二甲双胍对糖尿病患者胃促生长素和YY肽的影响

目的研究二甲双胍对2型糖尿病患者胃促生长素和YY肽水平的作用,以及二甲双胍对2型糖尿病患者体重影响个体差异性的机制。方法选取72例2型糖尿病患者进行二甲双胍治疗12周,根据治疗后体重变化将患者分为体重减轻组和体重未变组。分别测定两组患者在治疗前后的空腹胃促生长素和YY肽水平等指标。结果患者经二甲双胍治疗后空腹胃促生长素水平(10.92±2.64)ng.mL-1明显低于治疗前(11.75±4.87)ng.mL-1,空腹血清PYY(peptide YY,YY肽)水平(135.79±34.07)pg.mL-1明显高于治疗前(125.97±32.98)pg.mL-1,差异均有统计学意义(P<0.05)。治疗后有32名患者体重下降明显,占总数的44.4%。体重减轻组治疗后空腹胃促生长素水平明显低于体重未变组;空腹血清PYY水平明显高于体重未变组,差异均有统计学意义(胃促生长素:t=0.320,P=0.005;PYY:t=1.380,P=0.042)。结论 2型糖尿病患者经二甲双胍治疗后,体重减轻者空腹胃促生长素水平较体重未减轻者降幅更显著,空腹血清PYY水平较体重未减轻者升幅更显著。     

2型糖尿病患者骨密度与血清C肽水平的相关性研究

目的 研究2型糖尿病患者骨密度及骨代谢指标与血清C肽水平的关系.方法 收集我院就诊的2型糖尿病患者127例,对照组为105例非糖尿病正常人群.双能X线骨密度仪测定腰椎(L2～4)及左股骨颈骨密度;ELISA法检测骨钙素(BGP)及1型胶原胶联蛋白羧基肽(CTX-I);放射免疫法检测空腹及餐后2 hC肽水平.结果两组间年龄差异无统计学意义(P>0.05).2型糖尿病组腰椎、左侧股骨颈BMD、空腹及餐后C肽水平均低于对照组(P<0.05),在骨代谢指标方面,2型糖尿病组CTX-1水平高于对照组,BGP水平低于对照组(P<0.05).2型糖尿病患者腰椎、股骨颈骨密度、血清BGP水平与空腹及餐后2 hC肽水平均呈正相关(P<0.05),CTX-1水平与空腹及餐后2 hC肽呈负相关(P<0.05).结论 2型糖尿病患者骨密度及骨代谢水平与空腹及餐后2 hC肽水平密切相关.     

格列美脲与格列本脲治疗2型糖尿病比较

目的 :研究格列美脲治疗 2型糖尿病的疗效、不良反应及对胰岛素分泌的影响。方法 :6 7例 2型糖尿病分为 2组 ,格列美脲组 33例 ,初始剂量为1mg ,po ,qd ;格列本脲组 34例 ,初始剂量为2 .5mg ,po ,qd ;2组均根据血糖调整剂量 ,服药 12wk后测定血糖、胰岛素、糖化血红蛋白 (HbA1c)等变化。结果 :12wk治疗后格列美脲组空腹血糖、餐后 2h血糖和HbA1c值明显下降 [(2 .5±s 0 .4 )mmol·L- 1,(3.72± 0 .0 6 )mmol·L- 1和 (1.5 7±0 .0 5 ) % ,均P <0 .0 1];空腹胰岛素水平升高值无明显变化 [(0 .8± 0 .4 )mU·L- 1,P >0 .0 5 ];餐后 2h胰岛素水平明显升高 [(13.5± 2 .2 )mU·L- 1,P <0 .0 1],与格列本脲组比较差异均无显著意义 (P >0 .0 5 )。但格列本脲组餐后 2h胰岛素水平变化明显高于格列美脲组 [(37± 4 )mU·L- 1vs (34± 4 )mU·L- 1,P <0 .0 1) ]。结论 :格列美脲是一种安全有效的降糖药 ,较格列本脲有更强的胰外降糖作用     

