苯克磷、阿托品、解磷定伍用治疗急性有机磷中毒72例

目的　通过应用阿托品、解磷定 ,苯克磷及苯克磷与阿托品、解磷定三组治疗急性有机磷中毒 ,观察比较其疗效。方法　将急性有机磷中毒 72例患者随机分为三组。2 4例应用阿托品和解磷定为 A组 ,2 4例应用苯克磷为B组 ,2 4例应用三药伍用为 C组。结果　达预期效应时间。 A组 :(2 .75± 0 .6 2 ) h;B组 :(0 .4 8± 0 .2 0 ) h;C组 :(0 .2 1± 0 .15 ) h,差异有非常显著性 (P<0 .0 0 1)。结论　苯克磷、阿托品、解磷定三药伍用能快速、持久、全面地解除有机磷中毒引起的烟碱样症状、毒蕈碱样症状及中枢神经症状 ,减少中毒和反跳现象的发生     

大剂量氯磷定抢救急性重度有机磷农药中毒的疗效观察

目的观察大剂量氯磷定抢救急性重度有机磷农药重度的疗效。方法 94例急性重度有机磷农药重度患者,48例(治疗组)予大剂量氯磷定冲击治疗.46例(对照组)予常规剂量氯磷定治疗。结果治疗组胆碱酯酶恢复时间,平均住院时间,机械通气比例明显低于对照组,阿托品用量明显低于对照组。治疗组治愈率明显高于对照组。结论大剂量氯磷定冲击治疗急性有机磷中毒优于常规剂量。     

苯扎托品、丙环定、双复磷合并治疗急性有机磷中毒30例

自1989年我院应用军事医学科学院,研制的复合特效解毒剂——苯克磷救治急性有机磷农药中毒30例(M10,F20;年龄40±8a),获得满意疗效。用量:中、重度中毒4-18mL,平均10±s5mL。显效时间15min左右。苯克磷由苯扎托品,丙环定,双复磷组成。具有奏效快,持续久,疗效高和副作用小的特征。较传统的联合应用解磷定,氯磷定和阿托品更有效,方便与安全。     

解磷注射液抢救有机磷农药中毒分析

目的探讨解磷注射液抢救急性有机磷中毒(AOPP)的临床效果。方法采用历史对照法,治疗组为1997年以后103例,用解磷注射液即刻肌注或静注并持续使用3天,辅以氯磷定使用3～7天;对照组1993～1996年86例,采用传统方法,即使用足量阿托品静滴使迅速达"阿托品化"并维持治疗量至治疗结束,辅以氯磷定即肌注或静滴并持续3～5天。结果治愈率治疗组97.1％,对照组82.6％(P<0.01);阿托品用量,治疗组94.34±28.39mg,对照组449.19±146.83mg(P<0.001);乐果中毒反跳,治疗组32例反跳2例死0例,对照组30例反跳9例死6例(P<0.05);住院天数,治疗组6.88±2.10天,对照组10.03±3.26天(P<0.001)。结论采用解磷注射液抢救AOPP疗效显著优于传统阿托品化法。     

氯磷定持续静脉维持抢救急性重度有机磷中毒

目的:观察氯磷定持续静脉维持和重复静脉给药对急性重度有机磷中毒的疗效。方法:采用前瞻性研究方法,将37例患者随机分为2组,均应用机械通气,静脉给予负荷量氯磷定后,对照组18例重复静脉给药;治疗组19例8 mg·kg-1.h-1微泵静脉维持。2组其他治疗相同。结果:治疗组阿托品用量和使用时间、机械通气时间明显低于对照组(P<0.01);治疗3,7 d后全血ChE活性明显高于对照组。结论:氯磷定持续静脉维持可加速急性重度有机磷中毒患者全血ChE的恢复,减少阿托品的用量和用药时间,减少机械通气时间。     

