阿司匹林联合氯吡格雷治疗大脑中动脉狭窄脑梗死的临床研究

目的探讨阿司匹林联合氯吡格雷治疗大脑中动脉狭窄脑梗死的临床效果。方法大脑中动脉狭窄脑梗死患者168例,随机分两组,对照组84例采用阿司匹林治疗,观察组84例采用阿司匹林联合氯吡格雷治疗,于治疗前后行Barthel指数、Fugl-Meyer评分、NIHSS评分、VAS评分,并检测血流动力学指标(全血低切黏度、全血高切黏度、血浆黏稠度、纤维蛋白原),比较两组临床疗效、预后。结果治疗后,两组Barthel指数、Fugl-Meyer评分增加(P0.05)。两组NIHSS评分、VAS评分、血流动力学指标(全血低切黏度、全血高切黏度、血浆黏稠度、纤维蛋白原)降低(P0.05)。观察组Barthel指数、Fugl-Meyer评分、治疗总有效率高于对照组(P0.05)。观察组NIHSS评分、VAS评分、血流动力学指标(全血低切黏度、全血高切黏度、血浆黏稠度、纤维蛋白原)、并发症发生率、疾病进展率、疾病复发率低于对照组(P0.05)。结论阿司匹林联合氯吡格雷治疗大脑中动脉狭窄脑梗死的疗效显著。患者临床指标、神经功能改善明显,预后较好。     

注射用尤瑞克林与硫酸氢氯吡格雷联用治疗进展性脑梗死疗效观察

目的观察注射用尤瑞克林与硫酸氢氯吡格雷联用治疗进展性脑梗死的疗效及安全性。方法将进展性脑梗死患者100例随机分为治疗组和对照组各50例,在给予常规治疗同时,对照组给予口服硫酸氢氯吡格雷,治疗组在对照组的基础给于注射用尤瑞克林,连用14d,于治疗前后14d评价临床疗效及神经功能。结果治疗组治疗14d后临床疗效评定总有效率88%,显著优于对照组(P<0.05);治疗组神经功能缺损评分与对照组比较,差异有统计学意义(P<0.05)。结论注射用尤瑞克林与硫酸氢氯吡格雷联用治疗进展性脑梗死疗效明显,安全可靠,值得推广。     

阿司匹林联合硫酸氢氯吡格雷口服治疗脑梗死的临床效果观察

目的对阿司匹林联合硫酸氢氯吡格雷口服治疗脑梗死患者的临床效果进行分析评价。方法102例脑梗死患者,按随机盲选法分为对照组和观察组,每组51例。对照组实施阿司匹林治疗,观察组实施阿司匹林联合硫酸氢氯吡格雷治疗。比较两组患者临床疗效和治疗前后神经功能缺损评分。结果观察组治疗总有效率为94.12%,显著高于对照组的76.47%,差异具有统计学意义(P<0.05)。对照组治疗前神经功能缺损评分为(32.14±2.83)分,治疗后14 d为(29.78±6.54)分,治疗后28 d为(23.17±5.73)分;观察组治疗前神经功能缺损评分为(32.15±2.82)分,治疗后14 d为(24.31±5.61)分,治疗后28 d为(16.78±4.49)分。两组治疗前神经功能缺损评分比较差异无统计学意义(P>0.05);治疗后14、28 d,观察组患者神经功能缺损评分均明显低于对照组,差异具有统计学意义(t=4.534、6.269,P<0.05)。结论脑梗死患者采取阿司匹林联合硫酸氢氯吡格雷口服医治不仅可以保证临床疗效,还可以改善神经功能缺损程度,具备推广及使用的价值。     

阿司匹林联合硫酸氢氯吡格雷治疗老年急性脑梗死临床疗效及对患者血清炎性因子的影响研究

目的 研究阿司匹林+硫酸氢氯吡格雷运用于老年急性脑梗死中的价值。方法 选取我院收治的老年急性脑梗死患者100例,随机分为研究者对照组,各50例。研究组服用阿司匹林+硫酸氢氯吡格雷,对照组使用阿司匹林,比较两组总有效率、不良反应、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白介素-18(IL-18)、超敏C反应蛋白(hs-CRP)、血小板聚集率、血浆比黏度、全血比黏度。结果 研究组总有效率高出对照组(P<0.05)。服药后,研究组IL-6、TNF-α、IL-18、hs-CRP均低于对照组(P<0.05)。研究组不良反应与对照组比较无差异(P>0.05)。服药后,研究组血小板聚集率、血浆比黏度、全血比黏度均低于对照组(P<0.05)。结论 阿司匹林+硫酸氢氯吡格雷的效果更为理想,不仅能够减轻患者机体的炎性反应,同时可改善血液流变学指标,不良反应少,值得推广。     

国产硫酸氢氯吡格雷治疗急性脑梗死的疗效分析

目的探讨硫酸氢氯吡格雷治疗急性脑梗死的疗效。方法研究组60例,均经头颅CT扫描确诊为急性脑梗死,口服硫酸氢氯吡格雷2周,并于入院时和服药2周后分别测量患者GMP140、血浆黏度、全血黏度和血小板聚集率指标;对照组为入院体检健康者56例,同样测以上四项指标并记录分析。结果研究组患者在GMP140、血浆黏度、全血黏度和血小板聚集率四项指标上明显高于对照组,且研究组患者于服用硫酸氢氯吡格雷2周后,其各项指标有明显下降,但仍高于健康人。所有数据经分析均具有统计学意义(P<0.05)。结论国产硫酸氢氯吡格雷具有降低血黏度、抗血小板的作用,对于治疗急性脑梗死患者具有积极的临床价值。     

