冠心病患者血清葡萄糖和果糖胺测定的临床应用

目的探讨冠心病患者高血糖和果糖胺之间的关系。方法测定35例冠心病合并糖尿病患者和38例无糖尿病的冠心病患者的血清葡萄糖和果糖胺浓度。结果冠心病合并糖尿病组及无糖尿病的冠心病组的血糖水平分别为（9.58±1.30）mmol/L、（5.16±0.60）mmol/L,都明显高于正常对照组（4.78±0.55）mmol/L,P〈0.05。冠心病合并糖尿病组果糖胺（280±62）μmol/L,显著高于正常对照组果糖胺（180±35）μmol/L,P〈0.05,糖尿病组与无糖尿病组患者的果糖胺水平比较有显著差异（P〈0.05）,但无糖尿病冠心病组果糖胺水平（180±68）μmol/L与正常对照组比较却无显著差异（P〉0.05）。结论联合检测血糖与果糖胺对冠心病患者血糖增高的原因有鉴别价值。     

腺苷脱氨酶与癌胚抗原检测在胸腔积液诊断中的价值

目的分析腺苷脱氨酶（ADA）与癌胚抗原（CEA）检测在胸腔积液诊断和鉴别诊断中的应用价值。方法对46例自2008年9月～2009年6月我院经治有胸腔积液症状的患者检测胸腔积液和血清ADA、CEA水平,对不同疾病组结果分析比较。结果结核性胸腔积液组ADA为（43.00±13.82）U/L,CEA的含量为（1.25±1.22）μg/L;恶性胸腔积液组A-DA为（17.57±6.20）U/L,CEA为（293.74±197.50）μg/L。结核性胸腔积液组ADA含量较恶性胸腔积液组明显增高（P〈0.01）,恶性胸腔积液组CEA含量较结核性胸腔积液组明显增高（P〈0.01）。胸腔积液ADA（pADA）/血清ADA（sADA）及胸腔积液CEA（pCEA）/血清CEA（sCEA）比值,结核性胸腔积液组（2.69±0.83、1.05±0.89）与恶性胸腔积液组（0.87±0.22、9.47±5.91）相比有显著性差异（P〈0.01）,pADA及pCEA判断结核性胸腔积液的临界值分别为：39U/L、pCEA〈5μg/L,恶性胸腔积液的敏感性为95%、特异性为99.8%。结论胸腔积液腺苷脱氨酶与癌胚抗原测定对结核性胸腔积液和恶性胸腔积液的诊断具有重要价值。     

C-反应蛋白与急性脑梗死相关性研究分析

目的研究血清中C-反应蛋白（CRP）水平与急性脑梗死的关系。方法测定110例急性脑梗死患者和96例健康对照者血清CRP含量,并根据梗死灶面积大小分组,分析各组与CRP水平的相关性。结果急性脑梗死患者平均CRP浓度为（11.2±2.38）mg/L,而对照组为（2.32±0.84）mg/L,两组比较有显著性差异（P〈0.05）。小梗死灶组平均CRP浓度为（4.70±1.52）mg/L,中梗死灶组平均CRP浓度为（9.21±2.23）mg/L,与小梗死灶组比较,有显著性差异（P〈0.05）,大梗死灶组平均CRP浓度为（17.46±3.68）mg/L,与小梗死灶组及中梗死灶组比较,有显著性差异（P〈0.05）。结论血清CRP水平增高与脑梗死的发生和严重程度有密切关系。     

心理干预加文拉法星治疗冠状动脉支架植入术后患者负性情绪的临床研究

目的探讨心理干预加文拉法星治疗在冠状动脉支架植入术后抑郁障碍患者中的作用。方法将符合诊断标准的冠状动脉支架植入术后患者随机分为研究组（A组）和对照组（B组）,并用焦虑自评量表（SAS）、抑郁自评量表（SDS）进行焦虑抑郁水平测定,进行不同时段和2组间比较。结果心理行为干预及药物治疗前A组,SAS、SDS分别为63±7、64±6,B组为63±8,65±7,2组对比差异无统计学意义（P〉0.05）。心理行为干预及药物治疗后,A组术后8h、1、3、5周SAS评分分别为63±7、52±5、48±6、44±4;SDS分别为64±6、57±6、48±6、45±5,1、3、5周SAS和SDS与B组对比差异有统计学意义（P〈0.05）。结论对冠状动脉支架植入术后抑郁障碍患者,治疗给予常规用药的同时,积极应用抗抑郁治疗加心理干预能明显改善患者负性情绪,提高患者生活质量。     

