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。     

小儿双清颗粒联合头孢西丁治疗小儿急性上呼吸道感染的临床研究

目的探讨小儿双清颗粒联合头孢西丁治疗小儿急性上呼吸道感染的临床疗效。方法选取2018年8月—2019年8月在天津市泰达医院就诊的急性上呼吸道感染患儿150例,根据用药的差别分为对照组(75例)和治疗组(75例)。对照组静脉滴注注射用头孢西丁钠,13.3～26.7mg/kg加入生理盐水100m L;治疗组在对照组基础上口服小儿双清颗粒,1～3岁,2～3 g/次,4～6岁,3～4 g/次,6岁,4～5 g/次,3次/d。两组患儿均治疗7 d。观察两组患者临床疗效,同时比较治疗前后两组患儿临床症状消失时间,及血清超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)、IL-1β、肿瘤坏死因子-α(TNF-α)水平。结果治疗后,对照组和治疗组临床有效率分别为82.67%和97.33%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组患者症状消失时间明显早于对照组(P0.05)。治疗后,两组患者血清hs-CRP、PCT、IL-6、IL-1β、TNF-α水平均明显降低(P0.05),且治疗组患者明显低于对照组(P0.05)。结论小儿双清颗粒联合头孢西丁钠治疗小儿急性上呼吸道感染,能显著改善临床症状,降低机体炎症因子表达,具有一定的临床推广应用价值。     

清热散结胶囊联合头孢克肟治疗儿童急性支气管炎的临床研究

目的探讨清热散结胶囊联合头孢克肟治疗急性支气管炎患儿的临床疗效。方法选取2018年2月—2018年11月在成都市第三人民医院治疗的急性支气管炎患儿118例,根据用药的差别分为对照组(59例)和治疗组(59例)。对照组口服头孢克肟分散片,0.1 g/次,2次/d;治疗组在对照组基础上口服清热散结胶囊,1.75 g/次,3次/d。两组均治疗14 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和炎症因子水平。结果治疗后,对照组和治疗组临床有效率分别为81.36%和96.61%,两组比较差异具有统计学意义(P0.05)。经治疗,治疗组患者体温、咳嗽和肺部啰音复常时间均明显早于对照组,两组比较差异具有统计学意义(P0.05)。经治疗,两组患者血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、半胱氨酰白三烯(CysLTs)、可溶性髓系细胞触发因子-1(sTREM-1)、白细胞介素-6(IL-6)水平显著降低(P0.05),且治疗组患者hs-CRP、TNF-α、CysLTs、sTREM-1、IL-6水平明显低于对照组患者(P0.05)。结论清热散结胶囊联合头孢克肟治疗急性支气管炎患儿可有效改善患者临床症状,降低机体炎症反应,具有一定的临床推广应用价值。     

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。     

肺宁颗粒联合头孢唑肟钠治疗老年慢性支气管炎急性发作期的临床研究

目的探讨肺宁颗粒联合注射用头孢唑肟钠治疗老年急性发作期慢性支气管炎的临床疗效。方法选择2019年5月—2020年5月在平顶山市第二人民医院治疗的96例老年急性发作期慢性支气管炎患者,根据就诊顺序分为对照组(48例)和治疗组(48例)。对照组静脉滴注注射用头孢唑肟钠,2 g加入生理盐水100 mL,12 h/次;治疗组在对照组的基础上口服肺宁颗粒,5g/次,3次/d。两组均经2周治疗。观察两组患者临床疗效,比较治疗前后两组患者临床症状改善时间,血清超敏C反应蛋白(hs-CRP)、巨噬细胞刺激蛋白(MSP)、降钙素原(PCT)、白三烯B4(LTB4)、白细胞介素-8(IL-8)和巨噬细胞炎症蛋白-1α(MIP-1α)水平,肺功能第1秒用力呼气末容积(FEV1)、用力肺活量(FVC)和最大呼气流速(PEF),及动脉血气指标氧分压(pO₂)和二氧化碳分压(pCO₂)水平。结果经治疗,对照组总有效率为81.25%,显著低于治疗组的97.92%(P<0.05)。经治疗,治疗组临床症状改善时间上均明显早于对照组(P<0.05)。经治疗,两组血清hs-CRP、MSP、PCT、LTB4、IL-8、MIP-1α水平均显著降低,并以治疗组降低最明显(P<0.05)。经治疗,两组FEV1、FVC、PEF、pO₂、pCO₂水平均明显改善,并以治疗组改善最显著(P<0.05)。结论老年急性发作期慢性支气管炎患者采用肺宁颗粒联合注射用头孢唑肟钠治疗可明显改善其症状,促进肺功能恢复,降低机体炎症水平,具有一定的临床推广应用价值。     