洛伐他汀联合氯吡格雷治疗急性脑梗死的临床疗效

目的 观察洛伐他汀联合氯吡格雷治疗急性脑梗死的临床疗效。方法 选取2019年2—12月广东省广宁县人民医院收治的急性脑梗死患者70例,采用随机数字表法分为研究组和对照组各35例。对照组应用常规药物治疗,研究组在对照组的基础上应用洛伐他汀联合氯吡格雷治疗,2组患者均持续用药30 d。比较2组患者治疗前后基质金属蛋白酶-9 (MMP-9)、血管紧张素Ⅱ(AngⅡ)、血管内皮生长因子(VEGF)、血清超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平、全血低切黏度、全血高切黏度、血浆黏度、纤维蛋白原及临床疗效。结果 治疗30 d后,2组患者的MMP-9、AngⅡ水平均低于治疗前,VEGF水平均高于治疗前,且研究组降低/升高幅度大于对照组(P <0.01); 2组患者的血清hs-CRP、IL-6及TNF-α水平均低于治疗前,且研究组低于对照组(P <0.01); 2组患者的全血低切黏度、全血高切黏度、血浆黏度、纤维蛋白原水平均低于治疗前,且研究组低于对照组(P <0.01)。治疗30 d后,研究组患者的总有效率为91.43%,高于对照组...     

舒血宁注射液联合氢氯吡格雷治疗急性脑梗死的疗效研究

目的:分析对急性脑梗死患者实施舒血宁注射液联合氢氯吡格雷治疗的效果。方法:择取80例择取急性脑梗死患者,将其随机分为对照组和研究组各40例,对照组实施氢氯吡格雷治疗,研究组实施舒血宁注射液联合氢氯吡格雷治疗,对照分析两组临床效果。结果:从血液流变学指标来看,治疗后研究组全血低切黏度、全血高切黏度、血小板聚集率、血浆黏度均优于对照组(P<0.05);从神经功能指标来看,治疗后研究组MBP、H-FABP、NSE、GFAP均优于对照组(P<0.05);从相关细胞因子水平变化来看,治疗后研究组sVCM-1、TNF-α、IL-18均优于对照组(P<0.05)。结论:对急性脑梗死患者实施舒血宁注射液联合氢氯吡格雷治疗的效果确切。     

阿司匹林肠溶片联合硫酸氢氯吡格雷片治疗急性脑梗死的临床疗效

目的探讨阿司匹林肠溶片联合硫酸氢氯吡格雷片治疗急性脑梗死(ACI)的临床疗效。方法选取三明市第二医院神经内科2016年3月—2017年9月收治的ACI患者78例,随机分为对照组与观察组,各39例。对照组给予阿司匹林肠溶片,观察组在对照组基础上给予硫酸氢氯吡格雷片。两组均治疗21 d。比较两组住院时间,治疗前后日常生活能力量表(ADL)、美国国立卫生研究院卒中量表(NIHSS)评分,临床疗效,并观察两组不良反应发生情况。结果观察组住院时间短于对照组(P<0.05)。治疗前两组ADL、NIHSS评分比较,差异无统计学意义(P>0.05);治疗后观察组ADL、NIHSS评分低于对照组(P<0.05)。观察组总有效率、不良反应发生率高于对照组(P<0.05)。结论阿司匹林肠溶片联合硫酸氢氯吡格雷片治疗ACI的临床疗效确切,可缩短住院时间,改善神经功能和日常生活能力,但安全性不高。     

阿司匹林联合硫酸氢氯吡格雷口服治疗脑梗死的有效性和安全性研究

目的分析阿司匹林联合硫酸氢氯吡格雷治疗脑梗死的应用效果。方法选择50例在我院进行救治的脑梗死患者进行研究,根据患者入院时间的顺序将50例患者划分为观察组和对照组,每组25例;两组均用阿司匹林治疗,观察组加入硫酸氢氯吡格雷。结果疗效及神经功能缺损评分对比,观察组均明显占优(P<0.05)。结论阿司匹林联合硫酸氢氯吡格雷治疗脑梗死整体效果良好,值得借鉴。     

阿司匹林联合硫酸氢氯吡格雷口服治疗脑梗死的有效性和安全性分析

目的 探讨阿司匹林联合硫酸氢氯吡格雷口服治疗脑梗死的有效性和安全性。方法 100例脑梗死患者为研究对象,随机分为观察组与对照组,各50例。对照组给予患者阿司匹林治疗,观察组给予患者阿司匹林联合硫酸氢氯吡格雷口服治疗。对比两组治疗效果、治疗前后神经功能损伤程度、不良反应发生情况。结果 观察组治疗总有效率98.00%高于对照组的68.00%,差异有统计学意义(P<0.05)。治疗后,观察组美国国立卫生研究院卒中量表(NIHSS)评分(7.21±1.75)分低于对照组的(14.88±1.17)分,差异有统计学意义(P<0.05)。观察组不良反应发生率2.00%低于对照组的28.00%,差异有统计学意义(P<0.05)。结论 脑梗死患者使用阿司匹林联合硫酸氢氯吡格雷口服治疗效果理想,可有效改善患者神经功能,降低不良反应发生率,值得推广使用。     

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.

     

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.