小儿原发性肾病综合征的血清甲状腺激素水平临床分析

目的研究小儿原发性肾病综合征同血清甲状腺激素水平间的关系。方法选择本院64例原发性肾病综合征患儿,作观察组,同期入院体检的64例同龄健康儿童作对照组,检测两组儿童的血清甲状腺激素水平和蛋白水平,对比分析检测结果。结果观察组患儿的血清游离三碘甲腺原氨酸（FT3）和血清游离甲状腺素（FT4）水平均要明显低于对照组,促甲状腺激素（TSH）水平明显高于对照组,上述差异具有统计学意义（P〈0.05）;经直线相关分析,FT3和FT4同血清白蛋白水平呈正相关,同24h尿蛋白呈负相关,TSH同血清蛋白水平无显著相关性。结论 FT3、FT4同血清蛋白有着密切的联系,甲状腺激素水平的检测利于原发性肾病综合征的临床治疗。     

小剂量左甲状腺素治疗肾病综合征低TT3、TT4血症的疗效

目的探讨小剂量左甲状腺素片治疗原发性肾病综合征低TT3、TT4血症疗效。方法将48例原发性肾病综合征低TT3、TT4血症患者随机分成两组,治疗组在对照组应用肾病综合征常规治疗基础上加用小剂量左甲状腺素片50μg／a,疗程12周,比较两组治疗前后甲状腺功能、肾功能、24h尿蛋白定量,血清白蛋白的变化和肾病综合征缓解情况。结果治疗12周后治疗组TT3、TT4、血清白蛋白较治疗前明显升高（P〈0．01）,血肌酐、24h尿蛋白定量较治疗前明显下降（P〈0．001）,组间比较差异有显著性（P〈0．05）,治疗组缓解率优于对照组（P〈0．05）。结论补充小剂量左甲状腺素片明显提高原发性肾病综合征低TT3、TT4血症疗效,缩短病程。     

血清FT3、FT4浓度变化与肾病综合征的关系

目的研究血清游离甲状腺原氨酸（FT3）,游离甲状腺素（FT4）浓度变化与肾病综合征的关系,并探讨其临床意义。方法用放射免疫检测86例肾病综合征患者血清FT3、FT4水平,并与血清白蛋白下降程度进行比较,检测给予甲状腺片治疗与否其肾功能,血清白蛋白变化情况。结果肾病综合征患者血清FT3、FT4较对照组显著降低（P〈0.05）,A组（血清白蛋白〉20g/L）血清FT3、FT4较对照组显著降低（P〈0.05）,B组（血清白蛋白≤20g/L）血清FT3、FT4较A组显著降低（P〈0.05）。肾病综合征患者血清FT3、FT4与白蛋白下降程度呈正比,且给予甲状腺素治疗后其白蛋白上升明显,而肾功能变化不明显。结论随着肾病综合征患者白蛋白下降程度加重,血清FT3、FT4呈下降趋势,血清FT3、FT4水平与白蛋白下降程度密切相关。血清FT3、FT4水平变化对判断肾病综合征严重程度,指导治疗及判断预后有一定的临床价值。     

抗病毒治疗对乙肝肝硬化患者血清甲状腺激素的影响

目的：探讨抗病毒治疗对乙肝肝硬化患者血清甲状腺激素的影响。方法选取乙肝肝硬化患者80例（肝硬化组）,对照组为同期健康体检人群40例。肝硬化组接受恩替卡韦抗病毒治疗。根据肝硬化患者治疗后乙型肝炎病毒（HBV） DNA是否转阴分为转阴组56例,未转阴组24例,观察患者治疗前后血清甲状腺激素水平及肝功能指标。结果治疗前,肝硬化组血清三碘甲状腺原氨酸（T3）、游离三碘甲状腺原氨酸（FT3）、甲状腺素4（T4）、游离甲状腺素（FT4）低于对照组（P＜0．05）,促甲状腺激素（TSH）高于对照组（P＜0．05）。治疗后,肝硬化组患者总胆红素（TBil）、丙氨酸氨基转移酶（ALT ）、谷氨酸氨基转移酶（AST ）降低,白蛋白（Alb）提高（P＜0．05）;HBV DNA转阴组T3、FT3、T4、FT4高于未转阴组（P＜0．05）,TSH低于未转阴组（P＜0．05）。结论抗病毒治疗可以有效改善乙肝肝硬化患者血清甲状腺激素水平的紊乱失衡状态。     

