B超预测肝硬化食管静脉曲张破裂出血

目的:探讨肝炎后肝硬化患者用B超预测食管静脉曲张破裂出血的方法。方法:采用B型超声诊断仪探测肝门静脉和脾静脉直径,将186例肝硬化患者分成两组比较。结果:肝硬化出血组肝门静脉直径和脾静脉直径分别为(1.68±0.23)Cm和(1.24±0.18)Cm,均大于肝硬化非出血组的(1.32±0.21)Cm和(1.02±0.22)Cm,两组比较差异均有显著性(P<0.05);肝门静脉直径和脾静脉直径与肝硬化食管静脉曲张破裂出血率均呈显著性正相关关系(P<0.001)。结论:B型超声显像测定肝门静脉直径≥1.6Cm、脾静脉直径≥1.1Cm,可作为预测出血危险的参考指标。肝门静脉和脾静脉可作为预测食管静脉曲张破裂出血危险性的安全有效的方法。     

强肝胶囊治疗慢性肝炎患者血清肝纤维化指标的变化

肝纤维化是慢性肝炎发展为肝炎肝硬化的必经阶段 ,能否早期诊断肝纤维化是控制肝炎、肝硬化形成的关键[1] 。 1998年至 2 0 0 0年 ,我们采用强肝胶囊治疗血清肝纤维化指标高的慢性肝炎患者 ,取得了良好的效果 ,报告如下。1　临床资料1 1　一般情况　全部病例均为我院住院及门诊患者 ,诊断符合1995年北京第五次全国传染病与寄生虫病学术会议修订的标准。将 80名患者随机分 2组。治疗组 40例 ,男 3 2例 ,女 8例 ;平均年龄 ( 4 0 .6± 10 .3 )岁 ;慢性中度肝炎 2 2例 ,重度肝炎 4例 ,肝硬化 14例。对照组 40例 ,男 3 1例 ,女 9例 ;平均年龄 ( 4…     

129例病毒性肝炎患者血清高密度脂蛋白检测及其临床意义

采用酶法测定129例各型肝炎和肝硬化患者高密度脂蛋白(HDL)含量,并与102例健康人作对照,各肝炎组HDL含量(0.89±0.12)mmoL/L低于对照组(1.33±0.15mmoL/L)(P<0.01),其降低幅度与病情严重程度有关。急性黄疸型肝炎(AIH)(0.85±0.15)mmoL/L和重症肝炎(FH)(0.19±0.13)mmoL/L显著低于其它各组。提示血清HDL含量可作为反映肝细胞功能损害程度的一项简便灵敏指标。     

酒精性肝硬化46例临床特点分析

目的:了解酒精性肝硬化在山西地区的临床特征。方法:将1999年1月-2005年10月在我院治疗,资料较完整的山西籍酒精性肝硬化患者46例与同期住院的48例病毒性肝硬化(随机抽取)患者的特点进行分析。结果:酒精性肝硬化组的乏力、纳差、肝区疼痛、腹腔积液的出现率明显高于肝炎后肝硬化组的乏力、纳差(P<0.05),肝区疼痛、腹腔积液(P<0.01);而酒精性肝硬化组的肝大明显高于肝炎后肝硬化(P<0.01),而脾脏轻度以上增大者低于肝炎后肝硬化(P<0.01);酒精性肝硬化组的r-GT、ALP明显高于肝炎后肝硬化(P<0.05),而腹胀、肝掌、蜘蛛痣、A ST、ALT、B IL、A/G两组比较差异无显著性(P>0.05);结论:山西地区酒精性肝硬化具有其临床特点,只要认真询问病史,掌握其临床特点不难作出鉴别诊断。     

肝促凝血活酶试验在判断肝炎病情及预后方面的意义

目的　研究肝促凝血活酶试验 (HPT)对判断肝炎病情及预后方面的意义。方法　应用含有组织凝血活酶、去除Ⅱ、Ⅶ、Ⅹ凝血因子的牛血浆和氯化钙的特制试剂 ,检测了 130例不同类型病毒性肝炎和 9例其它患者血浆肝促凝血活酶活动度 (HPA)。结果　HPA值按下列次序递减 ,轻度慢性肝炎为 ( 85 7± 86 9) % ,急性无黄疸型肝炎为 ( 80 4± 16 7) % ,急性黄疸型肝炎为 ( 72 5±2 5 0 ) % ,中度慢性肝炎为 ( 5 9 8± 8 7) % ,肝炎肝硬化失代偿期为 ( 4 3 8± 12 3) % ,重度慢性肝炎为( 34 3± 2 9) % ,亚急性重型肝炎为 ( 30 5± 8 1) % ,当肝功能好转时HPA值随之回升。胆结石、胰头癌等肝外疾病未伤及肝脏时 ,HPA值多在正常范围 ;若伴有肝功能损害 ,则HPA值亦有下降。结论　肝促凝血活酶试验是一项有用的肝脏储备功能试验 ,HPA的变化能反映肝炎轻重和病情预后 ,并可作为判断药物疗效的一项指标     

肝病患者血清透明质酸检测及临床意义(附355例报告)

应用放射分析法测定355例肝病患者血清透明质酸(SHA)水平。结果:肝炎后肝硬化组(902±662μg/L)、血吸虫肝硬化组(469±512μg/L)、慢活肝组(477±309μg/L)、肝癌组(392±260μg/L)升高最为显著,其次为慢性血吸虫病组(202±184μg/L)、急性病毒性肝炎组(181±117μg/L)和慢迁肝组(91±64μg/L)。正常对照组SHA 值为63±40μg/L。表明SHA 是一项反映肝纤维化及其程度较好的临床生化指标,对病情判断、预后估价和药物疗效观察具一定的实用价值。     

