蕲蛇酶注射液治疗早期急性脑梗死的临床观察

目的探讨蕲蛇酶注射液治疗早期脑梗死患者的临床疗效及其安全性。方法将40~80岁的年龄段急性脑梗死患者150例随机分成治疗组(79例)与对照组(71例)。治疗组(79例)用蕲蛇酶注射液,对照组(71例)用丹参注射液。用药前后进行神经功能缺损程度评分(ESS)、血液流变学、纤维蛋白原、颅脑CT检查。并观察其不良反应。结果治疗组治疗总有效率(75.6%)高于对照组(66.2%)(P<0.05),起病24h内开始治疗,治疗组的显效率(86.1%)优于对照组(58.1%)(P<0.05),两组均未发现出血倾向。结论早期急性脑梗死患者可在严密观察下应用一般剂量蕲蛇酶治疗。     

蕲蛇酶注射液用于治疗急性脑梗死的疗效观察

目的观察蕲蛇酶注射液用于治疗急性脑梗死的疗效。方法将39例急性脑梗死患者随机分成蕲蛇酶治疗组23例：蕲蛇酶注射液1ml（0.75U）溶解于250ml生理盐水中静滴,1次/d,连用10d。对照组16例：胞二磷胆碱1.0g溶于5%葡萄糖500ml中静滴,1次/d,连用14d。进行对照研究。结果蕲蛇酶治疗组的疗效优于对照组。结论蕲蛇酶可使急性脑梗死患者临床症状显著改善。     

蕲蛇酶注射液治疗高龄进展性脑梗死患者的临床观察

目的探讨靳蛇酶注射液治疗高龄进展性脑梗死患者的临床疗效及其安全性。方法将≥80岁的高龄进展性脑梗死患者135例随机分成治疗组(71例)与对照组(64例)。两组均采用胞二磷胆碱静脉滴注作为基础治疗。治疗组同时加用蕲蛇酶注射液(0.75u)静脉滴注,每日1次,连续10d。用药前后进行神经功能缺损程度评分(ESS)、血液流变学、纤维蛋白原、颅脑CT检查。并观察其不良反应。结果治疗组治疗总有效率(76.1%)高于对照组(64.1%)(P<0.05),尤以降低急性期死亡率更为明显(P<0.05)。起病24h内开始治疗,治疗组的显效率(88.2%)优于对照组(55.2%)(P<0.05),两组均未发现出血倾向。结论高龄进展性脑梗死患者可在严密观察下应用普通剂量蕲蛇酶治疗。     

激肽原酶治疗颈内动脉系统急性缺血性卒中的疗效研究

目的探讨人尿激肽原酶在颈内动脉系统急性脑梗死中的疗效及安全性。方法将60例急性前循环脑梗死患者随机分为治疗组和对照组,治疗组在对照组治疗基础上加用尤瑞克林0.15PNA静脉滴注14d,对照组按常规+依达拉奉治疗。治疗前后分别进行神经功能缺损评分(NHSS)、日常生活能力及社会功能评估(BI及OHS),并观察治疗期间不良反应。结果治疗组和对照组治疗前后NIHSS、BI、OHS评分比较均有统计学差异(P<0.01);两组之间总有效率比较,治疗组为86.68%,对照组为73.33%,两组差异有统计学意义(P<0.05)。结论人尿激肽原酶治疗颈内动脉系统急性脑梗死疗效明显,且安全性良好。     

蕲蛇酶治疗脑梗死68例临床分析

目的　探讨蕲蛇酶治疗脑梗死的临床疗效。 方法 　治疗组、对照组病例均选脑梗死急性期患者 ,分别静脉点滴蕲蛇酶及丹参注射液 ,并对疗效进行评价。 结果 　蕲蛇酶组优于对照组 ,经秩和检验 P<0 .0 1,有统计学意义。 结论 　蕲蛇酶是治疗急性脑梗死有前途的临床新药     

