米力农注射液治疗老年缺血性心肌病心力衰竭的临床效果评价

目的:探讨米力农注射液(鲁南力康:鲁南贝特制药有限公司生产)治疗老年缺血性心肌病心力衰竭的临床效果。方法:选定2018年6月～2019年2月到本院接受治疗的40例老年缺血性心肌病心力衰竭患者,随机分为对照组20例(基础治疗)与观察组20例(米力农注射液治疗),比较两组LVEDD、SV、EF、BNP与治疗优良率指标。结果:治疗结束后,观察组LVEDD指标与对照组差异不显著,无统计学意义(P0.05);观察组SV、EF及治疗优良率指标高于对照组,差异有统计学意义(P0.05);观察组BNP指标低于对照组,差异有统计学意义(P0.05)。结论:米力农注射液治疗方法可有效改善老年缺血性心肌病心力衰竭患者预后,值得推广使用。     

芪参益气滴丸联合米力农治疗扩张性心肌病心力衰竭的临床研究

目的探讨芪参益气滴丸联合米力农注射液治疗扩张性心肌病心力衰竭的临床疗效。方法选取2014年5月—2017年5月天津市第三中心医院分院心内科收治的扩张性心肌病心力衰竭患者64例为研究对象,将所有患者随机分为对照组和治疗组,每组各32例。对照组静脉泵注米力农注射液,0.3μg/(kg·min),10 mg/d;治疗组在对照组的基础上口服芪参益气滴丸,1袋/次,3次/d。两组均连续治疗10 d。观察两组的临床疗效,比较两组的心功能指标和生化指标。结果治疗后,对照组和治疗组的总有效率分别为75.0%、93.8%,两组比较差异具有统计学意义(P0.05)。治疗后,两组心排出量(CO)、每搏输出量(SV)、左室射血分数(LVEF)均显著升高,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组这些心功能指标明显高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组肌钙蛋白I(cTnI)和脑利钠肽(BNP)水平均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组这些生化指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论芪参益气滴丸联合米力农注射液治疗扩张性心肌病心力衰竭具有较好的临床疗效,能改善心功能,降低cTnI、BNP水平,安全性较好,具有一定的临床推广应用价值。     

益气复脉注射液治疗缺血性心肌病心力衰竭患者的疗效观察

目的评价益气复脉注射液治疗缺血性心肌病心力衰竭患者临床疗效。方法将入选56例缺血性心肌病心力衰竭患者随机分为常规治疗组和应用益气复脉注射液组,益气复脉组在常规组治疗基础上给予静脉滴注益气复脉2.6 g溶于5%葡萄糖液250 m L,每天1次,连续应用2周。观察治疗前后NYHA心功能分级、NT-pro BNP值、左室射血分数(LVEF)变化。结果治疗前后两组别患者临床主要症状体征均明显好转,治疗组胸闷、气短、活动耐力改善较对照组更明显。NYHA心功能分级比较:两组患者治疗后NYHA心功能分级均显著改善。结论常规西药治疗基础上加用中药益气复脉注射液,可显著改善缺血性心肌病心力衰竭患者的临床症状。     

生脉注射液联合重组人脑利钠肽治疗急性心力衰竭的临床研究

目的探讨生脉注射液联合重组人脑利钠肽治疗急性心力衰竭的临床效果。方法选取2014年1月—2017年10月在中国人民解放军第二五四医院收治的112例急性心力衰竭患者,随机分为对照组和治疗组,每组各56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,随后按照0.01μg/(kg·min)静脉泵入。治疗组在对照组治疗基础上静脉滴注生脉注射液,50 m L生脉注射液加入到5%葡萄糖注射液100 m L,1次/d。两组均连续治疗3 d。观察两组的临床疗效,比较两组治疗前后左心室射血分数(LVEF)、左室舒张末内径(LVEDD)、尿素氮(BUN)、肌酐(Cr)、血清脑钠肽(BNP)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%、94.64%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者LVEF显著升高,但LVEDD、BUN、Cr、BNP显著降低,同组治疗前后比较差异有统计学意义(P0.05);治疗后,治疗组LVEF高于对照组,LVEDD、BUN、Cr、BNP低于对照组,两组比较差异具有统计学意义(P0.05)。结论生脉注射液联合重组人脑利钠肽治疗急性心力衰竭具有显著的临床治疗效果,可明显改善患者心功能,保护肾功能,具有一定的临床推广应用价值。     

