正常成年人血清骨钙素含量与年龄的相关关系及其意义探讨

为了解人类随增龄而出现的骨丢失是由于骨形成下降,还是骨吸收增加,或二者共同作用的结果,本文测定了241名健康成年人的血清骨钙素(BGP),一个骨转换的敏感指标的含量。131名年龄20～69岁的妇女,血清骨钙素随年龄线性增高(r=0.538,P<0.01)。女性在50岁后骨钙素血清含量有一明显坡蜂,从40岁年龄组的4.9±1.1ng/ml(M±SD)增至60岁年龄组的5.9±0.84ng/ml。骨形成的另一指标,血清硷性磷酸酶(AKP)亦随年龄增加,且与血清BGP 的升高相关(r=0.248 P<0.05)。110名年龄20～79岁男性,血清骨钙素亦与年龄相关(r=0.21 P<0.05),但不及女性显著。血清 AKP 无随年龄升高现象。本文研究结果提示,妇女随年龄增长骨转换增加,不支持与年龄相关的骨量减少是由于骨形成下降的观点。     

2型糖尿病人骨代谢指标测定的临床观察

目的观察2型糖尿病人骨代谢指标的变化。方法测定149例2型糖尿病患者及31例正常人血清骨钙素(BGP)，甲状旁腺素(PTH)，尿Ⅰ型胶原交联C末端肽/肌酐(Crosslap/Cr)浓度。结果病人血清BGP(1.84±0.69)低于(正常)对照组(2.44±1.02，P＜0.05)。尿Crosslaps/Cr浓度(313.97±147.89)高于对照组(213.91±85.48，P＜0.05)。PTH与正常人无明显差异(P＞0.05)。结论2型糖尿病人骨吸收增加，骨转化率降低。     

胰岛素样生长因子-Ⅰ与原发性高血压

目的探讨胰岛素样生长因子-Ⅰ(IGF-Ⅰ)与原发性高血压及高血压左心室肥厚(LVH)的关系,为高血压的诊断和治疗提供新思路。方法对26名正常人及74例原发性高血压患者均行超声心动图检查,并用放射免疫法测定血清IGF-Ⅰ水平。74例原发性高血压患者降压治疗3个月后测定血压与血清IGF-Ⅰ水平。结果①原发性高血压患者血清IGF-Ⅰ水平(298±61)ng/ml明显高于正常对照组(178±51)ng/ml,P<0.05。②原发性高血压组血压1～3级间血清IGF-Ⅰ水平比较差异有统计学意义[分别为(238±54)ng/ml,(295±79)ng/ml,(376±62)ng/ml,P<0.05]。③原发性高血压伴LVH者血清IGF-Ⅰ水平[(369±64)ng/ml]高于无LVH者[(255±69)ng/ml],IGF-Ⅰ水平与左室重量指数(LVMI)中度正相关(r=0.52)。④原发性高血压组经药物治疗3个月后血压达标者其血清IGF-Ⅰ水平[(241±59)ng/ml]显著低于血压未达标者[(299±49)ng/ml],P<0.05。结论IGF-Ⅰ可能参与了原发性高血压的病理生理过程及LVH形成。     

地高辛血药浓度监测结果与临床疗效分析

采用荧光偏振免疫法 ( FPIA)测定 2 1 6例口服地高辛患者的血药浓度 ,同时进行疗效观察。结果1 35例有效 ,血药浓度在治疗范围为 ( 1 .0 5± 0 .49)ng/ml;无效 5 2例 ( 0 .94± 0 .61 ) ng/ml;血药浓度为( 2 .76± 1 .2 8) ng/ml 5 3例 ,其中有中毒症状者 2 9例     

阿仑膦酸钠治疗2型糖尿病骨质疏松病人的效果及对骨代谢指标的影响

目的 探讨阿仑膦酸钠治疗2型糖尿病(T2DM)骨质疏松病人的临床效果。方法 选取承德钢铁集团有限公司职工医院2016年3月至2017年3月收治的120例T2DM骨质疏松病人,其中研究组60例采用阿仑膦酸钠治疗,对照组60例采用钙尔奇D治疗,对比两组的治疗效果。结果 治疗前,两组病人的L2、L3、L4腰椎、股骨颈的骨密度值差异无统计学意义(P>0.05);治疗后两组病人的L2、L3、L4腰椎、股骨颈的骨密度值较治疗前均显著提高(P<0.05),研究组病人的L2、L3、L4腰椎、股骨颈的骨密度值显著高于对照组(P<0.05);治疗前,两组病人的血清骨钙素(BGP)、碱性膦酸酶(BAP)、人抗酒石酸酸性膦酸酶5b(TRAP-5b)、血清钙、血Ⅰ型胶原N末端肽(NTX)差异无统计学意义(P>0.05);治疗后,两组病人的血清BGP、血清钙值较治疗前均显著提高(P<0.05),两组病人的BAP、TRAP-5b、NTX较治疗前显著降低(P<0.05);治疗后,研究组病人的血清BGP、血清钙分别为(7.82±1.69) ng/mL,(2.40±0.20) mmol/L,显著高于对照组(P<0.05),研究组的BAP、TRAP-5b、NTX分别为(26.62±3.77) ng/mL、(2.71±0.43)ng/mL、(23.04±1.67) ng/mL,显著低于对照组(P<0.05)。结论 阿仑膦酸钠治疗T2DM骨质疏松病人能有效调节其骨代谢水平、提升病人的骨密度。     

