240例肝病患者血脂血糖检测的临床意义

目的探讨肝病患者血清总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）及血糖（GLU）的变化情况及其临床意义。方法测定240例肝病患者（其中急性肝炎62例、慢性肝炎57例、肝硬化52例、重型肝炎69例）血清TC、TG、HDL—C、LDL—C、GUL水平,并与100名健康人进行比较。对重型肝炎患者血清TC、TG、HDL—C、LDL-C、GUL浓度与其TBil、Alb进行相关性分析。结果各型肝病患者血清TC、TG、HDL．C、LDL—C、GUL水平和对照组比较均有所降低,其中肝硬化和重型肝炎患者以上指标与对照组比较明显下降（P〈0．01或P〈0．05）。重型肝炎组血清TC、TG、HDL—C、LDL—C、GUL与TBil呈负相关[P〈0．01],与Alb呈正相关（P〈0．0t）,血清TC与LDL—C呈正相关（P〈0．05）。重型肝炎组中39例死亡患者与32例存活患者的血清TC、TG、HDL-C、LDL-C、GUL水平差异均具有统计学意义（P〈0．05）。结论对肝病患者进行定期的血脂、血糖水平测定能及时反映体内的脂类代谢状况,对了解肝病患者的肝脏损伤程度、病程进展情况以及重型肝炎的预后判断都有重要价值。     

辛伐他汀联用多烯康与两药单独应用治疗混合性血脂异常临床观察(附103例分析)

目的 评价辛伐他汀联用多烯康及两药单用治疗混合性血脂异常患者的疗效与安全性。方法 103例混合性血脂异常患者随机分为三组。辛伐他汀＋多烯康组33例，给予辛伐他汀20mg／d，多烯康4．05g／d；辛伐他汀组42例，给予辛伐他汀20mg／d；多烯康组28例，给予多烯康4．05g／d；治疗12周，观察降脂疗效和不良反应。结果 辛伐他汀＋多烯康组，总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）均显著降低（P〈0．01），高密度脂蛋白胆固醇（HDL-C）升高（P〈0．01）；辛伐他汀组TC、LDL—C显著降低（P〈0．01），HDL—C升高（P〈0．05）；多烯康组TG下降明显（P〈0．01），TC及LDL—C下降、HDL-C升高不明显（P〉0．05）。结论 辛伐他汀＋多烯康组降低TC、TG、LDL—C明显，升高HDL—C明显；辛伐他汀组降低TC、LDL—C及升高HDL-C明显；多烯康组降低TG明显。辛伐他汀＋多烯康组与单用辛伐他汀组不良反应轻微，多烯康组无明显不良反应。提示对混合性血脂异常患者两药联用疗效好而副作用轻微。     

应用ROC曲线分析2型糖尿病大血管并发症患者血脂和脂质比值的临床应用价值

目的分析2型糖尿病大血管并发症患者血脂和脂质比值的的临床应用价值。方法选择2型糖尿病患者120例,分为糖尿病无大血管并发症组60例（B组）,糖尿病大血管并发症组60例（C组）及正常对照人群100例（A组）,检测3组血脂并计算脂质比值,运用ROC曲线进行比较和分析。结果与B组比较,C组总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）、TC／高密度脂蛋白胆固醇（HDL—C）、LDL-C/HDL-C水平明显升高（P〈0．05）;TC／LDL-C、LDL-C／HDL-C对糖尿病大血管并发症的诊断灵敏度较高,均〉80％,TC、LDL-C的诊断特异度最高,达95％,LDL—C、TC／LDL—C、LDL—C／HDL-C的诊断正确率较高,均〉70％,LDL-C的阳性预测值、阳性似然比最高,分别为91％、10．33,TC／LDL—C的阴性预测值最高、阴性似然比最小,分别为81％、0．24;将B组作为对照组,C组与B组进行比较,TC、LDL—C、TC／LDL—C、LDL—C／HDL—C的ROC曲线下面积均≥0．7且差异有统计学意义（P〈0．01）。结论TC、LDL—C、TC／LDL—C、LDL—C／HDL-C对糖尿病大血管并发症的有较高的临床应用价值。     