辛伐他汀和普伐他汀对急性冠状动脉综合征患者血脂及C反应蛋白的影啦

目的观察辛伐他汀一日40mg强化降脂治疗与普伐他汀一日20mg常规治疗对急性冠状动脉综合征（ACS）患者血脂及c反应蛋白（CRP）水平的影响。方法选择我院2006年1月-2007年6月ACS住院患者96例，随机分为普伐他汀组（n=46）和辛伐他汀组（n=50），晚间一日1次口服普伐他汀20mg或辛伐他汀40mg，疗程4周，测定患者治疗前及治疗后血脂及CRP水平，同时观察药物不良反应。结果治疗前两组总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL．C）、高密度脂蛋白胆固醇（HDL—C）及CRP水平分别为（5．02±0．85）mmol／L、（1．74±1．52）mmol／L、（2．63±0．36）mmol／L、（1．19±0．05）mmol／L、（12．49±9．02）mg／L和（4．90±1125）mmol／L、（1．64±1.29）mmol／L、（2．62±0．47）mmol／L、（0．95±0．05）mmol／L、（12．67±17．97）mg／L，组间相比无显著差异（P〉0．05）。治疗后两组上述指标分别为（4．50±0．89）mmol／L、（1．55±0．28）mmol／L、（2．36±0．39）mmol／L、（1．12±0．06）mmol／L、（3．11±9．33）mg/L和（4．11＋050）mmol／L、（1．45±0．22）mmol／L、（2．04±0．24）mmol／L、（0．94±0．09）mmol／L、（1．70±1．42）mg／L，其中TC、LDL—C和CRP水平均较治疗前显著下降，且辛伐他汀组与普伐他汀组相比，前者TC、LDL—C和CRP水平下降更为显著（P〈0．05）。两组患者均未出现非可逆性严重不良反应。结论与普伐他汀一日20mg相比，辛伐他汀一日40mg强化降脂治疗不仅能显著降低TC和LDL—C，而且能显著降低CRP，从而使ACS患者获益更多。     

利多卡因-氯胺酮合剂静脉麻醉用于小儿斜视手术的临床观察

目的探讨利多卡因-氯胺酮合剂（以下简称利氯合剂）静脉麻醉在小儿眼科斜视手术中的应用效果。方法择期手术患儿60例随机分为3组：氯胺酮肌注＋静脉麻醉组（A组）、氯胺酮静脉麻醉组（B组）和利氯合剂静脉麻醉组（C组）。记录并比较各组在麻醉前、诱导后、手术开始及术毕时循环功能和呼吸功能变化以及氯胺酮用量、术后苏醒时间和并发症。结果各组的苏醒时间分别为（24.2±5.8）min、（16.8±4.2）min及（10.3±4.6）min,和A组比较,B、C组的苏醒时间明显缩短（P〈0.05）;和B组比较,C组的苏醒时间明显缩短（P〈0.05）。离开恢复室时间分别（39.7±4.3）min、（24.1±3.6）min及（15.6±3.2）min,和A组比较,B、C组的离开恢复室时间明显减少（P〈0.05）;和B组比较,C组的离开恢复室时间明显减少（P〈0.05）。氯胺酮用量各组分别为（8.44±0.62）mg/kg、（5.48±0.84）mg/kg及（3.52±0.46）mg/kg,C组显著少于A组和B组（P〈0.05）。结论在小儿斜视手术麻醉中,利氯合剂静脉麻醉效果优于单用氯胺酮麻醉。     

硫普罗宁联合复方甘草甜素治疗酒精性肝病的疗效

目的：探讨硫普罗宁联合复方甘草甜素对中重度酒精性肝病的疗效。方法：将46例酒精性肝病患者随机分为两组，每组23例。治疗组采用硫普罗宁200mg和复方甘草甜素注射液40ml静脉滴注，对照组采用谷胱甘肽1．2g静脉滴注。治疗前后分别检测两组血清总胆红素（TBil）、丙氨酸氨基转移酶（ALT）和门冬氨酸氨基转移酶（AST），并对照两组疗效。结果：治疗后治疗组血清TBil、ALT和AST均值明显低于对照组（37．85±19．68vs．68．33±13．07μmol·L^-1，P〈0．01；56．33±14．78vs．89．38±35．67μ·L^-1，P〈0．01：79．76±24．65vs．121．32±23．44．μ·L^-1，P〈0．01）。治疗组的总有效率明显高于对照组（P〈0．05）。结论：硫普罗宁联合复方甘草甜素可明显改善酒精性肝病患者肝功能，使总有效率明显提高。     

