左卡尼汀对维持性血液透析患者营养状况及红细胞免疫功能的影响

目的:探讨左卡尼汀对维持性血液透析(MHD)患者营养状况及红细胞免疫功能的影响。方法:选择行MHD的患者40例,将其随机分为两组,每组20例,两组患者均使用血液透析、蔗糖铁和红细胞生成素治疗,治疗组在对照组基础上应用左卡尼汀2.0克。治疗前及治疗12周后均检测外周血常规中的相关项目及红细胞免疫功能。结果:两组贫血状况均有改善,但治疗组血红细胞、血红蛋白、红细胞压积、红细胞免疫功能较对照组显著提高,营养状况明显好转。结论:左卡尼汀在一定程度上可改善MHD患者的营养状况及红细胞免疫功能。     

应用左卡尼汀联合促红细胞生成素治疗肾性贫血

目的应用左卡尼汀联合重组人促红细胞生成素（EPO）治疗肾性贫血。方法将56例尿毒症透析患者随机分为两组,两组均同时给予EPO皮下注射。治疗组于每次透析结束后注射左卡尼汀,对照组不用左卡尼汀,疗程共三个月。治疗前和治疗后每月取血查血红蛋白、红细胞比容,同时观察并发症的发生率。结果治疗组患者的血红蛋白及红细胞比容上升的水平显著高于对照组,且并发症的发生率低。结论左旋卡尼汀联合应用EPO显著提高尿毒症透析患者贫血的疗效。     

左卡尼汀联合重组人促红细胞生成素治疗MHD患者肾性贫血的疗效观察

目的观察左卡尼汀联合重组人促红细胞生成素（rh-EPO）治疗MHD患者肾性贫血的疗效。方法将40例在本院进行维持性血液透析肾性贫血患者随机分成两组,每组20例,对照组于血液透析后静脉注射EPO,每周150 U/kg,治疗组在此基础上于每次血液透析后静脉注射左卡尼汀1.0 g,每周3次,疗程12周,观察两组治疗前后血红蛋白（Hb）、红细胞压积（HCT）变化情况。结果治疗12周后,两组Hb、HCT均较治疗前有明显改善,差异均有统计学意义（P〈0.05）,治疗组较对照组改善更明显,两组相比较差异有统计学意义（P〈0.05）,两组治疗至12周时EPO用量相比较差异有统计学意义（P〈0.05）。结论左卡尼汀联合重组人促红细胞生成素治疗维持性血液透析肾性贫血疗效更佳,同时可减少EPO用量,降低促红素不良反应。     

左卡尼汀联合促红细胞生成素治疗肾性贫血

目的：探讨左卡尼汀联合促红细胞生成素对尿毒症血液透析患者贫血的疗效.方法：将2007年6月至2009年7月间在我院接受血液透析治疗的尿毒症患者90例,随机分为治疗组与对照组两组,治疗组采用左卡尼汀联合促红细胞生成素（EPO）治疗,对照组只采用EPO进行治疗.观察两组的Hb、Hct的变化及疗效.结果：经过治疗后,两组的Hb含量及血细胞比容均出现上升现象,且治疗组的上升幅度远大于对照组.治疗后,两组疗效的差异具有统计学意义（P〈0.01）,治疗组的疗效优于对照组.结论：左卡尼汀联合EPO治疗尿毒症血液透析患者的贫血,效果显著,值得进一步推广应用.     

左卡尼汀联合促红细胞生成素改善MHD患者贫血及营养状态的疗效

目的观察左卡尼汀联合促红细胞生成素治疗MHD患者肾性贫血及营养状态的疗效。方法将肾性贫血患者62例分成2组,每组31例。两组同时于血液透析后注射促红细胞生成素,每周150 U/kg。在此基础上,治疗组于每次血液透析后静脉注射左卡尼汀2.0 g,2次/周,疗程12周。结果治疗组血红蛋白、红细胞压积水平、白蛋白、总蛋白水平显著高于对照组(P<0.05)。结论左卡尼汀能显著提高促红细胞生成素对血液透析患者贫血的疗效,并且改善患者的营养状况。     

维持性血液透析患者纠正贫血对逆转左心室肥大的影响

目的 观察维持性血液透析(MHD)患者应用促红细胞生成素(EPO)、左旋卡尼汀纠正贫血的效果及贫血纠正对逆转左心室肥厚(LVH)的影响.方法 MHD伴贫血[血红蛋白(Hb)＜90 g/L]患者40例,每周血透后予EPO(A组)或EPO 左旋卡尼汀(B组)治疗,为期24周,监测血压、左心室重量指数(LVWI)、红细胞压积(Hct)、网织红细胞(RCT)、血清白蛋白和肉碱浓度.结果 治疗后两组LVH均明显下降(P＜0.05或P＜0.01),Hb均明显升高(P＜0.05),且B组比A组更明显(P＜0.05);白蛋白、肉碱浓度A组略有升高(P＞0.05),B组明显升高(P＜0.05或P＜0.01),且高于A组(P＜0.05或P＜0.01).结论 EPO 左旋卡尼汀治疗能明显提高MHD患者Hb水平,同时可部分逆转LVH.     

