老年急性脑血管病合并心肌梗死的临床分析

目的：回顾性分析老年急性脑血管病(ACVD)合并急性心梗(AMI)临床特点，治疗及预后。方法：对646例ACVD中合并AMI的23例，进行回顾性分析。结果：23例ACVD合并AMI均经CT或MRI证实，均有AMI的典型心电图动态变化及血清心肌酶(包括CK、AST、LDH、I—BDH、CK-MB、LDH-1)的明显增高。常见于中老年人，具有发病急，进展快，病死率高的特点。结论：早期诊断，及时、合理治疗，减少并发症，是降低ACVD合并AMI病死率的关键。     

急性脑血管病致脑心综合征心电图改变的特点分析

目的：收集并分析急性脑血管病（ACVD）引起脑心综合征患者的心电图资料,总结其心电图形态改变的临床特点。方法以本院2010年12月~2013年12月收治的310例急性脑血管疾病致脑心综合征患者为研究对象,收集其入院首次及1个月后复查ECG结果,对其进行统计分析,总结其特征。结果急性脑血管病患者心电图检查可出现房性早搏及ST-T段改变等异常表现,急性发作期心电图改变发生率约为76.8%。结论 ACVD致脑心综合征患者心电图改变呈现多样化。急性脑血管病并发脑心综合症病情危重,进展迅速,心电图检查对于确定其是否伴有心脏损害有较高临床价值。     

cTnT、NT-proBNP及心肌酶谱联合检测在诊治急性冠脉综合征中的临床意义

目的：探究cTnT、NT-proBNP及心肌酶谱联合检测诊治急性冠脉综合征（ ACS）中的临床意义。方法选取该院2012年1月至2013年5月所收治的收治并确诊急性冠脉综合征患者24例,作为观察组,同时,针对该院在同期间入住的24例主要临床表现为“胸闷,难受,呼吸困难,胸痛”的患者为对照组,对患者的血样进行肌钙蛋白（ cTnT ）、N-端脑钠肽前体（ NT-proBNP ）、天门冬氨酸转移酶（ AST）、肌酸激酶（ CK）、乳酸脱氢酶（ LDH）及肌酸激酶同工酶（ CK-MB）的含量进行测定。结果治疗前,观察组在急性冠脉综合征患者各个指标均高于对照组,并且数据间差别存在显著性,即P＜0．05。治疗后,观察组中急性冠脉综合征患者在CTnT、NT-proBNP均高于对照组,并且数据间差别存在显著性,即P＜0．05,而两组在CK、CK-MB、LDH和AST上与对照组相比,无统计学差异（ P＞0．05）。结论 cTnT、NT-proBNP及心肌酶谱的检测对急性冠脉综合征患者的应用价值较高,可以有效反映ACS的具体情况,对ACS 的早期诊断及治疗具有非常重要的价值。     

急性脑血管病合并脑心综合征与病死率的相关性分析

目的：探讨急性因管病合并脑心综合征与病死率的相关性。方法与结果：通过１３５例急性脑血管病人的心电图分析，结果发现其中合并脑心综合征６５例（脑出血４１例，脑梗塞２４例）共死亡２３例（脑出血２１例，占６３．１％脑梗塞２例，占３６．９％，Ｐ〈０．００１），其中合并及心综合征２０例（９１．３％）无脑心综合征３例（８．７％，Ｐ〈０．００１），结论：急性因管病病死率不仅与病变部位，性质，出血量有关。     

急性脑血管病并脑心综合征的临床研究（附68例报告）

目的研究急性脑血管病并脑心综合征的临床特征。方法对2010年2月至2012年1月我院收治的68例急性脑血管病并脑心综合征的患者进行回顾性分析。结果 68例患者均有不同程度的心电图及心肌酶的改变,ST段下移28例,T波低平或倒置15例,窦性心动过速26例;窦性心动过缓4例;早搏14例（室早10例,房早4例）;心律不齐13例;心肌酶学：CK-B增高38例（55.9%）;CK增高7例（10.3%）;LDH增高19例（27.9%）;肌钙蛋白阳性率4例（5.9%）.死亡5例（7.5%）,4例死于脑出血并发呼吸心力衰竭,1例脑梗死并发多脏器衰竭。结论急性脑血管病并脑心综合征的发生率脑出血最高,应尽早常规检查心肌酶、心电图,以便早发现早治疗。     

