物理降糖及其作用机理的初步研究

目的：以三精锐普降糖仪（SSD）为代表研究物理降糖（PSRT）的作用机制。方法：临床实验：12名NIDDM患者在治疗前后分别测空腹血糖（FBS），胰岛素（INS），胰高血糖素，计算胰岛素敏感性指数（ISI）；动物实验：将32只Wistar大鼠分为四组：A：正常的对照组，B：糖尿病对照组，C:糖尿病大鼠治疗一天组，D：糖尿病大鼠治疗10天组，在D组大鼠治疗过程中，其它组大鼠不给任何处置，仅C组大鼠于第十天时治疗一次，在此10天前后分别测各组FBS；各组INS，胰高血糖素仅在10天后测量。结果：临床实验：FBS在治疗后降低（P＜0．05），胰高血糖素也降低（＜0．01），INS变化无差异，ISI上升（P＜0．05）；动物实验：D组在治疗后FBS下降（P＜0．05），D组INS与B组相比上升（P＜0．05），而胰高血糖素与B组相比降低（＜0．05）。结论：SSD可能通过改善胰岛素受体前，受体和受体后三个水平的缺陷达到治疗糖尿病的目的。     

三精锐普降糖仪在糖尿病治疗过程中胰高血糖素水平的变化

目的：观察三精锐普降糖仪在治疗糖尿病过程中血胰高血糖素的变化；方法：（1）临床实验观察了12名非胰岛素依赖性糖尿病（NIDDM）患者治疗前后空腹血糖（FBS），胰高血糖素水平的变化；（2）动物实验：取32只Wistar大鼠分为4组：A正常对照组，B糖尿病对照组，C糖尿病大鼠治疗一次组，D糖尿病大鼠治疗10次组，在治疗前后分别测FBS作自身对照，同时在治疗前后测胰高血糖素作组间对照；结果：（1）临床经验：FBS在治疗后显著降低（P＜0．05），胰高血糖素在治疗后下降（P＜0．05），（2）动物实验：A，B，C组FBS无显著性改变（P＜0．05），D组在治疗后FBS下降（P＜0．05），胰高血糖与B组比较上升（P＜0．05）；结论：三精锐普降糖仪通过降低胰高血糖的水平对血糖素的水平对糖尿病患者及大鼠有一定的治疗作用。     

三精锐普降糖仪对糖尿病患者及大鼠血糖水平的影响

目的：观察糖尿病患者及大鼠使用三精锐普降糖仪治疗前后血糖水平的影响。方法：临床实验：对16例糖尿病患者使用三精锐普降糖仪一次治疗前后的血糖进行测定，动物实验：取12只大鼠，用四氧嘧啶制成糖尿病模型后分成3组；（1）模型组；（2）治疗组；（3）对照组。另有空白对照组大鼠6只。结果：临床实验：16名糖尿病患者血糖均显著下降（P＜0．01）。动物实验：经过一个疗程（10d）的治疗后，治疗组大鼠的血糖明显低于模型组与对照组（P＜0．05），而与空白对照组无显著性差异（P＞0．05）。结论：三精锐普降糖仪可以降低糖尿病患者和大鼠的血糖。     

慢性乙型肝炎合并非酒精性脂肪性肝病的临床分析

目的：分析慢性乙型肝炎（ CHB）合并非酒精性脂肪性肝病（ NAFLD）患者的临床特点及病理特征。方法选取该院2009年1月收治的CHB＋NAFLD患者150例作为A组,予以肝穿刺组织活检及肝脏CT平扫,对血液生化学指标进行测定,同时选取同时期150例CHB和150例NAFLD患者分别作为B、C组。比较3组（1）血清学检查：丙氨酸转氨酶（ALT）、天门冬氨酸转氨酶（AST）、碱性磷酸酶（ALP）和丙氨酰转肽酶（GGT）。（2）血脂、血糖、胰岛素检查：总胆固醇（TC）、三酰甘油（TG）、空腹血糖（FBS）、胰岛素（INS）和胰岛素抵抗指数（IRI）。（3）肝组织学检查、肝/脾CT比值。结果 A组ALT、AST和GGT水平均高于B组和C组（P＜0．05）。3组血清ALP水平差异无统计学意义（P＞0．05）。 B组TC、TG、FBS、INS和IRI水平低于A组和C组,差异均有统计学意义（P＜0．05）。但A组和C组TC、TG、FBS、INS和IRI水平差异无统计学意义（ P ＞0．05）。 A组和 C 组脂肪变程度差异无统计学意义（ P＞0．05）。 A组炎症程度和纤维化程度高于B组和C组（P＜0．05）。 A组患者肝/脾CT比值低于B组,高于C组（P＜0．05）。结论 CHB＋NAFLD患者临床特点和病理特征与单纯CHB、NAFLD存在差异性,检查诊断时应予以区分。     

实验性糖尿病血管病变病理形态研究

观察实验性糖尿病大鼠后肢血管的病理形态改变及血栓形成情况，测定血纤溶酶原活化物抑制物（PAI－1）。结果显示：糖尿病（DM）组和胰岛素治疗（INS）组的血管内皮细胞、内弹力膜和平滑肌病变与对照组比较均有显著性差异（P＜0．05）。DM组的PAI－1活性明显升高（P＜0．05），尤其是有血栓形成者更为显著；INS组明显低于DM组（P＜0．05），提示DM的PAI－1活性增高与血栓形成呈正相关。INS治疗可降低PAI－1活性。     

