麝香通心滴丸对冠状动脉慢血流改善作用的研究

目的:探讨麝香通心滴丸对冠状动脉慢血流的改善作用.方法:选取我院诊治的冠状动脉慢血流患者72例作为研究对象,按随机平均分组的方式将患者分为两组,每组36例.对照组给予常规治疗,观察组在常规治疗的基础上给予麝香通心滴丸.比较治疗前后两组患者的冠状动脉微循环阻力指数(IMR)及心绞痛程度.结果:治疗前两组患者的IMP差异不明显(P>0.05);治疗后观察组的IMP低于对照组(P<0.05).治疗后,两组患者的SAQ评分升高,CCS分级降低,(P<0.05);观察组患者的SAQ评分高于对照组,CCS分级低于对照组,(P<0.05).结论:麝香通心滴丸可明显降低患者的I MP及心绞痛的发作程度,冠状动脉慢血流改善显著.     

益心舒片联合伊伐布雷定治疗慢性稳定型心绞痛的临床研究

目的观察益心舒片联合盐酸伊伐布雷定片治疗慢性稳定型心绞痛的临床疗效。方法选取2015年12月—2017年12月中国人民武装警察8650部队医院收治的100例慢性稳定型心绞痛患者作为研究对象,所有患者根据随机对照原则分为对照组(50例)和治疗组(50例)。对照组患者口服盐酸伊伐布雷定片,1片/次,2次/d;治疗组患者在对照组基础上口服益心舒片,3片/次,3次/d。两组患者均连续治疗12周。观察两组患者的临床疗效,比较两组治疗前后的心绞痛频率、持续时间、西雅图心绞痛量表(SAQ)评分、血清生化指标。结果治疗后,治疗组总有效率为94.00%,显著高于对照组的78.00%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者心绞痛发作次数和持续时间均较明显降低,而SAQ评分显著升高,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组心绞痛发作次数、持续时间和SAQ评分显著优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者内皮素-1(ET-1)、可溶性CD40配体(sCD40L)水平均明显降低,而降钙素基因相关肽(CGRP)水平显著升高,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组各指标显著优于对照组,两组比较差异具有统计学意义(P0.05)。结论益心舒片联合盐酸伊伐布雷定片治疗慢性稳定型心绞痛具有较好的临床疗效,能够明显改善患者临床症状和血清生化指标,具有一定的临床推广应用价值。     

杏灵分散片联合伊伐布雷定治疗稳定型心绞痛的临床研究

目的探讨杏灵分散片联合伊伐布雷定治疗稳定型心绞痛的临床研究。方法选取2018年9月—2019年10月在濮阳市安阳地区医院治疗的150例稳定性心绞痛患者,随机分成对照组(75例)和治疗组(75例)。对照组患者口服盐酸伊伐布雷定片,5mg/次,2次/d;治疗组患者在对照组基础上口服杏灵分散片,1片/次,3次/d,两组患者连续治疗2周。观察两组患者临床疗效,比较治疗前后两组患者西雅图心绞痛(SAQ)量表评分,血清生化指标内皮素-1(ET-1)、降钙素基因相关肽(CGRP)和可溶性CD40配体(sCD40L),血清炎性因子白细胞介素6(IL-6)、C反应蛋白(CRP)和肿瘤坏死因子α(TNF-α)及不良反应情况。结果治疗后,治疗组临床总有效率97.33%,显著高于对照组的86.67%(P0.05)。治疗后,两组患者心绞痛稳定状态、躯体活动受限度、治疗满意程度、心绞痛发作情况、疾病认识程度评分均高于治疗前水平(P0.05);治疗组SAQ量表评分高于对照组(P0.05)。治疗后,两组患者血清ET-1、sCD40L水平均显著降低,但血清CGRP水平升高(P0.05);治疗后,治疗组血清生化指标优于对照组(P0.05)。治疗后,两组患者血清IL-6、CRP、TNF-α水平均显著降低(P0.05);治疗后,治疗组血清炎性因子水平低于对照组(P0.05)。治疗组不良反应总发生率为6.67%,明显低于对照组的13.33%(P0.05)。结论杏灵分散片联合伊伐布雷定治疗稳定型心绞痛临床疗效显著,可以有效改善患者心绞痛症状,有效较低血脂及炎性因子水平,不良反应发生率低,患者的生活质量得到显著提高。     

