胰岛素抵抗与冠心病危险因素的相关性分析

目的:探讨胰岛素抵抗(IR)与冠心病常见危险因素之间的关系。方法:采用回顾性研究,整理自2005年4月—2006年8月住院并行冠状动脉造影确诊冠心病的患者资料,分析胰岛素抵抗与冠心病常见危险因素之间的关系。结果:IR组患者高血压发生率、收缩压、体质量指数(BMI)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、空腹胰岛素(FINS)、尿酸(UA)高于胰岛素敏感(IS)组,高密度脂蛋白胆固醇(HDL-C)低于IS组(P<0.05或P<0.01);经Spearman相关分析表明HOMA-IR与患者的高血压、收缩压、TG、FINS、FPG、BMI和UA水平呈正相关(r在0.283～0.937,P<0.05或P<0.01),与HDL-C呈负相关(r=-0.455,P<0.01);经多元逐步Logistic回归分析表明HOMA-IR与高血压、收缩压、TG、FINS、FPG、BMI、UA和HDL-C相关。结论:IR患者存在冠心病危险因素的聚集趋势,常合并高血压、肥胖、血脂代谢紊乱、血糖和胰岛素代谢紊乱,IR可能是冠心病的危险因素。     

血脂生化检验中采用分级检验方法的检验结果分析

目的研究分级检验法在血脂生化检验中的效果。方法选取60例临床标本进行分级检验以及常规检验,其中检验指标包含血清总胆固醇(Total Cholesterol)、三酰甘油(triglyceride)、高密度脂蛋白胆固醇(High-density lipoprotein cholesterol)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol)、载脂蛋白(Apolipoprotein)。结果拉网测定法和分级检验法分析中,TC、TG、HDL-C数据对比无显著差异性(P> 0.05);LDL-C、ApoAI、ApoB对比差异性显著(P <0.05);60例病例中,ApoB并未出现漏检的情况,分级检验出现2例漏检(3.3%)、LDL-C出现1例漏检情况(1.7%)。结论在血脂生化检验中,分级检验以及常规拉网式检验的关联性很强,临床推广价值存在。     

高尿酸血症与冠心病的相关性及性别差异

目的 ：观察住院人群中血尿酸（serum uric acid,SUA）、高尿酸血症（hyperuricemia,HUA）和冠心病之间的相关性及性别差异。方法：纳入2016年1月至2018年12月在上海市第六人民医院东院心内科首次行冠状动脉（冠脉）造影检查的住院患者781名,经冠脉造影确诊冠心病者512例为观察组,冠脉造影除冠心病外者269例为对照组。收集两组的临床资料,分析冠心病的危险因素。采用多因素logistic回归分析冠心病与HUA的关系,并按性别分层。结果 ：本研究人群中HUA总患病率为23.7%,观察组患病率为27.3%,对照组患病率为16.7%。在校正年龄、2型糖尿病（type2 diabetes mellitus,T2DM）、高血压和低密度脂蛋白胆固醇（low density lipoprotein cholesterol,LDL-C）、高密度脂蛋白胆固醇（high density lipoprotein cholesterol,HDL-C）、总胆固醇（serum total cholesterol,TC）、甘油三酯（triacylglycerol,TG）、空腹血糖（fa...     

北京地区健康人群血脂水平调查

血脂异常是动脉粥样硬化性病变发生、发展的必要因素,而动脉粥样硬化可造成相应器官或组织供血不足,导致冠心病、脑缺血性发作、脑梗死及周围血管病变[1,2]。在心脑血管疾病已成为导致人类死亡头号杀手的今天,对高脂血症的研究和防治也越显重要。本文以北京市健康成年人为调查对象,以日立7600全自动生化分析仪检测了血清三酰甘油(triglyceride,TG)、胆固醇(cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)及高密度脂蛋白胆固醇(highdensity lipoprotein cholesterol,HDL-C),分析其血脂水平及分布特征,探讨血脂异常防治对策,报告如下。     

