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。     

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。     

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。     

儿童鼾症与体格发育

儿童鼾症是常见疾病，我院统计占耳鼻咽喉科门诊儿童患者的２７．３９％。对２１８例鼾症儿童进行全身发育情况调查，结果：①体重低于标准占３９．９％，对照组１０％。②身高低于标准占４５．４％，对照组８．６７％。③腺样体面容占３８．５％。④牙齿发育不良占２３．３９％，对照组占２％。⑤智力减退占１５．４％，对照组２％。⑥听力减退占１２．３９％，对照组占１．３３％。⑦消化不良占２５．２３％，对照组占５．３３％。结论：儿童鼾症对儿童全身发育产生多方面不良影响，应予及时诊治。     

医院感染病原菌检验与抗生素药敏试验研究

本次调查采集普通外科术后病人样本２７２份，阳性１４７份，阳检率为５４．０４％，伤口分泌物检出率高达６６．６７％，引流液检出率为５８．１１％，痰液检出率３０．７７％，血液检出率２７．２７％，尿液检出率１２．９％。１４７个阳性标本中共检出２１种细菌１５６株，其中革兰阴性菌占６４．７４％，革兰阳性菌２７．５６％，真菌７．６９％。１４４株细菌中（不包括真菌），用药敏试验的纸片法测定，不耐药菌１０株占６．９４％，耐药菌１３４株占９３．０６％，其中耐一种抗生素１１株７．６４％，耐二种抗生素３５株２４．３１％，耐三种抗生素３０株２０．８３％，耐四种抗生素２５株１７．３６％，耐五种以上抗生素３３株２２．９２％。用最小抑菌试验测定四种优势菌（绿脓杆菌、大肠艾希菌、金黄色葡萄球菌及肺炎克雷伯菌）共４８株的结果：总耐药率为４４．９１％，耐药率的高低依次为：绿脓杆菌耐药率４７．９２％、金黄色葡萄球菌４６．７％、大肠艾希菌４３．１４％、肺炎克雷伯菌３７．７８％。     

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。     

本院2000-2005年鲍氏不动杆菌的耐药性分析

目的了解本院2000—2005年鲍氏不动杆菌的耐药性，有助于及时发现病房内细菌耐药的流行状况．为临床合理用药提供依据。方法用常规方法对本院收集的标本进行细菌培养、分离和鉴定，严格按照NCCLS（美国临床实验室标准委员会）的标准。用法国生物梅里埃ATB自动细菌分析仪进行细菌鉴定和药敏分析。结果2000-2005年鲍氏不动杆菌的耐药率分别是阿莫西林23．70％，阿莫西林／舒巴坦15．56％，替卡两林25．17％，替卡西林／克拉维酸22．10％．哌啦西林19．39％，头孢曲松18．04％，头孢他定14．70％，氨曲南66．91％，亚胺培南6．46％，妥布霉索21．09％，丁胺卡那17．01％，庆大霉索22．07％，奈替米星15．33％，培氟沙星18．11％，环丙沙星19．73％，复方新诺明23．47％，磷霉索100．00％。结论应重视鲍氏不动杆菌耐药性的监测，以指导临床合理使用抗菌药物。     

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。     

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.     

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.