川芎嗪注射液联合常规疗法对大面积脑栓塞患者支架植入术后血小板血流变学及疗效的影响

摘 要 目的：探讨川芎嗪注射液联合常规疗法对大面积脑栓塞患者术后血小板及血流变学的影响。方法: 2014年1月~2015年1月,100例大面积脑栓塞患者随机分为对照组和观察组各50例。对照组患者术后采用常规治疗,观察组患者在对照组基础上加用川芎嗪注射液。两组疗程均为2周。比较两组患者治疗前、治疗后1周、治疗后2周的神经功能损失（NIHSS评分）、血小板聚集率及血液流变学（全血黏度、血浆黏度、红细胞变形指数、红细胞聚集指数、纤维蛋白原）指标变化,评价两组疗效与药品不良反应。结果: 治疗后,观察组与对照组的有效率分别为92.00%与80.00%,差异无统计学意义（P>0.05）。治疗后1周、2周,两组NIHSS评分、血小板聚集率、血液流变学各项指标均较治疗前显著改善（P<0.05）;且观察组改善较对照组更为明显（P<0.05）。观察组药品不良反应发生率明显低于对照组（P<0.05）。结论:在常规治疗基础上加用川芎嗪注射液,可抗血小板聚集,改善血液流变学指标,在治疗大面积脑栓塞的疗效确切。     

针刺联合加巴喷丁治疗紧张性头痛患者的疗效及对血液流变学的影响观察

摘 要 目的：探讨针刺联合加巴喷丁治疗紧张性头痛患者疗效及对患者血液流变学的影响。方法: 紧张性头痛患者92 例随机分为观察组与对照组各46 例。对照组给予加巴喷丁治疗,观察组在对照组基础上结合针刺治疗。两组疗程均为4 周。比较两组治疗疗效,治疗前后头痛指数、视觉模拟评分（VAS）、血液流变学指标变化,及药品不良反应发生情况。结果: 观察组治疗总有效率为93.48%,高于对照组的73.91%（P<0.05）。治疗后,两组头痛指数、VAS评分均较治疗前明显下降（P<0.05）;且观察组头痛指数和VAS评分明显低于对照组（P<0.05）。治疗后,两组血浆黏度、红细胞压积、血小板聚集率等指标较治疗前下降（P<0.05）,且观察组上述指标均低于对照组（P<0.05）。两组患者未见严重药品不良反应发生。结论:针刺联合加巴喷丁治疗紧张性头痛患者疗效显著,且可改善患者血液流变学,安全性良好。     

丹红注射液联合曲美他嗪治疗冠心病不稳定心绞痛临床观察

目的观察丹红注射液联合曲美他嗪治疗冠心病不稳定心绞痛的疗效。方法将64例冠心病不稳定型心绞痛患者随机分为对照组和观察组各32例,对照组给予曲美他嗪治疗,观察组在对照组基础上给予丹红注射液治疗,观察两组患者治疗后疗效。结果观察组临床症状改善显著优于对照组（P〈0．05）,血液流变学指标改善程度显著优于对照组（P〈0．05）;观察组心绞痛发作次数、持续时间及硝酸甘油用量改善均显著优于对照组（P〈0．05）。结论丹红注射液联合曲美他嗪可提高冠心病不稳定心绞痛的疗效和改善临床症状,且不良反应少,值得推广应用。     

心悦胶囊联合美托洛尔治疗冠心病心绞痛的临床研究

目的 观察心悦胶囊联合琥珀酸美托洛尔缓释片治疗冠心病心绞痛的临床疗效。方法 选取2018年4月—2021年2月郑州大学第一附属医院收治的136例冠心病心绞痛患者作为观察对象,根据随机数字表法分为对照组（68例）和治疗组（68例）。对照组口服琥珀酸美托洛尔缓释片,1片/次,1次/d。治疗组患者在对照组治疗的基础上口服心悦胶囊,2粒/次,3次/d。两组治疗疗程均为4周。观察两组临床疗效、心电图疗效,比较两组心绞痛症状、心功能指标、心肌损伤指标、血液流变学指标。结果 治疗后,治疗组的临床疗效总有效率为94.12%,高于对照组的80.88%,治疗组的心电图疗效总有效率为92.65%,高于对照组的76.47%,组间对比差异有统计学意义（P<0.05）。治疗后,两组心绞痛发作频率降低、持续时间缩短（P<0.05）,与对照组相比,治疗后治疗组心绞痛发作频率降低、持续时间缩短更显著（P<0.05）。治疗后,两组左心室射血分数（LVEF）、心排血量（CO）较治疗前升高（P<0.05）,与对照组相比,治疗后治疗组的LVEF、CO升高更显著（P<0.05）。治疗后,两组全血低切黏度、全血高切黏度、血浆黏度、纤维蛋白原较治疗前降低（P<0.05）。与对照组相比,治疗后治疗组全血低切黏度、全血高切黏度、血浆黏度、纤维蛋白原降低更显著（P<0.05）。治疗后,两组肌酸激酶同工酶（CK-MB）、心肌肌钙蛋白I（cTnI）、脑钠肽（BNP）水平较治疗前降低（P<0.05）,与对照组相比,治疗后治疗组CK-MB、cTnI、BNP水平降低更显著（P<0.05）。结论 心悦胶囊联合琥珀酸美托洛尔缓释片治疗冠心病心绞痛具有较好的临床疗效,能够改善血液流变学、心功能,减轻心肌损伤,安全性好。     

