拉西地平对老年原发性高血压踝臂脉搏波传导速度及尿微量清蛋白的影响

目的：探讨拉西地平对老年原发性高血压（EH）踝臂脉搏波传导速度（baPWV）和尿微量清蛋白（MAU）水平的影响。方法：选取100例轻中度老年EH患者为观察组,60例健康人为对照组。观察组给予拉西地平治疗12周,采用欧姆龙科林VP-1000动脉硬化测定仪检测baPWV,采用免疫透射比浊法测尿微量清蛋白。结果：观察组治疗前踝臂脉搏波传导速度及尿微量清蛋白明显高于对照组（P〈0.05）,观察组经拉西地平治疗12周后,收缩压、舒张压明显降低,踝臂脉搏波传导速度及尿微量清蛋白显著下降。结论：拉西地平在降压的同时可降低尿微量清蛋白对肾脏有保护作用,能减慢踝臂脉搏波传导速度,改善大动脉弹性。     

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。     

缬沙坦与苯磺酸左旋氨氯地平治疗原发性高血压的疗效及对血尿酸影响的比较研究

目的：比较缬沙坦与苯磺酸左旋氨氯地平治疗原发性高血压的疗效及对血尿酸的影响。方法将84例原发性高血压患者随机分为治疗组和对照组各42例。对照组予以缬沙坦片80mg,每日1次。治疗组予以苯磺酸左旋氨氯地平片5mg,每日1次。两组疗程均为8周。结果两组患者治疗后收缩压、舒张压与同组治疗前比较,差异均有统计学意义（P＜0.01）。治疗组治疗后收缩压、舒张压与对照组比较,差异均无统计学意义（P＞0.05）。治疗组治疗后血压达标有26例,达标率为61.90%,对照组治疗后血压达标有17例,达标率为54.76%。两组血压达标率比较,差异无统计学意义（P＞0.05）。治疗后,治疗组血尿酸与对照组比较,差异具有统计学意义（P＜0.01）。结论缬沙坦与苯磺酸左旋氨氯地平均能改善原发性高血压患者的血压水平,且缬沙坦能显著降低原发性高血压患者血尿酸水平。     

缬沙坦氨氯地平联合美托洛尔治疗老年高血压的效果研究

目的：探讨缬沙坦氨氯地平联合美托洛尔治疗老年高血压的效果。方法：选取2020年5月—2022年1月我院诊治的120例老年高血压患者作为研究对象,按随机数字表法分为对照组、观察组,每组60例。对照组予以美托洛尔治疗,观察组予以缬沙坦氨氯地平+美托洛尔治疗,比较两组临床疗效、血压水平、血管弹性功能[大动脉弹性指数（C1）、踝臂指数（ABI）、小动脉弹性指数（C2）]及用药安全性。结果：观察组治疗总有效率为96.67%,高于对照组的85.00%(P<0.05);观察组舒张压、收缩压水平低于对照组（P<0.05）;观察组C1、ABI、C2高于对照组（P<0.05）;观察组用药后不良反应发生率与对照组比较,差异无统计学意义（P>0.05）。结论：缬沙坦氨氯地平与美托洛尔联合治疗老年高血压患者的效果确切,可有效控制血压水平,改善血管弹性功能,且安全性良好,具有较高临床应用价值。     

缬沙坦分别联合氨氯地平和氢氯噻嗪治疗原发性高血压78例疗效观察

目的探讨比较缬沙坦分别联合氨氯地平和氢氯噻嗪治疗原发性高血压疗效。方法 78例原发性高血压患者随机分为A组与B组,分别予以缬沙坦联合氨氯地平和缬沙坦联合氢氯噻嗪治疗。结果 A、B组治疗后收缩压与舒张压值较治疗前下降,差异有统计学意义（P〈0.05）;A、B组间相比,治疗前后舒张压、收缩压和治疗总有效率差异均无统计学意义（P〉0.05）;A组患者心血管事件及不良反应发生情况低于B组,差异有统计学意义（P〈0.05）。结论缬沙坦联合氨氯地平与缬沙坦联合氢氯噻嗪都能有效的降低原发性高血压患者血压,二者降压效果相当,但缬沙坦联合氨氯地平用药安全性更高,更适宜患者长期服用。     

