博乐欣缓释片与氯丙咪嗪治疗抑郁症的临床疗效和安全性比较

目的探讨博乐欣缓释片治疗抑郁症的临床疗效和安全性。方法对符合CCMD-3抑郁症发作诊断标准的74例抑郁症患者进行博乐欣缓释片和氯丙咪嗪的对照研究,其中博乐欣缓释片组34例,氯丙咪嗪组40例。于治疗前及治疗后1、2、4、6周末采用汉密顿抑郁量表（HAMD）,副反应量表（TESS）评定。采用HPLC测定治疗后的第2、6周末博乐欣缓释片血浓度。结果经6周治疗后,博乐欣缓释片组治疗显效率为82％,氯丙咪嗪组为75％,两组相比较,差异无显著性（P〉0．05）;第1周末两组的HAMD减分率比较差异有高度显著性（P〈0．01）;博乐欣缓释片组显效时间为（5．68±3．55）d,氯丙咪嗪组为（12．74±5．63）d。结论博乐欣缓释片治疗抑郁症的疗效与氯丙咪嗪相当,但前者起效更快,副反应少,依从性好,安全性高。适合临床快速控制抑郁症状。     

氯丙咪嗪口服与口服加静脉滴注治疗抑郁症比较

目的比较单纯口服与口服加静脉滴注氯丙咪嗪治疗抑郁症的疗效。方法选择60例中重度抑郁症患者随机分为两组,分别接受单纯口服氯丙咪嗪和口服加静脉滴注氯丙咪嗪的方法治疗。用汉密顿抑郁量表(HAMD)的减分率评价疗效。结果口服加静脉滴注氯丙咪嗪组HAMD减分率高,且无1例出现自杀行为。结论口服加静滴氯丙咪嗪治疗中重度抑郁症,奏效快、疗效高,出现自杀的风险低。     

吗氯贝胺与丙咪嗪治疗抑郁症的随机双盲对照研究

目的：采用吗氯贝胺和丙咪嗪治疗抑郁症的双盲对照试验,同时对吗氯贝胺进行开放临床研究。方法：１５对双盲和３０例开放的临床研究,采用疗前和疗后第１,２,４,６周末进行ＨＡＭＤ,ＨＡＭＡ,ＴＥＳＳ及ＣＧＩ的评定。结果;吗氯贝胺组、丙咪嗪组、吗氯贝胺开放组ＨＡＭＤ减分率分别为６９．３％,８３．６％,７５．６％,前二者经统计学分析组间无差异性（Ｐ〉０．０５）,各组内治疗前后ＨＡＭＤ得分均有差异性（Ｐ〈０．０     

吗氯贝胺与丙咪嗪治疗抑郁症的双盲对照研究

目的：比较吗氯贝胺与丙咪嗪治疗抑郁症的疗效和不良反应。方法：对４９例住院抑郁症患者进行了随机双盲对照研究。采用ＨＡＭＤ、ＣＧＩ和ＴＥＳＳ评定疗效和不良反应。结果：吗氯贝胺组显效率８４．０％，与丙咪嗪组的７０．８％疗效相近，两者无显著性差异（Ｐ〉０．０５）。吗氯贝胺抗胆碱能不良反应明显少于丙咪嗪，两者有明显差异（Ｐ〈０．０５）。结论：吗氯贝胺治疗抑郁症疗效与丙咪嗪相当，不良反应轻，耐受性好。     

氯丙咪嗪、帕罗西汀、万拉法新治疗老年抑郁症的对照研究

目的:比较氯丙咪嗪、帕罗西汀、万拉法新治疗老年抑郁症的疗效和不良反应。方法:对符合CCMD-Ⅲ抑郁发作诊断标准的患者随机分为3组,每组30例,分别给予氯丙咪嗪、帕罗西汀和万拉法新治疗,疗程6周。用Hamilton抑郁量表(HAMD),临床大体印象量表(CGI)、不良反应量表(TESS)进行评分。结果:氯丙咪嗪显效率70%,帕罗西汀显效率65%,万拉法新显效率75%,差异无显著性(x2=0.42,P>0.05)。万拉法新显效快,2周内的HAMD总分低于氯丙咪嗪和帕罗西汀组。结论:万拉法新是一种疗效较好而不良反应较少的治疗老年抑郁症的药物。     

