A solid-phase extraction approach for the identification of pharmaceutical–sludge adsorption mechanisms

It is important to understand the adsorption mechanism of chemicals and active pharmaceu-tical ingredients （API） on sewage sludge since wastewater treatment plants are the last barrier before the release of these compounds to the environment. Adsorption models were developed considering mostly hydrophobic API-sludge interaction. They have poor predictive ability, especially with ionisable compounds. This work proposes a solid-phase extraction （SPE） approach to estimate rapidly the API-sludge interaction. Sludge-filled SPE cartridges could not be percolated with API spiked mobile phases so different powders were tested as SPE sludge supports. Polytetrafluoroethylene （PTFE） was selected and tested at different PTFE/sludge ratios under eight different adsorption conditions with three API ionisable compounds. The PTFE/sludge mixtures with 50% or less sludge could be used in SPE mode for API sorption studies with methanol/water liquid phases. The results gave insights into API-sludge interactions. It was found that π-π, hydrogen-bonding and charge-charge interactions were as important as hydrophobicity in the adsorption mechanism of charged APIs on sludge.

Clinical effects investigation of continuous plasma filtration with adsorption and continuous hematodialysis on improving the immune level of patients with sepsis in ICU

Objective:To investigate the clinical effects of continuous plasma filtration with adsorption and continuous hematodialysis on improving the immune level of patients with sepsis in ICU. Methods:A total of 80 patients with sepsis were randomly divided into study group and control group, 40 patients in each group. All the patients were treated by routine treatment. Patients in study group were treated by continuous plasma filtration with adsorption and patients in control group were treated by continuous hematodialysis. The blood samples were collected before and after treatment. The immune cell level, inflammatory factors level, APACHEⅡ score and death rate were compared between two groups.Results:All immune cell indexes were significantly improved in both groups. All immune cell indexes in study group were significantly better than those in control group, after treatment. All inflammatory factors were significantly decreased in both groups. All inflammatory factors in study group were significantly better than those in control group, after treatment. The APACHEⅡ in study group was significantly better than that in control group, after treatment. The death rate in study group was significantly less than that in control group.Conclusion:Continuous plasma filtration with adsorption has a great clinical efficacy on patients with sepsis in ICU, which can improve the immune level and prognosis, makes it worth for clinical application.

Efficacy of artificial liver support system in severe immuneassociated hepatitis caused by camrelizumab:A case report and review of the literature

BACKGROUND Immune checkpoint inhibitors(ICIs)can lead to immune-related hepatitis(IRH)and severe liver damage,which is life-threatening in the absence of specific treatment.CASE SUMMARY A 75-year-old man was admitted to our hospital complaining of loss of appetite,yellow urine,and abnormal liver function for the past 2 wk.Three months prior to admission,he was treated with two rounds of capecitabine in combination with camrelizumab for lymph node metastasis of esophageal cancer.Although liver function was normal before treatment,abnormal liver function appeared at week 5.Capecitabine and camrelizumab were discontinued.Ursodeoxycholic acid and methylprednisolone 40 mg daily were administered.Liver function continued to deteriorate.Prothrombin time and international normalized ratio were 19 s and 1.8,respectively.The patient was diagnosed with acute liver failure.A pathological analysis of liver biopsy indicated a strongly positive immunohistochemical staining of T8+cells,thereby suggesting that drug-induced liver injury was related to IRH caused by camrelizumab.Subsequently,we performed sequential dual-molecule plasma adsorption system(DPMAS)treatment with plasma exchange(PE).After two rounds of treatment,the patient's appetite significantly improved,the yellow color of urine reduced,and liver function improved(total bilirubin level decreased)after five rounds of treatment.Liver function normalized 4 wk after discharge.CONCLUSION The use of sequential DPMAS with PE can reduce liver injury and systemic toxic reactions by clearing inflammatory mediators and harmful substances from blood,and regulate immune cell activity,which may be effective in the treatment of severe ICI-induced IRH.

