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1.
夏训和  阮丹燕  程运涛 《安徽医药》2017,38(10):1343-1345
目的 研究血清多配体蛋白聚糖4(SDC4)、正五聚体蛋白-3(PTX-3)及脑钠肽(BNP)在诊断慢性心力衰竭(CHF)中的临床价值及其与心脏结构和功能的相关性。方法 选取上海市金山区亭林医院2015年8月至2017年3月收治的CHF患者172例。其中,美国纽约心脏病协会(NYHA)分级Ⅱ级51例、Ⅲ级63例、IV级58例。选择同期体检的健康人群60例作为对照组。采用超声心动图测定心脏功能和结构指标,同时检测血清SDC4、PTX-3、BNP水平,采用Pearson分析各指标与左室射血分数(LVEF)、左室舒张末期内径(LVEDD)及NYHA分级的相关性。结果 CHF组患者的血清SDC4、PTX-3、BNP水平均高于对照组,差异有统计学意义(P<0.05)。随着CHF患者的NYHA分级升高,血清SDC4、PTX-3、BNP水平和LVEDD均升高,LVEF均降低,差异均有统计学意义(P<0.05)。血清SDC4、PTX-3、BNP与LVEF呈负相关(r=-4.063、-4.438、-4.917,P<0.05),与LVEDD和NYHA分级呈正相关(r=5.907、4.855、5.426、0.812、0.694、0.783,P<0.05)。结论 SDC4、PTX-3、BNP水平可判断CHF发生,对评估患者病情及预后有意义。  相似文献   

2.
目的 探讨高血压合并心力衰竭(HF)患者血尿酸(SUA)水平与HF病情及预后的关系。方法 选取2015年1月至2018年1月周口市中心医院诊断为高血压合并HF患者52例为HF组[并按心功能分级分为Ⅱ级组(18例)、Ⅲ级组(21例)、Ⅳ级组(13例)],选取同期年龄、性别相匹配的门诊就诊单纯高血压患者65例和体检中心体检正常者50例分别为单纯高血压组、对照组。比较3组对象入院时SUA水平、左室射血分数(LVEF),并分析HF组患者SUA、LEVF值与入院时心功能分级的关系;HF组患者出院后随访6个月,记录其终点事件(终点事件发生组)发生情况,比较终点事件发生组和未发生组入院时SUA水平、LVEF差异,非条件logistic回归分析入院时SUA、LVEF与高血压合并HF的患者预后的关系。结果 HF组入院时,SUA高于单纯高血压组、对照组,LVEF低于单纯高血压组、对照组(P<0.05),单纯高血压组与对照组SUA、LVEF比较,差异有统计学意义(P<0.05);心功能分级Ⅱ级组患者入院时SUA水平低于Ⅲ、Ⅳ级组,LVEF高于Ⅲ、Ⅳ级组(P<0.05),Ⅲ级组与Ⅳ级组SUA、LVEF比较,差异有统计学意义(P<0.05)。Spearman相关分析显示,入院时SUA与LVEF呈负相关关系(r=-0.512,P<0.05);心功能分级与入院时SUA呈正相关关系(r=0.631,P<0.05),与入院时LVEF呈负相关关系(r=-0.792,P<0.05)。终点事件发生组入院时SUA高于未发生组,入院时LEVF低于未发生组(P<0.05);logistic回归分析发现,入院时SUA、LEVF是高血压合并HF患者近期终点事件发生的独立危险因素。结论 高血压合并HF患者入院时SUA水平与心功能分级有关,且SUA水平升高是影响预后的独立危险因素。  相似文献   

