老年骨质疏松症股骨颈骨折术后抗骨质疏松治疗的初步观察

目的探讨老年骨质疏松症股骨颈骨折术后抗骨质疏松治疗的临床效果。方法将60例骨折疏松症所致股骨颈骨折患者随机分为观察组和对照组,各30例,分别在术后给予常规康复治疗和同步进行抗骨质疏松治疗,比较两组临床治疗效果。结果观察组临床症状改善总有效率(86.7%)高于对照组(73.3%),骨密度值高于对照组,比较差异显著(P<0.05)。结论老年骨质疏松症股骨颈骨折术后接受抗骨质疏松治疗,能够有效改善疼痛症状,并通过增加骨密度来预防再次骨折。     

甲巯咪唑与丙基硫氧嘧啶对甲亢继发骨质疏松患者骨密度的影响

目的观察甲巯咪唑与丙基硫氧嘧啶对甲亢继发骨质疏松患者骨密度的影响,为临床甲亢继发骨质疏松的治疗提供参考。方法选取2012年12月至2013年12月来我科住院治疗的46例甲亢继发骨质疏松患者,采用随机数字法平均分为观察组和对照组。在常规治疗基础上,观察组采用甲巯咪唑进行治疗,对照组使用丙基硫氧嘧啶进行治疗。比较两组治疗前后的血钙(Ca)、血镁(Mg)、血磷(P)、血碱性磷酸酶(ALP)、24 h尿钙(UCa)变化;于治疗前后测量患者腰椎、股骨颈骨密度(BMD),分析甲巯咪唑与丙基硫氧嘧啶对甲亢继发骨质疏松患者骨密度的影响;并比较两组药物不良反应的发生情况。结果观察组治疗后24 h UCa水平明显低于对照组,差异有统计学意义(P<0.05);观察组治疗后Mg水平明显高于对照组,差异有统计学意义(P<0.05)。观察组治疗后Ca、P、ALP水平与对照组比较差异无统计学意义(P>0.05)。观察组治疗后腰椎、股骨颈骨密度均略高于对照组,但差异无统计学意义(P>0.05)。对照组肝功能损害的发生率明显高于观察组,差异有统计学意义(P<0.05)。结论甲巯咪唑和丙基硫氧嘧啶均可以改善甲亢继发骨质疏松患者的骨代谢状态,但甲巯咪唑升高患者骨密度的作用更明显,且不良反应相对较轻,值得临床借鉴使用。     

新辅助化疗结合保乳术治疗乳腺癌患者的疗效观察

目的：研究新辅助化疗结合保乳术治疗乳腺癌患者的临床效果。方法将医院2009年9月-2013年10月收治的乳腺癌患者80例随机分为观察组和对照组各40例,观察组给予新辅助化疗结合保乳术治疗,对照组采取根治术进行治疗。术后随访时间为3年,所有患者均行化疗,比较2组临床效果。结果观察组手术时间、住院时间均短于对照组,术中出血量、并发症的发生率均少于对照组,差异有统计学意义（ P<0.05）。随访中,观察组癌症复发率、远处转移率与对照组比较,差异无统计学意义（ P﹥0.05）。结论新辅助化疗结合保乳术治疗乳腺癌患者的临床效果较好,患者满意度高,且具有手术时间较短、术中出血量较少、并发症发生率较低、住院时间较短等优势,临床应用价值很高,值得进一步推广使用。     