肌钙蛋白、脑钠肽、心肌酶谱和心电图检查在急性冠状动脉综合征诊治中的意义

目的研究血清脑钠肽、心肌酶谱、肌钙蛋白的水平和心电图的变化在急性冠状动脉综合征早期诊断中的临床意义。方法选取2015年1月至2017年1月在我院确诊的急性冠状动脉综合征患者62例作为病例组和健康体检者30例作为对照组,检查两组的血清肌钙蛋白、、脑钠肽、心肌酶谱指标和心电图变化。结果急性冠状动脉组血清的LDH、CK-MB、AST、NT-proBNP和cTnI均明显高于对照组,差异具有统计学意义(P<0.01)。心电图阳性组的患者血管闭塞率明显高于心电图阴性组,二者差异有统计学意义。结论血清NTproBNP、cTnI和心肌酶谱的水平可以帮助早期诊断急性冠状动脉综合征,心电图检查可以有效反映ACS患者的血管闭塞情况。     

急性感染性喉炎血清心肌酶谱的临床分析

目的探讨急性感染性喉炎患儿血清心肌酶谱变化的临床意义。方法选择急性感染性喉炎患儿112例,于入院24h内抽取静脉血2ml用全自动生化分析仪检测AST（谷草转氨酶）、CK（磷酸肌酸激酶）、CK-MB（磷酸肌酸激酶同工酶）、LDH（乳酸脱氢酶）。结果 AST、CK、CK-MB、LDH活性的改变与急性感染性喉炎喉梗阻的程度呈正相关,其中CK、CK-MB值的升高有显著统计学意义（P〈0.05）。结论心肌酶谱测定可作为早期诊断急性感染性喉炎患儿心肌损伤的指标,动态测定,可了解心肌损伤程度,指导治疗,需引起重视。     

糖尿病酮症对中青年患者心脏的影响

目的通过观察中青年糖尿病酮症患者心肌酶谱以及心电图改变,探讨糖尿病酮症对心脏的损害。方法入选78例中青年2型糖尿病酮症患者,急性期及酮症纠正后检测肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）及天门冬氨基转移酶（AST）;同时观察并比较患者心电图的变化。结果78例酮症期患者血清肌酸激酶、CK-MB及AST水平与缓解期比较均明显升高;78例急性期患者心电图异常者46例（58．9％）,主要异常是ST-T改变32例（41．0％）,其中ST段压低8例,ST段抬高1例,T波平坦或倒置23例,窦性心动过速18例（23．1％）,缓解期有32例心电图异常的患者好转,其中20例恢复正常;急性期心电图异常患者组血清肌酸激酶、CK—MB及AST水平明显高于心电图正常组（P〈0．05）;78例患者中有3例酮症患者急性期肌酸激酶、CK—MB及AST超过正常值2倍,2例患者ST段压低0．1mV,1例患者ST段轻度抬高,缓解期肌酸激酶、CK-MB及AST恢复正常,3例心电图均有明显改善,2例ST段压低患者升高0．05mV以上,ST段抬高者恢复到基线水平。结论糖尿病酮症患者存在心脏-过性非特异性损害,心肌酶谱可以出现异常升高,酮症期间应重视心脏的监测,酮体纠正后应重视心脏的随访与评价。     

轮状病毒性肠炎与非轮状病毒性肠炎对心肌酶谱的影响

目的：探讨轮状病毒性肠炎与非轮状病毒性肠炎心肌酶谱的变化及两种肠炎的心肌酶谱的区别。方法：选取本院2006年1月～2009年1月收治的轮状病毒性肠炎64例作为观察组,同时选取收治的其他类型的非轮状病毒性肠炎64例作为对照组,分别检测两组血清AST、LDH、α-HBDH、CK、CK-MB。结果：观察组心肌酶AST、LDH、α-HBDH、CK、CK-MB显著高于对照组,差异有统计学意义（P〈0.05）。收治的64例轮状病毒性肠炎患者经检测后,发现其中47例心肌酶谱升高,给予治疗后,AST、LDH、α-HBDH、CK、CK-MB与治疗前比较,差异有统计学意义（P〈0.05）。结论：轮状病毒性肠炎心肌酶谱改变较非轮状病毒性肠炎明显。     

心肌酶谱在急性心肌梗死诊断中的价值比较

目的探讨在急性心肌梗死诊断中心肌酶谱测定的临床价值。方法对2010年2月至2012年7月收治的80例急性心肌梗死患者进行心肌酶谱测定,并与60例正常对照组比较天冬氨酸转氨酶（AST）、肌酸激酶同工酶（CK-MB）、肌酸激酶（CK）、羟丁酸脱氢酶（HBDH）和乳酸脱氢酶（LDH）的含量,观察在急性心肌梗死诊断中心肌酶谱测定的临床价值。结果对照组AST、CK-MB、CK、HBDH和LDH含量低于心肌梗死组,差异有统计学意义（P〈0.05）。AST、CK-MB、CK、HBDH和LDH的检出敏感性分别为91.8%、93.9%、94.9%、85.2%和92.8%。结论在急性心肌梗死诊断中心肌酶谱测定具有良好的临床价值。     

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.     

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.