麝香保心丸联合藻酸双酯钠治疗不稳定型心绞痛的疗效观察

目的探讨麝香保心丸联合藻酸双酯钠治疗不稳定型心绞痛患者的临床疗效。方法选取2014年2月—2016年2月天津医科大学总医院收治的不稳定型心绞痛患者126例,随机分为对照组和治疗组,每组各63例。对照组静脉滴注藻酸双酯钠注射液,0.1 g加入到生理盐水500 m L,1次/d。治疗组患者在对照组治疗基础上口服麝香保心丸,2丸/次,3次/d。两组均连续治疗15 d。观察两组患者的临床疗效和心电图疗效,同时比较两组患者治疗前后SAQ评分、心绞痛发作次数和心绞痛持续时间的变化情况。结果治疗后,对照组和治疗组的总有效率分别为80.77%、98.08%;两组心电图总有效率分别为80.95%、96.83%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者SAQ评分均显著升高,心绞痛发作次数和心绞痛持续时间均显著降低,同组治疗前后比较差异有统计学意义(P0.05);治疗后,治疗组SAQ评分高于对照组,心绞痛发作次数和心绞痛持续时间低于对照组,两组比较差异具有统计学意义(P0.05)。结论麝香保心丸联合藻酸双酯钠治疗不稳定型心绞痛具有较好的临床疗效,可显著降低心绞痛发作次数和持续时间,具有一定的临床推广应用价值。     

伊伐布雷定联合美托洛尔治疗稳定型心绞痛的临床研究

目的探讨盐酸伊伐布雷定片联合酒石酸美托洛尔片治疗稳定型心绞痛的临床疗效。方法选取2019年9月—2020年4月天津市第二医院收治的84例稳定型心绞痛患者为研究对象。所有患者均口服酒石酸美托洛尔片,25 mg/次,2次/d。治疗4周后静息心率70次/min的患者为对照组(34例),对照组继续口服酒石酸美托洛尔片,25 mg/次,2次/d。静息心率≥70次/min的患者继续口服上述剂量酒石酸美托洛尔片的基础上口服盐酸伊伐布雷定片,5mg/次,2次/d,根据患者心率变化调整用药量,最大耐受度7.5 mg/次,2次/d。治疗12周后心率70次/min的患者为治疗组(38例)。两组患者均连续治疗12周。观察两组的临床疗效,比较两组静息和最大运动量时心率、心绞痛发作情况和生活质量评分。结果治疗后,治疗组总有效率为92.11%,高于对照组的79.41%,两组总有效率比较差异有统计学意义(P0.05)。治疗后,两组静息心率、最大运动量时心率均较治疗前明显降低,差异有统计学意义(P0.05);治疗后,治疗组最大运动量时心率较对照组降低更显著,差异有统计学意义(P0.05)。治疗后,两组患者发作频率、持续时间、硝酸甘油消耗量均较治疗前显著下降,差异有统计学意义(P0.05),且治疗组发作频率、持续时间、硝酸甘油消耗量较对照组下降更显著,差异具有统计学意义(P0.05)。治疗后,两组西雅图心绞痛量表(SAQ)中各维度评分较治疗前均显著升高,差异有统计学意义(P0.05),且治疗组SAQ中除对疾病的认识外,其他各维度评分均显著高于对照组,差异有统计学意义(P0.05)。结论盐酸伊伐布雷定片联合酒石酸美托洛尔片治疗稳定型心绞痛疗效良好,可能明显降低患者的心率,改善患者的心绞痛发作情况,保护心脏功能,提高患者的生活质量。     