小剂量甲状腺素治疗慢性充血性心力衰竭伴低T_3综合征的疗效观察

目的观察小剂量左旋甲状腺素治疗慢性充血性心力衰竭心功能Ⅲ～Ⅳ级伴低T3综合征的临床治疗效果和安全性。方法选择慢性充血性心力衰竭心功能Ⅲ～Ⅳ级伴低B综合征患者40例，随机分为治疗组和对照组，治疗组在常规心衰治疗基础上加口服左旋甲状腺素（L-T4）25～50μg／d治疗，疗程为12周。比较两组治疗前后血清甲状腺激素水平、左室射血分数（LVEF）、左窒舒张术期（LVDD）、E峰从峰比（E／A），心输出量（CO）、心率变化（HR）以及新发心律失常、急性冠脉综合征发生情况。，结果治疗组治疗后甲状腺激素水平较治疗前明显上升（P〈0．05）。两组心功能LVEF、LVDD、CO、E／A治疗后较治疗前有明显改善．差异最著有统计学意义（P〈0．05）；治疗后治疗组心功能LVEF、LVDD、CO、E／A较对照组有明显改善，差异显著有统计学意义（P〈0．05）．．结论存慢性充血性心力衰竭心功能Ⅲ～Ⅳ级伴低T3综合征患者积极补充小剂量左旋甲状腺素可明显改善患者心功能和提高患者生存质量，本研究认为中短期应用小剂量左旋甲状腺素治疗CHF伴低T3综合征是一种安全有效可行的辅助治疗疗法．     

血清甲状腺激素及血友病因子水平与 COPD 并发Ⅱ型呼吸衰竭的相关性分析

目的：探究血清甲状腺激素、血友病因子（ vWF）水平与COPD并发Ⅱ型呼吸衰竭的关系。方法选取该院就诊的COPD并发Ⅱ型呼吸衰竭患者108例作为观察组,同期进行体检的健康人130例作为对照组,分别检测2组促甲状腺素（ TSH）、总三碘甲状腺原氨酸（ TT3）、总甲状腺素（ TT4）、游离三碘甲状腺原氨酸（ FT3）、游离甲状腺素（ FT4）和vWF水平,并比较分析。结果观察组的TT3、TT4、FT3水平低于对照组,vWF水平高于对照组,差异均有统计学意义（P＜0．05）。2组TSH、FT4水平差异无统计学意义（P＞0．05）。结论 COPD并发Ⅱ型呼吸衰竭患者的甲状腺激素TT3、TT4、FT3水平明显降低,但TSH、FT4水平降低不明显,同时vWF水平明显升高。     

左旋甲状腺素钠治疗60例小儿甲状腺功能减低症的临床效果分析

目的探讨左旋甲状腺素钠治疗小儿甲状腺功能减低症的临床疗效。方法回顾性分析本院收治的60例小儿甲状腺功能减低症患者的临床资料,将所有患者随机分为治疗组和对照组,对照组给予常规治疗,治疗组给予左旋甲状腺素钠治疗,比较两组患者的临床疗效。结果治疗组患儿的总有效率为93．33％,对照组的总有效率为76．67％,差异有统计学意义（P〈0．05）;治疗前两组患儿的血清FT3、FT4、TSH差异均无统计学意义（P〉0．05）;治疗后FT3、FT4均显著升高,TSH显著降低,且治疗组变化幅度显著大于对照组（P〈0．05）。结论采用左旋甲状腺素钠治疗小儿甲状腺功能减低症能迅速升高血清FT4和FT3,降低血清TSH,临床疗效显著。     

