降糖丸对2型糖尿病患者胰岛素抵抗的临床观察

目的：观察降糖丸对2型糖尿病患者胰岛素敏感性的作用。方法：选择2型糖尿病患者84例，随机分为对照组和治疗组各42例，两组均常规应用二甲双胍，治疗组同时加用降糖丸。测定两组治疗前后空腹血糖、胰岛素、C肽水平。结果：治疗组和对照组血糖降低的总有效率分别为90．4％、73．8％，两组比较差异有统计学意义（P〈0．05）；治疗组治疗后空腹血糖、胰岛素及C肽水平均比治疗前明显下降（P〈0．01）；而对照组只是治疗后的空腹血糖比治疗前下降明最（P〈0．01），胰岛素、C肽水平则无明显变化。结论：降糖丸可通过改善胰岛素抵抗来提高疗效。     

二甲双胍对胰岛素抵抗患者血脂和胰岛素敏感性的影响

目的：研究二甲双胍对2型糖尿病合并高血压病患者血脂和胰岛素敏感性的影响。方法：将76例2型糖尿病合并高血压病患者分为31例治疗组与45例对照组，并与26例2型糖尿病组相比。三组应用格列齐特或格列吡嗪降糖，治疗组加用二甲双胍0．5g，3次／d，治疗组与对照组用卡托普利或依那普利降压。治疗2个月后作胰岛素及C肽兴奋试验，测胰岛素，C肽浓度。空腹血糖、血脂，并计算胰岛素敏感指数，C肽及胰岛素面积。治疗前后测体重指数。结果：对照组的胰岛素，C肽浓度及面积与2型糖尿病组相比，上升非常显著，胰岛素敏感指数降低25．17％；治疗组的C肽及胰岛素面积上升显著，胰岛素敏感指数降低11．31％，总胆固醇，载脂蛋白B降低，高密度脂蛋白胆固醇，载脂蛋白A1上升，治疗组治疗后体重指数下降显著。结论：二甲双胍能改善2型糖尿病合并高血压病患者的血脂代谢，提高胰岛素敏感性。     

中西医药结合治疗2型糖尿病的临床研究

目的观察中西医药结合对2型糖尿病（DM）血糖及胰岛β细胞功能相关指标的影响。方法60例使用口服降糖西药而血糖控制不佳的2型DM患者分为2组,对照组30例患者继续原治疗方案,试验组30例患者在原治疗方案基础上再加用金芪降糖片,每次8-10片,3次／d。12周后观察血糖、胰岛素、C肽、糖化血红蛋白（HbA1C）及血脂的变化;同时以HOMA模型计算胰岛素分泌指数（Homa-β）、Homa胰岛素抵抗指数（Homa-IR）。结果12周后,试验组空腹血糖、餐后2h血糖、HbA1C和总胆固醇、三酰甘油显著下降,对照组无明显变化,两组差异有非常显著意义（P〈0.01）;空腹胰岛素、C肽无明显变化（P〉0.05）,餐后2h胰岛素、C肽升高（P〈0.01）,且两组差异有统计学意义（P〈0.01）Homa-β升了10±0.6,Homa-IR下降0.7±0.5（P〈0.01）结论对于2型糖尿病患者辩证为气阴两虚火旺者,在应用西药降血糖时加用中成药金芪降糖片,还能改善胰岛B细胞功能。     

罗格列酮联合胰岛素治疗2型糖尿病临床观察

目的：评价马来酸罗格列酮联合胰岛素对2型糖尿病患者的降糖作用,观察其安全性和有效性。方法：对63例用胰岛素治疗而血糖控制不佳的2型糖尿病合用马来酸罗格列酮,随访观察12周。结果：与治疗前相比,治疗组的空腹血糖、餐后血糖水平明显下降（P〈0．01）。结论：应用胰岛素治疗而血糖控制不佳的2型糖尿病患者联合应用罗格列酮可有效控制血糖。     

口服降糖药联合甘精胰岛素治疗2型糖尿病临床观察

目的观察口服降糖药联合甘精胰岛素治疗2型糖尿病的临床疗效。方法对36例饮食控制及口服降糖药物治疗但血糖控制不满意的2型糖尿病患者,每天加用1次甘精胰岛素（来得时）治疗。观察治疗前后空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血清蛋白（GSP）及腔腹C肽变化。结果治疗后FBG、2hPG、GSP均较治疗前明显下降,差异均有统计学意义（P〈0.01）,但空腹C肽未见明显变化。结论口服降糖糖药联合甘精胰岛素治疗2型糖尿病有良好的效果和安全性。     

