醒脑静联合乙酰谷酰胺治疗急性重度一氧化碳中毒的疗效

目的观察醒脑静联合乙酰谷酰胺在急性重度一氧化碳中毒治疗中的临床疗效。方法选择89例急性重度CO中毒患者,对照组予常规治疗加用乙酰谷酰胺治疗,观察组加用醒脑静注射液、乙酰谷酰胺治疗,比较两组患者的短期疗效,GCS评分及迟发性脑病的发生率。结果短期疗效比较:观察组49例,总有效率91.83%,对照组40例,总有效率92.5%,两组相比无显著差异,P>0.05;观察组显效41例,显效率83.67%,显著高于对照组62.5%,P<0.05;治疗24 h后两组患者GCS评分均有显著改善,观察组(12.33±2.01)分显著高于对照组(10.25±1.98)分,差异有统计学意义,P<0.05;观察组30 d内发生迟发性脑病2例,发生率为4.0%,对照组6例,发生率15%,两组发生率有显著差异,P<0.05。结论传统治疗联合应用醒脑静注射液、乙酰谷酰胺治疗急性重度一氧化碳中毒,不仅能取得较好的短期疗效,同时可以使迟发性脑病的发生率下降,疗效显著。     

早期大剂量纳洛酮治疗急性CO中毒临床观察

目的：探讨院前早期应用大剂量纳洛酮治疗急性CO中毒的疗效与安全性。方法：以随机对照设计对145例急性CO中毒昏迷患者进行临床研究．对照组采用常规治疗方案，治疗组在对照组的基础上接受院前早期应用大剂量纳洛酮。观察两组病例在治疗期间的Glascow评分变化、平均意识觉醒时间以及发病2个月时迟发性脑病的发生率的差异。结果：两组病例在治疗期间的Glascow评分、平均意识觉醒时间以及发病2个月时迟发性脑病的发生率等情况的差异显著。结论：院前早期廊用大剂量纳洛酮治疗急性CO中毒疗效显著．安全性高。     

氟美松对急性一氧化碳中毒预后的影响

目前一氧化碳(CO)中毒后迟发性脑病的发生机制尚不十分明确，在急性CO中毒后昏迷持续2～3天的患者易发生迟发性脑病，且尚无有效的预防及治疗手段。因此，对CO中毒后迟发性脑病的预防及预测显得尤为重要。为此，我们采用氟美松对20例急性CO中毒患者进行了治疗，发现迟发性脑病的发生率明显低于对照组，并得到了脑电图及头颅CT的证实。     

丁苯酞治疗急性一氧化碳中毒迟发性脑病59例

目的观察丁苯酞在急性一氧化碳（CO）中毒迟发性脑病治疗中的作用。方法在给予高压氧、脑细胞活化剂、糖皮质激素等治疗的基础上,治疗组30例加用丁苯酞200mg,4次／d,口服,对照组29例加用安慰剂,比较两组疗效。结果在急性CO中毒迟发性脑病患者的临床症状改善和头颅CT或MRI检查结果改善方面,治疗组优于对照组（P〈0．05）。结论丁苯酞治疗急性CO中毒迟发性脑病安全、有效。     

综合疗法治疗急性一氧化碳中毒的疗效观察

目的观察纳洛酮联合高压氧综合疗法治疗急性一氧化碳中毒的临床疗效。方法我科于2008年11月至2010年2月共收治97例急性一氧化碳中毒患者,随机分为对照组48例和观察组49例。两组患者均给予常规的对症支持治疗,对照组给予高压氧治疗,观察组在对照组的基础上给予纳洛酮,观察两组的临床疗效。结果观察组的总有效率为95.9%,对照组的总有效率为68.8%,两组比较差异有统计学意义（P〈0.05）;观察组的平均昏迷时间和迟发性脑病及病死率与对照组比较差异亦有统计学意义（P〈0.05）。结论纳洛酮联合高压氧综合疗法治疗急性一氧化碳中毒疗效显著,能明显缩短患者昏迷时间,减少迟发性脑病的发生率及病死率,值得推广应用,     

急性一氧化碳中毒及迟发性脑病的MRI表现与临床分析

目的 探讨急性一氧化碳中毒及迟发性脑病(DEACMP)患者的头颅磁共振成像特点.方法 对564急性CO中毒例和102例迟发性脑病患者行头颅MRI及DWI检查,急性期患者在入院后48h内进行检查,迟发性脑病者在临床出现异常表现后即行头颅MRI检查.结果 急性期CO中毒患者MRI表现可分为3型:(1)苍白球受累型;(2)弥漫性脑肿胀型;(3)大脑皮质及白质受累型.CO中毒迟发性脑病患者MRI表现可分为5型:(1)脑白质受累型;(2)基底节受累型;(3)枕叶皮层受累型;(4)小脑半球受累型;(5)多灶型.结论 急性CO中毒及CO中毒后迟发性脑病的MRI表现既有相同点又有区分点,临床应加以区分,应依据MRI的表现作出相应的诊断与治疗.     

纳洛酮治疗急性重度一氧化碳中毒65例体会

目的探讨纳洛酮救治急性重度一氧化碳中毒的效果。方法在急性重度一氧化碳中毒常规综合治疗基础上加用纳洛酮,据临床观察及出院随访结果对疗效进行综合评价。结果 65例患者中1例转院,64例痊愈出院,随访无一例出现迟发性脑病。结论纳洛酮治疗急性重度一氧化碳中毒疗效肯定,安全。     

高压氧救治急性一氧化碳中毒65例临床分析

目的提高急性一氧化碳（CO）中毒抢救成功率,降低神经系统后遗症。方法回顾分析2007年1月～2009年6月采用高压氧救治急性CO中毒65例。结果65例采用高压氧（HBO）及配合常规治疗,取得较好疗效。53例有意识障碍的中、重度中毒50%患者在2h内清醒,81.1%在6h内清醒。HBO治疗未发生明显不良反应,清醒时间、迟发性脑病发生率与对照组比较,具有显著差异性（P〈0.01）。结论HBO是急性CO中毒救治的有效方法,尤其是中、重度中毒患者。     

醒脑静注射液联合纳洛酮治疗重度CO中毒疗效观察

目的：观察醒脑静注射液联合纳洛酮治疗重度CO中毒疗效。方法：回顾性分析2014年6月～2015年6月本院诊治的100例重度CO中毒患者临床资料,按照治疗方式分为两组（各50例）,对照组采用纳洛酮治疗,研究组采用醒脑静注射液联合纳洛酮治疗,对比两组治疗情况。结果：研究组苏醒时间显著短于对照组,治疗总有效率94.00%显著高于对照组的78.00%,研究组迟发型脑病发生率8.00%显著低于对照组的22.00%（P＜0.05）。结论：醒脑静注射液联合纳洛酮治疗重度CO中毒疗效显著。     

急性一氧化碳中毒的脑电图改变分析

急性CO中毒的临床报道甚多,但有关急性CO中毒及其迟发性脑病脑电图分析的报道则较少。本文对26例急性CO中毒和8例迟发性脑病的EEG进行了动态观察分析。现报告如下。     

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.     

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.     

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.     

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.