还原型谷胱甘肽联合生长抑素在重症急性胰腺炎治疗中的临床研究

目的观察还原型谷胱甘肽联合生长抑素治疗重症急性胰腺炎的效果,为临床重症急性胰腺炎的治疗提供参考。方法选择2010年8月至2013年8月来我科住院治疗的重症急性胰腺炎患者52例,采用随机数字法平均分为观察组和对照组。在常规治疗基础上,观察组采用还原型谷胱甘肽联合生长抑素进行治疗,对照组使用生长抑素进行治疗。比较两组的症状及体征恢复正常时间、胃肠道功能恢复时间、血清淀粉酶及血清脂肪酶恢复正常时间、肝功能、炎性细胞因子、氧化指标、并发症发生情况、死亡例数。结果观察组腹痛、腹胀、胃肠道功能、血清淀粉酶、脂肪酶恢复正常时间明显短于对照组,差异有统计学意义(P<0.05);体温恢复正常时间略短于对照组,但差异无统计学意义(P>0.05)。治疗后,观察组ALT、AST、TB、γ-GT、IL-6、IL-8、CRP、TNF-α、MDA、SOD均明显低于对照组,差异有统计学意义(P<0.05);IL-10、GSH-Px明显高于对照组,差异有统计学意义(P<0.05)。观察组呼吸窘迫综合征、肝功能衰竭、胰腺假性囊肿、脓肿发生例数及死亡例数均略低于对照组,差异无统计学意义(P>0.05)。结论还原型谷胱甘肽联合生长抑素治疗重症急性胰腺炎具有症状缓解时间短、胃肠道功能恢复快、保护肝功能、抗炎及抗氧化作用强、并发症发生较少等优点,是一种有效的治疗方式,值得临床借鉴使用。     

联用生长抑素与乌司他丁治疗急性胰腺炎患者40例临床疗效

目的:探讨联合应用生长抑素与乌司他丁治疗重症急性胰腺炎(SAP)的临床效果.方法:所有患者均为2018年1月至2019年6月期间我院收治的,均为重症SAP患者,共计80例.采用随机数字表法的原则将所有患者分为2组:研究组(40例)、对照组(40例),应用生长抑素治疗的患者作为对照组,联合应用生长抑素与乌司他丁治疗的患者作为研究组.评价临床疗效,比较两组临床症状缓解时间、血淀粉酶恢复正常时间,检测治疗前后血清炎症因子水平,记录治疗期间并发症发生情况.结果:研究组临床总有效率较对照组的显著提高(92.50％VS 72.50％,x2=5.541,P<0.05).在临床症状缓解时间、血淀粉酶恢复时间方面,研究组低于对照组(P<0.05).血清AMS、IL-6、TNF-α和CRP水平治疗后,两组均减低(P<0.05).研究组治疗后血清炎症因子水平低于对照组(P<0.05).在治疗期间,研究组并发症发生率低于对照组(P<0.05).结论:重症SAP患者联合应用生长抑素与乌司他丁治疗可以快速改善患者临床重症,恢复血清淀粉酶水平,机体炎症反应得到有效控制,并发症发生率较低,取得了确切临床效果.     

生长抑素对急性重症胰腺炎患者肿瘤坏死因子-α水平的影响

目的 观察生长抑素治疗急性重症胰腺炎的临床疗效及对血清肿瘤坏死因子-α(TNF-α)水平的影响.方法 将68例急性重症胰腺炎患者随机分为两组,对照组34例给予常规治疗,观察组34例在常规治疗的基础上给予生长抑素治疗,连续应用5～7d.观察两组的临床疗效及临床指标的变化.结果 观察组治疗后第3天血清TNF-α水平显著低于对照组(P＜0.05),且观察组患者恢复较快;观察组治疗后血淀粉酶恢复时间、肠功能恢复时间、住院时间、并发症发生率、病死率均明显少于对照组(均P＜0.05).结论 生长抑素治疗急性重症胰腺炎的疗效确切,能明显降低患者血清TNF-α水平,缩短病程,明显改善患者预后.     

生长抑素+奥美拉唑对急性胰腺炎患者血清炎症因子的影响研究

目的:探讨生长抑素+奥美拉唑对急性胰腺炎患者血清炎症因子的影响。方法:选取2017年2月到2018年2月接受诊治的60例急性胰腺炎患者作为此次的研究对象,按住院登记的顺序将前30例患者分为对照组,将后30例患者分为观察组,对照组选择生长抑素进行治疗,观察组选择生长抑素联合奥美拉唑进行治疗,对两组患者的临床疗效、血清炎症因子水平以及临床症状消失时间进行比较。结果:观察组的临床疗效明显高于对照组(P0.05);观察组患者的临床症状消失时间均明显优于对照组(P0.05);观察组的血清炎症因子水平低于对照组。结论:在急性胰腺炎患者中采用生长抑素联合奥美拉唑进行治疗,临床疗效优于生长抑素,同时可以降低患者血清炎症因子水平。     

生长抑素联合泮托拉唑对急性胰腺炎患者炎症介质的影响

目的 探讨生长抑素联合泮托拉唑对急性胰腺炎患者炎症介质的影响.方法 将我院诊治的116例急性胰腺炎患者随机分为2组,两组患者均接受常规治疗,对照组（56例）给予生长抑素静点,观察组（60例）给予生长抑素联合泮托拉唑治疗.比较两组临床症状缓解时间、实验室指标恢复正常时间及血清炎症因子改变情况.结果 观察组患者腹痛腹胀、腹水消失时间、恢复进食时间明显短于对照组（P〈0.05）;与对照组相比,观察组患者血、尿淀粉酶及白细胞恢复正常时间明显缩短（P〈0.05）;观察组血清超敏C-反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）及白细胞介素（IL-6）显著低于对照组（P〈0.05）.结论 生长抑素联合泮托拉唑治疗急性胰腺炎可降低机体炎症因子水平,提高临床疗效.     