全科团队服务模式干预对农村原发性高血压患者的影响

目的：探讨全科团队服务模式干预对农村原发性高血压患者的临床效果。方法选取2011年2月—2013年2月原平市长梁沟镇卫生院收治的原发性高血压患者36例,随机分为观察组与对照组,各18例。对照组患者予以门诊治疗,观察组患者在对照组基础上予以全科团队服务模式干预。观察两组患者临床疗效、血压变化及用药依从情况。结果观察组患者总有效率高于对照组,差异有统计学意义（ P<0.05）。治疗前两组患者收缩压和舒张压比较,差异无统计学意义（P>0.05）。治疗后观察组患者收缩压和舒张压低于对照组（P<0.05）。观察组患者用药依从性高于对照组（ P<0.05）。结论全科团队服务模式干预对农村原发性高血压患者的临床效果显著,有助于改善患者血压,提高用药依从性。     

非洛地平联合缬沙坦方案在社康中心老年高血压治疗中的应用分析

目的：探讨在社康中心非洛地平联合缬沙坦方案治疗老年高血压的效果。方法：选择2013年7月～2015年7月社康中心收治的120例老年高血压患者,随机分为两组,观察组经非洛地平联合缬沙坦方案治疗,对照组仅经非洛地平治疗,比较两组疗效。结果：治疗后观察组总有效率显著高于对照组（P<0.05）;两组患者治疗前收缩压与舒张压比较,差异无统计学意义,P>0.05;治疗后观察组收缩压为（121.4±8.5）mmHg,舒张压为（81.3±5.3）mmHg均显著低于治疗前,对照组收缩压为（143.5±11.5）mmHg,舒张压为（92.1±7.4） mmHg,观察组收缩压与舒张压均低于对照组（P<0.05）。结论：经非洛地平联合缬沙坦方案治疗老年高血压,预后效果良好。     

阿托伐他汀联合二甲双胍治疗非酒精性脂肪性肝病对患者臂踝动脉脉搏波传导速度的影响

目的探讨阿托伐他汀联合二甲双胍治疗非酒精性脂肪性肝病(NAFLD)对患者臂踝动脉脉搏波传导速度的影响。方法选取2018年12月～2019年9月收治的122例NAFLD患者为本次研究对象。根据随机抛硬币法分为观察组与对照组,每组各61例。对照组采用单纯阿托伐他汀治疗,观察组采用阿托伐他汀联合二甲双胍治疗。对比两组患者治疗前及治疗12周后血清脂质代谢指标水平,血清胰岛素抵抗相关指标及臂踝动脉脉搏波传导速度。结果治疗前两组患者各项血清脂质代谢指标水平差异无统计学意义(P> 0.05),治疗后观察组甘油三酯(TC)、血清总胆固醇(CHO)、低密度脂蛋白胆固醇(LDL-C)低于对照组,高密度脂蛋白胆固醇(HDL-C)水平均高于对照组(P <0.05);治疗前两组患者血清胰岛素抵抗相关指标差异无统计学意义(P> 0.05),治疗后观察组纤维蛋白原(FBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)水平均低于对照组(P <0.05);治疗前两组患者收缩压(SBP)、舒张压(DBP)、臂踝动脉脉搏波传导速度(baPWV)比较差异无统计学意义(P>0.05)...     

缬沙坦联合硝苯地平控释片对原发性高血压的临床疗效观察

目的：探讨缬沙坦联合硝苯地平控释片治疗原发性高血压的临床疗效。方法：选取原发性高血压患者100例,随机分为观察组（n=50）和对照组（n=50）。对照组采用硝苯地平控释片治疗;观察组采用缬沙坦联合硝苯地平控释片治疗。分析两组治疗前后的收缩压（SBP）、舒张压（DBP）、心率（HR）、不良反应发生率和临床疗效。结果：治疗后两组SBP、DBP、HR均小于治疗前,差异有统计学意义（P<0.05）,观察组治疗后小于对照组治疗后,差异有统计学意义（P<0.05）。观察组不良反应发生率小于对照组,总有效率大于对照组,差异有统计学意义（P<0.05）。结论：缬沙坦联合硝苯地平控释片治疗原发性高血压疗效显著,值得临床推广。     

臂踝脉搏波传导速度与原发性高血压患者亚临床靶器官损害的关系

目的探讨臂踝脉搏波传导速度与原发性高血压病患者亚临床靶器官损害的关系。方法60例高血压病患者根据臂踝脉搏波传导速度分为正常组24例与增高组36例,所有病例均行头颅磁共振成像、心脏与颈动脉多普勒超声及尿微量白蛋白检查。结果增高组无症状性脑梗死发生率、颈动脉内膜中层厚度、左心室质量指数及尿微量白蛋白均高于臂踝脉搏波传导速度正常组,差异有统计学意义（P〈0．05）。结论臂踝脉搏波传导速度与高血压病患者亚临床靶器官损害有关,对高血压病患者亚临床靶器官损害有良好的预测作用。     

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.

     

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.     

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.