3.
目的 探讨沙库巴曲缬沙坦钠联合环磷腺苷葡胺治疗左心室射血分数(LVEF)≤40%慢性心力衰竭(CHF)的临床疗效。方法 选取2020年1月—2020年12月福建医科大学附属南平市第一医院治疗的127例LVEF≤40%的慢性心力衰竭患者作为研究对象,根据治疗方法将患者分为对照组(n=63)和观察组(n=64)。对照组患者静脉滴注注射用环磷腺苷葡胺,60 mg/次,1次/d。观察组在对照组的基础上口服沙库巴曲缬沙坦钠片,50 mg/次,2次/d。两组均治疗15 d后观察疗效。比较两组治疗前后的心率变异性[全部窦性心搏RR间期的标准差(SDNN)、RR间期平均值标准差(SDANN)、相邻NN之差>50 ms的个数占总窦性心搏个数的百分比(PNN50)]、心脏功能指标[LVEF、6 min步行距离(6MWD)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)]及血清胱抑素(CysC)、miR-451a、脑钠肽(BNP)水平。统计主要不良心脏事件(MACE)发生率。结果 治疗后,观察组治疗总有效率87.50%,显著高于对照组的71.43%(P<0.05)。治疗后,两组SDANN、SDNN、PNN50均显著升高(P<0.05),且观察组SDANN、SDNN、PNN50高于对照组(P<0.05)。治疗后,两组LVEF和6MWD均显著升高,LVESV和LVEDV显著降低(P<0.05);且观察组心功能指标显著优于对照组(P<0.05)。治疗后,两组血清CysC、BNP水平均显著降低,miR-451a表达显著升高(P<0.05);治疗后,观察组血清CysC、BNP水平及miR-451a表达情况显著优于对照组(P<0.05)。治疗后随访3个月,两组MACE发生率比较,差异无统计学意义。结论 环磷腺苷葡胺与沙库巴曲缬沙坦钠片联合治疗LVEF≤40%慢性心力衰竭患者疗效确切,能有效控制心率变异性,改善心功能,抑制心室重构,延缓心力衰竭进展,具有一定的临床推广价值。  相似文献   

4.
目的 探讨注射用益气复脉(冻干)联合重组人脑利钠肽治疗心房颤动伴慢性心力衰竭患者的临床疗效。方法 回顾性收集2018年9月—2020月12月在贵州医科大学附属乌当医院心血管内科住院的房颤伴慢性心衰患者203例为研究对象,按治疗方法不同将患者分为对照组(n=97)和联合组(n=106)。所有入组的患者均进行常规的抗心衰治疗。对照组患者在常规治疗的基础上给予注射用重组人脑利钠肽,首次给药剂量为0.15 μg/kg、iv给药,后以0.075 μg/(kg·min)的速度,持续静脉泵入72 h。联合组在对照组治疗的基础上加用注射用益气复脉(冻干)5.2 g药液溶至5%葡萄糖注射液250 mL中,静脉滴注,1次/d,连续治疗14 d。治疗1个月后对两组患者进行疗效评价及脑利钠肽(BNP)、左室射血分数(LVEF)、6分钟步行试验(6MWT)检测。结果 联合组的临床治疗总有效率为81.1%,明显高于对照组的67.0%(P<0.05)。治疗前两组患者BNP、LVEF、6MWT差异无统计学意义(P>0.05),经治疗后各组上述指标与治疗前比差异有统计学意义(P<0.05)。治疗后联合组BNP下降更为明显(P<0.05),LVEF升高更明显(P<0.05),6WMT增加更明显(P<0.05)。结论 注射用益气复脉(冻干)联合重组人脑利钠肽治疗心房颤动伴慢性心力衰竭患者可明显提高患者临床总有效率,对患者LVEF、6MWT及BNP有明显的改善作用。  相似文献   

5.
目的 探讨阿托伐他汀对慢性心衰患者NT-proBNP水平及氧化应激状态的影响。方法 选择2015年9月—2017年2月非缺血性心脏病慢性心衰患者102例,将所有患者随机分为对照组(n=51)和阿托伐他汀组(n=51)。对照组实施常规抗心衰药物治疗,阿托伐他汀组在常规抗心衰治疗基础上加用阿托伐他汀治疗,20 mg/d。两组疗程均为24周。观察并比较两组治疗前后三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、NYHA分级、左室射血分数(LVEF)、NT-proBNP、6 min步行距离(6MWT)、超氧化物歧化酶(SOD)、髓过氧化物酶(MPO)、丙二醛(MDA)等指标。结果 阿托伐他汀组治疗后TG、TC、LDL-C水平明显下降,与治疗前及对照组比较,差异均有统计学意义(P<0.05)。两组患者治疗后NT-proBNP水平均有明显下降,与治疗前比较,差异有统计学意义(P<0.05),但阿托伐他汀组下降幅度优于对照组,组间比较差异有统计学意义(P<0.05)。与同组治疗前及对照组比较,阿托伐他汀组治疗后SOD明显增高,MDA、MPO明显下降,差异均有统计学意义(P<0.05);而对照组治疗前后无明显变化。结论 在常规抗心衰治疗的基础上加用阿托伐他汀,能有效降低CHF患者的NT-proBNP水平和抑制患者的氧化应激状态。  相似文献   

