急性有机磷中毒合并肝损伤患者AST、ChE、CRP动态变化及对病情的评估价值

目的动态监测急性有机磷中毒(acute organophosphorus pesticide poisoning,AOPP)合并肝损伤患者天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、胆碱酯酶(cholinesterase,ChE)和C反应蛋白(C-reactive protein,CRP)变化并评估其对病情转归的预测效能。方法选取2017年1月至2021年12月高邮市人民医院收治的60例AOPP合并肝损伤患者,根据病情转归情况分为生存组(31例)和病死组(29例),比较两组基线资料以及入院时、第3天和第7天AST、ChE、CRP变化,采用Cox回归分析AOPP预后的影响因素,采用受试者工作特征(receiver operator characteristic,ROC)曲线分析第3天AST、ChE、CRP对预后的预测价值。结果病死组有机磷暴露量多于生存组[(97.26±12.07)ml比(58.97±8.43)ml],APACHEⅡ评分[(31.23±6.86)分比(25.18±5.72)分]高于生存组;病死组入院第3天和入院第7天AST[3 d:(167.99±18.36)U/L比(91.35±16.58)U/L;7 d:(55.62±13.59)U/L比(28.71±6.44)U/L]、CRP高于生存组[3 d:(76.39±22.03)mg/L比(54.55±17.60)mg/L;7 d:(73.66±24.87)mg/L比(32.90±8.46)mg/L],ChE低于生存组[3 d:(44.59±7.08)%比(48.91±6.33)%;7 d:(43.12±8.53)%比(57.49±12.27)%],差异均有统计学意义(P均<0.05)。Cox回归分析表明有机磷暴露量(HR=15.791,95%CI:4.685~53.225,P<0.001)、APACHEⅡ评分(HR=12.166,95%CI:2.208~67.039,P<0.001)、入院第3天AST(HR=6.670,95%CI:1.162~38.283,P<0.001)、CRP(HR=8.208,95%CI:1.573~42.829,P<0.001)为AOPP患者预后不良的危险因素,入院第3天ChE为保护性因素(HR=0.362,95%CI:0.159~0.825,P<0.001)。入院第3天AST、ChE、CRP联合预测预后的ROC曲线下面积为0.900,均显著高于AST(0.852;Z=2.754,P=0.045)、ChE(0.804;Z=3.184,P=0.032)、CRP(0.818;Z=3.075,P=0.026)单独的ROC曲线下面积。结论AOPP合并肝损伤不同预后患者入院后AST、ChE、CRP呈现不同变化特点,动态监测三者变化有助于早期预测患者病情转归,为临床管理提供参考。

Alterations of serum cholinesterase in patients with gastric cancer

AIM: To understand the correlation of serum cholinesterase (CHE) activity with gastric cancer and to assess their clinical significance.METHODS: The velocity method was adopted to detect the activity of serum CHE in patients with gastric cancer and in patients with non-malignant tumor as controls.RESULTS: The serum CHE activity in the treatment group was significantly lower than that in the control group with a very significant difference between the two groups (83.3:113.1,P = 0.0003). Age was significantly associated with the incidence of gastric caner.CONCLUSION: Serum CHE activity has a close relation with the incidence of gastric cancer.

Stimulation by nizatidine,a histamine H_2-receptor antagonist,of duodenal HCO_3^-secretion in rats:relation to anti-cholinesterase activity

