利培酮合并氟西汀对无精神病性症状抑郁症的疗效比较

目的 观察利培酮合并氟西汀对无精神病性症状抑郁症的疗效和安全性.方法 147例无精神病性症状抑郁症患者随机分为研究组(利培酮 氟西汀)72例、对照组(氟西汀)75例,治疗8wk.于治疗前、治疗后每2 wk测评汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、治疗中需处理的不良反应量表(TESS).疗效评价以HAMD减分率为标准,不良反应以TESS评分为标准.结果 2组HAMD、HAMA评分组间比较从wk2末开始差异有统计学意义(P＜0.05),2组疗效比较差异有统计学意义(P＜0.05),各时期TESS评分组间比较差异无统计学意义(P＞0.05).结论 利培酮合并氟西汀治疗无精神病性症状抑郁症的疗效和安全性较好.     

自制解郁汤联合氟西汀治疗抑郁症效果观察

目的 观察自制解郁汤联合氟西汀治疗抑郁症的效果.方法 84例抑郁症随机分为观察组和对照组各42例,对照组采用氟西汀治疗,观察组在对照组基础上联合自制解郁汤治疗,两组疗程均为8周,采用汉密尔顿抑郁量表(HAMD)评定临床疗效,应用治疗意外症状量表(TESS)评定不良反应,随访3年观察复发率.结果 观察组痊愈率和总有效率均高于对照组,治疗8周末两组HAMD评分均低于治疗前,观察组治疗后2、4、6、8周末HAMD评分均低于对照组(P<0.01,P<0.05).对照组发生不良反应53例次,观察组仅发生12例次.随访3年,观察组复发率低于对照组,差异有统计学意义(P<0.05).结论 自制解郁汤联合氟西汀治疗抑郁症效果好、复发率低.     

疏肝解郁汤联合氟西汀治疗抑郁症的临床疗效观察

目的 观察疏肝解郁汤联合氟西汀治疗抑郁症的临床疗效.方法 将纳入的70例患者随机分为疏肝解郁汤联合氟西汀组(35例),氟西汀组(35例),两组分别于治疗前及治疗第1、2、4、8周末用汉密尔顿抑郁量表(HAMD)、临床疗效总评(CGI)评定疗效,并记录不良反应,疗程8周.结果 治疗结束后,两组HAMD、CGI评分较治疗前均有明显下降(P<0.05);在治疗第4周、第8周后,疏肝解郁汤联合氟西汀组HAMD评分较氟西汀组显著改善,差异有统计学意义(P<0.05);疏肝解郁汤联合氟西汀组有效率(80.0%)显著优于氟西汀组(62.9%)(P<0.05).结论 疏肝解郁汤联合氟西汀组治疗抑郁症,可以增强抗抑郁疗效,减轻不良反应,安全有效.     

瑞波西汀与氟西汀治疗抑郁症随机双盲多中心临床研究

目的:评价瑞波西汀治疗抑郁症的疗效和安全性。方法:采用随机、双盲双模拟、氟西汀平行对照、剂量固定的多中心研究。受试者分别口服瑞波西汀胶囊8mg·d-1或氟西汀片20mg·d-1。采用汉密尔顿抑郁量表(HAMD)总分减分值作为主要疗效指标,以临床总体印象量表(CGI)和汉密尔顿焦虑量表(HAMA)评分作为次要疗效指标;采用药物不良反应量表(TESS)、实验室检查、生命体征等观察药物安全性。结果:共收集符合意向治疗抑郁症病人(ITT)222例,瑞波西汀组(试验组)109例,氟西汀组(对照组)113例。符合研究方案病人(PP)213例,瑞波西汀组104例,氟西汀组109例。治疗6wk后,瑞波西汀组HAMD总分减分值为(16±s7)分,氟西汀组为(16±7)分,与治疗基线相比差异均有非常显著意义(P<0.01),但2组相比差异无显著意义(P>0.05);瑞波西汀组有效率(HAMD减分率≥50%)为81.7%,氟西汀组为77.9%,2组相比差异无显著意义(P>0.05);瑞波西汀组临床治愈率(HAMD总分≤8)为62.4%,氟西汀组为58.4%,2组差异无显著意义(P>0.05);在CGI,HAMA评分上,2组差异亦无显著意义。安全性分析显示,2组不良反应的症状和发生率相比差异均无显著意义。结论:瑞波西汀治疗抑郁症安全有效。     

利培酮联合氟西汀对焦虑抑郁共病患者的治序观察

目的 观察利培酮联合氟西汀对焦虑抑郁共病的疗效和安全性.方法 71例焦虑抑郁共病患者随机分为研究组(利培酮+氟西汀)38例、对照组(氟西汀)33例,治疗8周.于治疗前、治疗后每2周测评汉密尔顿抑郁量表(HAMD)24项、汉密尔顿焦虑量表(HAMA)、治疗中需处理的不良反应量表(TESS).疗效评价以HAMD减分率为标准,不良反应以TESS评分为标准.结果 两组HAMD、HAMA评分组间比较从第2周末开始差异有统计学意义(P＜0.05、P＜0.01),两组疗效比较差异有统计学意义(P＜0.05),各时期TESS评分比较差异无统计学意义(P＞0.05).结论 利培酮联合氟西汀治疗焦虑抑郁共病的疗效和安全性较好.     

