药物治疗糖尿病周围神经病变120例疗效观察

目的：研究糖尿病周围神经病变治疗中硫辛酸与甲钴胺联合用药的临床治疗效果。方法将本院进行糖尿病周围神经病变治疗的120例患者随机均分为三组,对照A组患者接受甲钴胺治疗,对照B组患者不接受营养神经类药物治疗;治疗组患者接受硫辛酸联合甲钴胺治疗。结果治疗组患者治疗有效率92.5%显著高于对照A组、对照B组,对照A组患者治疗有效率67.5%显著高于对照B组。结论硫辛酸与甲钴胺联合可有效治疗糖尿病周围神经病变。     

α-硫辛酸、甲钴胺、贝前列腺素钠口服治疗糖尿病周围神经病变的效果观察

目的探讨α-硫辛酸、甲钴胺、贝前列腺素钠口服治疗糖尿病周围神经病变的效果。方法选取210例糖尿病周围神经病变患者,随机分为A组(口服硫辛酸组)、B组(口服贝前列腺素钠)、C组(口服甲钴胺)、AB组(口服硫辛酸联用贝前列腺素钠)、BC组(口服贝前列腺素钠联用甲钴胺)、AC组(口服硫辛酸联用甲钴胺),对比各组治疗效果。结果 AB组、BC组、AC组治疗后总有效率明显高于A组、B组、C组;A组、B组、C组三组治疗总有效率差异不显著;AB组、BC组、AC组治疗总有效率差异不显著。结论α-硫辛酸、甲钴胺、贝前列腺素钠口服治疗糖尿病周围神经病变效果明显,联合应用效果优于单纯用药。     

甲钴胺注射液联合银杏达莫治疗糖尿病周围神经病变疗效观察

目的：探讨甲钴胺注射液联合银杏达莫治疗糖尿病周围神经病变（DPN）的疗效。方法：将120例糖尿病周围神经病变患者随机分为A、B、C3组各40例,A组单用甲钴胺注射液治疗,B组单用银杏达莫治疗,C组甲钴胺注射液联合银杏达莫治疗。观察治疗前后3组自觉症状、神经肌电图的运动速度的改变。结果：3组治疗前后FBG、PBG、HbA1c差异无统计学意义（P〉0.05）;3组治疗前后MCV比较,差异有统计学意义（P〈0.05）;3组疗效比较,C组总有效率明显高于A、B组,组间差异有统计学意义（P〈0.05）。结论：甲钴胺注射液联合银杏达莫治疗糖尿病周围神经病变安全有效,能快速改善患者的自觉症状,更好地修复受损神经组织。     

前列地尔联合甲钴胺治疗糖尿病周围神经病变的疗效观察

目的观察前列地尔联合甲钴胺治疗糖尿病周围神经病变的临床疗效。方法将102例2型糖尿病合并周围神经病变患者,随机分为3组,每组34例患者,前列地尔治疗组(A组)、甲钴胺治疗组(B组)、前列地尔联合甲钴胺治疗组(C组),在血糖控制稳定情况下,分别给予静脉注射前列地尔10μg,每日一次;肌内注射注射用甲钴胺500μg,每日一次;及两药联合应用。2周为1个疗程,2周后观察治疗效果。结果三组治疗后患者的下肢疼痛、麻木、间歇性跛行等症状均有不同程度的减轻,以C组有效率最高,显著高于A组和B组。结论前列地尔联合甲钴胺对糖尿病周围神经病变有较好的治疗效果。     

甲钴胺联合依帕司他或α-硫辛酸治疗糖尿病周围神经病变的疗效观察与比较

目的：观察依帕司他联合甲钴胺与α-硫辛酸联合甲钴胺治疗糖尿病周围神经病变的疗效。方法将110例糖尿病周围神经病变患者在控制血糖基础上随机分为 A 组36例,B 组37例和 C 组37例。A 组予甲钴胺＋维生素 B1;B 组予α-硫辛酸＋甲钴胺＋维生素 B1;C 组予依帕司他＋甲钴胺＋维生素 B1。均连续3周给药,对治疗前后症状及神经传导速度改善情况进行比较分析。结果 A 组总有效率77.77％,B 组有效率94.59％,C 组有效率91.89％;正中神经、腓总神经传导速度（MNCV 和 SNCV）3组间进行比较,A 组与 B 组、A 组与 C 组差异均有统计学意义（P ＜0.05）,B 组与 C 组差异无统计学意义（P ﹥0.05）。结论依帕司他联合甲钴胺、维生素 B1与硫辛酸联合甲钴胺、维生素 B1治疗糖尿病周围神经病变均能显著改善患者症状体征和神经传导功能,且明显优于甲钴胺加维生素 B1治疗,但从经济学考虑首选依帕司他。     