AIM To examine whether nizatidine stimulates duodenal HCO_3^- secretion in rats by inhibiting AChE activity. METHODS Under pentobarbital anesthesia,a proximal duodenal loop was perfused with saline,and the HCO_3 secretion was measured at pH 7.0 using a pH-stat method and by adding 10mM HCI.Nizatidine,neostigmine,carbachol or famotidine was administered i.v.as a single injection. RESULTS Intravenous administration of nizatidine(3-30 mg/kg)dose-dependently increased duodenal HCO_3^- secretion,and the effect at 10mg/kg was equivalent to that obtained by carbachol at 0.01 mg/kg.This nizatidine action was observed at the same dose range that inhibited acid secretion and enhanced gastric motility,mimicked by i.v.injection of neostigmine(0.03 mg/kg),and significantly attenuated by bilateral vagotomy and prior s.c. administration of atropine but not by indomethacin,a cyclooxygenase inhibitor,or N^G-nitro-L-arginine methyl ester,a NO synthase inhibitor.The HCO_3^- secretory response to acetylcholine(0.001 mg/kg)was significantly potentiated by the concurrent administration of nizatidine(3mg/kg,i.v.).The IC_(50)of nizatidine for AChE of rat erythrocytes was 1.4×10^(-6)M,about 12 times higher than that of neostigmine.Neither famotidine(>10^(-3)M, 30mg/kg,i.v.)nor cisapride(> 10^(-3)M, 3mg/kg,i.v.)had any influence on AChE activity or duodenal HCO_3^- secretion.Duodenal damage induced by acid perfusion(100 mM HCI for 4 h)in the presence of indomethacin was significantly prevented by nizatidine and neostigmine,at the doses that increased the HCO_3^- secretion. CONCLUSION Nizatidine stimulates duodenal HCO_3^- secretion,in both vagal-dependent and atropine-sensitive manners,and the action is associated with the anti-AChE activity of this agent.

Serum cholinesterase: A predictive biomarker of hepatic reserves in chronic hepatitis D

To determine the predictive performance of cholinesterase compared to existing prognostic models in evaluating liver function in patients with chronic hepatitis D. METHODSIn an observational, cross-sectional and retrospective study, consecutive patients with hepatitis D cirrhosis were evaluated. Demographic, clinical and laboratory parameters were recorded. Serum cholinesterase levels were correlated with existing scoring models for chronic liver disease and Liver function tests. Receiver operating characteristic (ROC) curves were constructed to find an optimal cholinesterase level predicting ascites, Child Turcotte Pugh (CTP) score ≥ 10, model for end stage liver disease (MELD) score ≥ 15, baseline-event-anticipation (BEA) score for hepatitis D ≥ 5 and the aspartate transaminase to Platelet Ratio Index (APRI) ≥ 1.5. RESULTSThis study investigated 233 patients with chronic liver disease due to hepatitis D; 192 were male, median age 42 (16-69 years). Fifty patients had ascites and 15 had encephalopathy. One hundred and sixty-seven (71.7%) were in Child class A, 52 (22.3%) in Child class B and 14 (5.0%) in class C. A MELD score of 15 or more was seen in 24 patients. Cholinesterase levels correlated well with the INR, albumin, CTP score, MELD, MELD sodium, BEA and APRI scores (P < 0.001 each). Area under the ROC curve for ascites, CTP ≥ 10, MELD ≥ 15, BEA ≥ 5, APRI ≥ 1.5 was 0.836, 0.966, 0.913, 0.871 and 0.825 respectively (P < 0.001 each). Cut off values of cholinesterase (IU/L) for predicting ascites, CTP ≥ 10, MELD ≥ 15, BEA ≥ 5 and APRI ≥ 1.5 were < 3812, < 2853, < 2829, < 4719 and < 3954 with a sensitivity of 80%, 100%, 91.67%, 82.50%, 58.0% and specificity of 81.97%, 84.79%, 87.56%, 77.06% and 55.64% respectively. CONCLUSIONSerum cholinesterase demonstrates promising correlations with serum albumin, INR and CTP, MELD, BEA and APRI scores and is predictive of liver reserves in hepatitis D cirrhosis.