肝炎后肝硬化与酒精性肝硬化患者临床特征的比较及防治

目的研究肝硬化患者肝炎后和酒精性的临床特点和防治方法。方法 40例肝炎后肝硬化患者作为肝炎后肝硬化组,另选取同期治疗的40例酒精性肝硬化患者作为酒精性肝硬化组,对比分析两组患者的临床特点和不同的防治方法。结果特征分析结果 ,肝硬化男性居多,肝炎后肝硬化组19例,酒精性肝硬化组31例,两组比较差异有统计学意义(P<0.05);肝掌、肝大以及蜘蛛痣的发生率、γ-谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、门冬氨酸氨基转移酶/丙氨酸氨基转移酶(AST/ALT)等指标两组比较,差异具有统计学意义(P<0.05)。结论结合各自的临床特征,予以目的明确的防治措施,能够获得较为理想的防治效果。     

尼索地平对心衰患者左室收缩性能的作用

作者研究了尼索地平(Nisoldipine)对心衰患者血流动力学及左室收缩性能的急性作用。 10例缺血性心脏病伴心力衰竭的患者,常规药治疗2～3周,并停用钙通道阻滞剂。然后静滴尼索地平,每分钟0.12/μg/kg。静滴尼索地平过程中,平均动脉压由89±14降为73±7mmHg(P=0.001),体循环血管阻力由1285±177降为1064±253dyn·s·cm~(-5)(P<0.02),心脏指数由每分钟2.8±0.2增至3.0±0.4 L/m~2(无统计学意义),每搏指数由32±5增至35±7ml/m~2     

血清Cys C尿mAlb和尿β2-MG联合检测在肝硬化及原发性肝癌早期肾功能损伤中的应用价值

目的测定慢性肝病、肝硬化和原发性肝癌(PLC)患者血清半胱氨酸蛋白酶抑制剂C(Cys C)、尿微量白蛋白(mAlb)及尿β2微球蛋白(尿β2-MG)含量,探讨三项联合检测的临床应用价值。方法分别检测67例慢性肝病、63例肝硬化、33例PLC患者和78例正常对照者血清Cys C、肌酐(SCr)、尿素(Urea)、尿mAlb及尿β2-MG含量,并分析差异。比较肝硬化、PLC患者Child-Pugh不同等级间血清Cys C、SCr、Urea、尿mAlb、尿β2-MG水平。同时比较血清Cys C、尿mAlb、尿β2-MG单独及联合检测在慢性肝病、肝硬化、PLC患者的检出率。结果肝硬化、PLC组患者血清Cys C、尿mAlb及β2-MG水平分别为(1.40±0.47,27.57±21.45,0.29±0.09)mg/L和(1.21±0.21,19.60±7.28,0.22±0.09)mg/L,均高于慢性肝病组(1.01±0.13,11.30±3.46,0.14±0.05)mg/L(P<0.05)和正常对照(0.81±0.11,11.21±2.47,0.14±0.03)mg/L(P<0.05),肝硬化组血清Cys C、尿mAlb水平明显高于PLC组(P<0.05)。肝硬化和PLC组Child-Pugh B级、C级患者血清Cys C、尿mAlb水平均明显高于Child-Pugh A级(P<0.05)。肝硬化、PLC组患者血清Cys C、尿mAlb、尿β2-MG单独及联合检测的异常检出率分别为57.1%、38.1%、31.7%、68.3%和51.5%、33.3%、30.3%、78.8%,均高于慢性肝病组(11.9%、3.0%、3.0%、16.4%)(P<0.05),且联合检测的异常检出率明显高于同组患者单独检测异常检出率(P<0.05)。结论血清Cys C、尿mAlb及尿β2-MG水平随着慢性肝病的进展和肝功能的下降而升高,且比SCr、Urea更能灵敏的反映肝硬化、PLC患者继发早期肾功能损伤。同时三项目联合检测对肝硬化、PLC患者早期肾损伤的诊断价值优于单独检测。     

核磁共振显像三维测量预测老年轻度认知功能损害发展为痴呆的价值

目的：探索认知障碍发展为痴呆的结构性脑影像的预测指标。方法：前瞻性随访对照研究。研究对象为患轻度认知功能损害的老年人(MCI组)21例,男性5例,女性16例；和认知功能正常的老年人(对照组,NC组)29例,男性12例,女性17例2组。随访对象转为痴呆的标准是根据DSM-Ⅳ的相关标准。认知评价工具为世界卫生组织老年认知功能评价成套神经心理测验(WHO-BCAI)和韦氏记忆测验。基线进行核磁共振显像三维测量(3D-MRI)并以分析基线检测结果对MCI是否发展为痴呆的预测作用。结果：MCI组的颅内总体积为(1316±s111)cm~3,NC组为(1388±90)cm~3,2组间差异有显著意义(P＜0．05)。MCI组的脑灰质体积为(615±66)cm~3,NC组为(674±46)cm~3,2组间差异有非常显著意义(P＜0．01)。MCI组的灰质百分比为46．7%,而NC组为48．6%,差异有非常显著意义(P＜0．01)。MCI组的颅内总体积和脑灰质体积较NC组显著性缩小(P＜0．05)。3a随访时,MCI组有5例发展为痴呆,NC组没有发展为痴呆的病例。以基线脑核磁共振三维测量指标为自变量Logistic回归分析,结果没有指标入选回归方程。结论：3D-MRI的脑灰质减少和侧脑室体积增大有助于诊断MCI,但预测MCI病人是否发展为痴呆的价值有待进一步研究。     

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.     

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.