人血清卵泡抑素样蛋白1与急性心肌梗死患者左室重构相关性的研究

目的:探讨急性心肌梗死(AMI)患者及健康体检者血清人卵泡抑素样蛋白1(FSTL-1)水平的变化及其与急性心肌梗死后左室重构的相关性。方法:选取急性心肌梗死患者48例(AMI组)和健康对照患者48例(对照组)。AMI组均在发病72 h内就诊,采集外周静脉血,采用酶联免疫吸附法检测血清FSTL-1水平。超声心动图测定左室重构指标:左房内径、左室舒张末内径、射血分数。通过统计学分析FSTL-1在两组间的表达水平及其与左室重构的相关性。结果:AMI组FSTL-1表达水平明显高于对照组(P<0.05);FSTL-1与AMI后左房内径(r=0.54,P<0.05)、左室舒张末内径(r=0.58,P<0.05)呈正相关;与左室射血分数(r=-0.64,P<0.05)呈负相关;与性别、年龄、是否吸烟及饮酒、身体质量指数、血脂、高血压、糖尿病无相关性,与脑钠肽呈正相关。结论:FSTL-1在急性心肌梗死患者中高表达,并且与急性心肌梗死后左室重构相关。     

卡托普利对前壁心肌梗死后早期心室重构的影响

急性心肌梗死(AMI)6周内早期心室重构是梗死病人急性期泵衰竭的重要病理过程,容易出现并发症而影响预后。本文以左室舒张末期内径(LVEDD)、左室舒张末期容量(LVEDV)和左室射血分数(LVEF)为对照观察,探讨卡托普利对前壁心肌梗死后早期心室重构的影响。     

卡托普利对心肌梗死后左室重塑的影响

目的 探讨卡托普利(开搏通)与急性心肌梗死(AMI)后左室重塑的关系.方法 选择首次AMI患者70例,在发病后给予卡托普利治疗,应用彩色多普勒超声显像仪,于发病第4周和52周行超声心动图检查,观察左室形态、大小、室壁运动并记录左室收缩末期内径(LVDs)、舒张末期内径(LVDd)、左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)、左室射血分数(LVEF)、左房内径(LAD)和二尖瓣血流频谱图中快速充盈E波最大流速(VE)和心房充盈A波最大流速(VA)等指标并计算VE/VA等指标.其中8例退出研究,将不规律应用卡托普利(n=29)和规律服用卡托普利(n=33)患者分为A、B 2组,比较52周时2组超声心动图观察指标.结果 B组的LVDs、LVDd、LVESV、LVEDV和LAD比A组降低,但LVEF和VE/VA比A组升高(P＜0.05).结论 卡托普利可以干预AMI后左室重塑,明显改善左室舒缩功能.     

急诊冠状动脉介入治疗对急性心肌梗死患者左心室功能的影响研究

目的应用超声心动图(ECHO)分析评价急诊经皮冠状动脉介入术(PCI)及静脉溶栓治疗对急性心肌梗死(AMI)患者左心室功能的影响。方法 60例AMI患者,随机分为PCI组(30例)与溶栓组(30例),两组的内科治疗相同。应用彩色多普勒超声测定两组患者治疗后第2、4周的左室舒张末期内径(LVD)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、射血分数(EF)及左室短轴缩短率(FS)的变化情况,以评价左心室功能。结果 PCI组患者治疗后第4周与第2周LVD、LVEDV、LVESV比较差异均无统计学意义(P>0.05),EF及FS比较差异均有统计学意义(P<0.05)。溶栓组患者治疗后第4周与第2周LVD、LVEDV、LVESV比较差异均有统计学意义(P<0.05);EF及FS比较差异均无统计学意义(P>0.05,);溶栓组治疗第2、4周的LVD、LVEDV、LVESV、EF及FS与PCI组比较差异均有统计学意义(P<0.05)。结论直接PCI开通梗死相关动脉,改善左室重构,提高左心室功能较静脉药物溶栓疗效显著。     

人参总皂苷促进血管新生改善急性心肌梗死大鼠心功能

目的探讨人参总皂苷(total ginsenosides,TG)对大鼠急性心肌梗死(acute myocardial infarction,AMI)模型血管新生及心功能的影响。方法结扎♂SD大鼠冠状动脉前降支,制备AMI模型,随机分为模型组、TG低剂量和高剂量组(腹腔注射给予TG 20、40 mg·kg~(-1)·d~(-1)),假手术组与模型组给予等量生理盐水;彩色多普勒超声检测大鼠心功能;HE染色、Masson染色和免疫组化染色后观察心肌病理组织学变化和微血管密度;real-time PCR检测心肌组织中血管内皮生长因子(VEGF)和碱性成纤维细胞生长因子(bFGF)mRNA水平。结果 TG治疗35 d后,与模型组比较,TG高和低剂量组均能明显缩小左心室舒张末期内径、左心室收缩末期内径、舒张末期左室容积和收缩末期左室容积(P<0.05),明显增加左室射血分数、左室短轴缩短率(P<0.01)。TG组心肌梗死面积和纤维化改变明显减小,心室壁较厚;梗死区及其周边心肌组织CD31阳性细胞组成的微血管密度较模型组增高(P<0.05);缺血区心肌组织中VEGF和bFGF mRNA表达明显高于模型组(P<0.01)。结论 TG可明显促进急性心肌梗死大鼠心脏功能恢复和改善心室重构及梗死区心肌血液供应,作用机制与上调心肌组织VEGF和bFGF基因表达、促进血管新生而增加血液供应有关。     