99锝-亚甲基双膦酸盐治疗乳腺癌术后化疗致骨质疏松症

摘 要 目的：探讨乳腺癌术后化疗对骨质密度变化的影响及⁹⁹锝-亚甲基双膦酸盐的治疗作用。方法: 观察58例乳腺癌术后化疗患者化疗期间骨质密度、血钙素(BGP)、碱性磷酸酶(AKP)、24h尿钙水平变化。化疗结束后,将其中23例骨质疏松症患者分为对照组和观察组,对照组给予碳酸钙D₃,观察组在对照组基础上加用⁹⁹锝-亚甲基双膦酸盐,治疗1年后比较两组患者骨质密度、BGP、AKP、24h尿钙水平变化。结果: 化疗患者腰椎骨密度、股骨骨密度较化疗前显著降低,BGP、AKP、24 h尿钙则较前显著升高(P<0.05)。乳腺癌术后化疗3个疗程后骨质疏松症发生率为22.4%,化疗6个疗程后骨质疏松症发生率为39.7%。观察组患者腰椎骨密度、股骨骨密度较治疗前显著升高,BGP、AKP、24 h尿钙则显著降低;且两组比较,差异有统计学意义(P<0.05)。结论:乳腺癌术后化疗可导致骨质密度降低,使用⁹⁹锝-亚甲基双膦酸盐治疗乳腺癌术后化疗所致骨质疏松症安全有效。     

鲑鱼降钙素联合钙尔奇D治疗老年骨质疏松疗效观察

目的探讨鲑鱼降钙素联合钙尔奇D治疗老年骨质疏松症的临床疗效。方法 120例老年骨质疏松患者随机分为观察组和对照组各60例,对照组口服钙尔奇D片,治疗组在对照组基础上给予鲑鱼降钙素注射液。两组均1个月为1疗程,连续治疗3个疗程。观察治疗后的骨密度和疼痛变化。结果两组治疗后骨密度均明显上升,与治疗前比较差异有统计学意义（P〈0.05）,治疗后观察组骨密度明显高于对照组,差异有统计学意义（P〈0.05）。治疗后两组VAS评分均明显下降,与治疗前比较差异有统计学意义（P〈0.05）,治疗后观察组VAS评分下降程度高于对照组,差异有统计学意义（P〈0.05）。结论鲑鱼降钙素联合钙尔奇D治疗老年骨质疏松临床疗效好,优于单纯钙尔奇D治疗。     

加味二仙汤治疗绝经后骨质疏松症35例疗效观察

目的:观察加味二仙汤治疗绝经后骨质疏松症(OP)的临床疗效。方法:将70例绝经后OP患者随机均分成治疗组和对照组。对照组给予常规抗骨质疏松治疗,治疗组在对照组治疗的基础上给予加味二仙汤口服治疗。治疗12周后比较两组患者的中医症状积分,临床疗效,血清中钙、磷、碱性磷酸酶及骨密度测值,并判断总有效率。结果:治疗组和对照组总有效率分别为88.6%和77.1%,差异有统计学意义(P<0.05)。与对照组比较,治疗后治疗组患者中医症状积分升高,临床疗效改善,骨密度测值升高,血清中钙浓度升高,磷浓度降低,差异有统计学意义(P<0.05)。结论:加味二仙汤联合常规抗骨质疏松治疗对绝经后OP的临床疗效较好。     

骨质疏松性骨折患者阿仑膦酸钠治疗的有效性分析

目的:探讨分析骨质疏松性骨折患者阿仑膦酸钠治疗的有效性.方法:2018年1月至2020年2月,本院收治320例骨质疏松性骨折患者,按照奇偶次序分为两组,两组患者均结合骨折类型给予骨折手术治疗、术后常规治疗,观察组联合应用阿仑膦酸钠治疗,获取两组骨折治疗效果,并进行比较.结果:两组术后即刻的血清碱性磷酸酶、1型胶原交联羧基末端肽、骨钙素、尿脱氧吡啶酚比较,无统计学意义(P>0.05);两组术后3月的血清碱性磷酸酶、1型胶原交联羧基末端肽、骨钙素、尿脱氧吡啶酚水平优于两组术后即刻,观察组术后3月的血清碱性磷酸酶、1型胶原交联羧基末端肽、骨钙素、尿脱氧吡啶酚优于对照组术后3月,有统计学意义(P<0.05).两组术后即刻的骨折疼痛评分、骨密度值比较,无统计学意义(P>0.05);两组术后14天的骨折疼痛评分、骨密度值优于两组术后即刻,观察组术后3月的骨折疼痛评分、骨密度值优于对照组,有统计学意义(P<0.05).观察组60例随访期间(6个月)的再次骨折率小于对照组,有统计学意义(P<0.05).结论:骨质疏松性骨折采用对症手术治疗、术后常规治疗期间,联合阿仑膦酸钠治疗,可改善机体骨代谢水平,可改善患者的骨密度与骨折疼痛程度,可降低患者的再发骨折几率,值得推广.     