6.
目的 探讨烧伤脓毒血症患者血清降钙素原(PCT)和血浆凝溶胶蛋白(GSN)水平的变化及意义。方法 选取2008年2月至2013年3月恩施州中心医院烧伤整形科118例严重烧伤患者,分为烧伤脓毒血症组(n=51)和烧伤非脓毒血症组(n=67),选取健康者45例作为对照组,烧伤脓毒血症组患者根据预后,分为死亡组(n=18)和存活组(n=33)。分别于患者入院当天(T1)、第2天(T2)、第4天(T3)、第7天(T4)和第14天(T5),以及对照组体检当天,利用全自动免疫分析仪检测PCT水平,利用酶联免疫吸附试验(ELISA法)检测血浆中GSN含量,利用logistic回归分析血清PCT和血浆GSN水平对患者预后的影响。结果 烧伤脓毒血症组患者T1-4时血清PCT水平均高于烧伤非脓毒血症组和对照组,差异均有统计学意义(P < 0.05);烧伤脓毒血症组患者T2-5时血浆GSN水平均低于烧伤非脓毒血症组,差异均有统计学意义(P < 0.05);烧伤脓毒血症组患者T1-5时血浆GSN水平均低于烧伤非脓毒血症组和对照组,差异均有统计学意义(P < 0.05);死亡组患者T1-5时血清PCT水平均高于存活组,而T1-5时血浆GSN水平均低于存活组,差异均有统计学意义(P < 0.05);Spearman相关分析显示,烧伤脓毒血症组患者血清PCT总体水平与患者预后呈正相关(r=0.437,P < 0.05),而血浆GSN水平与患者预后呈负相关(r=-0.518,P < 0.05);logistic回归分析显示,血清PCT总体平均值和血浆GSN总体平均值均是影响患者预后的独立危险因素(P < 0.05)。结论 烧伤脓毒血症患者血清PCT和血浆GSN水平随病情变化而动态改变,PCT总体水平与患者预后呈正相关,而血浆GSN水平与患者预后呈负相关,可作为早期预测患者病情及预后的指标。  相似文献   

7.
目的 探讨血浆纤维蛋白原水平与原发性高血压患者血压水平的关系,明确原发性高血压患者血压显著升高的危险因素及其相关性。方法 选取2012年9月至2014年12月郑州大学第一附属医院收治的258例原发性高血压患者,按血压控制水平分为正常血压组(68例)、1级高血压组(63例)、2级高血压组(79例)、3级高血压组(48例)。采用Kruskal-Wallis检验及Mann-Whitney U检验比较4组纤维蛋白原血浆水平。采用logistic回归分析筛选促使血压显著升高的影响因素。利用Spearman相关分析纤维蛋白原与这些影响因素的相关性。结果 3级高血压组的血浆纤维蛋白原水平与其他3组比较,差异有统计学意义(P<0.01),而其他3组间纤维蛋白原水平的差异无统计学意义(P>0.05)。logistic回归分析显示,血糖升高(OR=2.746,P=0.004)、胆固醇升高(OR=2.169,P=0.037)、肌酐升高(OR=2.711,P=0.011)以及尿酸升高(OR=2.975,P=0.002)是3级高血压形成的重要危险因素。Spearman相关分析结果显示纤维蛋白原与血糖、胆固醇及尿酸无相关性(P>0.05),仅与血肌酐呈弱相关(r=0.173,P=0.005)。结论 纤维蛋白原水平升高是血压升高的促进因素。血糖、胆固醇、肌酐及尿酸水平的升高对于极高危高血压(3级高血压)的形成有促进作用。  相似文献   