依那普利对老年心肌梗死后左室重构的防治效果

目的探讨老年人急性心肌梗死(AMI)后左室重构的发生及血管紧张素转换酶抑制剂(ACEI)-依那普利的防治效果.方法51例老年AMI患者于发病后24小时随机分为依那普利组(5mg/d逐渐加量至20mg/d)和对照组.定期检查超声心动图,随访观察6个月(n=49).结果依那普利组(n=23)左室舒张末期容量指数(LVEDVI ml/m2)和左室收缩末期容量指数(LVES-Ⅵml/m2)从1～6个月没有明显增加,左室质量指数(LVMI gl/m2)在6个时明显减少.而对照组(n=25)上述指标明显增加伴左室射血分数(LVEF%)降低.对照组前壁AMI的LVEDVI、LVESVI比下壁AMI和治疗组前壁AMI均显著增加(P＜0.05～0.01).结论急性AMI后的左室重构主要是梗塞区膨展,左室扩张及容量负荷增加.依那普利可减少AMI后左室容量和质量指数,对左室重构的发生和发展有明显的防治作用.     

氟伐他汀对心肌梗死后心衰大鼠白介素-1β表达的影响

目的探讨羟甲基戊二酰辅酶A(HMG-CoA)还原酶抑制剂氟伐他汀对急性心肌梗死后心衰大鼠白介素-1β(IL-1β)表达变化的影响。方法♀SD大鼠急性心肌梗死(AMI)术后6 h随机分为:①AMI对照组;②氟伐他汀组;另设:③假手术组。直接灌胃给药8 wk后行高频多普勒超声、血流动力学、心室重塑指标、左室心肌IL-1βmRNA表达的测定。结果与假手术组相比,AMI组左室舒张末期内径(LVEDD)、左室舒张末期容积(LVEDV)、E峰、E峰减速度、E/A、左室舒张末压(LVEDP)、左、右心室心肌肥厚指数、非梗死区胶原容积分数(CVF)和IL-1βmRNA均增加(P均<0.01),左室短轴速短率(FS)和射血分数(EF)均降低(P均<0.01)。与AMI组相比,氟伐他汀组的LVEDD、LVEDV、E峰、E峰减速度、E/A、LVEDP和左、右心室心肌肥厚指数、CVF和IL-1βmRNA均降低(P均<0.01),FS和EF升高(P均<0.01)。结论氟伐他汀能有效抑制心室重塑,延缓心衰进展,其机制可能部分通过下调心梗后心衰大鼠心肌IL-1β的表达,改善炎症反应。     

不同类型急性心肌梗死早期介入治疗效果的比较

目的:比较急性非ST段抬高型心肌梗死(NSTEMI)和急性ST段抬高型心肌梗死(STEMI)患者接受早期再灌注治疗后冠脉血流、心肌灌注及心功能情况的差异。方法:接受早期再灌注治疗的急性心肌梗死患者共168例,分为NSTEMI组55例和STEMI组113例,比较2组患者的术后心肌呈色分级(MBG),术前及术后的溶栓治疗(TIMI)血流分级、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV),左室质量(LVW)、左室质量指数(LVWI)及左室射血分数(LVEF)。结果:2组术后TIMI血流情况、LVEDV、LVW及LVWI差异无统计学意义(P>0.05),但NSTEMI组术前TIMI血流3级的比例、术后MBG3级比例和LVEF明显优于STEMI组,差异有统计学意义(P<0.05或P<0.01)。结论:NSTEMI患者接受早期介入治疗术后的心肌再灌注情况以及左室收缩功能优于STEMI患者。     

左室急性心肌梗死急诊介入治疗与择期介入的对比分析

目的探讨左室急性心肌梗死急诊介入与择期介入对心室重构和心脏功能的影响。方法选取笔者所在医院门诊确诊并收治的76例初次左室急性心肌梗死患者,随机分为急诊组(24h内)52例、延迟1组(24h～2周)18例和延迟2组(2周以上)6例,心肌梗死术前及术后3、6个月分别进行心脏功能的测量和舒张末期内径的测定。结果急诊组及延迟1组术后3、6个月心脏功能明显改善,差异有统计学意义(P<0.05);急诊组、延迟1组术前和术后3、6个月舒张末期内径均较延迟2组小,差异有统计学意义(P<0.05)。结论左室急性心肌梗死急诊介入及延迟(12h～2周)介入均能对心室重构和心脏功能有所改善。     

不同剂量阿托伐他汀对急性心肌梗死患者介入治疗后血浆脑钠素水平及心室重构的影响

目的探讨不同剂量阿托伐他汀治疗接受经皮冠状动脉介入治疗(PCI)的急性心肌梗死患者对血浆脑钠素水平和左室重构的影响。方法接受经皮冠状动脉介入治疗的急性心肌梗死患者共116例,其中阿托伐他汀20mg为A组,阿托伐他汀40mg为B组,阿托伐他汀80mg为C组。ELISA法测定入院即刻、24h、48h、7d、14d、30d时血浆脑钠素水平;入院后3-5d、30d超声心动图测量左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室射血分数(LVEF)。结果 B组血浆脑钠素水平在48h、7d、14d时间点较A组降低,有显著性差异(P<0.05);C组血浆脑钠素水平在24h、48h、7d、14d、30d时间点较A组、B组降低,有显著性差异(P<0.05和P<0.01)。B组在30d时间点左室舒张末期容积、左室收缩末期容积、左心室射血分数均较A组明显改善(P<0.05);C组在3-5d、30d时间点均较A组明显改善(P<0.05和P<0.01),在30d时间点较B组明显改善(P<0.05)。结论早期大剂量阿托伐他汀治疗可在PCI治疗基础上更快速、有效的改善左室重构,其机制之一可能是通过降低血浆脑钠素水平实现的。     

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.