复方角菜酸酯栓治疗156例内痔的观察

目的 观察研究肛栓剂－－复方角菜酸酯栓治疗内痔的有效性和安全性。方法 选择156例内痔患者采用复方角菜酸酯栓剂纳入肛门，每次1枚，早晚各一次，连用7d。结果 总有效率为80．1％，其中Ⅰ，Ⅱ，Ⅲ，Ⅳ度内痔和混合痔有效率分别为95．8％，92．3％，39．1％，28．6％，82．0％。主要症状如出血，疼痛，瘙痒，脱出，坠胀，溢液，用药3d后症状消失分别为51．72％，46．94％，50．79％，30．77％，47．67％，50．91％；7d后分别为77．24％，74．49％，74．60％，44．87％，70．93％，70．91％。所有患者均未发现全身不良反应，局部副作用少见，而且十分轻微。结论 复方角酸酯内痔疗效明显，用药安全。     

自体血光量子疗法治疗肺心病30例临床分析

我院应用自体血光量子疗法治疗肺心病３０例，并和对照组比较，结果治疗组显效率５０．０％，有效率４３．３％，无效率３．３％，死亡率３．３％，总有效率９３．３％，对照组显效率３０．０％，有效率４５．０％，无效率２０．０％，死亡率５．０％，两组相比较，Ｐ〈０．０５，说明有显著性差异。     

应用动态心电图监测147例老年心血管病人的心律失常分析

本分析动态心电图（Holter)监测的147例老年心血管病人的各种心律失常，室上性早搏78．25％，室性早搏61．9％，窦性心动过速34．69％，窦性心动过缓31．29％，房性心动过速27．21％，心房颤动9．52％，右束支传导阻滞4．76％，房室传导阻滞4．76％，窦性停搏为2．72％，窒性心动过速为2．04％，窦房传导阻滞和左束支传导阻滞的1．36％，随年龄增长而检出率降低的窦性心动过速38．38％和27．08％。随年龄增长检出率无明显差异有室性早搏61．61％和62．5％，室性心动过速2．02％和2．08％，窦性心动过缓31．31％和31．25％。Holter监测的174例心律失常和其常规心电图112例作比较，其检出率前比后高，其中心房颤动高1．78倍，窦房传导阻滞及房室传导阻滞高1．5－4．76倍，室上性早搏和室性早搏均高11倍。     

药物治疗甲真菌病的临床应用分析

目的：综述药物治疗甲真菌病的临床应用分析。方法：检索1995年-2005年3月MEDLINE网站收入的药物治疗甲真菌病的Meta分析，系统综述10个Meta分析4种口服药物（灰黄霉素、伊曲康唑、特比萘芬、氟康唑）和一种外用药物（环吡酮）治疗甲真菌病的临床证据。结果：灰黄霉素、伊曲康唑、特比萘芬、氟康唑、环吡酮真菌学治愈率分别为24．5％～68％，56．5％～93％，74％～96．5％，48％～65．6％，29％～85．7％；临床治愈率为33．7％～41oA．70％，70％，45％～66．5％，52％；复发率为40％．10．4％～21％，15％，4．4％，20．7％；治疗总费用（美元）为569．00～1470．70，713．00～1783．00，422．00～1106．00，1005．24，361．12～682．00；费用／真菌学治愈率为837．00～3578．40，767．00～2215．60，454．00～1233．90，1532．40，686．50。结论：特比萘芬是一种较经济有效的治疗甲真菌病口服药物，环吡酮甲涂剂是一种较好的外用药物，伊曲康唑冲击疗法明显降低了治疗成本。     

595例儿童结核病分析

目的 探讨儿童结核的发病特点和诊治情况。方法 对1970年－1979年和1991年－2000年住院的595例结核病患儿临床资料进行分析和前后十年比较。结果 595例中≤1岁16．5％，－3岁23．0％，－7岁30．4％，－14岁30．1％。种卡史30．3％，结核病既往史10．8％。结核菌素试验阴性15．1％，强阳性16．8％，误漏诊率40．7％，原发型肺结核26．9％，急性粟粒型肺结核11．9％，浸润性肺结核2．0％，结核性胸膜炎19．2％，结核性脑膜炎18．2％，腹腔结核7．2％，骨关节结核8．7％，泌尿系结核1．2％。近十年农村病人增加（89．6％），1岁内病人增加（19．2％），家人患结核病我（78．0％），急性粟粒型肺结核和结核性脑膜炎增多，分别占19．2％和19．7％，主要化疗方案是异蔺肼＋链霉素（卡那霉素）＋利福平（58．8％），异菸肼＋链霉素＋利福平＋吡嗪酰胺（14．8％）和异菸肼＋利福平（10．5％）。结论 加强对儿童结核病的防治，提高对结核病的警惕性，掌握儿童结核病的规律，减少误漏诊。     

