阿卡波糖和二甲双胍干预治疗糖耐量异常的疗效观察

目的 观察阿卡波糖和二甲双胍干预治疗糖耐量异常的疗效。方法 糖耐量异常患者60例，随机分为2组．30例给予阿卡波糖50～100mg，3次／d，即阿卡波糖组；另30例给予盐酸二甲双胍片250～500mg，3次／d，即二甲双胍组。疗程均为6个月。结果 治疗后2组空腹及餐后2h血糖较治疗前均显著下降（P〈0．05和P〈0．01），但对餐后2h血糖控制阿卡波糖组优于二甲双胍组（P〈0．01）。结论 阿卡波糖能显著控制餐后血糖，疗效优于二甲双胍；且具有调节血脂的作用，故可治疗2型糖尿病，预防心血管疾病的发生。     

阿卡波糖联合二甲双胍治疗2型糖尿病观察

目的:观察二甲双胍与阿卡波糖联合应用治疗2型糖尿病的临床疗效.方法:60名初诊2型糖尿病患者随机分为两组,在饮食运动治疗的基础上,治疗组给予二甲双胍及阿卡波糖联合治疗,对照组予瑞格列奈和二甲双胍治疗.每周查空腹及餐后2h血糖,调整药物用量.结果:2组患者空腹血糖、餐后2h血糖、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、糖化血红蛋白等指标治疗前后有显著差异.治疗后,治疗组总胆固醇、体质量等指标与对照组比较,差异有统计学意义.讨论:二甲双胍联合阿卡波糖治疗糖尿病有良好效果.     

阿卡波糖和二甲双胍治疗2型糖尿病的比较

目的 :比较阿卡波糖和二甲双胍治疗 2型糖尿病的疗效。方法 :选择 6 0例 2型糖尿病病人 ,分为阿卡波糖组 30例 (男 ,女各 15例 )口服阿卡波糖 50～ 10 0mg ,tid。另 30例为二甲双胍组 (男性 16例 ,女性 14例 ) ,口服二甲双胍 2 50～ 50 0mg ,tid ,均用 6wk。结果 :阿卡波糖和二甲双胍均能明显降低空腹和餐后血糖 ,阿卡波糖的有效率分别为 83%和97% ,二甲双胍的有效率分别为 87%和 73%。降低餐后血糖的作用 ,阿卡波糖优于二甲双胍 (P <0 .0 1) ,而降低胆固醇的作用 ,阿卡波糖不如二甲双胍 (P <0 .0 1)。阿卡波糖不良反应为腹胀和排气增多 ,发生率为 17% ;二甲双胍为恶心和腹泻 ,发生率为 13%。结论 :阿卡波糖治疗 2型糖尿病安全有效 ,降低餐后血糖优于二甲双胍     

阿卡波糖与二甲双胍对我国新发2型糖尿病的疗效及对胰岛功能的影响

目的探讨阿卡波糖与二甲双胍对我国新发2型糖尿病的疗效及对胰岛功能的影响。方法以2016年3月~2017年3月中山市古镇人民医院收治的未经药物治疗的新诊断2型糖尿病患者60例为研究对象。随机分为二甲双胍组(n=30)和阿卡波糖组(n=30),分别予以二甲双胍和阿卡波糖治疗。比较两组治疗前后血糖、血脂水平,以及稳态模型β细胞功能指数(HOMA-β)和稳态模型胰岛素抵抗指数(HOMAIR)。结果治疗后,两组患者的空腹血糖、餐后2h血糖、糖化血红蛋白、总胆固醇、甘油三酯、低密度脂蛋白和HOMA-IR均显著降低(P<0.05),胰岛素和HOMA-β均显著升高(P<0.05)。二甲双胍组空腹血糖明显低于阿卡波糖组,而餐后2h血糖明显高于阿卡波糖组,差异均有统计学意义(P<0.05)。两组其他各生化指标比较差异无统计学意义(P>0.05)。结论阿卡波糖对于新发2型糖尿病的疗效与二甲双胍相当,均能有效降低患者血糖、血脂水平,改善胰岛功能。     

