2种文拉法辛制剂治疗抑郁症的对照研究

目的:研究2种文拉法辛制剂治疗抑郁症的疗效和安全性。方法:入组病例符合CCMD-2R抑郁症诊断标准,随机分为试验组(文拉法辛缓释胶囊)30例,对照组(文拉法辛胶囊)30例,用HAMD、HAMA、TESS量表评价疗效和不良反应。结果:2组药物均对抑郁症治疗效果良好,2组病人的HAMD评分自治疗后1wk起均有明显改善。试验组HAMD减分率自2wk末开始明显高于对照组(P<0.05), HAMA减分率自治疗后1wk末即明显高于对照组(P<0.01),显效率87％,有效率97％,均高于对照组,TESS评分对照组高于试验组,但无严重不良反应,不影响治疗。结论:文拉法辛缓释胶囊治疗抑郁症起效快,疗效好,不良反应少,服用方便,依从性好。     

文拉法辛与帕罗西汀治疗抑郁症的对照研究

目的比较文拉法辛与帕罗西汀治疗抑郁症的临床疗效和不良反应。方法 92例抑郁症患者随机分为文拉法辛组和帕罗西汀组,每组46例,疗程8周。在治疗前及治疗后1、2、4、8周末以汉密尔顿抑郁量表(HAMD)和不良反应量表(TESS)评定疗效与不良反应。结果文拉法辛组显效率和有效率分别为78.26%和91.30%,帕罗西汀组显效率和有效率分别为76.08%和89.13%,两组总体疗效相仿(P>0.05);治疗后两组HAMD评分与治疗前比较均有显著性差异(P<0.01);治疗1周末文拉法辛组HAMD评分与帕罗西汀组比较有显著性差异(P<0.05),其他各时点两组间HAMD评分无显著性差异(P>0.05);两组不良反应均较轻微,组间比较无显著性差异(P>0.05)。结论文拉法辛和帕罗西汀治疗抑郁症的疗效无显著差异,不良反应均较轻,但文拉法辛起效更快,值得推广应用。     

盐酸文拉法辛治疗抑郁症40例

目的观察盐酸文拉法辛治疗抑郁症的临床疗效和安全性。方法将80例抑郁症患者随机均分为两组，治疗组用盐酸文拉法辛（博乐欣胶囊）口服，起始剂量75mg／d，治疗剂量75～225mg／d；对照组用氟西汀胶囊口服，治疗剂量为40mg／d。两组疗程均为6周。采用汉密顿抑郁量表（HAMD）、汉密顿焦虑量表（HAMA）和副反应量表（TESS）评价疗效和不良反应。结果治疗组总有效率为95．00％，不良反应少而轻，对照组总有效率为90．00％，两组总有效率差异无显著性（P〉0．05）。结论盐酸文拉法辛治疗抑郁症安全、有效。     

文拉法辛与阿米替林治疗抑郁症的疗效比较

目的 观察文拉法辛与阿米替林治疗抑郁症的疗效及不良反应. 方法 将50例抑郁症患者分为治疗组和对照组各25例. 治疗组给予文拉法辛100～250 mg&#8226;d-1,对照组给予阿米替林100～250 mg&#8226;d-1,均分为2次口服,两组疗程均8周. 应用汉密尔顿抑郁量表（HAMD）和不良反应量表（TESS）评定疗效及不良反应. 结果 经8周治疗,两组抑郁症状均明显减少,治疗组有效率为82.1%,对照组为78.4%（P＞0.05）. 对照组不良反应发生率明显高于治疗组（P＜0.01）. 结论 文拉法辛治疗抑郁症的疗效与阿米替林相当,但不良反应小,耐受性好,可作为治疗抑郁症的一线用药.     

度洛西汀与文拉法辛治疗产后抑郁的临床疗效比较

目的 比较度洛西汀与文拉法辛治疗产后抑郁的临床疗效和不良情况.方法 分娩后出现抑郁症的产妇126位,按随机数字表法分成度洛西汀组和文拉法辛组进行治疗,每组63例.度洛西汀组和文拉法辛组起始用药量都为20 mg/d,1周后用药量加为60 mg/d,持续用药6周.使用汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)判断治疗前、治疗1、2、4、6周末各时点的治疗效果,使用副反应量表(TESS)评定两种药物的安全性.结果 两组患者在实施药物治疗6周以后,度洛西汀组显效率74.60％,有效率88.89％;文拉法辛组显效率69.84％,有效率84.13％,两组的治疗效果差异无统计学意义(P＞0.05);治疗后1、2、4、6周末各时间点两组的HAMD评分和HAMA评分均比治疗前有明显下降(P＜0.01),两组减分率差异无统计学意义(P＞0.05);治疗过程中,度洛西汀组的不良反应率为46.8％,文拉法辛组的不良反应率为49.2％,两组的不良反应发生率差异无统计学意义(P＞0.05);治疗1、2、4、6周末以后两组的TESS评分差异无统计学意义,可是均和治疗前差异有统计学意义(P＜0.01).结论 度洛西汀与文拉法辛治疗产后抑郁的治疗效果接近,治疗过程出现的不良反应近似.     

