乌拉地尔对充血性心力衰竭患者血浆脑钠肽水平的影响及意义

目的观察乌拉地尔对充血性心力衰竭患者血浆脑钠）hk（BNP）的影响及临床疗效。方法将65例充血性心力衰竭患者,随机分为乌拉地尔治疗组33例、对照组32例,两组均给予常规治疗,治疗组在此治疗基础上静脉持续泵入乌拉地尔50—400I．Lg／min,通过观察两组患者血浆脑钠肽浓度变化来判断心功能改善情况。结果治疗组的总有效率为90．81％,明显高于对照组的62．50％（P〈0．05）;两组治疗后6min步行距离均增加,血浆脑钠肽水平均下降,而治疗组改善程度优于对照组（P〈0．05）。两组均未见严重不良反应。结论乌拉地尔能明显降低充血性心力衰竭患者血浆脑钠肽浓度,改善心功能,治疗急性心力衰竭安全、有效。     

有创呼吸支持在重度急性心力衰竭患者中的应用

目的：探讨有创呼吸支持在重度急性心力衰竭患者中的应用价值。方法：选择经常规药物手段和面罩无创正压通气（NIPPV）无效的34例重度急性心力衰竭患者进行经口气管插管接呼吸机辅助通气，观测患者的临床征象、血气分析和心率、血压变化。结果：34例重度急性心力衰竭患者抢救成功24例次，抢救成功率70．6％。有创呼吸支持治疗后24例生命体征稳定、心力衰竭减轻，PaO2和SaO2明显提高（P〈0．01）；10例无效，其中4例休克不能纠正、1例猝死、3例合并严重肺气肿伴呼吸机相关性肺炎（VAP）无法脱机、2例多器官功能衰竭死亡。结论：对于经常规药物手段和面罩无创机械通气治疗不佳、濒临死亡的重度急性心力衰竭患者，及时行气管插管有创呼吸支持，可迅速改善低氧血度和CO2潴留，减轻肺水肿，改善心功能，提高生存率。     

正压通气对慢性心衰脑利钠肽水平影响

目的 通过观察无创正压通气（NIPPV）对慢性充血性心力衰竭患者脑利钠肽水平（BNP）的影响,探讨NIPPV治疗慢性充血性心力衰竭的机制。方法 31例慢性充血心力衰竭患者随机分为治疗组与对照组,治疗组在常规强心、利尿、扩血管治疗基础上予NIPPV,对照组予治疗常规强心、利尿扩血管治疗,治疗2h和48h后,分别测定血浆BNP含量,进行对比分析。结果 治疗前两组血浆BNP含量无明显差异（P〉0．05）。治疗48h后治疗组血浆BNP含量比对照组明显下降（P〈0．05）。结论 NIPPV在改善患者临床症状同时,明显降低患者血浆BNP水平,NIPPV不仅影响CHF的血流动力学,对慢性充血性心力衰竭患者神经肽含量的影响在治疗中起到一定作用。     

脑钠肽评估慢性充血性心力衰竭患者长期预后的研究

目的:探讨心力衰竭患者血浆脑钠肽(BNP)浓度与其预后之间的关系。方法:采用美国博适(Biosite-Tri-age)快速定量心力衰竭诊断仪,对2008年1月—2008年12月间收治入院的60例充血性心力衰竭患者治疗前后血浆BNP浓度进行测定,并于出院后继续跟踪随访三年,主要随访内容包括心功能的变化及患者再入院时间。结果:充血性心力衰竭患者治疗后BNP改变值与心衰复发及再入院时间存在相关效应(P<0.001)。结论:充血性心力衰竭患者治疗后的血浆BNP变化水平是临床心力衰竭疗效判断和预后估测的重要指标。     

生脉注射液对急性心力衰竭时血浆脑钠肽水平影响的分析

目的：分析生脉注射液对急性心力衰竭时血浆脑钠肽（BNP）水平的影响。方法随机选取本院2012年8月~2014年4月急诊ICU住院的116例急性心力衰竭患者,并编号分组,对照组（n=58）患者给予西医吸氧、利尿、扩张血管等基础治疗,治疗组（n=58）患者在此基础上给予葡萄糖250 ml＋生脉注射液50 ml静脉滴注。比较两组患者治疗后临床症状、左室射血分数、BNP等指标的变化。结果观察组患者的有效率为93.1%,明显低于对照组的84.5%（χ2=6.053,P〈0.05）;治疗后,两组患者左室射血分数和BNP浓度变化均得到改善,观察组的改善幅度较对照组明显（P〈0.05）。结论生脉注射液对心肌细胞功能有一定的保护作用,且能有效降低BNP的水平,改善急性心力衰竭患者的预后。     