中西医结合治疗慢性阻塞性肺疾病的效果分析

目的：探讨中西医结合治疗慢性阻塞性肺疾病的临床效果。方法选取本院收治的120例慢性阻塞性肺疾病患者作为研究对象,随机分为观察组和对照组,各60例。对照组给予常规西医治疗,观察组在对照组的基础上给予麻杏石甘汤加减治疗。比较两组的总有效率及治疗后肺功能。结果观察组的总有效率为96.7%,显著高于对照组的78.3%,差异有统计学意义(P<0.05)。两组治疗后的肺功能显著优于治疗前,差异有统计学意义(P<0.05)。观察组治疗后的肺功能显著优于对照组治疗后,差异有统计学意义(P<0.05)。结论中西医结合治疗慢性阻塞性肺疾病效果显著,值得临床推广应用。     

人参养荣汤干预乳腺癌新辅助化疗所致气血两虚证的临床研究

目的本文主要探讨乳腺癌新辅助化疗所致气血两虚证患者给予人参养荣汤干预治疗的临床效果。方法我院在2013年5月至2015年9月期间共有91例乳腺癌患者进行新辅助化疗,其中,有60例患者出现气血两虚症状,将这60例患者随机分为观察组和对照组,对照组患者给予常规西药进行治疗,观察组患者给予人参养荣汤进行治疗,观察比较两组患者治疗前后的中医症状总积分。结果治疗前,两组患者的中医症状总积分没有明显的差异,P>0.05,不具有统计学意义。经过系统的治疗后,观察组患者的中医症状总积分明显低于对照组患者,P<0.05,具有统计学意义。结论本次研究结果表明,乳腺癌新辅助化疗导致的气血两虚证患者给予人参养荣汤进行治疗,可以有效改善患者的临床症状,确保后续治疗可以顺利进行。     

热敏灸治疗原发性骨质疏松(肝肾不足)的临床疗效研究

目的:探讨热敏灸治疗原发性骨质疏松(肝肾不足)的临床疗效。方法:按照是否接受热敏灸治疗将42例原发性骨质疏松(肝肾不足)患者分为观察组22例和对照组20例。对照组患者给予鲑降钙素,观察组患者在此基础上给予热敏灸治疗,观察两组患者疗程结束时临床疗效以及初诊首日和治疗1个月后中医证候积分、骨密度以及骨吸收指标[甲状旁腺激素(PTH)、降钙素(CT)]变化情况。结果:观察组患者临床总有效率明显高于对照组,差异有统计学意义(P<0.05);观察组患者治疗1个月后腰背疼痛、腰膝酸软、下肢疼痛、下肢痿软、步履艰难、目眩等中医证候积分均显著低于对照组,差异有统计学意义(P<0.05);观察组患者治疗1个月后腰椎骨密度水平显著高于对照组,差异有统计学意义(P<0.05);观察组患者治疗1个月后PTH水平显著低于对照组,CT水平显著高于对照组,差异有统计学意义(P<0.05)。结论:在鲑降钙素基础上加用热敏灸治疗原发性骨质疏松(肝肾不足),能够有效提高疗效,改善患者症状体征,提高骨密度,改善骨吸收指标。     

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.

     

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.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

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.