生脉注射液治疗缺血性心肌病心力衰竭的疗效观察

目的观察生脉注射液治疗缺血性心肌病心力衰竭患者的临床疗效。方法将缺血性心肌病引起心力衰竭的患者50例,随机分为治疗组（27例）和对照组（23例）。对照组给予强心、利尿等常规治疗,治疗组在对照组治疗的基础上加用生脉注射液静脉滴注,疗程均为14d,观察2组心功能改善情况。结果2组治疗后心功能均有改善（P〈0.05或P〈0.01）,组间比较差异有统计学意义（P〈0.05）。结论生脉注射液对缺血性心肌病的心功能具有明显改善作用,值得临床应用。     

灯盏生脉胶囊联合替罗非班治疗冠心病心绞痛的临床研究

目的研究灯盏生脉胶囊联合盐酸替罗非班注射液治疗冠心病心绞痛的临床疗效。方法选取2015年6月—2017年6月榆林市第一医院接收的冠心病心绞痛患者120例为研究对象,将所有患者随机分为对照组和治疗组,每组各60例。对照组患者给予盐酸替罗非班注射液,初始以10μg/kg进行静脉推注,3 min内完成,之后以0.15μg/(kg·min)维持滴注。治疗组患者在对照组治疗的基础上口服灯盏生脉胶囊,3粒/次,3次/d。两组患者持续治疗2周。观察两组的临床疗效和心电图疗效,比较两组的临床症状、血清细胞因子水平。结果治疗后,对照组和治疗组的总有效率分别为81.67%、96.67%,两组比较差异有统计学意义(P0.05)。治疗后,对照组和治疗组的心电图疗效总有效率分别为81.67%、96.67%,两组比较差异有统计学意义(P0.05)。治疗后,两组心绞痛发作次数和心绞痛持续时间显著下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组TNF-α和IL-6均显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论灯盏生脉胶囊联合盐酸替罗非班注射液治疗冠心病心绞痛具有较好的临床疗效,可改善患者临床症状,调节血清细胞因子水平,安全性较高,具有一定的临床推广应用价值。     

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。     

肺力咳胶囊联合依替米星治疗慢性支气管炎急性加重期的临床研究

目的探讨肺力咳胶囊联合依替米星治疗慢性支气管炎急性加重期的有效性与安全性。方法选取2015年7月—2017年7月在郑州市第九人民医院治疗的慢性支气管炎急性加重期患者176例,随机分为对照组(88例)和治疗组(88例)。对照组患者静脉滴注硫酸依替米星注射液,100 mg加入5%葡萄糖注射液250 mL,2次/d;治疗组患者在对照组基础上口服肺力咳胶囊,3粒/次,3次/d。两组患者均连续治疗2周。观察两组患者临床疗效,同时比较治疗前后两组患者临床症状消失时间、SF-36评分和症状积分、血清炎症因子、肺表面活性蛋白A水平和不良反应情况。结果治疗后,对照组临床有效率为85.23%,显著低于治疗组的95.45%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组患者哮鸣音、咳痰等症状消失时间均显著早于对照组(P0.05)。治疗后,两组患者SF-36评分显著升高(P0.05),症状积分显著降低(P0.05),且治疗组患者SF-36评分和症状积分明显优于对照组(P0.05)。治疗后,两组患者血清肿瘤坏死因子-α(TNF-α)和IL-6水平显著降低(P0.05),肺表面活性蛋白A(SP-A)水平显著升高(P0.05),且治疗组患者血清炎症因子和SP-A明显优于对照组患者(P0.05)。治疗期间,治疗组患者不良反应发生率为2.27%,显著低于对照组的11.36%,两组比较差异具有统计学意义(P0.05)。结论肺力咳胶囊联合依替米星治疗慢性支气管炎急性加重期疗效显著,安全性高,具有一定的临床推广应用价值。     

