血塞通片联合特立帕肽治疗老年骨质疏松症的临床研究

目的 探讨血塞通片联合特立帕肽治疗老年骨质疏松症的临床疗效及安全性。方法 选取南京医科大学第二附属医院2018年1月—2019年12月收治的80例老年骨质疏松症患者作为研究对象,将所有患者按照数字随机表法分为对照组和观察组,每组各40例。对照组患者皮下注射特立帕肽注射液,20 μg/d,注射部位应选择大腿或腹部。观察组患者在对照组治疗的基础上口服血塞通片,1片/次,3次/d。两组均治疗2周。观察两组患者的临床疗效和不良反应发生情况,同时比较两组治疗前后的骨密度、骨代谢指标水平。结果 治疗后,观察组的患者治疗总有效率为97.5%,显著高于对照组的70.0%（P<0.05）。治疗后,两组的腰椎骨、股骨颈和股骨大转子骨密度检测值明显升高（P<0.05）,且观察组患者高于对照组（P<0.05）。治疗后两组患者血清I型胶原氨基端前肽（P1NP）、Ⅰ型胶原羧基端交联肽（CTX）水平均显著降低,骨钙素（BGP）和25-羟基维生素D（25（OH）D）水平均显著升高（P<0.05）;且治疗后,观察组患者P1NP、CTX显著低于对照组,BGP、25（OH）D显著高于对照组（P<0.05）。治疗期间,两组患者不良反应发生率在整个治疗期间的对比没有统计学差异。结论 血塞通片联合特立帕肽治疗老年骨质疏松可提高患者骨密度,改善相关骨代谢指标,安全有效,值得临床推广应用。     

特立帕肽联合阿仑膦酸钠治疗绝经后骨质疏松症的临床研究

目的探讨特立帕肽联合阿仑膦酸钠治疗绝经后骨质疏松症的临床疗效。方法选取2014年1月—2015年6月天津中医药大学第一附属医院收治的绝经后骨质疏松症患者140例,随机分为对照组和治疗组,每组各70例。对照组患者口服阿仑膦酸钠片,1片/次,1次/d。治疗组在对照组治疗基础上皮下注射特立帕肽注射液,20μg/次,1次/d。两组患者均连续治疗6个月。观察两组患者治疗前后骨密度和骨代谢指标的变化情况。结果治疗组治疗3个月时腰椎骨密度相对于治疗前有明显上升,全髋与股骨颈骨密度则无明显变化,治疗组治疗6个月时腰椎、全髋、股骨颈骨密度均明显上升,同组治疗前后差异具有统计学意义(P0.05);对照组治疗3个月各部位骨密度均未出现明显上升,治疗6个月腰椎骨密度较治疗前有明显上升(P0.05)。治疗组治疗6个月时腰椎、全髋、股骨颈骨密度改善情况明显优于对照组,两组比较差异有统计学意义(P0.05)。治疗组治疗3、6个月血清骨钙素(OC)水平逐渐上升,均明显高于治疗前,同组治疗前后差异具有统计学意义(P0.05);对照组则逐渐下降,均明显低于治疗前(P0.05);治疗组治疗3、6个月血清Ⅰ型胶原羧基端肽交联(β-CTX)水平逐渐下降,对照组也逐渐下降,对照组下降幅度则明显大于治疗组(P0.05)。结论特立帕肽联合阿仑膦酸钠治疗绝经后骨质疏松症具有较好的临床疗效,可增加患者的骨密度,可有效改善骨代谢,具有一定的临床推广应用价值。     

地舒单抗联合特立帕肽治疗绝经后骨质疏松症的临床研究

目的 观察地舒单抗注射液联合特立帕肽注射液治疗绝经后骨质疏松症的临床疗效。方法 选择2022年1～12月南通市肿瘤医院收治的绝经后骨质疏松症患者91例,按照随机数字表法将所有患者分为对照组（45例）和治疗组（46例）。对照组在大腿或腹部皮下注射特立帕肽注射液20 μg,1次/d,持续治疗6个月。治疗组在对照组的基础上在大腿、腹部或上臂部单次皮下注射地舒单抗注射液60 mg,6个月仅注射1次。比较两组的临床疗效、骨密度、骨代谢指标。结果 治疗后,治疗组的总有效率为89.13%,高于对照组的总有效率75.56%（P＜0.05）。治疗后,两组腰椎L_1-4、股骨颈、全髋骨密度均显著升高（P＜0.05）,且治疗组腰椎L_1-4、股骨颈、全髋骨密度均高于对照组（P＜0.05）。治疗后,两组血清β-胶原特殊序列（β-CTX）、抗酒石酸酸性磷酸酶-5b（TRAP-5b）、Ⅰ型胶原羧基末端肽（CTX-Ⅰ）水平显著下降,血清总I型胶原氨基端延长肽（TP1NP）、骨钙素（OCN）、骨保护素（OPG）水平显著升高（P＜0.05）,且治疗组血清β-CTX、TRAP-5b、CTX-Ⅰ水平低于对照组,血清TP1NP、OCN、OPG水平高于对照组（P＜0.05）。结论 地舒单抗联合特立帕肽注射液治疗绝经后骨质疏松症可提高临床疗效,改善骨密度,调节骨代谢。     