左卡尼汀联合重组人促红细胞生成素治疗28例肾性贫血疗效观察

目的分析比较左卡尼汀联合重组人促红细胞生成素(rh-EPO)治疗肾性贫血的疗效。方法选择维持性血液透析(MHD)6个月以上的肾性贫血患者28例,其中男18例,女10例;年龄36-65岁。随机分为治疗组16例,对照组12例。两组患者均给予rh-EPO 100-150 U/kg,每周2次皮下注射,并用叶酸、琥珀酸亚铁常规剂量纠正贫血。治疗组患者每次血液透析后给予左卡尼汀注射液1 g,连用12周。对照组每次血液透析后给予20 mL生理盐水静脉注射,观察时间共12周。结果两组患者治疗后血红蛋白和血细胞比容均高于治疗前,差异有统计学意义(P<0.05);治疗组治疗后第12周rh-EPO用量分别减少37.4%,而对照组rh-EPO用量无明显减少;治疗组血压升高2例(12.5%),对照组9例(75.0%),差异有统计学意义(P<0.05)。结论左卡尼汀联合rh-EPO用于MHD贫血患者,能显著改善贫血症状,减少rh-EPO的用量,对肾性贫血有较好疗效,可降低MHD相关高血压的发生率。     

左卡尼汀联合促红细胞生成素治疗肾性贫血临床观察

目的观察左卡尼汀联合促红细胞生成素（EPO）治疗肾性贫血的疗效及不良反应。方法将38例肾性贫血患者随机分成治疗组和对照组各19例。治疗组于每次血液透析后静脉注射左卡尼汀及EPO,而对照组仅注射EPO,疗程均为15周。观察2组治疗前后血红蛋白（Hb）、红细胞压积（HCT）变化情况、EPO用量及高血压发生率。结果2组治疗后Hb、HCT均明显升高,差异均有统计学意义（P〈0.01）,且治疗组Hb和HCT高于对照组,差异均有统计学意义（P〈0.01）;治疗组高血压发生率低于对照组,差异有统计学意义（P〈0.05）。结论左卡尼汀联合EPO能提高治疗肾性贫血疗效,降低EPO的不良反应发生率。     

慢性心力衰竭合并贫血患者采用左卡尼汀联合促红细胞生成素治疗的临床效果分析

目的探讨左卡尼汀联合促红细胞生成素治疗慢性心力衰竭合并贫血的临床治疗效果。方法将我院收治的86例慢性心力衰竭合并贫血患者作为对象,根据对比实验方法分为观察组与参考组,各为43例,给予观察组左卡尼汀联合促红细胞生成素治疗,给予参考组单纯左卡尼汀注射液治疗,观察两组患者临床治疗效果,记录患者治疗期间不良反应发生情况。结果观察组治疗血清FFA含量、血红蛋白含量均出现明显改善(P<0.05);观察组患者红细胞膜Na+-K+ATP酶的活性改善明显优于参考组(P<0.05);两组患者治疗期间不良反应发生率比较无统计学意义(P>0.05)。结论左卡尼汀联合促红细胞生成素治疗慢性心力衰竭合并贫血有助于纠正贫血现象,促进患者心功能的改善,安全性高,可推广使用。     

左卡尼汀联合促红细胞生成素治疗肾性贫血临床观察

目的：探讨左卡尼汀联合促红细胞生成素治疗肾性贫血的临床疗效。方法：56例血液透析（hemodialysis,HD）伴有肾性贫血的尿毒症患者随机分为治疗组与对照组,每组28例。全部患者均应用促红细胞生成素（EPO）4000u,皮下注射,每周2次。治疗组于HD结束后静脉注射左卡尼汀1．0g,每周2次,疗程12周。所有患者分别记录治疗前和治疗开始后12周的血红蛋白、红细胞压积、C-反应蛋白。结果：两组患者经治疗后,贫血指标均得以改善,但治疗组升高的幅度更明显（P〈0．05）,炎症指标CRP水平均较治疗前下降,但治疗组下降的幅度更明显（P〈0．05）。治疗组总有效率达到92．85％,亦明显高于对照组（P〈0．05）。治疗组2例患者出现轻度恶心。结论：左卡尼汀可加强EPO的疗效。左卡尼汀联合EPO治疗肾性贫血安全有效。     

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.