奥扎格雷钠阿司匹林联合治疗急性脑梗死33例

［摘要］目的探讨奥扎格雷钠联合苦碟子注射液和阿司匹林对急性脑梗死的疗效。方法急性脑梗死患者66例，随机双盲分为治疗组和对照组各33例。治疗组给予奥扎格雷钠80 mg溶于0.9%氯化钠注射液250 mL中，苦碟子注射液40 mL溶于0.9%氯化钠注射液250 mL中，均静脉滴注，qd，阿司匹林0.1 g，po，qd；对照组给予500 mL右旋糖酐40,苦碟子注射液40 mL溶于0.9%氯化钠注射液250 mL中，均静脉滴注，qd,阿司匹林0.1 g，po，qd。2组均以14 d为1个疗程，按临床神经功能缺损评分标准于治疗后14 d进行疗效评定。结果治疗组与对照组总有效率分别为81.82%，63.64%（P＜0.05）。结论奥扎格雷钠、苦碟子注射液、阿司匹林联合治疗急性脑梗死临床疗效满意，且无明显不良反应。     

苦碟子注射液联合阿替普酶治疗急性脑梗死的临床研究

目的 探讨苦碟子注射液联合阿替普酶治疗急性脑梗死临床疗效。方法 选取2020年7月—2022年7月郑州市第三人民医院收治的112例急性脑梗死患者,随机分为对照组和治疗组,每组各56例。对照组患者静脉注射注射用阿替普酶,0.9 mg/kg,最大剂量不超过90 mg,在1 min内静脉推注总药量的10%,剩下的90%在1 h内静脉泵入。在对照组基础上,治疗组静脉滴注苦碟子注射液,40 mL/次加入生理盐水300 mL,1次/d。两组治疗14 d。观察两组患者临床疗效,比较治疗前后两组患者症状改善时间、神经功能受损程度（NIHSS）评分、氧化应激水平,血清炎性因子白细胞介素-6(IL-6)、胱抑素C(CysC)、肿瘤坏死因子-α(TNF-α)和同型半胱氨酸（Hcy）水平,及不良反应情况。结果 治疗后,治疗组患者临床有效率为91.07%,明显高于对照组（71.43%,P<0.05）。治疗后,治疗组症状改善时间均早于对照组（P<0.05）。治疗后,两组患者NIHSS评分指标均明显下降（P<0.05）,且治疗组NIHSS评分指标明显低于对照组（P<0.05）。治疗后,两组患...     

神经节苷脂联合苦碟子治疗急性脑梗死78例疗效观察

目的观察神经节苷脂联合苦碟子治疗急性脑梗死的治疗效果。方法选择急性脑梗死患者156例,随机数字表法分为两组。观察组78例,予神经节苷脂40mg加0．9％氯化钠注射液250mL静脉滴注,1次／d,联合应用苦碟子注射液40mL加0．9％氯化钠注射液250mL静脉滴注,1次／d;对照组78例,予银杏叶提取物注射液20mL加0．9％氯化钠注射液250mL静脉滴注,1次／d。两组均于治疗14d后,观察临床疗效、血液中自由基丙二醛（MDA）、超氧化物歧化酶（SOD）、谷胱甘肽（GSH）和血小板各参数变化情况。结果观察组临床有效率87．2％,高于对照组的64．1％（χ2=11．914,P=0．017）;与治疗前比较,两组治疗后血中MDA和GSH降低、SOD升高（均P〈0．01）,且观察组更明显（均P〈0．01）;与治疗前比较,观察组患者平均血小板体积（MPV）、血小板分布宽度（PDW）和血小板计数（PLT）均升高（均P〈0．01）;但两组治疗后MPV、PDW比较,差异均有统计学意义（均P〈0．01）。结论神经节苷脂联合苦碟子能更好地改善急性脑梗死患者的预后,清除血中自由基,降低血小板活化程度。     

