重组人生长激素治疗肝硬化低清蛋白血症

目的:观察重组人生长激素(rhGH)治疗肝硬化引起的低清(白)蛋白血症的临床疗效。方法:选择血清清蛋白低于30g·L-1的肝硬化病人46例,男性39例,女性7例,分为治疗组、对照组各23例。治疗组在常规保肝及对症治疗基础上,给予rhGH,4IU,皮下注射,每日1次,连续14d;对照组仅给予常规保肝及对症治疗,14d为一个疗程。检测2组病人治疗前及治疗结束d1和4wk后血清清蛋白及其他肝功能指标变化,并进行临床观察。结果:治疗组治疗前血清清蛋白(25±s3)g·L-1,治疗结束d1血清清蛋白(31±3)g·L-1(P<0.01),4wk后血清清蛋白(33±3)g·L-1(P<0.01);对照组治疗前血清清蛋白(25±3)g·L-1,治疗结束d1血清清蛋白(25±3)g·L-1,4wk后血清清蛋白(24.4±2.6)g·L-1(P>0.05),2组治疗结束d1及4wk后血清清蛋白相比,差异有非常显著意义(P<0.01)。治疗结束d1及4wk内治疗组比对照组病人精神状态、食欲、尿量、腹腔积液、肝功能等均明显改善且持续稳定,有显著差异(P<0.05)。无明显不良反应。结论:rhGH可以增加肝硬化病人的血清清蛋白的水平,改善营养状况,无明显不良反应。     

生长激素治疗肝硬化低蛋白血症的观察

目的：观察生长激素治疗肝炎后肝硬化低蛋白血症的疗效。方法：肝硬化患者38例，随机分为治疗组、对照组各19例，治疗组在保肝治疗基础上，给予生长激素，sc或im，qod，对照组给予20%清蛋白50 mL，iv，qod，0.5个月为1个疗程。观察0.5，1，2个月血清清蛋白水平及肝功能变化，并进行临床观察。结果：治疗组应用该药1个疗程后，较对照组血清清蛋白明显上升，患者神态、食欲、尿量、腹腔积液、肝功能明显改善且持续稳定，差异有显著性(P＜0.05)。该药无明显不良反应。结论：生长激素是一种安全有效的改善慢性肝病肝硬化患者蛋白营养状况及预后的治疗药物。     

生长激素治疗肝硬化低蛋白血症34例疗效观察

目的观察重组人生长激素(r-hGH)对肝硬化患者蛋白质代谢的影响。方法对68例肝硬化患者在保证热量的综合治疗前提下,随机分为r-hGH组及对照组。观察两组患者治疗前后的临床症状,检测治疗前、治疗后、停药2周后血清白蛋白、肝肾功能等指标的变化,检测治疗前内源性生长激素水平。结果肝硬化患者血清内源性生长激素水平升高[(15.8±3.2)ng/L],治疗10d后,患者食欲不振、腹胀、乏力、恶心等症状改善率高于对照组(P<0.05,P<0.01,P<0.01,P<0.05);治疗后及停药2周后血清白蛋白明显升高[分别为(31.9±4.2)g/L、(32.4±2.8)g/L],肝肾功能等指标无明显变化。结论在综合治疗基础上,使用r-hGH能迅速改善肝硬化患者的症状,改善低蛋白血症和营养状况,无明显不良反应。     

重组人生长激素治疗肝炎后肝硬化低蛋白血症的临床观察

目的　观察重组人生长激素 (r.h GH)对肝炎后肝硬化和慢重肝低蛋白血症临床治疗效果。方法　治疗组 4 6例 ,用重组人生长激素 (每日 4 u) ;对照组 2 0例 ,用人血白蛋白 (2 0～ 30 g/周 ) ,每两周为 1个疗程 ,共治疗 2～ 3疗程。治疗前 2 4 h和治疗后2、4、8周分别测定肝功能、血清白蛋白 ,观察临床症状变化情况作对照。结果　两组病人治疗前临床表现 ,肝功能状况 ,血清白蛋白比较 ,无显著性差异 ,P>0 .0 5 ;治疗后 8周 ,治疗组肝功能改善 ,白蛋白上升 ,乏力、食欲差、腹水、少尿等临床症状缓解等效果明显优于对照组 ,P<0 .0 1～ 0 .0 5。结论　重组人生长激素可以克服肝硬化患者的生长激素抵抗现象 ,明显提高病人肝脏合成白蛋白能力和改善临床症状 ,临床应用安全 ,成本与效果也优于人血白蛋白 ,值得临床进一步推广应用。     

重组人生长激素辅助治疗肝硬化的临床效果观察

目的 :观察重组人生长激素 (rhGH)辅助治疗肝硬化的临床效果。方法 :将 2 2例肝硬化患者配对分成观察组与对照组 ,两组均常规保肝及对症支持治疗 ,观察组加用rhGH 4U ,3次 /周 ,疗程 2个月。结果 :观察组有改善症状、消除腹水等效果 ,患者外周血红细胞、白细胞、血小板及血清白蛋白水平均显著上升 ,尿素氮、肌酐水平逐渐下降 ,未出现肝肾综合征及肝脑综合征病例。结论 :短期协用hGH治疗肝炎后肝硬化 (失代偿期 )有一定近期效果 ,可防止或延缓肝肾综合征、肝脑综合征的发生。     