氢溴酸西酞普兰与盐酸文拉法辛治疗抑郁症的疗效观察

目的 观察对比氢溴酸西酞普兰与盐酸文拉法辛治疗抑郁症的效果.方法 随机选择2011至2012年来我院治疗的52例与2009至2012年的157例抑郁症患者,分别作为实验组与对照组.实验组服用氢溴酸西酞普兰,对照组服用盐酸文拉法辛,疗程6周.再分别采用汉密尔顿抑郁量表(HAMD)及汉密尔顿焦虑量表(HAMA)在治疗前及治疗后的2,4,6周评定疗效;并用副反应量表(TESS)评定不良反应.结果 两组的HAMA评分与HAMD评分均有明显下降(P＜ 0.01),两组HAMA评分差异无显著性(P＞0.05).治疗第6周,两组HAMD评分差异有显著性(P＜0.05),并且两组出现不良反应的情况较少,实验组焦虑、失眠、恶心呕吐各3例,嗜睡4例.对照组焦虑、失眠各2例,恶心呕吐5例、嗜睡1例.结论 氢溴酸西酞普兰与盐酸文拉法辛治疗抑郁均具有不良反应小,起效快的特点,值得临床推广应用.     

文拉法辛联合解郁汤治疗难治性抑郁症疗效分析

目的 了解文拉法辛联合解郁汤治疗难治性抑郁症( treatment-resistant depression,TRD)的疗效和不良反应.方法 将76例患者随机分为研究组和对照组,研究组采用文拉法辛联合解郁汤治疗,对照组采用文拉法辛治疗.在治疗前及治疗第2、4、6周进行汉密尔顿抑郁量表(HAMD评定,按HAMD减分率判定疗效,药物不良反应采用不良反应量表(TESS)评定.结果 研究组有效率79.41％,对照组有效率56.25％,两组比较差异有统计学意义(x2=4.08,P＜0.05).在治疗后第2周起,两组间HAMD评分有统计学差异(t=2.21,P＜0.05)、研究组不良反应发生率低于对照组.结论 文拉法辛联合解郁汤治疗TRD疗效优于单独使用文拉法辛,起效更快,不良反应轻.     

米氮平治疗广泛性焦虑症的疗效及安全性

目的:探讨米氮平治疗广泛性焦虑症的疗效和不良反应.方法:对60例广泛性焦虑症患者随机分为试验组及对照组,分别服用米氮平15～30mg·d-1和马普替林50～150mg·d-1,疗程均为6周.于治疗前及治疗后第1,2,4,6周末进行汉密尔顿焦虑量表(HAMD)及不良反应量表(TESS)评定疗效和不良反应.结果:试验组治疗广泛性焦虑症的显效率84.69%,有效率100%;对照组显效率66.67%,有效率88.89%,但两组比较经Ridit分析差异无显著性(P＞0.05).不良反应方面比较米氮平TESS评分显著低于马普替林(p＜0.05).结论:米氮平是治疗广泛性焦虑症的快速、安全、有效的药物.     

文拉法辛联合齐拉西酮治疗抑郁症62例

目的观察文拉法辛联合齐拉西酮治疗抑郁症的疗效和安全性。方法选择2009年3月至2011年11月医院治疗的抑郁症患者124例,随机分成两组,各62例,对照组给予文拉法辛治疗,治疗组在对照组基础上加用齐拉西酮,疗程均为8周。于治疗前和治疗1,2,4,6,8周后,分别采用汉密尔顿抑郁量表(HAMD)和不良反应量表(TESS)评定疗效和不良反应。结果治疗1,2,4周后,对照组的HAMD评分显著高于治疗组(P<0.05),而治疗组和对照组的TESS评分比较无显著差异(P>0.05),治疗组显效率(74.20%)和有效率(93.55%)均显著高于对照组的59.67%和85.87%(P<0.05)。结论文拉法辛联合齐拉西酮治疗抑郁症疗效好、起效迅速、不良反应少,可在临床推广。     

文拉法辛与帕罗西汀治疗抑郁症的对照分析

目的:比较文拉法辛与帕罗西汀治疗抑郁症的疗效及安全性.方法:将96例抑郁症患者,分为文拉法辛组48例,用文拉法辛75～150 mg/d;帕罗西汀组48例,用帕罗西汀20～40 mg/d,观察期6周,疗效评定用汉密尔顿抑郁量表(HAMD),汉密尔顿焦虑量表(HAMA).不良反应评价用不良反应量表(TESS)、实验室榆查及体检.结果:经过6周治疗,文拉法辛组有效率为79.17%,帕罗西汀组为75.00%,两组比较差异无显著性(P>0.05).同时,文拉法辛的抗抑郁作用起效较快,对焦虑症状的疗效优于帕罗西汀(P<0.01).文拉法辛不良反应轻,常见的有:口于、便秘、视力模糊、出汗、食欲减退等.结论:文拉法辛是一种安全、有效、抗焦虑疗效好的抗抑郁药.     

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.