原发性高血压与血清C反应蛋白及血脂水平的关系研究

目的探讨原发性高血压与血清c反应蛋白（CRP）和血脂水平的关系。方法186例原发性高血压患者按高血压水平分为A组85例（1级高血压）、B组65例（2级高血压）、C组36例（3级高血压）,另选同期健康体检者66例为D组,比较各组CI：IP、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）水平。结果A、B、C组CRP、TC、TG、HDL—C、LDL-C水平与D组比较差异均有统计学意义（均P〈0．05）,A、B、C三组问各项指标差异均有统计学意义,且三组CRP水平与TG、TC、HDL—C、LDL—C水平有明显相关性（均P〈0．05）。结论高血压水平与患者血清CRP及血脂水平具有明显相关性。     

214例社区2型糖尿病患者血脂控制现状分析

目的：描述和分析社区糖尿病管理中患者的血脂控制水平。方法：检测社区规范管理的214例糖尿病患者的血脂4项指标：总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL—C）和低密度脂蛋白胆固醇（LDL—C），并观察不同组别的血脂控制情况。结果：214例患者中，高TC为40．1％、高TG为48．1％、低HDL—C为10．3％、高LDL-C为17．5％，血TG、HDL—C、LDL-C的达标率分别51．9％、60．3％、29．9％，三项全部达标率11．2％。结论：社区糖尿病管理中血脂达标率低，在综合管理中应加强血脂检测并评估危险因素；加强医患教育，改善依从性；合理选择降脂药物，减少并发症。     

高血压中医证型与血脂、血尿酸关系研究

目的探讨高血压中医证型与血脂、血尿酸关系。方法收集高血压患者118例,进行中医辨证分型。另选同期健康体检者20例作对照组。检测两组总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）、高密度脂蛋白胆固醇（HDL-C）、甘油三酯（TG）、血尿酸（SUA）。比较高血压各证型组及对照组血脂、血尿酸水平及异常率。结果高血压阴虚阳亢证和高血压痰湿壅盛证血脂、SUA异常者均高于对照组（P〈0．05）且SUA异常者低于高血压阴阳两虚证（P〈0．05）。阴虚阳亢证、痰湿壅盛证、肝火亢盛证TC高于对照组（P〈0．01）;痰湿壅盛证型的TG高于阴虚阳亢证型（P〈0．05）;高血压阴阳两虚证型的HDL．C低于对照组及高血压其他各证型（P〈0．05或〈0．01）,高血压阴阳两虚证型SUA高于对照组其他组及高血压其他各证型对照组（P〈0．01）。结论高血压患者TG升高与痰湿壅盛证有关,可作为高血压痰湿壅盛证的参考指标。HDL—C下降、SUA升高与阴阳两虚有关,可作为阴阳两虚证的参考指标。．     

低密度脂蛋白／载脂蛋白B在他汀类药物治疗冠心病中的监测作用

目的探索他汀类药物治疗稳定型冠状动脉粥样硬化性心脏病（简称冠心病）患者低密度脂蛋白的基本特征和低密度脂蛋白／载脂蛋白B（LDL—c／apoB）的作用。方法选取2008年11月至2011年4月在医院他汀类药物治疗的男性冠心病患者（试验组）和非冠心病患者（对照组）各107例,检测血清总胆固醇（TC）、高密度脂蛋白胆固醇（HDL—C）、高敏c反应蛋白（hs—CRP）、甘油三酯（TG）和印oB,计算LDL-C和血清非高密度脂蛋白胆固醇（non—HDL—C）。结果试验组（n=107）的LDL—C／apoB比值显着低于对照组（n=107）（中位数,1．16与1．18,P=O．01）。血清TG≥150mg／dL组LDL—C／apoB明显低于血清TG〈150mg／dL组（P=0．012）,血清HDL—C〈40mg／dL组的LDL—C／apoB明显低于血清HDL-C≥40mg／dL组（P=0．002）。Logistic回归分析显示,在所有研究对象中升高的血清TG是小颗粒低密度脂蛋白的独立预测因素（β=-0．154,P=0．02）。在LDL～C〈100mg／dL组中,升高的血清TG也是小颗粒低密度脂蛋白的独立预测因素（β=--0．243,P=0．012）。结论血清LDL—C水平和低密度脂蛋白的定性特征可用于监测冠心病二级预防的效果。由于高TG水平与小颗粒低密度脂蛋白相关,对于血清TG水平升高的患者尤其适合。     

