肺心病合并二型呼吸衰竭右心衰竭患者的NT-BNP的临床观察

目的 探讨NT-BNP在肺源性心脏病合并二型呼吸衰竭患者中的意义.方法 57例确诊为肺心病合并二型呼吸衰竭患者分为常规治疗组和呼吸机治疗组,测定其治疗前及治疗48 h NT-BNP变化,并与同年龄组健康人进行比较.结果 肺心病NT-BNP明显高于健康组,肺心病组治疗前与治疗48 hNT-BNP明显下降(P<0.001).结论 脑钠肽水平变化对慢性肺源性心脏病诊断及治疗有一定的临床评价意义.     

BiPAP无创通气治疗呼吸衰竭并慢性肺源性心脏病疗效观察

目的 探讨双水平气道正压无创通气(BiPAP)对呼吸衰竭并慢性肺源性心脏病临床治疗效果.方法 选择2012年1月至2014年10月我科收治的65例呼吸衰竭并慢性肺心病(失代偿期)患者,随机分为两组,对照组32例,观察组33例.对照组给予常规对症治疗,观察组在常规对症治疗基础上加用BiPAP无创通气治疗,观察两组患者治疗前及治疗后6、24、48 h心率(HR)、呼吸频率(R)、血气分析指标(PaCO2、PaO2)及血液N端脑钠肽前体(NT-proBNP)水平.结果 观察组治疗6h后,患者心率、呼吸频率、血气分析指标改善较对照组差异有统计学意义(P＜0.05),治疗48 h后观察组NT-proBNP下降较对照组差异有统计学意义(P＜0.05).结论 采用BiPAP无创通气治疗呼吸衰竭并慢性肺源性心脏病患者,可有效改善临床症状、血气分析、心衰指标,纠正呼吸衰竭、心力衰竭,值得临床推广应用.     

血尿酸水平与慢性肺源性心脏病病情判断中的相关性探讨

目的探究血液中尿酸水平与慢性肺源性心脏病病情变化的相关性,为慢性肺源性心脏病病情的判断提供重要方法。方法由2008年6月至2010年12月之间就诊长春市双阳区鹿乡镇卫生院的慢性肺心病患者中随机抽取60例患者,同时随机抽取60例非慢性肺源性心脏病患者作为对照组,对两组患者的血尿酸含量及不同时期慢性肺源性心脏病的血尿酸含量进行比较。结果研究组的血尿酸水平明显高于对照组,两组之间差异显著(P<0.05),具有统计学意义。慢性肺心病病情越重者其血清中尿酸含量越高,处于疾病早期阶段患者的血尿酸水平明显低于晚期患者血尿酸的含量,经统计学分析,差异显著(P<0.05)。结论慢性肺源性心脏病患者的血尿酸水平的变化与病情发展相一致,表现为病情越重,血尿酸含量越高。     

心钠素水平改变在慢性肺源性心脏病患者中的临床意义

目的：探讨心钠素水平改变在慢性肺源性心脏病患者中的临床意义。方法慢性肺源性心脏病患者共40例,作为观察组。上述患者均因为急性加重而入院实施临床治疗,经临床治疗后所选患者进入缓解期。同时选择到本院体检的健康者30例,作为对照组。所选的肺源性心脏病患者均在入院治疗的第2天和进入缓解期后清晨空腹取静脉血约2 ml,离心取血浆,测定心钠素水平。对照组所测定心钠素水平方法同观察组。结果观察组患者急性加重期检测的心钠素水平为（345±29）μg/L,观察组患者进入缓解期后检测的心钠素水平为（241±34）μg/L；对照组中测定的心钠素水平为（112±25）μg/L。观察组患者在急性加重期的心钠素水平高于对照组,差异有统计学意义（P＜0.05）。观察组患者在缓解期的心钠素水平高于对照组,差异有统计学意义（P＜0.05）。观察组患者急性加重期的心钠素水平高于本组患者缓解期的心钠素水平,差异有统计学意义（P＜0.05）。结论慢性肺源性心脏病患者心钠素水平升高,了解此类患者心钠素水平有助于评估慢性肺心病的病情严重程度及预后。     

心肌肌钙蛋白Ⅰ与N-末端脑钠肽前体检测在慢性肺源性心脏病急性加重期的临床意义

目的：观察慢性阻塞性肺疾病（COPD）并发慢性肺源性心脏病急性加重期患者血清心肌肌钙蛋白Ⅰ（cTnⅠ）、血浆N-末端脑钠肽前体（NT-proBNP）水平变化的临床意义。方法检测慢性肺源性心脏病急性加重期患者（A组）治疗前及治疗后15天,以及单纯COPD患者（C组）治疗前的血清 cTnⅠ、血浆 NT-proBNP、动脉血氧分压（PaO2）及二氧化碳分压（PaCO2）水平。结果血cTnⅠ、NT-proBNP、PaO2值由C 组→A组治疗后→A 组治疗前呈明显上升趋势,PaCO2由C 组→A 组治疗后→A 组治疗前呈明显下降趋势,三组间两两比较,差异均有统计学意义。A组治疗前、后血浆NT-proBNP 水平分别与PaO2呈显著正相关,与PaCO2呈显著负相关。结论血清cTnⅠ和血浆NT-proBNP 水平可作为评价慢性肺心病急性加重患者心肌损伤、心力衰竭的一项重要指标。     

