痹祺胶囊联合塞来昔布治疗膝骨性关节炎的临床研究

目的探讨痹祺胶囊联合塞来昔布治疗膝骨性关节炎的临床疗效。方法选取2013年10月—2016年8月天津中医药大学第一附属医院收治的膝骨性关节炎患者85例,根据治疗方式的不同将患者分为对照组(42例)和治疗组(43例)。对照组患者口服塞来昔布胶囊,1粒/次,2次/d;治疗组患者在对照组的基础上口服痹祺胶囊,2粒/次,2次/d。两组患者治疗时间均为8周。评价治疗后两组患者临床疗效,同时比较治疗前后两组Lequesnse指数、WOMAC评分和血清炎症指标变化。结果治疗后,对照组的总有效率为73.81%,显著低于治疗组的90.70%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者Lequesnse指数和WOMAC评分均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组患者Lequesnse指数和WOMAC评分下降更显著,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血清超敏C-反应蛋白(hs-CRP)、白细胞介素-1(IL-1)、IL-6水平较治疗前均明显降低(P0.05);且治疗后治疗组患者hs-CRP、IL-1、IL-6水平显著优于对照组(P0.05)。结论痹祺胶囊联合塞来昔布治疗膝骨性关节炎临床疗效较好,能够显著改善膝关节功能,并降低血清炎症因子水平,具有一定的临床推广应用价值。     

附桂骨痛胶囊联合塞来昔布治疗老年膝关节骨性关节炎的临床研究

目的探讨附桂骨痛胶囊联合塞来昔布治疗老年膝关节骨性关节炎的临床疗效。方法选取许昌市中医院在2016年4月—2017年4月收治的老年膝关节骨性关节炎患者63例,随机分成对照组(31例)和治疗组(32例)。对照组患者口服塞来昔布胶囊,1粒/次,1次/d;治疗组在对照组的基础上口服附桂骨痛胶囊,4粒/次,3次/d。两组患者均治疗4周。评价两组患者临床疗效,同时比较治疗前后两组患者VAS、Lequesne和ADL评分,白细胞介素1β(IL-1β)、基质金属蛋白酶-3(MMP-3)和肿瘤坏死因子-α(TNF-α)水平以及不良反应发生情况。结果治疗后,对照组和治疗组总有效率分别为77.42%、96.88%;两组比较差异具有统计学意义(P0.05)。治疗后,两组患者VAS评分、Lequesne评分均明显降低,ADL评分明显升高,同组比较差异具有统计学意义(P0.05);且治疗组患者VAS评分、Lequesne评分和ADL评分均明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者IL-1β、MMP-3和TNF-α水平均明显降低(P0.05);且治疗组患者各指标水平比对照组降低的更明显(P0.05)。对照组患者不良反应发生率为25.81%,显著高于治疗组的6.25%,两组比较差异具有统计学意义(P0.05)。结论附桂骨痛胶囊联合塞来昔布治疗老年膝关节骨性关节炎疗效显著,安全性较高,具有一定的临床推广应用价值。     

塞来昔布联合玻璃酸钠治疗膝关节骨性关节炎的临床疗效探讨

目的分析塞来昔布联合玻璃酸钠治疗膝关节骨性关节炎的临床疗效。方法104例膝关节骨性关节炎患者,根据治疗方案的不同分为观察组与对照组,各52例。观察组采取塞来昔布联合玻璃酸钠治疗,对照组采取玻璃酸钠治疗。比较两组患者临床疗效、治疗前后的视觉模拟评分法(VAS)评分及膝关节功能评分。结果观察组患者的临床治疗总有效率92.3%高于对照组的78.8%,差异有统计学意义(P<0.05)。治疗后,观察组VAS评分(2.5±0.4)分低于对照组的(3.3±0.8)分,膝关节功能评分(65.3±6.8)分高于对照组的(60.4±5.7)分,差异均有统计学意义(P<0.05)。结论塞来昔布与玻璃酸钠的联合应用有助于减轻膝骨关节炎患者的关节疼痛程度,改善膝关节功能状况,有助于提高患者的治疗效果,值得推广应用。     