脑钠肽测定在慢性充血性心力衰竭患者诊断及预后评估中的应用价值观察

目的：探讨脑钠肽（BNP）测定在慢性充血性心力衰竭患者诊断及预后评估中的应用价值。方法本研究共入选研究对象100例,均为2012年2月至2014年8月本院收治的慢性充血性心力衰竭患者,在患者入院后测定其脑钠肽水平,同时测定患者的左室舒张末期容积（EDV）、左室收缩末期容积（ESV）、左室射血分数（LVEF）。结果 BNP水平随着心功能分级的上升逐渐升高,各组水平差异显著（P<0.05）;EDV≤88.50mL/m2、ESV≤36.50mL/m2、LVEF≥50%水平正常组的BNP水平明显高于EDV、ESV、LVEF水平异常组（P<0.05）;BNP>110pg/mL患者进入终末事件发生率明显高于BNP<110pg/ml患者（P<0.05）。结论脑钠肽（BNP）测定在慢性充血性心力衰竭患者诊断中具有重要意义,其可为患者的早期诊断及治疗起到指导作用,避免患者病情进一步恶化。     

生脉对充血性心力衰竭患者疗效观察及对血浆活性物质的影响

目的：观察生脉注射液对充血性心力衰竭的疗效,及对患者血浆活性物质的影响。方法：采用随进对照方法,对40例充血性心力衰竭患者随即分为常规治疗组和生脉组,两组疗程均为2周。2周后观察心功能变化及内皮素（ET）、脑钠肽（BNP）、前列环素（PGI2）的变化及临床意义。结果：与常规治疗组比较,生脉组心功能指标改善更为明显,血浆ET、BNP下降,PGI2升高,P〈0.05。结论：生脉可以改善充血性心力衰竭患者心功能,同时可以调节异常的血管活性物质。     

前列地尔脂对慢性心力衰竭患者脑钠肽及左室功能的影响

目的观察前列地尔脂微球载体制剂对慢性充血性心力衰竭（CHF）患者治疗前后左心功能、血浆B型脑钠肽（BNP）水平的变化及6rain步行距离的影响。方法对武汉市第一医院2010年2月至2012年9月收治的慢性充血性心力衰竭患者70例按入院先后顺序随机分为治疗组和对照组各35例,对照组采用常规心力衰竭药物治疗,治疗组在此基础上加用前列地尔脂微球载体制剂治疗。比较两组患者治疗前后血浆B型脑钠肽（BNP）水平、左室射血分数（LVEF）、左室短轴缩短率（FS）、每搏量（SV）、左室舒张末期容积（LVEDD）及6min步行距离的变化。结果两组患者治疗后各项指标均得到改善,治疗组较对照组左室射血分数、搏出量及左室短轴缩短率增加（P〈0．05）,左室舒张末期内径减小（P〈0．05）,血浆BNP水平显著下降（P〈0．05）,6min步行距离明显延长。结论慢性心力衰竭在常规治疗的同时,加用前列地尔辅助治疗,可进一步提高慢性充血性心力衰竭患者的心功能,且无明显不良反应。     

注射用重组人脑利钠肽联合呋塞米注射液治疗急性心力衰竭患者的临床疗效观察

目的 探讨注射用重组人脑利钠肽联合呋塞米注射液治疗急性心力衰竭患者的临床疗效.方法 100例急性心力衰竭患者,随机分为观察组与对照组,每组50例.对照组患者接受呋塞米注射液治疗,观察组患者在对照组基础上联合注射用重组人脑利钠肽治疗.比较两组患者心功能相关生化指标[脑利钠肽(BNP)、血肌酐(SCR)、血钾(K+)、血钠...     

新活素治疗老年急性心力衰竭患者疗效及安全性观察

目的观察应用新活素治疗老年人急性心力衰竭的临床疗效及不良反应。方法86例老年急性心力衰竭患者随机分为对照组、治疗组,对照组给予常规抗急性心力衰竭治疗,治疗组在对照组治疗的基础上,再给予新活素治疗。观察两组患者的临床疗效及不良反应。结果治疗组老年急性心力衰竭患者在改善临床症状、降低血浆脑钠肽水平、提高左室射血分数方面治疗有效率明显优于对照组（P〈0．05）。结论在老年急性心力衰竭患者治疗中应用新活素对改善患者症状、提高左室射血分数、降低血浆脑钠肽水平有一定的临床价值,且在老年患者中应用新活素安全可靠,值得在临床应用中进一步推广。     

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.     

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.