突发性耳聋患者不同类型听力曲线与临床疗效关系分析

目的 分析突发性耳聋患者不同类型听力曲线与临床疗效的关系.方法 回顾性分析本院收治的113例(118耳)突发性耳聋患者临床资料,按不同的初始听力曲线分为低频型23耳,中频型9耳,高频型28耳,平坦型41耳和全聋型17耳5组.均在接受高压氧治疗的同时给予1~3周的静脉用药治疗.结果 经治疗后患者各型听力曲线有效率分别为:低频型95.7%,中频型77.8%,高频型60.7%,平坦型78%和全聋型52.9%.结论 不同类型听力曲线突聋患者中,低频型疗效最好,其次为平坦型、中频型,全聋型疗效最差.     

耳聋左慈丸联合甲泼尼龙治疗突发性耳聋的临床研究

目的研究耳聋左慈丸联合注射用甲泼尼龙琥珀酸钠治疗突发性耳聋的临床疗效。方法选取2017年1月—2018年12月阜阳市人民医院收治的103例突发性耳聋患者为研究对象,将所有患者采用随机数字表法分为对照组(51例)和治疗组(52例)。对照组患者鼓室注射注射用甲泼尼龙琥珀酸钠,40 mg溶于适当生理盐水,1次/2 d;治疗组患者在对照组基础上口服耳聋左慈丸,1丸/次,2次/d。两组患者接受治疗10 d。观察两组的临床疗效,比较两组的听力阈值、血液流变学指标、血清炎症因子水平。结果治疗后,对照组和治疗组的总有效率分别为82.35%、96.15%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者1、2、4 kHz的听力阈值较治疗前均显著下降,同组治疗前后比较差异具有统计学意义(P0.05);且治疗后治疗组患者1、2、4kHz的听力阈值明显低于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患者血浆黏度、纤维蛋白原和血小板聚集率均显著降低,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组患者血浆黏度、纤维蛋白原和血小板聚集率明显低于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患者超敏-C反应蛋白(hs-CRP)水平显著降低,白细胞介素-10(IL-10)水平显著升高,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组患者hs-CRP、IL-10水平明显优于对照组,两组比较差异有统计学意义(P0.05)。结论耳聋左慈丸联合注射用甲泼尼龙琥珀酸钠治疗突发性耳聋具有较好的临床疗效,能降低听力阈值,改善患者血液流变学指标,降低血清炎性因子水平,具有一定的临床推广应用价值。     

耳后骨膜下注射甲强龙治疗突发性耳聋的疗效观察

目的探讨耳后骨膜下注射甲强龙治疗突发性耳聋临床疗效。方法回顾我院2014年2月～2017年10月期间应用甲强龙治疗的127例突发性耳聋患者,根据甲强龙应用途径分为全身用药组及耳后注射组,对比其临床治疗疗效。结果耳后注射组总体有效率63.24%,全身用药组总体有效率44.07%,差异有统计学意义(P0.05)。亚组分析显示耳后注射组能明显提高低频下降型突发性耳聋患者总体有效率,而高频下降型、平坦下降型及全聋型组均无差别。结论耳后骨膜下注射甲强龙提高突发性耳聋患者特别是低频下降型总体有效率。     

参麦注射液联合长春西汀治疗突发性耳聋的疗效观察

目的探讨参麦注射液联合长春西汀注射液治疗突发性耳聋的临床疗效。方法选取2016年8月—2018年1月延安大学咸阳医院收治的突发性耳聋患者96例为研究对象,按照随机数字表法分为对照组和治疗组,每组各48例。对照组静脉滴注长春西汀注射液,20 mg加入到生理盐水250 m L中,1次/d。治疗组在对照组治疗基础上静脉滴注参麦注射液,20 m L加入到5%葡萄糖溶液250 m L,1次/d。两组患者均连续治疗14 d。观察两组的临床疗效,比较两组的听力和血液流变学。结果治疗后,对照组和治疗组的总有效率分别为77.08%、91.67%,两组比较差异有统计学意义(P0.05)。治疗后,两组低频区听阀、高频区听阀、平均纯音听阀均显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组听力指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组全血黏度、血浆比黏度、血沉方程K值、红细胞电泳指数、纤维蛋白原均明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组血液流变学指标明显低于对照组,两组比较差异具有统计学意义(P0.05)结论参麦注射液联合长春西汀注射液治疗突发性耳聋具有较好的临床疗效,可改善听力功能,调节血液流变学指标,安全性较好,具有一定的临床推广应用价值。     

