厄贝沙坦片联合盐酸贝尼地平片治疗高血压肾病的临床疗效

目的：探讨厄贝沙坦片联合盐酸贝尼地平片治疗高血压肾病的临床疗效。方法选取2011年1月—2014年1月魏县人民医院收治的高血压肾病患者132例,采用随机数字表法将患者分为厄贝沙坦组（49例）,贝尼地平组（43例）,联合治疗组（40例）。厄贝沙坦组患者予以厄贝沙坦片治疗;贝尼地平组患者予以盐酸贝尼地平片治疗;联合治疗组患者予以厄贝沙坦片联合盐酸贝尼地平片治疗。观察3组患者治疗前后血压、肾功能〔24h 尿蛋白定量、血肌酐（Scr）、血尿素氮（BUN）、内生肌酐清除率（Ccr）〕及不良反应发生情况。结果治疗前3组患者收缩压、舒张压、24h 尿蛋白定量、Scr、BUN、Ccr 比较,差异无统计学意义（P ﹥0.05）;治疗后3组患者收缩压、舒张压、24h 尿蛋白定量、Scr、BUN、Ccr 比较,差异有统计学意义（ P ﹤0.05）;联合治疗组患者收缩压、舒张压、24h 尿蛋白定量、Scr、BUN 低于厄贝沙坦组和贝尼地平组,Ccr 高于厄贝沙坦组和贝尼地平组,差异有统计学意义（P ﹤0.05）;3组患者不良反应发生率比较,差异无统计学意义（P ﹥0.05）。结论厄贝沙坦联合贝尼地平治疗高血压肾病的临床疗效显著,可改善患者临床症状,且不良反应小。     

氯沙坦联合苯磺酸氨氯地平治疗老年高血压合并糖尿病的临床疗效

目的：探讨氯沙坦联合苯磺酸氨氯地平治疗老年高血压合并糖尿病的临床疗效。方法选取2013年12月—2014年12月黔南州人民医院收治的老年高血压合并糖尿病患者100例,随机分为氯沙坦组（30例）、苯磺酸氨氯地平组（30例）、联合治疗组（40例）。氯沙坦组患者予以氯沙坦治疗,苯磺酸氨氯地平组患者予以苯磺酸氨氯地平治疗,联合治疗组患者予以氯沙坦联合苯磺酸氨氯地平治疗。观察3组患者治疗前后血压变化情况、尿清蛋白排泄量及不良反应发生情况。结果治疗前3组患者收缩压、舒张压比较,差异无统计学意义（ P﹥0.05）;治疗后3组患者收缩压、舒张压比较,差异有统计学意义（ P﹤0.05）,联合治疗组患者收缩压、舒张压低于氯沙坦组和苯磺酸氨氯地平组,差异有统计学意义（ P﹤0.05）。治疗前3组患者尿清蛋白排泄量比较,差异无统计学意义（ P﹥0.05）,治疗后3组患者尿清蛋白排泄量比较,差异有统计学意义（P﹤0.05）,联合治疗组患者尿清蛋白排泄量低于氯沙坦组和苯磺酸氨氯地平组,苯磺酸氨氯地平组患者尿清蛋白排泄量低于氯沙坦组,差异均有统计学意义（P﹤0.05）。3组患者不良反应发生率比较,差异无统计学意义（ P﹥0.05）。结论氯沙坦联合苯磺酸氨氯地平治疗老年高血压合并糖尿病的临床疗效显著,可改善患者血压,保护肾功能,且不良反应小。     