壮骨关节胶囊治疗膝关节骨性关节炎60例临床研究

目的：观察壮骨关节胶囊治疗膝关节骨性关节炎的临床疗效。方法60例膝关节骨性关节患者,随机分为治疗组和对照组,各30例。治疗组给予壮骨关节胶囊,对照组给予塞来昔布胶囊,疗程均为4周,比较两组患者的临床治疗效果、视觉模拟评分(VAS)、Lequesne指数评分及不良反应发生情况。结果治疗组总有效率为93.3%,明显高于对照组的73.3%(χ2=4.32, P<0.05);两组治疗后VAS评分均显著降低, Lequesne指数评分均显著降低(P<0.05);组间比较,差异均有统计学意义(P<0.05);对照组4例出现恶心,胃脘部不适不良反应,治疗组无不良反应。结论相对于塞来昔布胶囊,壮骨关节胶囊可更加有效缓解患者疼痛等症状,改善膝关节功能,提高生活质量,不良反应少,值得临床推广。     

健脾补肾汤联合塞来昔布在膝骨性关节炎患者治疗中的疗效观察

目的:探讨健脾补肾汤联合塞来昔布治疗膝骨性关节炎的疗效。方法:选择2017年4月—2018年5月收治的100例膝骨性关节炎患者,依据随机数字表法将其分为观察组和对照组,每组50例。对照组予以塞来昔布治疗,观察组在对照组基础上加以健脾补肾汤治疗,对比两组膝关节功能评分及炎性因子水平。结果:治疗后,观察组Lysholm膝关节功能评分高于对照组,差异有统计学意义(t=17.213,P<0.001);观察组治疗后超敏C反应蛋白(hs-CRP)、白介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)水平均显著低于对照组,差异有统计学意义(t=8.768,13.989,13.400,P均<0.001);观察组不良反应发生情况较对照组无明显增加,差异无有统计学意义(P>0.05)。结论:健脾补肾汤联合塞来昔布能显著改善膝骨性关节炎患者膝关节功能及炎性因子水平,且不良反应发生率无明显增加,安全性较高。     

膝骨性关节炎联合应用玻璃酸钠及复方倍他米松注射液治疗的临床研究

目的:观察分析膝骨性关节炎患者联合应用玻璃酸钠及复方倍他米松注射液治疗的临床疗效.方法:选择我院2017年11月—2019年11月收治的110例膝骨性关节炎患者为观察对象,按照入院顺序单双号分为两组:治疗组(n=55)、对照组(n=55).对照组患者采用玻璃酸钠关节腔内注射,治疗组患者玻璃酸钠与复方倍他米松注射液联合应用关节腔内注射.比较两组患者的临床疗效,采用视觉模拟评估法(VAS)、Lvsholm关节功能评分、WOMAC的疼痛量表评价两组疼痛程度及膝关节功能,检测比较两组治疗前后关节液基质金属蛋白酶-3(MMP-3)、MMP-9及白细胞介素1β(IL-1β)水平.结果:治疗组患者的治疗总有效率较对照组的显著提高(92.73％VS 78.18％,P<0.05).两组治疗后VAS、Lvsholm及WOMAC评分均降低,关节液MMP-3、MMP-9及IL-1β水平均降低(P<0.05).治疗组治疗后VAS、Lvsholm及WOMAC评分低于对照组,治疗后关节液MMP-3、MMP-9及IL-1β水平低于对照组(P<0.05).结论:玻璃酸钠与复方倍他米松注射液联合应用关节腔内注射治疗膝骨性关节炎可以取得满意效果,患者关节局部疼痛程度及膝关节功能明显改善,考虑作用机制可能与降低关节液MMP-3、MMP-9及IL-1β的水平有关.     

正清风痛宁联合塞来昔布治疗膝关节骨性关节炎40例

目的 观察正清风痛宁缓释片结合塞来昔布治疗膝关节骨性关节炎的临床疗效.方法 膝关节骨性关节炎患者80例,随机分为治疗组和对照组各40例.治疗组口服正清风痛宁片(每片60 mg),每次2片,bid;同时服用塞来昔布,每次200 mg,bid.对照组40例单独服用塞来昔布,每次200 mg,bid.对两组治疗前、治疗8周后的患膝疼痛程度、关节肿胀度、下肢日常活动能力、医患双方对病情的评价以及WOMAC评分等指标进行评价.结果 治疗组总有效率为82.5%,对照组为77.5%,两组比较差异无统计学意义(P>0.05);两组治疗后主要症状及体征均有显著改善(均P<0.01),但两组间差异无统计学意义(P>0.05);两组治疗后WOMAC评分均显著减小,与治疗前比较,差异有统计学意义(均P<0.01),但两组间差异无统计学意义(P>0.05);治疗组不良反应发生率7.5%,对照组为12.5%,两组间差异无统计学意义(P>0.05).结论 正清风痛宁结合塞来昔布治疗膝关节骨性关节炎安全有效,能有效改善患者的临床症状,值得临床进一步推广.     

