门冬氨酸钾镁和胺碘酮治疗充血性心力衰竭合并室性心律失常疗效观察

目的:为观察门冬氨酸钾镁和胺碘酮治疗充血性心力衰竭合并室性心律失常的疗效及副作用发生情况。方法将我院2002年1月～2005年1月收治的充血性心力衰竭合并室性心律失常患者118例,随机分为两组:治疗组62例,常规治疗加门冬氨酸钾镁和胺碘酮;对照组56例,常规治疗加胺碘酮。共用4周。结果治疗组总有效率91.9%,QT离散度(QTd)由66.05±11.32ms减至30.28±6.25ms;对照组总有效率73.2%,QTd由65.38±11.46ms减至42.38±10.16ms。两组对比差异有显著性(P<0.05)。结论门冬氨酸钾镁和胺碘酮治疗充血性心力衰竭合并室性心律失常有较好疗效,且副作用较少发生。     

美托洛尔对充血性心力衰竭患者QT离散度的影响及临床意义

目的:探讨美托洛尔对充血性心力衰竭患者QT离散度的影响及临床意义。方法:将54例CHF患者随机分为治疗组(26例)和对照组(28例),治疗组加用美托洛尔,对照组常规治疗,并作治疗前后的QTd测量及比较。结果:QTd与心功能受损的程度呈正相关;CHF伴室性心律失常者QTd大于不伴室性心律失常者(P<0.05);给予美托洛尔治疗后CHF患者QTd明显缩短(P<0.05)。结论:CHF患者QTd明显增大。美托洛尔可使QTd缩小,对防治室性心律失常和猝死有重要意义。     

胺碘酮治疗充血性心力衰竭及QT离散度影响

目的观察胺碘酮治疗充血性心力衰竭疗效及Q-T离散度的影响。方法选择2003年2月~2005年2月收治充血性心力衰竭患者100例,在常规利尿剂、洋地黄、转换酶抑制剂,血管扩张剂、硝酸盐类制剂的基础上给予口服碘酮8周。结果治疗2周后心功能明显改善65%,室性心律失常得到有效控制55%,Q-T离散度(QTd)由(65.5±11.2)ms减至(41.1±10.5)ms(P<0.01)。治疗8周后心功能明显改善80%,室性心律失常控制率75%,QTd由(65.5±11.2)ms减至(31.2±6.5)ms(P<0.01)。结论胺碘酮可明显改善心力衰竭患者的心功能,降低QTd,抗室性心律失常,可安全用于治疗充血性心力衰竭合并室性心律失常。     

小剂量可达龙治疗老年人室性心律失常临床疗效观察

目的 探讨小剂量可达龙治疗老年人室性心律失常的临床疗效和安全性.方法 选择45例60岁以上室性心律失常患者给予小剂量可达龙治疗,观察治疗前后患者心律失常的有效控制率,LVEF、QTc、QTd及平均心率的变化,心脏外不良反应.结果 45例患者室性心律失常的有效控制率高达84.4%;QTc延长(420±80 ms比360±40 ms,P＜0.05)、平均心率减慢(76±10 bpm比85±11 bpm,P＜0.05),LVEF及QTd无明显变化(P＞0.05),亦未发现明显不良反应.结论 小剂量可达龙治疗老年人室性心律失常临床安全、有效.     

门冬氨酸钾镁与胺碘酮联合治疗急性心肌梗死室性心律失常的临床效果评价

目的研究门冬氨酸钾镁联合胺碘酮治疗急性心肌梗死室性心律失常的临床疗效。方法选取我院2014年11月至2016年11月所收治的99例急性心肌梗死室性心律失常患者作为本次研究对象,将其按照就诊时间分为两组,其中研究组45例,对照组44例,对照组患者应用单纯胺碘酮药物治疗,研究组患者在此基础上联合应用门冬氨酸钾镁治疗,对比分析两组患者的临床效果与不良反应发生情况。结果研究组患者的治疗总有效率(93.33%)显著高于对照组(72.73%),不良反应率(6.67%)明显低于对照组(25.00%),两组之间差异明显(P<0.05),具有统计学意义。结论门冬氨酸钾镁联合胺碘酮治疗急性心肌梗死室性心律失常的效果明显,能够有效提高患者的治疗总有效率,且不良反应少,值得应用。     