贝那普利联合厄贝沙坦治疗糖尿病并发高血压的疗效观察

目的：探究贝那普利联合厄贝沙坦治疗糖尿病并发高血压的临床疗效。方法选择2010—2012年我院门诊及住院部确诊的糖尿病并发高血压患者124例,随机分为贝那普利组（40例）、厄贝沙坦组（41例）及联合治疗组（43例）。贝那普利组予以贝那普利治疗,厄贝沙坦组予以厄贝沙坦治疗;联合治疗组予以贝那普利联合厄贝沙坦治疗。比较治疗前、治疗4周及治疗8周后3组患者收缩压（SBP）、舒张压（DBP）、空腹血糖（FBG）、血肌酐（Cr）、血尿素氮（BUN）,尿微量清蛋白（MA）。结果3组患者治疗4、8周后的血压均较治疗前下降,差异有统计学意义（P 〈0.05）;联合治疗组治疗4、8周后的血压均低于贝那普利组和厄贝沙坦组,差异有统计学意义（ P 〈0.05）。3组患者治疗前后组间、组内的 FBG 比较,差异均无统计学意义（P 〉0.05）。3组患者治疗后 Cr、BUN、MA均较治疗前下降,差异有统计学意义（P 〈0.05）;联合治疗组治疗8周后的 Cr、BUN、MA 均低于贝那普利及厄贝沙坦组,差异有统计学意义（P 〈0.05）。结论贝那普利联合厄贝沙坦治疗糖尿病并发高血压疗效显著,且对肾脏有保护作用。     

瑞舒伐他汀联合福辛普利治疗糖尿病肾病的效果观察

目的：观察瑞舒伐他汀联合福辛普利治疗糖尿病肾病的临床疗效。方法90例糖尿病肾病患者随机分为福辛普利组和联合用药组各45例。福辛普利组给予福辛普利10mg,口服,1次/ d;联合用药组给予瑞舒伐他汀与福辛普利,瑞舒伐他汀10mg,口服,1次/ d,福辛普利用法同前组。2组疗程均为24周,观察2组治疗前后的尿微白蛋白排泄率（UAER）、24h 尿蛋白、血肌酐（Scr）、血脂、血压等指标。结果治疗后,2组 UAER 与24h 尿蛋白均降低,差异有统计学意义（P ﹤0.01）。联合用药组 UAER、24h 尿蛋白降低幅度大于福辛普利组,差异有统计学意义（ P ﹤0.01）,2组 Scr 与空腹血糖均下降,差异无统计学意义（P ﹥0.05）。2组血脂和血压降低均有所改善,差异有统计学意义（P ﹤0.01）,联合用药组血脂改变程度优于福辛普利组,差异有统计学意义（P ﹤0.01）。结论瑞舒伐他汀钙联合福辛普利治疗糖尿病肾病,对肾脏保护有协同作用。     

苯磺酸氨氯地平联合贝那普利治疗高血压合并2型糖尿病临床观察

目的 探讨苯磺酸氨氯地平联合贝那普利治疗高血压合并2型糖尿病的疗效.方法 将176例高血压合并2型糖尿病患者随机分为3组,联合组60例给予苯磺酸氨氯地平联合贝那普利治疗,而苯磺酸氨氯地平组（58例）及贝那普利组（58例）仅分别给予苯磺酸氨氯地平和贝那普利治疗.治疗结束后比较观察3组的疗效及降压效果.结果 治疗组总有效率为93.3%远高于苯磺酸氨氯地平组的65.5%和贝那普利组的65.5%（P〈0.05）.3组治疗前后收缩压和舒张压比较差异均有统计学意义（P〈0.05）;治疗后联合组收缩压和舒张压明显低于苯磺酸氨氯地平组及贝那普利组,差异均有统计学意义（P〈0.05）.结论 苯磺酸氨氯地平联合贝那普利治疗高血压合并2型糖尿病疗效确切,值得临床推广应用.     

苯那普利联合氨氯地平治疗79例高血压的临床观察

目的探讨苯那普利与氨氯地平联合应用于高血压治疗的疗效优势。方法回顾性分析本院诊治的79例高血压患者的临床资料,均予以5mg的氨氯地平,口服,1次/d,同时予以苯那普利10mg,口服,1次/d,共治疗6周。结果 79例患者经治疗后,收缩压、舒张压明显低于治疗前（P〈0.05）;治疗后心功能明显改善,与治疗前比较差异具有统计学意义（P〈0.05）。结论苯那普利与氨氯地平联合应用于高血压治疗的临床疗效显著,能有效改善患者临床症状,不良反应较少,降压明显,值得临床推广。     