麝香通心滴丸联合美托洛尔治疗冠心病心绞痛的疗效观察

目的探讨麝香通心滴丸联合美托洛尔治疗冠心病心绞痛的临床疗效和安全性。方法选取2015年12月—2017年1月上海市浦东医院收治的冠心病心绞痛患者90例,随机分为对照组和治疗组,每组各45例。对照组患者口服酒石酸美托洛尔缓释片,5 mg/次,2次/d,依据患者耐受程度和病情逐渐加量到10~25 mg/次,2次/d。治疗组在对照组的基础上口服麝香通心滴丸,2丸/次,3次/d。两组患者治疗时间均为2个月。观察两组患者临床疗效,比较治疗前后两组患者心电图疗效、心绞痛持续时间和发作次数、ST段及不良反应情况。结果治疗后,对照组临床有效率和心电图疗效分别为77.7%和75.6%,均分别低于治疗组的93.3%和95.6%。两组比较差异具有统计学意义(P0.05)。治疗后,两组患者心绞痛持续时间和发作次数及ST段均显著降低,同组比较差异具有统计学意义(P0.05);且治疗组上述指标改善后水平显著低于对照组,两组比较差异具有统计学意义(P0.05)。治疗中,治疗组不良反应发生率为4.4%,明显低于对照组的13.3%,两组比较差异具有统计学意义(P0.05)。结论麝香通心滴丸联合美托洛尔治疗冠心病心绞痛临床疗效显著,有助于减少心绞痛发作次数和持续时间,安全性高,具有一定的临床推广应用价值。     

活心丸联合伊伐布雷定治疗稳定型心绞痛的临床研究

目的 探讨活心丸联合盐酸伊伐布雷定片治疗稳定型心绞痛的临床疗效。方法 选取2021年4月—2023年5月来宾市兴宾区人民医院收治的102例稳定型心绞痛患者,按照随机数字表将患者分为对照组（51例）和治疗组（51例）。对照组口服盐酸伊伐布雷定片,1片/次,2次/d。治疗组在对照组基础上口服活心丸,2丸/次,2次/d。治疗8周分析治疗效果。比较两组的总有效率、心绞痛症状、冠状动脉血管狭窄程度和血清指标。结果 治疗后,治疗组的总有效率为94.12%,对照组的总有效率为80.39%,组间差异明显（P<0.05）。治疗后,两组的心绞痛发作频率、疼痛持续时间、视觉模拟评分法（VAS）评分、Gensini评分均显著降低（P<0.05）;治疗组的心绞痛发作频率、疼痛持续时间、VAS评分、Gensini评分低于对照组（P<0.05）。治疗后,两组的血清氧化性低密度脂蛋白受体-1(LOX-1)、高迁移率族蛋白1(HMGB1)水平低于治疗前,血清可溶性晚期糖基化终末产物受体（SRAGE）水平高于治疗前（P<0.05）;治疗组的血清LOX-1、HMGB1水平低于对照组,血清SRAGE水...     

