辛伐他汀对急性冠状动脉综合征患者超敏C反应蛋白以及白细胞介素6和白细胞介素8浓度的影响

目的 探讨辛伐他汀对急性冠状动脉综合征(ACS)患者减少炎症反应、稳定斑块的作用.方法 选定ACS患者80例,稳定型心绞痛(SA)患者40例(SA组)及健康体检者40例(对照组).完全随机将ACS患者分为辛伐他汀治疗组40例和常规治疗组40例,比较各组间血清白细胞介素6(IL-6)、白细胞介素8(IL-8)及超敏C反应蛋白(hs-CRP)的水平变化.结果 ACS组与SA组及对照组之间血清IL-6[SA组(29.2±22.1)ng/L、ACS组(49.3±29.6)ng/L、对照组(4.5±2.9)ng/L]、IL-8[SA组为(0.37±0.05)ng/L、ACS组为(0.58±0.09)ng/L、对照组为(0.14±0.05)ng/L]及hs-CRP[SA组为(1.31±0.64)mg/L、ACS组为(28.35±21.02)mg/L、对照组为(1.19±0.92)mg/L]相比差异有统计学意义,SA组与ACS组治疗后血清IL-6、IL-8及hs-CRP水平相比差异有统计学意义.结论 辛伐他汀可降低ACS患者血清IL-6、IL-8及hs-CRP水平,减少冠状动脉粥样斑块基质成分的降解和炎症反应,从而起到稳定动脉粥样硬化斑块的作用.     

心绞痛与血清尿酸、C-反应蛋白相关性的临床观察和分析

目的观察冠心病患者血清尿酸、C-反应蛋白含量变化及其临床意义。方法选择35例冠心病心绞痛患者及30例健康者(对照组),用尿酸酶法测尿酸含量、用比浊法测量C-反应蛋白含量。结果冠心病心绞痛组与对照组血尿酸比较:冠心病心绞痛组(382±99)μmol/L,对照组(337±87)μmol/L,(P<0.01)。心病心绞痛组与对照组C-反应蛋白比较:冠心病心绞痛组(2.7±0.3)mg/L,对照组(1.9±0.2)mg/L,(P<0.05)。结论血清尿酸、C-反应蛋白在冠心病心绞痛的发生、发展中起重要作用,对临床升高的尿酸及C-反应蛋白应进行及早干预和有效治疗,以防不良心血管事件的发生。     

ICU危重患者预后与早期胃肠营养干预的关系探讨

目的 探讨ICU危重患者预后与早期胃肠营养干预之间的关系.方法 将我院2014年1月至2015年1月诊治的ICU高危患者100例采用随机分组分为观察组和对照组,其中对照组50例采用常规护理,观察组50例在对照组基础上采用早期胃肠营养干预,对比分析两组患者的营养状态指标及并发症的发生率.结果 观察组治疗前血红蛋白含量为(83.2±4.7)g/L,血清前白蛋白为(187.4±3.2)mg/L,蛋白摄入量为(0.7±0.5)kg/d;对照组各指标分别为(82.9±5.1)g/L,(186.9±2.9)mg/L,(0.8±0.4)kg/d,两组对比无统计学差异(P>0.05);治疗后观察组的血红蛋白含量为(144.7±5.7)g/L,血清前白蛋白为(258.4±6.2)mg/L,蛋白摄入量为(1.7±0.6)kg/d;治疗后对照组对应各指标分别为(129.9±4.1)g/L,(251.9±3.2)mg/L,(1.2±0.4)kg/d,观察组治疗后各指标和对照组相比差异具有统计学意义(P<0.05).观察组并发症发生例数为4例,对照组并发症发生例数为13例,差异具有统计学意义(P<0.05).结论 针对ICU危重患者应用早期胃肠营养干预能够保证患者的身体营养成分有效改善,预后效果更佳,降低并发症发生率,值得临床借鉴.     