阿卡波糖联合参芪降糖胶囊治疗糖耐量减低患者的临床疗效观察

目的观察阿卡波糖联合参芪降糖胶囊治疗糖耐量减低(IGT)的临床疗效。方法将82例糖耐量减低患者随机分为两组,各41例,对照组只用阿卡波糖治疗。观察组在阿卡波糖常规治疗基础上加用参芪降糖胶囊治疗,治疗4个疗程以后测定患者空腹血糖(FPG)及餐后2 h血糖(2h PG)、血脂水平(总胆固醇、三酰甘油)、体质量指数(BMI)、腰臀比(WHR)、空腹胰岛素(FINS)和葡萄糖耐量试验(OGTT)2 h后胰岛素(PINS)等指标。结果两组对空腹血糖、餐后2 h血糖、血脂、体质量指数、腰臀比、空腹胰岛素和葡萄糖耐量试验2 h后胰岛素都有明显的降低作用(P<0.05),且观察组疗效优于对照组。结论阿卡波糖联合参芪降糖胶囊较单用阿卡波糖对治疗IGT更加有效。     

阿卡波糖与瑞格列奈联合二甲双胍治疗2型糖尿病餐后高血糖的效果观察

摘 要 目的：比较阿卡波糖与瑞格列奈分别联合二甲双胍治疗2型糖尿病餐后高血糖的效果。方法: 160例餐后高血糖的糖尿病患者随机分为阿卡波糖组与瑞格列奈组,每组80例。分别给予阿卡波糖联合二甲双胍治疗与瑞格列奈联合二甲双胍治疗8周。比较两组治疗前后血糖、糖化血红蛋白（HbA1c）、胰岛素、血脂与体质指数（BMI）等指标的变化,以及两组药品不良反应发生情况。结果: 治疗后,两组患者空腹血糖（FPG）、餐后2 h血糖（2hPG）及HbA1c水平均较治疗前明显降低（P<0.05）,且瑞格列奈组FPG水平明显低于阿卡波糖组（P<0.05）。治疗后,瑞格列奈组空腹胰岛素、餐后2 h胰岛素水平均较治疗前明显上升（P<0.05）,而阿卡波糖组则较治疗前明显降低（P<0.05）;两组间比较差异有统计学意义（P<0.05）。治疗后,阿卡波糖组三酰甘油、低密度脂蛋白胆固醇水平和BMI均较治疗前明显降低（P<0.05）,而瑞格列奈组上述指标治疗前后比较差异无统计学意义（P＞0.05）;两组间比较差异有统计学意义（P<0.05）。瑞格列奈组药品不良反应发生率明显低于阿卡波糖组（P<0.05）。结论:阿卡波糖与瑞格列奈联合二甲双胍均降低2型糖尿病患者餐后高血糖,瑞格列奈降低FPG作用优于阿卡波糖,而阿卡波糖能使患者餐后胰岛素、血脂及BMI降低,对肥胖患者更为适合。     

阿卡波糖联合二甲双胍治疗初发2型糖尿病伴高脂血症的分析

目的探讨阿卡波糖联合二甲双胍治疗初发2型糖尿病伴高脂血症分析。方法从2017年3月至2018年5月来院接受治疗的初发2型糖尿病伴高脂血症患者中,随机选取102例,102例患者按照随机双盲法分为两组(n=51),所有患者均符合入组标准,医护人员给予对照组患者二甲双胍治疗,给予观察组患者阿卡波糖联合二甲双胍治疗,在实验研究结束后,观察两组患者的餐后2 h血糖值、空腹血糖值。结果观察组患者的空腹血糖为(6.17±2.85)mmol/L、餐后2 h血糖为(7.84±2.81)mmol/L,对照组患者的空腹血糖为(8.53±1.75)mmol/L、餐后2 h血糖为(9.51±2.91)mmol/L,观察组患者的治疗效果明显优于对照组患者,两组患者的实验数据具有统计学意义(P <0.05)。结论针对我院接受治疗的初发2型糖尿病伴高脂血症患者,让其接受阿卡波糖联合二甲双胍治疗,能有效的将患者的餐后2 h血糖以及空腹血糖值控制在合理水平,促进患者疾病的好转,具有临床治疗意义与应用价值。     

