丹红注射液治疗血管性痴呆疗效观察

目的观察丹红注射液治疗血管性痴呆的临床疗效,并探讨其作用机制。方法将108例血管性痴呆患者随机分成治疗组(55例)和对照组(53例),在基本药物治疗基础上,分别给予丹红注射液40ml静脉注射,每日一次,盐酸丁咯地尔200mg静脉注射,每日一次,疗程28天,观察血流动力学、神经功能缺损程度和认知功能变化。结果治疗组在血流动力学、神经功能和认知功能改善方面均优于对照组(P<0.05)。结论丹红注射液治疗血管性痴呆具有较好临床效果,改善血流动力学是其重要作用机制之一。     

尤瑞克林治疗血管性认知障碍的临床疗效观察

目的观察血管性认知障碍患者应用尤瑞克林的疗效及安全性,并初步探讨其可能的作用机制。方法选取2016年1-8月我院神经内科收治的血管性认知障碍患者48例,随机分为2组。观察组24例,给予静脉滴注注射用尤瑞克林治疗;对照组24例,给予静脉滴注奥拉西坦注射液治疗。治疗周期为21 d。对比治疗前后两组患者颈内动脉系统(双侧大脑前动脉ACA、双侧大脑中动脉MCA)和椎-基底动脉系统(双侧大脑后动脉PCA、双侧椎动脉VA、基底动脉BA)的平均血流速度、Addenbrooke改良认知评估量表(ACE-R)评分、简易智力状态检查量表(MMSE)评分、血管内皮生长因子(VEGF)、神经元特异性烯醇化酶(NSE),观察临床疗效。结果两组患者入院时一般基线资料比较差异无统计学意义(P>0.05);治疗后,两组患者认知功能障碍相关症状较治疗前均有好转;颈内动脉系统、椎-基底动脉系统平均血流速度较治疗前均改善,且观察组改善程度明显优于对照组,差异均有统计学意义(P<0.05);两组ACE-R、MMSE量表评分均有升高,且观察组较对照组升高明显,差异均有统计学意义(P<0.05);治疗后两组患者VEGF均升高、NSE均降低,观察组较对照组变化明显,差异均有统计学意义(P<0.05)。结论尤瑞克林可明显改善血管性认知障碍患者脑部血流状态及认知功能,在临床治疗中具有较高的应用价值。其机制可能与提高患者VEGF水平,促进脑微循环生成,并且降低NSE水平,抑制缺血性脑损伤有关。     

灯盏细辛注射液治疗老年椎基底动脉供血不足40例

目的应用经颅多普勒脑血流测定仪对40例老年椎基底动脉供血不足性眩晕病人灯盏细辛注射液治疗前后,椎基底动脉血流速度等进行对比观察。方法所有病例均用灯盏细辛注射液30mL加入50g·L-1葡萄糖注射液或生理盐水250mL静脉滴注,每日1次,连用2周。治疗前后用经颅多普勒血流测定仪,检测左、右椎动脉及基底动脉,记录峰值血流速度、平均血流速度、舒张末期血流速度及搏动指数。结果治疗后椎基底动脉供血不足性眩晕患者椎动脉及基底动脉峰值血流速度、平均血流速度、舒张末期血流速度均明显增加(P<0.05),搏动指数降低(P<0.05)。结论灯盏细辛注射液增加椎基底动脉供血疗效确切。     

盐酸多奈哌齐治疗中轻度血管性痴呆的疗效分析及对认知功能和日常生活能力的影响

目的:探究盐酸多奈哌齐治疗中轻度血管性痴呆的疗效及对认知功能和日常生活能力的影响.方法:将我院收治的80例血管性痴呆患者随机分为两组,分别是对照组和观察组,每组40例,两组均予以常规治疗,观察组在常规治疗的基础上添加盐酸多奈哌齐,对比两组治疗有效率.结果:观察组的治疗总有效率为90.0％,高于对照组的72.5％,P<0.05;观察组治疗后的简易智能精神状态量表(MMSE)和日常生活能力量表(ADL)评分均优于对照组,差异显著,P<0.05.结论:用盐酸多奈哌齐治疗中轻度血管性痴呆具有确切的效果,可改善认知功能从而提高日常生活能力.     

