缬沙坦与硝苯地平治疗原发性高血压的疗效对比

目的 探讨应用缬沙坦与硝苯地平缓释片治疗原发性高血压的临床疗效.方法 选取原发性高血压患者210例随机分为两组,各105例.其中观察组给予缬沙坦治疗,对照组给予硝苯地平缓释片治疗.对两组患者治疗效果及心功能改善情况进行统计对比.结果 缬沙坦治疗原发性高血压临床总有效率为90.48％,明显优于对照组硝苯地平缓释片治疗疗效(62.86％);两组患者每搏输出量(SV)、每分钟排血量(CO)及心脏指数(CI)治疗后均轻治疗前有明显提高,且观察组提高更加明显.以上各项比较差异均有统计学意义(P＜0.05).结论 与硝苯地平缓释片相比,缬沙坦用以治疗原发性离血压效果更佳.     

探讨硝苯地平缓释片联合厄贝沙坦治疗原发性高血压的临床效果

目的研究硝苯地平缓释片联合厄贝沙坦片治疗原发性高血压的临床疗效。方法将原发性高血压患者106例的病例资料作为对象,均为2015年1月至2017年2月收治,依据治疗药物的不同分为对照组(硝苯地平缓释片)和观察组(硝苯地平缓释片与厄贝沙坦片联用)。连续治疗3个月后,观察两组患者的临床治疗效果和血压改善情况。结果观察组显效率49.06%,有效率43.40%,对照组显效率41.51%,有效率32.08%;两组总有效率比较χ2=11.523,P=0.001;两组患者治疗后血压均有显著下降,其中观察组患者的血压改善情况更为明显,对比差异具有显著性(P<0.05)。结论对于原发性高血压患者的临床治疗,采用硝苯地平缓释片联合厄贝沙坦具有显著的临床效果。     

硝苯地平缓释片联合依那普利治疗126例原发性高血压病疗效分析

目的：探究硝苯地平缓释片与依那普利联合用药治疗原发性高血压临床疗效,为硝苯地平缓释片联合依那普利治疗原发性高血压提供科学理论依据。方法选择本院2011年4月~2013年8月收治的126例原发性高血压患者为研究对象,采用随机数字表法分为对照组与观察组（每组63例）,对照组给予常规口服依那普利治疗,观察组在对照组治疗基础上加用硝苯地平缓释片治疗,对比两组患者临床治疗效果及治疗前后血压变化情况。结果两组患者经为期2个月治疗后,血压均有下降,观察组患者血压下降水平显效36例,对照组10例;观察组患者血压下降水平有效24例,对照组35例;观察组患者血压未曾变化甚至恶化3例,对照组18例,组间数据对比,观察组降压效果明显优于对照组（P〈0.05）;两组患者治疗前后舒张压、收缩压均有明显变化（P〈0.05）。结论硝苯地平缓释片联合依那普利治疗原发性高血压有显著降压治疗效果,可在临床上进行大力推广并应用。     

老年原发性高血压的治疗分析

目的探讨不同药物使用方案治疗老年原发性高血压的效果。方法选取来我院接受治疗的254例原发性高血压患者作为研究对象,以入院时间先后顺序将其分为研究组与对照组,对照组给予左旋氨氯地平片治疗,研究组在对照组基础上加用硝苯地平缓释片,比较两组患者收缩压和舒张压变化,以及睡眠质量差异。结果治疗后两组患者收缩压、舒张压均明显降低,并且研究组的收缩压与舒张压变化幅度均大于对照组,差异具有统计学意义(P <0.05);治疗后两组患者睡眠质量评分均降低,并且研究组变化幅度大于对照组,差异具有统计学意义(P <0.05)。结论在治疗老年原发性高血压时联合应用左旋氨氯地平片和硝苯地平缓释片,能够提高对患者血压控制的效果并更好地改善患者睡眠质量。     

两种不同联合降压方案对轻中度原发性高血压患者血压变异性及肌酸激酶的影响

目的比较硝苯地平控释片联合美托洛尔缓释片和厄贝沙坦片联合美托洛尔缓释片对轻中度原发性高血压患者血压变异性(BPV)和肌酸激酶(CK)的影响。方法①入选2017年6月—2018年5月门诊和住院年龄在18～65岁且静息心率≥80次·min~(-1)的初诊为轻中度原发性高血压患者52例为高血压组,选择同期体检的正常人60例为正常血压组,比较两组一般资料的差异;②将52例高血压患者随机分为两组:硝苯地平组(27例,硝苯地平控释片联合美托洛尔缓释片)及厄贝沙坦组(25例,厄贝沙坦片联合美托洛尔缓释片),比较两组治疗前及治疗12周后常规生化和部分24 h动态血压监测指标。结果①高血压组CK、尿酸(UA)与体质量指数(BMI)明显高于正常血压组(P <0.05,P <0.01);②治疗12周后,硝苯地平组及厄贝沙坦组较治疗前平均血压均明显降低(P <0.01),硝苯地平组24 h收缩压标准差(24 h SBPSD)、白昼收缩压标准差(d SBPSD)、夜间收缩压标准差(n SBPSD)较治疗前明显降低(P<0.05);③治疗12周后硝苯地平组及厄贝沙坦组CK、UA等较治疗前均无明显差异(P> 0.05),但硝苯地平组CK有下降趋势。结论①硝苯地平组及厄贝沙坦组对轻中度原发性高血压患者降压疗效相当,但硝苯地平组在降低轻中度原发性高血压患者收缩压变异性方面优于厄贝沙坦组;②硝苯地平组与厄贝沙坦组对CK均无明显影响。     