脓毒症的血液净化策略

脓毒症是机体对感染免疫失调导致危及生命的器官功能障碍。当感染发生时,病原体相关分子模式(pathogen-associated molecular patterns,PAMPs)启动炎症反应,以清除病原体。然而,免疫系统的强烈激活可能导致细胞功能障碍和器官衰竭。其受损的宿主细胞释放损伤相关分子,并通过损伤相关分子模式(damage-associated molecular patterns,DAMPs)途径放大炎症反应形成细胞因子风暴。有趣的是,在脓毒症期间,中性粒细胞从强大的抗菌保护效应转变为组织损伤和器官功能障碍的危险介质。而血液净化作为脓毒症的重要治疗策略,其清除目标也发展到了除炎症介质外的免疫细胞。这篇综述总结了脂多糖、细胞因子、DAMPs和中性粒细胞在脓毒症发病机制中的作用,详述了脓毒症时靶向内毒素、细胞因子、炎症级联反应上游(免疫细胞)的不同血液净化方式及相应的临床研究。

Solid-phase extraction and separation of indium with P_(2)O_(4)-UiO-66-MOFs (di-2-ethylhexyl phosphoric acid-UiO-66-metal-organic frameworks)

Compared with the traditional liquid–liquid extraction method,solid-phase extraction agents are of great significance for the recovery of indium metal due to their convenience,free of organic solvents,and fully exposed activity.In this study,P_(2)O_(4)(di-2-ethylhexyl phosphoric acid)was chemically modified by using UiO-66 to form the solid-phase extraction agent P_(2)O_(4)-UiO-66-MOFs(di-2-ethylhexyl phosphoric acid-UiO-66-metal-organic frameworks)to adsorb In(Ⅲ).The results show that the Zr of UiO-66 bonds with the P-OH of P_(2)O_(4) to form a composite P_(2)O_(4)-UiO-66-MOF,which was confirmed by X-ray photoelectron spectroscopy(XPS)and Fourier transform infrared spectroscopy(FT-IR).The adsorption process of indium on P_(2)O_(4)-UiO-66-MOFs followed pseudo first-order kinetics,and the adsorption isotherms fit the Langmuir adsorption isotherm model.The adsorption capabilities can reach 192.8 mg/g.After five consecutive cycles of adsorption-desorption-regeneration,the indium adsorption capacity by P_(2)O_(4)-UiO-66-MOFs remained above 99%.The adsorption mechanism analysis showed that the P=O and P-OH of P_(2)O_(4) molecules coated on the surface of P_(2)O_(4)-UiO-66-MOFs participated in the adsorption reaction of indium.In this paper,the extractant P_(2)O_(4) was modified into solid P_(2)O_(4)-UiO-66-MOFs for the first time.This work provides a new idea for the development of solid-phase extractants for the recovery of indium.

1例哌拉西林钠/舒巴坦钠致免疫性溶血性贫血患者治疗的药学实践

1例65岁男性患者,因“突发意识障碍2 h”入院,诊断为右侧丘脑出血、吸入性肺炎。入院时血红蛋白正常。入院后行双侧侧脑室钻孔外引流术,积极给予抗感染治疗,效果欠佳,医师请临床药师会诊。经临床药师建议调整抗感染方案为哌拉西林钠/舒巴坦钠(6 g,q 8 h,ivgtt)联合阿米卡星,治疗后患者肺部感染好转,但血红蛋白呈进行性下降。临床药师分析贫血为哌拉西林钠/舒巴坦钠相关不良反应,建议停用该药。通过微柱凝胶法,最终判断为哌拉西林钠/舒巴坦钠的非免疫蛋白吸附机制诱发的药物性免疫性溶血性贫血。停药后患者血红蛋白逐渐回升。之后患者体温反复,临床药师建议停用抗菌药物并给予中医药协助治疗,后患者体温降至正常,病情稳定出院。

电化学生物传感器研究进展

电化学生物传感器对临床医学和遗传工程的研究具有深远的意义和应用价值,已逐渐成为分子生物学和生物技术研究重要领域。近些年来,关于它的性能和检测方法的优化研究也越来越多。本文主要介绍电化学生物传感器的原理、分类及最近几年来国内外的一些研究进展。

免疫吸附疗法在急性炎症性脱髓鞘性多发性神经病中的疗效研究

目的：分析免疫吸附疗法（IA）在急性炎症性脱髓鞘性多发性神经病（AIDP）中的疗效,并与传统的血浆置换疗法（PE）进行对比。方法：分析2011年1月-2014年1月在我院接受治疗的AIDP患者的临床资料,依据患者治疗方法不同分为观察组（IA法治疗）、对照组（PE法治疗）。结果：治疗后2周,观察组患者Hughes评分显著低于对照组（2.31±0.94 vs.2.85±1.02;t=2.085,P=0.042）。治疗后观察组患者C-反应蛋白水平显著低于对照组[（7.21±2.89）mg/L vs.（11.51±3.35）mg/L;t=5.194,P〈0.001）];治疗后观察组患者肿瘤坏死因子-a（TNF-α）水平显著低于对照组[（21.25±7.15）mg/Lvs.（28.40±8.65）mg/L;t=3.400,P=0.001）]。Pearson相关性分析显示,Hughes评分与C-反应蛋白呈现显著性正相关（r=0.463,P〈0.001）;Hughes评分与TNF-α呈现显著性正相关（r=0.491,P〈0.001）。结论：免疫吸附疗法治疗AIDP疗效可靠,其清除血浆促炎因子的疗效优于血浆置换。