栽培河套大黄根、茎、叶中游离葸醌类成分的含量分析

目的：利用HPLC法测定栽培河套大黄根、茎、叶中游离蒽醌的含量。方法：采用Agilent Zorbax SB-C18（4．6mm×250mm，5μm）色谱柱，以甲醇-0．1％磷酸（85：15）为流动相，流速：1．0mL·min^-1，检测波长为254nm，理论板数按大黄素峰计算不低于3000。结果：芦荟大黄素、大黄酸、大黄素、大黄酚、大黄素甲醚5种成分的线性范围分别为0．046-0．232峭（r=0．9998）、0．069-0．343μg（r=0．9999）、0．063-0．314μg（r=0．9995）、0．060-0．298μg（r=0．9994）、0．032-0．161μg（r=0．9997）。河套大黄样品1（根）中上述5种成分的回收率（n=6）分别为97．31％（RSD为1．3％），96．73％（RSD为2．2％），98．85％（RSD为1．9％），98．96％（RSD为1．0％），98．11％（RSD为2．3％）。河套大黄根中上述5种成分的含量依次为0．42％-0．48％，0．06％-0．08％，0．40％-0．47％，1．90％-2．40％，0．44％-0．62％；茎中的含量依次为0，0，0．08％-0．1％，0．01％，0．03％-0．06％；叶中的含量依次为：0．01％，0，0．62％-0．90％，0．01％，0．05％-0．07％。结论：栽培河套大黄根、茎、叶中均含有游离蒽醌，其中根的含量最高，叶次之，茎最少；根中游离蒽醌最高为大黄酚，其次为大黄素甲醚，芦荟大黄素与大黄素的含量基本相同，大黄酸的含量最低。可针对河套大黄中含量较高的游离蒽醌进行开发。     

三种不同构型的宫内节育器临床应用效果比较

采用随机分配法观察３种不同构型的宫内节育器：宫型器，ＴＣｕ２２０Ｃ和Ｒｉｎｇ共７５０例，随访满８年者７０１例，随访订为９３．４７％。使用８年结果表明：３组累计妊娠率分别为１２．９３％，５．１１％和１７．０９％；脱落率依次为３．８８％，５．１１％及１８．８０％；因症取出率则顺序为４．３１％，８．５１％和３．８５％；继续存放率分别为７６．２９％、７９．５７％和５８．５５％。     

251例慢性酒精中毒所致精神障碍临床分析

目的了解慢性酒精中毒所致精神障碍的精神神经症状及躯体损害。方法对1985—2005年住院251例慢性酒精中毒所致精神障碍患者临床资料进行分析。结果主要精神症状出现率分别为：记忆和智能障碍69．72％，人格改变66．93％，幻觉61．75％，妄想52．19％，冲动行为50．60％。主要神经系统症状出现率分别为：肢体震颤79．28％，共济失调62．55％，末梢神经炎41．04％，意识障碍26．69％，癫闲样发作21．51％，构音障碍18．33％。颅脑CT90．48％示脑萎缩。脑电图异常率为74．90％。伴各种躯体疾病者65．34％。本病复发率高达84．00％。结论慢性酒精中毒可造成严重精神障碍、神经及躯体损害，应引起全社会对本病防治的重视。     

儿童肺炎支原体感染689例分析

目的 调查儿童肺炎支原体(MP)感染的临床特点。方法 对2001年1月1日至2003年12月31日，在本院住院的689例MP感染患儿的发病、临床表现、经过及预后等方面进行回顾性分析。结果 (1)2001～2003年，每年住院的患病率依次为3．80％，6．45％及13．67％，MP肺炎占住院肺炎患儿的比例依次为6．9％、13．3％及37．2％。男女之比为1．89：1，其中57．3％为3岁以下患儿。(2)首发症状：以咳嗽多见(占48．2％)，其他依次为发热(38．6％)、皮疹(5．7％)、哮喘(3．3％)、鼻塞(1．2％)、关节痛(0．9％)、抽搐(0．9％)及肉眼血尿、腹泻、心律失常、胸闷(各0.3％)。(3)主要诊断：表现为肺炎80．83％，其中有肺外表现者30．16％；支气管炎及哮喘各4．06％，上呼吸道感染2．61％，过敏性紫癜2．32％，血小板减少性紫癫及心肌炎各1．74％，传染性单核细胞增多症1．45％，川崎病1．31％，脑炎1．16％，肾炎0．87％。(4)X线改变：支气管肺炎28．9％，局灶片状均一实变影20．9％，弥漫性间质改变16．1％，支气管周围炎9．3％，肺门周围模糊影9．1％，仅为肺纹理增租4．1％，肺部无改变11．6％。(5)实验室检查：ALT升高35．1％，血细胞学检查有30％单核细胞升高。(6)治疗及预后：2～12周不等的大环内酯类抗生素治疗，治愈率达95．4％，1例死亡。结论 (1)2001～2003年MP感染住院患病率逐年升高。男性及3岁以下患儿为主。(2)MP感染以肺炎表现为主，有多种肺外表现，首发症状及临床表现多样，重者可引起多脏器功能衰及死亡。(3)X线改变多样，可出现血细胞学异常，肝功能多异常。(4)少数患儿难治，可再次感染，易误诊。     

原发性肝癌化疗栓塞术后不良反应观察

本文分析报告６８例各型肝癌化疗栓塞术后不良反应的发生情况：总发生率９７．０％，肝区疼痛６７．６％，发热６０．２％，恶心呕吐４１．２％，腹胀３８．２％，腹水形成２０．６％，黄疸１７．６％，呃逆１３．２％，上消化道出血８．８％，本文讨论了肝癌化疗栓塞的病理生理改变，化疗栓塞术后不良反应发生机理及临床对症处理方法。     

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.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

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.     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.