苦甘颗粒联合注射用头孢西丁钠治疗急性气管–支气管炎的临床研究

目的探讨苦甘颗粒联合注射用头孢西丁钠治疗急性气管–支气管炎的临床疗效。方法选取2017年5月—2018年5月在绵阳市中医医院治疗的急性气管–支气管炎患者86例,根据用药的不同分为对照组(43例)和治疗组(43例)。对照组静脉滴注注射用头孢西丁钠,2.0 g加入100 mL生理盐水,2次/d;治疗组在对照组的基础上口服苦甘颗粒,8 g/次,3次/d。两组患者均经过2周治疗。观察两组患者临床疗效,同时比较治疗前后两组患者临症状改善时间及血清超敏C反应蛋白(hs-CRP)、半胱氨酰白三烯(CysLTs)、降钙素原(PCT)、白细胞介素-1β(IL-1β)和人可溶性髓系细胞触发受体-1(sTREM-1)水平。结果治疗后,对照组临床有效率为81.40%,显著低于治疗组的97.67%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组热消退、咳嗽咳痰消失、肺部啰音消失和喘息症状消失时间均显著早于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血清hs-CRP、CysLTs、PCT、IL-1β和sTREM-1水平均显著降低(P0.05),且治疗组患者这些炎症因子水平明显低于对照组(P0.05)。结论苦甘颗粒联合头孢西丁钠治疗急性气管–支气管炎有利于临床症状改善,还可降低机体hs-CRP、CysLTs、PCT、IL-1β、sTREM-1水平,具有一定的临床推广应用价值。     

玉屏风颗粒联合头孢克肟治疗儿童反复呼吸道感染的临床研究

目的探讨玉屏风颗粒联合头孢克肟颗治疗儿童反复呼吸道感染的临床疗效。方法选取2016年8月—2017年10月天津市第一中心医院收治的反复呼吸道感染患儿96例为研究对象,采用随机数字表法将96例患儿分为对照组和治疗组,每组各48例。对照组患儿口服头孢克肟颗粒,3.0 mg/kg,2次/d。治疗组患儿在对照组治疗的基础上口服玉屏风颗粒,2岁的患儿2.5g/次,≥2岁的患儿5g/次,3次/d。两组患儿均连续治疗5d。观察两组的临床疗效,比较两组的炎性因子水平。结果治疗后,对照组、治疗组的总有效率分别为72.92%、91.67%,两组比较差异有统计学意义(P0.05)。治疗后,两组患儿干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白细胞介素-5(IL-5)、白细胞介素-4(IL-4)、降钙素原(PCT)、半胱氨酰白三烯(CysLTs)水平均较治疗前降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组患儿的炎性因子水平明显低于对照组,两组比较差异有统计学意义(P0.05)。结论玉屏风颗粒联合头孢克肟颗粒治疗儿童反复呼吸道感染具有较好的临床疗效,能减轻炎症反应,安全性较高,具有一定的临床推广应用价值。     

愈美颗粒联合阿莫西林克拉维酸钾治疗小儿急性支气管炎的临床研究

目的探讨愈美颗粒联合阿莫西林克拉维酸钾治疗小儿急性支气管炎的临床疗效。方法选取2018年3月—2019年3月在延安大学咸阳医院治疗的急性支气管炎患儿94例,根据用药的差别分为对照组(47例)和治疗组(47例)。对照组口服阿莫西林克拉维酸钾颗粒,20 mg/kg,1次/8 h;治疗组在对照组基础上口服愈美颗粒,1～6岁,0.5包/次,7～12岁,1包/次,3次/d。两组均经10 d治疗。观察两组患者临床疗效,同时比较治疗前后两组患者临床症状改善时间,血清超敏C反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β)、IL-13、IL-17、可溶性髓系细胞触发受体-1(sTREM-1)和半胱氨酰白三烯(CysLTs)水平及肺功能。结果治疗后,对照组临床有效率为80.85%,显著低于治疗组的97.87%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组患者的发热、咳嗽咳痰、喘息、肺部啰音等症状消失时间均明显早于对照组(P0.05)。治疗后,两组患者血清hs-CRP、IL-1β、IL-13、IL-17、sTREM-1、CysLTs水平均明显下降(P0.05),且治疗组血清指标水平明显低于对照组(P0.05)。治疗后,两组患者RR、Ti/Te均明显降低(P0.05),而VT、t PTEF/tE均明显升高(P0.05),且治疗后治疗组患者肺功能明显好于对照组(P0.05)。结论愈美颗粒联合阿莫西林克拉维酸钾治疗急性支气管炎可有效改善患儿临床症状,降低机体炎症反应,促进肺功能改善。     

