子宫切除途径的选择趋势

传统的子宫切除有经腹 (ｔｒａｎｓａｂｄｏｍｉｎａｌｈｙｓｔｅｒｅｃｔｏｍｙ ,ＴＡＨ)和经阴道 (ｔａｎｓｕａｇｉｎａｌｈｙｓｔｅｒｅｃｔｏｍｙ ,ＴＶＨ)两种。最近 10年随着内镜技术的发展 ,又出现了腹腔镜辅助的阴道子宫切除术 (ｌａｐａｒｏ ｓｃｏｐｉｃａｌｌｙａｓｓｉｓｔｅｄｖａｇｉｎａｌｈｙｓｔｅｒｅｃｔｏｍｙ ,ＬＡＶＨ)和标准的完全性腹腔镜子宫切除术[1 ] 。几十年来 ,英、美等国报道其ＴＡＨ与ＴＶＨ之比约为 3～ 4∶1[2 ] ,国内目前尚无有关这方面确切的统计资料。2 0世纪 5 0年代末 ,个别医院ＴＶＨ最多时与ＴＡ…     

医院抑郁/焦虑量表在住院期间孕妇心理评估及护理干预中的应用研究

医院抑郁/焦虑量表(HAD)在国内外常用于综合医院患者中焦虑和抑郁情绪的筛查,是一种自评量表,公认有较高的内部一致性[1,2]。女性在怀孕和生产期间,许多生物、心理、社会因素都会影响她们,产生一系列精神卫生问题,产后抑郁是临床上最常见的现象。本研究在已获得HAD     

哌嗪二酮衍生物的合成研究进展

哌嗪二酮衍生物 (ｄｉｋｅｔｏｐｉｐｅｒａｚｉｎｅｓ,ＤＫＰ)是结构最小的环二肽 ,最初在肽合成中尤其在固相肽合成中被视为副反应产物[1～ 4 ] 。生成的ＤＫＰ从固相载体上断裂 ,使肽合成无法继续。这不仅使反应收率下降 ,而且在载体上生成新的反应位点 ,从而引起其他的副反应。另一方面 ,ＤＫＰ骨架是稳定的六元环 ,有两个氢键给体和两个氢键受体。氢键是药物与受体相互作用的主要方式之一 ,因而ＤＫＰ在药物化学中是一个重要的药效团。现已发现许多有活性的天然产物中含有ＤＫＰ结构 ,如抑制哺乳动物细胞生长周期的化合物 1 ,2 [5～ 7] ,抑制谷胱甘肽 Ｓ 转移酶的3 [8] ,抑制血小板活化因子 (ＰＡＦ)的 4[9] (图 1 )。此外 ,ＣＣＫ Ｂ受体激动剂[1 0 ] ,局部异构酶抑制剂[1 1 ] 和具有细胞毒性的ｐｉｓｃａｒｉｎｉｅ[1 2 ] 和ｐｈｅｎｙｌａｈｉｓｔｉｎ (Ｉ) [1 3] 等分子中也含ＤＫＰ结构。Ｆｉｇｕｒｅ 1　Ｎａｔｕｒａｌｐｒｏｄｕｃｔｓｃｏｎｔａｉｎｉｎｇｔｈｅｓｔｒｕｃｔｕｒｅｏｆｄｉｋｅｔｏｐｉｐｅｒａｚｉｎｅ　　ＤＫＰ有两种类型 ,即 2 ,5 ｄｉｋｅｔｏｐｉｐ...     

2型糖尿病患者生活质量调查及影响因素分析

目的 探讨病程超过10年的2型糖尿病患者生活质量的影响因素.方法 对2009年12月至2011年12月在我院就诊或住院的病程超过10年的2型糖尿病患者95例进行问卷调查,采用多元逐步Logistic回归分析方法进行影响生活质量因素的分析.结果 特异性生存质量量表(DSQL)平均得分在不同年龄[50～60岁为(47±11)分,61～70岁为(54±13)分,＞70岁为(64±15)分]、婚姻状况[已婚为(48±11)分,离异或丧偶为(59±14)分]、文化程度[大专及以上为(46±11)分,高中为(54±12)分,初中及以下为(60±12)分]、抑郁[无抑郁为(50±12)分,可能抑郁为(55±12)分,有抑郁为(61±14)分]、病程[病程10 ～ 15年为(50±13)分,16 ～ 20年为(53±16)分,＞20年为(61±12)分]、并发症[无并发症为(46±10)分,1～2种并发症为(52±12)分,≥3种并发症为(59±13)分]的2型糖尿病患者之间比较差异有统计学意义(P＜0.05);将初筛得到的6个变量因素进行多元逐步Logistic回归分析,得到影响2型糖尿病患者生活质量的因素为抑郁严重程度、病程及并发症种类.结论 2型糖尿病患者抑郁程度越严重、病程越长、并发症种类越多,其总体生活质量越差.     