突发性耳聋患者内耳循环障碍与血脂水平的相关性

目的探讨突发性耳聋患者内耳循环障碍与血脂水平的相关性。方法选择我院诊断及治疗的突发性耳聋患者86例为突聋组,同时选取同一时期来我院体检的健康者102名为健康组,2组均进行内耳道磁共振成像(MRI)扫描和血清总胆固醇(TC)、甘油三酯(TG)检测。结果与突聋组比较,健康组内听动脉、小脑前下动脉、基底动脉指标较高,TC、TG水平较低(P<0.05)。健康组在内听动脉、小脑前下动脉、基底动脉上,高于低频型组、高频型组、平坦型组、全聋型组,在TC、TG水平上低于低频型组、高频型组、平坦型组、全聋型组(P<0.05)。突聋患者不同严重程度患者间内耳微循环与血脂水平差异有统计学意义(P<0.05),在内听动脉、小脑前下动脉、基底动脉上,健康组>轻度组、中度组>重度组>极重度组,在TC、TG水平上,健康组<轻度组<中度组<重度组<极重度组,差异有统计学意义(P<0.05)。突聋患者内耳微循环指标与血脂水平呈负相关(P<0.05)。结论突发性耳聋患者存在内耳循环障碍和血脂异常,且二者之间呈负相关,对突发性耳聋的诊治具有一定的参考价值。     

葛根素注射液联合神经节苷脂钠治疗突发性耳聋的临床研究

目的探讨葛根素注射液联合神经节苷脂钠治疗突发性耳聋的临床疗效。方法选取2015年10月—2017年2月在宜兴市人民医院进行治疗的100例突发性耳聋患者为研究对象,根据用药的差别分为对照组(50例)和治疗组(50例)。对照组静脉滴注单唾液酸四己糖神经节苷脂钠注射液,40 mg加入生理盐水100 m L,1次/d。治疗组在对照组的基础上静脉滴注葛根素注射液,400 mg加入生理盐水250 m L,1次/d。两组患者均治疗10 d。评价两组患者临床疗效,同时比较治疗前后两组患者血清细胞因子水平、血液流变学指标和力阈值。结果治疗后,对照组和治疗组总有效率分别为80.00%和96.00%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血浆内皮素(ET)、可溶性血管细胞间黏附分子-1(s VCAM-1)水平降低,降钙素基因相关肽(CGRP)水平增高,同组比较差异具有统计学意义(P0.05);且治疗组患者血清细胞因子水平显著优于对照组(P0.05)。治疗后,两组患者血浆黏度(PV)、全血黏度高切(HS)、红细胞聚集指数(EAI)、纤维蛋白原(FIB)均显著降低(P0.05);且治疗组患者血液流变学指标明显低于对照组(P0.05)。治疗后,两组患者听力阈值均显著下降(P0.05);且治疗组患者听力阈值明显低于对照组(P0.05)。结论葛根素注射液联合神经节苷脂钠治疗突发性耳聋可有效改善血液流变学指标和血管内皮功能,有利于听力恢复,具有一定的临床推广应用价值。     

甲强龙静脉注射联合针灸治疗突发性耳聋的疗效观察

目的:探究针灸联合甲强龙静脉注射治疗突发性耳聋的临床疗效作用。方法:选择突发性耳聋患者入组联合治疗组和对照组,分别采取针灸联合甲强龙静脉注射治疗和药物治疗,比较两组间多疗程后疗效结果差异及治疗前后听力治疗差异。结果:治疗后联合治疗组总有效率高于对照组,疗效明显优于对照组(χ~2=7.134,P0.01),显著治愈和有效治疗率也均高于对照组;治疗后,各组听力损伤数值均下降,差异具有统计学意义。联合治疗组对听力的改善明显优于对照组(t=2.193,P0.05)。结论:针灸联合甲强龙静脉注射治疗突发性耳聋可通过中医调理和药物抗炎协同作用有效改善患者血黏度及耳局部微循环,提高治疗效果和患者听力恢复水平。     

