美托洛尔+胺碘酮用于冠心病心律不齐治疗的临床价值探析

目的:分析美托洛尔联合胺碘酮治疗冠心病心律不齐的临床价值.方法:选取冠心病心律不齐患者95例随机分为两组,对照组胺碘酮治疗,观察组美托洛尔联合胺碘酮治疗;对比两组治疗效果.结果:观察组治疗后心率、血压较对照组改善,心率转复时间较对照组缩短,差异有统计学意义(P<0.05);观察组不良反应发生率2.1%,对照组不良反应发生率4.3%,P>0.05.结论:美托洛尔联合胺碘酮治疗冠心病心律不齐效果让人满意,安全性高.     

美托洛尔与胺碘酮联合应用治疗快速性心律失常的临床研究

目的研究美托洛尔与胺碘酮联合应用治疗快速性心律失常的效果及和安全性。方法 132例快速性心律失常患者,随机分为对照组和试验组,各66例。对照组患者应用胺碘酮治疗,试验组患者应用胺碘酮与美托洛尔联合治疗。比较两组患者显效率、心率情况和不良反应发生率。结果试验组患者显效率为93.9%,对照组患者显效率为77.3%,两组比较差异有统计学意义(P<0.05);治疗前两组心率比较,差异无统计学意义(P>0.05);治疗后试验组心率远低于对照组,差异有统计学意义(P<0.05)。试验组患者不良反应发生率为6.1%,对照组患者不良反应发生率为4.5%,比较差异无统计学意义(P>0.05)。结论美托洛尔与胺碘酮联合应用治疗快速性心律失常临床效果确切,有助于恢复正常的心率,不良反应轻,较胺碘酮单独治疗效果更优,具有广阔的临床应用前景。     

胺碘酮联合β受体阻断药治疗冠脉搭桥术后早期新发房颤

目的:观察胺碘酮联合β受体阻断药治疗冠状动脉搭桥(CABG)术后早期新发房颤(AF)的效果和不良反应。方法:102例CABG术后早期发生快室率房颤患者随机分为对照组48例和治疗组54例,对照组给予胺碘酮注射液静脉泵入,治疗组在对照组基础上加用艾司洛尔注射液或美托洛尔注射液。观察心电监护、心电图及24h动态心电图心率变化,比较两组1周内转复为窦性心律的有效率和不良反应发生率。结果:两组有效率分别为79.1%和94.4%,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:胺碘酮联合艾司洛尔或美托洛尔转复CABG术后早期新发房颤效果优于单用胺碘酮。不良反应少,安全性高,值得临床推荐。     

胺碘酮联合美托洛尔治疗老年冠心病的疗效分析

目的探究胺碘酮联合美托洛尔治疗老年冠心病并发心律失常的效果。方法选取2018年6月~2019年6月某院收治的108例冠心病患者,随机分为两组,对照组采用胺碘酮治疗,观察组采用胺碘酮联合美托洛尔治疗,比较两组的治疗效果、心率、QTd情况以及不良反应情况。结果对比治疗有效率,观察组治疗总有效率90.7%高于对照组68.5%,差异有统计学意义(P<0.05);对比心率、QTd(QT期间离散度)情况,两组治疗前比较无统计学意义(P>0.05),治疗后比较观察组优于对照组,差异有统计学意义(P<0.05);对比不良反应发生率,观察组5.6%低于对照组16.7%,差异有统计学意义(P<0.05)。结论老年冠心病并发心律失常治疗中联合胺碘酮与美托洛尔治疗可有效减缓心率,改善QTd,具有较高的安全性,疗效显著。     

胺碘酮联合美托洛尔治疗心律失常的临床疗效

目的探讨胺碘酮联合美托洛尔治疗心律失常的临床疗效。方法选取2014年6月—2015年6月丰县人民医院收治的心律失常患者48例,随机分为对照组与观察组,各24例。对照组患者予以美托洛尔治疗,观察组患者在对照组基础上加用胺碘酮治疗。观察两组患者临床疗效、起效时间及不良反应发生情况。结果观察组患者总有效率高于对照组,起效时间短于对照组,差异有统计学意义(P<0.05);两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论胺碘酮联合美托洛尔治疗心律失常的临床疗效显著,可缩短起效时间,且不良反应少。     

