痰热清注射液对病毒性肝炎高胆红素血症患者细胞因子的影响

目的探讨痰热清注射液治疗病毒性肝炎高胆红素血症的可能机制。方法病毒性肝炎高胆红素血症患者50例，随机分为治疗组和对照组，每组各25例。对照组给予甘草酸二铵、门冬氨酸钾镁注射液、前列地尔（凯时）、腺苷蛋氨酸（思美泰）、促肝细胞生长素、清蛋白、血浆等综合治疗。治疗组在综合治疗的基础上，加用痰热清注射液20 mL，加入5%葡萄糖注射液中静脉滴注，qd，4周为一个疗程。观察两组治疗前后肝功能、凝血酶原时间(PT)以及血清肿瘤坏死因子α（TNF α）、白细胞介素（IL）-4、IL-18的变化。结果两组患者治疗前后血清总胆红素（T-BiL）、丙氨酸氨基转移酶（ALT）、PT、TNF α、IL-18等指标均显著下降(P＜0.01)，IL-4显著上升（P＜0.01)；治疗后两组比较，治疗组T-BiL、PT、TNF α、IL-18的下降较对照组更明显(P＜0.01)，而ALT水平差异无显著性(P＞0.05)。结论痰热清注射液能显著降低病毒性肝炎高胆红素血症患者血清细胞因子TNF α、IL-4、IL-18水平，是治疗高胆红素血症的重要作用机制。     

痰热清注射液与抗菌药物联用对胸外科手术患者术后肺部感染的疗效及其对血清炎性因子水平的影响

目的:评价痰热清注射液与抗菌药物联用对胸外科手术患者术后肺部感染的疗效及其对血清炎性因子水平的影响。方法:选取2015年4月—2017年2月期间收治的胸外科患者术后肺部感染78例资料,将其随机分为对照组与联合组,每组39例;对照组患者给予常规抗菌药物治疗,联合组患者在对照组治疗基础上加用痰热清注射液治疗,比较两组患者治疗前和治疗2周后的血清炎性因子即血清高敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平测得值的变化情况,以及治疗后的总有效率差异。结果:治疗前两组患者的hs-CRP、IL-6和TNF-α水平测得值经比较其差异均无统计学意义(P>0.05);治疗2周后两组患者的hs-CRP、IL-6和TNF-α水平测得值均低于治疗前(P<0.05),联合组患者的hs-CRP、IL-6和TNF-α水平测得值均低于对照组(P<0.05);联合组患者治疗后的总有效率为97.44%高于对照组为84.62%(P<0.05)。结论:采用痰热清注射液与抗菌药物联用治疗胸外科患者手术后肺部感染的临床疗效较为确切,有效改善了其血清炎性因子水平。     

痰热清注射液治疗慢性乙型病毒性肝炎疗效观察

目的观察痰热清注射液治疗慢性乙型病毒性肝炎患者的临床疗效。方法将68例慢性乙型病毒性肝炎患者随机分为治疗组与对照组。对照组给予肝太乐为主的综合治疗,治疗组加用痰热清注射液20ml,静脉滴注,每日1次,疗程2周。治疗前后检测乙肝病毒DNA(PCR)、血清总胆红素、ALT、AST并进行比较。结果治疗组在抑制乙肝病毒复制及降低血清胆红素、ALT、AST等方面均优于对照组(P<0.05)。结论痰热清注射液治疗慢性乙型病毒性肝炎有良好疗效。     

痰热清注射液与氨溴索和头孢哌酮-舒巴坦联用对高血压脑出血患者术后肺部感染的临床疗效评价

目的:评价痰热清注射液与氨溴索和注射用头孢哌酮-舒巴坦联用对高血压脑出血患者术后肺部感染的临床疗效。方法:选取2014年1月—2018年1月期间收治的高血压脑出血患者88例资料,采用随机分组法将其分为对照组(44例)和观察组(44例);对照组患者给予盐酸氨溴索和头孢哌酮-舒巴坦治疗,观察组患者在对照组基础上加用痰热清注射液治疗;比较两组患者治疗前后C-反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、氧合指数水平测得值的变化情况,以及治疗后的总有效率和用药间不良反应发生率的差异。结果:治疗前两组患者的CRP、TNF-α、氧合指数测得值经比较其差异无统计学意义(P>0.05);治疗后观察组患者CRP、TNF-α水平测得值均低于对照组(P<0.05),氧合指数均高于对照组(P<0.05),总有效率显著高于对照组(P<0.05)。结论:采用痰热清注射液与氨溴索和头孢哌酮-舒巴坦联用治疗高血压脑出血患者术后肺部感染的临床疗效确切,有效改善了炎性各因子水平,提高了氧合指数,安全性高。     

