组织多普勒显像检测二尖瓣环速度评价冠心病左室舒张功能

目的:探讨应用组织多普勒显像(TDI)检测二尖瓣环运动速度评价冠心病左室舒张功能的应用价值。方法:冠心病患者45例,正常对照组30例,应用脉冲多普勒(PWT)检测二尖瓣口舒张早、晚期血流峰值流速(E、A)、计算E/A;应用TDI速度模式,在心脏四腔心切面检测二尖瓣内、外环运动速度(Ea、Aa),计算Ea/Aa。结果:冠心病组左室舒张功能假性正常组(E/A>1)与正常对照组比较,二尖瓣血流频谱E、A、E/A及二尖瓣环Aa差异无统计学意义(P>0.05),TDI检测二尖瓣环Ea及Ea/Aa较正常组明显减低,差异有统计学意义(P<0.01)。冠心病组左室舒张功能减低组(E/A<1)与正常对照组比较,二尖瓣环Aa差异无统计学意义(P>0.05),二尖瓣血流频谱A较正常对照组增高,E、E/A及二尖瓣环Ea、Ea/Aa较正常组明显减低,差异有统计学意义(P<0.01)。结论:TDI检测二尖瓣内、外环运动速度Ea、Aa,计算Ea/Aa,可评价冠心病左室舒张功能,与二尖瓣血流检测左室舒张功能(E/A<1)减低者有很好相关性,并可鉴别左室舒张功能假性正常化,估测舒张功能受损的程度。     

TDI技术评价卡维地洛对高血压患者左室舒张功能的影响

目的:应用组织多普勒显像(TDI)技术评价卡维地洛对高血压患者左室舒张功能的影响.方法:对30例高血压给予卡维地洛治疗24周.治疗前、治疗后12周、24周用TDI技术测量左室收缩期二尖瓣环平均舒张早期运动速度(Ea)、舒张晚期运动速度(Aa)及Ea/Aa,并与血流多普勒指标E波速度(E)、A波速度(A)、E/A进行比较,观察降压效果及对左室舒张功能的影响.结果:卡维地洛治疗12周后收缩压(SBP)、舒张压(DBP)、心率(HR)均较治疗前下降(P＜0.05),Ea、Ea/Aa均较治疗前升高(P＜0.05),治疗24周后E、E/A较治疗前升高(P＜0.05),Aa较治疗前降低(P＜0.05),Ea、Ea/Aa有进一步改善的趋势(P＜0.05).结论:TDI技术在评价左室舒张功能方面较二尖瓣血流频谱更敏感;卡维地洛对轻、中度高血压具有良好的降压作用,且能改善患者左室舒张功能.     

TDI技术评价卡维地洛对高血压患者左室舒张功能的影响

目的:应用组织多普勒显像(TDI)技术评价卡维地洛对高血压患者左室舒张功能的影响.方法:对30例高血压给予卡维地洛治疗24周.治疗前、治疗后12周、24周用TDI技术测量左室收缩期二尖瓣环平均舒张早期运动速度(Ea)、舒张晚期运动速度(Aa)及Ea/Aa,并与血流多普勒指标E波速度(E)、A波速度(A)、E/A进行比较,观察降压效果及对左室舒张功能的影响.结果:卡维地洛治疗12周后收缩压(SBP)、舒张压(DBP)、心率(HR)均较治疗前下降(P＜0.05),Ea、Ea/Aa均较治疗前升高(P＜0.05),治疗24周后E、E/A较治疗前升高(P＜0.05),Aa较治疗前降低(P＜0.05),Ea、Ea/Aa有进一步改善的趋势(P＜0.05).结论:TDI技术在评价左室舒张功能方面较二尖瓣血流频谱更敏感;卡维地洛对轻、中度高血压具有良好的降压作用,且能改善患者左室舒张功能.     