肠炎宁糖浆联合头孢克肟治疗小儿急性肠胃炎的临床研究

目的探讨肠炎宁糖浆联合头孢克肟干混悬剂治疗小儿急性肠胃炎的临床疗效。方法选取2017年7月—2019年7月在宝鸡市妇幼保健院治疗的急性肠胃炎患儿82例,根据用药的差别分为对照组(41例)和治疗组(41例)。对照组口服头孢克肟干混悬剂,1.5～3 mg/kg,2次/d;治疗组在对照组基础上口服肠炎宁糖浆,10 mL/次,3次/d。两组患儿均经7 d。观察两组患者临床疗效,同时比较治疗前后两组患者临床症状改善时间,以及血清超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)和降钙素(PCT)水平。结果治疗后,对照组临床有效率为80.49%,显著低于治疗组的97.56%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组患儿腹痛缓解时间、发热缓解时间、呕吐缓解时间、腹泻缓解时间均明显短于对照组(P0.05)。治疗后,两组患者血清hs-CRP、IL-6、PCT水平均明显下降(P0.05),且治疗组患者明显低于对照组(P0.05)。结论肠炎宁糖浆联合头孢克肟干混悬剂治疗小儿急性肠胃炎可有效改善患儿临床症状,降低机体炎症反应,具有一定的临床推广应用价值。     

胆木浸膏片联合头孢克肟治疗上呼吸道感染的临床研究

目的探讨胆木浸膏片联合头孢克肟治疗上呼吸道感染的临床疗效。方法选取2017年5月—2018年5月在成都市青白江区人民医院治疗的上呼吸道感染患者92例,根据用药的不同分为对照组(46例)和治疗组(46例)。对照组口服头孢克肟分散片,100 mg/次,2次/d;治疗组在对照组基础上口服胆木浸膏片,1.5 g/次,3次/d。两组患者均治疗7 d。观察两组患者临床疗效,同时比较治疗前后两组患者临床症状消失时间及降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β)、IL-10和γ-干扰素(IFN-γ)水平。结果治疗后,对照组临床总有效率为80.43%,显著低于治疗组的97.83%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组患者发热、咳嗽、咽痛、咽部充血等临床症状消失时间均明显短于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血清PCT、hs-CRP、IL-1β水平均显著降低(P0.05),IL-10和IFN-γ水平显著升高(P0.05),且治疗组患者炎症因子水平明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论胆木浸膏片联合头孢克肟分散片治疗上呼吸道感染能够明显改善患者临床症状,降低机体炎症反应,具有一定的临床推广应用价值。     

蓝芩口服液联合头孢克肟治疗小儿急性咽炎的临床研究

目的探讨蓝芩口服液联合头孢克肟治疗小儿急性咽炎临床疗效。方法选取2018年1月—2020年1月在河南大学第一附属医院治疗的92例急性咽炎患儿,随机分为对照组和治疗组,每组各46例。对照组患者口服头孢克肟颗粒,1.5~3.0 mg/kg,2次/d。治疗组在对照组的基础上口服蓝芩口服液,20 mL/次,3次/d。两组患者均连续治疗7 d。观察两组患者临床疗效,同时比较治疗前后两组患者临床症状消失时间、血清炎性因子水平和不良反应。结果治疗后,对照组和治疗组临床有效率分别为78.26%和95.65%,两组比较差异具有统计学意义(P<0.05)。治疗后,治疗组患儿咽部红肿、咽痛、咳痰症状消失时间均早于对照组(P<0.05)。治疗后,两组患儿血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平均明显降低(P<0.05),且治疗组明显低于对照组(P<0.05)。治疗期间,对照组不良反应发生率为23.91%,显著高于治疗组的10.87%,两组比较差异具有统计学意义(P<0.05)。结论蓝芩口服液联合头孢克肟治疗小儿急性咽炎的临床疗效显著,能明显改善患儿临床症状消失时间,有效改善血清炎性因子水平,具有一定的临床推广应用价值。     

