Sugar‐Derived Poly(β‐thioester)s as a Biomedical Scaffold

The monomer isosorbide diacrylate (iSDA) and commercially available dithiols allowed access to a range of biosourced, degradable polymers. Altering the dithiol identity significantly affected the glass transition T_gs of the polymer products; however, polymers did not exhibit T_gs above room temperature. Incorporating the comonomer N,N′‐methylene bisacrylamide provided mechanical reinforcement through hydrogen bonding, resulting in soft, pliable materials. Differential scannin calorimetry (DSC) and variable‐temperature fourier‐transform infrared (FTIR) spectroscopy indicated that increases in mechanical integrity resulted from hydrogen bonding. Dynamic mechanical analysis (DMA) revealed materials that exhibited suitable moduli and service windows at body temperature. Biological evaluation demonstrated favorable cytotoxicity and cell attachment, rendering these materials potential candidates as novel scaffold materials for tissue growth.     

单硝酸异山梨酯缓释片联合治疗老年单纯收缩期性高血压病

目的探讨单硝酸异山梨酯缓释片联合治疗老年单纯收缩期性高血压病的疗效。方法将182例经血管紧张素转换酶抑制剂(ACEI)、钙离子阻滞剂、β-受体阻滞剂、利尿剂等合理剂量治疗4周后全天平均收缩压仍≥160mmHg、舒张压<95mmHg的患者分为两组,治疗组加用单硝酸异山梨酯缓释片40mg,每天1次,对照组加用α-受体阻滞剂或外周肾上腺能神经元阻滞剂。均实行24小时动态血压(24hABP)监测。结果治疗组全天收缩压平均值较对照组明显减小,总有效率治疗组87.9%,对照组35.2%(P<0.01)。结论单硝酸异山梨酯缓释片联合治疗老年单纯收缩期性高血压病是一种有效的方法。     

硝酸酯类联合降压降脂治疗对老年单纯收缩期高血压的影响

目的观察硝酸酯类和他汀类药物对老年单纯收缩期高血压（ISH）伴高脂血症患者血压、血脂及大动脉结构的影响.方法 96例老年ISH伴高脂血症患者随机分为单硝酸酯三联组（A组）：给予单硝酸异山梨酯、辛伐他汀和非诺地平治疗;辛伐他汀二联组（B组）：给予辛伐他汀和非诺地平治疗;对照组（C组）：单用非诺地平治疗,疗程均为12周.于试验期间观察血压、血脂及大动脉结构等变化.结果 A组的降压疗效明显优于B组、C组（ P＜0.01）,A组与B组的降脂效果及颈动脉内膜厚度的变化均优于C组（ P＜0.05）.结论硝酸酯类药物能降低老年ISH患者的收缩压,使脉压减小,而对舒张压影响不大;他汀类药物可干预、延迟大动脉内膜中层增厚进程,两药合用,有益于控制老年ISH.     

中西医结合治疗冠心病劳力型心绞痛60例疗效分析

目的：比较分析中西医结合治疗与单纯西药治疗冠心病劳力型心绞痛的疗效,以为今后临床本病的治疗提供参考。方法114例冠心病合并劳力型心绞痛患者,随机分为中西医结合治疗组(观察组,60例)以及西药治疗组(对照组,54例),对照组给予单硝酸异山梨酯片治疗,观察组在对照组基础上联合自制中药汤剂治疗。观察两组疗效。结果观察组显效34例,有效18例,无效8例,总有效率为86.7%,对照组患者显效18例,有效20例,无效为16例,总有效率为70.4%,观察组总有效率明显高于对照组,差异具有统计学意义(P<0.05)。两组均有个别患者有副作用,经对应调节后副作用均消失,所有患者均坚持全程服药。结论中西医结合治疗冠心痛劳力型心绞痛疗效显著,值得临床应用推广。     

Comparison of the effects of molsidomine,nitroglycerin and isosorbide dinitrate on experimentally induced coronary artery thrombosis in the dog

Summary Platelet activation and aggregation in the coronary circulation may be important in the pathogenesis of myocardial ischemia. Molsidomine (M), isosorbide dinitrate (ISDN) and nitroglycerin (NTG) have been found to inhibit platelet aggregationin vitro. In the present study, the activity of these compounds was investigated in a model of coronary artery thrombosisin vivo. Dogs were ancsthetized, thoracotomized, and their heart was exposed. An electrode was inserted into the left circumflex coronary artery and set to rest on the intima. Electrical stimulation (9 V, 150 A) lasted for 6 h. Compounds (each in 2 dose levels) were given as an i.v. infusion starting 30 min after the beginning of the stimulation and lasting for the duration of the experiment. All control (saline-treated) animals underwent thrombotic occlusion of the coronary artery as assessed by flow measurement. On the other hand, 2/8 dogs treated with the lower M dose and 4/8 dogs treated with the higher M dose did not have a coronary occlusion. Neither ISDN nor NTG, at both doses, prevented the coronary occlusion. In control animals thrombus wet weight was 74.43±11.25 mg. M reduced the thrombus weight in a doserelated manner, while ISDN (marginally) and NTG (significantly at the higher dose) increased this parameter. Following the coronary thrombosis, all control animals developed myocardial infarcts as assessed by the tetrazolium technique. Similarly all animals treated with ISDN and with NTG (at both doses) showed infarcts. However, 3/8 M-dogs did not have a myocardial infarction in the lower as well as in the higher dose groups. The hemodynamic changes induced by the 3 compounds were similar in magnitude.Thus M but not ISDN or NTG showed in thisin-vivo study antithrombotic and consequently antiischemic activity.     