前胰高血糖素样肽-1对非糖尿病小鼠降糖作用的实验研究

摘要目的：观察胰高血糖素样肽-1（glucagon—likepeptide-1，GLP-1）的前体药物前胰高血糖素样肽-1（Pro-GLP-1）对非糖尿病小鼠的血糖和血清胰岛素水平的影响。方法：C57BL／6小鼠皮下注射不同剂量Pro-GLP-1，不同时间间隔取血测定血糖及血清胰岛素水平。结果：非糖尿病小鼠注射Pro-GLP-1后，血糖血清和胰岛素水平均无明显改变；给予糖负荷后的小鼠Pro—GLP-1呈剂量依赖性降低血糖浓度，同时升高血清胰岛素水平。等剂量Pro-GLP-1的降糖作用较GLP-1作用强。于第一次糖负荷后150min给予第二次糖负荷，Pro—GLP-1仍能发挥其降糖作用。结论：Pro—GLP-1通过葡萄糖依赖方式促进胰岛素分泌，剂量依赖性降低过高血糖，不降低正常血糖，其降糖作用可以维持3h以上。     

黄连素与格列吡嗪联合应用对2型糖尿病的降糖效果

目的探究2型糖尿病患者临床治疗中实施黄连素与格列吡嗪联合应用的疗效。方法选取2016年12月～2018年5月在我院接受治疗的70例2型糖尿病患者作为研究对象,随机分为对照组35例,观察组35例。对照组行格列吡嗪治疗观察组行格列吡嗪联合黄连素治疗,对两组患者治疗后血脂、血糖、胰岛素水平及C肽水平进行统计学分析和比较。结果与对照组相比,观察组患者治疗后血糖水平及胰岛素水平显著下降,差异有统计学意义(P <0.05);血脂水平中总胆固醇(TC)以及高密度脂蛋白胆固醇(HDL-C)水平与对照组比较,差异无统计学意义(P> 0.05),而甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平相较于对照组则明显下降,差异有统计学意义(P <0.05);治疗后观察组患者C肽水平相较于对照组显著上升,差异有统计学意义(P <0.05)。结论黄连素联合格列吡嗪治疗2型糖尿病效果理想,可有效改善患者血糖、胰岛素等水平,调整患者血脂水平,进而达到降糖目的,因此该种治疗方案可在临床中推广。     

瑞格列奈治疗2型糖尿病的疗效及安全性分析

目的：对瑞格列奈治疗2型糖尿病的疗效及安全性进行评估。方法：对2型糖尿病48例进行10天清洗后给予瑞格列奈治疗。结果：用瑞格列奈治疗4周、8周、后空腹血糖分别下降了1．64mmol/L,1.89mmol/L，餐后2h血糖下降3.05mmol/L,3.78mmol/L，空腹胰岛素，C肽及餐后2h胰岛素、C肽均有上升，但随血糖的降低而上升的程度减少，治疗前后血 无显著性变化。无低血糖等不良反应发生。结果：瑞格列奈是一种安全、有效的治疗2型糖尿病的降糖药物。     

卡托普利的降糖作用及机理

用双盲方法观察34例非胰岛素依赖型糖尿病（NIDDM）患者口服卡托普利（CPT）或安慰剂治疗对糖代谢、胰岛素水平、甲状腺、肾上腺皮质功能的影响。表明：（1）用CPT治疗2wk后NIDDM患者的空服和餐后血糖均降低，CPT与降糖药合用血糖下降更明显，说明CPT对NIDDM患者有降糖作用，并与降糖药有协同作用，（2）CPT治疗前后血清胰岛素无显著差异，说明CPT的降糖作用不是通过刺激胰岛素分泌来实现的；（3）CPT治疗后血FT3、FT4、皮质醇等胰岛素拮抗激素的浓度降低是其降糖作用原理之一。     

黄连素治疗68例2型糖尿病的临床评价

目的 :评价黄连素对 2型糖尿病患者临床疗效及毒副作用。方法 :对 6 8例 2型糖尿病患者及 2 0例血糖正常者口服黄连素片 ,同时监测服药前后的空腹血糖、餐后血糖、血浆胰岛素、血尿常规、肝肾功能等。结果 :患者血糖明显下降 ,总有效率为 86 .8% ,无明显毒副作用。结论 :黄连素治疗 2型糖尿病患者疗效良好 ,且无明显毒副作用     

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.

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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.