复方菖蒲益智汤联合尼莫地平治疗中风后轻度认知功能障碍的临床研究

目的:考察复方菖蒲益智汤联合尼莫地平对中风后轻度认知功能障碍(MCI)患者临床症状、认知功能和脑血管血流速度的影响,以及用药安全性。方法:选择2013年2月-2015年10月在我院就诊的中风后MCI患者84例作为研究对象,采用随机数字表法分为观察组和对照组,各42例。两组患者均给予脑卒中基础预防治疗;对照组患者在此基础上给予尼莫地平片30 mg,tid,po;观察组患者在对照组治疗基础上加服复方菖蒲益智汤,每日1剂,分早晚温服。两组患者疗程均为3个月。分别于治疗前后采用血管性痴呆中医辨证量表比较两组患者的临床症状、采用简易智能量表(MMSE)比较两组患者的认知功能,并比较两组患者治疗前后的脑血管血流速度和不良反应发生情况。结果:治疗前,两组患者的各项临床症状评分、认知功能评分和主要动脉的血流速度比较,差异均无统计学意义(P>0.05)。治疗后,两组患者的临床症状评分均明显降低,认知功能评分均明显升高,脑血管血流速度均明显加快,与治疗前比较,差异均有统计学意义(P<0.05)。观察组患者的记忆、疼痛、面色、舌质、脉象评分,以及附加分和总分均明显低于对照组;定向能力、回忆能力、语言能力以及综合认知功能评分均明显高于对照组;大脑前动脉、中动脉、后动脉、椎动脉和基底动脉的血流速度均明显快于对照组,差异均有统计学意义(P<0.05)。观察组与对照组患者的不良反应发生率分别为11.90%、9.52%,组间比较差异无统计学意义(P>0.05)。结论:复方菖蒲益智汤联合尼莫地平有助于缓解中风后MCI患者的临床症状,改善其脑部血液循环,提高其认知功能,且安全性较好。     

谷红注射液治疗血管性痴呆的效果及对患者相关指标的影响分析

目的探讨谷红注射液治疗血管性痴呆患者的临床效果及对其相关指标的影响。方法74例血管性痴呆患者,依据随机数字表法分为观察组与对照组,各37例。对照组患者应用脑复康(通用名:吡拉西坦片)治疗,观察组则应用谷红注射液治疗。对比两组治疗前后的蒙特利尔认知评估量表(MoCA)评分、简明精神状态量表(MMSE)评分、日常生活活动能力量表(ADL)评分、大脑动脉血流速度,药物不良反应发生率。结果治疗后,观察组的MoCA评分(22.03±3.62)分、MMSE评分(20.96±3.97)分、ADL评分(69.79±10.15)分高于对照组的(19.53±3.01)、(17.82±2.36)、(53.26±5.19)分,差异有统计学意义(P<0.05)。治疗后,观察组的大脑前动脉、大脑中动脉、大脑后动脉血流速度均高于对照组,差异有统计学意义(P<0.05)。观察组的药物不良反应率为2.70%,与对照组的为5.41%比较,差异无统计学意义(P>0.05)。结论对于血管性痴呆患者通过给予谷红注射液治疗可获得满意疗效,有利于改善患者的认知功能并提升日常生活自理能力,且有利于提高患者大脑动脉血流速度,同时药物安全性良好。     

经颅多普勒对精神分裂症及躁狂症患者脑血流检测和研究

目的探讨精神分裂症及躁狂症患者脑血流的特征。方法用经颅多普勒超声(TCD)检测100例精神分裂症患者(A组)及100例躁狂症患者(B组)的双侧大脑中动脉(MCA)、大脑前动脉(ACA)及大脑后动脉(PCA)动脉和椎动脉-基底动脉(VA-BA)血流速度,以及搏动指数(PI)、阻力指数(RI)等脉动性指标。并与60例正常人(对照组)进行对照分析。结果A、B组3条大脑动脉的血流速度较对照组加快,椎-基底动脉血流速度呈A组减慢、B组加快。检查结果异常者在A组有82%,在B组有88%;而PI和RI值均属正常。结论精神分裂症和躁狂症患者3条大脑脑动脉的血流速度加快,提示脑动脉痉挛。对精神分裂症患者,椎—基底动脉血流速度减慢,可导致脑供血减少,这些血流动力学上的特征可能为改善患者脑血流循环的治疗提供线索。     

