依达拉奉注射液治疗急性脑出血疗效分析

目的 评价依达拉奉注射液治疗急性脑出血的疗效.方法 将82例脑出血患者随机分成两组:依达拉奉组(治疗组)42例和常规治疗组(对照组)40例.治疗组和对照组在治疗前和治疗4周后进行神经功能缺损程度评分(ESS).结果 治疗组ESS评分显著高于对照组(P<0.01),且治疗组无明显不良反应.结论 依达拉奉治疗急性脑出血安全有效.     

依达拉奉与丹红注射液联合应用在急性脑梗死患者中的临床效果观察

目的 探讨依达拉奉与丹红注射液联合治疗急性脑梗死的临床效果.方法 选择我院急性脑梗死患者100例,根据随机原则分为观察组和对照组.在对症处理基础上对照组给予依达拉奉,观察组给予依达拉奉和丹红注射液,两组均连续治疗14 d.对两组治疗前后进行神经功能缺损评分.结果 观察组和对照组总有效率分为为94.0%和78.0%,两组总有效率经统计学检验显示差异有统计学意义(P<0.05);观察组治疗后神经功能缺损评分显著低于对照组治疗后,差异有统计学意义(P<0.05).结论 依达拉奉与丹红注射液联合应用治疗急性脑梗死临床效果显著,能够显著改善急性脑梗死神经功能缺损症状,值得借鉴.     

依达拉奉治疗急性脑出血的临床疗效观察

目的观察依达拉奉治疗急性脑出血的临床疗效。方法将80例急性脑出血患者随机分为治疗组和对照组,每组40例,对照组给予常规治疗,治疗组在常规治疗基础上加用依达拉奉静脉滴注,连用14d。两组均在治疗前及治疗14d后进行神经功能缺损评分及临床疗效评定。结果依达拉奉组治疗14d后神经功能缺损有明显改善;依达拉奉组总有效率明显高于对照组总有效率,差异有统计学意义（P〈0.05）。结论依达拉奉治疗急性脑出血安全有效,值得临床推广应用。     

依达拉奉联合银杏达莫治疗急性脑梗死疗效观察

目的:探讨依达拉奉与银杏达莫联用治疗急性脑梗死的临床疗效.方法:将40例急性脑梗死患者随机分为两组,对照组20例予以银杏达莫注射液.治疗组20例在对照组基础上联用依达拉奉.于治疗前和治疗后分别进行神经功能缺损程度评分,并判定临床疗效.结果:治疗组治疗后神经功能缺损评分明显降低,与治疗前比较差异有统计学意义(P<0.05),治疗组显效率,总有效率与对照组比较差异均有统计学意义(P<0.05).结论:依达拉奉与银杏达莫联用治疗急性脑梗死可有效终止病情进展,改善神经功能缺损.提高临床疗效.     

依达拉奉治疗急性脑出血的临床疗效及对自由基含量的影响

目的:观察依达拉奉治疗急性脑出血的临床疗效和对自由基的影响。方法:62例急性脑出血患者随机分为治疗组与对照组各31例。对照组给予常规治疗,治疗组在对照组治疗基础上加用依达拉奉,并在治疗前后14d进行神经功能缺损评分及血清超氧化物歧化酶(SOD)和丙二醛(MDA)含量测定。结果:治疗组神经功能缺损评分较对照组明显降低(P<0.05),血清SOD活性显著提高,MDA水平明显降低(P<0.01)。结论:依达拉奉明显改善急性脑出血患者神经功能,与其清除自由基有一定关系。     

依达拉奉治疗急性脑出血的临床疗效观察

目的:观察依达拉奉治疗急性脑出血的临床疗效。方法:将72例急性脑出血患者随机分为治疗组和对照组各36例。对照组:治疗组在对照组常规治疗的基础上给予依达拉奉针剂30mg静滴,2次/d,两组疗程均为14d。结果:两组患者治疗前、后神经功能缺损评分有统计学意义(P<0.05),且两组患者的临床疗效异均有统计学意义(P<0.05)。结论:依达拉奉可促进脑出血患者的神经功能康复。     

依达拉奉联合醒脑静注射液治疗急性脑出血临床疗效观察

目的：探讨依达拉奉联合醒脑静注射液治疗急性脑出血的临床疗效。方法86例急性脑出血患者,随机分为治疗组(43例)与对照组(43例)。对照组进行临床常规治疗,治疗组在常规治疗的同时,加用依达拉奉、醒脑静注射液。经过2周的治疗,分析比较两组患者的临床治疗效果和神经功能缺损评分情况。结果神经功能缺损评分治疗组明显低于对照组;治疗组总有效率为95.3%,对照组为81.4%;两组比较差异均有统计学意义(P<0.05)。结论依达拉奉联合醒脑静注射液治疗急性脑出血疗效显著,能够改善脑功能、恢复神经功能、促进康复。     

依达拉奉与长春西汀联合乌司他丁治疗急性脑出血的疗效对比分析

目的对比分析依达拉奉与长春西汀联合乌司他丁治疗急性脑出血的疗效。方法将2013年2月至2014年4月在我院进行急性脑出血治疗的117例患者按随机数字表法分成2组,对照组(54例)行依达拉奉治疗,观察组(63例)行长春西汀联合乌司他丁治疗,均连续治疗14d。比较2组患者治疗前后血肿量、神经功能缺损程度评分、格拉斯哥昏迷评分。结果治疗前,2组患者血肿量、神经功能缺损程度评分、格拉斯哥昏迷评分比较,差异均无统计学意义(P>0.05)。治疗后,2组患者血肿量均明显减少(P<0.05),且观察组血肿量明显少于对照组(P<0.05);2组患者神经功能缺损程度评分均明显降低(P<0.05),且观察组患者神经功能缺损程度评分明显低于对照组(P=0.002);2组患者格拉斯哥昏迷评分均明显降低(P<0.05),且观察组患者格拉斯哥昏迷评分明显低于对照组(P=0.007);观察组治疗总有效率(56%)明显高于对照组总有效率(37%)(P<0.05);观察组出现不良反应的患者34例(63%)明显高于观察组出现不良反应总人数24例(38%)(P<0.05)。结论依达拉奉、长春西汀联合乌司他丁治疗急性脑出血能够有效地减少患者血肿量,降低神经功能缺损程度评分、格拉斯哥昏迷评分,但是后者治疗效果优于依达拉奉。     