NT—proBNP在鉴别慢性肺源性心脏病病程进展分期的临床价值

目的观察NT—proBNP（11]t清N-端B型钠尿肽前体）在鉴别慢性肺源性心脏病病程进展分期的临床价值。方法选取慢性肺源性心脏病功能代偿期患者45例（f弋偿组）和功能失代偿期患者45例f失代偿组），并选取同时期住院的慢性阻塞性肺疾病非慢性肺源性心脏病不合并心功能不全患者45例作为对照组，测定他们的血清NT—proBNP值，对比各组之间NT—proBNP值的变化。结果代偿组、失代偿组及对照组的NT—proBNP水平分别为（996．34±832．44）pg／ml、（6302．68±2451．54）pg／ml、（43．27±36．4）pg／ml。各组间比较，差异有极显著性（F=237．57，P〈0．01）。结论检测慢性肺源性心脏病患者血清NT—proBNP有助于鉴别慢性肺源性心脏病病程进屠分期。     

NT-proBNP对老年急性左心衰患者24小时预后的评估价值

目的评价NT-proBNP水平预测老年急性左心衰患者24h预后的价值。方法对104例老年急性左心衰患者运用荧光免疫分析技术行快速NT-proBNP定量检测,观察患者24h内心脏不良事件发生率。结果若以NT-proBNP水平20000pg/ml判定老年急性左心衰患者24h死亡阳性预测值为38.10%,阴性预测值为7.23%。进而以NT-proBNP水平20000pg/ml为界值对两组死亡构成比进行检验,0.01相似文献   

Nt-porBNP鉴别急性呼吸困难200例分析

目的了解N末端脑钠肽(NT-proBNP)血浆浓度的检测对心源性和肺源性呼吸困难的诊断价值。方法选择我院收治的急性呼吸困难患者200例,迅速采静脉血1~2mL,测定血浆NT-proBNP血浆浓度;病情稳定后,均常规行超声心动检查,经统计学分析进行心源性与肺源性呼吸困难患者NT-proBNP血浆浓度水平的比较。结果 NT-proBNP在心源性患者为(2380±376)pg/mL,肺源性患者为(54±65)pg/mL。心源性患者NT-proBNP血浆浓度水平值明显高于非心源性患者(P<0.01)。结论 NT-proBNP血浆浓度水平的检测在急性心源性与肺源性呼吸困难患者中具有明显鉴别意义。     

N端B型钠尿肽前体对急诊患者呼吸困难鉴别诊断的价值

目的研究血浆N端B型钠尿肽前体（NT-proBNP）水平对急诊患者呼吸困难鉴别诊断意义。方法对我院急诊科呼吸困难患者,检测血浆NT-proBNP含量,并进行超声心动图检查,比较心源性和肺源性呼吸困难患者血浆NT-proBNP水平的差异。结果心源性呼吸困难组和肺源性呼吸困难组血浆NT-proBNP分别为（471.40±190.99）pg/mL和（84.77±24.17）pg/ml（P〈0.01）;心源性呼吸困难组血浆NT-proBNP与左室射血分数呈负相关（r=-0.82,P〈0.01）。结论血浆NT-proBNP对心源性呼吸困难和肺源性呼吸困难的鉴别诊断有重要意义。     

双水平气道正压通气联合法舒地尔治疗CPHD合并Ⅱ型呼吸衰竭疗效观察

目的 观察双水平气道正压通气联合法舒地尔治疗慢性肺源性心脏病合并Ⅱ型呼吸衰竭的临床疗效,旨在为今后更有效抢救慢性肺源性心脏病合并Ⅱ型呼吸衰竭提供参考和借鉴.方法 前瞻性选取2015年1月至2016年6月120例确诊为慢性肺源性心脏病合并Ⅱ型呼吸衰竭患者,采用随机数字表法将其分为2组,对照组行常规支持+双水平气道正压通气,观察组加用法舒地尔,比较2组心率、呼吸、mMRC评分、血气指标、肺通气功能、CRP和NT-proBNP水平以及肺动脉压变化情况.结果 观察组呼吸、心率水平及mMRC评分改善情况较对照组更为显著(P<0.05);观察组pH、PaO2、SaO2水平增高程度和PaCO2水平降低程度较对照组更为明显(P<0.05);FEV1％、FEV1/FVC水平增高程度较对照组更为显著(P<0.05);观察组CRP、NT-proBNP水平降低程度较对照组更显著(P<0.05);观察组PASP、PADP、MPAM水平改善情况明显优于对照组(P<0.05).结论 法舒地尔联合双水平气道正压通气可早期明显改善肺源性心脏病伴Ⅱ型呼吸衰竭患者肺通气功能,纠正呼吸衰竭,同时还可减轻机体的炎性反应并降低肺动压力,具有广阔的应用前景.     

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.