依帕司他联合甲钴胺治疗糖尿病周围神经病变

目的观察依帕司他与甲钴胺联合治疗对糖尿病周围神经病变(DPN)的临床疗效。方法将68例DPN患者随机分为治疗组36例,采用依帕司他联合甲钴胺片治疗;对照组32例,单用甲钴胺片治疗。两组均以4周为1疗程,连续治疗2疗程。观察临床疗效及治疗前后神经传导速度(NCV)的变化。结果总有效率,治疗组为88.9%,明显高于对照组65.6%,差异有显著性(P<0.01)。NCV改善情况,治疗组明显优于对照组(P<0.05)。结论依帕司他与甲钴胺片联合应用可明显改善糖尿病周围神经病变的治疗效果,依帕司他联合甲钴胺片治疗糖尿病周围神经病变疗效优于单药治疗组。     

通脉降糖胶囊治疗糖尿病周围神经病变的效果观察

目的 观察通脉降糖胶囊治疗糖尿病周围神经病变(DPN)的临床效果.方法 收集符合DPN诊断标准的60例患者,将其随机分成对照组和治疗组,每组30例.对照组常规应用降糖药及甲钴胺片,治疗组在对照组基础上加用通脉降糖胶囊.比较两组的HbA1c、多伦多临床评分、总有效率.结果 两组治疗后的HbA1c和多伦多临床评分低于治疗前,且治疗组治疗后的HbA1c和多伦多临床评分低于对照组(P＜0.05);治疗组的总有效率为83.3％,高于对照组的53.3％(P＜0.05);两组治疗均无不良反应.结论 通脉降糖胶囊治疗DPN的效果明显,值得临床推广.     

奥扎格雷联用甲钴胺治疗糖尿病周围神经病变的疗效观察

目的 探讨奥扎格雷与甲钴胺片联合治疗对糖尿病周围神经病变(DPN)的临床疗效.方法 将86例DPN患者随机分为治疗组48例,采用奥扎格雷治疗,同时甲钴胺肌内注射;对照组38例,单纯用甲钴胺肌内注射.两组均以4周为1疗程,治疗1疗程.观察临床疗效及治疗前后神经传导速度(NCV)的变化.结果 总有效率,治疗组明显高于对照组,差异有显著性(P<0.05).NCV改善情况,治疗组明显优于对照组(P<0.01).结论 奥扎格雷与甲钴胺联合应用能够减轻DPN患者的临床症状,并改善其神经传导速度,提高临床疗效.     

甲钴胺联合α-硫辛酸对糖尿病周围神经病变患者AR活性、NO水平的影响

目的 探讨甲钴胺联合α-硫辛酸治疗糖尿病周围神经病变(DPN)的疗效及对AR活性、NO水平的影响.方法 选择2014年5月至2016年5月DPN患者68例作为研究对象,将研究对象随机分为研究组和对照组.对照组采取常规西医治疗,研究组在对照组基础上采取甲钴胺联合α-硫辛酸方法进行治疗.比较2组患者DPN治疗总有效率;治疗前后醛糖还原酶(aldosereductase,AR)活性、一氧化氮(NO)水平、多伦多CSS评分、生活质量SF-36评分及不良反应发生率.结果 研究组患者DPN治疗总有效率显著比对照组高(P<0.05);2组患者治疗前AR活性、NO水平、多伦多CSS评分、生活质量SF-36评分差异不显著(P>0.05);研究组治疗后AR活性、NO水平、多伦多CSS评分、生活质量SF-36评分显著比对照组好(P<0.05);2组患者不良反应发生率差异不显著(P>0.05).结论 甲钴胺联合α-硫辛酸治疗DPN的疗效确切,可改善AR活性、NO水平,延缓疾病进展,促进患者生活质量的提高,且无明显不良反应,值得推广.     