冠心病患者超敏C-反应蛋白检测分析

目的探讨超敏C-反应蛋白（hs—CRP）与冠心病的关系。方法测定冠心病患者（冠心病组）和健康体检者（对照组）的TC、TG、HDL-C、LDL-C、TC／HDL—C和hs—CRP,对比检测结果。结果与正常对照组比较,冠心病患者血清hs．CRP和TC、TG、LDL—C水平显著增高（P〈0．01,P〈0．05）,而HDL—C水平显著降低（P〉0．01）。结论hs—CRP是已知冠心病患者未来心血管病发病和死亡的预测指标。     

慢性胆囊炎患者血糖、血脂及血液流变学的变化

目的了解慢性胆囊炎患者血糖、血脂、血液流变学变化及其相关性。方法慢性胆囊炎组（n=30）：为初诊的慢性胆囊炎患者，经B超检查均有胆囊结石。无糖尿病、心脑血管病、肾脏疾病和消化系统疾病的人员作为正常对照组（11：30）。上述两组在晨间测定血糖、血脂水平及血液流变学指标，并对血脂和血液流变学指标之间的相关性进行检验。结果慢性胆囊炎组餐后2小时血糖（2h—PPG）、甘油三酯（TG）、总胆固醇（Tch）、低密度脂蛋白胆固醇（LDL-C）、极低密度脂蛋白胆固醇（VLDL—C）、高切变率（150S^-1）下全血粘度及血浆粘度均显著高于正常对照组（P〈0．01）；慢性胆囊炎组高密度脂蛋白胆固醇（HDL-C）及红细胞变形指数均显著低于正常对照组（P〈0．01）。慢性胆囊炎患者Tch、LDL—C水平与高切变率下全血粘度呈显著正相关（r分别为0．521，0．512，P〈O．01）；与红细胞变形指数呈显著负相关（r分别为-0．513，～0．520．P〈0．01）；血TG、VLDL与血浆粘度呈显著正相关（r分别为0．481，0．472，P〈0．01）。结论慢性胆囊炎患者存在血糖、血脂及血液流变学异常；血胆固醇水平增高影响红细胞变形性；血TG水平增高影响血浆粘度。     

冠心病患者外周血血脂和载脂蛋白水平的研究

目的：探讨冠心病患者外周血脂和载脂蛋白的表达水平及其临床意义。方法：采集76例冠心病患者外周血,检测其总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL—C）、高密度脂蛋白胆固醇（HDL—C）和载脂蛋白A1（apo-A1）、载脂蛋白B（apoB）的水平：另入选58例年龄、性别匹配的健康体检者作为对照组。结果：与对照组相比,冠心病患者外周血TG、TC、LDL—C、apoB升高,而HDL—C、apo—A1水平下降,差异均有统计学意义（P〈0．05）。其中心肌梗死患者TG、TC、LDL—C、apoB水平低于心绞痛患者。HDL—C、apo—A1高于心绞痛患者,差异均有统计学意义（P〈0．05）。单支病变组TG、TC、LDL—C、apoB水平低于多支病变组,HDL—C、apo—A1高于多支病变组,差异有统计学意义（P〈0．05）。结论：冠心病患者外周血脂和载脂蛋白异常,且与疾病的严重程度相关。     

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.