吗氯贝胺治疗抑郁症

目的 :比较吗氯贝胺和丙米嗪治疗抑郁症的疗效及不良反应。方法 :10 7例抑郁症分成 3组。吗氯贝胺双盲组 (吗氯贝胺组 ) 2 5例 (男性 16例 ,女性 9例 ;年龄 36a±s 10a) ,予吗氯贝胺 2 0 0mg ,po ,bid。丙米嗪双盲组 (丙米嗪组 ) 2 6例 (男性 14例 ,女性 12例 ;年龄 36a± 12a) ,予丙米嗪 10 0mg ,po ,bid。吗氯贝胺开放组 (开放组 ) 56例 (男性 2 7例 ,女性 2 9例 ;年龄 39a± 13a)予吗氯贝胺 2 0 0mg ,po ,bid ;均 4wk为一个疗程。结果 :吗氯贝胺组有效率 96% ,丙米嗪组 96% ,Ridit分析P >0 .0 5,开放组 95%。药物不良反应发生率丙米嗪组高于吗氯贝胺组。结论 :吗氯贝胺与丙米嗪治疗抑郁症疗效相同 ,不良反应少     

西酞普兰与氯丙咪嗪治疗阿尔茨海默病抑郁的对照研究

目的 比较西酞普兰与氯丙咪嗪治疗阿尔茨海默病（AD）抑郁症状中的疗效和不良反应.方法 对60例AD患者分别以西酞普兰与氯丙咪嗪治疗,共治疗8周,采用汉密尔顿抑郁量表（HAMD）评定临床疗效,采用副反应量表（TESS）评定副反应.结果 西酞普兰与氯丙咪嗪总体疗效相当,但西酞普兰起效较快,不良反应发生率低.结论 西酞普兰治疗AD抑郁症状的疗效与氯丙咪嗪相当,不良反应少,值得推广应用.     

万拉法新治疗抑郁性神经症对照研究

目的：比较万拉法新与氯丙咪嗪治疗抑郁性神经症的疗效及副反应。方法对符合CCMD2-R抑郁性神经症诊断标准的病人，随机分为万拉法新组和氯丙咪嗪组，治疗12周后，用汉米尔顿抑郁量表（HAMD），药物副反应量表（TESS）评定疗效和药物的不良反应。结果万拉法新与氯丙咪嗪疗效相当，起效较氯丙咪嗪早，副反应较氯丙咪嗪轻。结论万拉法新治疗抑郁性神经症疗效较好，起效快，副反应小，患者服药依从性好。     

帕罗西汀与氯丙咪嗪治疗强迫症的临床对照研究

目的：观察并对比帕罗西汀和氯丙咪嗪治疗强迫症患者的疗效和不良反应。方法：以CCMD-3作为诊断标准,选取强迫症患者100例,随机分为2组,分别用帕罗西汀和氯丙咪嗪治疗8周。应用Yale-Brown强迫量表（Y-BOCS）、汉密顿抑郁量表（HAMD）、汉密顿焦虑量表（HAMA）及临床4级标准评定疗效,用副反应量表（TESS）评定不良反应。在治疗前及治疗后4、8周末,分别评定临床疗效、以上量表的分数及不良反应。结果：帕罗西汀与氯丙咪嗪两组患者疗效的差异无显著性（P〉0.05）;帕罗西汀不良反应明显少于氯丙咪嗪（P〈0.01）,而且耐受性好。结论：帕罗西汀治疗强迫症的疗效与氯丙咪嗪相当,但帕罗西汀具有日剂量小、给药简单方便、不良反应比氯丙咪嗪少而轻等优点     

甘麦大枣汤辅助治疗抑郁症的临床观察

目的观察甘麦大枣汤配合氯丙咪嗪治疗抑郁症的临床疗效。方法选取2007年6月至2010年6月的186例抑郁症患者,随机分成两组,治疗组93例,应用甘麦大枣汤配合氯丙咪嗪治疗,对照组93例,单纯应用氯丙咪嗪治疗,在治疗前后对两组疗效不良反应进行测查。结果两组抑郁情况都均有明显改善,HAMD减分率显著(P<0.01),治疗组组的疗效评价及不良反应发生概率均优于对照组(P<0.05)。结论甘麦大枣汤配合氯丙咪嗪治疗抑郁症非常有效,且会减少不良反应,明显提高药物治疗依从性。     

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.