酒石酸美托洛尔联用小剂量胺碘酮治疗心肌梗死后室性心律失常的比较研究

目的 探讨酒石酸美托洛尔与小剂量胺碘酮联合治疗心肌梗死后室性心律失常的有效性和成功率.方法 回顾性分析本院收治的150例心肌梗死后室性心律失常患者的临床诊治资料,根据治疗方法分为对照组和联合组,其中对照组72例采用酒石酸美托洛尔单一治疗方案,联合组78例采用小剂量胺碘酮联合酒石酸美托洛尔治疗,对比两组治疗后的各项心脏参数、效果及不良反应发生情况.结果 联合组患者的心率、LVEF％、P-R间期及QRS间期均较对照组平稳,两组差异有统计学意义（P＜0.05）;联合组治疗总有效率为97.44％,对照组为86.11％,差异有统计学意义（P＜0.05）;两组患者治疗后总不良反应发生率差异无统计学意义（P＞0.05）.结论 酒石酸美托洛尔联合胺碘酮治疗心肌梗死后室性心律失常,安全性好,临床效价比较高.     

胺碘酮联合美托洛尔治疗快速心律失常的疗效观察

目的探讨胺碘酮联合美托洛尔治疗快速心律失常的临床疗效观察。方法将我院收治的112例快速心律失常患者随机分为观察组(56例)和对照组(56例),观察组给予胺碘酮联合美托洛尔治疗,对照组给予单用胺碘酮治疗。结果观察组有效率为96.4%,明显优于对照组的76.8%,两组比较差异有统计学意义(P<0.05);观察组血压、心率下降幅度均较之对照组大,两组比较差异有统计学意义(P<0.05)。结论胺碘酮联合美托洛尔治疗快速心律失常可起到协同作用,疗效显著,具有起效快、安全可靠、不良反应少等优点,是一种控制快速心律失常的心室率有效方法,值得临床推广。     

胺碘酮与美托洛尔联合治疗阵发性房颤的疗效观察

目的观察胺碘酮联合美托洛尔治疗阵发性房颤的疗效。方法选取46例阵发性心房颤动患者随机分为对照组和观察组各23例,在常规治疗的基础上,对照组单用胺碘酮,观察组给予口服胺碘酮和美托洛尔联合治疗。结果对照组总的有效率73.9%,观察组总的有效率78.3%。两组相比差异无统计学意义(P>0.05);但是对照组与观察组患者心房颤动发作时平均心室率相比(112.0+15.2)VS(86.1+11.2)min和每次房颤发作时持续时间相比(18.6+3.2)VS(12.1+2.8)h,差异有统计学意义(P<0.05)。结论胺碘酮联合美托洛尔治疗阵发性心房颤,能有效的转复窦性心律,维持窦律;对不能转复者也能更好地控制心室率和房颤发作的持续时间,疗效优于单用胺碘酮。     

胺碘酮片联合酒石酸美托洛尔在心力衰竭伴室性期前收缩中的疗效分析

目的:观察胺碘酮片联合酒石酸美托洛尔在心力衰竭伴室性期前收缩中的临床应用效果.方法:对照组给予常规治疗+胺碘酮片,观察组在常规治疗基础上加用胺碘酮片、酒石酸美托洛尔进行治疗,对比分析两组室性期前收缩情况和心功能.结果:观察组疗效优于对照组(P<0.05).结论:应用胺碘酮片联合酒石酸美托洛尔在心力衰竭伴室性期前收缩中的临床疗效显著,具有较高的临床应用价值.     

酒石酸美托洛尔联合小剂量胺碘酮对心肌梗死后室性心律失常患者心电图变化及生存质量的影响

目的:探究酒石酸美托洛尔联合小剂量胺碘酮对心肌梗死后室性心律失常患者心电图变化及生存质量的影响.方法:将2016年3月～2017年3月我院收治的90例心肌梗死后室性心律失常患者纳入研究,随机分为两组,对照组给予酒石酸美托洛尔治疗,观察组在此基础上应用小剂量胺碘酮,对比两组治疗效果.结果:观察组的HR低于对照组,而LVEF、P-R间期、QRS间期等心电图监测指标数据均高于对照组,两组数据差异有统计学意义(P<0.05);观察组在生理功能、社会功能、生理职能、情感职能、活力这5个指标上的评分明显高于对照组,两组数据差异有统计学意义(P<0.05).结论:酒石酸美托洛尔联合小剂量胺碘酮治疗心肌梗死后室性心律失常,可有效改善心功能及生存质量,值得采纳.     

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.     

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.

     

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.     

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.     

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.