小儿双清颗粒联合头孢西丁治疗小儿急性上呼吸道感染的临床研究

目的探讨小儿双清颗粒联合头孢西丁治疗小儿急性上呼吸道感染的临床疗效。方法选取2018年8月—2019年8月在天津市泰达医院就诊的急性上呼吸道感染患儿150例,根据用药的差别分为对照组(75例)和治疗组(75例)。对照组静脉滴注注射用头孢西丁钠,13.3～26.7mg/kg加入生理盐水100m L;治疗组在对照组基础上口服小儿双清颗粒,1～3岁,2～3 g/次,4～6岁,3～4 g/次,6岁,4～5 g/次,3次/d。两组患儿均治疗7 d。观察两组患者临床疗效,同时比较治疗前后两组患儿临床症状消失时间,及血清超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)、IL-1β、肿瘤坏死因子-α(TNF-α)水平。结果治疗后,对照组和治疗组临床有效率分别为82.67%和97.33%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组患者症状消失时间明显早于对照组(P0.05)。治疗后,两组患者血清hs-CRP、PCT、IL-6、IL-1β、TNF-α水平均明显降低(P0.05),且治疗组患者明显低于对照组(P0.05)。结论小儿双清颗粒联合头孢西丁钠治疗小儿急性上呼吸道感染,能显著改善临床症状,降低机体炎症因子表达,具有一定的临床推广应用价值。     

小儿解感颗粒联合头孢呋辛酯治疗小儿急性上呼吸道感染的临床研究

目的研究小儿解感颗粒联合头孢呋辛酯分散片治疗小儿急性上呼吸道感染的疗效。方法选取2018年2月—2020年2月河南科技大学第一附属医院收治的180例急性上呼吸道感染患儿,将所有患儿随机分为对照组和治疗组,每组各90例。对照组口服头孢呋辛酯分散片,0.125g/次,2次/d。治疗组患儿在对照组基础上口服小儿解感颗粒,1～3岁患儿,0.5袋/次,4～6岁患儿,1袋/次,3次/d。两组患儿持续治疗10d。观察两组患儿临床疗效,比较两组的临床症状缓解时间、心肌酶指标、血清炎性因子。结果治疗后,治疗组总有效率为94.44%,明显高于对照组的80.00%,两组比较差异有显著性(P0.05)。治疗后,治疗组患儿退热时间、咽喉红肿消失时间、止咳时间、鼻塞流涕消失时间明显短于对照组(P0.05)。治疗后,两组血清α-羟丁酸脱氢酶(α-HBDH)和肌酸激酶同工酶(CK-MB)水平显著降低(P0.05);并且治疗组血清α-HBDH和CK-MB水平降低较明显(P0.05)。治疗后,两组血清高敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和降钙素原(PCT)水平明显降低(P0.05);且治疗组血清hs-CRP、IL-6、TNF-α和PCT水平降低程度较大(P0.05)。结论小儿解感颗粒联合头孢呋辛酯分散片治疗小儿急性上呼吸道感染可改善临床症状,降低血清心肌酶和炎性因子水平。     

胰胆舒颗粒联合兰索拉唑治疗急性胰腺炎的临床研究

目的研究胰胆舒颗粒联合注射用兰索拉唑治疗急性胰腺炎的临床疗效。方法选取2018年12月—2019年12月郑州大学附属洛阳中心医院收治的100例急性胰腺炎患者为研究对象,将所有患者随机分为对照组和治疗组,每组各50例。对照组患者静脉注射注射用兰索拉唑,30 mg溶于0.9%氯化钠注射液100 m L中,2次/d。治疗组在对照组基础上口服胰胆舒颗粒,10 g/次,3次/d。两组患者持续治疗10 d。观察两组患者临床疗效,比较两组的临床症状缓解时间、胰腺炎床旁严重度指数(BISAP)评分、血清学指标、血清炎性因子水平。结果治疗后,治疗组总有效率94.00%,显著高于对照组的80.00%(P0.05)。治疗后,治疗组排气恢复正常时间、腹水消失时间、血淀粉酶恢复正常时间、排气恢复正常时间、腹痛消失时间、尿淀粉酶恢复正常时间明显短于对照组(P0.05)。治疗后,两组胰腺炎床旁严重度指数(BISAP)评分显著降低(P0.05);并且治疗组BISAP评分降低较明显(P0.05)。治疗后,两组血清淀粉酶(AMS)、脂肪酶(LPS)水平显著降低(P0.05);并且治疗组血清AMS、LPS水平明显低于对照组(P0.05)。治疗后,两组患者血清肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)和白细胞介素-6(IL-6)水平显著降低(P0.05);并且治疗组血清TNF-α、CRP和IL-6水平明显低于对照组(P0.05)。结论胰胆舒颗粒联合注射用兰索拉唑治疗急性胰腺炎具有较好的治疗效果,能够改善临床症状,降低血清AMS和LPS、炎性因子水平,值得在临床上推广应用。     