阿卡波糖+二甲双胍治疗2型糖尿病伴高脂血症的疗效和安全性分析

目的分析阿卡波糖+二甲双胍治疗2型糖尿病伴高脂血症的疗效和安全性。方法108例2型糖尿病伴高脂血症患者作为研究对象,采用随机数字表法分为对照组和观察组,每组54例。对照组患者接受二甲双胍治疗,观察组患者接受阿卡波糖联合二甲双胍治疗。对比两组患者不良反应发生情况、治疗后血糖(空腹血糖、餐后2 h血糖、糖化血红蛋白)水平、治疗后血脂[血清总胆固醇(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。结果观察组不良反应发生率9.26%高于对照组的7.41%,但比较差异无统计学意义(P>0.05)。观察组患者治疗后的空腹血糖、餐后2 h血糖、糖化血红蛋白分别为(8.75±0.86)mmol/L、(12.55±1.14)mmol/L、(6.86±0.67)%,均低于对照组的(12.87±1.19)mmol/L、(15.29±1.38)mmol/L、(9.00±0.85)%,差异统计学有意义(P<0.05)。观察组患者治疗后的TC、TG、LDL-C分别为(7.09±0.68)、(1.63±0.15)、(3.35±0.31)mmol/L均低于对照组的(8.82±0.87)、(3.14±0.29)、(4.39±0.42)mmol/L,HDL-C(1.55±0.13)mmol/L高于对照组的(1.15±0.10)mmol/L,差异统计学有意义(P<0.05)。结论2型糖尿病伴高脂血症患者接受阿卡波糖联合二甲双胍治疗,能够有效降低其血脂水平和血糖水平,且治疗期间的不良反应较少。     

门冬胰岛素30联合二甲双胍或阿卡波糖对2型糖尿病患者血糖变异的影响及达标状况的比较

目的 观察门冬胰岛素30单用或联合二甲双胍、阿卡波糖对2型糖尿病患者血糖变异的影响及达标状况。方法 患者随机分为3组,分别接受门冬胰岛素30、门冬胰岛素30+二甲双胍(简称二甲双胍组)、门冬胰岛素30+阿卡波糖(简称阿卡波糖组)治疗,保持三餐前和睡前血糖平衡,观察血糖波动指标、达标时间、低血糖事件、胰岛素量及费用。结果 门冬胰岛素30组在晚餐后及2：00血糖高于二甲双胍组及阿卡波糖组;其余时间点血糖差异无统计学意义。治疗后8个时间点血糖标准差、最大血糖波动幅度二甲双胍组及阿卡波糖组<门冬胰岛素30组。餐后血糖波动幅度则阿卡波糖组<门冬胰岛素30组。从治疗开始到达标时间门冬胰岛素30组较二甲双胍组和阿卡波糖组长,低血糖发生率3组无显著性差异,每日2次胰岛素比例二甲双胍组>阿卡波糖组>门冬胰岛素30组,达标后胰岛素日用量门冬胰岛素30组、阿卡波糖组均>二甲双胍组(P<0.05),日费用阿卡波糖组>二甲双胍组和门冬胰岛素30组。结论 单用门冬胰岛素30治疗血糖波动幅度较大,从治疗到达标所需要的时间相对较长;联合二甲双胍或阿卡波糖可以降低血糖波动幅度,减少胰岛素注射次数;联合二甲双胍可以减少胰岛素日用量。     

二甲双胍联合阿卡波糖治疗2型糖尿病疗效观察

目的观察二甲双胍联合阿卡波糖治疗2型糖尿病的临床疗效。方法取门诊确诊为2型糖尿病的患者68例,随机分为两组各34例。在给予糖尿病教育、饮食控制、体育锻炼的基础上,治疗组给予二甲双胍联合阿卡波糖治疗,对照组单给予二甲双胍治疗。2周后复查两组患者空腹及餐后血糖,观察临床疗效。结果 2型糖尿病患者用二甲双胍联合阿卡波糖在治疗前与治疗后空腹和餐后2小时血糖有显著性差异（P〈0.01）。结论二甲双胍联合阿卡波糖治疗2型糖尿病具有良好的临床疗效,值得临床推广。     

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.