8.
王京  赵莉  赵婷婷 《现代药物与临床》2020,43(11):2250-2253
目的 探讨伊伐布雷定对老年心力衰竭患者心功能、心率变异性及NT-proBNP水平的影响。方法 选择2016年4月—2019年4月延安大学附属医院治疗的老年心力衰竭患者92例作为研究对象,根据入院单双号分为对照组(n=46)和观察组(n=46)。对照组接受常规的标准化抗心衰治疗,观察组在对照组的基础上口服盐酸伊伐布雷定片,初始剂量2.5 mg/次,2次/d,之后根据患者心率调整给药剂量,最大剂量不超过7.5 mg/次,2次/d,控制患者静息心率在55~65次/min,两组均连续治疗2个月。观察两组患者的临床疗效,同时比较两组治疗前后的心功能、心率变异性和N末端B型钠尿肽原(NTproBNP)水平。结果 治疗后,观察组总有效率为93.48%,显著高于对照组的78.26%,两组总有效率比较差异具有统计学意义(P<0.05)。治疗后,两组左心室射血分数(LVEF)、6 min步行距离(6 MWT)均明显升高,左室收缩末期内径(LVESD)和左室舒张末期内径(LVEDD)均显著降低(P<0.05);且观察组心功能指标显著优于对照组(P<0.05)。治疗后两组各心率变异性指标及NT-proBNP水平均明显改善(P<0.05),且观察组各指标显著优于对照组(P<0.05)。结论 伊伐布雷定可有效改善患者的心功能及心率变异性,降低NT-proBNP水平,疗效确切,安全性高,对控制老年心力衰竭患者病情进展有积极意义。  相似文献   

9.
目的 探讨托拉塞米联合乌拉地尔治疗慢性心力衰竭的临床疗效。方法 选取2019年1月—2021年1月在宝鸡高新医院住院治疗的96例慢性心力衰竭患者,随机分为对照组(48例)和治疗组(48例)。对照组静脉滴注乌拉地尔注射液,25 mg加入生理盐水100 mL,1次/d。治疗组患者在对照组的基础上口服托拉塞米片,10 mg/次,1次/d。两组患者连续治疗7 d。观察两组患者临床疗效,比较治疗前后两组患者临床症状缓解时间,心功能指标左室舒张末期内径(LVEDD)、左室射血分数(LVEF)和脑钠肽(BNP)水平,血清炎性因子白细胞介素6(IL-6)、白细胞介素10(IL-10)、肿瘤坏死因子α(TNF-α)和C反应蛋白(CRP)水平及不良反应情况。结果 治疗后,治疗组患者总有效率明显高于对照组(97.92%vs 81.25%,P<0.05)。治疗后,治疗组患者症状缓解时间均早于对照组(P<0.05)。治疗后,两组患者LVEDD、BNP指标明显下降,而LVEF明显升高(P<0.05),且治疗组患者心功能指标水平明显好于对照组(P<0.05)。治疗后,两组患者IL-6、TNF-α、CRP水平明显降低,而IL-10水平明显升高(P<0.05),且治疗组患者炎性因子水平明显好于对照组(P<0.05)。治疗组药物不良反应发生率明显低于对照组(8.33%vs 16.67%,P<0.05)。结论 托拉塞米联合乌拉地尔治疗慢性心力衰竭临床效果较好,能增强患者心功能,并有效抑制炎性因子释放,降低不良反应发生率。  相似文献   

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魏璐璐  吉文伟  黄维平 《安徽医药》2020,41(10):1198-1200
目的 探究分泌性中耳炎(SOM)患者血清与耳积液中白介素8(IL-8)、IL-10、IL-1β水平变化及其临床意义。方法 以南阳市中心医院2017年12月至2018年12月收治的97例SOM患者(观察组)和同期97例健康体检者(对照组)为研究对象,观察组依据病程、临床症状以及检查结果分为急性组(n=30)、亚急性组(n=33)以及慢性组(n=34)等亚组。比较观察组患者血清与耳积液、对照组血清炎症因子水平,观察组各亚组患者血清中、耳积液中炎症因子水平,分析血清及耳积液炎症因子水平与病程的相关性。结果 观察组患者血清中IL-8、IL-10、IL-1β水平高于对照组,差异有统计学意义(P<0.05),观察组患者耳积液中IL-8、IL-10、IL-1β水平高于观察组血清中水平(P<0.05);急性组SOM患者血清与耳积液中IL-8、IL-10、IL-1β水平低于亚急性组和慢性组,亚急性组上述指标水平低于慢性组,差异有统计学意义(P<0.05);SOM患者血清与耳积液中IL-8、IL-10、IL-1β等炎症因子水平与患者病程之间均呈正相关性(r血清=0.856,0.763,0.925;r耳积液=0.776,0.849,0.927;P均<0.05)。结论 SOM患者血清中IL-8、IL-10、IL-1β水平异常上升,而这种异常上升状态在患者耳积液中更显著,炎症因子水平与患者病程关系密切。  相似文献   

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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.
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.
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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.  相似文献   

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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.  相似文献   

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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.  相似文献   

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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.  相似文献   

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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.  相似文献   

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