脑心通胶囊联合盐酸美金刚治疗血管性痴呆的临床研究

目的探究脑心通胶囊联合盐酸美金刚治疗血管性痴呆患者临床效果。方法选取天津中医药大学第一附属医院2016年4月—2018年1月收治的血管性痴呆患者94例,随机分成对照组和治疗组,每组各47例。对照组口服盐酸美金刚片,第1周剂量5 mg/d,然后每周递增5 mg至第4周达到维持剂量20 mg/d。治疗组在对照组基础上口服脑心通胶囊,3粒/次,3次/d。两组均连续治疗2个月。观察两组患者临床疗效,同时比较治疗前后两组患者认知障碍改善情况、脑血流动力学和血清炎性细胞因子水平。结果治疗后,对照组和治疗组临床总有效率分别为74.47%和91.49%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者日常生活能力量表(ADL)、简易智力状态检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)评分显著升高(P0.05),且治疗组患者ADL、MMSE和MoCA评分明显高于对照组(P0.05)。治疗后,两组大脑前动脉(ACA)、大脑后动脉(PCA)、大脑中动脉(MCA)和左右椎动脉(VA)平均血流速度明显升高(P0.05),且治疗组患者ACA、PCA、MCA、VA平均血流速度明显高于对照组(P0.05)。治疗后,两组患者血清C反应蛋白(CRP)、白细胞介素-18(IL-18)、IL-6、肿瘤坏死因子-α(TNF-α)水平明显降低(P0.05),且治疗组CRP、IL-18、IL-6、TNF-α水平明显低于对照组(P0.05)。结论脑心通胶囊联合盐酸美金刚治疗血管性痴呆患者对认知障碍改善起积极作用,促使脑部血液循环改善,还可抑制炎症反应,具有较高用药安全性,疗效显著。     

盐酸多奈哌齐治疗轻中度血管性痴呆的临床效果与安全性

目的 观察盐酸多奈哌齐在轻中度血管性痴呆患者中的临床应用效果与药物安全性。方法 选取2021年10月—2022年10月福州市长乐区人民医院接诊并进行系统治疗的轻中度血管性痴呆患者50例,根据随机数字表法分为药物配合组和对症干预组,各25例。对症干预组患者予常规对症治疗,药物配合组在对症干预组基础上予盐酸多奈哌齐片治疗。2组均以30 d为1个疗程,连续治疗3个疗程。比较2组治疗前后认知功能与生活能力[蒙特利尔认知功能评估量表(MoCA)、简易智能精神状态量表(MMSE)及日常生活能力评价量表(Barthel指数)]评分、脑血流指标[中动脉(MCA)、后动脉(PCA)及椎动脉(VA)血流速度]、血清因子[C反应蛋白(CRP)、β-淀粉样蛋白(Aβ)、神经营养因子(NT3)及脑源性神经营养因子(BDNF)]水平变化,及不良反应。结果 治疗3个疗程后,2组MoCA、MMSE、Barthel指数评分和NT3、BDNF水平均较治疗前提高,MCA、PCA、VA血流速度均较治疗前增加,CRP、Aβ水平均较治疗前降低,且药物配合组提高、增加或降低的程度大于对症干预组(P<0.05或P<0.0...     

丁苯酞胶囊联合艾地苯醌对改善血管性痴呆患者认知功能的影响

目的 探讨丁苯酞胶囊联合艾地苯醌对改善血管性痴呆患者认知功能及生活能力的作用.方法 将84例血管性痴呆患者随机分为两组,观察组采用丁苯酞胶囊联合艾地苯醌治疗,对照组单独使用艾地苯醌治疗,治疗前后分别依据呆智能检查量表(HDS)和美国国立卫生研究院卒中量表(NIHSS)及日常生活能力量表(ADL)的进行评分.结果 两组治疗后HDS评分均升高,NIHSS 评分、ADL评分均下降,与同组治疗前比较差异有统计学意义(P<0.05).治疗后观察组HDS、NIHSS和ADL评分与同期对照组比较,差异有统计学意义(P<0.05).结论 丁苯酞胶囊联合艾地苯醌能明显改善血管性痴呆患者的认知功能障碍以及提高生活自理能力.     

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.