重组人脑利钠肽对急性冠脉综合征患者炎症因子及心功能的影响

目的:观察重组人脑利钠肽对急性冠脉综合征患者心功能及炎症因子的影响。方法:选择急性冠脉综合征患者200例,随机分成重组人脑利钠肽组(120例)和硝酸甘油组(80例);两组均测定治疗前后血浆中BNP水平、血清炎症因子hs-CRP、TNF-α、IL-6、IL-8的含量,采用超声心动图检测射血分数(LVEF);并比较两组治疗前后上述指标的变化。结果:治疗后两组患者BNP及炎症因子hs-CRP、TNF-α、IL-6、IL-8的表达均显著降低(P0.05),LVEF均有显著升高(P0.05),但以重组人脑利钠肽治疗组更为显著(P0.05)。结论:人脑利钠肽治疗急性冠脉综合征能显著改善心功能,降低炎症因子水平;有助于改善急性冠脉综合征后心力衰竭的炎症应激状态。     

重组人脑利钠肽联合硝普钠治疗老年慢性心衰急性期疗效观察

目的：观察重组人脑利钠肽联合硝普钠治疗老年慢性心衰急性期的临床疗效。方法：选取我院收治的60例慢性心衰急性期老年患者,随机分为观察组和对照组。对照组给予硝普钠治疗,观察组给予重组人脑利钠肽联合硝普钠治疗,比较两组临床疗效及参数指标。结果：观察组总有效率为96.7%,对照组总有效率为80.0%。观察组总有效率显著高于对照组,差异有统计学意义（P〈0.05）;两组患者血清BNP、NE及Cr水平均明显降低（P〈0.05）;两组血清BNP及NE水平相比,差异有统计学意义（P〈0.05）。结论：重组人脑利钠肽联合硝普钠治疗老年慢性心衰急性期效果显著,可有效改善患者血流动力学状态,值得在临床上推广。     

重组人脑利钠肽对老年急性失代偿性心力衰竭患者BNP和肾功的影响及疗效研究

目的探讨重组人脑利钠肽辅助对老年急性失代偿性心力衰竭(ADHF)患者BNP和肾脏功能的影响并观察临床疗效。方法回顾性分析2015年1月至2016年6月我院心血管内科收治的96例临床确诊的ADHF患者,按随机数字表法分为观察组和对照组,每组48例。对照组患者仅采用常规抗心力衰竭治疗,观察组患者在常规治疗基础上,辅助应用重组人脑利钠肽。连续治疗2周后,比较两组患者治疗前后BNP和肾功能变化,通过心功能指标评估人脑利钠肽的临床疗效。结果治疗后,观察组总体心功能改善有效率、24 h尿量和左心室射血分数(LVEF)高于对照组,血清肌酐、尿素氮、BNP水平低于对照组,差异均有统计学意义(P<0.05)。结论在常规抗心衰治疗基础上辅助应用重组人脑利钠肽治疗ADHF,可有效改善心功能、肾功能。     

关于重组人脑利钠肽在急性心肌梗死后急性左心衰竭中的临床疗效观察

目的观察并分析重组人脑利钠肽治疗急性心肌梗死后急性左心衰竭的临床效果。方法随机将66例急性心肌梗死合并急性左心衰竭的患者分为两组:治疗组、对照组,每组各有33例患者,对照组应用一般常规疗法,如吸氧、扩血管、利尿等;治疗组在对照组治疗的基础上加用重组人脑利钠肽进行治疗。治疗前与治疗后7 d分别测定血清BNP的水平及LVEF值并记录两组的治疗有效率。结果治疗7 d后,血清中BNP的水平降低,LVEF值升高,治疗组的治疗总有效率90.91%比对照组的治疗总有效率63.63%高,二者的差异具有统计学意义(P<0.05)。结论重组人脑利钠肽可治疗急性心肌梗死后的急性左心衰竭,而且疗效显著,值得推广应用。     

