诺和锐30在初发糖尿病中应用分析

目的观察诺和锐30治疗初诊2型糖尿病的临床疗效及安全性。方法将60例初诊2型糖尿病患者随机分为诺和锐30组和诺和灵30R组各30例。诺和锐30组每日早晚餐前皮下注射诺和锐30;诺和灵30R组每日早晚餐前15～30min皮下注射诺和灵30R。结果两组患者胰岛素治疗后FBG、2hPBG及HbAlc水平均明显下降（P〈0．01）,诺和锐30组餐后血糖、糖化血红蛋自下降幅度更明显（P〈0．05）。两组患者空腹血糖下降差异无统计学意义（P〉0．05）,但诺和锐30组空腹血糖下降幅度高于诺和灵30R组。诺和锐30组低血糖（〈2．8mmol／L）发生率显著低于诺和灵30R组（P〈0．05）。结论诺和锐30可模拟人胰岛素生理分泌模式,实现更佳降糖,且低血糖发生率低,为DM患者提供了方便、安全、灵活的治疗手段。     

门冬胰岛素30治疗老年2型糖尿病26例疗效观察

目的：观察比较治疗老年2型糖尿病的临床疗效。方法：将51例老年2型糖尿病患者随机分成治疗组（门冬胰岛素30组）26例和对照组（预混人胰岛素30R组）25例,治疗12周后,观察两组患者空腹血糖（FBG）、餐后2h血糖（2hPBG）、糖化血红蛋白（HbA1c）及低血糖发生的情况。结果：两组治疗后FBG、2hPBG、HbA1c均明显下降（P〈0.01）,但治疗组餐后血糖、糖化血红蛋白下降更明显（P〈0.05）,低血糖发生率明显低于对照组（P〈0.05）。结论：门冬胰岛素30治疗老年2型糖尿病患者具有安全、方便、有效的优点,易于被老年患者接受,是一种理想的治疗方案。     

诺和锐30和诺和灵30R治疗2型糖尿病的临床比较

目的:研究诺和锐30和诺和灵30R治疗2型糖尿病的效果。方法:将84例2型糖尿病患者随机分为治疗组42例(诺和锐30)和对照组42例(诺和灵30R),均为每日2次皮下注射。应用12周,观察两组日胰岛素总量、血糖控制情况、体重及低血糖发生率。结果:两组的空腹血糖、餐后血糖、中餐前血糖及糖化血红蛋白较治疗前差异有统计学意义(P<0.05)。两组的空腹血糖、中餐前血糖及糖化血红蛋白下降值差异无统计学意义(P>0.05),而餐后血糖的下降值差异有统计学意义(P<0.05)。两组体重变化差异无统计学意义(P>0.05)。治疗组日胰岛素总量低于对照组,两组比较差异有统计学意义(P<0.05)。结论:治疗组的餐后血糖有明显降低,而且低血糖发生率较低,治疗2型糖尿病尤其以餐后血糖高为主的患者更适合使用。     

诺和锐30与诺和灵30R临床疗效的比较

目的研究诺和锐30与诺和灵30R治疗2型糖尿病的疗效。方法将78例2型糖尿病患者（不包含严重的晚期糖尿病并发症或其他严重疾病的患者）随机分为诺和锐30组（n=37）和诺和灵30R组（n=41）。诺和锐30组为餐前即刻皮下注射,诺和灵30R组为餐前30min皮下注射,治疗2周后观察2组7点血糖水平（空腹、三餐前、三餐后）,低血糖发生率,使用药物计量的差异及3个月后糖化血红蛋白水平的差异。结果诺和锐30组空腹和餐后2h血糖水平、糖化血红蛋白水平及低血糖发生率均低于诺和灵30R组（P〈0.05）,但使用药物计量2组差异无统计学意义（P〉0.05）。结论诺和锐30和诺和灵30R都具有安全有效的降血糖的作用。但诺和锐30在降低餐后血糖及糖化血红蛋白方面更有优势,低血糖发生率更低。     

诺和锐30和诺和灵30R治疗老年2型糖尿病临床观察

目的比较两组人门冬胰岛素（诺和锐30）和可溶性人胰岛素（诺和灵30）对老年2型糖尿病患者的疗效与安全性。方法2006年2月-2008年2月对本院90例2型糖尿病患者用诺和锐30以及诺和灵30治疗前后测定三餐前后血糖。糖化血红蛋白（HBmC），并记录胰岛素用量，低血糖发生率。结果治疗两周后两组血糖均有显著降低，诺和锐组餐后血糖下降幅度显著大于诺和灵组．且诺和锐组每日所需胰岛素剂量低。诺和锐组餐后血糖下降幅度显著大于诺和灵组，且诺和锐组每日所需胰岛素剂量低，低血糖发生率少。结：呛诺和锐能更好地降低餐后血糖。安全性和耐受性良好。     