痰热清注射液治疗慢性乙型黄疸肝炎的临床观察

目的观察痰热清注射液用于治疗慢性乙型黄疸肝炎的疗效。方法将60例慢性乙型黄疸肝炎患者分为2组,对照组(30例)在基础治疗上加用苦黄注射液,观察组(30例)在基础治疗上加用痰热清注射液。结果观察组总有效率(93.3%)明显高于对照组(70%)(P<0.05)。,观察组治疗后TB IL、AST、TBA明显低于对照组(P<0.05)。结论痰热清注射液能有效的治疗慢性乙型黄疸肝炎。     

腺苷蛋氨酸治疗重型肝炎高胆红素血症37例

目的： 探讨腺苷蛋氨酸治疗重型肝炎高胆红素血症的疗效。方法：重型肝炎高胆红素血症患者67例分成治疗组37例，对照组30例。治疗组采用腺苷蛋氨酸注射用灭菌粉末1 000 mg加5%葡萄糖注射液250 mL，静脉滴注，qd。对照组采用茵栀黄注射液30 mL加5%葡萄糖注射液250 mL，静脉滴注，qd。两组均治疗4周，停药1周，然后再治疗4周。结果： 治疗组血清总胆红素(T BiL)及丙氨酸氨基转移酶(ALT)恢复正常的时间均比对照组短(P＜0.05)。治疗组有效率89.2%，高于对照组有效率70.0%(P＜0.05)。结论：腺苷蛋氨酸治疗重型肝炎高胆红素血症疗效较好，无不良反应。     

痰热清辅助莫西沙星对门诊肺部感染患者的临床疗效及其对炎症因子水平的影响

目的:探究痰热清注射液辅助莫西沙星对门诊肺部感染患者的临床疗效及其对炎症因子水平的影响。方法:选取2016年3月—2018年11月间收治的肺部感染患者130例资料,按治疗方法的不同将其分为对照组和观察组,每组65例;对照组患者给予盐酸莫西沙星治疗,观察组患者在对照组基础上加用痰热清注射液治疗,比较两组患者治疗后临床症状(咳嗽咯痰、肺部啰音、体温)复常时间,以及治疗前后血清炎症因子(IL-6、IL-10、IL-17、TNF-α)水平测得值的变化情况。结果:观察组患者治疗后临床症状(咳嗽咯痰、肺部啰音、体温)复常时间均早于对照组(P<0.05);两组患者治疗前血清IL-6、IL-10、IL-17、TNF-α水平测得值经组间比较其差异均无统计学意义(P>0.05),治疗后低于治疗前(P<0.05);观察组患者治疗后IL-6、IL-10、IL-17、TNF-α水平测得值均低于对照组(P<0.05)。结论:采用痰热清注射液辅助盐酸莫西沙星治疗门诊肺部感染患者,有效降低了血清炎症因子水平,促进患者转归,加快了临床症状的复常。     

痰热清注射液治疗 慢性重型肝炎伴胆郁痰扰证患者67例

［摘要］目的观察痰热清注射液治疗慢性重型肝炎伴胆郁痰扰证患者的疗效。方法慢性重型肝炎伴胆郁痰扰患者128例，分为治疗组67例，对照组61例。对照组给予甘草酸二铵胶囊（甘利欣）、苦黄颗粒、前列地尔等护肝、降酶、退黄及血浆、清蛋白支持等治疗。治疗组在对照组治疗的基础上，给予痰热清注射液20 mL加入5%葡萄糖注射液500 mL中，qd,静脉滴注，连续28～35 d。结果治疗后两组患者黄疸、丙氨酸氨基转移酶、凝血功能均较治疗前改善(P＜0.05＝，但治疗组患者改善更显著，治疗组和对照组总有效率分别为71.6%，54.1%( P＜0.05＝。结论痰热清注射液结合西医治疗慢性重型肝炎伴胆郁痰扰证患者安全有效。     

痰热清注射液在老年急性上呼吸道感染中的抗病毒疗效观察

目的探讨痰热清注射液治疗老年急性上呼吸道感染患者的抗病毒作用疗效。方法12O例上呼吸道感染老年患者随机分成治疗组和对照组,每组60例。治疗组给予痰热清注射液静脉滴注,对照组给予利巴韦林静脉滴注,比较临床症状缓解的效果。结果治疗后第二日症状缓解率,治疗组为86．67％,对照组51．67%,治疗后第四日症状缓解程度比较,治疗组总有效率为96．67％对照组为65．00％,差异有统计学意义（均P〈0．05）。结论痰热清注射液治疗老年急性上呼吸道感染的抗病毒疗效显著,值得临床推广应用。     

茵栀黄注射液治疗新生儿高胆红素血症疗效观察

目的:评价茵栀黄注射液治疗新生儿高胆红素血症疗效。方法:对符合新生儿高胆红素血症的70例患儿随机分成两组,对照组常规治疗,治疗组给予常规治疗加茵栀黄注射液静脉滴注,连续5天。结果:治疗组降低胆红素水平明显优于对照组(P<0.01),治愈天数明显缩短(P<0.01).结论:茵栀黄注射液治疗新生儿高胆红素血症有较好的疗效,可缩短平均治疗时间.     

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.

     

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.     

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.