诺迪康胶囊联合米力农治疗慢性充血性心力衰竭的临床研究

目的探讨诺迪康胶囊联合米力农治疗慢性充血性心力衰竭的临床效果。方法选取2015年6月—2018年6月郑州大学第一附属医院收治的慢性充血性心力衰竭患者280例,随机分成对照组(140例)和治疗组(140例)。对照组静脉注射米力农注射液,首剂量50μg/kg,给药时间10 min,然后以0.5μg/(kg·min)持续静脉输注4 h。治疗组在对照组基础上口服诺迪康胶囊,2粒/次,3次/d。两组患者均治疗14 d。观察两组患者临床疗效,同时比较治疗前后两组患者心功能参数、血液流变学指标和GMP-140及一氧化氮(NO)、内皮素-1(ET-1)和血管性血友病因子(v WF)水平。结果治疗后,对照组临床有效率为84.3%,显著低于治疗组的93.6%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者左室射血分数(LVEF)值较治疗前显著升高(P0.05),左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)值和血清心肌肌钙蛋白T(cTnT)浓度及血浆B型利钠肽(BNP)水平均显著降低(P0.05),且治疗组患者心功能明显好于对照组(P0.05)。治疗后,两组患者血浆黏度(PV)和红细胞聚集指数(EAI)值及血浆血小板α颗粒膜蛋白-140(GMP-140)水平均显著降低(P0.05),且治疗组患者PV值、EAI值和GMP-14水平明显低于对照组(P0.05)。治疗后,两组患者血管内皮功能指标NO、ET-1和vWF血浆浓度均显著降低(P0.05),且治疗组NO、ET-1和vWF血浆浓度明显低于对照组(P0.05)。结论诺迪康胶囊联合米力农治疗慢性充血性心力衰竭能有效控制患者心衰病情,改善心功能及血流变状态,抑制血小板活性,解除内皮功能障碍。     

通心络胶囊联合福辛普利治疗缺血性心肌病的临床研究

目的观察通心络胶囊联合福辛普利治疗缺血性心肌病的临床疗效。方法选取2015年1月—2017年1月在青岛思达心脏医院就诊的缺血性心肌病患者82例,随机分为对照组和治疗组,每组各41例。对照组口服福辛普利钠片,10 mg/次,1次/d;治疗组在对照组的基础上口服通心络胶囊,2～4粒/次,3次/d。两组患者均治疗2周。观察两组患者临床疗效和心电图疗效,同时比较治疗前后两组患者静息心率、收缩压、舒张压、三酰甘油(TG)、总胆固醇(CHO)、低密度脂蛋白(LDL-C)、N末端B型钠尿肽原(NT-proBNP)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)和左室射血分数(LVEF)。结果治疗后,对照组临床有效率和心电图疗效分别为73.17%和68.29%,均分别显著低于治疗组90.24%和87.80%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者静息心率、收缩压和舒张压均显著降低(P0.05),且治疗组静息心率、收缩压和舒张压水平明显低于对照组(P0.05)。治疗后,两组TG、CHO、LDL-C和NT-proBNP水平均显著降低(P0.05),且治疗组TG、CHO、LDL-C和NT-proBNP水平明显低于对照组(P0.05)。治疗后,两组LVEDD和LVESD显著降低(P0.05),LVEF显著升高(P0.05),且治疗组患者心功能明显好于对照组(P0.05)。结论通心络胶囊联合福辛普利治疗缺血性心肌病,能有效改善患者的临床症状、炎性反应和血脂水平。     

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.