多普勒组织成像技术评价高血压左室肥厚患者左室舒张功能

目的应用多普勒组织成像(DTI)技术,评价高血压左室肥厚(LVH)患者左室舒张功能.方法用DTI方法检测20例正常人和20例高血压左室肥厚患者二尖瓣环舒张早期运动速度(Ea)、舒张晚期运动速度(Aa)及Ea/Aa,比较两者不同,并用血流多普勒法检测二尖瓣口舒张期血流早期峰值速度(E)和晚期峰值速度(A)及E/A,分析高血压左室肥厚血流参数的异常.结果DTI技术二尖瓣环DTI参数、二尖瓣口血流参数明显低于正常对照组.结论DTI技术能准确定量高血压LVH患者二尖瓣环舒张期运动速度改变,评价左室舒张功能较二尖瓣血流频谱更准确.     

组织多普勒评价氯沙坦钾对高血压患者左心室舒张功能影响的作用观察

目的：应用组织多普勒成像（ TDI）技术评价氯沙坦钾对高血压患者左室舒张功能的影响。方法对38例高血压患者,给予氯沙坦钾治疗12周及24周,治疗前、后用TDI技术测量舒张早期运动速度（ Ea）、舒张晚期运动速度（ Aa）及Ea/Aa,并与血流多普勒指标E波速度（ E）、A波速度（ A）、E/A进行比较,观察降压效果及对左室舒张功能的影响。结果氯沙坦钾治疗12周后收缩压（SBP）、舒张压（DBP）均较治疗前下降（ P ＜0 ．05）,心率（HR）差异无统计学意义（ P ＞0．05）,Ea、Ea/Aa均较治疗前升高（ P ＜0．05）,治疗24周后E、E/A均较治疗前升高（ P ＜0．05）,Ea、Ea/Aa有进一步改善的趋势。结论氯沙坦钾对中、重度高血压具有良好的降压作用,且能改善左心室舒张功能,组织多普勒比二尖瓣血流频谱更早、更敏感地发现高血压所致的左室舒张功能障碍。     

组织多普勒显像检测二尖瓣环速度评价冠心病左室舒张功能

目的：探讨应用组织多普勒显像（TDI）检测二尖瓣环运动速度评价冠心病左室舒张功能的应用价值。方法：冠心病患者45例,正常对照组30例,应用脉冲多普勒（PWT）检测二尖瓣口舒张早、晚期血流峰值流速（E、A）、计算E／A;应用TDI速度模式,在心脏四腔心切面检测二尖瓣内、外环运动速度（Ea、Aa）,计算Ea／Aa。结果：冠心病组左室舒张功能假性正常组（E／A〉1）与正常对照组比较,二尖瓣血流频谱E、A、E／A及二尖瓣环Aa差异无统计学意义（P〉0．05）,TDI检测二尖瓣环Ea及Ea／Aa较正常组明显减低,差异有统计学意义（P〈0．01）。冠心病组左室舒张功能减低组（E／A〈1）与正常对照组比较,二尖瓣环Aa差异无统计学意义（P〉0．05）,二尖瓣血流频谱A较正常对照组增高,E、E／A及二尖瓣环Ea、Ea／Aa较正常组明显减低,差异有统计学意义（P〈0．01）。结论：TDI检测二尖瓣内、外环运动速度Ea、Aa,计算Ea／Aa,可评价冠心病左室舒张功能,与二尖瓣血流检测左室舒张功能（E／A〈1）减低者有很好相关性,并可鉴别左室舒张功能假性正常化,估测舒张功能受损的程度。     

组织多普勒测量Tei指数对糖尿病患者左室功能的评价作用(附90例报告)

目的 应用组织多普勒Tei指数评价不同时期糖尿病患者左室功能,为早期诊断及治疗糖尿病心肌病变提供依据.方法 对确诊为2型糖尿病的患者30例,2型糖尿病前期患者30例及正常对照组30例分别进行常规超声心动图检查,并应用组织多普勒技术测量Tei指数,将Tei指数与常规左室收缩舒张功能指标进行相关分析,评价其临床应用价值.结果 糖尿病组及糖尿病前期组Tei指数较对照组明显增加(P<0.05),Tei指数与左室射血分数(LVEF)、左室短轴缩短率(FS)、二尖瓣口血流速度比值(E/A)、二尖瓣环运动速度比值(Ea/Aa)呈负相关.结论 糖尿病前期患者即可存在左室舒张功能不全.Tei指数较敏感,能早期诊断糖尿病左室舒张功能受损.     