益心通脉颗粒联合贝尼地平治疗冠心病心绞痛的临床研究

目的探讨益心通脉颗粒联合贝尼地平治疗冠心病心绞痛的临床疗效。方法选取2018年11月—2020年11月在郑州市第一人民医院治疗的112例冠心病心绞痛患者,根据随机数字表法分为对照组(56例)和治疗组(56例)。对照组饭后口服盐酸贝尼地平片,1片/次,2次/d。治疗组在对照组基础上口服益心通脉颗粒,1包/次,3次/d。两组连续治疗14 d。观察两组患者临床疗效,比较治疗前后两组患者临床症状好转时间,心绞痛发作情况,血清炎性因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)和细胞间黏附分子1(ICAM-1)水平及不良反应情况。结果治疗后,治疗组患者总有效率明显高于对照组(P0.05);治疗后,治疗组患者症状好转时间均早于对照组(P0.05)。治疗后,两组患者心绞痛发作频率、每次发作持续时间明显降低(P0.05),且治疗组患者均明显低于对照组(P0.05)。治疗后,两组患者血清炎性因子IL-6、TNF-α、hs-CRP、ICAM-1水平均明显降低(P0.05),且治疗组患者明显低于对照组(P0.05)。治疗组患者不良反应发生率明显低于对照组(P0.05)。结论益心通脉颗粒与贝尼地平联合治疗后,可有效改善冠心病心绞痛患者临床症状,降低血脂及炎性水平,且药物安全有效。     

清喉利咽颗粒联合头孢呋辛酯治疗急性化脓性扁桃体炎的临床研究

目的探讨清喉利咽颗粒联合头孢呋辛酯片治疗急性化脓性扁桃体炎的临床疗效。方法选取2017年1月—2019年12月在天津医科大学中新生态城医院治疗的106例急性化脓性扁桃体炎患者,随机分为对照组(53例)和治疗组(53例)。对照组口服头孢呋辛酯片,0.25 g/次,2次/d。治疗组在对照组治疗的基础上口服清喉利咽颗粒,5 g/次,3次/d。两组患者均治疗5 d。观察两组患者临床疗效,比较治疗前后两组患者临床症状消失时间,血清炎性因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和超敏C反应蛋白(hs-CRP)水平。结果治疗后,治疗组临床有效率明显比对照组高(P0.05)。治疗后,治疗组退热时间、咽痛消失时间及扁桃体脓性分泌物消失时间均明显比对照组短(P0.05)。治疗后,两组血清TNF-α、IL-6和hs-CRP水平均明显比治疗前低(P0.05),且治疗组均明显比对照组低(P0.05)。结论清喉利咽颗粒联合头孢呋辛酯片治疗急性化脓性扁桃体炎能够明显减轻患者临床症状,抑制炎症反应,疗效显著,且安全性较好。     

苦甘颗粒联合注射用头孢西丁钠治疗急性气管–支气管炎的临床研究

目的探讨苦甘颗粒联合注射用头孢西丁钠治疗急性气管–支气管炎的临床疗效。方法选取2017年5月—2018年5月在绵阳市中医医院治疗的急性气管–支气管炎患者86例,根据用药的不同分为对照组(43例)和治疗组(43例)。对照组静脉滴注注射用头孢西丁钠,2.0 g加入100 mL生理盐水,2次/d;治疗组在对照组的基础上口服苦甘颗粒,8 g/次,3次/d。两组患者均经过2周治疗。观察两组患者临床疗效,同时比较治疗前后两组患者临症状改善时间及血清超敏C反应蛋白(hs-CRP)、半胱氨酰白三烯(CysLTs)、降钙素原(PCT)、白细胞介素-1β(IL-1β)和人可溶性髓系细胞触发受体-1(sTREM-1)水平。结果治疗后,对照组临床有效率为81.40%,显著低于治疗组的97.67%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组热消退、咳嗽咳痰消失、肺部啰音消失和喘息症状消失时间均显著早于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血清hs-CRP、CysLTs、PCT、IL-1β和sTREM-1水平均显著降低(P0.05),且治疗组患者这些炎症因子水平明显低于对照组(P0.05)。结论苦甘颗粒联合头孢西丁钠治疗急性气管–支气管炎有利于临床症状改善,还可降低机体hs-CRP、CysLTs、PCT、IL-1β、sTREM-1水平,具有一定的临床推广应用价值。     

