左奥硝唑片Ⅰ期临床耐受性试验

目的:评价健康人体对左奥硝唑片的耐受性。方法:采用随机、盲法、安慰剂对照的单中心临床研究。48名健康受试者经筛选进入临床试验,其中38名健康受试者随机分为4组参加了单次给药耐受性试验,各组剂量分别为250、500、1000、1500 mg。10名健康受试者参与了为期7 d的连续给药耐受性试验,剂量为1000 mg。各组均设2例安慰剂。观察受试者用药前后生命体征、心电图及实验室检查的变化,并观察和记录不良事件。结果:在单次和多次给药耐受性试验中,受试者用药前后生命体征、心电图及实验室检查均没有临床意义的改变。20名受试者发生轻度不良事件,表现为头晕、乏力、困倦、恶心等。结论:健康受试者服用左奥硝唑片日剂量250~1000 mg,可安全耐受。     

帕拉米韦三水合物氯化钠注射液在健康人体的耐受性研究

 目的：研究单次和多次静脉滴注帕拉米韦三水合物氯化钠注射液在健康人体内的耐受性和安全性。方法：单次给药试验共入选26名健康志愿者,分为5个剂量组,由初始剂量150 mg开始,在耐受性较好的情况下,逐渐增加至300,450,600,750 mg。连续给药试验在单次给药试验结束后进行,共入选20例健康志愿者,分为150和300 mg两个剂量组,连续5 d,qd。试验中多次进行生命体征、心电图、体格检查及实验室检查,并严密观察不良事件。结果：与研究药物有关的不良事件主要为部分实验室检查值异常和心电图异常,不良事件的程度均为轻度,均未经处理而恢复正常。试验中未发生严重不良事件。结论：中国健康受试者单次静脉滴注150~750 mg和连续5 d, 每天单次静脉滴注150~300 mg的帕拉米韦三水合物氯化钠注射液是安全的,能耐受的。     

单次口服高剂量盐酸安妥沙星片在健康人体的耐受性研究

目的：评价健康受试者单次口服高剂量盐酸安妥沙星的耐受性和安全性。方法30例受试者分为600mg组、800mg组、1000mg组,每组8名,分别予以单次口服盐酸安妥沙星600,800,1000 mg,以及安慰剂组6名。用药后,定时进行实验室检查、心电图和脑电图检查。结果30名受试者全部完成了研究。600mg组未见不良事件。800 mg组有3例受试者出现5件不良事件,主要为恶心、呕吐,考虑与研究药物有关。1000 mg组6例受试者出现10件不良事件,主要为恶心、呕吐、头晕、双足点状红斑,考虑与研究药物有关或很可能有关。安慰剂组未见不良事件。结论盐酸安妥沙星片600 mg为本次试验用药的最大安全耐受剂量。     

奥兰替胃康片I期临床耐受性试验

 　目的：观察奥兰替胃康片（枳实总黄酮苷提取物）在健康志愿者中的安全性和耐受性。方法：单次给药组38名健康志愿者分为7个剂量组,分别给予奥兰替胃康片100,300,600,1 000,1 600,2 400和3 000 mg (1片,n=4;3片,n=4;6片,n=6;10片,n=6;16片,n=6;24片,n=6;30片,n=6)。多次给药组12名健康志愿者分为2个剂量组,分别给予奥兰替胃康片200 mg（2片,n=6）或400 mg（4片,n=6）,tid,连续给药7 d。观察受试者的临床症状和体征、生命体征、实验室检查、心电图检查、腹部彩色B超及不良事件。结果：共32名健康志愿者完成了耐受性试验。单次、多次试验均未发生严重不良事件。单次给药试验和多次给药试验中,受试者均未出现有临床意义的体格检查、实验室检查、心电图检查异常。单次给药1 000 mg组发生了5例不良事件,很可能与试验药物有关;1 600,2 400,3 000 mg组停止进行试验。多次给药试验中无不良事件发生。结论：奥兰替胃康片在100~600 mg范围内用药的安全性和耐受性良好。单次给药的最大耐受剂量为600 mg。多次给药每次200~400 mg,tid,连续7 d安全且耐受性好。推荐的II期临床试验的给药方案为每次400 mg,tid。     