小儿肺咳颗粒联合环酯红霉素治疗小儿急性支气管炎的临床研究

目的观察小儿肺咳颗粒联合环酯红霉素治疗急性小儿支气管炎的临床疗效。方法选择2018年6月—2019年6月在彭州市妇幼保健计划生育中心就诊的急性支气管炎患儿216例,随机分为对照组和治疗组,每组各108例。对照组口服环酯红霉素干混悬剂,10～15 mg/kg,1次/12 h;治疗组在对照组基础上口服小儿肺咳颗粒,1岁以下患儿2 g/次、1～4岁患儿3 g/次、5～8岁6 g/次,3次/d。两组患儿均治疗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改善情况,及超敏C反应蛋白(hs-CRP)、白细胞介素-10(IL-10)和IL-13水平。结果治疗后,对照组和治疗组临床有效率分别为75.93%和93.52%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组患者体温恢复正常时间、咳嗽消失时间、肺部喘鸣音消失时间均较对照组明显缩短(P0.05)。治疗后,两组患者hs-CRP、IL-10和IL-13水平均明显降低(P0.05),且治疗组患者的炎症指标水平显著低于对照组(P0.05)。结论小儿肺咳颗粒联合环酯红霉素治疗急性小儿支气管炎能够快速缓解症状,改善炎症指标,具有一定的临床推广应用价值。     

金振口服液联合美洛西林治疗小儿急性支气管炎的临床研究

目的探讨金振口服液联合美洛西林钠治疗小儿急性支气管炎的临床疗效。方法回顾性分析2019年10月—2020年10月在濮阳市人民医院治疗的172例急性支气管炎患儿的临床资料,根据用药的差别分为对照组和治疗组,每组各86例。对照组静脉滴注注射用美洛西林钠,0.1～0.2 g/kg加入生理盐水100 mL,1次/d。治疗组在对照组的基础上口服金振口服液,6个月～1岁5 mL/次,3次/d;2～3岁10 mL/次,2次/d;4～7岁10 mL/次,3次/d;8～12岁15 mL/次,3次/d。两组患儿均治疗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失时间,血清白细胞计数(WBC)、中性粒细胞百分比(NEUT)、淋巴细胞百分比(LYMPH)、超敏C反应蛋白(hs-CRP)、白细胞介素-4(IL-4)、白细胞介素-8(IL-8)、降钙素原(PCT)和白细胞介素-17A(IL-17A)水平。结果治疗后,治疗组总有效率为98.84%,明显高于对照组的82.56%(P0.05)。治疗后,治疗组临床症状改善时间明显早于对照组(P0.05)。治疗后,两组患儿血清WBC和NEUT显著降低,但LYMPH水平显著升高(P0.05),且治疗组改善最明显(P0.05)。治疗后,两组患儿血清hs-CRP、IL-4、IL-8、PCT、IL-17A水平均显著下降,且治疗组降低最明显(P0.05)。结论注射用美洛西林钠联合金振口服液治疗急性支气管炎不仅可有效改善患儿临床症状,还可显著降低机体炎症反应,具有一定的临床推广应用价值。     