注射用鼠神经生长因子联合丁苯酞对急性脑梗死患者的疗效及血清因子的影响

目的 研究注射用神经生长因子联合丁苯酞对急性脑梗死患者的临床疗效和对血清因子的影响。方法 选取于2015年1月～2020年1月治疗的50例急性脑梗死患者,按随机数表法分为观察组和对照组,各25例。对照组给予常规疗法联合丁苯酞治疗,观察组在对照组治疗基础上给予鼠神经生长因子注射治疗,比较两组的临床疗效、神经功能（NIHSS）评分、肢体运动功能（ADL）评分、血清超敏CRP(hs-CRP)、肿瘤坏死因子α(TNF-α)、神经元特异性烯醇化酶（NSE）及不良反应发生率。结果 观察组治疗后的NIHSS评分低于对照组（P <0.05）;观察组治疗后的ADL评分高于对照组（P <0.05）;观察组治疗后的hs-CRP、TNF-α及NSE水平均低于对照组（P <0.05）;观察组的治疗总有效率高于对照组（P<0.05）,两组的不良反应发生率差异无统计学意义（P> 0.05）。结论 注射用鼠神经生长因子联合丁苯酞可显著降低急性脑梗死患者血清炎性因子水平及提高临床治疗有效率。     

银杏达莫治疗急性脑梗死80例疗效观察

目的观察银杏达莫注射液治疗急性脑梗死的疗效。方法瘵160例急性脑梗死患者随机分为治疗组(80例)和对照组(80)例,治疗组应用银杏达莫注射液20ml静脉滴注,每日1次,连用14天,对照组应用维脑路通注射液500rag,静脉滴注,每日1次,连用14天。观察两组治疗前后神经功能缺损改善情况和血液流变学指标的变化。结果治疗组疗效显著高于对照组,尸<0.0I;血液流变学指标治疗前后比较有显著性差异(P<0.05或P<0.01),优于对照组。结论银杏达莫注射液治疗急性脑梗死具有良好的疗效。     

奥扎格雷钠治疗急性脑梗死的疗效观察

目的观察奥扎格雷钠治疗急性脑梗死的临床疗效,神经功能缺损程度(NDS)评分和对血液流变学的影响。方法选择发病48h内的脑梗死患者58例,随机按1∶1配对分为治疗组和对照组。治疗组给予奥扎格雷钠80mg,静脉滴注,每日1次,连用14d;对照组给予肠溶阿司匹林100mg·d-1,口服,每日3次,连用30d,在此基础上,给予复方丹参注射液20mL,静脉滴注,每日1次,连用14d。结果治疗组和对照组的临床总显效率分别为89.66%和68.97%(P<0.01);NDS评分2组在治疗14d后有明显变化(P<0.05),治疗30d后有显著变化(P<0.01);与治疗前相比,治疗后2组血液流变学均有明显变化(P<0.05),但治疗组尤为显著(P<0.01)。结论奥扎格钠治疗急性脑梗死疗效显著,明显优于肠溶阿司匹林。     

注射用鼠神经生长因子与胞二磷胆碱注射液治疗急性脑出血的疗效比较

目的对比分析注射用鼠神经生长因子与胞二磷胆碱注射液治疗急性脑出血的疗效。方法将115例急性脑出血患者分为两组,观察组患者63例,接受注射用鼠神经生长因子治疗;对照组患者52例,接受胞二磷胆碱注射液治疗,对比分析两组患者的疗效。结果 1治疗前,两组患者Barthel指数、NIHSS评分相比差异无统计学意义（P〉0.05）;治疗后,观察组Barthel指数高于对照组,差异具有统计学意义（P〈0.05）,NIHSS评分显著低于对照组,差异具有统计学意义（P〈0.05）。2经疗效评价,观察组治疗效果优于对照组,差异具有统计学意义（P〈0.05）。结论注射用鼠神经生长因子治疗急性脑出血的疗效优于胞二磷胆碱,值得临床推广应用。     

曲克芦丁联合灯盏花素注射液治疗急性脑梗死的疗效观察

目的探讨曲克芦丁联合灯盏花素注射液治疗急性脑梗死的临床效果。方法60例急性脑梗死患者,随机分为对照组和观察组,各30例。对照组采用灯盏花素注射液治疗,观察组采用曲克芦丁联合灯盏花素注射液治疗。比较两组临床疗效及治疗前后美国国立卫生研究院卒中量表(NIHSS)评分。结果观察组临床治疗总有效率90.00%明显高于对照组的66.67%,差异具有统计学意义(P<0.05)。治疗前,两组NIHSS评分比较差异无统计学意义(P>0.05);治疗后,两组NIHSS评分均显著低于治疗前,且观察组NIHSS评分(3.08±1.21)分低于对照组的(5.15±1.59)分,差异具有统计学意义(P<0.05)。结论曲克芦丁联合灯盏花素注射液治疗急性脑梗死患者疗效显著,可有效改善患者神经功能缺损情况,具有一定的推广价值。     

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.     

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.     

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.