重组人脑利钠肽治疗顽固性心衰疗效分析

目的：探讨重组人脑利钠肽治疗顽固性心衰的临床疗效。方法将126例顽固性心衰患者随机均分为观察组和对照组,两组患者均给予相同基础治疗,观察组加用重组人脑利钠肽治疗,对照组加用硝酸甘油治疗,观察两组患者心功能改善情况,并进行疗效评价。结果观察组患者治疗后LVEDD小于对照组,LVEF明显高于对照组（P＜0.05）;观察组治疗总有效率为92.06%,明显高于对照组的66.67%（P＜0.05）;两组患者不良反应发生率比较差异无统计学意义（P＞0.05）。结论重组人脑利钠肽治疗顽固性心衰疗效显著、安全性好。     

芪苈强心胶囊联合重组人脑利钠肽治疗扩张型心肌病心力衰竭的临床研究

目的探讨芪苈强心胶囊联合重组人脑利钠肽治疗扩张型心肌病心力衰竭的临床疗效。方法选取2014年12月—2016年11月在延安市人民医院住院的扩张型心肌病心力衰竭患者85例,随机分为对照组(42例)和治疗组(43例)。对照组静脉泵入冻干重组人脑利钠肽1.5μg/kg,1 h后按7.5 ng/(kg·min~(-1))持续泵入,72 h后给予常规治疗。治疗组患者在对照组治疗基础上口服芪苈强心胶囊,4粒/次,3次/d。两组患者均连续治疗2周。观察两组的临床疗效,比较两组治疗前后临床指标、心功能指标、B型脑钠肽(BNP)、高敏C反应蛋白(hs-CRP)水平的变化情况。结果治疗后,对照组和治疗组的总有效率分别为78.57%、90.69%,两组比较差异具有统计学意义(P0.05)。治疗后,两组心率、左室舒张末期内径(LVEDd)、收缩末期内径(LVESD)、BNP、hs-CRP水平均显著降低,6 min步行距离、左心室射血分数(LVEF)显著升高,同组治疗前后差异有统计学意义(P0.05);治疗后,治疗组心率、LVEDd、LVESD、BNP、hs-CRP水平低于对照组,6 min步行距离、LVEF高于对照组,两组比较差异具有统计学意义(P0.05)。结论芪苈强心胶囊联合重组人脑利钠肽治疗扩张型心肌病心力衰竭患者具有较好的临床疗效,可显著改善患者的临床症状和心功能指标,降低BNP、hs-CRP水平,具有一定的临床推广应用价值。     

重组人脑利钠肽联合左西孟旦治疗急性心肌梗死合并心力衰竭的效果观察

目的:探讨重组人脑利钠肽(rh-BNP)联合左西孟旦治疗急性心肌梗死合并心力衰竭的临床效果。方法:收集河南省范县人民医院2015年5月~2016年10月80例急性心肌梗死合并心力衰竭患者,随机数字法分为观察者和对照组各40例,两组患者均给予基础治疗,对照组给予左西孟旦治疗,在此基础上观察组给予重组人脑利钠肽(rh-BNP)治疗,比较两组患者的临床治疗效果。结果:治疗后联合组左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、脑钠肽(BNP)水平低于对照组,差异有统计学意义(P<0.05);左室射血分数(LVEF)、心输出量(CO)高于对照组,差异有统计学意义(P<0.05);联合组收缩压(SBP)、心率(HR)、呼吸频率(RR)低于对照组,动脉血氧饱和度(SaO_2)高于对照组,差异有统计学意义(P<0.05)。结论:采用重组人脑利钠肽(rh-BNP)联合左西孟旦可有效改善急性心肌梗死合并心力衰竭患者心功能情况,缓解临床症状,值得临床推广应用。     

