颈动脉内膜中层厚度及斑块对高血压脑卒中的预测研究

目的应用彩色多普勒超声研究高血压患者颈动脉内膜中层厚度对预测高血压脑卒中的价值。方法应用彩色多普勒超声检测100例单纯高血压患者及50例健康人颈动脉的内膜中层厚度(IMT)及斑块情况,比较单纯高血压患者与高血压合并脑卒中患者颈动脉内膜中层厚度的差别。结果100例高血压患者中内膜中层增厚者94例,占94%;动脉粥样斑块形成62例,共123处斑块。脑卒中组内膜中层厚度及斑块形成明显多于单纯高血压组。结论彩色多普勒超声能有效检测颈动脉管壁及管腔的变化,在临床预测高血压脑卒中具有重要的参考价值。     

氨氯地平阿托伐他汀钙片对原发性高血压患者颈动脉硬化病变的影响

<正>颈动脉内膜中层厚度(CIMT)增厚是颈动脉粥样硬化的早期表现,且发生于颈动脉粥样斑块形成之前[1]。颈动脉内膜中层厚度增厚是心脑血管事件的独立危险因子,且随着CIMT增厚缺血性脑卒中发生率增高[2],及早干预及逆转CIMT的增厚对于消退及稳定颈动脉斑块,减少缺血性脑卒中的发生有着重要意义。积极有效的降压、降脂治疗对高血压大动脉内膜中层的增厚有一定的抑制和逆转效应,本研究采用彩色多普勒超声检测CIMT及颈动脉粥样斑块的变化,     

血栓调节蛋白纤溶酶原激活物抑制物与糖尿病颈动脉粥样硬化

糖尿病患者心脑血管疾病发病率高,心脑血管疾病的病因大多与动脉粥样硬化有关,Teri等[1]报道头部磁共振成像(MRI)发现冠心病和脑梗死患病率随着颈动脉内膜中层(IMT)增厚及颈动脉斑块率增加而增加。最近的研究发现,在大血管发生动脉粥样硬化的早期,血中血栓调节蛋白(thrombomodu     

老年性脑白质改变与颈动脉粥样斑块的关系

目的研究老年性脑白质改变与颈动脉粥样硬化斑块的关系。方法随机对120例脑MRI检查确诊的老年性脑白质改变者(观察组)和100例脑MRI正常者(对照组)行颈动脉彩色多普勒检查,测量颈动脉内膜中层厚度、颈动脉粥样硬化斑块的部位、形态、大小、回声特点和颈动脉管腔的狭窄程度及Crouse积分。结果观察组颈动脉粥样硬化斑块发生率为70·7%,颈动脉内膜中层厚度>1·0mm者占23·9%,颈动脉狭窄发生率为16·3%,Crouse积分534·9;对照组颈动脉粥样硬化斑块发生率为32·1%,颈动脉内膜中层厚度>1·0mm者占12·3%,Grouse积分259·5。经统计学分析,两组间上述各指标差异均有显著性?P<0·05?。结论颈动脉粥样硬化斑块与老年性脑白质改变明显相关,颈动脉粥样硬化斑块是老年性脑白质改变的重要危险因素。     

糖尿病患者颈动脉中层厚度的测定及与冠状动脉病变的相关性

目的建立糖尿病患者颈动脉中层厚度的测定方法,探讨糖尿病患者颈动脉中层厚度与冠状动脉病变的相关性。方法 2型糖尿病中未伴发冠状动脉病变患者50例(A组),糖尿病伴发冠状动脉病变患者90例(B组);其中B组中稳定型心绞痛者48例,不稳定型心绞痛患者42例;正常对照组50例。对研究对象进行临床检查,测定MT值及斑块分布情况,比较MT值及粥样斑块发生率。结果 A、B组的MT值均较正常对照组高,差异有统计学意义(P<0.01),B组的MT值较A组明显增厚,差异有统计学意义(P<0.01);不稳定型心绞痛组的不稳定型斑块发生率高于稳定型心绞痛组(P<0.0167)。结论颈动脉超声可用于测量颈动脉内膜中层厚度及斑块性质,中层内膜厚度可以作为冠状动脉病变程度的参考依据,2型糖尿病与冠状动脉病具有一定的相关性。     

颈动脉超声评价冠状动脉粥样硬化性心脏病合并缺血性脑血管疾病患者颅内动脉狭窄性病变的预测价值分析

目的 观察分析颈动脉超声评价冠状动脉粥样硬化性心脏病(CAD)合并缺血性脑血管疾病(ICVD)患者颅内动脉狭窄性病变的预测价值.方法 从2015年4月-2016年4月期间该院收治的CAD合并ICVD患者中,随机选取180例纳入此研究领域中,均经血管造影确诊,采用颈动脉超声(即彩色多普勒超声和经颅多普勒超声联合)对颈动脉、颅内动脉进行检查,并分为动脉狭窄组、动脉非狭窄组,分析颈动脉超声检查结果.结果 颈动脉超声检查发现颅内动脉狭窄患者多发斑块、不均质斑块、颈动脉内膜中层厚度(IMT)增厚、颈动脉狭窄比例较非狭窄组患者更高,多发斑块、不均质斑块、IMT增厚、颈动脉狭窄与CAD合并颅内动脉狭窄性病变具有相关性(P<0.05).结论 针对CAD合并ICVD患者实施颈动脉超声检查,可更加准确地筛选心脑血管高危人群,为疾病诊断、治疗提供科学依据,具有重要的临床应用价值.     