CD64、PCT、SChE对感染性休克患者预后的预测价值

目的探究血清CD64、降钙素原(PCT)和胆碱酯酶(SChE)对感染性休克患者预后的预测价值。方法选取2020年1月至2022年12月皖北煤电集团总医院重症医学二科收治的感染性休克患者118例为研究对象,根据患者28 d预后分为生存组(n=98)与死亡组(n=20)。收集两组患者一般资料,采用全自动生化分析仪检测血清PCT、SChE,流式细胞检测仪检测血清CD64水平,比较两组患者血清CD64、PCT、SChE水平,并绘制ROC曲线评估上述指标单一及联合检测对感染性休克患者预后的预测价值。结果死亡组CD64、PCT水平、APACHEⅡ评分、血清乳酸、白细胞计数、C反应蛋白水平高于生存组,差异均具有统计学意义(t=3.942、7.723、5.246、11.530、6.533、4.426,P<0.05)。生存组血清SChE水平高于死亡组,差异有统计学意义(t=6.288,P<0.05)。多因素Logistic回归分析显示,CD64(β=1.251,OR=3.494)、PCT(β=0.562,OR=1.754)、SChE(β=0.961,OR=2.614)是感染性休克患者预后不良的独立影响因素(P<0.05)。ROC曲线显示,CD64、PCT、SChE三者联合检测时,预测感染性休克患者死亡的AUC为0.960,敏感性、特异性分别为90.0%、94.9%,优于单一检测(P<0.05)。结论感染性休克预后不良患者血清CD64和PCT水平明显升高,SChE水平明显降低,三者联合诊断可为感染性休克患者预后提供重要的参考依据。

Effects of Diazepam on Rat Cholinesterase andMembrane Stability of Red Cell in vitro

The results confirmed that diazepam inhibits the cholinesterase in rat serum,red cell,corpus striatum and diaphragm in vitro,that the higher the diazepam concentration,the stronger the cholinesterase inhibition,and that diazepam is a reversible inhibitor to acetylcholinesterase and diazepam has a stabilizing action on red cell membranes.The role of these effects of diazepam in the treatment of organic phosphate poisoning is discussed

Acetylcholinesterase,butyrylcholinesterase and paraoxonase 1 activities in rats treated with cannabis,tramadol or both

Objective:To investigate the effect of Cannabis sativa resin and/or tramadol,two commonly drugs of abuse on acetylcholinesterase and butyrylcholinesterase activities as a possible cholinergic biomarkers of neurotoxicity induced by these agents.Methods:rats were treated with cannabis resin(5,10 or 20 mg/kg)(equivalent to the active constituent A'-tetrahydrocannabinol),tramadol(5,10 and 20 mg/kg) or tramadol(10 mg/kg)combined with cannabis resin(5,10 and 20 mg/kg) subcutaneously daily for 6 weeks.Acetylcholinesterase(AChE) and butyrylcholinesterase(BChE) activities were measured in brain and serum.We also measured the activity of paraoxonase-1(PONl) in serum of rats treated with these agents.Results:(i) AChE activity in brain increased after 10-20 mg/kg cannabis resin(by 16.3%-36.5%).AChE activity in brain did not change after treatment with 5-20 mg/kg tramadol.The administration of both cannabis resin(5,10 or 20 mg/kg) and tramadol(10 mg/kg) resulted in decreased brain AChE activity by 14.1%,12.9%and 13.6%,respectively;(ii) BChE activity in serum was markedly and dose-dependenlly inhibited by cannabis resin(by 60.9%-76.9%).BChE activity also decreased by 17.6%-36.5%by 10-20mg/kg tramadol and by 57.2%-63.9%by the cannabis resin/tramadol combined treatment;(iii)Cannabis resin at dose of 20 mg/kg increased serum PONl activity by 25.7%.In contrast,tramadol given at 5,10 and 20 mg/kg resulted in a dose-dependent decrease in serum PON1 activity by 19%,36.7%,and 46.1%,respectively.Meanwhile,treatment with cannabis resin plus tramadol resulted in 40.2%,35.8%,30.7%inhibition of PONl activity compared to the saline group.Conclusions:these data suggest that cannabis resin exerts different effects on AChE and BChE activities which could contribute to the memory problems and the decline in cognitive function in chronic users.