阿卡波糖对2型糖尿病病人胰岛素抵抗的影响

目的 :探讨阿卡波糖对 2型糖尿病病人胰岛素抵抗的影响。方法 :16 0例 2型糖尿病病人随机分为 2组 ,治疗组 80例口服阿卡波糖治疗 ,前 2wk ,5 0mg ,po ,tid ,2wk后 ,10 0mg ,po ,tid ;安慰剂组 80例口服安慰剂 ,方法同治疗组 ,疗程为 2 4wk。同时观察空腹及餐后 2h血糖、血清胰岛素水平、体重指数、糖化血红蛋白、空腹时的红细胞胰岛素受体和红细胞膜流动性治疗前后变化。结果 :(1)wk 4时 ,阿卡波糖明显降低病人的空腹血糖、餐后 2h血糖、糖化血红蛋白 ,下降值分别为 :(2 .9±s 0 .8)mmol·L- 1,(4.0± 1.8)mmol·L- 1,(1.2± 2 .1) % ,P<0 .0 1;(2 ) 2 4wk后 ,阿卡波糖降低病人的体重、空腹血清胰岛素、餐后 2h血清胰岛素 ,下降值分别为 :(6± 4 )kg·m- 2 ,(10± 6 )MIU·L- 1,(14± 10 )MIU·L- 1,增加红细胞胰岛素受体 ,升高值为 :(80± 71)sites·RBC- 1,降低膜流动性 ,下降值为 :(1.5± 1.3) ,P <0 .0 1。结论 :阿卡波糖能改善 2型糖尿病病人的胰岛素抵抗     

格列美脲(98例)与格列本脲(87例)治疗2型糖尿病的比较

目的 :比较格列美脲与格列本脲治疗 2型糖尿病的临床疗效。方法 :2型糖尿病病人 185例 ,随机分为 2组。格列美脲组 98例 ,男性 5 2例 ,女性4 6例 ,年龄 (5 2±s 8)a ,予格列美脲 ,po ,剂量范围1～ 8mg·d- 1;格列本脲组 87例 ,男性 4 6例 ,女性4 1例 ,年龄 (5 2± 9)a ,予格列本脲 ,po ,剂量范围2 .5～ 15mg·d- 1;疗程均为 10wk。观察 2组血糖、胰岛素、C肽等的变化及不良反应。结果 :2组均具有良好的降空腹血糖、餐后 2h血糖及糖化血红蛋白作用 ,对空腹胰岛素、C肽水平影响 2组无差异。治疗 10wk末 2组餐后 2h胰岛素和C肽水平均升高 ,升高程度格列美脲组低于格列本脲组 (P <0 .0 1) ,低血糖反应发生率格列美脲组 (15 % )低于格列本脲组 (31% ) ,且不增加病人体重。结论 :格列美脲和格列本脲治疗 2型糖尿病疗效均良好 ,格列美脲不良反应少。     

血浆同型半胱氨酸浓度与2型糖尿病微血管并发症关系探讨

目的 :探讨空腹血浆总同型半胱氨酸 (tHcy)水平与 2型糖尿病 (DM)微血管病变的关系及其影响因素。方法 :10 8例 2型DM患者和 4 5例正常对照者 (C组 ) ,DM组分为无并发症组 (NDC组 )、视网膜病变组 (DR组 )和肾病组 (DN组 ) ,酶免疫分析法测定血浆tHcy浓度 ;发光免疫法测定血清叶酸 (FA)和VitB1 2 水平。结果 :DR组和DN组的空腹血浆tHcy浓度明显高于NDC组和C组 (P <0 .0 1) ;高Hcy血症的DM患者DN、DR发生率明显高于无高Hcy血症DM患者 (P <0 .0 1) ;VitB1 2 、FA、和血清肌酐 (Scr)、餐后 2h血糖 (2hPBG)均为DM患者tHcy的决定因素 (均P <0 .0 1) ;Logistic回归分析显示空腹tHcy、体质量指数 (BMI)、胆固醇 (TC)、FA、VitB1 2 与DN的发生有关 ;空腹tHcy、2hPBG、TC、Scr均为DR的独立危险因素。结论 :空腹高tHcy血症是糖尿病微血管病变的危险因素 ;血清VitB1 2 、FA、Scr以及代谢紊乱程度影响tHcy的浓度。     

罗格列酮对2型糖尿病病人肿瘤坏死因子和瘦素的影响

目的 :探讨罗格列酮治疗 2型糖尿病对肿瘤坏死因子 (TNF)和瘦素的影响及其治疗糖尿病的可能机制。方法 :4 8例 2型糖尿病病人 ,男性 2 4例 ,女性 2 4例 ,年龄 (5 8±s 8)a ,随机分为 2组 ,每组 2 4例 ,对照组维持原磺酰脲类和双胍类药物降糖治疗 ,治疗组在原治疗基础上加用罗格列酮 4mg·d- 1,疗程 3mo。测定治疗前后 2组血糖、胰岛素、糖化血红蛋白及TNF和瘦素水平。结果 :治疗后 ,治疗组空腹和餐后 2h血糖下降 (1.0± 1.0 )和 (4±3)mmol·L- 1,TNF和瘦素下降 (0 .8± 0 .4 )和 (10±7) μg·L- 1,空腹和餐后 2h胰岛素下降 (3± 4 )和(8± 7)mU·L- 1,与治疗前及对照组相比 ,差异有显著或非常显著意义 (P <0 .0 5或P <0 .0 1)。结论 :罗格列酮可明显改善 2型糖尿病病人的血糖和胰岛素抵抗 ,可能与降低TNF和瘦素有关     