糖尿病肾病患者血清脂蛋白(a)水平变化及其意义

目的探讨血清脂蛋白(a)犤Lp(a)犦在糖尿病肾病中的意义。方法检测132例尿白蛋白排泄量不同的糖尿病患者血清Lp(a)等指标,并以正常人为对照。结果糖尿病肾病组Lp(a)水平为359±293mg/L,明显高于糖尿病无肾病组的208±221mg/L及正常对照组123±91mg/L(P<0.01)。临床蛋白尿组Lp(a)水平为(482±341)mg/L,明显高于微量蛋白尿组254±179mg/L(P<0.05)。Lp(a)与尿白蛋白呈正相关(r=0.498,P<0.01)。结论糖尿病肾病患者伴有Lp(a)代谢紊乱,并随着肾损害加重,Lp(a)水平呈进行性增高。     

肾脏疾病患者血清同型半胱氨酸 超敏C反应蛋白载脂蛋白a检测的临床意义

目的探讨急性肾功能衰竭患者和慢性肾功能不全患者血清同型半胱氨酸(Hcy),超敏C反应蛋白(hs-CRP),载脂蛋白a(Lpa)检测的临床意义。方法应用化学发光法、散射浊度法和透射浊度法分别测定21例急性肾功能衰竭患者,37例慢性肾功能不全患者Hcy和hs-CRP,Lpa水平,以30名正常人为对照组,进行t检验及线性相关分析。结果慢性肾功能不全组Hcy,hs-CRP,Lpa水平[分别为(19±6)μmol/L,(11±6)mg/L,(262±103)mg/L]明显高于对照组[分别为(8±6)μmol/L,(2.0±0.8)mg/L,(170±82)mg/L],急性肾功能衰竭组更高一些[(25±9)μmol/L,(14±8)mg/L,(293±118)mg/L]。从相关分析看,两组患者Hcy,hs-CRP,Lpa浓度随着尿素氮、肌酐浓度的增高而增高。结论急性肾功能衰竭患者和慢性肾功能不全患者普遍存在高Hcy血症,hs-CRP,Lpa也明显升高,这几项指标的检测有助于判断患者病情的发生发展。     

血清孕酮在鉴别异位妊娠与先兆流产中的意义

目的:探讨血清孕酮对异位妊娠与先兆流产鉴别的意义。方法:选择2004年6月～2005年6月我院住院的异位妊娠患者46例和先兆流产患者56例,检测并比较两组病人血清孕酮值。结果:异位妊娠组的血清孕酮值为(20.83±16.68)nmol/L,显著低于先兆流产组的血清孕酮值(56.22±32.74)nmol/L。两组比较差异有显著性(P<0.05)。结论:血清孕酮的测定可以协助异位妊娠与先兆流产的鉴别诊断。     

血清锌含量对脑梗死患者的临床意义

目的探讨血清锌含量对脑梗死患者的临床意义。方法选取48例脑梗死患者作为研究组,根据NIHSS评分和MRS分别给予评分;选取40例短暂性脑缺血发作者作为对照组,两组患者均抽取空腹血测定血清锌水平。结果脑梗死组锌平均含量为(0.68±0.29)mg/L,TIA组锌平均含量为(0.76±0.18)mg/L,脑梗死组低于短暂性脑缺血发作组(P<0.05)。脑梗死预后差的患者中锌含量为(0.63±0.27)mg/L,而预后较好的患者锌含量(0.73±0.25)mg/L,预后差者低于预后较好者(P<0.05)。NIHSS评分≤8和锌≤65mg/L与预后不良有关联(P<0.05)。结论血清锌的降低与脑梗死预后密切相关,且能够较准确判定患者的预后及生存质量。     

冠状动脉扩张症患者血清基质金属蛋白酶3、高敏C反应蛋白水平变化及意义

目的探讨血清基质金属蛋白酶3(MMP-3)、高敏C反应蛋白(hs-CRP)与冠状动脉扩张症的相关性。方法采集30例单纯冠状动脉扩张症(CAE)患者、70例阻塞性性冠心病患者[包括40例急性冠状动脉综合征(ACS)患者和30例稳定型心绞痛(SAP)患者]及20例无冠心病正常者的血清。所有患者均行冠状动脉造影;采用免疫比浊法测定CRP,酶联免疫吸附法检测MMP-3,并进行组间MMP-3、CRP水平的相关分析。结果 CAE组MMP-3及Hs-CRP水平显著高于ACS组、SAP组和正常对照组(26.2±6.5ng/mL比(22.39±5.1)ng/mL,(12.42±6.1)ng/mL和(10.61±4.2)ng/mL,P值分别为P<0.01、P<0.001、P<0.001;(9.05±3.3)mg/L比(6.79±4.1)mg/L、(2.79±2.6)mg/L和(1.61±1.02)mg/L,P值分别为P<0.01、P<0.001、P<0.001),而后两组间差异无显著性[(12.42±6.1)ng/ml比(10.61±4.2)ng/mL,P>0.05;(2.79±2.6)mg/L比(1.61±1.02)mg/L,P>0.05]。结论 MMP-3、hs-CRP在CAE组明显升高,表明炎性反应在其发病中起重要的作用。     