注射用骨肽治疗老年桡骨远端骨折临床疗效

目的：观察老年桡骨远端骨折给予注射用骨肽治疗的临床效果。方法：抽选我院于2015年2～12月收治的老年桡骨远端骨折患者48例,将其随机分为两组,对照组（碳酸钙片治疗）、试验组（注射用骨肽治疗）各24例。观察骨折愈合情况,比较骨代谢指标。结果：试验组治疗有效21例（87.5%）,高于对照组的14例（58.3%）,骨折愈合时间短于对照组;治疗后两组患者的BMD、BALP、PICP、BGP指标明显提高,试验组改善程度优于对照组,P＜0.05,差异有统计学意义。结论：注射用骨肽治疗老年桡骨远端骨折效果确切,能够改善骨代谢,促进骨折愈合,值得推广。     

壮骨止痛胶囊联合特立帕肽治疗绝经后骨质疏松症的临床研究

目的 探讨壮骨止痛胶囊联合特立帕肽治疗绝经后骨质疏松症的临床疗效。方法 选取2020年1月—2021年10月平煤神马医疗集团总医院收治的126例绝经后骨质疏松症患者,采用随机数字表法将所有患者分为对照组和治疗组,每组各63例。对照组皮下注射特立帕肽注射液,20μg/次,1次/d,注射部位选择下腹部或大腿。治疗组在对照组基础上口服壮骨止痛胶囊,4粒/次,3次/d。两组疗程均为6个月。观察两组临床疗效;并比较治疗前后两组主要部位骨密度（BMD）值,相关症状评分,原发性骨质疏松症患者生活质量量表（OQOLS）总分及血清骨转换标志物[Ⅰ型前胶原N-端前肽（PINP）、Ⅰ型胶原交联C-末端肽β-降解产物（β-CTX）]和白细胞介素（IL）-33、IL-17、胰岛素样生长因子-1(IGF-1)水平。结果治疗后,治疗组总有效率为92.1%,显著高于对照组的79.4%(P<0.05)。治疗后,两组腰椎L1～4、髋部股骨颈、全髋BMD值均显著增加（P<0.05）,且治疗后治疗组主要部位BMD值增加更显著（P<0.05）。治疗后,两组腰背疼痛、下肢抽筋、腰膝酸软、步履艰难、持重困难评分均...     

阿胶强骨口服液联合骨化三醇治疗老年骨质疏松的临床研究

目的 探讨阿胶强骨口服液联合骨化三醇胶丸治疗老年骨质疏松的临床疗效。方法 选取2019年3月—2021年3月在安康市人民医院就诊治疗的128例老年骨质疏松患者,根据随机数字法将128例老年骨质疏松患者分为对照组（n=64）和治疗组（n=64）。对照组口服骨化三醇胶丸,1粒/次,2次/d。治疗组在对照组的基础上口服阿胶强骨口服液,10 mL/次,3次/d。两组患者均连续服用药物3个月。观察两组的临床疗效,比较两组临床症状好转时间、骨代谢指标和骨密度的变化。结果 治疗后,治疗组患者总有效率是98.44%,显著高于对照组的84.38%（P<0.05）。治疗组患者腰酸背痛好转时间、骨骼疼痛好转时间、下肢无力好转时间、肌肉痉挛好转时间均显著短于对照组（P<0.05）。治疗后,两组Ⅰ型胶原羧基端交联肽（CTX）、血清Ⅰ型胶原氨基端前肽（P1NP）均显著降低,但25-羟基维生素D[25（OH） D]、骨钙素（BGP）升高（P<0.05）;治疗后,治疗组骨代谢指标改善优于对照组（P<0.05）。治疗后,两组患者股骨颈骨骨密度、腰椎骨骨密度、股骨大转子骨密度均较治疗前显著升高（P<0.05）;治疗后,治疗组骨密度改善优于对照组（P<0.05）。结论 阿胶强骨口服液联合骨化三醇胶丸治疗老年骨质疏松临床疗效显著,能有效改善骨密度,增强骨代谢功能,值得临床推广应用。     

骨康胶囊联合骨肽片治疗桡骨远端骨折的临床研究

目的 探讨骨康胶囊联合骨肽片治疗桡骨远端骨折的临床疗效。方法 选取十堰市太和医院在2021年6月-2023年5月收治的桡骨远端骨折患者100例,按计算机随机法将100例患者分为对照组(50例)和治疗组(50例)。对照组患者口服骨肽片,2片/次,3次/d。治疗组在对照组治疗的基础上口服骨康胶囊,4粒/次,3次/d。15 d为1个疗程,持续治疗3个疗程。比较两组的临床疗效、恢复情况、症状情况和血清指标。结果 治疗后,治疗组的总有效率高于对照组,差异有统计学意义(96.00% vs 82.00%,P<0.05)。治疗后,治疗组疼痛消失时间、肿胀消失时间和骨折愈合时间均比对照组短,差异有统计学意义(P<0.05)。治疗后,两组疼痛评分、功能状况评分、活动范围评分、握力评分,血清骨碱性磷酸酶(BALP)、骨钙素(BGP)水平比治疗前高,血清Ⅰ型胶原羧基端肽β特殊序列(β-CTX)水平比治疗前低(P<0.05);治疗组的症状情况和血清指标均好于对照组(P<0.05)。结论 骨康胶囊联合骨肽片可提高桡骨远端骨折的疗效,促进骨折愈合,减轻临床症状,调节骨代谢。     

