葛根素与复方丹参注射液联用对急性高血压脑出血患者神经功能的改善作用

目的:探讨葛根素与复方丹参注射液联用对急性高血压脑出血患者神经功能的改善作用.方法:200例急性高血压脑出血患者随机分为对照组、葛根素组、复方丹参组和联合治疗组,每组50例.对照组采用西医常规治疗,葛根素组是在西医常规治疗基础上加用葛根素注射液治疗,复方丹参组是在西医常规治疗基础上加用复方丹参注射液治疗,联合治疗组是在西医常规治疗基础上加用葛根素和复方丹参注射液联合治疗,每组均连续给药2周.计算血肿体积和脑水肿程度,检测血浆D-二聚体和C-反应蛋白浓度,记录美国国立卫生院神经功能缺损评分和Barthel评分.结果:经析因设计方差分析,治疗后第14天,联合治疗组血肿体积和脑水肿程度均显著低于另外3组(均P＜0.05),治疗后第7天和第14天,联合治疗组血浆D-二聚体和C-反应蛋白浓度均显著低于另外3组(均P＜0.05);治疗后3个月,联合治疗组美国国立卫生院神经功能缺损评分均显著小于另外3组(均P＜0.05),联合治疗组Barthel评分均显著大于另外3组(均P＜0.05).结论:复方丹参注射液和葛根素之间有正性协同作用,联合应用可以更好地促进急性高血压脑出血患者的神经功能恢复.     

局部亚低温治疗高血压性脑出血的临床疗效观察

目的观察局部亚低温治疗高血压性脑出血患者的临床疗效。方法66例高血压性脑出血患者随机分为局部亚低温治疗组36例和对照组30例。在给予脑出血常规治疗的同时,局部亚低温治疗组加用局部亚低温治疗仪(电子冰帽)治疗。观察脑内血肿体积、血肿周围水肿体积及神经功能缺失评分的变化。结果入组后7d两组的血肿体积、血肿周围水肿体积及神经功能缺失评分差异无统计学意义。入组后14d时,局部亚低温治疗组颅内血肿体积(20.54±16.41ml)和对照组(22.26±13.20)ml相比,差异无统计学意义(P<0.05);血肿周围水肿体积(22.01±12.08)ml较对照组(28.21±10.02)ml有显著缩小;神经功能缺失评分(20.15±10.02)分亦较对照组(26.18±11.26)分有显著改善。结论电子冰帽局部亚低温治疗能促进高血压脑出血患者血肿周围水肿的消退,改善临床神经功能缺损。     

丹参注射液联合尼莫地平治疗急性高血压脑出血84例

目的观察丹参注射液联合尼莫地平治疗急性高血压脑出血的临床疗效。方法选择2009年6月至2012年6月收治的急性高血压脑出血168例,随机分成对照组和治疗组,各84例。两组患者均给予常规对症治疗,对照组在常规治疗基础上给予丹参注射液治疗,治疗组在对照组基础上给予尼莫地平静脉滴注,1次/天,2周为1个疗程。2个疗程后观察两组临床疗效、治疗前后颅内血肿情况,并进行神经功能缺损评分（ESS）评定神经功能。结果治疗组总有效率为90.47%,显著高于对照组的71.43%,差异有统计学意义（P〈0.05）;治疗组治疗后颅内血肿周围水肿面积缩小情况显著优于对照组;ESS评分治疗组下降显著低于对照组,两组比较差异有统计学意义（P〈0.05）。结论丹参注射液联合尼莫地平治疗急性高血压脑出血疗效显著,可有效改善神经功能缺损,促进颅内血肿吸收,值得临床推广。     

丹参注射液联合尼莫地平治疗急性高血压脑出血80例

目的观察丹参注射液联合尼莫地平治疗急性高血压脑出血的临床疗效。方法将来我院就诊的80例急性高血压脑出血患者随机分为两组,两组均给予常规对症治疗,观察组40例在常规治疗的基础上给予丹参注射液10 mL Qd静滴和尼莫地平30 mg TID口服或鼻饲。2周为1个疗程,2个疗程后观察两组临床疗效、治疗前后颅内血肿和神经功能缺损评分(ESS)评定情况。结果 观察组总有效率为90.0%显著高于对照组的72.5%(P<0.05)。观察组治疗后颅内血肿周围水肿面积明显缩小,显著优于对照组(P<0.05);观察组ESS评分下降显著低于对照组(P<0.05)。结论丹参注射液联合尼莫地平治疗急性高血压脑出血疗效显著,能有效改善神经功能缺损,减少颅内血肿面积,促进水肿吸收,值得在临床推广应用。     