甘精胰岛素联合格列美脲片治疗2型糖尿病的疗效观察

目的 探讨甘精胰岛素联用格列美脲片治疗磺脲类药物继发性失效的2型糖尿病患者的疗效及安全性.方法 60例口服磺脲类降糖药血糖控制不理想的2型糖尿病患者随机分为甘精胰岛素治疗组(GL组)和中性鱼精蛋白锌胰岛素(NPH)组,予睡前皮下注射胰岛素联合口服格列美脲治疗12周,观察12周前后空腹血糖、餐后2h血糖、糖化血红蛋白、空腹C肽、餐后C肽的变化.结果 GL组治疗后FPG(6.3±1.4)mmol/L,2hPG(8.7±1.4)mmol/L,HbAlc(6.7±0.61%;NPH组治疗后FPG(6.4±1.0)mol/L,2hPG(8.8 4±1.2)mmol/L,HbAlc(6.6±0.7)%,较治疗前差异有极显著性(P<0.01);但GL组的低血糖事件明显少于NPH组(P<0.05).且GL组治疗后C肽水平明显升高.结论 甘精胰岛素联用格列美脲片治疗2型糖尿病的方案安全有效,简便易行,能减少低血糖事件的发生,且可能改善胰岛功能.     

甘精胰岛素联合格列美脲片治疗2型糖尿病的疗效观察

目的 探讨甘精胰岛素联用格列美脲片治疗磺脲类药物继发性失效的2型糖尿病患者的疗效及安全性.方法 60例口服磺脲类降糖药血糖控制不理想的2型糖尿病患者随机分为甘精胰岛素治疗组(GL组)和中性鱼精蛋白锌胰岛素(NPH)组,予睡前皮下注射胰岛素联合口服格列美脲治疗12周,观察12周前后空腹血糖、餐后2h血糖、糖化血红蛋白、空腹C肽、餐后C肽的变化.结果 GL组治疗后FPG(6.3±1.4)mmol/L,2hPG(8.7±1.4)mmol/L,HbAlc(6.7±0.61%;NPH组治疗后FPG(6.4±1.0)mol/L,2hPG(8.8 4±1.2)mmol/L,HbAlc(6.6±0.7)%,较治疗前差异有极显著性(P<0.01);但GL组的低血糖事件明显少于NPH组(P<0.05).且GL组治疗后C肽水平明显升高.结论 甘精胰岛素联用格列美脲片治疗2型糖尿病的方案安全有效,简便易行,能减少低血糖事件的发生,且可能改善胰岛功能.     

格列吡嗪控释片治疗老年人2型糖尿病的临床研究（附80例分析）

目的　观察服用格列吡嗪控释片 (瑞易宁 )治疗 2型糖尿病的临床疗效 ,并与每日 2、 3次服用格列齐特 (达美康 )作为对照 ,以评价两者是否具有相同的降血糖效果。方法　选择 80例老年 2型糖尿病患者 ,随机分为瑞易宁组 (4 0例 )和达美康组 (4 0例 ) ,进行治疗和比较。结果　治疗 8周后两组空腹血糖水平 (FBG)、餐后 2小时血糖、糖基化血红蛋白 (Hb Alc)均有显著下降。瑞易宁组 FBG下降 2 .1 5 mm ol/ L,Hb Alc下降 0 .72 % (P均<0 .0 5 ) ;达美康组 FBG下降 2 .1 0 m mol/ L ,Hb Alc下降 0 .73% ,(P均 <0 .0 5 ) ;组间比较差异无显著性 (P>0 .0 5 )。两组均未见明显的不良反应 ,瑞易宁组治疗后血清胆固醇及甘油三酯较治疗前有明显下降 ,而达美康组无变化。结论　对 2型糖尿病患者每日 1次服用瑞易宁可有效控制血糖水平 ,与每日多次服用达美康疗效相似 ,且耐受性良好。     

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.     

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.     

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.     

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.