Inhibition Mechanism of Cholinesterases by Carbamate: A Theoretical Study

The density functional theory at the B3LYP/6-311G（d, p） level was applied to exploring the inhibition mechanism of cholinesterases by carbamate. The results indicate that the inhibition reactions with or without the catalytic effect of the catalytic triad in eholinesterases underwent a two-step addition-elimination mechanism, which is in good agreement with the proposed mechanism. The solvent has a strong effect on the inhibition reactions and the reaction with the catalytic triad in the solvent phase is close to the real reaction under biological condition.

In vitro cholinesterase inhibitory and antioxidant effect of selected coniferous tree species

Objective:To explore cholinesterase inhibitory and antioxidant effect of six coniferous trees(Abies bornmulleriana,Picea pungens,Juniperus communis,Cedrus libani,Taxus baccata,and Cupressus sempervirens var.horizantalis).Methods:Acetone(Ace),ethyl acetate(EtOAc),and ethanol(EtOH)extracts prepared from the needles and shoots of the six coniferous trees were screened for their acetylcholinesterase(AChE)and butyrylcholinesterasc(BChE)inhibitory activity at 100μg/mL.Antioxidant activity of the extracts was tested using 2,2-diphenyl-1-picrylhydrazyl(DPPH)and N,N-dimethyl-p-phenylendiamine(DMPD)radical scavenging,nietal-chelation capacity,ferric-(FRAP)and phosphomolibdenum-reducing antioxidant power(PRAP)assays.All of the assays were performed in ELISA microplate reader.Total phenol and flavonoid amounts in the extracts were determined spectrophotometrically.Results:Among thirty-six extracts in total,the shoot-Ace extract of Cupressus sempervirens var.horizantalis exerted the highest inhibition against AChE[(54.84±2.51)%],while the needle-Ace extract of Cedrus libani was the most effective in inhibiting BChE[(67.54±0.30)%].The highest DPPH radical scavenging effect,FRAP and PRAP was observed in the shoot-Ace and EtOAc extracts from Taxus baccata.whereas all the extracts showed a variable degree of scavenging effect against DPMD radical.The shoot-EtOAc extract of Cedrus libani had the highest metalchelation capacity[(58.04±0.70)%].The shoot extracts of Taxus baccata were determined to have the richest total phenol content,which may contribute to its marked antioxidant activity.Conclusions:The conifer species screened in this study may contain cholinesterase-inhibiting and antioxidant properties,which might be useful against Alzheimer's disease.

Evaluation of HemogloBind^TMtreatment for preparation of samples for cholinesterase analysis

Acetylcholine is an essential neurotransmitter found throughout the nervous system. Its action on postsynaptic receptors is regulated through hydrolysis by various carboxylesterases, especially cholinesterases (ChEs). The acute toxicity of organophosphate (OP) compounds is directly linked to their action as inhibitors of ChE. One widely used assay for evaluating ChE activity is a spectrophotometric method developed by Ellman et al. When the enzyme source is from tissues or, in particular, blood, hemoglobin displays a spectrophotometric peak at the same wave-length used to analyze cholinergic activity. This creates a substantial background that interferes with the Ellman’s assay and must be overcome in order to accurately monitor cholinesterase activity. Herein, we directly compare blood processing methods: classical method (1.67 ± 0.30 U/mL) and HemogloBindTM treatment (1.51 ± 0.17 U/mL), and clearly demonstrate that pretreatment of blood samples with HemoglobindTM is both a sufficient and rapid sample preparation method for the assessment of ChE activity using the Ellman’s method.