云南白药联合依达拉奉治疗急性脑出血的临床研究

目的观察云南白药联合依达拉奉治疗急性脑出血的临床疗效。方法将60例急性脑出血患者随机分成对照组和治疗组,每组30例,对照组给予常规治疗,治疗组在常规治疗的基础上,给予云南白药联合依达拉奉治疗,比较两组治疗前后的血肿体积,神经功能缺损评分及总有效率。结果治疗前后对比,治疗后两组的头颅CT血肿体积及神经功能缺损评分均降低(P0.01);治疗后治疗组的血肿体积及神经功能缺损评分均明显低于对照组(P0.05),治疗组总有效率86.7%,对照组总有效率73.3%,治疗组高于对照组,未出现严重的不良反应。结论云南白药联合依达拉奉治疗急性脑出血,可显著促进患者脑血肿吸收,改善神经功能缺损,安全有效。     

黄芪注射液在急性脑出血治疗中的应用

目的临床观察黄芪注射液在急性脑出血治疗中的应用。方法选取急性脑出血患者70例,随机分成两组,对照组按常规治疗方法,观察组在常规治疗基础上予黄芪注射液20mL加入250mL生理盐水中每日静滴一次,共14d。第21天时进行血肿体积、水肿容积测量和神经功能缺损程度评分并比较。结果两组血肿体积大小变化无明显差异,观察组水肿体积和神经功能缺损评分较对照组明显减少(P<0.05)。结论黄芪注射液能有效减轻脑出血血肿周围水肿程度,改善出血周围缺血带血循环,促进神经功能恢复。     

复方丹参联合疏血通治疗急性脑出血的疗效观察

目的 观察复方丹参联合疏血通治疗急性脑出血的治疗效果.方法 80例急性脑出血患者随机分为两组(对照组和治疗组),对照组给予疏血通治疗,治疗组采用复方丹参和疏血通联合治疗.结果 治疗组的总有效率明显高于对照组(P＜0.05),神经功能缺损改善效果明显优于对照组(P＜0.05),血肿体积及周围低密度区面积也明显小于对照组(P＜0.05).治疗组患者治疗期间,患者未发生严重不良反应.结论 复方丹参和疏血通具有协同作用,两者联合治疗脑出血疗效显著,安全可靠.     

电子冰帽对高血压性脑出血预后的影响

目的　探讨用颅脑降温治疗仪 (电子冰帽 )使头部轻度低温 (亚低温 )改善血肿周围缺血及水肿治疗高血压性脑出血的效果。方法　 60例高血压性脑出血患者随机分为治疗组 ( 3 0例 )和对照组 ( 3 0例 ) ,在给予脑出血常规治疗的同时 ,治疗组加用电子冰帽 ,观察血肿体积、血肿周围水肿体积及神经功能缺损评分的变化。结果　入组后 7d及 2 1d血肿体积无差异 (P >0 .0 5 ) ,2 1d时治疗组和对照组血肿周围水肿体积分别为 ( 13 .3 6± 11.5 8)ml,( 19.5 6± 12 .0 9)ml,有显著差异 (P <0 .0 1)。入组 7d治疗组和对照组神经功能缺损评分无显著差异 (P >0 .0 5 ) ,入组 2 1d两组间神经功能缺损评分有显著差异 (P<0 .0 1)。结论　用电子冰帽使头部轻度低温治疗高血压性脑出血 ,能促进血肿周围水肿的消退 ,改善临床神经缺损功能     

银杏达莫注射液治疗急性脑梗死疗效观察

目的 观察评价银杏达莫注射液(杏丁注射液)治疗急性脑梗死的疗效.方法 将80例急性脑梗死患者随机分为银杏达莫观察组和复方丹参对照组各40例.观察组:银杏达莫注射液20ml,加入生理盐水250ml,每日一次,静脉滴注14d,对照组:复方丹参注射液20ml,加入生理盐水250ml,每日一次,静脉滴注14d,治疗前后做神经功能缺损程度评分,查血液流变学指标.结果 观察组较对照组治疗前后总分显著下降(P＜0.05),显效率观察组(67.5%)显著高于对照组(40%)(P＜0.05),血液流变学指标改善.结论 银杏达莫注射液可以改善脑血液流变学及脑梗死症状,疗效优于复方丹参,是治疗急性脑梗死的有效药物.     

舒血宁注射液治疗急性脑梗死60例临床分析

目的探讨舒血宁注射液治疗急性脑梗死的临床效果。方法选取我院收治的120例急性脑梗死患者为研究对象,随机分为对照组和观察组,两组均给予常规对症治疗,对照组在常规治疗的基础上加用复方丹参注射液治疗,观察组在常规治疗的基础上加用舒血宁注射液治疗,比较两组治疗效果及神经功能改善情况。结果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）。两组治疗前脑梗死体积、神经功能缺损程度评分经统计学分析,差异无统计学意义（P〉0.05）。观察组治疗后脑梗死体积、神经功能缺损程度评分显著优于对照组,差异有统计学意义（P〈0.05）。结论采用舒血宁注射液治疗急性脑梗死疗效优于复方丹参注射液治疗,治疗后梗死体积减少显著,神经功能损伤恢复良好,值得临床推广应用。     

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.     

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.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

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.