吸入沙美特罗替卡松联合口服孟鲁司特治疗支气管哮喘的临床观察

目的 探讨吸入沙美特罗替卡松联合口服孟鲁司特治疗支气管哮喘的临床疗效,减少患者哮喘急性发作.方法 选取符合标准的患者80例,随机分为观察组和对照组各40例,对照组给予口服孟鲁司特,观察组在此基础上加用沙美特罗替卡松粉吸入剂,比较二者临床发作及肺功能改善等情况.结果 治疗3个疗程后,观察组患者临床有效率95.00％,对照组为82.50％,二者差异有统计学意义(x2=4.114,P=0.043).治疗前,两组患者肺功能各项指标及哮喘控制测试表(ACT)评分比较,差异无统计学意义(P＞0.05);治疗3个疗程后,两组患者肺功能各项指标水平及ACT评分较治疗前均提高(P＜0.05),但是观察组患者改善幅度更大(P＜0.05).结论 吸入沙美特罗替卡松联合口服孟鲁司特治疗支气管哮喘,兼顾改善症状和减轻炎症,具有较好的临床疗效;吸入疗法具有给药剂量小、作用迅速、吸收完全及不良反应少等特点,是治疗支气管哮喘的理想途径.     

噻托溴铵粉雾剂联合沙美特罗替卡松粉吸入剂治疗支气管哮喘-慢阻肺重叠综合征的疗效分析

目的探究噻托溴铵粉雾剂联合沙美特罗替卡松粉吸入剂治疗支气管哮喘-慢阻肺重叠综合征的效果。方法将2017年6月~2018年5月收治的70例支气管哮喘-慢阻肺重叠综合征患者作为研究对象,按照入院顺序分为两组。对照组使用沙美特罗替卡松粉吸入剂进行治疗,研究组患者使用噻托溴铵粉雾剂联合沙美特罗替卡松粉吸入剂进行治疗。对比两组患者临床治疗效果,临床症状改善情况以及不良发应发生情况。结果研究组患者临床治疗有效率明显高于对照组,治疗后ACT、CAT评分均优于对照组,且药物不良反应发生率明显低于对照组,差异均有统计学意义(P<0.05)。结论噻托溴铵粉雾剂联合沙美特罗替卡松粉吸入剂治疗支气管哮喘-慢阻肺重叠综合征,能够有效改善患者临床症状,用药安全性更高。     

羧甲司坦联合沙美特罗替卡松吸入剂治疗慢阻肺稳定期患者的疗效

目的：评价羧甲司坦联合沙美特罗替卡松吸入剂治疗慢阻肺(COPD)稳定期患者的效果。方法：选取2018-02～2019-10本院COPD稳定期患者96例，按照随机数字表法分成研究组和对照组，各48例，其中对照组予以沙美特罗替卡松吸入剂治疗，研究组采用羧甲司坦、沙美特罗替卡松吸入剂联合治疗，对比两组临床疗效、肺功能指标[第1 s用力呼出容积(FEV1)、FEV1占预计值百分比(FEV1/perd%)]变化、圣乔治呼吸问卷(SGRQ)评分。结果：与对照组79.17%(38/48)相比较，研究组总有效率95.83%(46/48)明显升高(P<0.05);治疗后研究组FEV1、FEV1/perd%高于对照组(P<0.05);治疗后两组AGRQ评分较治疗前低，研究组比对照组更低(P<0.05)。结论：羧甲司坦、沙美特罗替卡松吸入剂联合治疗COPD稳定期效果确切，可有效改善肺功能，增强生活质量。     

沙美特罗替卡松粉吸入剂治疗支气管哮喘的疗效观察

目的探讨沙美特罗替卡松粉吸入剂对支气管哮喘患者的疗效,为临床工作提供参考价值。方法将2010年10月到2012年6月期间接受本院诊治的支气管哮喘患者78例,随机分为观察组（39例）和对照组（39例）,对照组患者给予常规治疗,观察组患者在此基础上给予沙美特罗替卡松粉吸入剂吸入治疗,观察8周,比较两组的疗效,并观察不良反应。结果治疗后观察组的FEV1、PEF水平、ACT总分均高于对照组,差异具有统计学意义（P〈0.05）。两组患者均未出现明显不良反应。结论沙美特罗替卡松粉吸入剂用于支气管哮喘治疗安全有效,值得在临床上推广应用。     

孟鲁司特钠治疗支气管哮喘疗效观察

目的观察孟鲁司特钠对成人支气管哮喘疗效及安全性。方法 98例支气管哮喘患者分为两组,对照组给予氨茶碱和沙美特罗替卡松,观察组加服孟鲁司特钠,观察临床疗效,并对哮喘控制评价,监测治疗前后呼气流量峰值（PEF）情况。结果观察组总有效率89.1%,明显优于对照组（63.8%）（P〈0.05）,观察组血浆ACT评分、PEF、IFN-γ水平与治疗前比较,差异有统计学意义（P〈0.05）。IFN-γ水平与对照组比较,差异有统计学意义（P〈0.05）。结论孟鲁司特治疗支气管哮喘效果明显,副作用小,值得推广。     