金莲清热泡腾片联合头孢西丁钠治疗小儿急性上呼吸道感染的临床研究

目的探讨金莲清热泡腾片联合头孢西丁钠治疗小儿上呼吸道感染的临床疗效。方法选取2017年6月—2018年6月在河南省省立医院治疗的小儿上呼吸道感染患者102例,根据住院号分为对照组(51例)和治疗组(51例)。对照组静脉滴注头孢西丁钠注射液,100～150 mg/kg加入生理盐水100 mL,2次/d;治疗组在对照组治疗基础上口服金莲清热泡腾片,8 g/次,4次/d。两组患者经7 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、肺功能和炎症因子水平。结果治疗后,对照组临床有效率为82.35%,显著低于治疗组的98.04%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组患儿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,两组患儿呼吸频率(RR)、呼吸时间比(Ti/Te)均显著降低(P0.05),潮气量(VT)、达峰时间比(tPTEF/t E)显著升高(P0.05),且治疗组患儿肺功能明显好于对照组(P0.05)。治疗后,两组患儿超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)、IL-13、肿瘤坏死因子-α(TNF-α)水平均明显下降(P0.05),且治疗组患儿上述炎症因子水平明显低于对照组(P0.05)。结论金莲清热泡腾片联合头孢西丁钠治疗小儿上呼吸道感染可显著改善患儿临床症状,促进患儿肺功能改善,降低患儿机体炎症反应。     

蒲公英颗粒联合头孢拉定治疗急性乳腺炎的临床研究

目的探讨蒲公英颗粒联合注射用头孢拉定治疗急性乳腺炎的临床疗效。方法选择2020年2月—2020年9月在河南省中医院治疗的112例急性乳腺炎患者,根据诊治顺序分成对照组(56例)和治疗组(56例)。对照组静脉滴注注射用头孢拉定,1.0 g加入生理盐水100 mL,6 h/次。治疗组在对照组基础上口服蒲公英颗粒,15 g/次,3次/d。两组均治疗1周。观察两组患者临床疗效,比较治疗前后两组患者临床症状改善时间,及血清学指标超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)、细胞间黏附分子-1(ICAM-1)和肿瘤坏死因子-α(TNF-α)水平。结果经治疗,对照组总有效率为85.71%,显著低于治疗组的98.21%(P0.05)。经治疗,治疗组在乳房肿痛消失时间、退热时间、肿块消失时间、通乳时间上均优于对照组(P0.05)。经治疗,两组患者血清hs-CRP、IL-6、PCT、ICAM-1、TNF-α水平均显著降低(P0.05),治疗组下降最明显(P0.05)。结论蒲公英颗粒联合注射用头孢拉定治疗急性乳腺炎可有效改善患者临床症状,降低机体炎症反应,具有一定的临床推广应用价值。     

孟鲁司特钠联合布地奈德治疗小儿呼吸道合胞病毒感染毛细支气管炎的临床疗效及其对气道炎性反应的影响

目的探讨孟鲁司特钠联合布地奈德治疗小儿呼吸道合胞病毒(RSV)感染毛细支气管炎的临床疗效及其对气道炎性反应的影响。方法选取成都市双流区妇幼保健院2017年1月—2018年1月收治的RSV感染毛细支气管炎患儿86例,按照随机数字表法分为对照组与研究组,各43例。对照组予以布地奈德雾化吸入治疗,研究组在对照组基础上口服孟鲁司特钠治疗。比较两组临床疗效、症状体征(发热、喘憋、咳嗽、哮鸣音、湿啰音)消失时间与住院时间、治疗前后血清炎性因子〔包括嗜酸粒细胞阳离子蛋白(ECP)、白介素8(IL-8)、肿瘤坏死因子α(TNF-α)、半胱氨酰白三烯(CysLTs)〕,并观察两组3个月复发情况和不良反应发生情况。结果研究组治疗总有效率高于对照组,喘憋、咳嗽、哮鸣音、湿啰音消失时间及住院时间短于对照组(P<0.05)。两组发热消失时间比较,差异无统计学意义(P>0.05)。治疗前两组ECP、IL-8、TNF-α、CysLTs水平比较,差异无统计学意义(P>0.05);治疗后研究组ECP、IL-8、TNF-α、CysLTs水平低于对照组(P<0.05)。研究组复发率低于对照组(P<0.05)。两组治疗过程中均未见明显不良反应。结论孟鲁司特钠联合布地奈德治疗小儿RSV感染毛细支气管炎的临床疗效确切,可有效缩短症状缓解时间,减轻气道炎性反应,降低复发率,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.     

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.