胺碘酮联合美托洛尔治疗心律失常的临床疗效观察

目的：探讨胺碘酮联合美托洛尔治疗心律失常的临床疗效。方法选取2011年4月—2014年4月屯留县人民医院收治的心律失常患者85例,随机分为观察组（42例）与对照组（43例）。对照组患者予以胺碘酮治疗,观察组患者予以胺碘酮联合美托洛尔治疗。观察两组患者转复率、有效率、药物起效时间、治疗前后心率、血压变化情况及不良反应发生情况。结果观察组患者窦性心律转复率和有效率明显高于对照组,药物起效时间短于对照组,差异有统计学意义（P ﹤0.05）;治疗前两组患者收缩压、舒张压及心率比较,差异无统计学意义（ P ﹥0.05）;治疗后观察组患者收缩压、舒张压及心率低于对照组,差异有统计学意义（ P ﹤0.05）;两组患者不良反应发生率比较,差异无统计学意义（P ﹥0.05）。结论胺碘酮联合美托洛尔治疗心律失常的临床疗效显著,可缩短药物起效时间,改善患者心率、血压,且不良反应小。     

苯磺酸左旋氨氯地平片治疗原发性高血压的临床疗效

目的：探讨苯磺酸左旋氨氯地平片治疗原发性高血压的临床疗效。方法选取2013年1月—2014年1月宁波市澥浦镇卫生院收治的原发性高血压患者118例,随机分为研究组与对照组,各59例。对照组患者予以厄贝沙坦治疗,研究组患者予以苯磺酸左旋氨氯地平片治疗。观察两组患者临床疗效、治疗前后血压（舒张压、收缩压）变化情况及不良反应发生情况。结果研究组患者总有效率高于对照组（P ﹤0.05）;治疗前两组患者收缩压、舒张压比较,差异无统计学意义（P ﹥0.05）,治疗后研究组患者收缩压、舒张压低于对照组（P ﹤0.05）;研究组患者不良反应发生率低于对照组（P ﹤0.05）。结论苯磺酸左旋氨氯地平片治疗原发性高血压的临床疗效显著,可改善患者血压,且不良反应小。     

螺内酯联合苯那普利治疗高血压性心脏病充血性心力衰竭的临床效果观察

目的 观察螺内酯联合苯那普利治疗高血压性心脏病充血性心力衰竭的临床效果.方法 选择2012年6月～2013年12月本院接诊的80例高血压性心脏病充血性心力衰竭患者,按照随机数字表法分为观察组和对照组,对照组采用苯那普利治疗,观察组在对照组的基础上,采用螺内酯治疗.比较两组的疗效和不良反应发生率,治疗前后心功能相关指标、血压及心率.结果 两组治疗后的LAD、INS、LVEDD、LVEF及NT-pro-BNP改善均明显优于治疗前,观察组治疗后的LVPW改善优于治疗前,差异有统计学意义（P＜0.01）;观察组治疗后的LAD、INS、LVPW、LVEDD、LVEF及NT-pro-BNP改善均明显优于对照组,差异有统计学意义（P＜0.05）.两组治疗后的收缩压、舒张压及心率均明显低于治疗前,差异有统计学意义（P＜0.01）;观察组治疗后的收缩压、舒张压及心率均明显低于对照组,差异有统计学意义（P＜0.05）.观察组的总有效率为87.50％,明显高于对照组的67.50％,两组比较差异有统计学意义（u=-2.2686,P=0.0233）.两组的不良反应发生率比较差异无统计学意义（x2=0.6723,P=0.4123）.结论 螺内酯联合苯那普利治疗高血压性心脏病充血性心力衰竭的效果显著,安全性高,值得临床推广应用.     

联合用药治疗高血压合并糖尿病患者的疗效观察

目的探讨贝那普利与非洛地平联合治疗高血压合并糖尿病的临床疗效。方法选择高血压合并糖尿病患者90例,随机分为贝那普利组、非洛地平组和联合治疗组3组,分别治疗3个月后评价血压控制效果及不良反应。结果治疗3个月后,3组患者的收缩压和舒张压均下降（P〈0.01）,且联合治疗组的收缩压降低幅度大于其他2组（P〈0.05）,联合治疗组的舒张压降低幅度与其他2组比较差异无统计学意义（P〉0.05）。结论贝那普利与非洛地平联合应用降压效果优于单药降压。     

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.     

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.     

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.