糙叶败酱大孔吸附树脂提取物对荷瘤小鼠红细胞免疫功能的影响

目的观察糙叶败酱大孔吸附树脂提取物对荷瘤小鼠红细胞免疫功能的调节作用。方法D101大孔吸附树脂分离糙叶败酱水提物,测定其多糖含量和皂甙含量;糙叶败酱提取物作用于荷瘤小鼠(S180),观察生命延长率,检测红细胞C3b受体花环率、红细胞免疫复合物花环率、红细胞肿瘤细胞花环率和红细胞膜CD35和CD44s数量。结果糙叶败酱大孔吸附树脂提取物中多糖含量为21.4%,皂甙含量为41.8%,作用于荷瘤小鼠,生命延长率增加,红细胞C3b受体花环率和红细胞肿瘤细胞花环率升高,红细胞免疫复合物花环率降低,红细胞天然免疫活性得到改善,同时红细胞膜CD35和CD44s数量增加,与模型组比较,差异有显著性(P<0.05或P<0.01)。结论糙叶败酱大孔吸附树脂提取物有一定的红细胞免疫调节作用。

南瓜多糖抑瘤及增强红细胞免疫吸附作用研究

目的探讨南瓜多糖体内体外的抗肿瘤作用以及对红细胞免疫功能的影响。方法 (1)MTT法检测南瓜多糖对H22细胞增殖的影响。(2)建立H22荷瘤小鼠肿瘤模型,观察南瓜多糖对瘤块重量及红细胞免疫吸附肿瘤细胞能力的影响。结果南瓜多糖可抑制H22细胞增殖,中高剂量组细胞生长抑制率分别为33.7%、40.3%,与对照组相比有显著差别。南瓜多糖可抑制肿瘤的生长,抑瘤率为55.8%,与对照组相比有显著差别。南瓜多糖可增强红细胞免疫吸附能力。结论南瓜多糖具有一定的抗肿瘤及提高免疫活性的作用。

连续血浆滤过吸附与连续血液透析改善ICU脓毒血症患者免疫水平效果分析

目的:探讨连续血浆滤过吸与连续血液透析在治疗脓毒血症中的临床效果。方法:选取入院治疗的脓毒血症患者80例随机分为研究组和对照组,每组40例。两组患者均给予脓毒血症基础治疗,研究组给予连续血浆滤过吸附,对照组给予连续血液透析。于治疗前后抽取采集患者的血标本,检测治疗前后两组患者的免疫细胞指标、炎症因子水平、APACHEⅡ评分和病死率统计,并进行比较分析。结果:两组治疗后各免疫水平均得到显著改善(P<0.05),然而研究组改善效果均显著优于对照组(P<0.05)。两组治疗后各炎症反应水平均得到显著改善(P<0.05),然而研究组改善效果均显著优于对照组(P<0.05)。两组治疗后的APACHEⅡ评分和病死率均存在统计学差异(P<0.05)。结论:连续血浆滤过吸附治疗在脓毒血症患者的血液净化治疗中效果更佳,具有临床应用价值。

血液净化治疗系统性红斑狼疮

目的为评价血浆置换和免疫吸附治疗系统性红斑狼疮的疗效提供客观依据。方法将47例系统性红斑狼疮患者分为两组,36例采用血浆置换治疗,11例采用免疫吸附治疗。观察两组治疗前后抗核抗体、抗双链DNA抗体清除效果,以及免疫球蛋白变化情况。结果血浆置换后,补体C4、白蛋白水平升高,IgG、IgA和IgM水平下降(P<0.0 5),抗核抗体转阴率为2 3.3%,抗双链DNA抗体转阴率为5 5.2%。免疫吸附后,抗核抗体转阴率为3 3.3%,抗双链DNA抗体转阴率为6 6.7%。两组比较无统计学意义(P>0.05)。结论血液净化治疗系统性红斑狼疮可以清除血液中与免疫有关的某些致病因子。

