α-硫辛酸联合替米沙坦对2型糖尿病早期肾病患者蛋白尿及血管内皮功能的影响

目的分析α-硫辛酸和替米沙坦对2型糖尿病早期肾病患者尿蛋白排泄率及血管内皮功能的影响。方法将47例伴有微量白蛋白尿的2型糖尿病患者随机分为常规治疗组(例数=24)和联合治疗组(例数=23),两组均服用替米沙坦80mg,1次,d。联合治疗组予静脉注射α-硫辛酸600mg,1次/d,总疗程2周。治疗前后测定24h尿白蛋白排泄率(UAER)、血浆内皮素-1(ET-1)及血清一氧化氮(NO)水平。结果与治疗前比较,两组UAER均显著降低(P<0.01),联合治疗组降低更明显(P<0.05)。联合治疗组治疗后ET-1显著降低(P<0.01),NO明显升高(P<0.01);而常规治疗组ET-1、NO无明显变化(P>0.05)。结论α-硫辛酸联合替米沙坦能减少尿蛋白的排泄,改善血管内皮功能,对肾功能有一定的保护作用。     

替米沙坦联合阿魏酸钠治疗糖尿病肾病70例疗效观察

目的探讨替米沙坦联合阿魏酸钠治疗糖尿病肾病的临床效果。方法选择高州市人民医院2008年10月至2010年9月糖尿病肾病患者70例,上述患者随机分为两组,观察组和对照组。两组患者均实施饮食控制,给予糖尿病饮食,给予口服降糖药或者胰岛素控制血糖。对照组患者给予替米沙坦每天80mg口服;观察组在对照组治疗基础上给予阿魏酸钠0.3g加入0.9%氯化钠注射液250mL中静脉滴注,每天1次,连续治疗4周。测定两组患者治疗前后尿微量白蛋白排泄率、血清肌酐、尿素氮、空腹血糖。结果观察组和对照组治疗后尿微量白蛋白排泄率与本组治疗前比较,差异有统计学意义(P<0.05);观察组治疗后尿微量白蛋白排泄率与对照组治疗比较,差异有统计学意义(P<0.05);观察组治疗后血清肌酐水平显著治疗前,差异有统计学意义(P<0.05)。结论替米沙坦联合阿魏酸钠治疗糖尿病肾病临床效果显著,值得借鉴。     

替米沙坦联合前列地尔治疗早期糖尿病肾病的疗效观察

目的替米沙坦联合前列地尔治疗早期糖尿病肾病的疗效。方法将56例早期糖尿病肾病患者随机分为两组:常规治疗组(n=28)和联合治疗组(n=28)。两组患者均接受糖尿病饮食、降糖、控制血压及调脂治疗。两组均服用替米沙坦80mg,1次/d。联合治疗组予静脉注射前列地尔10μg,1次/d。总疗程4周。观察治疗前后两组患者的24h尿白蛋白排泄率、血清肌酐、尿素氮。结果替米沙坦联合前列地尔治疗早期糖尿病肾病,明显降低尿白蛋白排泄率(P<0.01)结论替米沙坦联合前列地尔能够有效治疗早期糖尿病肾病。     

前列地尔联合替米沙坦治疗糖尿病肾病的临床疗效

目的探讨前列地尔联合替米沙坦治疗糖尿病肾病的临床疗效。方法选取高安市人民医院2019年1月—2020年1月收治的糖尿病肾病患者60例,随机分为对照组与观察组,各30例。对照组予以替米沙坦治疗,观察组在对照组基础上予以前列地尔治疗。比较2组临床疗效、治疗前后肾功能指标(血肌酐、血尿素氮、24 h尿蛋白、24 h尿微量蛋白排泄量),并观察2组不良反应发生情况。结果观察组治疗总有效率高于对照组(P<0.05)。治疗前2组血肌酐、血尿素氮、24 h尿蛋白、24 h尿微量蛋白排泄比较,差异无统计学意义(P>0.05);治疗后观察组血肌酐、血尿素氮、24 h尿蛋白、24 h尿微量蛋白排泄量低于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论前列地尔联合替米沙坦治疗糖尿病肾病的临床疗效确切,可有效改善肾功能,减少尿蛋白,且安全性较高。     

替米沙坦对原发性高血压患者偶测血压及动态血压的影响

目的 观察替米沙坦对轻中度原发性高血压患者偶测血压和动态血压的影响，评价替米沙坦降血压疗效。方法 43例轻中度原发性高血压患者，经历1周清洗期后给予替米沙坦40 mg·d^-1，po，qd，疗程为8周，测定治疗后偶测血压，并用24 h动态血压测定用药前后血压变化及降压谷峰比（T/P）。结果 替米沙坦治疗轻中度原发性高血压总有效率为79.1%，用药后全天血压均值、白天血压均值、夜间血压均值、给药末4 h平均血压均明显下降( P＜0.01)，收缩压的谷峰比为68.4%，舒张压的谷峰比为79.3%。结论 替米沙坦治疗轻中度原发性高血压有显著的疗效，降血压作用可持续24 h，适合每天一次服用。     