Cholinesterase inhibitors for co-morbid Alzhemer’s disease dementia and schizophrenia: Systematic review and meta-analysis

Cholinergic dysfunction is common to Alzheimer’s dementia and Schizophrenia. The objective of this study is to undertake a systematic review and meta-analysis of the literature on the cognitive and clinical effects of cholinesterase inhibitors administered to patients with schizophrenia and co-morbid Alzheimer’s disease dementia. A literature search of the MEDLINE, CINAHL, PubMed, PsycINFO, EMBASE, AMED, BNI, HMIC and Health Business Elite databases has been performed (up to January 2013) to investigate the use of cholinesterase inhibitors in patients with schizophrenia and dementia. The terms “schizophrenia”, “dementia”, “rivastigmine”, “donepezil”, “galantamine” and “cognitive deficit” have been searched, with a restriction for English language. Five published studies including 1 RCT have been included for the qualitative review. Treatments include Donepezil 5 mg and 10 mg as well as Rivastigmine 9 mg. The numbers of participants vary from 2 incase report to20 inthe RCT. Only 1 study qualifies for meta-analysis. There is a very limited evidence on the efficacy and safety of using acetylcholinesterase inhibitors in the management of dementia co-morbid with schizophrenia. The only randomised controlled study shows lack of evidence in terms of efficacy in using cholinesterase inhibitors in the management of dementia with schizophrenia. Future research projects will have to look at an adequate sample size to explore treatment on various cognitive and noncognitive domains and the sample should be selected by using definitive and internationally acceptable diagnostic criteria.

多层螺旋CT联合血清ChEα-HBDH PGRN对肺结核合并肺癌的诊断价值

目的:探究多层螺旋CT联合血清胆碱酯酶(ChE)、α-羟丁酸脱氢酶(α-HBDH)、颗粒蛋白前体(PGRN)对肺结核合并肺癌的诊断价值。方法:选取2021年6月至2023年6月本院收治的84例肺结核患者,其中经过病理检测确诊为肺结核合并肺癌患者36例即为研究组,单纯肺结核患者48例为对照组。患者均进行多层螺旋CT检测。采用酶联免疫吸附试验(ELISA)法检测血清中ChE、α-HBDH、PGRN表达水平。ROC曲线分析多层螺旋CT联合血清ChE、α-HBDH、PGRN对肺结核合并肺癌的诊断价值。结果:研究组肿块、胸膜凹陷征、分叶征、胸腔积液、毛刺征、结节影占比显著高于对照组(P<0.05)。与对照组相比,研究组患者血清中ChE水平显著降低,α-HBDH、PGRN水平显著升高(P<0.05)。与单独诊断相比,多层螺旋CT联合血清ChE、α-HBDH、PGRN对肺结核合并肺癌诊断的AUC显著升高(z=3.497,P=0.001;z=4.310,P<0.001;z=3.328,P=0.001;z=4.518,P<0.001)。结论:肺结核合并肺癌患者血清ChE低表达,α-HBDH、PGRN高表达,多层螺旋CT联合血清ChE、α-HBDH、PGRN对肺结核合并肺癌具有较高诊断价值。

Effects of Cholinesterase Inhibitors in Cognition on Parkinson’s Disease Dementia: A Systematic Review and Meta-Analysis

Introduction: Dementia is frequently associated with Parkinson’s disease, especially in later stages. Efficacy of cholinesterase inhibitors (ChI) in Alzheimer’s dementia is well established. However, treatment with ChI in Parkinson’s disease dementia (PDD) remains controversial. The objective of this systematic review and meta-analysis was to assess the effects of ChI in PDD. Methods: A comprehensive literature search was performed in MEDLINE, EMBASE and Cochrane library up to March 2014 using the descriptors “Parkinson’s disease”, “dementia in Parkinson’s disease”, “cognition”, “acetylcholinesterase inhibitors”, “cholinesterase inhibitors”, “anticholinesterase agents”, “rivastigmine”, “donepezil” and “galantamine” (Pubmed search strategy). All randomized, doubleblinded, placebo-controlled trials that met the eligibility criteria and assessed the effects of ChI in PDD were considered for analysis. There were no restrictions regarding paper language. Summary effect-sizes were presented as standardized mean differences (SMD) and the pooled analysis was performed with a fixed-effects model. Outcomes considered for analysis were the Mini Mental Status Exam (MMSE) score and the cognition scale for evaluation of dementia ADAS-Cog. The degree of heterogeneity between included studies was assessed through the I2 test. Results: After a comprehensive search, 175 references were retrieved. From these, five randomized trials involving 946PDD subjects were included in the review. Four studies used donepezil and only one study used rivastigmine. The pooled analysis of five studies that assessed the effects of ChI in MMSE total score showed a SMD of 0.24 (CI 95% 0.11 - 0.38). Three studies considered the effects of ChI on Adas-Cog and the pooled results showed a SMD of 0.21 (CI 95% 0.07 - 0.35). There was no significant heterogeneity between the studies. Conclusions: The results of this systematic review and meta- analysis suggest that ChI improves cognitive impairment in PDD subjects. Despite statistically significant, the translation of these results into relevant clinical improvement should be taken with caution, as the studies did not address what would be considered a clinically significant result.

