于辅舒酮组。结论：沙美特罗替卡松粉吸入剂（舒利迭）治疗哮喘能够明显改善临床症状,对支气管哮喘的疗效显著。     

吸入舒利迭与辅舒酮防治慢性阻塞性肺病的对比观察

目的对比观察吸入舒利迭（丙酸氟替卡松／沙美特罗）与辅舒酮（氟替卡松）对慢性阻塞性肺病（COPD）的疗效。方法204例COPD患者随机分为治疗组和对照组各102例，治疗组吸入舒利迭，对照组吸人辅舒酮，观察2组临床疗效和肺功能改善情况。结果治疗组治疗后肺功能明显改善（P〈0．05），治疗组总有效率为91．2％高于对照组的74．5％，差异有统计学意义（P〈0．05），使用β2受体激动剂次数和因急性发作住院次数少于对照组（P〈0．01）。结论吸入舒利达防治COPD疗效显著。     

沙美特罗替卡松粉吸入剂治疗儿童哮喘疗效观察

目的探讨沙美特罗替卡松粉吸入剂(商品名舒利迭Seretide,葛兰素史克公司生产)治疗儿童哮喘的疗效及副作用.方法62例儿童哮喘按就诊顺序随机分成两组,治疗组患儿按病情严重程度分别予舒利迭50/100、100/200、150/300μg·d-1吸入,对照组按病情严重分别予丙酸氟替卡松吸入剂(商品名辅舒酮,葛兰素史克公司生产)125、250、375μg-1吸入,分别于治疗后4、8、12周评价其日、夜间哮喘症状计分及PEFR值变化.结果治疗后4、8、12周,治疗组与对照组相比,患儿日夜间哮喘症状计分明显减少(P＜0.01);治疗组PEFR值占预计值的百分比与对照组相比明显改善(P＜0.05),差异非常显著.且两组患儿在治疗期间均未发现明显副作用.结论联合应用糖皮质激素和长效β2-肾上腺素受体激动剂具有协同抗炎和平喘作用,且联合使用时可以减少糖皮质激素的用量,减少较大剂量的糖皮质激素的不良反应.舒利迭就是含有沙美特罗和丙酸氟替卡松的混合干粉吸入剂,用舒利迭治疗不同程度的儿童哮喘疗效明显优于辅舒酮.     

舒利迭在慢性阻塞性肺疾病稳定期的应用

目的 对比研究舒利迭（沙美特罗／丙酸氟替卡松）治疗慢性阻塞性肺疾病（COPD）的疗效。方法 对180例确诊为COPD的患者分成3组：分别吸入舒利迭（实验组）、施立稳（对照组1）、辅舒酮（对照组2），根据圣．乔治（St．George）呼吸疾病问卷（SGRQ）的方法对临床症状问卷调查及体征检查评分；测定肺功能指标FEVI、FEV1／FVC及FEV1占预计值的百分率（％），评价治疗前后肺功能的变化。结果临床症状积分及上述肺功能指标均获得了改善，与单独应用施立稳及辅舒酮组比较，舒利迭组治疗后临床症状积分及上述肺功能指标的改善更加显著（P〈0．01）。结论舒利迭是治疗COPD的有效的药物，其疗效明显优于应用其单一组。     

舒利迭治疗成人支气管哮喘48例临床分析

目的：探讨舒利迭治疗成人支气管哮喘的临床疗效。方法：将48例确诊为支气管哮喘的患者给予舒利迭吸入治疗，剂量100／200μg／d（沙美特罗，丙酸氟替卡松），每次1吸，2次/日，急性发作期剂量加倍，维持剂量50，100μg/d，常规疗程6周。观察患者吸入前后临床症状变化及药物反应，检测治疗前后患者用力呼气肺活量（FVC）、第一秒用力呼气容积率（1秒率，FEV1.0%）及用力呼气峰流速（PEFR）的变化。结果：支气管哮喘患者经舒利迭吸入治疗后哮喘症状明显改善，治疗后患者FVC、FEV1.0%及PEFR显著提高。结论：舒利迭吸入治疗对支气管哮喘疗效显著．患者肺功能显著改善。     

