参麦注射液对非ST段抬高型急性冠脉综合征患者C反应蛋白和同型半胱氨酸水平的影响

目的 探讨参麦注射液对非ST段抬高型ACS患者血浆CRP和同型半胱氨酸（Hcy）的影响.方法 96例非ST段抬高型ACS患者按照数字表法随机分为两组,对照组48例,观察组48例.对照组采用常规治疗,观察组在常规治疗的基础上加用参麦注射液,两组治疗14 d.治疗前后测定患者血浆CRP和Hcy.结果 观察组总有效率（95.8％）显著高于对照组（87.5％）（x2=4.760,P ＜0.05）.两组治疗后患者血浆CRP和Hcy均明显降低,并且观察组降低更明显[CRP（t=2.927,P＜0.05）；Hcy（t=2.624,P＜0.05）].结论 参麦注射液可以明显降低非ST段抬高型ACS患者血浆CRP和Hcy水平.     

谷氨酰胺对多器官功能障碍综合征患者血浆内毒素水平的影响

目的探讨添加谷氨酰胺(Gln)的全肠外营养(TPN)对多器官功能障碍综合征(MODS)患者血浆内毒素(LPS)水平的影响.方法将入住聊城市人民医院ICU的MODS患者40例随机分为A组、B组.A组按常规给予TPN,B组在给予TPN基础上加用Gln 0.27 g·kg-1·d-1,共7 d.TPN治疗前及治疗后第1,3,7天检测血浆Gln、LPS浓度,观察TPN治疗时间、死亡率.选取健康献血员作C组.结果血浆Gin浓度TPN治疗前A、B两组均显著低于C组(P＜0.01),两组间无显著性差异(P＞0.05).TPN治疗第1,3,7天,A组显著低于B组(P＜0.01).血浆内毒素浓度TPN治疗前A、B两组显著高于C组(P＜0.01),A、B两组间无显著性差异(P＞0.05),经Gln TPN治疗后,B组血浆LPS显著低于A组(P＜0.01).A组TPN治疗时间为(15.8±2.3)d,B组为(12.5±2.4)d,A组显著高于B组(P＜0.05).A纽死亡率为25%,B组为10%,两组间比较无显著性差异(P＞0.05).结论经静脉补充Gln(力肽),显著降低MODS患者血浆LPS浓度,有利于缩短TPN治疗时间.     

同型半胱氨酸与糖尿病肾病的关系及叶酸、甲钴胺的治疗效果

目的 研究同型半胱氨酸与糖尿病肾病的发病关系及叶酸、甲钴胺降低血浆Hcy水平的效果.方法 (1)血浆Hcy与糖尿病肾病关系研究:选取健康者30例为对照组,2型糖尿病患者50例,其中糖尿病肾病患者25例,测定3组受检者SBP、DBP及血浆Hcy、FBG、TG、HDL、LDL并分析其余糖尿病肾病的相关性.(2)糖尿病肾病患者Hcy水平干预研究:将60例2型糖尿病患者随机分为A、B两组各30例,A组患者未予干预.B组患者给予口服叶酸及甲钴胺干预治疗8周,比较干预前后血浆Hcy水平的变化.结果 非DN组和DN组患者Hcy水平均显著高于对照组(P＜0.05)且DN组显著高于非DN组(P＜0.01),多因素分析得Hcy是糖尿病肾病的独立危险因素.干预后患者血浆Hcy水平显著下降且显著低于对照组(P＜ 0.01).结论 Hcy是糖尿病肾病的独立危险因素,且叶酸联合甲钴胺治疗可显著降低2型糖尿病患者血浆Hcy水平.     

阿托伐他汀对高血压脑出血急性期患者C-反应蛋白的影响

目的 探讨阿托伐他汀对高血压脑出血急性期患者CRP的影响.方法 80例高血压脑出血急性期患者随机分为治疗组和对照组各40例,均给予常规治疗,治疗组加用阿托伐他汀钙.结果 两组入院后血清CRP水平呈下降趋势,治疗组从治疗4d起而对照组从治疗7d起血清CRP水平较入院当日下降显著(P＜0.05),治疗4、7、10、14d治疗组血清CRP水平显著低于对照组(P＜0.05).两组入院后NIHSS评分呈下降趋势(P＜0.05),治疗后治疗组NIHSS评分显著低于对照组(P＜0.05).血清CRP与NIHSS评分呈正相关(r=0.56,P＜0.05).结论 结论:阿托伐他汀用于治疗高血压患者急性脑出血,能有效降低CRP水平,通过抑制炎症反应对神经系统的损害发挥脑保护作用.     

糖尿病心脏病患者血清同型半胱氨酸水平及其干预研究

目的:探讨糖尿病心脏病(DC)患者血清同型半胱氨酸(Hcy)水平,观察叶酸、维生素B12和甲钴铵治疗高同型半胱氨酸血症的疗效.方法:确诊的DC患者(干预组)36 例及正常对照组36 例,用高效液相色谱法测定血浆Hcy水平,用放免法测定血浆叶酸和维生素B12浓度.其中高Hcy血症患者每天服用叶酸5 mg,每日3次,甲钴胺针0.5 mg肌肉注射,每日1次,2周后改为口服甲钴胺片500 μg,每日3次.观察4周血浆Hcy、叶酸和维生素B12水平变化.结果:DC患者血浆Hcy水平明显高于正常对照组(P＜0.05),叶酸和维生素B12水平则明显低于正常对照组(P＜0.05);干预治疗4周后,干预组血浆Hcy水平明显下降(P＜0.05);叶酸和维生素B12水平则明显升高(P＜0.05).结论:DC患者血浆Hcy水平明显高于正常人,高Hcy血症是DC的危险因素之一,叶酸和甲钴铵干预治疗可使DC患者血浆Hcy浓度明显降低.     