鸡胆口服液联合头孢克肟治疗急性上呼吸道感染的临床研究

目的探讨鸡胆口服液联合头孢克肟治疗急性上呼吸道感染的临床疗效。方法选取2018年3月—2019年3月在天津市滨海新区大港医院治疗的106例急性上呼吸道感染患者,根据随机数字表法分为对照组(53例)和治疗组(53例)。对照组患者口服头孢克肟片,100 mg/次,2次/d;治疗组在对照组的基础上口服鸡胆口服液,20 m L/次,3次/d,两组患者均连续治疗7d。观察两组患者临床疗效,比较治疗前后两组患者临床症状消退时间,血清白细胞介素6(IL-6)、IL-8、C反应蛋白(CRP)和肿瘤坏死因子α(TNF-α)水平及不良反应情况。结果治疗后,治疗组患者临床总有效率为98.11%,显著高于对照组的79.25%(P0.05);治疗后,治疗组患者的发热消退时间、咽部红肿消退时间、咳嗽消退时间均短于对照组患者(P0.05);治疗后,两组患者IL-6、IL-8、CRP、TNF-α水平均显著低于治疗前(P0.05),且治疗组患者明显低于对照组(P0.05);治疗组不良反应发生率为7.55%,显著低于对照组的24.53%。结论鸡胆口服液联合头孢克肟治疗急性上呼吸道感染,能有效缩短临床症状消失时间和改善机体免疫功能水平,明显改善炎性因子水平。     

头孢克洛与头孢克肟治疗小儿急性细菌性肠炎药学分析

目的:分析头孢克洛与头孢克肟治疗小儿急性细菌性肠炎的疗效与药学效果。方法:选取某院儿科于2016年3月～2017年3月收治的62例急性细菌性肠炎患儿作为研究对象,随机分为对照组与观察组,每组31例,观察组患者给予头孢克肟治疗,对照组患儿给予头孢克洛治疗,观察记录两组患儿治疗效果、血清TNF-α、PCT、IL-8水平改善情况。结果:观察组患儿的治疗有效率高于对照组,P0.05;两组患儿经治疗后血清TNF-α、PCT、IL-8水平均得到有效改善,P0.05,组间差异存在统计学意义。结论:相比于头孢克洛治疗,头孢克肟对小儿急性细菌性肠炎患儿疗效更佳,值得临床推广普及。     

桉柠蒎肠溶软胶囊联合头孢克肟治疗老年肺炎的临床研究

目的探讨桉柠蒎肠溶软胶囊联合头孢克肟治疗老年肺炎的临床疗效。方法选取2017年2月—2017年9月在航空总医院治疗的老年肺炎患者82例,根据用药的差别分为对照组(41例)和治疗组(41例)。对照组口服头孢克肟胶囊,0.1 g/次,2次/d;治疗组在对照组基础上口服桉柠蒎肠溶软胶囊,0.3 g/次,3次/d。两组患者均经过14 d治疗。观察两组患者临床疗效,比较治疗前后两组患者临床症状评分和血清学指标。结果治疗后,对照组和治疗组的临床有效率分别为80.49%和97.56%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者咳嗽、咳痰、发热、喘息气急评分均显著降低,同组比较差异具有统计学意义(P0.05);且治疗组患者的临床症状评分明显低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血清C反应蛋白(CRP)、降钙素(PCT)和白细胞介素-6(IL-6)水平均显著降低,同组比较差异具有统计学意义(P0.05);且治疗组血清学指标比对照组降低更显著,两组比较差异具有统计学意义(P0.05)。结论桉柠蒎联合头孢克肟胶囊治疗老年肺炎可有效改善患者临床症状,降低血清CRP、PCT和IL-6水平,具有一定的临床推广应用价值。     

头孢克肟与盐酸氨溴索对重症支气管肺炎患儿伴心力衰竭的疗效及其对炎症因子水平改善的影响

目的:探究头孢克肟与盐酸氨溴索联用对重症支气管肺炎患儿伴心力衰竭的疗效及其对脑钠肽(BNP和炎症因子水平改善的影响。方法:选取2017年3月—2018年3月间收治的重症支气管肺炎伴心力衰竭患儿88例,按治疗方法的不同将其分为对照组和观察组,每组44例;对照组患者给予头孢克肟治疗,观察组患者在对照组基础上加用盐酸氨溴索治疗,比较两组患儿治疗前后血清BNP及炎症因子水平测得值的变化情况,以及治疗后的总有效率差异。结果:两组患儿治疗前的血清BNP、肿瘤坏死因子(TNF-α)和白介素细胞-6(IL-6)水平测得值经组间比较其差异均无统计学意义(P>0.05),治疗后优于治疗前(P<0.05);观察组患儿治疗后的BNP、TNF-α和IL-6水平测得值均低于对照组(P<0.05),总有效率高于对照组(P<0.05)。结论:采用孢克肟与盐酸氨溴索联用治疗重症支气管肺炎伴心力衰竭患儿的疗效优于单用头孢克肟的疗效,有效改善了BNP及炎症因子水平。     

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.     

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.