自拟解郁汤联合氟西汀治疗抑郁症临床疗效观察

目的观察自拟解郁汤联合氟西汀治疗抑郁症的临床疗效。方法选择抑郁症患者68例,随机分为观察组34例和对照组34例,两组患者性别、年龄、病程、辨证分型等临床资料差异均无统计学意义,具有可比性。对照组仅给予基础治疗（包括对症给予心理治疗;口服盐酸氟西汀胶囊）,观察组在此基础上加用自拟解郁汤进行辨证加减治疗,疗程均为4周。结果治疗后两组HAMD评分均有显著下降,和治疗前比较差异均有显著统计学意义（P〈0.01）。观察组治疗后第1、2、4、周末HAMD评分均低于对照组,差异均有统计学意义（P〉0.05）。临床疗效：观察组总有效率94.1%;对照组总有效率73.5%,两组比较差异有统计学意义（P〉0.05）。结论自拟解郁汤加氟西汀治疗抑郁症能明显增强疗效,不良反应较小,安全性好,服用方便,且经济性高,可在临床推广使用。     

瑞波西汀片治疗抑郁症的多中心随机双盲临床研究

目的评价甲磺酸瑞波西汀(抗抑郁药)治疗抑郁症的有效性和安全性以及对伴焦虑症状抑郁症的疗效。方法采取多中心、随机、双盲双模拟、阳性药平行对照、剂量固定的研究方法,对212例抑郁症患者分别进行甲磺酸瑞波西汀(试验组105例)和盐酸氟西汀(对照组107例)治疗,观察疗程均为6周;以汉密尔顿抑郁量表(HAMD)作为主要疗效评价指标,以HAMA评分的变化评价治疗抑郁症伴焦虑症状的疗效;采用不良事件记录、实验室检查、生命体征等评价药物安全性。结果治疗6周末,2组HAMD总分减分值(15.91 vs 15.93)、HAMD总分减分率和治疗有效率差异均无统计学意义(P>0.05);2组HAMA总减分值差异无统计学意义(P>0.05)。2组药物不良反应发生率(20.56%vs 28.57%)差异无统计学意义(P>0.05)。结论甲磺酸瑞波西汀与盐酸氟西汀相似,是一种安全有效的新型抗抑郁药。     

瑞波西汀治疗抑郁伴随焦虑症状的临床疗效

目的评价瑞波西汀治疗抑郁症伴随焦虑症状的有效性。方法采用随机、双盲、双模拟、氟西汀平行对照、多中心临床研究的方法。入组汉密尔顿抑郁量表(HAMD)17项≥18分且汉密尔顿焦虑量表(HAMA)≥14分的抑郁伴焦虑患者共137例(意向性治疗数据集,ITT集),分为试验组67例和对照组70例;完成试验132例(符合方案数据集,PP集),试验组64例,对照组68例。试验组每天服瑞波西汀8 mg,对照组每天服氟西汀20 mg。治疗时间为6 wk,在基线及治疗1、2、46、wk时评定HAMA、HAMD量表。结果根据PP集,治疗6 wk后,试验组和对照组HAMA减分值分别为(16.25±6.16)和(14.29±7.45)(P<0.05);治疗6 wk后,2组HAMD总分及因子分值变化在2组间无明显差异;2组不良反应无明显差异。结论瑞波西汀治疗抑郁伴随焦虑症状的作用有一定的优势;患者对瑞波西汀的耐受性好。     

黄精联合氟西汀治疗抑郁症的临床疗效观察

目的 观察黄精联合氟西汀治疗抑郁症的疗效.方法 将60例患者随机分为两组,试验组(黄精颗粒联合氟西汀组)30例,对照组(氟西汀组)30例.疗程6周,于治疗前及治疗第2、4、6周末分别用汉密尔顿抑郁量表(HAMD)评定疗效,并记录不良反应.结果 (1)治疗结束后,两组HAMD评分较治疗前均有明显下降(P＜0.01);(2)在治疗第2周和第4周后,试验组的HAMD评分较对照组显著改善,差异有统计学意义(P＜0.05),试验组的有效性略高于氟西汀组,且起效较快;(3)治疗6周后,两组组间HAMD评分比较,差异无统计学意义(P＞0.05),两组长期治疗效果相当;(4)试验组比对照组的不良反应较少.结论 黄精颗粒联合氟西治疗抑郁症,不但可以增强后者的抗抑郁疗效,还可以减轻不良反应,疗效肯定,安全有效.     

氟哌噻吨/美利曲辛联合盐酸氟西汀治疗抑郁症的临床分析

目的 探讨氟哌噻吨/美利曲辛(黛力新)联合盐酸氟西汀胶囊(百忧解)治疗抑郁症的疗效.方法 将符合CCMD-3抑郁症诊断标准的患者60例数按字表格法分成单用组和联合组,每组30例.分别用单用盐酸氟西汀和氟哌噻吨/美利曲辛联合盐酸氟西汀治疗6周,采用HAMD、HAMA评定疗效,用TESS评定不良反应.结果 两组治疗第1周末的HAMD、HAMA的减分率[(45.6±6.6)％和(26.1±6.2)％,(26.8±3.5)％和(22.5±4.6)％]差异均有统计学意义(均P ＜0.05),在治疗6周末两组间的减分率[(76.6±6.5)％和(76.2±4.9)％,(66.8±8.4)％和(67.1±5.3)％]差异均无统计学意义(均P＞0.05).两组不良反应差异无统计学意义(P＞0.05).结论 氟哌噻吨/美利曲辛联合盐酸氟西汀胶囊治疗抑郁症起效快.     

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.     

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.