高频超声对老年糖尿病患者颈动脉粥样硬化斑块的诊断价值

目的 探讨高频超声在老年糖尿病患者颈动脉粥样硬化斑块诊断中的价值。方法 选择2013年6月至2014年6月90例该院老年糖尿病患者,根据病程分为A组(病程小于5年)、B组(病程5~10年)及C组(病程大于10年),另选择同时段健康志愿者30例为D组。各组受试者均接受高频超声检查,比较各组颈动脉斑块、颈动脉内膜中层厚度(IMT)及颈动脉重构情况。结果 随着糖尿病病程延长,颈动脉斑块检出数量逐渐增加,斑块评分逐渐升高,差异均有统计学意义(P<0.05)。各组颈总动脉主干、颈动脉分叉处及颈内动脉主干IMT比较,差异有统计学意义(P<0.05)。与D组比较,A、B、C三组中发生颈动脉重构的比例均显著升高,四组无重构及负性重构发生率比较,差异均有统计学意义(P<0.05)。结论 高频超声能够清晰显示颈动脉内膜增厚,斑块特征及颈动脉重构情况,在老年糖尿病患者颈动脉评价中有很高的应用价值。     

颈动脉超声应用于缺血性脑血管病分型诊断中的价值研究

目的探讨颈动脉超声对于缺血性脑血管疾病分型诊断的价值。方法选取2015年2月至2017年12月在沈阳市第二中医医院神经内科治疗的120例缺血性脑血管疾病患者作为本文的病例组研究对象,选取同期在我院检查治疗的120例非心脑血管疾病患者作为本文的对照组研究对象,所有患者均进行颈动脉超声检查,比较两组患者的颈动脉超声检查结果。结果 120例缺血性脑血管疾病患者经颈动脉超声检查后发现,颈动脉斑块患者38例,颈动脉内中膜厚度增加患者47例,颈动脉官腔狭窄患者35例,与对照组比较时差异显著,P<0.05,具有统计学意义。结论颈动脉斑块、中膜厚度及官腔情况是反应缺血性脑血管疾病分型的重要指标,经颅颈动脉超声检查可明显显示主要指标情况,进而监测患者的病情进展并及时为患者提供高效的治疗仪促进患者病情的好转。     

血超敏C反应蛋白与颈动脉斑块的关系

动脉粥样硬化是一种损害全身大、中动脉内膜的慢性疾病,最初是内膜中层厚度(intima media thickness,IMT)增厚,内膜粗糙,继而斑块形成,管腔狭窄.C反应蛋白(CRP)是重要的炎症标记物之一,它可预测发生动脉粥样硬化及心脑血管事件的危险性.彩色多普勒超声测量的颈动脉IMT可作为全身动脉粥样硬化的一个"窗口",颈动脉IMT增厚是一种反应早期动脉粥样硬化的无创性指标,能作为心脑血管患病率和病死率的独立危险因素.本研究对老年椎基底动脉供血不足患者进行颈动脉超声及超敏CRP(hs-CRP)的检测,研究超敏CRP与颈动脉粥样硬化之间的关系.     

短暂性脑缺血发作患者行阿托伐他汀钙治疗对颈动脉粥样硬化斑块和血脂的影响

目的探讨短暂性脑缺血发作患者行阿托伐他汀钙治疗对颈动脉粥样硬化斑块和血脂的影响。方法选取2014年3月~2015年10月我院收治的250例伴有颈动脉粥样硬化斑块的短暂性脑缺血发作患者为研究对象,根据治疗方法的不同分为观察组(150例)和对照组(100例)。两组均给予阿司匹林治疗,在此基础上对照组给予辛伐他汀治疗,观察组给予阿托伐他汀钙治疗。两组患者在治疗前后均行颈动脉超声检查,以观察颈动脉粥样硬化斑块面积与内膜中层厚度,对血脂水平的变化进行检测,并比较两组脑血管事件的发生率。结果与治疗前比较,观察组治疗后颈动脉斑块面积与内膜中层厚度均明显减小,血清TG、TC、LDL水平明显降低,HDL水平上升(P<0.05),而对照组治疗后颈动脉斑块面积与内膜中层厚度改变不太明显,且血脂水平无显著改善;观察组脑血管疾病发生率为4.67%,低于对照组的19.00%(P<0.05)。结论阿托伐他汀不但具有调节血脂水平的作用,而且可减少或消除短暂性缺血发作患者的颈动脉粥样硬化斑块,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.

---

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.