脉血康胶囊联合巴曲酶治疗突发性耳聋的临床研究

目的探讨脉血康胶囊联合巴曲酶治疗突发性耳聋的临床效果。方法选取天津市泰达医院2015年10月—2017年10月收治的突发性耳聋患者114例,随机分为对照组(57例)和治疗组(57例)。对照组静脉滴注巴曲酶注射液,首剂量为10 BU加入100 mL生理盐水,隔日1次,维持剂量为5 BU/次,每次给药时间1 h。治疗组在对照组基础上口服脉血康胶囊,3粒/次,3次/d。两组均连续治疗10 d。观察两组患者临床疗效,同时比较治疗前后两组患者听力阈值、凝血–抗凝–纤溶系统指标、血液流变学指标和炎性因子水平。结果治疗后,对照组和治疗组的临床总有效率分别为77.2%和91.2%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者0.5、1、2、4 k Hz的听力阈值较治疗前均显著下降(P0.01),且治疗后治疗组听力阈值明显低于对照组(P0.01)。治疗后,两组血浆纤维蛋白原(FIB)水平和血清D-二聚体(D-D)水平均显著下降(P0.01),血清抗凝血酶Ⅲ(ATⅢ)水平显著上升(P0.01),且治疗后治疗组凝血–抗凝–纤溶系统指标优于对照组(P0.01)。治疗后,两组患者红细胞沉降率(ESR)、血浆黏度(PV)值较治疗前明显降低(P0.05),红细胞变形指数(EDI)值明显增加(P0.05),且治疗后治疗组血液流变学指标明显优于对照组(P0.05)。治疗后,两组患者白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α和超敏C反应蛋白(hs-CRP)水平均显著下降(P0.01),且治疗组上述炎性因子水平明显低于对照组(P0.01)。结论脉血康胶囊联合巴曲酶注射液治疗突发性耳聋可短期内消除患者耳周感觉异常、头晕等症状,有效调节凝血–抗凝–纤溶系统平衡,改善血液流变学状态,减轻炎性反应。     

凯时联合舒血宁治疗突发性耳聋的疗效观察

目的探讨凯时联合舒血宁治疗突发性聋的疗效。方法对95例(98耳)突发性耳聋患者随机抽样分组,分为甲组(舒血宁组)、乙组(凯时组)、丙组(凯时+舒血宁组),分别给予舒血宁、凯时、凯时联合舒血宁静滴。结果甲、乙、丙组总有效率分别为58.82%、58.06%、87.88%,甲、丙组间及乙、丙组间疗效均差异有统计学意义(均P<0.05),甲、乙组间疗效差异无统计学意义(P>0.05)。纯音电测听听力图中盆型、上升型、平坦型听力图预后较好,下降型及全聋型预后较差。结论凯时及舒血宁治疗突发性聋有效,凯时联合舒血宁治疗突发性聋效果更好,有显著的协同效应。     

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。     

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.     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.     

Biochemical and molecular characterisation of cubozoan protein toxins

Class Cubozoa includes several species of box jellyfish that are harmful to humans. The venoms of box jellyfish are stored and discharged by nematocysts and contain a variety of bioactive proteins that are cytolytic, cytotoxic, inflammatory or lethal. Although cubozoan venoms generally share similar biological activities, the diverse range and severity of effects caused by different species indicate that their venoms vary in protein composition, activity and potency. To date, few individual venom proteins have been thoroughly characterised, however, accumulating evidence suggests that cubozoan jellyfish produce at least one group of homologous bioactive proteins that are labile, basic, haemolytic and similar in molecular mass (42-46 kDa). The novel box jellyfish toxins are also potentially lethal and the cause of cutaneous pain, inflammation and necrosis, similar to that observed in envenomed humans. Secondary structure analysis and remote protein homology predictions suggest that the box jellyfish toxins may act as α-pore-forming toxins. However, more research is required to elucidate their structures and investigate their mechanism(s) of action. The biological, biochemical and molecular characteristics of cubozoan venoms and their bioactive protein components are reviewed, with particular focus on cubozoan cytolysins and the newly emerging family of box jellyfish toxins.     

Dose tolerability of chronically inhaled voriconazole solution in rodents

Invasive pulmonary aspergillosis (IPA) is a fungal disease of the lung associated with high mortality rates in immunosuppressed patients despite treatment. Targeted drug delivery of aqueous voriconazole solutions has been shown in previous studies to produce high tissue and plasma drug concentrations as well as improved survival in a murine model of IPA. In the present study, rats were exposed to 20 min nebulizations of normal saline (control group) or aerosolized aqueous solutions of voriconazole at 15.625 mg (low dose group) or 31.25 mg (high dose group). Peak voriconazole concentrations in rat lung tissue and plasma after 3 days of twice daily dosing in the high dose group were 0.85 ± 0.63 μg/g wet lung weight and 0.58 ± 0.30 μg/mL, with low dose group lung and plasma concentrations of 0.38 ± 0.01 μg/g wet lung weight and 0.09 ± 0.06 μg/mL, respectively. Trough plasma concentrations were low but demonstrated some drug accumulation over 21 days of inhaled voriconazole administered twice daily. Following multiple inhaled doses, statistically significant but clinically irrelevant abnormalities in laboratory values were observed. Histopathology also revealed an increase in the number of alveolar macrophages but without inflammation or ulceration of the airway, interstitial changes, or edema. Inhaled voriconazole was well tolerated in a rat model of drug inhalation.