血清甲状腺激素水平在小儿原发性肾病综合征中的临床意义

目的探讨血清甲状腺激素在小儿原发性肾病综合征中的临床意义。方法选择我院2015年4月～2016年9月纳入的20例原发性肾病综合征患儿为观察组,在我院体检的20例健康儿童作为对照组,分别检测其血清甲状腺激素水平,对比两组检测结果。结果观察组(活动期)的FT3、FT4、TT3以及TT4水平低于对照组,但24h尿蛋白、血浆白蛋白高于对照组(P 0.05);观察组(缓解期)的FT3、FT4、TT3、TT4、24h尿蛋白及血浆白蛋白水平与对照组无统计学差异(P 0.05);且三组TSH水平无明显差异(P 0.05)。观察组的活动期FT3、FT4水平与24h尿蛋白呈负相关性(r=-0.684,-0.508,P 0.05),与血浆白蛋白呈正相关性(r=0.109,0.582,P 0.05)。结论小儿原发性肾病综合征可导致甲状腺激素水平暂时性下降,而病情缓解后激素水平可逐渐恢复,同时甲状腺激素水平与其肾病综合征具有密切相关性。因此,定期监测肾病综合征的甲状腺功能,可体现患者病情变化,为临床治疗及预后提供参考依据。     

老年2型糖尿病甲状腺激素水平与代谢指标相关性分析

目的分析老年2型糖尿病甲状腺激素水平与代谢指标的相关性。方法选择2010年1月至2012年6月于我院就诊的300例老年2型糖尿病患者作实验组,并按照糖化血红蛋白水平分为四组。选择健康体检者300例作正常对照组。分别检测所有试验者的甲状腺素总量（TT4）、游离甲状腺素（FT4）、游离甲腺原氨酸（FT3）、促甲状腺激素（TSH）和血清三碘甲腺原氨酸总量（TT3）,并对其进行比较。结果实验组患者的FT3、TT3均明显低于正常对照组,差异有统计学意义（P〈0．05）;GHbAIc〈6．5％组患者的Fr3、Tr3明显高于GHbAl（6．5％-7．5％）组、GHbAle（7．6％-10．0％）组、GHbAlc〉10．0％组,差异有统计学意义（P〈0．05）。各组患者的TT4、FT4、TSH比较,差异无统计学意义（P〉0．05）。结论准确检测患者的甲状腺激素代谢指标对老年2型糖尿病患者的病情控制有重要意义。     

地塞米松治疗桥本甲状腺炎的临床价值

目的 观察口服左旋甲状腺素钠（1evothyroxine，LT）联合甲状腺内注射地塞米松磷酸钠（DX）治疗亚临床甲状腺功能减退（SCH）的桥本甲状腺炎（HT）的疗效。方法80例伴SCH的HT患者随机分为LT组40例和DX组40例。两组于治疗前及治疗后测定游离甲状腺素（FT4）、游离三碘甲状腺原氨酸（FT3）、高敏促甲状腺激素（sTSH）、抗甲状腺球蛋白抗体（TGAb）、抗甲状腺过氧化物酶抗体（TPOAb）、皮质醇（Cortisol）、促肾上腺皮质激素（ACTH）等含量。结果两组治疗后FT3、FT4含量较治疗前升高（t=2．123，P〈0．05；t=2．210，P〈0．05），sTSH含量较治疗前下降（t=2．183，P〈0．05）。两组治疗后血清TPOAb、TGAb水平较治疗前下降（t=2．198，P〈0．05；t=2．230，P〈0．05）。DX组sTSH含量下降更明显。两组治疗后甲状腺体积较治疗前缩小，DX组缩小更明显。颈部外观积分及压迫症状均下降，DX组积分下降更明显。DX组在缩小甲状腺肿、降低甲状腺自身抗体滴度及改善颈部外观、压迫症状等方面均优于LT组。结论口服LT联合甲状腺内注射DX治疗HT患者明显优于单用LT。     

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.