冠心病危险因素与冠状动脉病变的相关性分析

目的探讨冠心病危险因素与冠状动脉病变的相关性。方法回顾性分析我院行选择性冠状动脉造影检查(coronary angiography,CAG)337例的临床资料,设计调查表调查相关指标,依据CAG结果将其分为冠心病组和非冠心病组进行比较,分析冠心病危险因素与冠状动脉病变的关系,采用多因素Logistic回归分析筛选冠心病独立相关危险因素。结果两组血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血清总胆红素(TBIL)、血尿酸(UA)、空腹血糖(FBG)、纤维蛋白原(FIB)水平比较差异有统计学意义(P<0.05或P<0.01),MPV比较差异无统计学意义(P>0.05);随着男性比例、高血压、高血脂、吸烟、糖尿病等单个危险因素及年龄、血TC、LDL-C、FBG、FIB增加,血HDL-C、TBIL降低,冠状动脉病变支数、狭窄程度逐渐增加,差异有统计学意义(P<0.05),TG、UA与冠状动脉病变支数及狭窄程度无明显关系,差异无统计学意义(P>0.05);冠状动脉病变支数、病变积分与男性比例、高血压、糖尿病、吸烟、TC、LDL-C、FBG、FIB呈正相关(...     

阿托伐他汀对冠心病合并糖尿病患者血脂、血流变与凝血功能的影响

目的分析冠心病并糖尿病患者疾病特点、治疗需求,评价阿托伐他汀药物治疗对患者血脂、血流变、凝血功能的影响。方法选择我院2019年7月至2020年3月诊治的110例冠心病并糖尿病患者,随机数字表法分组治疗。对照组患者采取常规基础用药,观察组患者配合阿托伐他汀药物治疗。结果治疗后,观察组冠心病合并糖尿病患者的血脂指标[三酰甘油(triglyceride,TG)、血清总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density liptein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)]、血流变指标(全血黏度、血浆黏度、纤维蛋白)、凝血功能指标[活化部分凝血活酶时间(activatedpartial thromboplastintime,APTT)、凝血酶原时间(prothrombintime,PT)、组织型纤溶酶原激活物(tissue—typeplasminogenactivator,t-PA)]水平改善程度均明显优于对照组(P均<0.05)。结论阿托伐他汀配合基础治疗可以促进冠心病合并糖尿病患者血脂、血流变、凝血功能的改善。     

地屈孕酮片与安慰剂治疗对女性更年期患者临床疗效、性激素及血脂水平的影响

目的 研究地屈孕酮片与安慰剂治疗对女性更年期患者临床疗效、性激素及血脂水平的影响.方法 选取2018年10月至2020年10月期间于我院接受治疗的98例女性更年期综合征作为本次研究目标,随机将98例更年期综合征列为对照组(n=49,予以安慰剂治疗)和研究组(n=49,予以地屈孕酮片治疗).对比两组患者的临床疗效、性激素水平[包括雌二醇(Estradiol,E2)、卵泡生成激素(Follicular Stimulating Hormone,FSH)]、血脂水平[包括总胆固醇(Total cholesterol,TC)、甘油三酯(Triglyceride,TG)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(High density lipoprotein cholesterol,HDL-C)]及不良反应.结果 ⑴研究组=临床总有效率(95.92％)显著高于对照组临床总有效率(83.67％)(P<0.05);⑵治疗后,研究组E2水平均较治疗前升高,FSH水平均较治疗前降低(P<0.05),对照组治疗后E2、FSH水平较前无明显变化(P>0.05);⑶治疗后,研究组TC、TG、LDL-C水平较前下降,HDL-C水平较前升高(P<0.05),对照组治疗前后TC、TG、HDL-C、LDL-C水平无明显变化(P>0.05;⑷两组不良反应对比无差异(P>0.05).结论 地屈孕酮片治疗女性更年期综合征的疗效显著,且对患者性激素及血脂水平改善效果优于安慰剂治疗,安全性高.     

顺式二苯乙烯苷与反式二苯乙烯苷降血脂作用的对比

目的对比研究顺式和反式二苯乙烯苷的降血脂作用。方法分别考察顺式、反式二苯乙烯苷对正常小鼠、慢性高血脂小鼠和急性高血脂小鼠血清中总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)和低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)含量的影响。结果顺式二苯乙烯苷能显著性降低高血脂小鼠血清中TC、TG及LDL-C的水平,也能显著性降低正常血脂小鼠血清中LDL-C的含量,高剂量顺式二苯乙烯苷还能显著性升高正常血脂小鼠和高血脂小鼠血清中HDL-C的水平。顺式二苯乙烯苷对正常小鼠和急性高血脂小鼠的降血脂作用与反式基本相同,但对慢性高血脂小鼠血浆中TC和TG的降低作用明显强于反式二苯乙烯苷。结论顺式二苯乙烯苷具有比反式二苯乙烯苷更好的降血脂作用。     