舒利迭粉吸入剂治疗儿童中重度哮喘的研究

目的 探讨沙美特罗/替卡松混合干粉剂(舒利迭)吸入治疗儿童中、重度哮喘的临床疗效及其不良反应.方法 本院2005年1月-2006年10月儿科门诊、急诊以及住院的中、重度哮喘儿童160例,按单双日随机分组,治疗组选用舒利迭吸入,对照组吸入糖皮质激素(辅舒酮)治疗,观察8周,分别对其临床疗效以及肺功能、不良反应进行观察研究.结果 舒利迭吸入治疗组的临床疗效,肺功能改善方面明显优于辅舒酮对照组(治疗组总有效率为98.7%,对照组为91.7%),具有统计学意义,未出现明显不良反应.结论 沙美特罗/替卡松联合治疗儿童中、重度哮喘,临床应用安全,不良反应少,依从性好,疗效明显优于单纯吸入糖皮质激素治疗,值得临床推广使用.     

酮替芬联合舒利迭治疗变应性鼻炎并支气管哮喘患者的临床效果及预后观察

目的观察酮替芬联合舒利迭治疗变应性鼻炎并支气管哮喘患者的临床效果及预后效果。方法选取2015年3月至2016年6月收治的94例变应性鼻炎并支气管哮喘患者临床资料,分为对照组(47例)、观察组(47例),前者予以舒利迭辅以孟鲁司特钠治疗,后者予以酮替芬联合舒利迭治疗,观察比较两组治疗效果及不良反应情况。结果观察组FEV_1(3.42±0.53)%、FVC(3.28±0.52)L、PEF(6.79±0.49)L/min指标较对照组高,其鼻炎症状积分(0.83±0.35)分较对照组低(P<0.05);对照组不良反应率19.25%则高于观察组(P<0.05)。结论酮替芬与舒利迭联合治疗变应性鼻炎合并支气管哮喘可有效改善患者肺功能,缓解鼻炎症状,不良反应少,安全性高。     

轴舒良鼻喷剂对变应性鼻炎的疗效观察

目的 探讨辅舒良鼻喷客剂治疗变应性鼻炎的疗效。方法 选择64例变应性鼻炎患者，随机分为两组，分别采用激素治疗组及抗组胺药物治疗组。结果 激素(辅舒良)治疗组有效率93％，抗组胺药治疗组有效率为80％，结论 激素疗法应用于变应性鼻炎疗效显著，副作用小。     

舒利迭治疗支气管哮喘的临床观察

目的观察舒利迭（沙美特罗/氟替卡松）治疗支气管哮喘的疗效。方法对120例确诊支气管哮喘的患者,分为吸入糖皮质激素和长效β2受体激动剂的复方制剂舒利迭（沙美特罗/氟替卡松）治疗组60例,吸入糖皮质激素（丙酸氟替卡松）对照组60例。治疗后对临床疗效、肺功能指标进行比较及统计学分析。结果舒利迭治疗组用药后临床疗效和肺功能改善方面明显优于对照组。结论舒利迭在治疗支气管哮喘改善临床症状和肺功能明显,较单纯吸入糖皮质激素能更好控制及改善的哮喘症状。     

酮替芬联合舒利迭治疗支气管哮喘44例

目的观察酮替芬联合舒利迭治疗支气管哮喘的疗效。方法将87例支气管哮喘患者按随机数字表法分为两组,治疗组44例予以酮替芬联合舒利迭治疗,对照组43例予以孟鲁司特联合舒利迭治疗,均治疗12周后进行哮喘控制评分、测定第1秒用力呼气容积占预计值的百分比（FEV．％）、呼气流量峰值（PEF）和药品不良反应（ADR）。结果与对照组比较,治疗组能显著提高哮喘患者的控制测试评分（P〈0．05）;两组治疗后FEV。％和PEF较治疗前均有显著提高,但两组比较差异无统计学意义;两组ADR发生率分别为6．82％和9．30％,差异无统计学意义。结论酮替芬联合舒利迭治疗支气管哮喘的综合疗效优于孟鲁司特联合舒利迭,且经济、安全,可作为孟鲁司特的替代药物用于治疗支气管哮喘。     

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.     

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.