膝关节骨性关节炎治疗的探讨

目的 探讨膝关节骨性关节炎(knee osteoarthritis,KOA)的治疗方法.方法 从双氯芬酸钠口服治疗组(甲组)、双醋瑞因口服治疗组(乙组)、玻璃酸钠膝关节腔内注射联合双醋瑞因口服治疗组(丙组)各随机抽取70例病例,比较分析3组治疗前后WOMAC指数、疗效、不良反应等情况.结果 3组患者治疗前WOMAC指数差异无统计学意义(P均>0.05);3组患者治疗2周后的WOMAC指数较治疗前明显下降(P均<0.05),甲组与丙组指数下降较乙组明显,同期比较差异均有统计学意义(P均<0.05);3组治疗3个月后的WOMAC指数较治疗前与治疗2周后均有明显下降(P均<0.01);丙组治疗3个月后的WOMAC指数较甲组与乙组均明显下降(P均<0.01);停药1个月后,乙组与丙组的WOMAC指数基本保持在停药前水平,同组比较差异均无统计学意义(P均>0.05),甲组则出现反弹现象,与停药前比较,差异有统计学意义(P<0.05);甲、乙、丙3组治疗3个月后总有效率分别为75.7%、74.3%、94.3%,甲组疗效与乙组差异无统计学意义(P>0.05),丙组疗效优于甲组与乙组(P均<0.01).甲、乙、丙3组不良反应发生率分别为18.6%、5.7%、7.1%,甲组不良反应发生率高于乙组与丙组(P均<0.05);乙组与丙组的不良反应发生率无显著性差异(P>0.05).结论 玻璃酸钠注射液膝关节腔内注射联合双醋瑞因口服治疗KOA,起效快、疗效好、作用持久、不良反应少,值得推荐.     

噻托溴铵联合沙丁胺醇治疗哮喘的临床疗效观察

目的探讨分析噻托溴铵、沙丁胺醇联合应用治疗哮喘病症的临床效果。方法选取2012年5月~2015年4月在本院住院治疗的哮喘患者96例,随机分为甲、乙、丙三组各32例,甲组给予噻托溴铵,乙组给予沙丁胺醇,丙组联合应用噻托溴铵和沙丁胺醇,评估三组治疗效果。结果治疗后,三组患者肺功能均有所改善,各组治疗前后比较差异有统计学意义(P<0.05)。总有效率甲组为78.12%,乙组为75.00%,丙组为96.88%;总有效率丙组显著高于甲、乙组,与甲、乙组比较差异均具统计学意义(P<0.05);甲组与乙组总有效率比较差异无统计学意义(P>0.05)。治疗后三组患者FEV1、FEV1/FVC、PEF均有改善,各组治疗前后比较差异有统计学意义(P<0.05)。三指标丙组显著高于甲、乙组,与甲、乙组比较差异均具统计学意义(P<0.05);甲组与乙组三指标比较差异无统计学意义(P>0.05)。结论噻托溴铵与沙丁胺醇联合应用治疗哮喘疗效优于两者单独用药,值得临床推广。     

三种方案治疗新生儿高胆红素血症的疗效比较

目的 探讨三种不同方案治疗新生儿高胆红素血症的疗效 方法 随机选取新生儿高胆红素血症患儿210例,分为甲、乙、丙三组,倒数分别为59、62、63例 甲组采用光疗联合清蛋白、全双歧(双歧杆菌乳杆菌三联活菌片)治疗,乙组采用光疗联合茵栀黄颗粒、金双歧治疗,丙组采用光疗联合清蛋白、茵栀黄颗粒,金双歧治疗,3d后观察皮肤黏膜黄疸程度及血清胆红素的变化,结果 采用X2检验进行分析 结果 甲、乙、丙组显效、有效、无效分别为35、13、11例,37、14、11例,46、13、4例,甲、乙组比较,总有效率差异无统计学意义(P＞0.05),丙组与甲、乙组比较,总有效率差异有统计学意义(P＜0.05).结论 丙组治疗方案优于甲、乙治疗方案,光疗联合清蛋白、茵栀黄颗粒、金双歧治疗方案时新生儿高胆红素血症效果良好.     

长春西汀联合舒血宁注射液治疗突发性耳聋的疗效

目的:对长春西汀联合舒血宁注射液治疗突发性耳聋的疗效进行观察,对其药理作用进行分析.方法:选取我院2014年7月~2016年6月收治并已确诊的突发性耳聋患者100例,根据就诊方式的不同进行随机分组,采取血塞通注射液联合低分子右旋糖酐治疗为参照组,采取长春西汀联合舒血宁注射液治疗为研究组,每组50例.治疗后分析对比两组疗效.结果:研究组治疗总有效率(96%)与参照组(78%)相比明显要高,P<0.05,两组差异有统计学意义.结论:突发性耳聋应用长春西汀联合舒血宁注射液治疗的临床效果确切,值得推广.     

舒血宁注射液治疗突发性聋的疗效观察

目的 探讨舒血宁注射液治疗突发性聋的临床疗效。方法 68（75耳）例突发性聋患者分别应用舒血宁注射液（舒血宁组,31例,34耳）及复方丹参注射液（对照组,37例,41耳）治疗,并辅予能量合剂、vitB1、vitB12激素及高压氧等,比较两组疗效。结果 舒血宁组总有效率达88．2％,明显高于对照组的65．9％,两组疗效有显著性差异（p〈0．05）。结论 舒血宁注射液治疗突发性聋的疗效显著,值得临床推广应用。     

舒血宁联合低分子肝素钙治疗急性脑梗死疗效分析

目的:比较舒血宁注射液治疗急性脑梗死及其联合应用低分子肝素钙的治疗效果.方法:选择急性脑梗死患者120例,随机分为舒血宁注射液联合低分子肝素钙组(治疗组)60例和舒血宁注射液组(对照组),评定两组治疗效果.结果:两组临床疗效均明显改善,治疗组总有效率(96.7%)明显高于对照组(71.7%),差异有统计学意义(P＜0.05).结论:舒血宁注射液治疗急性脑梗死效果好,联合应用低分子肝素钙效果更佳.     