麝香保心丸联合常规治疗对不稳定型心绞痛患者的疗效及血液流变学的影响

摘 要 目的:观察麝香保心丸联合常规治疗对不稳定型心绞痛（UAP）患者的临床疗效及对血液流变学的影响。方法: 91例UAP患者按就诊先后顺序分为对照组41例和观察组50例,对照组予常规治疗,观察组在对照组基础上加服麝香保心丸45 mg,po,tid。治疗8周后比较两组临床疗效和血液流变学指标,同时记录药品不良反应发生情况。 结果:治疗后,观察组心绞痛和心电图的显效率和总有效率均明显较高于对照组（P<0.05）。两组患者治疗后血浆黏度、全血黏度、红细胞压积、纤维蛋白原和血沉均较前明显降低（P<0.05）;且观察组血浆黏度、全血黏度、血沉较对照组下降更明显（P<0.05）。两组药品不良反应均较轻微。结论: 麝香保心丸联合常规治疗对UAP患者疗效优于单纯常规治疗,能明显改善患者血液流变学指标。     

丹红注射液治疗冠心病的临床疗效观察

目的观察丹红注射液治疗冠心病的效果。方法我科2012年1月至2013年1月住院268例冠心病患者,将患者随机分为两组,患者在治疗前后分别留取常规心电图、测定血液流变学参数,记录心绞痛发作次数。结果治疗组患者心绞痛症状改善明显优于对照组,治疗组治疗后血液流变学较治疗前改善,心电图总有效率分别优于对照组,差异有统计学意义(P<0.05)。结论丹红注射液是一种治疗冠心病安全、有效的药物。     

丹红注射液联合瑞舒伐他汀治疗不稳定型心绞痛患者的疗效及对血清TNF SymbolaA@、hs CRP和IL 6观察组

摘 要 目的：探讨丹红注射液联合瑞舒伐他汀治疗不稳定型心绞痛（UAP）的临床疗效及其对患者血清肿瘤坏死因子α（TNF-α）、高敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）水平的影响。方法: 72例UAP患者随机分为对照组和观察组各36例。两组患者均给予常规治疗,对照组患者在常规治疗基础上给予口服瑞舒伐他汀片10 mg,po,qd治疗,观察组患者则在对照组的基础上再加用丹红注射液30 ml,ivd,qd。两组患者均连续治疗2周。观察两组患者的临床疗效及药品不良反应发生情况,记录两组治疗前后心绞痛发作频度及持续时间。比较治疗前后两组患者血脂及血清TNF-α、hs-CRP和IL-6水平变化。结果:观察组治疗总有效率为91.67%,显著高于对照组的72.22%（P＜0.05）;观察组患者的心绞痛发作频度和持续时间均显著低于对照组（P＜0.05）。治疗后,两组患者的TG、TC、LDL-C等血脂指标水平以及血清TNF-α、hs-CRP和IL-6水平均较治疗前显著下降,HDL-C水平则较治疗前显著升高,差异均有统计学意义（P＜0.05）;且观察组TG、TC、LDL-C水平及血清TNF-α、hs-CRP和IL-6水平均显著低于对照组,HDL-C水平显著高于对照组（P＜0.05）。结论:丹红注射液联合瑞舒伐他汀治疗不稳定型心绞痛,可有效改善患者的临床症状,减少心绞痛发作频度及持续时间,同时可降低血清TNF-α、hs-CRP和IL-6水平,抑制炎症反应,安全有效,值得应用于临床。     