难治性类风湿关节炎的免疫净化治疗及护理

目的:观察血浆置换和免疫吸附治疗难治性类风湿关节炎的疗效,探索总结合理的护理方案。方法:11例活动期类风湿关节炎患者接受血浆置换或免疫吸附治疗4～5次,在治疗期间做好患者的宣教、治疗前准备、规范化操作、治疗过程中的监护和并发症的处理。结果:与治疗前比较,治疗后患者关节压痛数、关节压痛指数、关节肿胀数、关节肿胀指数和静息痛评分均明显降低(P<0.05);类风湿因子、C-反应蛋白、红细胞沉降率均明显降低(P<0.05)。有3例出现轻度过敏反应,2例出现低血压,经对症处理后缓解。结论:免疫净化治疗有助于迅速缓解活动期类风湿关节炎患者的病情,不良反应较少,是治疗难治性RA的有效方法之一。充分的术前准备、规范化的操作和密切的观察是免疫净化治疗成功的关键。

免疫吸附洗脱液细菌内毒素检查方法的研究

目的血液透析过程中如有热原存在,可直接对长期维持血液透析的患者造成一系列全身性组织器官并发症,影响患者生存质量。文中建立免疫吸附洗脱液细菌内毒素的检查方法。方法依据《中国药典》2010年版二部附录XI E细菌内毒素检查法中凝胶半定量试验方法对免疫吸附洗脱液进行干扰试验。结果用去热原的碳酸钠饱和溶液将免疫吸附洗脱液原液pH值调至6.5,可对其进行凝胶半定量试验。结论所建方法可用于免疫吸附洗脱液细菌内毒素的检查。

免疫吸附治疗系统性红斑狼疮的临床分析

目的探讨免疫吸附对系统性红斑狼疮(SLE)的治疗效果。方法对12例重症SLE患者给予免疫吸附治疗,每次间隔3～5 d,连续2次,观察患者免疫吸附治疗前后抗核抗体、双链DNA抗体、免疫球蛋白LgG、补体C3指标变化程度及临床症状和体征的变化。结果抗核抗体、双链DNA抗体和免疫球蛋白LgG均有明显下降,补体C3升高,临床症状有不同程度的缓解。结论免疫吸附能有效控制SLE活动,明显改善临床症状,是治疗重症SLE的有效方法。

酵母细胞壁在动保中的应用研究进展

在畜禽水产养殖生产过程中,由于养殖环境、饲料、管理等因素造成生产动物免疫抑制、霉菌毒素污染、疾病等一系列问题。酵母细胞壁的主要功能性成分为甘露聚糖和葡聚糖,由于甘露聚糖可吸附病原菌,葡聚糖能刺激机体免疫力,使其可用于免疫增强、霉菌毒素吸附、抗应激等,因此利用酵母源物质酵母细胞壁解决养殖生产中的实际问题越来越受到重视。

血液灌流器吸附材料研究进展

血液灌流技术由于其显著的疗效而被广泛应用,治疗的疾病从一般性的药物中毒到系统性红斑狼疮等免疫性疾病。本文阐述了血液灌流器吸附材料的发展和工作原理,重点介绍了活性炭吸附材料和高分子吸附树脂,并分析与评价了几类血液灌流器吸附材料的特点及发展趋势。

免疫吸附对系统性红斑狼疮自身抗体影响的研究

目的探讨免疫吸附对系统性红斑狼疮自身抗体的影响。方法14例患者均给予免疫吸附治疗,每次间隔3～5 d,连续3次。同时,患者既往应用药物激素及免疫抑制剂在免疫吸附治疗1次后,视病情逐渐减量。结果抗核抗体、抗ds-DNA抗体滴度均明显下降。结论免疫吸附可明显降低系统性红斑狼疮患者自身抗体滴度。

免疫吸附在重症狼疮患者中的疗效观察

目的评价重症狼疮患者实施免疫吸附治疗的临床疗效。方法将64例重症狼疮患者随机分为两组,对照组32例实施常规治疗方法,观察组32例实施免疫吸附治疗。结果在治疗总有效率上,观察组与对照组分别为93.75%、65.63%;观察组治疗总有效率明显要比对照组高(P<0.05)。经积极治疗,观察组血尿素氮、血清肌酐水平改善效果明显优于对照组(P<0.05)。结论重症狼疮患者实施免疫吸附治疗效果显著,值得推广应用。