脑卒中患者血清脂蛋白(a)水平变化

目的探讨脑梗死、脑出血患者血清脂蛋白(a)水平变化。方法回顾性分析了太钢总医医院2007年1月至2009年12月年间收治的67例脑梗死、35例脑出血以及40例同期对照患者脂蛋白(a)水平。结果 3组病例中,脑梗死组脂蛋白(a)水平最高,为(274.20±135.72)mg/L;脑出血组及对照组分别为(161.77±123.21)mg/L以及(142.57±101.44)mg/L,3组间差异有统计学意义(P<0.05)。进一步两两比较提示性脑梗死组与脑出血组以及对照组之间差异均有有统计学意义(P<0.017);脑出血与对照组之间差异无统计学意义(P>0.017)。结论脂蛋白(a)水平与脑梗死相关,但可能并不是脑出血的危险因素。     

血清同型半胱氨酸、维生素 B12和可溶性转铁蛋白受体联合检测对妊娠期贫血早期诊断的价值分析

目的检测血清同型半胱氨酸(Hcy)、维生素 B12(VB12)和可溶性转铁蛋白受体(sTfR)联合检测对妊娠期贫血早期诊断的价值。方法选取 2017年 3月至 2019年 3月邯郸市妇幼保健院收治的孕 12周前发生妊娠期贫血病人 150例作为研究对象(贫血组)根据发生贫血的严重程度分为轻度组( 84例)、中度组(45例)和重度组(21例)。另选取同期在进行围产保健检测的健康孕妇20，0例作为对照组。收集受试者一般资料；酶联免疫吸附法( ELISA)法检测受试者血清 Hcy、VB12、sTfR水平； Pearson法分析血清 Hcy、VB12、sTfR的相关性； logistic回归分析妊娠期发生贫血的影响因素；受试者工作特征曲线( ROC)分析血清 Hcy、VB12、sTfR水平对妊娠期发生贫血的预测价值。结果对照组、轻度组、中度组、重度组病人血清 Hcy［(9.42±2.74) μmol/L、(25.75±9.41)μmol/L、(38.47±13.26)μmol/L、(46.21±15.83)μmol/L］、 sTfR［( 4.41±1.36)mg/L、(7.34±2.85)mg/L、(9.65± 3.13)mg/L、(14.98±4.26)mg/L］水平均依次升高( P<0.05)，VB12［( 285.69±66.11)ng/L、(145.46±41.56)ng/L、(105.35±30.54)ng/ L、(66.73±22.37)ng/L］、 Hb［( 125.54±15.23)g/L、(102.36±10.37)g/L、(76.49±14.81)g/L、(51.74±13.68)g/L］水平均依次降低( P< 0.05)，且轻度组、中度组和重度组病人血清 Hcy、VB12、sTfR、Hb水平差异有统计学意义( P<0.05)。 Pearson法分析显示，血清 Hcy水平与 VB12呈负相关，与 sTfR呈正相关(r=.0.62、0.65，P<0.05)，VB12与 sTfR呈负相关( r=.0.64，P<0.05)，与 Hb呈正相关(r=0.59，P<0.05)； sTfR与 Hb呈负相关( r=.0.62，P<0.05)。logistic回归分析显示， Hcy、sTfR水平偏高及 VB12、Hb水平偏低是妊娠期发生贫血的危险因素( P<0.05)。 ROC分析结果显示， Hcy、VB12、sTfR预测妊娠期发生贫血的曲线下面积( AUC)分别为 0.768、0.761、0.769；灵敏度为 77.7%、70.3%、75.3%，特异度为 75.3%、85.5%、77.6%。联合检测预测妊娠期发生贫血的 AUC为 0.851，灵敏度为 80.4%，特异度为 84.1%。结论 Hcy、sTfR在妊娠期贫血孕妇血清中水平升高， VB12水平降低，与孕妇贫血严重程度有关，可能作为潜在的预测妊娠期贫血的标志物。     

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.