左向右分流先天性心脏病对儿童肺功能的影响

目的 探讨左向右分流先天性心脏病(congenital heart disease,CHD)对儿童肺功能的影响。方法 前瞻性入组2019年5月～2020年1月确诊为左向右分流先天性心脏病并完成肺功能检查的患儿,研究期间共入组69例研究对象。无法配合完成用力肺活量检查者(0～3.5岁,婴幼儿组),采用潮气呼吸法检查肺功能,能配合完成用力肺活量检查者(3.5～13岁,年长儿组),采用用力肺活量法完成肺功能检查。根据先天性心脏病类型及缺损口直径大小分为小分流量组(缺损口直径<8 mm的小型ASD、缺损口直径<5 mm的小型VSD)及大分流量组(缺损口直径≥8 mm的中大型ASD、缺损口直径≥5 mm的中大型VSD及PDA)。入选年龄、性别相匹配的正常儿童50例为对照组,比较小分流量组、大分流量组与婴幼儿对照组之间以及左向右分流先天性心脏病年长儿组与年长儿对照组间的肺功能差异。结果 婴幼儿组CHD患儿FRCp/kg显著高于对照组,差异有统计学意义(P<0.05),其中大分流量组CHD患儿RR显著高于小分流量组及对照组(P<0.05),PTEF/TEF₂₅     

肺功能检查在慢性阻塞性肺疾病诊断中的应用探讨

目的:探讨在诊断慢性阻塞性肺疾病(COPD)的过程中行肺功能检查的临床价值.方法:随机选取2014年2月～2015年2月之间于我院行肺功能检查的患者100例,设为观察组,另外选择同时期我院的健康体检者100例,设为对照组,所有受试者均接受肺功能检查,测定受试者第一秒用力呼气容积与用力肺活量之比(FEV1/FVC)、用力肺活量(FVC)、第一秒用力呼气容积在预计值中所占百分比(FEV1％)三个指标,以此为依据诊断患者并分级.结果:经过分析统计,本次研究的误诊率为4.41％,漏诊率为8.45％,正确诊断率为91.55％.观察组共71例COPD患者,其中轻度(16例)、中度(18例)、重度(22例)、极重度(15例)的FEV1、FEV1/FVC均低于对照组,P＜0.05,差异显著,具有统计学意义,且FEV1、FEV1/FVC随COPD患者病情的发展而降低.结论:在诊断COPD的过程中,应用肺功能检查正确诊断率较高,而且可以对患者进行病情分级,以便尽早采取有针对性的治疗措施,值得在临床上进行推广.     

肺功能检查对小儿哮喘及咳嗽变异性哮喘的临床应用价值探讨

目的:探讨肺功能检查在小儿哮喘及咳嗽变异性哮喘的临床应用。方法:选取2019年1月～2019年12月某院收治的小儿哮喘及咳嗽变异性哮喘患儿88例作为研究组,同时选取同期体检的健康儿童88例作为对照组。两组均进行常规检查与肺功能检查,比较两组患儿两种检查方法诊断率。结果:研究组残气量(RV)大于对照组(P0.05),研究组最高呼气流速(PEF)、第1秒呼气容积同肺活量(FVC)之间的比值(FEV1/FVC)、用力肺活量(FVC)、第1s用力呼气量(FEV1)小于对照组(P0.05);肺功能检查诊断率高于常规检查(P0.05)。结论:对小儿哮喘及咳嗽变异性哮喘诊断中,肺功能检查的确诊率更高,值得应用。     

综合护理干预在小儿重症肺炎中的护理效果研究

目的 分析对小儿重症肺炎患儿应用综合护理干预的护理效果.方法 选取2014年12月至2015年12月我院收治的76例小儿重症肺炎患儿,随机分成综合护理组(n=38,护理方案为综合护理干预)和常规护理组(n=38,护理方案为常规护理),比较护理后两组患儿治疗效果、肺功能检测指标(最大通气量、肺活量、用力肺活量)和家长满意度.结果 综合护理组临床总有效率为94.71％,常规护理组为78.95％,前者更高,差异有统计学意义(P＜0.05);综合护理组患儿最大通气量、肺活量和用力肺活量均优于常规护理组,差异有统计学意义(P＜0.05);综合护理组与常规护理组满意度分别为97.37％、84.21％,综合护理组满意度更高,差异有统计学意义(P＜0.05).结论 在小儿重症肺炎临床护理中应用综合护理干预可提高疗效,改善患儿肺功能,提高护理满意度.     

早期干预治疗对慢性阻塞性肺疾病预后的研究分析

目的 探讨早期干预治疗对慢性阻塞性肺疾病(慢阻肺,COPD)的预后价值.方法 80例慢阻肺患者,根据随机数字表法分为对照组与观察组,各40例.对照组给予常规治疗,观察组在对照组基础上给予早期干预治疗.比较两组肺功能指标[用力肺活量(FVC)、用力肺活量占预计值百分比(FVC％)、第1秒用力呼气容积(FEV1)、第1秒用...     