复方脑肽节苷脂注射液联合替罗非班治疗急性脑梗死的临床研究

目的 探讨复方脑肽节苷脂注射液联合盐酸替罗非班注射液治疗急性脑梗死的临床治疗效果。方法 选取2020年2月—2021年10月在安阳市第六人民医院治疗的82例急性脑梗死患者,根据随机数字表法将所有患者分为对照组和治疗组,各41例患者。对照组静脉滴注盐酸替罗非班注射液,50 mL加入250 mL生理盐水,1次/d。治疗组在对照组基础上静脉滴注复方脑肽节苷脂注射液,12 mL加入250 mL葡萄糖注射液充分稀释,1次/d。两组在治疗14 d后统计疗效。观察两组的临床疗效,比较两组的美国国立卫生研究院脑卒中量表（NIHSS）评分、弥散加权成像和Alberta卒中计划早期CT评分（DWIASPECTS）和基底动脉、椎动脉的血流速度的变化以及血清胰高血糖素样肽-1(GLP-1)、脑源性神经营养因子（BDNF）、神经特异性烯醇化酶（NSE）水平。结果 治疗后,治疗组患者的总有效率（90.24%）明显高于对照组的总有效率（73.17%）,差异有统计学意义（P<0.05）。治疗后,两组的NIHSS评分显著降低,DWI-ASPECTS评分显著升高（P<0.05）;治疗后,治疗组的NIHSS评分...     

醒脑静注射液联合吡拉西坦治疗脑挫裂伤的临床研究

目的 探讨醒脑静注射液联合吡拉西坦注射液治疗脑挫裂伤的临床疗效。方法 选取2020年1月—2021年11月天津市宁河区医院收治的94例脑挫裂伤患者,根据随机数字表法将所有患者分为对照组和治疗组,每组各47例。对照组静脉滴注吡拉西坦注射液,40 mL加入250 mL生理盐水,1次/d。治疗组在对照组治疗的基础上静脉滴注醒脑静注射液,20m L加入250 mL葡萄糖注射液充分稀释,1次/d。两组患者连续治疗2周。观察两组的临床疗效,比较两组患者的清醒时间、住院时间、神经缺损程度和昏迷程度以及血清中白细胞介素-8(IL-8)、血管内皮生长因子（VEGF）、神经元特异性烯醇化酶（NSE）的水平。结果 治疗后,治疗组的总有效率（95.74%）高于对照组（82.98%）,组间比较差异显著（P<0.05）。治疗后,治疗组的清醒时间、住院时间明显短于对照组（P<0.05）。治疗后,两组美国国立卫生研究院卒中量表（NIHSS）评分低于治疗前,格拉斯哥昏迷量表（GCS）评分高于治疗前（P<0.05）;治疗后,治疗组的NIHSS评分低于对照组,GCS评分高于对照组（P<0.05）。治...     

阿加曲班注射液治疗急性进展性脑梗死的疗效观察

目的：观察阿加曲班治疗急性进展性脑梗死的临床疗效及安全性。方法选取2013年5月—2014年5月在内蒙古自治区人民医院住院的急性进展性脑梗死患者50例,随机分为治疗组（25例）和对照组（25例）。治疗组患者第1、2天每天用阿加曲班注射液60 mg以500 mL生理盐水稀释,24 h持续静脉泵注;其后的5 d用阿加曲班20 mg以100 mL生理盐水稀释,分早晚2次持续静脉泵注,每次3 h,持续治疗7 d。对照组静脉滴注注射用奥扎格雷钠,80 mg/次,以500 mL生理盐水稀释,2次/d,连续7 d。两组其他治疗持续14 d。治疗后,观察两组患者的临床疗效,同时比较治疗前后两组患者的NIHSS评分和Barthel指数变化。结果治疗组和对照组总有效率分别为88.0%、72.0%,两组总有效率比较差异有统计学意义（P＜0.05）。两组治疗14 d与治疗前比较NIHSS评分均明显降低,同组治疗前后差异有统计学意义（P＜0.05）。两组治疗后 Barthel 指数较治疗前均明显提高,治疗前后差异有统计学意义（P＜0.05）。治疗后,治疗组这两项指标改善程度优于对照组,差异有统计学意义（P＜0.05）。结论阿加曲班注射液治疗急性进展性脑梗死具有较好的临床疗效,可降低NIHSS评分,提高Barthel指数,值得临床推广应用。     