α-硫辛酸联合甲钴胺注射液治疗糖尿病周围神经病变79例疗效观察

目的探讨α-硫辛酸联合甲钴胺注射液治疗糖尿病周围神经病变的临床疗效。方法选择2008年7月至2009年10月79例糖尿病周围神经病变患者,随机分为治疗组(39例)和对照组(40例),对照组单用甲钴胺注射液治疗,治疗组给予α-硫辛酸联合甲钴胺注射液治疗,4周为1个疗程,治疗时间为2个疗程。观察两组患者治疗前后临床疗效及神经传导速度改善情况。结果治疗结束后,治疗组及对照组的总有效率分别为93.41%和60.16%,治疗组有效率明显优于对照组(P<0.01);治疗组神经传导速度改善程度明显优于对照组,差异有统计学意义(P<0.05)。结论α-硫辛酸联合甲钴胺注射液是治疗糖尿病周围神经病变患者的一种有效,安全的治疗方法,值得临床推广使用。     

α-硫辛酸联合甲钴胺治疗2型糖尿病周围神经病变的临床研究

目的观察α-硫辛酸(LA)联合甲钴胺对2型糖尿病周围神经病变的治疗效果。方法选择2008年4月—2012年12月在该科住院的2型糖尿病伴有周围神经病变患者82例,随机分成两组。A组40例给予LA和甲钴胺联合治疗,B组42例给予单用甲钴胺治疗,疗程均为15 d。观察两组治疗前后的临床症状及神经传导速度(NCV)。结果 A组治疗总有效率(85.0%)高于B组(69.0%)(P0.05);两组治疗后临床症状及神经传导速度均有明显改善(均P0.05),但A组的疗效优于B组(P0.05);两组均未见明显药物不良反应。结论α-硫辛酸联合甲钴胺治疗能有效改善2型糖尿病周围神经病变的症状和神经传导速度,可以推广应用临床治疗。     

α-硫辛酸联合甲钴胺注射液治疗糖尿病周围神经病变临床价值分析

目的:探讨α-硫辛酸联合甲钴胺注射液应用于糖尿病周围神经病变的临床治疗效果.方法:对我院2014~2016年收治的78例糖尿病周围神经病变患者进行随机分组,分为观察组和对照组,每组39例,观察组行α-硫辛酸联合甲钴胺注射液治疗,对照组行甲钴胺注射液治疗,比较两组临床疗效.结果:两组肌电结果显示感觉神经传导速度(SCV)和腓总神经、胫神经、正中神经的运动神经传导速度(MCV)较治疗前均显著得到改善(P<0.05);观察组神经传导速度(SCV、MCV)明显优于对照组(P<0.05);观察组的总有效率为94.9%显著高于对照组的66.7%.结论:α-硫辛酸联合甲钴胺注射液治疗糖尿病周围神经病变效果显著,能有效改善神经传导速度且安全可靠,具有临床推广价值.     

甲钴胺联合α硫辛酸对糖尿病周围神经病变患者电生理的影响研究

目的观察分析甲钴胺联合α硫辛酸对糖尿病周围神经病变患者电生理的影响。方法选取糖尿病周围神经病变患者120例随机分为A、B两组,每组各60例,分别给予单纯甲钴胺和甲钴胺联合α硫辛酸治疗。比较两组的治疗效果及电生理改变情况。结果 A、B两组的治疗总有效率分别为86.67%和98.33%,B组的治疗效果明显好于A组(χ~2=5.886,P=0.015<0.05);治疗后两组的MCV、SSCV和SOD的检测值与治疗前比较均明显升高,而MDA值明显降低,而且B组的改变幅度明显大于A组,上述比较差异有统计学意义(P<0.05)。结论甲钴胺联合α硫辛酸治疗糖尿病周围神经病变具有较好的抗氧化作用,能够明显改善患者神经电生理状况,有较为显著的疗效。     

不同剂量甲钴胺治疗慢性酒精中毒性周围神经病变85例疗效分析

目的 观察不同剂量甲钴胺治疗酒精中毒性周围神经病变患者的疗效.方法 85例经确诊为酒精中毒性周围神经病变患者随机分为A组(29例)、B组(28例)和C组(28例).除常规治疗外,A组予甲钴胺1500 μg加入0.9％氯化钠注射液250 ml中静脉滴注,1次/d;B组予甲钴胺500μg加入0.9％氯化钠注射液250 ml中静脉滴注,1次/d;C组不予甲钴胺.治疗4周后评价患者症状改善情况,比较正中神经和腓总神经的神经传导速度.结果 各组治疗后症状均有明显改善.其中A组和B组效果优于C组(P＜0.01),而A组疗效又优于B组(P＜0.05).三组神经传导速度提高明显(P＜0.05),A组和B组改善优于C组(P＜0.05),A组优于B组(P＜0.05).结论 甲钴胺治疗酒精中毒性周围神经病变具有一定疗效,而大剂量使用的效果优于常规剂量.     

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.