哮喘患儿血清白细胞介素-5和IgE与肺功能的相关性研究

目的检测支气管哮喘患儿外周血白细胞介素(IL)-5、总IgE(TIgE)和肺功能水平,探讨IL-5、TIgE与肺功能水平及支气管哮喘之间的相关性。方法选取35例门诊随诊的哮喘缓解期患儿作为哮喘组,30名同期健康体检儿童作为健康对照组,2组儿童均于清晨空腹取外周静脉血1.0mL制备血清,应用双抗体夹心酶联免疫吸附试验(ELISA)法测定2组儿童血清IL-5、TIgE,并行肺功能检测。结果哮喘组患儿血清IL-5、TIgE水平均较健康对照组升高,差异有统计学意义(t=6.84、21.63,P<0.01),肺功能用力呼出25%肺活量时呼气流量(FEF25%)、用力呼出50%肺活量时呼气流量(FEF50%)哮喘组较健康对照组水平明显下降(t=-2.258、-2.428,P<0.05),而第1秒用力呼气容积占用力肺活量的比值(FEV1/FVC%)差异无统计学意义;IL-5与FEV1/FVC%、FEF25%、FEF50%无相关性,TIgE与FEV1/FVC%、FEF25%、FEF50%呈负相关(r=-0.534、-0.392、-0.394,P<0.05)。结论哮喘患儿体内存在Th1/Th2免疫失衡,IL-5和TIgE参与气道高反应与呼吸道重塑的病理生理过程,TIgE即使在哮喘缓解期也仍然和肺功能密切相关,可以成为辅助判定哮喘严重程度的参考指标。     

用吹熄火柴法测定通气功能

本文报告一种测定通气功能的简便方法。被检查者以橡皮接口连一3时直管,对准标准火柴之火焰用力吹气,火柴之距离可由近及远每次移动2～5厘米,直至不能吹灭为止(以三次不能吹灭为准),记录由口至能吹灭火柴之最远距离;如开始之距离即不能吹灭,则可将火柴逐步移近。作者对146例各种通气功能异常和通气功能正常的患者用此法进行测定,并作一般通气功能测定以资比较。由测定结果说明火柴距离与第1秒时间肺活量(绝对值)、最大通气量、最大通气量占     

吸入性糖皮质激素治疗小儿支气管哮喘的效果分析

目的 分析吸入性糖皮质激素治疗小儿支气管哮喘的效果.方法 42例小儿支气管哮喘患儿,随机分为实验组和对照组,各21例.对照组患儿实施常规治疗,实验组患儿实施吸入性糖皮质激素治疗.比较两组患儿临床疗效、临床症状改善时间及治疗前后肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、第1秒用力呼气容积与用力肺活...     

脉冲振荡技术在老年慢性阻塞性肺疾病诊断中的应用

目的 探讨脉冲振荡(IOS)技术在老年慢性阻塞性肺疾病(COPD)诊断中的应用.方法 检测75例老年COPD患者(COPD组)和60例老年健康者(对照组)常规肺功能并进行IOS测定.结果 COPD组1秒钟用力呼气容积与用力肺活量比值(FEV1/FVC)、用力肺活量占预计值百分比(FVC％pred)、1秒钟用力呼气容积占预计值百分比(FEV1％pred)、呼出肺活量中间50％时的平均用力呼气流量占预计值百分比(FEV25-75％pred)、呼出肺活量50％时的用力呼气流量占预计值百分比(FEF50％pred)、最大呼气流量占预计值百分比(PEF％pred)均明显低于对照组(P＜0.01).COPD组IOS参数中,气道总阻力占预计值百分比(R5％pred)、周边气道阻力占预计值百分比(X5％pred)、响应频率(Fres)、响应频率占预计值百分比(Fres％pred)和低频电抗面积(AX)均明显高于对照组(P＜0.01).COPD组的Fres、Fres％pred、AX、R5％pred、振荡频率在5-20 Hz时的气道阻力(R5-R20)与肺通气功能各指标呈负相关;X5％pred与FVC％pred、FEV1％pred、FEV25-75％pred及FEF50％pred呈负相关.结论 IOS可用于COPD的诊断及明确气流阻塞部位;特别适用于老年人及重症患者.     

孟鲁司特钠联合丙酸氟替卡松对轻度支气管哮喘患儿肺功能的影响

目的：探讨孟鲁司特钠联合丙酸氟替卡松对轻度支气管哮喘患儿肺功能的影响。方法：选取轻度哮喘患儿120例,随机分为丙酸氟替卡松治疗组（单独治疗组）和丙酸氟替卡松联合孟鲁司特钠治疗组（联合治疗组）各60例。记录患儿治疗前后肺功能指标——用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、最高呼气流量（PEF）、用力呼气75％肺活量时的瞬间流量（V75）、用力呼气50％肺活量时的瞬间流量（V50）、用力呼气25％肺活量时的瞬间流量（V25）及最大呼气中期流量（MMEF）的变化。结果：单独治疗组患儿治疗后FVC、FEV1、PEF、V75与治疗前比较差异均有统计学意义（P均〈0．01）;联合治疗组患儿治疗后FVC、FEV1、PEF、V75、V50、MMEF与治疗前比较差异均有统计学意义（P均〈0．01）。与治疗前相比较,联合治疗组FVC、FEV1、PEF三个指标的改善更加明显。结论：孟鲁司特钠联合丙酸氟替卡松能显著改善轻度哮喘患儿的肺功能。     

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.