改良型鼻肠管和鼻胃管联用于血液净化对预防和治疗重症有机磷农药中毒患者诱导迟发性多发神经病的疗效比较

目的:比较改良型鼻肠管和鼻胃管联用于血液净化对预防和治疗重症有机磷农药中毒患者诱导迟发性多发神经病的疗效。方法:选取2014年6月—2015年10月间收治的急性重度有机磷中毒(ASOP)患者80例,将其随机分为观察组和对照组,每组40例;两组患者均给予自动洗胃机清水洗胃、快速建立静脉通道,以及给予硫酸阿托品注射液、氯解磷定注射液及对症支持治疗;对照组患者则在此基础上给予单纯洗胃等治疗以及给予硫酸阿托品注射液、氯解磷定注射液及对症支持治疗;观察组患者均给予自动洗胃机清水洗胃、快速建立静脉通道,以及给予硫酸阿托品注射液、氯解磷定注射液及对症支持治疗,同时置入鼻肠管和鼻胃管洗胃等治疗,比较两组患者洗胃等治疗后昏迷复醒时间、机械通气时间、胆碱酯酶(ChE)活性复常时间、住院时间和药物用量,以及迟发性多发神经病的发生情况等。结果:观察组患者治疗后昏迷复醒时间、机械通气时间、胆碱酯酶(ChE)活性复常时间、住院时间均短于对照组(P<0.05),中间综合征的发生率和病死率低于对照组(P<0.05);阿托品、氯解磷定用量小于对照组(P<0.05),提示观察组患者治疗效果优于对照组(P<0.05);随访患者结果发现,观察组患者迟发性神经病的发生率低于对照组(P<0.05),运动传导速度(MCV)、感觉传导速度(SCV)优于对照组(P<0.05),提示改良型鼻肠管和鼻胃管联用于血液净化可有效预防重症有机磷农药中毒患者诱导迟发性多发神经病的发生,并有益于患者运动功能的恢复。结论:改良型鼻肠管和鼻胃管联用于血液净化可有效预防和治疗重症有机磷农药中毒患者诱导迟发性多发神经病的发生,可改善患者预后的康复。     

联合换血治疗重度急性有机磷农药中毒180例临床疗效观察

目的　为了提高重度急性有机磷农药中毒的抢救成功率 ,探讨换血治疗重度急性有机磷农药中毒的疗效。方法　对 3 6 0例重度急性有机磷农药中毒患者 ,随机分为换血组 (Ⅰ )和对照组 (Ⅱ )进行疗效对比。两组均接受阿托品及胆碱酯酶复能剂 (解磷定 )等综合治疗。Ⅰ组加用了换血治疗。结果　 ( 1)胆碱酯酶 (CHE)活力恢复正常所需时间 ,Ⅰ组平均 5 6d ,Ⅱ组平均 11d ;( 2 )阿托品平均总用量Ⅰ组 ( 5 5 7 2± 12 6 7)mg ,Ⅱ组 ( 15 10 2± 78 83 )mg ,Ⅰ组比Ⅱ组明显减少。 ( 3 )两组治疗效果比较Ⅰ组明显优于Ⅱ组。经统计学处理所有指标均差异显著。结论　重度急性有机磷农药中毒的治疗 ,换血组比对照组疗效更好。     

盐酸戊乙奎醚与氯解磷定治疗急性有机磷农药中毒疗效观察

目的:观察盐酸戊乙奎醚(长托宁)治疗急性有机磷农药中毒的疗效。方法:2003年1月我院收治的有机磷农药中毒57例患者作为治疗组,应用长托宁配合氯解磷定治疗,并以既往应用阿托品配合氯解磷定治疗的22例有机磷农药中毒患者作为对照组。结果:治疗组轻、中、重度的痊愈率(83·3%、88·2%、36·4%)均高于对照组(66·7%、50·0%、27·3%);抗胆碱药用药次数治疗组与对照组分别为2次~3次、120·5次(P<0·01)。结论:长托宁是一种较强的抗胆碱能新药,疗效可靠,易于掌握,值得推广。     

盐酸戊乙奎醚联合阿托品治疗有机磷农药中毒的应用

目的观察盐酸戊乙奎醚联合阿托品治疗急性有机磷农药中毒的临床疗效。方法 102例急性有机磷农药中毒的患者随机分为盐酸戊乙奎醚＋阿托品组和阿托品治疗组,两组同时给予氯解磷定治疗。结果盐酸戊乙奎醚＋阿托品组与阿托品治疗组比较,在中毒症状消失时间、阿托品化时间、恢复时间、血胆碱脂酶恢复时间、平均住院天数上均有显著性差异。盐酸戊乙奎醚＋阿托品组不良反应较阿托品治疗组明显减少。结论盐酸戊乙奎醚联合阿托品救治急性有机磷农药中毒副作用少、疗效高、安全可靠。     

长托宁治疗有机磷农药中毒临床观察

目的观察长托宁治疗有机磷农药中毒的疗效。方法有机磷农药中毒患者68例随机分为长托宁伍用氯解磷定作为治疗组,以阿托品伍用氯解磷定作为对照组,对两组疗效进行比较。结果治疗组比对照组起效时间快,症状消失时间短,用药时间、次数减少,胆碱酯酶活力恢复时间早,疗效好,治愈时间短,药物不良反应低。结论长托宁治疗有机磷农药中毒优于阿托品。     

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.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

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.     

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.