天麻素注射液联合前列地尔对腔隙性脑梗死患者的临床疗效及血脂、血液流变学指标的影响

目的 探讨天麻素注射液联合前列地尔注射液对腔隙性脑梗死患者的疗效及血脂、血液流变学的影响。方法 选取2015年10月-2017年12月连云港市赣榆区人民医院收治的腔隙性脑梗死患者90例作为研究对象,根据入院顺序随机分为观察组和对照组,每组各45例。对照组在常规治疗基础上,给予前列地尔注射液10 μg加入100 mL生理盐水中静脉滴注,1次/d。观察组在对照组的基础上给予天麻素注射液400 mg加入250 mL生理盐水中静脉滴注,1次/d。两组均连续治疗2周。观察两组的临床疗效,同时比较两组治疗前后的血脂和血液流变学指标水平。结果 治疗后,观察组治疗总有效率为91.11%,显著高于对照组的73.33%,两组比较差异有统计学意义（P<0.05）。治疗后,两组三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）均明显降低,同组治疗前后比较差异有统计学意义（P<0.05）;且观察组明显低于对照组,两组比较差异有统计学意义（P<0.05）;治疗后,观察组HDL-C水平明显升高,同组治疗前后比较差异有统计学意义（P<0.05）,但两组间比较无显著差异。治疗前,两组血液流变学指标无显著差异;治疗后,两组全血黏度高切变率、全血黏度低切变率、血浆黏度、红细胞比容和红细胞聚集指数均显著降低,同组治疗前后比较差异有统计学意义（P<0.05）;且观察组明显低于对照组,差异有统计学意义（P<0.05）。结论 天麻素注射液联合前列地尔注射液治疗腔隙性脑梗死可有效改善患者的血脂水平和血液流变学指标,疗效显著,优于单用前列地尔治疗。     

瓜蒌皮注射液联合磷酸肌酸治疗冠心病稳定型心绞痛的临床研究

目的 探讨瓜蒌皮注射液联合磷酸肌酸治疗冠心病稳定型心绞痛的临床疗效。方法 选取2020年1月—2021年4月在郑州颐和医院诊治的144例冠心病稳定型心绞痛患者,随机分为对照组（72例）和治疗组（72例）。对照组患者静脉滴注注射用磷酸肌酸钠,1 g加入100 mL生理盐水,1次/d。治疗组在对照组的基础上肌内注射瓜蒌皮注射液,4 mL/次,1次/d。两组患者均治疗7 d。观察两组患者临床疗效,比较治疗前后两组患者心绞痛发作次数和持续时间,24 h动态心电图变化,氧化应激指标总抗氧化能力（T-Aoc）、谷胱甘肽过氧化物酶（GSH-Px）和糖基化终末产物（AGEs）水平及血管内皮功能指标一氧化氮（NO）、血管内皮生长因子（VEGF）、内皮素-1（ET-1）和可溶性血栓调节蛋白（sTM）水平。结果 治疗后,对照组总有效率80.56%,治疗组总有效率93.06%,两组总有效率比较差异具有统计学意义（P<0.05）。两组患者心绞痛发作次数、心绞痛每次持续时间较治疗前下降（P<0.05）,且治疗组下降幅度更明显（P<0.05）。治疗后,两组患者缺血发作次数、缺血最长持续时间、缺血总时间显著降低（P<0.05）,且治疗组缺血发作次数、缺血最长持续时间、缺血总时间显著低于对照组（P<0.05）。治疗后,两组患者T-Aoc、GSH-Px水平均显著升高,AGEs水平显著降低（P<0.05）,且治疗组上述指标改善更显著（P<0.05）。治疗后,两组患者NO、VEGF水平显著升高,ET-1、sTM水平显著降低,且治疗组上述指标改善更显著（P<0.05）。结论 瓜蒌皮注射液联合磷酸肌酸可有效改善冠心病稳定型心绞痛患者临床症状,改善冠脉循环,抑制氧化应激反应,减轻血管内皮损伤,具有良好的临床疗效,安全性较高。     

心悦胶囊联合比索洛尔治疗冠心病心绞痛的疗效及其对血液流变学的影响

目的 探讨心悦胶囊联合比索洛尔治疗冠心病心绞痛的疗效及其对血液流变学的影响。方法 选取2019年3月-2020年3月在安阳市第六人民医院就诊的100例冠心病心绞痛患者作为研究对象,按照治疗方法将患者分为对照组和观察组,每组各50例。对照组患者口服富马酸比索洛尔片,5 mg/次,1次/d。观察组在对照组的基础上口服心悦胶囊,0.6 g/次,3次/d。两组均连续治疗1个月。观察两组患者的临床疗效,比较两组患者心绞痛症状（发作频率、持续时间）、视觉模拟评分（VAS）;检测两组治疗前后的纤维蛋白原、全血黏度、D-二聚体水平及左室射血分数（LVEF）、心输出量（CO）。记录药物相关不良反应的情况。结果 治疗后,观察组患者总有效率为94.00%,显著高于对照组的80.00%,组间比较差异有统计学意义（P<0.05）。治疗后,两组的发作频率、持续时间和VAS评分均显著降低（P<0.05）;观察组的发作频率、持续时间及VAS评分均低于对照组,差异有统计学意义（P<0.05）。治疗后,两组的LVEF、CO均明显升高（P<0.05）;且观察组升高更明显（P<0.05）。治疗后,两组的纤维蛋白原、全血黏度、D-二聚体均明显降低（P<0.05）;治疗后,观察组的纤维蛋白原、全血黏度、D-二聚体均低于对照组,差异有统计学意义（P<0.05）。两组的药物不良反应的发生率无明显差异。结论 心悦胶囊联合比索洛尔治疗冠心病心绞痛的疗效确切,能有效减轻症状和疼痛程度,改善血液流变学和心功能,且安全性较好。     

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.