青年女性冠心病患者血清尿酸与冠状动脉病变的关系

目的 探讨青年女性冠心病患者血清尿酸水平与冠状动脉病变程度的关系.方法 回顾性分析2002年1月至2011年1月于我院住院经冠状动脉造影明确诊断冠心病的青年女性患者183例的临床资料.根据冠状动脉造影结果,记录为单支病变变组(123例)、双支病变组(38例)和三支病变组(22例).观察冠心病危险因素与冠状动脉病变程度的关系.结果 ①在单支、双支和三支病变组,血清尿酸水平竺差异有统计学意义[分别为(263.88±66.08)、(263.99±71.39)、(312.62+75.86)μmol/L,P<0.05].②双支、三支病变组lnTG、TC及LDL-C水平明显高于单支病变组[分别为(0.44±0.56)、(0.62±0.46)mmol/L比(0.29±0.46)mmol/L,(4.68±1.37)、(5.60±1.53)mmol/L比(4.14±0.93)mmol/L,(2.87±1.15)、(3.76±1.28)mmol/L比(2.48±0.74)mmol/L,均P<0.05].③Logistic回归分析显示,影响冠状动脉多支病变的独立危险因素依次为TG、LDL-C水平(P<0.05);而尿酸水平不是冠状动脉多支病变的独立危险因素.结论 青年女性的血清高尿酸水平与冠心病患者冠状动脉的病变程度有一定的相关性.

Abstract：

Objective To study the relation between serum uric acid and the severity of coronary artery le-sion in young women. Methods One hundred and eighty-three young women patients underwent coronary angiogra-phy between January 2002 and January 2011 were selected. According to the results of coronary angiography, they were divided into three groups: the single, double and triple vessel lesions. The relation between body mass index (BMI) , systolic blood pressure( SBP) , diastolic blood pressure(DBP) , heart rates(HR) , serum uric acid(UA) , fasting blood glucose(FBG) , triglyceride(TG) , total cholesterol(TC), high density lipoprotein cholesterol(HDL-C) , low density lipoprotein cholesterol (LDL-C) with severity of coronary artery disease (CAD) were analyzed. Results The UA level in the triple vessel lesions group was significantly higher than that in the single and double vessel le-sions group[(312.62±75.86)μmol/L vs(263.88±66.08) ,(263.99±71.39) μmol/L, P<0.05]. In the mul-tiple vessel lesions group, lnTG, TC and LDL-C were significantly higher than those in the single vessel lesions group[(0.44±0.56) , (0.62 ±0.46)mmol/L vs(0.29±0.46)mmol/L;(4.68±1. 37) , (5. 60±1.63)mmol/L vs(4.14 ±0.93)mmol/L;(2. 87 ± 1.15) , (3. 76 ± 1.28)mmol/L vs(2. 48±0. 74)mmol/L] , but there was no significant difference of UA between the two groups. According to Logistic regression analysis, the factors related with the multiple vessel lesions CAD was TG, LDL-C(P<0.05) , meanwhile the UA was not an independent risk factor. Conclusion In young women patients, high UA level is related to severe coronary artery vessel lesions.     

干部人群腰身指数与心血管疾病危险因素的相关性研究

目的探讨干部人群中作为一种新型腹型肥胖指标的腰身指数(腰围/身高比值,WHtR)与心血管危险因素的相关性。方法对2009年在我院行健康体检的处级干部471例测量血压、身高、体质量和腰围(WC),计算体质量指数(BMI)和WHtR,检测血糖、血脂、尿酸等生化指标,并进行统计学分析。结果 WHtR≥0.5组的年龄、体质量、BMI、WC、SBP、DBP、FBG、2hPBG、CH、TG、UA均显着高于WHtR<0.5组,而HDL-C的结果则相反(P<0.01,P<0.05);WHtR与WC、BMI、体质量、SBP、DBP、2hPBG、TG、UA呈现出正相关关系,与HDL-C则有明显负相关关系(P<0.01,P<0.05)。结论 WHtR与心血管危险因素明显相关,及时控制WHtR可有效改善干部人群的健康状况。     

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.     

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.     

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.