盐酸法舒地尔治疗老年人不稳定性心绞痛

目的:观察盐酸法舒地尔治疗老年人不稳定性心绞痛(UAP)的疗效.方法:将60例60岁以上老年人UAP患者随机分为治疗组和对照组,每组30例,在常规治疗外,分别采用静脉滴注盐酸法舒地尔30 mg,12小时1次或口服硝苯地平10 mg,3次/日,治疗14天.治疗前后观察两组心绞痛发作情况,并做心电图检查,观察不良反应.治疗后随访6个月.结果:治疗组总有效率83.33%高于对照组73.33%,但两组比较差异无显著性(P＞0.05);治疗组显效率(70.00%)高于对照组(40.00%),差异有显著性(P＜0.05).两组均无明显不良反应.随访6个月,对照组死亡1例,死于肺部感染;治疗组发生1例心肌梗死.结论:盐酸法舒地尔可以试用于治疗老年人UAP.     

参芪扶正注射液对心力衰竭患者脑利钠肽浓度的影响

目的探讨参芪扶正注射液对心力衰竭患者血浆脑利钠肽(BNP)浓度的影响.方法将2005年7月至2006年2月收住我院心血管内科的心力衰竭患者60例,随机分成2组:A组为常规治疗组(30例);B组为常规治疗加参芪扶正注射液治疗组(30例).均治疗2周,治疗前后应用免疫荧光定量法快速测定血浆BNP水平.结果心功能Ⅳ级较心功能Ⅱ级、Ⅲ级的患者血浆BNP水平明显升高(P＜0.01).A、B两组治疗后,BNP水平较治疗前均有明显下降(P＜0.05),且B组较A组下降更显著(P＜0.05).结论参芪扶正注射液加常规治疗心力衰竭,不仅能进一步改善心力衰竭症状,而且能改善预后.     

急性脑梗死患者血清同型半胱氨酸、C-反应蛋白水平变化及意义

目的 探讨急性脑梗死患者血清同型半胱氨酸(Hcy)、C-反应蛋白(CRP)的变化及临床意义.方法 选择64例急性脑梗死患者作为观察组,于治疗后第1、7、14天检测Hcy、CRP、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白水平,并选取同期门诊健康体检正常者60例作为对照组.比较两组各项指标差异.结果 观察组治疗第1天、治疗第7天、第14天Hcy、CRP水平明显高于对照组(t=3.073、2.874、2.015,均P＜0.05);观察组治疗第7天、第14天Hcy 、CRP水平较第1天明显降低(t=2.223、2.268,均P＜0.05).结论 Hcy、CRP与急性脑梗死的发生发展有密切关系,检测其水平对于判断疾病的严重程度,指导临床治疗具有重要的意义.     

瑞舒伐他汀治疗不稳定型心绞痛的临床疗效研究

目的 对比瑞舒伐他汀及氟伐他汀在治疗不稳定型心绞痛（UAP）中的临床疗效.方法 将本院2009年3月～2012年3月收治的138例确诊为UAP的患者按照随机对照的原则分为A、B两组,每组各69例,全部患者均采取抗血小板治疗,并给予β受体阻滞剂、钙离子拮抗剂及硝酸酯类药物.在以上常规治疗措施进行的同时,A组患者另给予每晚40 mg氟伐他汀,B组患者另给予每晚10 mg瑞舒伐他汀,疗程为8周.对两组患者的临床疗效及高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）及C-反应蛋白（CRP）的改善情况进行比较.结果 全部患者经治疗,B组患者的有效率（94.2％）显著高于A组（69.6％）,差异具有统计学意义（P＜0.01）.全部患者治疗后HDL-C水平较治疗前明显提高,而LDL-C及CRP水平较治疗前明显降低,差异具有统计学意义（P＜0.05）.且治疗后B组患者的HDL-C水平上升及LDL-C及CRP下降程度与A组患者比较更加明显,差异具有统计学意义（P＜0.05）.结论 瑞舒伐他汀能在调脂及抗炎上充分发挥其作用,可明显改善患者的HDL-C、LDL-C及CRP水平,在UAP的治疗效果上优于氟伐他汀.     

氯吡格雷对不稳定型心绞痛患者血浆内皮素和降钙素基因相关肽的影响

目的 探讨氯吡格雷对不稳定型心绞痛(UAP)患者血浆内皮素和降钙素基因相关肽的影响.方法 将100例UAP患者随机分为两组,分别用消心痛(50例)及氯吡格雷加消心痛(50例)联合治疗,采用放免法观察治疗前后患者血浆内皮素(ET)及降钙素基因相关肽(CGRP)含量,另选20名健康体检者作对照.结果 与健康志愿者相比,UAP患者血浆ET含量明显升高(P＜0.05),CGRP明显降低(P＜0.05).较消心痛治疗组相比,联合使用氯吡格雷治疗后患者ET明显下降(P＜0.01),CGRP明显升高(P＜0.05).结论 氯吡格雷能显著改善ET、CGRP代谢失衡状况,是治疗UAP的有效药物.     

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.

     

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.     

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.     

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.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

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.