正痹关节片Ⅰ期临床人体耐受性试验

摘 要 目的： 观察正痹关节片在健康人体的耐受性和安全性,为制定本品的Ⅱ期临床试验给药方案提供安全的剂量范围。方法: 进行了400～3 200 mg五个剂量组每日1次的单次给药耐受性试验和1 600 mg、2 400 mg两个剂量组每日1次连续给药7 d的多次给药耐受性试验,共观察了36名健康受试者的一般情况、实验室检查及不良事件情况。结果:正痹关节片口服单次和多次给药试验,所有受试者生命体征均正常,实验室部分指标用药后转为异常,但临床判断无临床意义;试验期间无严重不良事件发生,无合并用药,有2人发生轻度不良事件,均未作处理自行恢复。结论: 单次及多次给药期间,所有受试者耐受性、安全性评价均为耐受、安全。     

奥兰替胃康片Ⅰ期临床耐受性试验

目的:观察奥兰替胃康片(枳实总黄酮苷提取物)在健康志愿者中的安全性和耐受性。方法:单次给药组38名健康志愿者分为7个剂量组,分别给予奥兰替胃康片100,300,600,1 000,1 600,2 400和3 000 mg(1片,n=4;3片,n=4;6片,n=6;10片,n=6;16片,n=6;24片,n=6;30片,n=6)。多次给药组12名健康志愿者分为2个剂量组,分别给予奥兰替胃康片200 mg(2片,n=6)或400 mg(4片,n=6),tid,连续给药7 d。观察受试者的临床症状和体征、生命体征、实验室检查、心电图检查、腹部彩色B超及不良事件。结果:共32名健康志愿者完成了耐受性试验。单次、多次试验均未发生严重不良事件。单次给药试验和多次给药试验中,受试者均未出现有临床意义的体格检查、实验室检查、心电图检查异常。单次给药1 000mg组发生了5例不良事件,很可能与试验药物有关;1 600,2 400,3 000 mg组停止进行试验。多次给药试验中无不良事件发生。结论:奥兰替胃康片在100~600 mg范围内用药的安全性和耐受性良好。单次给药的最大耐受剂量为600 mg。多次给药每次200~400 ...     

中国健康成年志愿者单次口服盐酸埃他卡林片耐受性研究

目的：在中国健康成年志愿者体内评估单次口服盐酸埃他卡林片的安全性、耐受性。方法：采用区组随机化设计,选择18～50岁健康志愿者52名,随机分配至2．5、5、10、15、20、25mg剂量组,其中2．5、25mg组各有6名受试者,其余各组均有10名受试者,男女各半,每组中均有2人（男、女各1人）接受安慰剂。严密观察给药前后的临床症状、体征、实验室指标变化,并观察试验期间发生的不良事件。结果：入选受试者给药后症状、体征以及实验室检查指标均未见有异常的改变。试验中未见严重不良事件,未见可能与药物有关的临床不良反应。结论：52名中国健康受试者单次空腹口服盐酸埃他卡林片最大剂量达25mg,比较安全,耐受性较好。     