胰岛素强化治疗糖尿病肾病30例分析

目的：分析胰岛素强化治疗糖尿病肾病的疗效。方法：在血糖严密监测下，每日三餐前皮下注射胰岛素或用Novo INS笔皮下注射。结果：Ⅲ期糖尿病肾病治疗前后BG，HbAlc,24h尿微量白蛋白差异均有非常显性（P＜0．01），Ⅳ期糖尿病肾病治疗前后BG，HbAlc差异有非常显性（P＜0．01），尿总尿白差异有显性（P＜0．05）。结论：胰岛素强化治疗糖尿病肾病可以缓解临床症状，纠正代谢紊乱，防止或延缓糖尿病肾病的发展。     

卡维地洛尔对高血压病患者胰岛素抵抗的影响

目的：探讨卡维地洛尔对高血压病（EH）患者胰岛素抵抗（IR）的影响。方法：42例EH患者给予卡维地洛尔5－40mg，每日里起一次口服。治疗前及治疗12周后，分别测血压、心率、空腹血糖（FPG）及空腹血浆胰岛素（FPI），计算胰岛素敏感指数（ISI）；20例健康人做为对照组。结果：EH患者血压均有明显下降（P＜0．05），心率无显著变化（P＞0．05），56．1％的EH患者存在IR，EH组FPI显著升高（P＜0．01），ISI显著下降（P＜0．01）；卡维地洛尔治疗12周后，FPI明显下降（P＜0．05），ISI明显升高（P＜0．05）。结论：高血压患者存在IR，卡维地洛尔在降压的同时可改善IR。     

胰岛素类似物与人胰岛素在初诊2型糖尿病治疗中的价效比分析

目的：比较胰岛素类似物与人胰岛素在初诊2型糖尿病治疗中的价格-疗效。方法96例初诊为2型糖尿病的患者,随机分为优泌乐25治疗组（ A组）和优泌林70/30治疗组（ B组）,监测血糖水平,记录低血糖事件、治疗前后测HbA1 c、胰岛功能,计算住院期间及出院后治疗糖尿病的费用。结果 A组与B组的餐后血糖明显下降（ P ＜0 y．01）,且A组比B组的餐后血糖下降显著（ P ＜0．05）;治疗3个月后2组的HbA1c明显下降（ P ＜0．01）,A组比B组的下降显著（ P ＜0．05）;胰岛素及C-肽水平较治疗前有所上升（ P ＜0．05）,A组比B组的上升显著（ P ＜0．05）;A组较B组的低血糖事件少（ P ＜0．05）,且无严重低血糖事件发生。结论胰岛素类似物比人胰岛素具有更好的疗效,且安全、灵活、方便、患者依从性好,同时也比人胰岛素更为经济。     

脂糖舒对正常和糖尿病小鼠耐寒和耐热能力的影响

目的：观察脂糖舒增强正常和糖尿病机体的抗寒和耐热能力。方法：分别用脂糖舒、优降糖、降糖灵和消渴刃灌胃正常小鼠和四氧嘧啶糖尿病模型小鼠15d，检测各组小鼠耐寒和耐热存活时间（min）。结果：①脂糖舒、优降糖、降糖灵和消渴刃均能显著延长正常和糖尿病小鼠的耐寒和耐热存活时间（较生理盐水组P＜0．05－0．00）。其中，正常小鼠耐寒：脂糖舒优于优降糖、降糖灵和消渴丸（P＜0．001）；糖尿病小鼠耐寒：脂糖舒优于降糖和消渴丸（P＜0．001），与降糖灵相当（P＞0．05）。正常小鼠耐热：脂糖舒剂量≥5g/kg时优于优降糖（P＞0．05），与降糖灵和消渴丸相当（P＞0．05）；糖尿病小鼠耐热：各给药组间差异无显著意义（P＞0．05）。②脂糖舒延长正常和糖尿病小鼠耐寒和耐热存活时间的量效关系明显（P＜0．01）。结论：脂糖舒明显增强正常小鼠和糖尿病小鼠的耐寒和耐热能力，且呈剂量依赖关系。     

达因－35联合二甲双胍治疗多囊卵巢综合征的临床效果评价

目的：评价达因－35联合二甲双胍治疗多囊卵巢综合征的临床效果。方法选择2008年10月～2013年10月在我院就诊的多囊卵巢综合征患者50例,A组30例,口服达因－35联合二甲双胍治疗。 B组20例,单独服用达因－35治疗。两组用药时间均为6个月。观察患者临床表现,测定患者血清卵泡刺激素（FSH）、黄体生成素（LH）、睾酮（T）、测量腰／臀（腰围／臀位）比值（WHR）,体重指数,测定空腹血糖（FBG）及空腹胰岛素（FINS）水平,并进行治疗前后的比较。结果 A组治疗后较治疗前LH、LH／FSH、T及WHR、FINS明显降低（P＜0．01或P＜0．05）,体重指数下降比例显著（P＜0．05）,FBS无显著改变（P＞0．05）;B组LH、LH／FSH、T明显降低（P ＜0．01）,体重指数下降比例不明显（P＞0．05）, WHR无明显变化（P＞0．05）,FBS、FINS无明显变化（P＞0．05）。结论达因－35联合二甲双胍治疗多囊卵巢综合征的临床疗效优于单用达因－35。     

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.     

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.