利心丸联合伊伐布雷定治疗老年稳定性心力衰竭的临床研究

目的探讨利心丸联合盐酸伊伐布雷定片治疗老年稳定性心力衰竭的临床疗效。方法选取2016年5月—2018年5月在黑龙江省森工总医院治疗的老年稳定性心力衰竭患者152例,根据用药的差别分为对照组(76例)和治疗组(76例)。对照组口服盐酸伊伐布雷定片,5 mg/次,2次/d,经两周治疗后,若静息心率持续大于60次/min,可增至7.5 mg/次,2次/d;若静息心率持续低于50次/min,可下调至2.5mg/次,2次/d;若心率为50～60次/min,则维持5mg/次,2次/d。治疗组在对照组基础上口服利心丸,9g/次,3次/d。两组患者均经2周治疗。观察两组患者临床疗效,同时比较治疗前后两组患者左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室收缩末期容积(LVESV)、左室舒张末期内经(LVEDD)、6分钟步行距离(6WMT)、西雅图心绞痛量表(SAQ)积分、GQOLI-74及血清N末端B型钠尿肽原(NT-proBNP)、胱抑素C(Cys-C)、心肌肌钙蛋白T(cTnT)、可溶性晚期糖基化终末产物受体(sRAGE)、内皮素-1(ET-1)、可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞黏附分子-1(s VCAM-1)水平和miR-423-5p。结果治疗后,对照组和治疗组临床有效率分别为81.58%和97.37%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者LVEE均明显升高(P0.05),LVESV、LVEDD和LVESD均明显下降(P0.05),且治疗组患者心功能指标水平明显好于对照组(P0.05)。治疗后,两组患者6WMT、SAQ积分和GQOLI-74评分均显著升高(P0.05),且治疗组患者这些评分明显高于对照组(P0.05)。治疗后,两组患者血清NT-proBNP、Cys-C、cTnT、miR-423-5p、sRAGE、ET-1、sVCAM-1、sICAM-1水平均明显下降(P0.05),而NO水平明显升高(P0.05),且治疗组患者这些血清学指标明显好于对照组(P0.05)。结论利心丸联合盐酸伊伐布雷定片治疗老年稳定性心力衰竭可有效改善患者心功能,促进血管内皮功能改善,提高患者运动耐量。     

不同剂量瑞舒伐他汀对不稳定型心绞痛患者炎症因子、内皮功能及内脂素的影响

目的:探讨不同剂量瑞舒伐他汀对不稳定型心绞痛患者炎症因子、内皮功能及内脂素的影响。方法:选取2015年7月至2017年7月年我院收治的96例不稳定型心绞痛患者,将其随机分成两组各48例。对照组给予患者瑞舒伐他汀10mg/d,观察组给予患者瑞舒伐他汀20mg/d,治疗12个月后比较两组患者血清细胞炎症因子、内脂素及内皮功能的变化情况。结果:经过治疗后,观察组患者炎症因子和内脂素水平改善效果均明显优于对照组(P0.05);观察组内皮功能明显优于对照组(P0.05)。结论:采给予不稳定型心绞痛患者大剂量瑞舒伐他汀可有效降低患者炎症因子水平,促进血管内皮功能恢复,效果显著,值得推广。     

麝香通心滴丸联合氯吡格雷治疗冠心病心绞痛的临床研究

目的研究麝香通心滴丸联合硫酸氢氯吡格雷片治疗冠心病心绞痛的临床疗效。方法选取2015年9月—2018年9月上海市第一人民医院宝山分院收治的124例冠心病心绞痛患者作为研究对象,将患者随机分为对照组和治疗组,每组各62例。对照组患者口服硫酸氢氯吡格雷片,75 mg/次,1次/d;治疗组在对照组治疗的基础上口服麝香通心滴丸,2丸/次,3次/d。两组患者均治疗4周。观察两组患者的临床疗效和心电图疗效,比较两组治疗前后的临床症状缓解情况和血液流变学指标。结果治疗后,对照组和治疗组的总有效率分别为83.87%、95.16%,两组比较差异具有统计学意义(P0.05)。治疗后,对照组和治疗组的心电图总有效率分别为82.26%、93.55%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者心绞痛发作次数和持续时间显著降低,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组心绞痛发作次数和持续时间显著低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组的全血黏度(WBV)、血浆黏度(PV)、纤维蛋白原(FIB)水平均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组血液流变学指标显著低于对照组,两组比较差异具有统计学意义(P0.05)。结论麝香通心滴丸联合硫酸氢氯吡格雷片治疗冠心病心绞痛具有较好的临床疗效,能显著缓解临床症状,改善血液流变学,且安全性较高,具有一定的临床推广应用价值。     

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.