绝经后妇女血清骨代谢生化指标的变化及意义

目的：为了探讨绝经后妇女的骨代谢。方法：本文对37例绝经后妇女及27例正常对照组，测定血清I型前胶原羧基末端前肽（PICP），I型胶原羧基端吡啶并啉交联肽（ICTP），骨钙素（BGP），碱性磷酸酶（ALP），钙（Ca),磷（P）等骨代谢指标。结果：绝经后妇女Ⅱ组血清PICP结果明显低于对照组（P＜0．01），ICTP结果明显高于对照组（P＜0．00－1），BGP明显低于对照组（P＜0．05），绝经后妇女I组ICTP结果明显高于对照组（P＜0．01），绝经后妇女年龄与血清PICP，ICTP，BGP具有相关性，骨形成指标PICP，BGP与骨吸收指标ICTP均有相关性。结论：表明了绝经后妇女骨吸收过程增加较为明显，造成骨量丢失。     

复方鹿茸健骨胶囊联合唑来膦酸治疗骨质疏松症的临床研究

目的 探讨复方鹿茸健骨胶囊联合唑来膦酸注射液治疗骨质疏松症的临床疗效。方法 选取唐山市人民医院2020年8月—2023年2月收治的132例骨质疏松症患者,根据计算机随机排列法将患者分为对照组和治疗组,各66例。对照组患者静脉滴注唑来膦酸注射液,1支/次,1次/4周。治疗组在对照组基础上口服复方鹿茸健骨胶囊,5粒/次,3次/d。两组患者连续治疗6个月。比较两组的临床疗效、疼痛程度、骨密度、血清骨代谢指标和血清炎症反应指标。结果 治疗后,治疗组的总有效率（92.42%）比对照组高（80.30%）,组间差异显著（P<0.05）。治疗后,两组的数字疼痛强度量表（NRS）评分均低于治疗前（P<0.05）,且治疗组的NRS评分低于对照组（P<0.05）。治疗后,两组粗隆、股骨颈、腰椎的骨密度比治疗前大（P<0.05）,且治疗组粗隆、股骨颈、腰椎的骨密度比对照组更大（P<0.05）。治疗后,两组的血清骨钙素（BGP）、基质金属蛋白酶-9(MMP-9)、白细胞介素-17(IL-17)水平显著降低,血清骨特异性碱性磷酸酶（BALP）、骨保护素（OPG）水平显著升高（P<...     

骨疏康颗粒联合雷洛昔芬治疗绝经后骨质疏松症的临床研究

目的 探讨骨疏康颗粒联合盐酸雷洛昔芬片治疗绝经后骨质疏松症的临床疗效。方法 选取2021年1月—2022年12月在漯河市郾城区中医院就诊的120例骨质疏松症患者,按照随机数字表法将120例患者分为对照组和治疗组,每组各60例。对照组患者口服盐酸雷洛昔芬片,1片/次,1次/d。治疗组患者在对照组治疗的基础上餐后温水冲服骨疏康颗粒,1袋/次,3次/d。两组患者连续治疗3个月。观察两组的临床疗效,比较两组自觉疼痛程度、股骨近端、桡尺骨的骨密度和血清骨钙素（BGP）、Ⅰ型胶原C末端肽（CTX-1）、Ⅰ型前胶原氨基末端肽（PINP）、转化生长因子-β₁（TGF-β₁）、白细胞介素-6（IL-6）、胰岛素样生长因子1（IGF-1）水平。结果 治疗后,治疗组患者的总有效率95.00%比对照组的83.33%更高（P＜0.05）。治疗后,两组数字疼痛强度量表（NRS）评分明显降低（P＜0.05）,且治疗组患者NRS评分较对照组更低（P＜0.05）。治疗后,治疗组股骨近端、桡尺骨的骨密度明显高于治疗前（P＜0.05）,且治疗组股骨近端、桡尺骨的骨密度明显高于对照组（P＜0.05）。治疗后,两组的血清BGP、CTX-1水平低于治疗前,血清PINP水平高于治疗前（P＜0.05）;治疗组的血清BGP、CTX-1水平低于对照组,血清PINP水平高于对照组（P＜0.05）。治疗后,两组的血清TGF-β₁、IL-6水平低于治疗前,血清IGF-1水平高于治疗前（P＜0.05）;治疗后,治疗组的血清TGF-β₁、IL-6水平低于对照组,血清IGF-1水平高于对照组,差异有统计学意义（P＜0.05）。结论 骨疏康颗粒联合盐酸雷洛昔芬片可提高骨质疏松症的疗效,有助于降低患者疼痛程度,提高骨密度,改善骨代谢水平,且安全性良好。     

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.

     

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.     

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.     

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.     

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.