依达拉奉联合马来酸桂哌齐特治疗急性脑梗死46例的疗效观察

目的探讨依达拉奉注射液联合马来酸桂哌齐特注射液治疗急性脑梗死的临床疗效。方法 86例急性脑梗死患者随机分为治疗组(40例)及对照组(46例)。两组患者除给予常规治疗外,治疗组(40例)给予依达拉奉注射液30mg,1日2次及马来酸桂哌齐特注射液320mg,1日1次;对照组(46例)给予依达拉奉注射液30mg,1日2次。两组患者均治疗14d,观察两组治疗前后临床疗效、神经功能缺损评分和欧洲脑卒中评分量表(ESS)评分的变化并进行对比分析。结果两组患者治疗后临床疗效、神经功能缺损评分和ESS评分的变化差异有统计学意义(P<0.05)。结论依达拉奉联合马来酸桂哌齐特注射液治疗急性脑梗死的效果明显好于依达拉奉的单药治疗,疗效显著,值得在临床推广应用。     

依达拉奉治疗高血压性脑出血疗效观察

目的:观察早期应用依达拉奉治疗高血压性脑出血的疗效。方法:将80例高血压性脑出血患者随机分为治疗组和对照组,各40例,分别在入院时及治疗后14 d对患者进行神经功能缺损评分并进行临床评价。结果:治疗组神经功能缺损评分改善情况与对照组相比,差异具有统计学意义(P<0.05)。治疗组临床结局改善明显优于对照组。结论:依达拉奉对高血压性脑出血神经功能康复有明显的效果。     

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.

     

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.     

2-(Acetoxyphenyl)-(Z)-styryl sulfides as cyclooxygenase inhibitors

2-(Acetoxyphenyl)-(Z)-styryl sulfides are described as selective cyclooxygenase-2 (COX-2) inhibitors, useful for treating inflammation and COX-2-mediated disorders including neoplasia. 2-(Acetoxyphenyl)-(Z)-styryl sulfide is claimed to be the most potent COX inhibitor in the series with a COX-2 selectivity ratio of 33. This compound is also claimed to be superior to celecoxib (Celebrex^®, Pfizer) in inhibiting cell growth of colorectal carcinoma cells. In this evaluation, the COX inhibitory activity of this compound is compared to that previously disclosed for diarylheterocycles and 2-(acetoxyphenyl)alkyl sulfides. The validity of the DLD-1 cell line in the growth inhibition studies is questioned based on recent literature reports indicating the lack of COX-2 expression in this cell line.     

Sleep-disordered breathing with chronic opioid use

Chronic opioid use for pain relief or as substitution therapy for illicit drug abuse is prevalent in our societies. In the US, retail distribution of methadone and oxycodone has increased by 824 and 660%, respectively, between 1997 and 2003. μ-Opioids depress respiration and deaths related to illicit and non illicit chronic opioid use are not uncommon. Since 2001 there has been an emerging literature that suggests that chronic opioid use is related to central sleep apnoea of both periodic and non-periodic breathing types, and occurs in ～ 30% of these subjects. The clinical significance of these sleep-related abnormalities are unknown. This review addresses the present knowledge of control of ventilation mechanisms during wakefulness and sleep, the effects of opioids on ventilatory control mechanisms, the sleep-disordered breathing found with chronic opioid use and a discussion regarding the future research directions in this area.     

Drug targets for cognitive enhancement in neuropsychiatric disorders

The investigation of novel drug targets for treating cognitive impairments associated with neurological and psychiatric disorders remains a primary focus of study in central nervous system (CNS) research. Many promising new therapies are progressing through preclinical and clinical development, and offer the potential of improved treatment options for neurodegenerative diseases such as Alzheimer's disease (AD) as well as other disorders that have not been particularly well treated to date like the cognitive impairments associated with schizophrenia (CIAS). Among targets under investigation, cholinergic receptors have received much attention with several nicotinic agonists (α7 and α4β2) actively in clinical trials for the treatment of AD, CIAS and attention deficit hyperactivity disorder (ADHD). Both glutamatergic and serotonergic (5-HT) agonists and antagonists have profound effects on neurotransmission and improve cognitive function in preclinical experiments with animals; some of these compounds are now in proof-of-concept studies in humans. Several histamine H3 receptor antagonists are in clinical development not only for cognitive enhancement, but also for the treatment of narcolepsy and cognitive deficits due to sleep deprivation because of their expression in brain sleep centers. Compounds that dampen inhibitory tone (e.g., GABA_A α5 inverse agonists) or elevate excitatory tone (e.g., glycine transporter inhibitors) offer novel approaches for treating diseases such as schizophrenia, AD and Down syndrome. In addition to cell surface receptors, intracellular drug targets such as the phosphodiesterases (PDEs) are known to impact signaling pathways that affect long-term memory formation and working memory. Overall, there is a genuine need to treat cognitive deficits associated with many neuropsychiatric conditions as well as an increasingly aging population.