植物蛋白肽粉对肝硬化型低蛋白血症的疗效研究

目的 研究复合植物蛋白肽粉对肝硬化低蛋白血症的临床治疗作用及特点.方法 将120例肝硬化低蛋白血症患者(血清白蛋白水平低于35 g/L)分为观察组和对照组,每组60例.对照组给予普通乳清蛋白粉,5 g/次,4次/d,并给予相同的保肝、对症治疗,分别于治疗后7 d、15 d、30 d、45 d、60 d,观察血清总蛋白(TP)、血清白蛋白(AIB)等及肾功能等观察指标及临床症状;观察组给予复合植物蛋白肽粉冬泽力,1次10 g,2次/d,疗程60 d,同时给予保肝、对症治疗.结果 治疗前,2组患者血清总蛋白、白蛋白等检测值比较,差异无统计学意义(P>0.05);治疗后,2组患者自身对照比较,血清总蛋白、白蛋白检测值均优于其治疗前;观察组检测值优于对照组,差异有统计学意义(P<0.05);观察组比对照组升高更明显,且临床症状缓解明显,2组均无明显不良反应发生,肝肾功能无明显影响(P>0.05).结论 植物蛋白肽粉冬泽力更易于被肝硬化低蛋白血症患者吸收,可明显提高血清白蛋白水平,缓解临床症状.     

生长激素治疗严重肝病伴低蛋白血症的临床研究

目的 探讨重组人生长激素(rhGH)治疗严重肝病伴低蛋白血症的疗效及作用机制。方法 治疗组18例，在对症治疗基础上加用重组人生长激素(rhGH)8IU皮下注射，每日1次，连用10天为1疗程，体息1周后再用1疗程；对照组20例，仅对症治疗。两组分别在治疗前、后观察肝功能、胰岛素样生长因子—1(IGF—1)、胰岛素样生长因子结合蛋白—3(IGFBP—3)、白细胞介素—4(IL—4)和干扰素—γ(IFN—γ)的变化。结果 治疗组临床症状明显改善，腹水消退较快，凝血酶元时间(PT)显缩短，血浆白蛋白渐有增加，IGF—1、IGFBP—3和IFN—γ有升高倾向，而IL—4水平略见下降。结论 rhGH能克服生长激素(GH)抵抗，改善GH／IGF—1轴功能，促进蛋白合成，调节免疫，适用于严重肝病伴低蛋白血症的患。     

加味五磨饮子治疗慢传输型便秘疗效及对血清SP、VIP影响

目的:观察加味五磨饮子对慢传输型便秘(STC)患者临床疗效及血清P物质(SP)、血管活性肠肽(VIP)的影响。方法:STC患者60例随机分为治疗组(30例)和对照组(30例),并设健康对照组30例。治疗组以加味五磨饮子治疗,对照组以枸橼酸莫沙必利治疗,疗程均为1个月。观察加味五磨饮子疗效及其对患者SP、VIP的影响。结果:治疗组在改善排便自觉症状以及大便的频率方面优于对照组(P<0.05),总有效率明显高于对照组(P<0.01)。两组治疗后血清SP的水平有明显上升,血清VIP水平则明显下降(P<0.01);且治疗后,治疗组血清SP水平明显高于对照组(P<0.01),与健康对照组接近(P>0.05)。结论:加味五磨饮子可能通过升高血清SP水平和降低VIP的水平,从而改善STC患者的便秘症状。     

依达拉奉在急性脑梗死患者中的临床疗效观察

目的:探讨依达拉奉治疗急性脑梗死患者的临床疗效,以及减轻脑水肿和降低血清超敏C-反应蛋白水平的价值。方法:选取符合标准的急性脑梗死患者100例,随机分为观察组和对照组各50例,2组患者均给予常规治疗,同时,观察组加用依达拉奉注射液30 mg,静脉滴注,bid;对照组给予吡拉西坦注射液8.0g,静脉滴注,qd;2组患者疗程均为14 d。分别于治疗前和治疗后7,14 d评价患者的脑水肿体积和血清超敏C-反应蛋白水平;疗程结束后,评价临床治疗效果。结果:观察组总有效率为86.00%,明显高于对照组的70.00%,二者差异有显著性(P<0.05);血清超敏C-反应蛋白水平及脑水肿体积较治疗前均下降(P<0.05),但观察组下降更明显(P<0.01)。结论:依达拉奉可以显著减轻急性脑梗死患者的脑水肿程度,改善神经缺损症状,提高临床疗效,值得临床推广应用。     

重组人生长激素对慢性重型肝炎患者的疗效观察

目的:探讨重组人生长激素(rhGH)治疗慢性重型肝炎患者的临床疗效。方法:将52例慢性重型肝炎患者分为2组,治疗组27例(rhGH每日4或4.5 IU2,～11周),对照组25例,比较2组的症状、生化指标及生存率。结果:治疗组临床症状改善总有效率明显高于对照组。生化指标显示:治疗4周后,治疗组前白蛋白(PALB)水平高于对照组,差异具有统计学意义。2组治疗后2周、4周、3个月6、个月1、年生存率比较,治疗组均明显高于对照组(P<0.05)。结论:rhGH可改善重型肝炎患者的症状及部分生化指标,并能提高慢性重型肝炎患者的生存率。     

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.