替米沙坦联合维持性血液透析治疗尿毒症合并高血压患者的临床研究

目的观察替米沙坦联合维持性血。液透析对尿毒症合并高血压患者的临床疗效。方法入选136例尿毒症合并高血压患者,按入院顺序随机分为对照组和联合组,每组68例,对照组予以常规维持性血液透析治疗,联合组在常规维持性血液透析治疗基础上加用替米沙坦（40～80mg.d-1）治疗,观察12周。比较两组患者治疗前后血压和肾功能（血尿素氮、血肌酐、估计肾小球滤过率、血尿酸、尿微量白蛋白、尿β2微求蛋白）的变化。结果治疗前两组患者的血压没有明显的差异（P〉0.05）,治疗12周后,两组患者的血压与本组治疗前比较均有下降（P〈0.05）,与对照组比较,联合组的血压下降更明显（P〈0.05）。治疗前后两组患者的肾功能指标差异没有统计学意义（P〉0.05）,但联合组与本组治疗前比较有好转的趋势（P〈0.05）。结论替米沙坦联合维持性血液透析治疗可有效控制尿毒症合并高血压患者的血压,从而保护患者的肾功能。     

替米沙坦联合丹参川芎嗪治疗糖尿病肾病临床观察

目的对替米沙坦联合丹参川芎嗪治疗糖尿病肾病的临床效果进行观察。方法选取本院自2011年3月~2013年3月收治的90例糖尿病肾病患者随机分为甲组、乙组与丙组,各为30例,甲组采用替米沙坦联合丹参川芎嗪治疗,乙组及丙组分别采用替米沙坦、丹参川芎嗪治疗,观察三组患者治疗前后24 h尿白蛋白排泄量、血压、血糖、尿素氮、尿酸、低密度脂蛋白、高密度脂蛋白等指标,比较治疗总有效率及不良反应发生率。结果三组患者治疗后尿白蛋白排泄量均有明显下降（P〈0.05）,甲组患者血压、血肌酐、血清白蛋白等指标均明显优于乙组、丙组（P〈0.05）;甲组患者治疗总有效率为93.3%,乙组患者治疗总有效率为73.3%,丙组患者治疗总有效率为70%,甲组与乙组、丙组比较差异有统计学意义（P〈0.05）;三组患者不良反应发生比较差异无统计学意义（〉0.05）。结论替米沙坦联合丹参川芎嗪治疗糖尿病肾病能够有效改善血液流变学指标,减少白蛋白排泄量,促进患者康复,值得推广使用。     

替米沙坦片联合苯磺酸氨氯地平片治疗糖尿病合并高血压30例

目的探讨替米沙坦片联合苯磺酸氨氯地平片治疗糖尿病合并高血压的疗效。方法选择在太平人民医院就诊的糖尿病合并高血压患者60例,分为观察组和对照组。对照组给予替米沙坦片治疗;观察组给予替米沙坦片联合苯磺酸氨氯地平片治疗。结果与治疗前相比,观察组治疗后收缩压、舒张压、24h尿白蛋白、24h尿蛋白等均有所下降,差异有显著性(P<0.01)。治疗后24h尿白蛋白、24h尿蛋白,观察组与对照组相比,差异有显著性(P<0.05)。结论替米沙坦片联合苯磺酸氨氯地平片治疗糖尿病合并高血压患者疗效佳,不良反应少。     

替米沙坦对轻中度原发性高血压患者脂肪因子的影响

目的 观察替米沙坦对轻中度原发性高血压患者血压、血糖、血脂及脂肪因子的影响. 方法轻中度原发性高血压患者78例,应用替米沙坦80 mg&#8226;d^-1治疗12周;测定治疗前后动态血压、血糖、血脂、胰岛素、血清瘦素、脂联素、游离脂肪酸. 结果 治疗后,血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇、空腹及餐后2 h胰岛素、餐后2 h血糖、游离脂肪酸及瘦素水平较治疗前非常显著下降(P<0.01),糖化血红蛋白明显下降(P<0.05);高密度脂蛋白胆固醇、脂联素明显上升,差异有统计学意义(P<0.01或P<0.05). 结论 替米沙坦可以有效控制轻中度原发性高血压患者的血压,且能改善血糖、血脂及脂肪因子.     

替米沙坦治疗早期糖尿病肾病疗效观察

目的 观察替米沙坦治疗早期糖尿病肾病(DN)的临床疗效.方法 选择本院门诊及住院的38例早期DN患者随机分为治疗组和对照组,对照组给予正规糖尿病治疗8周,治疗组加服替米沙坦80mg每日1次,比较两组治疗前后24h尿微量白蛋白排泄量.结果 治疗组尿微量白蛋白下降比对照组有显著差异(P＜0.01).结论 替米沙坦降早期糖尿病肾病尿微量白蛋白效果明显,且无明显副作用,能保护肾功能,延缓肾功能不全的发生.     

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.     

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.     

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.