津力达颗粒联合甲钴胺治疗糖尿病周围神经病变的疗效

目的观察津力达颗粒联合甲钴胺治疗糖尿病周围神经病变的疗效。方法 100例患者随机分为治疗组50例和对照组50例。对照组在控制血糖的同时,给予甲钴胺500μg,tid,po,治疗组在此基础上加用津力达颗粒9g,tid,po,疗程3个月。结果治疗组总有效率高于对照组（90%vs60%,P〈0.01）。治疗组SCV增加幅度〉对照组（P〈0.05）。结论津力达颗粒联合甲钴胺治疗糖尿病周围神经病变疗效优于单用甲钴胺。     

依帕司他联用甲钴胺治疗糖尿病周围神经病变疗效观察

目的探讨依帕司他与甲钴胺片联合治疗对糖尿病周围神经病变（DPN）的临床疗效。方法将74例DPN患者随机分为治疗组38例,采用依帕司他治疗,同时口服甲钴胺片;对照组36例,单纯用甲钴胺片治疗。2组均以3周为1疗程,连续治疗2疗程。观察临床疗效及治疗前后神经传导速度（NCV）的变化。结果总有效率,治疗组为86.9%,明显高于对照组63.9%,差异有显著性（P〈0.05）。NCV改善情况,治疗组明显优于对照组（P〈0.01）。结论依帕司他与甲钴胺片联合应用能够减轻DPN患者的临床症状,并改善其神经传导速度,提高临床疗效。     

复方降糖玉液联合二甲双胍和格列美脲治疗2型糖尿病

目的：观察复方降糖玉液联合盐酸二甲双胍和格列美脲治疗2型糖尿病（气阴两虚证）的临床疗效和安全性。方法：80例2型糖尿病（气阴两虚证）患者随机分为观察组和对照组各40例,两组患者均给予盐酸二甲双胍片0.25～0.5g,po,tid和格列美脲片1～2mg,po,qd治疗,观察组在此基础上加服复方降糖玉液10ml,po,tid。治疗12周后观察两组患者空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）及中医证候积分变化,评价临床疗效。结果：治疗后两组FPG、2hPG及HbA1c较治疗前明显下降,且观察组下降明显优于对照组（P＜0.05或0.01）;观察组中医证候积分下降明显优于对照组（P＜0.01）;观察组临床显效率为47.5%,高于对照组（P＜0.05）。结论：复方降糖玉液能有效降低2型糖尿病（气阴两虚证）患者的血糖,显著改善临床症状,安全性好,值得临床推广应用。     

依帕司他片与甲钴胺注射液治疗40例糖尿病周围神经病变的疗效评价

目的评价依帕司他片联合甲钴胺注射液治疗糖尿病性周围神经病变(DPN)患者的疗效。方法 80例DPN患者,分成观察组和对照组。对照组:采用甲钴胺注射液常规治疗;观察组:采用甲钴胺注射液联合依帕司他治疗。结果观察组总有效率为90.00%高于对照组总有效率62.50%,具有显著差异(P<0.01)。两组患者在治疗期间均未发现有明显不良反应。结论依帕司他片联合甲钴胺注射液治疗DPN患者疗效佳,而且也较安全,具有重要的临床意义。     

疏血通与甲钴胺联合治疗糖尿病周围神经病变35例

目的:评价疏血通联合甲钴胺治疗糖尿病周围神经病变(DPN)的疗效。方法:65例DPN患者随机分为两组,治疗组35例,给予疏血通6mL,甲钴胺500μg,静脉滴注,每日1次,共2～3周;对照组30例,单用甲钴胺500μg,静脉滴注,每日1次,共2～3周。观察治疗前后血糖、血液流变学、肌电图及临床症状的变化。结果:治疗组临床有效率达84.7％,比对照组提高了23.9％;感觉神经传导速度(SNCV)和运动神经传导速度(MNCV)也较对照组提高(P<0.05);全血高切、低切值,红细胞聚集指数,血浆粘度均较对照组降低(P<0.05或P<0.01)。结论:疏血通联合甲钴胺可有效缓解DPN症状,提高神经传导速度,降低血液粘稠度,是治疗DPN的较好方法     

前列地尔联合甲钴胺治疗糖尿病周围神经病变37例

目的观察前列地尔联合甲钴胺治疗糖尿病周围神经病变(DPN)的临床疗效。方法将74例DPN患者随机分为两组,对照组(37例)在综合治疗措施上加用甲钴胺治疗,观察组(37例)在对照组基础上加用前列地尔治疗,疗程均为2周,比较两组临床疗效、治疗前后运动和感觉神经传导速度及不良反应。结果观察组治疗总有效率为86.49%,明显高于对照组的67.57%(P<0.05)。两组患者运动和感觉神经传导速度,治疗前比较无显著性差异(P>0.05),治疗后均明显快于治疗前(P<0.05),且观察组较对照组增快更显著(P<0.05)。两组患者治疗期间均未出现严重不良反应。结论前列地尔联合甲钴胺治疗DPN疗效显著,可明显改善运动和感觉神经传导速度,值得临床推广。     

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.     

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.