糖皮质类固醇对促甲状腺激素分泌作用的研究

本文对9例原发性肾上腺皮质功能减退患者替代治疗前后观察了TSH、T_3、T_4的变化,并对10名健康人作了对比。结果9例患者未治疗的TSH值为12.29±2.37μu/ml,明显高于对照组4.62±1.91μu/ml,P<0.05;而经替代治疗后,TSH明显下降为7.36±2.91μu/ml,P<0.01。9例患者的血清T_3及T_4值与对照组比较为高,但在正常范围,临床上均无甲状腺功能减退症。我们认为未治疗的原发性肾上腺皮质功能减退患者的血清TSH值,判断甲状腺功能状态是不可靠的,测定血清TSH,应在替代治疗后进行才有诊断价值。     

多囊卵巢综合征患者血清抗苗勒管激素与胰岛素抵抗水平的相关性

目的 分析多囊卵巢综合征患者血清抗苗勒管激素与胰岛素抵抗水平的相关性.方法 选取本院2016年1月至11月81例多囊卵巢综合征患者为观察组,另选40例输卵管性不孕患者为对照组,各观察指标比较.结果 观察组血清抗苗勒管激素[(12.64±5.74) ng/ml]、黄体生成素[(12.34±7.09)mlU/ml]、黄体生成素/促卵泡激素[(3.16±1.45)]、睾酮[(0.51±0.17) ng/ml]、空腹胰岛素[(10.13±3.98)mIU/ml]、胰岛素抵抗指数[(2.17±0.87)]、体质量指数[(24.13±3.40) kg/m2],对照组血清抗苗勒管激素[(5.44±3.03) ng/ml]、黄体生成素[(4.24±2.63) mIU/ml]、黄体生成素/促卵泡激素[(1.09±0.53)]、睾酮[(0.40±0.12)ng/ml]、空腹胰岛素[(7.27±1.68) mIU/ml]、胰岛素抵抗指数[(1.46±0.39)]、体质量指数[(20.90±3.65) kg/m2],差异有统计学意义(P＜0.05).Spearman相关分析提示,多囊卵巢综合征患者血清抗苗勒管激素与胰岛素抵抗水平呈正相关(r=0.502,P=0.000),直线回归分析显示两者间有直线关系(R2=0.256).结论 多囊卵巢综合征患者血清抗苗勒管激素与胰岛素抵抗水平呈正相关,可作为早期诊断指标及临床治疗新思路.     

170例女性不孕患者血清AMH、FSH、LH及E2水平分析

目的 探讨女性不孕患者检测血清中抗缪勒管激素(AMH)、卵泡刺激素(FSH)、黄体生成素(LH)及雌二醇(E2)水平变化的临床价值.方法 选择2015年10月至2017年1月来本院生殖中心就诊的170例女性不孕患者为研究对象,对照组为同期在本院进行体检的150例已生育健康正常女性.采用化学发光法对以上两组受试者进行血清AMH、FSH、LH及E2检测.结果 不孕组患者血清中AMH、FSH及LH水平分别为(5.16± 1.45) ng/ml、(9.81±8.26) mIU/ml和(8.57±6.32)mIU/ml,均明显高于对照组(2.20±1.07) ng/ml、(5.53±1.49) mIU/ml和(3.98±1.64) mIU/ml;不孕组患者血清中E2水平为(29.43±12.96) pg/ml,明显低于对照组(40.25±18.10)pg/ml,差异有统计学意义(P＜0.05).结论 AMH、FSH、LH及E2联合检测在女性不孕症的诊断中具有重要价值,可为临床诊断和治疗提供依据.     

2型糖尿病患者选择素与胰岛素抵抗的临床意义

目的　探讨 2型糖尿病患者血清选择素 P、 L、 E和血清胰岛素变化及其临床意义。方法　用 EL ISA法测定 30例患者 ,男 2 5例 ,女 5例。结果　 2型糖尿病组 ,2型 DM+心血管疾病组 ,SP分别为 113.6± 12 .5 ng/ml、 170 .5± 16 .6 ng/m l、2 5 1.9± 11.3ng/ml;SL为 6 41.9± 2 0 .8ng/ml、 92 0± 17.5 ng/ml、10 2 9± 16 .4ng/ml;SE为 41.5± 5 .7ng/m l、 6 8.6± 4.8ng/m l、 70 .6 4± 6 .5 ng/ml。结论　选择素 P、 L、 E和胰岛素抵抗与 2型糖尿病微血管病变密切相关。     

严重烧伤患者血清肌钙蛋白T变化分析

目的　了解烧伤患者的血清肌钙蛋白T(TnT)水平 ,以明确TnT测定对烧伤后心肌损伤诊断的价值。方法　采用链霉亲合素预包被的双位点夹心ELISA法测定 75例烧伤患者血清TnT水平并与患者伤后血清心肌酶水平比较。结果　TnT在重度烧伤组为 ( 0 ..5 39± 0 .0 16 )ng/ml阳性率为 5 2 .0 % ;中度烧伤组为 ( 0 .0 8± 0 .0 7)ng/ml ,阳性率为 14 .2 % ;电烧伤组为 ( 0 .6 7± 0 .47)ng/ml ,阳性率为 45 .5 %。表明烧伤后血清TnT升高水平及阳性率与烧伤面积有关 ,且多数病人血清TnT水平在 48h内升高。结论　烧伤患者早期即存在心肌损伤 ,血清TnT测定对于烧伤后心肌损伤诊断的特异性明显优于心肌酶。     

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.

---

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.

     

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.     

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.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

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.