诺和锐30与预混人胰岛素治疗糖尿病的临床应用

目的：观察比较诺和锐30与预混人胰岛素（诺和灵30R）治疗2型糖尿病的临床疗效观察。方法：随机选取2型糖尿病患者86例,分为诺和锐30治疗组与诺和灵30R对照组．治疗12周后,观察两种治疗方案患者的空腹血糖（FBG）、餐后2h血糖（2hPBG）、糖化血红蛋白（HbAIC）及低血糖发生的情况。结果：治疗后诺和锐30组FBG、2hPBG、HbAIC降低显著优于诺和灵30R对照组（P〈0．01）。诺和锐30组中有1次轻度低血糖,诺和灵30R对照组有4例出现轻度低血糖。结论：应用诺和锐30每日1-2次治疗,可以显著改善、控制血糖,疗效优于预混人胰岛素（诺和灵30R）治疗。     

甘精胰岛素联合那格列奈治疗老年2型糖尿病分析

目的观察甘精胰岛素联合那格列奈治疗老年2型糖尿病患者的疗效和安全性。方法选取40例年龄大于70岁、病程大于5年、口服降糖药物血糖控制差的糖尿病患者。随机分为A组：甘精胰岛素联合那格列奈组20例,甘精胰岛素每晚皮下注射1次,联合那格列奈餐前5分钟口服;B组：预混胰岛素组20例,预混胰岛素70/30早晚餐前30分钟皮下注射。治疗3个月观察患者空腹血糖、餐后2小时血糖、糖化血红蛋白变化及低血糖发生率。结果治疗3个月后两组空腹血糖、餐后2小时血糖、糖化血红蛋白均明显下降（P〈0.01）,A组空腹血糖、餐后2小时血糖及糖化血红蛋白控制优于B组（P〈0.01）,A组1例轻微低血糖,B组调整过程中出现8例低血糖。两组比较P〈0.01,有统计学意义。结论甘精胰岛素联合那格列奈治疗老年2型糖尿病有较好疗效及安全性。     

门冬胰岛素30注射液治疗初诊2型糖尿病50例

目的观察门冬胰岛素30注射液（诺和锐30）对初诊2型糖尿病的血糖控制效果。方法对2008年5月至11月住院和门诊初诊患者50例进行12周的诺和锐30治疗,观察空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1C）、空腹C肽（F-C）、空腹胰岛素（FNS）、餐后2hC肽（2h-C）、餐后2h胰岛素（2h-NS）的变化及不良反应。结果治疗12周后,FPG,2hPG,HbA1C水平均较治疗前明显下降（P〈0.01）,F-C,FNS,2h-C,2h-NS均较治疗前明显升高（P〈0.01）,无严重低血糖事件及其他严重不良反应。结论诺和锐30是一种可有效降低2型糖尿病患者空腹及餐后血糖的预混胰岛素剂型。     

优泌乐50联合诺和锐30控制2型糖尿病血糖效果观察

目的观察优泌乐50联合诺和锐30与单独使用优泌乐50对2型糖尿病患者血糖控制效果观察。方法40例初诊或口服降糖药物效果不佳的2型糖尿病患者随机分至联合胰岛索组及优泌乐50组,联合胰岛素组给予早餐及中餐前优泌乐50,晚餐前诺和锐30注射,优泌乐50组三餐前h均给予优泌乐50注射,给予三餐前及睡前血糖监测,治疗12周后比较两组空腹血糖、日均血糖、糖基化血红蛋白（HbAlc）和低血糖发生率。结果①两组治疗后空腹血糖、日均血糖和HbAlc水平均较治疗前明显下降（均P〈0．01）。②治疗12周后,联合胰岛素组空腹血糖控制较优泌乐50组好（P〈0．05）,睡前血糖较优泌乐50组差（P〈0．05）,日均血糖和HbAlc水平比较差异无统计学意义（P〉0．05）。③2组低血糖发生次数差异无统计学意义（P〉0．05）,优泌乐50组常见睡前低血糖,联合胰岛素组常见午夜低血糖。结论对于应用优泌乐50控制血糖的2型糖尿病患者,若空腹血糖控制欠佳,采用睡前诺和锐30注射能更好的控制空腹血糖,且不增加低血糖风险,从而达到血糖达标。     

门冬胰岛素与生物合成人胰岛素治疗2型糖尿病的临床疗效分析

目的比较门冬胰岛素（诺和锐30R）与生物合成人胰岛素（诺和灵30R）治疗2型糖尿病的疗效。方法 36例2型糖尿病患者随机分为诺和锐30R组和诺和灵30R组各18例,诺和锐30R为餐前即刻皮下注射,诺和灵30R组餐前30min皮下注射2次/d治疗,治疗12周后,观察血糖控制情况及低血糖发生情况。结果诺和锐30R组空腹血糖、餐后2h血糖、HbA1c均低于诺和灵30R组,差异有统计学意义（P〈0.01）,诺和锐30R所需剂量较诺和灵30R少,差异有统计学意义（P〈0.05）,低血糖发生率显著降低,差异有统计学意义（P〈0.01）。结论诺和锐30R和诺和灵30R均可安全有效的降低血糖,诺和锐30R能更好地降低2型糖尿病血糖水平,减少低血糖反发生率,减少胰岛素剂量。     

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.     

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.     

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.