Continuous long-term dosing with oral slow-release isosorbide dinitrate does not reduce incidence of cardiac events in patients with healed myocardial infarction

BACKGROUND: In the short term, isosorbide dinitrate (ISDN) is considered to be therapeutically effective. The long-term effects of treatment with slow-release ISDN are less clear. HYPOTHESIS: The study was undertaken to investigate the effects of continuous, long-term dosing with oral slow-release ISDN on the incidence of cardiac events in patients with healed myocardial infarction (MI). The study was carried out in accordance with the intention-to-treat principle. METHODS: In all, 1.102 in- and outpatients, of either gender, with healed MI were randomly divided into groups treated with ISDN (n = 470) and not treated with ISDN (n = 632). Patients in the ISDN group received a continuous regimen of 20 mg of oral, long-acting ISDN three times a day, after meals. The mean observation period was 15.0 +/- 18.5 months. The primary endpoints were nonfatal and fatal recurrent MI, death from congestive heart failure, and sudden death. RESULTS: There were no significant differences in the baseline characteristics of the patients in the ISDN and no-treatment groups; nevertheless, significantly more patients in the ISDN group experienced cardiac events. In the ISDN group, 35 patients (7.4%) experienced cardiac events during the observation period, versus only 28 patients (4.4%) in the no-treatment group (p < 0.05; odds ratio 1.74; 95% confidence interval 1.04-2.90). CONCLUSION: Continuous long-term dosing with oral, slow-release ISDN does not reduce and probably increases the incidence of cardiac events among patients with healed MI.     

Isosorbide dinitrate inhibits platelet adhesion and aggregation in nonthrombolyzed patients with acute myocardial infarction

BACKGROUND: Apart from their vasodilatatory properties, nitrates have been shown to inhibit platelet aggregation. The effects of nitrates on platelet adhesion have not been studied. Nonselected patients with acute myocardial infarction (AMI) have been suggested to gain no benefit from administration of nitrates. However, the importance of nitrates may be greater in a subgroup of nonthrombolyzed patients with AMI. HYPOTHESIS: Isosorbide dinitrate (ISDN) decreases platelet adhesion and aggregation in nonthrombolyzed patients with AMI. METHODS: Consecutive 48 men with AMI, not eligible for thrombolytic therapy because of late presentation (> 12 h), were prospectively randomized 2:1 to double-blind ISDN (mean dose 2.4 +/- 0.9 mg/h) (n = 33) or placebo (0.9% sodium chloride) (n = 15) infusion. All patients received aspirin. Blood samples were taken at baseline (no study medication) and 3 h into ISDN or placebo infusion. Platelet adhesion to collagen was measured in the ethylene diamine tetraacetic acid (EDTA)-platelet rich plasma by recording changes in light transmission with an optical aggregometer. Platelet aggregation was measured using the Born's method. RESULTS: Isosorbide dinitrate significantly decreased both platelet adhesion and aggregation. No effect was seen in the placebo group. CONCLUSIONS: In patients with AMI who do not receive thrombolytic therapy, ISDN effectively inhibits platelet adhesion and aggregation. These effects of nitrates may be of therapeutic and prognostic significance in this group of patients.     

麝香保心丸治疗老年冠心病130例效果观察

目的探讨麝香保心丸治疗老年冠心病临床效果。方法选择2011年1月—2013年1月海洋石油总医院全科门诊中明确诊断的老年冠心病260例,随机分为治疗组和对照组各130例,对照组口服单硝酸异山梨酯缓释片60 mg,1次/d,同时口服阿司匹林肠溶片100 mg,1次/d,治疗组在对照组治疗的基础上,另外口服麝香保心丸2粒,3次/d,两组均观察半年。比较两组疗效、血脂水平及心电图。计量资料采用t检验,率的比较采用χ2检验,P0.05为差异有统计学意义。结果治疗组总有效率为96.9%高于对照组的47.7%,差异有统计学意义(P0.05)。治疗组总胆固醇、甘油三酯、低密度脂蛋白分别为(5.08±1.16)、(1.01±0.71)、(2.03±0.99)mmol/L平均低于对照组的(6.52±1.17)、(1.73±0.53)、(1.01±0.71)mmol/L,差异均有统计学意义(均P0.05)。治疗组心电图改善总有效率90.0%,对照组心电图改善总有效率42.3%,两组比较差异有统计学意义(P0.05)。结论麝香保心丸具有多方面的作用,能够显著改善患者的生活质量,有效防治意外事件的发生,并且安全、可靠,是老年冠心病的有效治疗药物。