Synthesis and Evaluation of Two Novel Naphthol Derivatives as Novel Cholinesterase Inhibitors

Two novel naphthol derivatives（1 and 2） were synthesized and characterized via IR,~1H NMR,and HRMS.The structure of compound 2 was verified by single-crystal X-ray crystallography.It crystallizes in monoclinic,space group C2/c with a = 21.6725（9）,b = 6.0127（3）,c = 25.5405（14） A,β = 94.716（5）o,V = 3316.9（3） A^3,Z = 8,F（000） = 1384,D_c = 1.511 Mg/m^3,M_r = 377.22 and μ = 2.487 mm^-1.In addition,their cholinesterase inhibitory activities in vitro toward Electrophorus electricus acetylcholinesterase（eel ACh E） and horse serum butyrylcholinesterase（eq BCh E） were further determined.The results showed that compound 1 as a new acetylcholinesterase（ACh E） inhibitor displayed higher ACh E inhibitory activity（IC_（50） = 1.4 μM）,which could be considered for Alzheimer＇s disease therapeutics.

The Prediction Value of the Infection Probability Score (IPS) Combined with Serum Cholinesterase and D-Dimer Detection for Infection and Survival in Critically Ill Patients

Objective: To evaluate early prediction value of IPS combined with SchE and D-dimer detection for infection and survival in critically ill patients. Methods: 199 critically ill patients admitted to the emergency intensive care unit (EICU) of our hospital from December 2018 to December 2019 were retrospectively analyzed, including 110 infection patients (infection group) and 89 non-infection patients (non-infection group). According to the survival, the infection group was divided into death group (68 cases) and survival group (42 cases). The IPS, APACHE II, SOFA and SchE, D-dimer expression levels were detected and compared;Univariate and logistic regression analysis were used to evaluate the independent prognostic factors. Results: The IPS and APACHE II of patients in the infected group were higher than those in the non-infected group, the level of SchE was lower than that in the non-infected group, and the level of D-dimer was higher than that in the non-infected group (P < 0.001). IPS, SOFA, APACHE II, SchE, D-dimer, invasive mechanical ventilation, septic shock, and ICU length of stay had significant influence on the prognosis of critically ill patients (P < 0.001). Logistic regression analysis showed that IPS (OR = 2.821, 95% CI 1.501 - 5.227), SOFA (OR = 5.078, 95% CI 3.327 - 7.690), APACHE II (OR = 14.308, 95% CI 8.901 - 21.893), SchE (OR = 0.223, 95% CI 0.165 - 0.291), D-dimer (OR = 2.10, 95% CI 1.55 - 2.85), septic shock (OR = 9.948, 95% CI 7.012 - 17.012) were independent factors affecting the prognosis of critically ill patients with infection (P < 0.001). Conclusion: IPS and D-dimer expression level in infected patients were increased and SchE decreased significantly compared with those in non-infected patients, and they significantly correlated with disease severity of infected patients and could be early prediction for prognosis.