灯盏花素分散片人体生物等效性研究

目的：以灯盏花素普通片为对照,研究灯盏花素分散片在健康人体内的相对生物利用度和生物等效性。方法：20名健康成年男性志愿者采用随机分组、自身交叉对照试验设计,用LC-MS法测定血浆中灯盏乙素苷元,线性范围为0.013~3.32μg.mL-1;平均回收率89.7%-100.5%,日内和日间精密度均小于12.0%。结果：灯盏花素分散片和普通片的主要药动学参数：tmax：（7.1±2.2）h和（6.6±1.9）h;Cmax：（0.87±0.37）mg.L-1和（1.0±0.44）mg.L-1;AUC（0-24h）：（4.68±1.53）mg·h·L^-1和（5.08±1.50）mg·h·L^-1;AUC（0-∞）：（4.78±1.55）mg·h·L^-1和（5.18±1.54）mg·h·L^-1.h;t1/2：（4.36±2.07）h和（4.09±1.35）h。以AUC（0-24h）计算的受试制剂的相对生物利用度为（93.1±16.9）%。结论：两种制剂的Cmax和AUC（0-24h）经方差分析和双单侧t检验其结果生物等效。     

丹参与心肌缺血预适应"第二窗口"保护的实验研究

目的研究中药丹参对心肌缺血再灌注（IR）损伤兔心肌的保护机制。方法新西兰大耳兔兔40只随机分成四组,假手术组、IR组、IP组、IR＋中药组,每组10只;各组动物麻醉后接动物呼吸机,胸正中切口开胸,冠状动脉第二角支穿线并结扎,假手术组只穿线不结扎;IR组建立模型后,心肌缺血45min,再灌注24h;IP组建立模型,先心肌缺血5min,再灌注5min。重复3次;中药组术前按生药3g/Kg灌胃法灌服水煎液,共10d后操作同IR组。24h后麻醉处死动物,采用NBT染色、称重法检测心肌梗死范围,光镜观察病理心肌损伤程度。结果对照组、中药组、IP组与IR组心肌梗死范围指标：心肌缺血量/全心重量、心肌缺血量/心室重量三组数值为（0、0;0.159±0.022、0.192±0.019;0.161±0.098、0.201±0.012;0.227±0.037、0.268±0.049）;统计学分析,对照组与其他三组有明显差异（P〈0.01）,中药组、IP组与IR组有明显差异（P〈0.01）,中药组与IP组比较差异无显著性（P〉0.05）;心肌损伤程度（0级;0.56±0.12级;0.52±0.14级;1.57±0.36级）,统计学分析对照组与其他三组有明显差异（P〈0.01）,中药组、IP组与IR组有明显差异（P〈0.05）,中药组与IP组比较差异无显著性（P〉0.05）。结论丹参和IP均可以减少心肌梗死范围,减轻心肌损伤程度,且功效相近,其保护作用可能为通过IP保护机制而实现。     

早期微创腹腔置管灌洗治疗重症急性胰腺炎46例分析

目的探讨早期微创腹腔置管灌洗治疗重症急性胰腺炎（SAP）的临床疗效。方法采用微创的方法,对46例SAP患者采用腹腔置管灌洗,同时给予生长抑素、抑酸、抗感染、保持水电解质及酸碱平衡等综合治疗,比较腹腔灌洗前,灌洗24、48、72h后腹水、血清淀粉酶、APACHEII评分、血清肿瘤坏死因子-α（TNF-α）和白细胞介素-8（IL-8）水平。结果46例患者经过腹腔灌洗后病情均有不同程度的好转;腹水淀粉酶从灌洗治疗前的（2057．6±91．7）u／L降至灌注72h后（261．6±26．9）u／k,A-PACHEⅡ分值从灌注前的（13．1±2．9）分降至灌洗治疗72h后的（4．3±1．4）分（P〈0．01）。血清淀粉酶、血清TNF-α和IL-8腹腔灌洗治疗前分别为：（3775．4±447．2）u／L、（1187．6±203．6）ng／L、（345．3±72．4）ng／L;灌洗治疗后72h分别为（988．6±201．7）u／L、（415．9±67．4）ng／L、（194．1±60．5）ng／L。治疗前后相比差异有统计学意义（P〈0．01）。结论早期微创腹腔置管灌洗简单易行、创伤小、疗效佳,是治疗SAP行之有效的方法之一。     

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.