卡维地洛联合缬沙坦氢氯噻嗪治疗顽固性高血压的临床研究

目的探讨卡维地洛联合缬沙坦氢氯噻嗪治疗顽固性高血压的临床疗效。方法选择2017年4月—2018年4月在延安大学附属医院治疗的顽固性高血压患者86例,根据用药差别分为对照组(43例)和治疗组(43例)。对照组口服缬沙坦氢氯噻嗪片,1片/次,1次/d;治疗组在对照组基础上口服卡维地洛片,起始6.25 mg/次,2次/d,根据血压情况成倍增减剂量,最大剂量小于50 mg/d。两组患者均治疗4周。观察两组患者临床疗效,同时比较治疗前后两组患者血压、HAMA评分、HAMD评分、SPIEGEL评分、SF-36评分、肱动脉内皮依赖性舒张功能(EDD)、肱动脉非内皮依赖的舒张功能(NMD)及血清C反应蛋白(CRP)、同型半胱氨酸(Hcy)、内皮素-1(ET-1)、血管性血友病因子(v WF)和血管紧张素Ⅱ(AngⅡ)水平。结果治疗后,对照组临床有效率为79.07%,显著低于治疗组的95.35%,两组比较差异具有统计学意义(P0.05)。经治疗,两组患者SBP、DBP均明显下降(P0.05),且治疗组患者收缩压(SBP)、舒张压(DBP)明显低于对照组患者(P0.05)。经治疗,两组HAMA、HAMD和SPIEGEL评分明显降低(P0.05),SF-36评分明显升高(P0.05),且治疗组患者HAMA、HAMD、SPIEGEL和SF-36评分明显优于对照组患者(P0.05)。经治疗,两组患者EDD、NMD均明显升高(P0.05),且治疗组患者EDD、NMD明显高于对照组患者(P0.05)。经治疗,两组患者血清CRP、Hcy、ET-1、v WF、AngⅡ均明显降低(P0.05),且治疗组患者上述血清细胞因子明显低于对照组(P0.05)。结论卡维地洛片联合缬沙坦氢氯噻嗪片治疗顽固性高血压可有效降低患者血压水平,促进血管内皮功能改善,改善患者焦虑、抑郁情绪,促进患者睡眠及生活质量提高。     

依那普利联合硝苯地平缓释片治疗原发性高血压的社区随访观察

目的 探讨社区随访观察依那普利联合硝苯地平缓释片治疗原发性高血压的临床疗效 方法 将72例原发性高血压患者随机分为治疗组和对照组,治疗组采用依那普利联合硝苯地平缓释片治疗,其中依那普利5 mg/d,1次口服,硝苯地平缓释片10 mg/d,1次口服对照组单用依那普利5mg/d,1次口服8周后,比较两组治疗效果 结果 治疗纽降压效果明显优于对照组.两组差异有统计学意义(P＜0.05).结论 依那普利联合硝苯地平缓释片较单独使用依那普利治疗原发性高血压痛疗效更为确切.     

苯磺酸氨氯地平和硝苯地平缓释片治疗原发性高血压的疗效观察

目的:比较苯磺酸氨氯地平和硝苯地平缓释片对轻、中度原发性高血压的降压疗效及安全性.方法:200 例原发性高血压患者随机分成苯磺酸氨氯地平组和硝苯地平缓释片组,疗程8周,观察治疗前后血压变化,判断降压疗效并记录不良反应.结果:两组均能有效降低血压(P＜0.01),苯磺酸氨氯地平组总有效率为95%,硝苯地平缓释片组总有效率为86%,两者比较差异无统计学意义(P＞0.05).苯磺酸氨氯地平组不良反应(5%)显著低于硝苯地平缓释片组(14%)(P＜0.05).结论:苯磺酸氨氯地平治疗轻、中度高血压具有较好的降压效果和依从性,不良反应轻微.     

缬沙坦治疗原发性高血压伴高尿酸血症的临床观察

目的探讨缬沙坦治疗原发性高血压伴高尿酸血症的临床疗效。方法 120例老年原发性高血压伴高尿酸血症患者,随机分为试验组与对照组,各60例。试验组给予缬沙坦,对照组给予硝苯地平缓释片,比较两组患者的疗效。结果治疗后两组患者SBP、DBP均较治疗前有明显降低(P0.05),两组患者血压均降至正常,组间差异无统计学意义(P0.05)。而试验组用药前尿酸(491.03±73.57)μmol/L,用药后尿酸(385.71±34.28)μmol/L,血尿酸明显下降(P0.05)。硝苯地平缓释片血尿酸较用药前后差异无统计学意义。结论缬沙坦对伴高尿酸血症的原发性高血压患者疗效显著,安全、作用持久,值得临床推广应用。     

生脉胶囊治疗原发性高血压患者的疗效观察

以生脉胶囊配合硝苯地平缓释片治疗原发性高血压患者38例(治疗组)与单纯应用硝苯地平缓释片治疗30例(对照组)比较,连续用药4周,观察血压、心脏舒张功能改善的情况。结果表明,治疗组各指标明显优于对照组(P<0.05)。     

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.