茵山莲颗粒联合生长抑素治疗急性胰腺炎的临床研究

目的研究茵山莲颗粒联合注射用生长抑素治疗急性胰腺炎的临床疗效。方法选取2015年6月—2017年6月开滦总医院收治的急性胰腺炎患者120例为研究对象,随机将所有研究对象分为对照组和治疗组,每组各60例。对照组微量泵静脉注射注射用生长抑素,首次100μg,而后以50μg/h匀速泵入。治疗组在对照组治疗基础上口服茵山莲颗粒,2袋/次,2次/d。两组患者均连续治疗14 d。观察两组的临床疗效,比较两组的临床症状消失时间和生化指标。结果治疗后,对照组和治疗组的总有效率分别为80.00%、95.00%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组呕吐、腹胀、高热、无便、上腹压痛消失时间短于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组脂肪酶、血淀粉酶、白细胞数、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平显著下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组生化指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论茵山莲颗粒联合注射用生长抑素治疗急性胰腺炎具有较好的临床疗效,能改善临床症状,调节生化指标,安全性较高,具有一定的临床推广应用价值。     

小儿柴桂退热颗粒联合炎琥宁治疗小儿急性上呼吸道感染的临床研究

目的探讨小儿柴桂退热颗粒联合注射用炎琥宁治疗小儿急性上呼吸道感染的临床疗效。方法选取2015年6月—2016年9月北京市门头沟区妇幼保健院收治的急性上呼吸道感染患儿130例,所有患儿按照随机数字表法分为对照组和治疗组,每组各65例。对照组静脉滴注注射用炎琥宁,15 mg/kg加入到5%葡萄糖溶液250 mL中,1次/d。治疗组在对照组基础上口服小儿柴桂退热颗粒,年龄4岁:4 g/次,4~6岁:6 g/次,年龄≥7岁:8 g/次,3次/d。两组患者均连续治疗7 d。观察两组的临床疗效,比较两组的临床症状改善和炎症因子水平。结果治疗后,对照组和治疗组的总有效率分别为81.54%、92.31%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组退热时间、咽肿消退时间和止涕时间明显短于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平均明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论小儿柴桂退热颗粒联合注射用炎琥宁治疗小儿急性上呼吸道感染具有较好的临床疗效,可改善患儿的临床症状,减轻炎症反应,具有一定的临床推广应用价值。     

银黄颗粒联合头孢丙烯治疗急性上呼吸道感染的临床研究

目的探讨银黄颗粒联合头孢丙烯片治疗急性上呼吸道感染的临床疗效。方法选取2017年5月—2018年5月周口市中心医院治疗的94例急性上呼吸道感染患者为研究对象,根据用药的不同将患者分为对照组(47例)和治疗组(47例)。对照组口服头孢丙烯片,0.5 g/次,1次/d;治疗组在对照组治疗的基础上口服银黄颗粒,8 g/次,2次/d。两组患者均连续治疗7 d。观察两组患者的临床疗效,同时比较两组的临床症状消失时间和炎症因子水平。结果治疗后,对照组的总有效率为80.85%,显著低于治疗组的95.74%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组的退热、咳嗽消失、咽痛消失、咽部充血消失时间均显著短于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清超敏C反应蛋白(hs-CRP)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和降钙素原(PCT)水平均显著下降(P0.05);治疗后,治疗组炎症因子水平显著低于对照组(P0.05)。结论银黄颗粒联合头孢丙烯片治疗急性上呼吸道感染能够明显改善患者临床症状,降低机体炎症反应,具有较好的临床推广应用价值。     

清热散结胶囊联合头孢克肟治疗儿童急性支气管炎的临床研究

目的探讨清热散结胶囊联合头孢克肟治疗急性支气管炎患儿的临床疗效。方法选取2018年2月—2018年11月在成都市第三人民医院治疗的急性支气管炎患儿118例,根据用药的差别分为对照组(59例)和治疗组(59例)。对照组口服头孢克肟分散片,0.1 g/次,2次/d;治疗组在对照组基础上口服清热散结胶囊,1.75 g/次,3次/d。两组均治疗14 d。观察两组患者临床疗效,同时比较治疗前后两组患者临床症状改善时间和炎症因子水平。结果治疗后,对照组和治疗组临床有效率分别为81.36%和96.61%,两组比较差异具有统计学意义(P0.05)。经治疗,治疗组患者体温、咳嗽和肺部啰音复常时间均明显早于对照组,两组比较差异具有统计学意义(P0.05)。经治疗,两组患者血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、半胱氨酰白三烯(CysLTs)、可溶性髓系细胞触发因子-1(sTREM-1)、白细胞介素-6(IL-6)水平显著降低(P0.05),且治疗组患者hs-CRP、TNF-α、CysLTs、sTREM-1、IL-6水平明显低于对照组患者(P0.05)。结论清热散结胶囊联合头孢克肟治疗急性支气管炎患儿可有效改善患者临床症状,降低机体炎症反应,具有一定的临床推广应用价值。     

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.     

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.     

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.     

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.