碘解磷定联合长托宁治疗对有机磷农药中毒患者外周血NLR、LAC、CHE水平的影响

目的探讨分析碘解磷定联合长托宁治疗对有机磷农药中毒(AOPP)患者外周血中性粒细胞-淋巴细胞比值(NLR)、血乳酸(LAC)、CHE(胆碱酯酶)水平的影响。方法选取2019年1月至2023年1月六安世立医院重症医学科收治的有机磷农药中毒患者合计100例,随机分为对照组及联合组各50例,两组均给予常规急诊治疗和长托宁进行治疗,联合组在前者基础上联合碘解磷定进行治疗。比较两组临床疗效、CHE拐点时间、中毒症状消失时间、机械通气时间和平均住院时间;比较两组治疗前后外周血NLR、LAC、CHE表达情况及心肌酶谱[乳酸脱氢酶(LD)、肌酸激酶(CK)]及肝功能[谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)]水平。结果治疗后,联合组临床疗效高于对照组,差异有统计学意义(χ^(2)=4.396,P<0.05);联合组CHE拐点时间、中毒症状消失时间、机械通气时间、平均住院时间较对照组均有缩短,差异有统计学意义(t=3.882,4.629,2.065,4.339,P<0.05);治疗后,两组外周血CHE水平较治疗前均明显升高且联合组升高更明显,NLR、LAC则明显降低且联合组下降更明显,差异有统计学意义(t=7.949,5.091,4.647,P<0.05);治疗后,两组LD、CK及TBIL、ALT、AST较治疗前均明显下降且联合组下降更明显,差异有统计学意义(t=3.568,4.469,4.894,3.447,5.896,P<0.05)。结论碘解磷定联合长托宁可有效改善AOPP患者外周血LAC、CHE、NLR表达,临床疗效确切。

Effects of hemoperfusion and hemofiltration combination on treating patients with acute organophosphours pesticide poisoning and influence of it on cholinesterase, dopamine and inflammatory factors

Objective:To investigate effects of hemoperfusion and hemofiltration combination on treating patients with acute organophosphours pesticide poisoning (AOPP) and influence of it on cholinesterase, dopamine and inflammatory factors.Methods:A total of 82 cases of AOPP patients treated in our hospital from Sep 2012 to Jul 2016 were selected as subjects. They were randomly divided to be the observation group and the control group, 41 cases for each. For patients in observation group, combined therapy of hemoperfusion (HP) and hemofiltration (HF) were provided. For patients in control group, combined therapy of HP and hemodialysis (HD) were provided. Effects on the two groups of patients were compared. Meanwhile, cholinesterase, dopamine and inflammatory factors levels in different times before and after treatment were compared.Results:Consciousness improvement times and hospitalization times in observation group were significantly lower than in control group. No significant difference showed on fatality rates between the two groups. Before treatment, no significant difference showed on CHE and DE levels between two groups of patients;6 h and 12 h after treatment, CHE average levels in two groups were significantly higher than before treatment in the same group, and levels in observation group at the same phase were significantly higher than in control group;6 h and 12 h after treatment, DA levels in observation group were significantly lower than the same group before treatment, and significantly lower than control group, while 12 h after treatment, DA levels in control group were significantly lower than the same group before treatment. Before treatment, no significant difference showed on serum TGF-β1, TNF-α, IL-6, IL-8 between two groups of patients. After treatment, each index levels in two groups were significantly lower than the same group before treatment, and levels in observation group at the same phase were significantly lower than control group. Conclusion:Effects of blood purification therapy on treating AOPP were worth approving, but effects of HP and HF combined therapy were more significant. In addition, improvement of HP+HF on CHE, DA and inflammatory factors were better than HP+HD.