苦碟子注射液联合脑苷肌肽治疗急性脑梗死的临床研究

目的探讨苦碟子注射液联合脑苷肌肽治疗急性脑梗死的临床效果。方法选取2015年9月—2017年9月皖南医学院第二附属医院收治的86例急性脑梗死患者,随机分为对照组和治疗组,每组各43例。对照组静脉滴注脑苷肌肽注射液,20 mL加入生理盐水250 mL充分稀释后给药,缓慢滴注,1次/d。治疗组在对照组基础上静脉滴注苦碟子注射液,40 mL加入生理盐水250 mL均匀混合后给药,1次/d。两组均连续治疗14 d。观察两组的临床疗效,比较两组治疗前后国立卫生研究院卒中量表(NIHSS)评分、日常生活能力量表(ADL)评分、颈总动脉内径(CCAD)、颈动脉内-中膜厚度(CIMT)、椎动脉收缩期峰值(Vs)、舒张末期血流速度(Vd)、血清低/高密度脂蛋白胆固醇比值(LDL-C/HDL-C)、超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、胱抑素C(Cys-C)、同型半胱氨酸(Hcy)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72.09%、90.70%,两组比较差异有统计学意义(P0.05)。治疗后,两组NIHSS、ADL评分、LDL-C/HDL-C值、hs-CRP、PCT、Cys-C、Hcy较治疗前均显著降低,两组双侧椎动脉Vs、Vd值均显著增加,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组NIHSS、ADL评分、双侧CCAD、CIMT值、LDL-C/HDL-C值、hs-CRP、PCT、Cys-C、Hcy均显著低于对照组,治疗组双侧椎动脉Vs、Vd值显著高于对照组,两组比较差异有统计学意义(P0.05)。结论苦碟子注射液联合脑苷肌肽治疗急性脑梗死具有较好的临床疗效,可有效改善患者脑血流状态,减轻组织损伤与颈动脉粥样硬化病变,促进神经功能恢复,提高生活质量,具有一定的临床推广应用价值。     

阿加曲班注射液治疗进展性脑梗死的疗效观察

目的 观察阿加曲班注射液治疗进展性脑梗死的临床疗效和安全性。方法 将100例进展性脑梗死患者随机分为治疗组（50例）和对照组（50例）,两组均给以活血化瘀、清除自由基、改善脑代谢、控制血压和血糖等常规治疗,均给予依达拉奉,30 mg/次,用100 mL生理盐水稀释,30 min内滴完,2 次/d。治疗组在此基础上加用阿加曲班注射液,第1、2天每天用阿加曲班60 mg,以750 mL生理盐水稀释,24 h持续静脉滴注;其后5 d每天用阿加曲班10 mg以100～250 mL生理盐水稀释,分早晚2次持续静脉滴注,每次3 h。对照组使用低分子肝素钙,4 100 U/次,每12小时腹部皮下注射一次,两组均治疗14 d。治疗前后使用NIHSS评分比较两组神经功能障碍程度,Barthel指数评价康复情况,统计两组临床治疗的总有效率,同时观察两组患者的不良反应。结果 两组治疗后14 d NIHSS评分均明显低于治疗前（P＜0.05）。治疗后,治疗组较对照组NIHSS评分有显著改善（P＜0.05）,治疗组与对照组总有效率分别为98%、72%,两组比较差异有统计学意义（P＜0.05）。两组均无不良反应发生。结论 阿加曲班注射液对进展性脑梗死有较好的治疗效果,且无不良反应发生。     

长春西汀注射液治疗脑梗死患者临床分析

目的：探讨长春西汀注射液治疗脑梗死急性期患者的临床疗效。方法：选取脑梗死急性期患者80例,随机分为对照组和观察组各40例,两组患者均给予丹参注射液20 ml 溶于5%葡萄糖注射液250 ml 静脉滴注,1次／ d;观察组在对照组基础上加用长春西汀注射液30 mg 溶于氯化钠注射液250 ml 静脉滴注,1次／ d,两组疗程均为2周。结果：治疗后两组的神经功能缺损评分（NIHSS）均明显降低（P ﹤0.01）,且观察组患者 NIHSS 评分显著低于对照组（P ﹤0.01）;观察组患者的总有效率（92.5%）明显高于对照组（80.0%）,两组间差异比较有统计学意义（P ﹤0.05）。结论：长春西汀注射液联合应用丹参注射液治疗脑梗死疗效肯定,可作为治疗脑梗死患者的推荐用药。     

依达拉奉联合丹红注射液治疗急性脑梗死的疗效观察

目的观察依达拉奉联合丹红注射液治疗急性脑梗死的临床疗效。方法将76例急性脑梗死患者随机分为治疗组（38例）与对照组（38例）。治疗组在常规治疗基础上同时给予依达拉奉30mg静脉滴注,1日2次,丹红注射液30mL静脉滴注,1日1次,连用14d;对照组在常规治疗基础上给予丹红注射液30mL静脉滴注,1日1次,连用14d。观察两组治疗前后美国国立卫生院卒中量表（NIHSS）评分的变化。结果两组治疗14d后NIHSS评分均下降,与治疗前比较差异均有统计学意义（P〈0.05）;但治疗组NIHSS评分改善更加明显,两组比较有显著差异（P〈0.05）。结论依达拉奉联合丹红注射液治疗急性脑梗死疗效显著,无明显不良反应。     

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.