中药肾毒性成分及其毒性机制研究进展

近年来,随着我国医药产业的稳步发展,中药作为补充和替代医学制剂在世界各地赢得了认可和信赖。然而,随着对中药的广泛应用和深入研究,中药的肾脏毒性引发了国内外学者的广泛关注。为保障中药临床应用的安全性,有必要深入研究并整理中药肾毒性成分及其毒性机制。在查阅近30年国内外常见中药肾毒性相关文献的基础上,对中药肾毒性成分及其毒性机制进行了总结与分析,以期为中药肾毒性深入研究提供思路,为中药安全合理应用提供参考。     

Inflammation,immunity and allergy

Injury or foreign invasion will instigate a cascade of events directed at eliminating the intruder and augmenting the healing process. This involves the unification of two separate processes (inflammatory and immune processes) to provide an effective host defence. Chemical mediators converge on the site of tissue damage and exert local and distant effects. The immune response is divided into innate and acquired immunity. The immediate, non-specific innate response, combined with the specifically targeted acquired response, provide our major defence mechanisms. Lymphocytes and immunoglobulins are the hallmark of acquired immunity. Regulation of these interlinked systems provide cohesion and a group of soluble proteins called cytokines have a major role. Protective immune mechanisms can sometimes cause detrimental effects to the host. We discuss and classify allergic reactions, in particular, the most severe and potentially life threatening form – anaphylaxis.     

How human neutrophils kill and degrade microbes: an integrated view

Summary:  Neutrophils constitute the dominant cell in the circulation that mediates the earliest innate immune human responses to infection. The morbidity and mortality from infection rise dramatically in patients with quantitative or qualitative neutrophil defects, providing clinical confirmation of the important role of normal neutrophils for human health. Neutrophil-dependent anti-microbial activity against ingested microbes represents the collaboration of multiple agents, including those prefabricated during granulocyte development in the bone marrow and those generated de novo following neutrophil activation. Furthermore, neutrophils cooperate with extracellular agents as well as other immune cells to optimally kill and degrade invading microbes. This brief review focuses attention on two examples of the integrated nature of neutrophil-mediated anti-microbial action within the phagosome. The importance and complexity of myeloperoxidase-mediated events illustrate a collaboration of anti-microbial responses that are endogenous to the neutrophil, whereas the synergy between the phagocyte NADPH (nicotinamide adenine dinucleotide phosphate) oxidase and plasma-derived group IIA phospholipase A₂ exemplifies the collective effects of the neutrophil with an exogenous factor to achieve degradation of ingested staphylococci.     

Changes in enzyme activity of leukocytes during amyloid formation experimentally and in patients with amyloidosis

In patients with secondary amyloidosis and in animals with experimental amyloidogenesis and amyloidosis (casein model) the activity of hydrolases, oxidoreductases, and myeloperoxidase was determined in neutrophils and lymphocytes of the peripheral blood. During the period of amyloid formation, hydrolase and myeloperoxidase activity in the neutrophis was reduced, especially in the stage of initial amyloid deposition. Changes in the activity of these enzymes in animals with developed amyloidosis coincided with those in the blood cells of patients with secondary amyloidosis. The results are discussed from the standpoint of the resorption theory.Presented by Academician of the Academy of Medical Sciences of the USSR E. M. Tareev.)Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 82, No. 7, pp. 799–801, July, 1976.     

艾恒、丝裂霉素、氟尿嘧啶辅以醛氢叶酸联合化疗治疗转移性胃癌的临床研究

目的：评价国产草酸铂（艾恒）,丝裂霉素,氟尿嘧啶辅以CF治疗转移性胃癌的临床效及其毒副反应,方法：23例转移性胃癌患者接受L－OHP（艾恒）130mg/m^2,静滴,第1天,MMC10mg/m^2,静脉冲注,第1天,CF130mg/m^2,静滴,第1－5天,5－Fu 500mg,静脉注射,500mg静滴（6－8h),第1－5天,第21天为一周期,连用两个周期。结果：总缓解率为65．2％（15／23）,完全缓解率（CR）17．4％（4／23）,部分缓解率（PR）47．8％（11／23）,毒性反应主要是白细胞减少,发生率为43．4％,但3度以上者仅为4．3％,血红蛋白及血小板降低分别为21．7％和26．0％,口唇、面部、指端感觉迟钝,麻木,遇冷加重发生率较高达60．11％,其他毒性反应较少。结论：国产草酸铂（艾恒）为主组成的LMF／CF方案治疗转移性胃癌疗效较好,毒副作用较小。     

猪链球菌引起人中毒性休克综合征和脑膜脑炎的流行病学调查及病原学研究

目的 本研究拟本明1998年华东地区一种与病死猪有接触史的人的急性传染病病原体的生物学特征与疾病流行的关系。方法 流行病学调查,并对病死猪及死亡患者进行病理检查,分离病原及其实验研究。结果 该病具有起病急、病情重、病程短、病死率高等特点。临床及病理表现为：起病多似感冒有高热、四肢疼痛、有时有呕吐、腹泻等,迅速发展为肌炎、筋膜炎、DIC、多脏器功能衰竭、休克,多于2～3d内死亡。25例患者中,临床表现为中毒性休克综合征的16例,链球菌性脑膜脑炎综合征的9例,两者的病死率分别为81.25%和11.11%。从猪和病人标本分离的病原体,其形态、生染色性、生物学特征均一致。结论 患者血和病猪脏器中分离的病原菌鉴定结果证明两者均为链球菌。     

环丙沙星与氧氟沙星联用抗结核药物肝毒性比较

目的　研究环丙沙星或氧氟沙星联用抗结核药的肝毒性并探讨其机制。方法　分别测定异烟肼和利福平联合用药 (IR)组及其分别联用氧氟沙星 (IRO)或环丙沙星 (IRC)组小鼠的血清谷氨酸氨基转移酶 (ALT)、肝指数、肝匀浆丙二醛 (MDA)含量、肝微粒体细胞色素P45 0和线粒体Ca2 ATP酶活性 ,及肝病理检查 ,结果与对照组以及实验组之间进行比较。结果　与正常对照组比较 ,IR组及IRO组的血清ALT、肝细胞匀浆MDA明显增高 (P <0 .0 5 ) ,而IRC组变化不大 (P >0 .0 5 ) ;同时发现IR组和IRO组的肝微粒体细胞色素P45 0含量较高和线粒体Ca2 ATP酶活性较低 ,而IRC组则相反 ;病理检查IRO和IRC组肝细胞坏死程度稍轻但与IR组比较无明显差异。结论　氧氟沙星、环丙沙星不增加异烟肼和利福平联用肝毒性 ,且环丙沙星有一定的拮抗作用。     

运动疲劳前后人体外周静脉血中性粒细胞变形性研究

本文用微吸管吸吮技术检测人疲劳运动前后中性粒细胞表面进入微吸管内的距离Ｄ（ｔ）有明显差异。提示疲劳运动会降低人中性粒细胞的变形能力,影响其与变形有关的细胞吞噬功能。     

消抗安胎口服液慢性毒性作用的实验研究

目的 观察消抗安胎口服液长期,大剂量使用对大鼠的慢性毒性作用。方法 血液生化分析法。结果 实验大鼠的整体状态,肝功能,肾功能,血糖等血液生化指标的测定及主要敏感脏器重量与对照组相比均无显著性差异。结论ＣＸＬ安全,无毒副作用,临床应用可靠。