创新药吡非尼酮胶囊在中国健康人体耐受性和安全性研究

目的：评价中国健康受试者单次和多次口服1.1类创新药吡非尼酮胶囊后的人体耐受性和安全性。方法：依据动物实验结果推算起始和最大剂量，以健康受试者为研究对象，从安全起始剂量开始，进行单次和多次给药耐受性试验。采用随机单中心临床研究，统一餐后给药。单次给药耐受性试验：36例，随机分成6个剂量组：200 mg（2例），400 mg（4例），800 mg（6例），1 200 mg（8例），1 800 mg（8例），2 400 mg（8例）；多次给药耐受性试验：12例，分成2个剂量组：400 mg（6例），600 mg（6例），每天3次，连续给药7 d。观察受试者用药前后症状、生命体征、实验室检查变化（包括血尿常规、肝肾功能、心电图等）、并记录药品不良事件。结果：单次和多次给药耐受性试验的受试者用药前后生命体征和心电图无显著变化，实验室检查等表明无器质性损伤。依据试验终止标准，20例受试者完成4个剂量组的单次耐受性研究。其中单次给药耐受性试验有12例，多次给药耐受性试验有7例受试者在口服药物后出现轻中度恶心、呕吐、烧心、食欲不振、头晕和头痛等不良事件，未经处理自行缓解。本试验过程中未发生严重不良事件。结论：中国健康人体对吡非尼酮胶囊单次（200~1 200 mg）或多次（400~600 mg，tid×7 d）给药的安全性和耐受性良好，将为临床合理应用提供依据。     

健康志愿者单次皮下注射重组人胰高血糖素类多肽-1(7-36)[rhGLP-1(7-36)]耐受性研究

目的：在中国健康成年志愿者中评价单次皮下注射重组人胰高血糖素类多肽-1（7-36）[rhGLP-1（7-36）]的安全性、耐受性。方法：根据GCP设计试验方案，并获得伦理委员会批准。受试者须自愿签署知情同意书。选择42名18～50岁健康成人，将受试者随机分至0．10～0．45mg7个剂量组，每组6名，男女各半，分别接受单次皮下注射rhGLP-1（7-36），进行临床和实验室检查，考察药物耐受性。结果：单次皮下注射rhGLP-1（7-36）耐受性试验中，各组受试者各项指标测定值均在正常范围内，条件均衡，具较好可比性。因剂量至0．30mg时，不良事件（恶心、呕吐）在该组发生率超过50％，故于该剂量组试验完成后终止了下一剂量组试验，仅有4个剂量组共24名健康受试者完成了本试验。24例受试者完成的4个剂量组耐受性试验中，给药后实验室检查未见有临床意义的改变。试验中出现10例（共15例次）可能与药物有关的不良反应，如头晕、恶心、呕吐等，但均可耐受，且为一过性反应，于给药后1h内自行消失。其中，不良反应主要发生在0.25、0．30mg组（共7例12例次），而低剂量组（0．10、0．20mg）仅有3例发生轻度不良反应。15例次不良反应中，头晕、恶心有10例次，呕吐有5例次；整个试验过程未见严重不良事件。结论：24名中国健康成年受试者分别单次皮下注射rhGLP-1（7-36），最大剂量至0．20mg，比较安全、耐受性较好，为最大耐受剂量。而单次给药剂量至0．25mg或0．30mg则不良反应发生率较高，最大耐受剂量为0．20mg。建议单次用药剂量不宜超过0．20mg。在Ⅱ期临床试验中需严密观察恶心、呕吐这些与药物可能有关的不良反应及其发生机制。     

异丁司特胶囊正常人体耐受性研究

目的：观察中国健康男、女性志愿者对异丁司特胶囊的耐受性，方法：32例青年男、女入选受试验者参加了单剂量耐受性试验；8名男受试者入选参加每次10mg,q12h，持续8d的连续药耐受性试验，分别比较单次给药和连续给药试验中给药前与给药后受试者的临床症状和实验室化验结果的变化。结果：在单次口服2．5，5，10，20和30mg异丁司胶囊时，服药后1，3，6，12，24，48h时受试者的体征和实验室检查结果与给药前比较沿有区别。连续药耐受性试验结果显示服药后第5d和第10d受试者的体征和实验室检查结果与给药前比较也没有区别。结论：受试者对异丁司特胶囊具有很好的耐受性，推荐临床一次10mg的应用剂量是可以接受的。     

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.