多普勒组织成像技术对前壁心肌梗死的定量诊断及对左室舒张功能的评价

目的　探讨多普勒组织成像 (DTI)技术对心肌梗死及左室局部与整体舒张功能检测的临床应用价值。方法　应用 DTI技术检测 30例前壁心肌梗死患者 ,分别探查左室 6个壁 12个节段运动情况及二尖瓣环侧壁处舒张期运动频谱 ,并与多普勒测定的二尖瓣口血流频谱进行对比研究 ,再与 30名健康成人作对照分析。结果　梗死组梗死节段收缩波峰值速度 (Vs)、舒张波早期峰值速度 (Ve)明显低于对照组 ,梗死组二尖瓣环处 Ea速度明显低于正常组 ,DTI测定的二尖瓣环舒张期运动频谱舒张早期峰值速度 /舒张晚期峰值速度 (Ea/ Aa)与常规检测的二尖瓣口舒张期血流频谱 E/ A存在相关关系。结论　 DTI-脉冲多普勒技术能准确测定心肌局部收缩和舒张运动速度 ,检测心肌梗死为一种可靠的无创方法 ;DTI也是一种新的安全、简便、定量分析左心舒张功能的有效手段     

类风湿关节炎30例左心室功能组织多普勒成像分析

目的 应用组织多普勒成像技术评价类风湿性关节炎患者的左心室功能.方法 选取类风湿性关节炎患者30例,正常对照组30例,分别进行超声心动图检查,测量常规左心室功能指标(射血分数EF、左室短轴缩短率FS、二尖瓣口血流速度比值E/A),并采用组织多普勒成像技术测量二尖瓣环运动频谱收缩期Sa峰、舒张早期Ea峰、舒张晚期Aa峰的峰值速度,Ea/Aa比值及Tei指数.结果 类风湿关节炎组与正常对照组相比,两组之间常规左室功能指标(EF、FS、E/A)差异无统计学意义(P＞0.05),而类风湿关节炎组Ea/Aa比值减低、Tei指数增高,两组之间差异有统计学意义(P＜0.05).结论 组织多普勒成像技术可早期评价类风湿关节炎患者的左心室功能受损情况,有助于临床及时制订相应的治疗措施,从而有效改善类风湿关节炎患者预后.     

组织多普勒技术评价原发性高血压患者左心室功能的临床研究

目的:评价组织多普勒(TDI)技术中Tei指数及二尖瓣环收缩期运动速度(Sa)测定原发性高血压病不同左室构型患者左室功能的价值.方法:原发性高血压患者80例,分为非肥厚组(Ⅰ组)、肥厚组(Ⅱ组),各40例,对照组40例.用PW技术测量室间隔(IVSd)、左心室后壁厚度(LVPWd)及左心室舒张末内径(LVDd),并记录左心室射血分数(LVEF)、二尖瓣血流频谱图舒张早期与舒张晚期血流峰值比(F/A).TDI技术于二尖瓣环选取室间隔、左心室侧壁、前壁和下壁4个位点,测量各位点Tei指数、二尖瓣环处收缩期运动速度Sa值(Sa为二尖瓣环收缩期运动速度)并取平均值(Sm)及舒张早期与舒张晚期峰速比(Ea/Aa).结果:(1)3组IVSd、LVPWd、Rwr差异有统计学意义(P<0.01),E/A与Ea/Aa在对照组均>1,在Ⅰ组、Ⅱ组均<1,Ⅰ组、Ⅱ组均低于对照组(P<0.01),Ⅰ组、Ⅱ组差异无统计学意义(P>0.05);3组LVEF差异无统计学意义(P>0.05).(2)3组Tei指数、IVCT呈递增趋势.Sm值呈递减趋势,差异有统计学意义(P<0.01).结论:(1)Sm值作为-个独立的TDI指标较LVEF更能早期、敏感地评价左心室收缩功能.(2)Tei指数能简便、敏感、综合评价高血压病患者左心室的舒缩功能,具有不易受其他因素干扰、重复性好等特点.     

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.