生长抑素联合生长激素治疗急性重症胰腺炎的疗效观察

目的探讨生长抑素联合生长激素治疗急性重症胰腺炎的疗效。方法将我院收治的30例重症急性胰腺炎患者分为对照组15例,给予生长抑素治疗;观察组15例,给予生长抑素联合生长激素治疗;检测两组住院时间、症状消失时间、血淀粉酶开始下降及恢复正常的时间、并发症的发生率、中转及死亡的例数。结果观察组住院时间、症状消失时间、血淀粉酶恢复正常时间、并发症发生率、死亡率均明显低于对照组,差异有统计学意义(P0.05)。结论联合应用生长抑素和生长激素是治疗急性重症胰腺炎的有效方法。     

生长抑素联合质子泵抑制剂治疗重症急性胰腺炎的效果

目的探讨生长抑素联合质子泵抑制剂治疗重症急性胰腺炎的效果。方法选取我院重症急性胰腺炎患者72例,随机分为两组各36例。观察组采用生长抑素联合艾司奥美拉唑钠治疗,对照组采用生长抑素联合奥美拉唑治疗。观察治疗2周后的临床效果、恢复时间、炎性指标以及药物不良反应。结果观察组治疗有效率为88.89%,对照组为80.56%,两组疗效比较差异无统计学意义(P> 0.05)。观察组血清淀粉酶、血清脂肪酶恢复正常时间均小于对照组(P <0.05)。观察组住院时间小于对照组(P <0.05)。观察组的C反应蛋白水平低于对照组(P <0.05)。两组患者药物不良反应发生率比较,差异无统计学意义(P> 0.05)。结论重症胰腺炎患者采用生长抑素联合艾司奥美拉唑钠或奥美拉唑治疗,均有良好效果,安全可靠。联合艾司奥美拉唑钠治疗能较快缓解患者病情、缩短住院时间,有效减轻机体炎症。     

前列地尔联合生长抑素治疗重症急性胰腺炎的临床观察

目的观察前列地尔联合生长抑素治疗重症急性胰腺炎的临床疗效。方法将68例重症急性胰腺炎患者随机分为生长抑素治疗组(对照组,32例)和前列地尔+生长抑素治疗组(观察组,36例)。比较两组患者症状、腹部体征消失时间、血淀粉酶恢复正常的时间。结果观察组、对照组的有效率分别为94.44%、65.63%。两组疗效比较差异有统计学意义,P<0.05。结论前列地尔联合生长抑素治疗重症急性胰腺炎安全有效。     

生长抑素泵入法联合持续血液净化治疗急性重症胰腺炎的疗效分析

目的探讨生长抑素泵入法联合持续血液净化治疗急性重症胰腺炎的效果。方法90例急性重症胰腺炎患者,通过数字表法分为观察组与对时组,每组45例。两组均接受常规治疗,对照组在常规治疗基础上使用生长抑素治疗,观察组在常规治疗基础上使用持续静脉血液净化治疗。比较两组身体各指标、治疗前后急性生理与慢性健康评分量表(APCHEII)评分、并发症发生情况。结果观察组患者腹痛减轻时间、住院天数、肠道功能恢复用时、胰腺功能恢复时间均显著短于对照组,差异具有统计学意义(P<0.05)。治疗前,两组APCHEII评分比较,差异无统计学意义(P>0.05);治疗24 h、72 h后,观察组患者的APCHEII评分均明显低于对照组,差异具有统计学意义(P<0.05)。观察组患者的并发症发生率为2.22%(1/45),明显低于对照组的15.56%(7/45),差异具有统计学意义(P<0.05)。结论采用生长抑素泵入法联合持续血液净化治疗急性重症胰腺炎患者,疗效突出,降低并发症发生几率,提升患者生活品质。     

生长抑素联合泮托拉唑钠治疗急性胰腺炎的临床观察

目的:探讨生长抑素联合泮托拉唑钠治疗急性胰腺炎的临床效果。方法:选取2017年2月到2018年2月接受诊治的60例急性胰腺炎患者作为此次的研究对象,按住院登记的顺序将前30例患者分为对照组,将后30例患者分为观察组,对照组选择泮托拉唑钠进行治疗,观察组选择生长抑素联合泮托拉唑钠进行治疗,对两组患者的临床疗效、血清炎症因子水平以及临床症状消失时间进行比较。结果:观察组临床疗效高于对照组(P0.05);观察组体征消退时间明显优于对照组(P0.05);观察组的血清炎症因子水平低于对照组(P0.05)。结论:在急性胰腺炎患者中采用生长抑素联合泮托拉唑钠进行治疗,临床疗效优于泮托拉唑钠,同时可以降低患者血清炎症因子水平。     

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.     

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.     

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.