胺碘酮治疗充血性心力衰竭并发室性心律失常临床疗效观察

目的 观察胺碘酮治疗充血性心力衰竭并发室性心律失常的疗效.方法 选择我院2003年5月～2004年5月CHF并发室性心律失常患者76例,给予口服胺碘酮(商品名可达龙)1年.结果 治疗2周后总有效率88.2%.18例短阵室性心动过速消失.QTc由(410±38)ms增至(496±62)ms(P<0.01),治疗1年后总有效率94.7%,20例短阵室性心动过速消失,QTc由(408±42)ms增至(516±72)ms(P<0.01).结论 胺碘酮是治疗充血性心力衰竭并发室性心律失常有效的药物之一,而副反应轻,使用安全.     

门冬氨酸钾镁治疗溶栓后室性心律失常疗效研究

目的 现察急性心肌梗死(AMI)患者早期采用静脉滴注门冬氨酸钾镁治疗对溶栓后室性心律失常疗效的影响.方法 选取66例AMI患者分为治疗组和对照组,两组均给予溶栓治疗,治疗组在常规治疗的基础上加用门冬氨酸钾镁治疗,观察其对室性心律失常的影响.结果 治疗组恶性室性心律失常发生率明显少于对照组,差别有统计学意义(P＜0.05).结论 门冬氨酸钾镁能明显减少AMI恶性室性心律失常的发生,减少并发症.     

门冬氨酸钾镁联用培哚普利治疗慢性心力衰竭的临床观察

目的观察门冬氨酸钾镁联用培哚利治疗慢心力衰竭的疗效.方法对117例慢性心力衰竭患者分两组,其中,59例病人作为治疗组,在常规强心,利尿的基础上,使用培哚普利口服,加用静脉滴注门冬氨酸钾镁;58例病人作为对照组,常规使用强心,利尿药物的基础上,加用培哚普利口服.比较其两组疗效及并发症的发生率.结果治疗组的显效率力为59/3%与对照组(22.4%)相比,有明显差异(P<0.01)疗效出现时间治疗组(3.6±0.8)d,校较对照组(6.3±0.6)d短(P<0.05);低血钾,洋地黄中毒,室性及房性心律失常发生率明显低于对照组.结论门冬氨酸钾镁联用培哚普利治疗心力衰竭,具有简单易行,疗效显著,未见明显不良反应.     

急性心肌梗死患者室性心律失常与Q—T离散度的关系

目的探讨急性心肌梗死（AMI）患者QT间期离散度（QTd）与室性心律失常的关系。方法测量180例AMI患者心电图的QTd,对有室性心律失常组与无室性心律失常组进行比较,分析其与室性心律失常的关系。结果AMI伴室性心律失常组QTd为（88．64±25．46）ms,较无室性心律失常组的（58．28±11．46）ms明显延长（P〈0．01）。结论AMI患者发生室性心律失常与QTd增大有关,Q-Td可作为预测急性心肌梗死发生室性心律失常的一项敏感指标。     

门冬氨酸钾镁联合胺碘酮对急性心肌梗死室性心律失常患者心功能及NT-proBNP、CTnI血清水平干预的影响

目的 探讨门冬氨酸钾镁联合胺碘酮治疗急性心肌梗死(Acute myocardial infarction,AMI)室性心律失常患者的效果.方法 选取我院AMI室性心律失常患者94例(2018年8月～2020年7月),按患者及其家属意愿依照治疗方案分组,常规干预基础上,采用胺碘酮治疗的45例为单一组,采用门冬氨酸钾镁联合胺碘酮治疗的49例为联合组.比较两组疗效、治疗前、治疗4周后心功能[左室射血分数(LVEF)、左室收缩末期内径(LVESD)]、血清N末端B型利钠肽前体(NT-proB-NP)、心肌肌钙蛋白I(CTnI)水平、不良反应发生率.结果 联合组治疗总有效率93.88％高于单一组77.78％(P<0.05);治疗4周后,联合组LVEF高于单一组,LVESD、血清NT-proBNP、CTnI水平低于单一组(P<0.05);联合组不良反应发生率6.12％低于单一组20.00％(P<0.05).结论 门冬氨酸钾镁联合胺碘酮治疗AMI室性心律失常疗效显著,能降低血清NT-proBNP、CTnI水平,改善心功能,且安全性高.     

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.     

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.