中药塌溃热敷辅助治疗膝骨性关节炎临床疗效

目的：观察中药热敷联合塞来昔布胶囊治疗膝骨性关节炎的临床疗效。方法：将膝骨性关节炎70例患者随机分为观察组（35例）和对照组（35例）,两组均给予硫酸氨基葡萄糖500 mg／次,3次／d;塞来昔布胶囊100 mg／次,2次／d;观察组在对照组基础上加用中药塌渍热敷2次／d,14 d为一疗程,连续治疗两个疗程,考察两组患者临床疗效和两组患者治疗前后疼痛程度评分（ VAS）和Lequesne评分改善情况。结果：观察组总有效率为88．57％,对照组总有效率为77．14％（P＜0．05）;两组患者治疗前后VAS和Lequesne评分均有明显改善（P＜0．05）,治疗后观察组改善更明显（P＜0．05）。结论：中药热敷联合塞来昔布胶囊治疗膝骨性关节炎疗效肯定,适合临床治疗膝骨性关节炎。     

祛风止痛胶囊联合塞来昔布治疗膝骨性关节炎的临床研究

目的探讨祛风止痛胶囊联合塞来昔布胶囊治疗膝骨性关节炎的临床疗效。方法选取2018年6月—2020年10月郑州市第七人民医院收治的80例膝骨性关节炎患者作为研究对象,按照随机数字表法将80例患者分为对照组和治疗组,每组各有40例。对照组口服塞来昔布胶囊,100 mg/次,2次/d。治疗组患者在对照组基础上口服祛风止痛胶囊,1.8 g/次,2次/d。两组患者连续治疗8周。观察两组的总有效率,比较两组的步态特征、膝关节功能和血清炎症因子水平。结果治疗后,治疗组患者总有效率为92.50%,对照组为75.00%,组间比较差异有统计学意义(P0.05)。治疗后,两组的步速、步长显著提高(P0.05),以治疗组步速、步长提高的更明显(P0.05)。治疗后,两组的Lysholm评分显著升高,差异有统计学意义(P0.05);治疗后,治疗组的Lysholm评分比对照组高,差异有统计学意义(P0.05)。治疗后,两组的前列腺素E_2(PGE_2)、白细胞介素-1β(IL-1β)、基质金属蛋白酶-3(MMP-3)水平显著降低(P0.05);治疗后,治疗组的PGE2、IL-1β、MMP-3水平低于对照组,差异有统计学意义(P0.05)。结论祛风止痛胶囊联合塞来昔布胶囊可提高膝骨性关节炎的疗效,改善步态情况和关节功能,降低炎症反应,安全性良好。     

玻璃酸钠联合复方倍他米松腔内注射治疗膝骨性关节炎的临床研究

目的:评价玻璃酸钠注射液结合复方倍他米松关节腔内注射治疗膝关节骨性关节炎的临床疗效.方法:将膝关节骨性关节炎患者随机分成治疗组和对照组.治疗组行玻璃酸钠注射液结合复方倍他米松关节腔内注射,对照组行关节腔注射玻璃酸钠针,观察两组疗效,并对其进行结果分析.按规定时间进行超声检查并记录髌上囊滑膜厚度(滑膜厚度)并进行VAS及WOMAC评分,用SPSS 19.0软件进行分析.结果:研究人群都有明显的膝关节功能改善,治疗组的WOMAC评分和VAS评分在近期及远期疗效评价中,均明显优于对照组(P＜0.05).在滑膜厚度变化方面,治疗5周,治疗组较对照组有显著差异(P＜0.05).治疗组治疗5周、随访3月,滑膜厚度较前均有显著差异(P＜0.05).对照组滑膜厚度在治疗5周时较治疗前无显著差异,但在治疗3月较前有显著差异(P＜0.05).结论:玻璃酸钠联合复方倍他米松腔内注射治疗膝骨关节炎较单纯使用玻璃酸钠注射效果好,是一种较好的治疗方法.     

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.     

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.