鼓室内注射地塞米松联合静脉注射用药与其他治疗方法对突发性感音神经性聋患者疗效的回顾性研究

目的比较鼓室内注射地塞米松联合静脉注射用药与其他治疗方法对突发性感音神经性聋疗效及预后的差异。方法对2017年1月～2019年9月在我院诊断突发性感音神经性聋并进行治疗的245例患者进行研究。所有患者均严格参照突发性聋诊断和治疗指南(2015)入组,分组包括常规静脉给药、单纯鼓室内注射地塞米松、静脉注射与鼓室内注射地塞米松联合应用。根据治疗前后恢复效果应用SPSS19.0统计软件对各组特征及疗效进行比较。结果常规静脉给药、单纯鼓室内注射地塞米松、静脉注射与鼓室内注射地塞米松联合应用中患者的性别、年龄、伴随症状、患病侧别、分型及严重程度比较差异均无统计学意义(P 0.05)。三组间有效率比较差异有统计学意义(P 0.05),进一步两两比较发现突发性聋患者联合用药组有效率为90.29%,明显高于常规静脉给药组的71.67%及单纯鼓室内注射组的48.78%,进一步将不同分型的突聋患者有效率在各组间进行比较,显示高频下降型与平坦型患者的疗效有效率在各组间差异有统计学意义(P 0.05),联合用药组有效率高于常规静脉给药组及单纯鼓室内注射组;而低频下降型与全聋型患者的疗效有效率在各组间差异无统计学意义(P 0.05)。结论鼓室内注射地塞米松与静脉注射联合用药比之单纯静脉给药及单纯鼓室内注射能显著提高治疗的有效率。     

去纤酶联合舒血宁注射液治疗突发性聋22例

目的 观察去纤酶联合舒血宁注射液治疗突发性聋的临床疗效. 方法突发性耳聋患者40例(43耳),分为治疗组22例(24耳)和对照组18例(19耳). 两组患者均使用常规药物、能量合剂、糖皮质激素、B族维生素、抗病毒药物等. 治疗组在此基础上,应用去纤酶5 U+0.9%葡萄糖注射液150 mL,静脉滴注,同时静脉滴注0.9%氯化钠注射液500 mL+舒血宁注射液30 mL,qd, 10 d为1个疗程. 对照组应用舒血宁注射液30 mL加入0.9%氯化钠注射液 500 mL静脉滴注,qd, 10 d为1个疗程. 治疗前后作血液流变学检查. 结果 两组患者的血液流变学均有改善,治疗组与治疗前比较差异有极显著性(P<0.01),对照组与治疗前比较差异有显著性(P<0.05),治疗组与对照组治疗后比较,差异有显著性(P<0.05). 治疗组痊愈10例,显效6例,有效4例,无效2例;对照组痊愈7例,显效4例,有效3例,无效4例. 结论 去纤酶联合舒血宁注射液可以明显改善患者的血液流变学,提高听力,且安全性高.     

舒血宁注射液联合胞磷胆碱钠治疗突发性耳聋的疗效观察

目的探究舒血宁注射液联合胞磷胆碱钠注射液治疗突发性耳聋的有效性和安全性。方法选取陕西中医药大学附属医院2015年2月—2017年2月收治突发性耳聋患者97例,随机分成对照组(48例)和治疗组(49例)。对照组患者静脉滴注胞磷胆碱钠注射液,0.25 g加入5%葡萄糖注射液250 m L,1次/d;治疗组在对照组的基础上静脉滴注舒血宁注射液,10 m L加入5%葡萄糖注射液250 m L,1次/d。所有患者均规律治疗14 d。观察两组患者临床疗效,比较治疗前后两组患者平均听阈和听力改善情况以及纯音电测听力图分型的分布、治疗后有效耳数和不良反应情况。结果治疗后,对照组和治疗组的临床总有效率分别为73.58%、94.44%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者平均听阈值明显降低(P0.05);且治疗组平均听阈值比对照组更低(P0.05)。治疗后,治疗组听力改善情况明显优于对照组(P0.05)。治疗后,两组患者上升型、平坦型、盆型患耳显著少于治疗前,同组治疗前后比较差异具有统计学意义(P0.05);且治疗后治疗组上升型、下降型、平坦型、盆型以及总耳的有效率显著高于对照组,两组比较差异具有统计学意义(P0.05)。治疗组患者不良反应发生率为8.16%,明显低于对照组的25.00%,两组比较差异具有统计学意义(P0.05)。结论舒血宁注射液联合胞磷胆碱钠注射液治疗突发性耳聋具有明显疗效,安全性较高,具有一定的临床推广应用价值。     

舒血宁联合脑蛋白水解物治疗脑梗死疗效分析

目的:探讨舒血宁注射液联合应用脑蛋白水解物治疗脑梗死的临床效果.方法:将120例脑梗死患者,随机分为两组.舒血宁注射液联合脑蛋白水解物组(治疗组)60例和舒血宁注射液组(对照组),评定两组治疗效果.结果:两组临床疗效均明显改善,治疗组总有效率(95.0%)明显高于对照组(71.7%),差异有显著性(P<0.05).结论:舒血宁注射液联合应用脑蛋白水解物治疗脑梗死效果更佳.     

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.