孟鲁司特钠片联合沙美特罗替卡松粉吸入剂治疗哮喘—慢性阻塞性肺疾病重叠综合征的临床效果

目的 分析孟鲁司特钠片联合沙美特罗替卡松粉吸入剂治疗哮喘-慢性阻塞性肺疾病重叠综合征的临床效果。方法 选择本院2019年1月至2020年1月收治的哮喘-慢性阻塞性肺疾病重叠综合征患者103例,采用随机数法将其分为研究组和对照组,研究组患者54例,对照组患者49例。对照组患者使用常规治疗方式（适当吸氧、支气管扩张剂、雾化治疗等）辅以沙美特罗替卡松粉吸入剂治疗,研究组患者在对照组治疗基础上辅以孟鲁司特钠片。对比两组患者治疗效果、慢性阻塞性肺疾病（CAT）评分和哮喘控制测试（ACT）评分,观察患者治疗前后的差异。结果 研究组患者的治疗效果明显好于对照组患者的治疗效果（P <0.05）,研究组患者治疗总有效率为90.74%,对照组患者治疗总有效率为65.30%。研究组CAT评分低于对照组,且ACT评分高于对照组（P <0.05）。结论 使用孟鲁司特钠片联合沙美特罗替卡松粉吸入剂治疗哮喘-慢性阻塞性肺疾病重叠综合征的效果显著,在接受1个疗程治疗后,患者的肺功能均得到了不同程度的升高。     

观察沙美特罗替卡松粉吸入剂治疗支气管哮喘的临床疗效和安全性

目的:分析沙美特替卡松粉吸入剂在治疗支气管哮喘时的临床治疗效果和安全性。方法:将某院收治的160例支气管哮喘患者随机分为两组,给予对照组患者布地奈德粉吸入剂进行临床治疗,观察组患者采用沙美特罗替卡松粉吸入剂进行治疗。结果:观察组患者治疗总有效率和肺功能观察指标都高于对照组患者,不良反应发生率则低于对照组患者,P0.05,具体统计学意义。结论:沙美特罗替卡松粉吸入剂在治疗支气管哮喘时具有良好的临床治疗效果,且安全性较高,适宜在临床治疗中使用。     

沙美特罗替卡松粉吸入剂与丙酸倍氯米松吸入剂治疗支气管哮喘的临床观察

目的对比观察沙美特罗替卡松粉吸入剂与丙酸氟替卡松吸入剂治疗支气管哮喘的临床疗效。方法将52例支气管哮喘患者随机分为治疗组24例和对照组28例。治疗组予沙美特罗替卡松粉吸入剂治疗,对照组予丙酸倍氯米松吸入剂治疗。结果治疗组的显效率为58.33%,总有效率为91.67%,对照组的显效率为42.86%,总有效率为71.43%,两组差异均有统计学意义(P<0.05)。两组治疗后第1秒用力吸呼气容积(FEV1)和呼气峰流量(PEF)预期值百分比均有显著改善,治疗组优于对照组,差异均有统计学意义(P<0.05)。结论沙美特罗替卡松粉吸入剂治疗效果优于丙酸倍氯米松吸入剂。     

沙美特罗替卡松粉吸入剂治疗支气管哮喘的疗效研究

目的：探讨沙美特罗替卡松粉吸入剂治疗支气管哮喘的临床疗效。方法选取我院2011年1月—2014年1月收治的支气管哮喘患者76例,随机分为观察组38例和对照组38例,观察组给予沙美特罗替卡松粉吸入剂治疗,对照组给予丙酸氟替卡松吸入治疗。观察比较治疗前后两组支气管哮喘患者肺功能的改变及治疗效果。结果两组临床有效率、用力肺活量（FVC）、最大呼气峰流速（PEF）和第1秒末用力呼气容积（FEV1）比较,差异均有统计学意义（P 〈0.05）。结论沙美特罗替卡松粉吸入剂治疗支气管哮喘疗效确切。     

孟鲁司特联合沙美特罗替卡松对咳嗽变异性哮喘患者白介素-4和γ-干扰素水平的影响

目的探讨孟鲁司特联合沙美特罗替卡松对咳嗽变异性哮喘患者白介素-4(IL-4)和γ-干扰素(IFN-γ)水平的影响。方法选择我院收治的咳嗽变异性哮喘患者74例,随机分为实验组和对照组。两组患者均予以沙美特罗替卡松吸入,1吸/次,2次/d。实验组在此基础上口服孟鲁司特咀嚼片10 mg,1次/d,连用12周。观察两组患者治疗前后血清IL-4和IFN-γ水平的变化,并观察临床疗效及安全性。结果治疗12周后,两组患者血清IL-4水平较治疗前明显下降,IFN-γ水平较治疗前明显上升(P<0.01或P<0.05),且实验组下降或上升值明显大于对照组(P<0.05);同时实验组的临床总有效率明显高于对照组(χ2=4.16,P<0.05)。对照组和实验组治疗过程中分别出现不良反应3例和6例,症状较轻,未发生严重药物不良反应。两组治疗过程中不良反应发生率比较差异无统计学意义(χ2=0.51,P>0.05)。结论孟鲁司特联合沙美特罗替卡松治疗咳嗽变异性哮喘效果明确,能降低血清IL-4水平,提高血清IFN-γ水平,纠正Thl/Th2细胞因子平衡失调,且安全性较高。     

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.     

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.     

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.