盐酸戊乙奎醚联合氯解磷定治疗ASOPP患者的疗效及对肾功能、血清PCT、CHE和CRP水平的影响

目的 探讨盐酸戊乙奎醚联合氯解磷定治疗急性重度有机磷中毒(ASOPP)患者的疗效及对肾功能、血清降钙素原(PCT)、胆碱酯酶(CHE)、C反应蛋白(CRP)水平的影响。方法 采用随机数字表法将2018年1月至2023年1月皖南医学院附属太和医院收治的100例急性重度有机磷中毒患者分为观察组(n=50)和对照组(n=50)。两组均予以常规治疗,对照组予以氯解磷定,观察组予以盐酸戊乙奎醚和氯解磷定联合治疗,比较两组治疗效果、治疗前后肾功能[血清肌酐(Scr)、β2-微球蛋白(β2-MG)、胱抑素C(Cys-C)]、治疗前后CHE、PCT、CRP、不良反应情况。结果 治疗后,观察组CHE恢复时间以及住院时间短于对照组,治愈率高于对照组,差异有统计学意义(P<0.05);治疗后,观察组Scr、β2-MG、Cys-C、PCT、CRP水平均低于对照组,CHE高于对照组,差异有统计学意义(P<0.05);两组不良反应发生情况比较差异无统计学意义(P>0.05)。结论 盐酸戊乙奎醚联合氯解磷定治疗可提高ASOPP患者血清CHE活性,缩短治疗时间,改善肾功能、降低血清PCT、CRP水平,且不会增加不良反应。

Changes of serum pancreatic stone protein and cholinesterase contents in children with sepsis and their correlation with systemic inflammatory response and target organ damage

Objective: To study the changes of serum pancreatic stone protein (PSP) and cholinesterase (ChE) contents in children with sepsis and their correlation with systemic inflammatory response and target organ damage. Methods: A total of 64 children with sepsis who were treated in the hospital between January 2015 and January 2017 were selected as observation group, and 50 healthy children who received vaccination in the hospital during the same period were selected as normal control group. The contents of PSP, ChE, inflammatory factors as well as liver and kidney function indexes in the two groups were detected. Pearson test was used to assess the correlation of serum PSP and ChE contents with systemic inflammatory response and target organ damage in children with sepsis. Results: Serum PSP content of observation group was higher than that of control group while ChE content was lower than that of control group;serum inflammatory factors PCT, CRP, IL-1, IL-6 and IL-10 contents of observation group were higher than those of normal control group;liver function indexes TBIL, ALT and AST contents were higher than those of normal control group;kidney function indexes Scr and BUN contents were higher than those of normal control group. Pearson test showed that the serum PSP and ChE contents in children with sepsis were directly correlated with the systemic inflammatory response as well as liver and renal function injury. Conclusion: Serum PSP content significantly increases while ChE content significantly decreases in children with sepsis and the specific change is directly correlated with the overall disease severity.

AST联合CHE、TBIL、ALT、ALB诊断肝硬化患者的应用价值分析

目的分析在肝硬化诊断中合用天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、胆碱酯酶(cholinesterase,CHE)、总胆红素(total bilirubin,TBIL)、谷丙转氨酶(alanine sminotransferase,ALT)、血清白蛋白(albumin,ALB)诊断的价值。方法非随机选取吉林市第二人民医院于2021年1月—2023年1月期间接收的82例肝硬化患者和60例健康体检人员作为研究对象,全部经生化检验测得其AST、CHE、TBIL、ALT、ALB水平,对比健康体验人员与肝硬化患者各生化指标间的差异,并分析AST联合CHE、TBIL、ALT、ALB诊断肝硬化的价值。结果肝硬化组CHE(2009.27±80.06)U/L、ALB(20.14±2.14)g/L水平均低于健康组,且AST(57.69±7.96)U/L、ALT(66.35±5.06)U/L、TBIL(93.56±8.42)μmol/L均高于健康组,差异有统计学意义(t=202.078、36.785、34.264、70.103、73.899,P均<0.05);AST联合CHE、TBIL、ALT、ALB诊断肝硬化患者的曲线下面积(area under curve,AUC)为0.894、特异度为90.04%、灵敏度为89.56%,均高于各指标单一检测的AUC、特异度及灵敏度。结论AST、CHE、TBIL、ALT、ALB等指标联合对肝硬化患者进行检测,能够进一步提高诊断价值,为临床早期诊治提供参考依据。