泥鳅多糖抗炎作用的实验研究

泥鳅 (ＭｉｓｇｕｒｎｕｓａｎｇｕｉｌｌｉｃａｕｄａｔｕｓＣａｎｔｏｒ)系鳅科动物 ,收载于《中药大辞典》[1] 。民间常用其黏液治痈肿、中耳炎 ,用活泥鳅捣碎外敷治疗乳癌、骨髓炎等 ,疗效显著[2 ] ,但至今尚未见到有关明确指出泥鳅中治疗炎症的活性成分的报道。在前文[3 ] 报道了泥鳅黏液是抗炎的有效部位的基础上 ,我们从泥鳅黏液中分离提纯得到泥鳅多糖[4 ] ,并对比研究了不同剂量的泥鳅多糖分别对五种抗炎实验模型的药理作用。1　材料和方法1.1　药品　地塞米松磷酸钠注射液 (ＤＥＸ ) ;生理盐水(ＮＳ) ;羧甲基纤维素钠 (ＣＭＣ) ,…     

主客体包结法选择分离补骨脂中的异补骨脂素

补骨脂又名破故纸 ,为豆科植物补骨脂(ＰｓｏｒａｌｅａｃｏｒｙｌｉｆｏｌｉａＬ)的成熟果实。主治温肾补精、白癜风、子宫出血等症[1] 。其化学成分有挥发油、树脂、补骨脂素 ( ｐｓｏｒａｌｅｎ )、异补骨脂素(ｉｓｏｐｓｏｒａｌｅｎ)、补骨脂酚 (ｂａｋｕｃｈｉｏｌ)和异补骨脂酮(ｉｓｏｂａｖａｃｈａｌｃｏｎｅ)等[2 ] 。其分离方法通常采用水蒸气蒸馏、溶剂分离及色谱等法[2～ 4 ] ,操作冗长 ,收率低 ,不能充分利用生药资源是分离工作的不足。我们曾报道了利用主客体分子相互识别的原理 ,将蛇床子中的欧前胡素和花椒毒素、马钱子中…     

大茴香酸-硫酸荧光体系测定黄芪甲苷

黄芪甲苷 (ａｓｔｒａｇａｌｏｓｉｄｅ)是中药膜荚黄芪Ａｓｔｒａｇａｌｕｓｍｅｍｂｒａｎａｃｅｕｓ (Ｆｉｓｃｈ .)Ｂｇｅ .和蒙古黄芪Ａｓｔｒａｇａｌｕｓｍｅｍｂｒａｎａｃｅｕｓ (Ｆｉｓｃｈ .)Ｂｇｅ .ｖａｒ .ｍｏｎｇｈｏｌｉｃｕｓ (Ｂｇｅ .)Ｈｓｉａｏ的主要活性成分 ,有抗炎、降压、镇痛、镇静、升高血浆中ｃＡＭＰ水平、促进小鼠再生肝ＤＮＡ的含量[1,2 ] 以及促进免疫功能等生理活性。黄芪甲苷的测定方法主要有 :紫外分光光度法[3 ,4 ] 、薄层扫描法[5,6] 和ＨＰＬＣ法[7,8] 。光度法常用香草醛在浓硫酸作用下与甲苷显色…     

单纯疱疹病毒1型感染引起的非典型脑干脑炎二例

单纯疱疹病毒 (Ｈｅｒｐｅｓｓｉｍｐｌｅｘｖｉｒｕｓ ,ＨＳＶ)是一种人类常见病毒 ,正常人大约 90 %呈血清学ＨＳＶｌ阳性 ,表明曾感染过病毒 ,这与尸检时 85 %～ 90 %人的三叉神经节存在潜伏的ＨＳＶｌ基因组相一致[1] 。ＨＳＶ引起的单纯疱疹病毒性脑炎 (Ｈｅｒｐｅｓｓｉｍｐｌｅｘｅｎ ｃｅｐｈａｌｉｔｉｓ ,ＨＳＥ)是人类最常见的散发性脑炎 ,其实际发病率尚不清楚 ,估计在 1/ 10万 /年[1] 。近年来用套式聚和酶链反应 (ｎｅｓｔｅｄＰＣＲ)在 93例ＨＳＥ病人中可检测到ＨＳＶｌ和ＨＳＶ2ＤＮＡ分别为 82例和 6例[2 ] 。神经系统Ｈ…     

人工制备浓缩血小板研究进展

<正>浓缩血小板(PC)的制备方法有富含血小板血浆(PRP)法、白膜层(BC)法和单采PC。目前,富浆法(PRP)和白膜法(BC)是国内、外最常用的两种人工制备浓缩血小板的方法[1]。PRP-PC因其制备过程与血小板激活相关,现已较少使用[2]。本文就人工制备浓缩血小板研究进展作一综述。     

应用氢溴酸西酞普兰治疗卒中后抑郁患者的临床疗效及脑电图改变分析

<正>脑卒中后抑郁(post-stroke depression,PSD)是脑血管疾病的一种常见并发症,是指脑出血或梗死后的伴随疾病出现的一种抑郁状态,患者常常表现为情绪低落、兴趣下降、睡眠障碍等抑郁症状[1]。有临床研究证实PSD患者如果不给予治疗,其症状可持续1年或更长时间,可导致躯体症状加重,而且加重精神痛苦,增加家庭和社会的负担,甚至可增加脑血管病的并发症和死亡率[2]。氢溴酸西酞普兰属于选择性5-羟     

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.     

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.