参附注射液联合重组人脑利钠肽治疗硝酸盐干预后效果不佳扩张型心肌病的临床研究

目的探讨参附注射液联合冻干重组人脑利钠肽治疗硝酸盐干预后效果不佳扩张型心肌病的临床疗效。方法选取天津市第四医院2013年2月—2015年10月收治的硝酸盐干预效果不佳扩张型心肌病患者90例,所有患者按照随机数字表格法分为3组,每组各30例。参附注射液组静脉滴注参附注射液,40 mL加入葡萄糖注射液250 mL中,1次/d。重组人脑利钠肽组给予冻干重组人脑利钠肽,先静脉推注1.5μg/kg,90 s内推注完,随后加以冻干重组人脑利钠肽7.5 ng/(kg·min)持续泵入48 h。联合用药组行参附注射液联合冻干重组人脑利钠肽治疗,其中参附注射液、重组人脑利钠肽治疗方案同上。3组患者均连续治疗10 d。观察3组的临床疗效,同时比较3组治疗前后心功能指标、6 min步行距离、血浆钠尿肽(BNP)和高敏C反应蛋白(hs-CRP)水平。结果 3组总有效率分别为86.7%、83.3%、93.3%,联合用药组总有效率高于其他两组,但是3组总有效率比较差异无统计学意义。治疗后,3组左心室射血分数(LVEF)、6 min步行距离明显升高,左心室舒张末内径(LVEDD)明显缩小,同组治疗前后比较差异具有统计学意义(P0.05);联合用药组LVEF、6 min步行距离均明显高于参附注射液组和重组人脑利钠肽组,3组比较差异具有统计学意义(P0.05)。治疗后,3组血浆BNP、hs-CRP水平明显下降,同组治疗前后比较差异具有统计学意义(P0.05);且联合用药组的这些指标下降幅度明显大于参附注射液组和重组人脑利钠肽组,3组比较差异具有统计学意义(P0.05)。结论参附注射液联合重组人脑利钠肽治疗硝酸盐干预后效果不佳扩张型心肌病具有较好的临床疗效,能够改善心功能,降低血浆BNP、hs-CRP水平,具有一定的临床推广应用价值。     

重组人脑利钠肽治疗急性左心衰可行性及应用价值评析

目的:探究重组人脑利钠肽治疗急性左心衰疾病的临床疗效。方法:选取某院从2013年9月~2014年12月收治的急性左心衰患者60例作为研究对象,通过随机分组,分为治疗组与对照组。治疗组在常规性治疗的基础上,再应用重组人脑利钠肽治疗急性左心衰患者,对照组则采用常规性的治疗。结果:治疗组患者的治疗总有效率为90.00%,对照组患者的治疗总有效率为60.00%,治疗组的效果更加明显,并且与对照组相比,不良反应发生率明显较低,差异具有统计学意义(P0.05)。结论:对急性左心衰患者应用重组人脑利钠肽治疗,具有显著的临床疗效,不良反应发生率较低,在一定程度上改善患者的肾功能,值得临床进一步推广与使用。     

大株红景天注射液联合重组人脑利钠肽治疗充血性心力衰竭的临床研究

目的探讨大株红景天注射液联合重组人脑利钠肽治疗充血性心力衰竭的临床疗效。方法选取2015年10月—2017年8月在陕西中医药大学附属医院接受治疗的充血性心力衰竭患者148例,随机分成对照组(74例)和治疗组(74例)。对照组静脉滴注注射用重组人脑利钠肽,首次静脉冲击1.5μg/kg,然后保持滴速7.5μg/(kg·min)。治疗组在对照组的基础上静脉滴注大株红景天注射液,10 m L加入生理盐水250 m L,1次/d。两组患者均连续治疗2周。观察两组的临床疗效,比较治疗前后两组患者超声心动图指标、血清内皮素-1(ET-1)、N-末端脑钠肽前体(NT-pro BNP)和肿瘤坏死因子-α(TNF-α)水平以及6 min步行距离(6MWT)。结果治疗后,对照组的临床总有效率为79.73%,显著低于治疗组的93.24%,两组比较差异具有统计学意义(P0.05)。治疗后,两组收缩末期内径(LVESD)和左室舒张末期内径(LVEDD)均显著降低,心指数(CI)和左心室射血分数(LVEF)均显著升高,同组比较差异具有统计学意义(P0.05);且治疗组患者超声心动图指标改善情况明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血清ET-1、NT-pro BNP、TNF-α水平明显降低,6MWT明显增加,同组比较差异具有统计学意义(P0.05);且治疗组患者血清标志物水平和6MWT明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论大株红景天注射液联合重组人脑利钠肽可显著缓解充血性心力衰竭患者心衰症状,改善心功能,具有一定的临床推广应用价值。     

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.