急性冠脉综合征糖代谢异常与高敏C反应蛋白的关系

目的 探讨急性冠脉综合征患者糖代谢异常与高敏C反应蛋白的关系。方法 急性冠脉综合征（ACS）患者155例分糖耐量正常A组、糖耐量异常B组、糖尿病C组，测定血糖（FBG、PBG）、胰岛素（FINS、PINS）、糖化血红蛋白（HbA1c）、高敏C反应蛋白（hs-CRP）、血脂等指标，95例做了冠状动脉造影。结果 进行统计分析，比较三组的高敏C反应蛋白、胰岛素、糖化血红蛋白、血脂水平及冠脉病变。结果 C组、B组与A组的Hs-CRP、FBG、PBG、FINS、PINS、HbA．C、TC、LDL．C等生化指标比较差异有统计学意义；C组和B组的PINS、TC水平差异无统计学意义；Hs，CRP的水平与PBG、PINS、HbA．C、TC、LDL．C相关。B和C组的冠状动脉造影显示病变更为严重，多支血管病变的发生率明显高于A组；多支血管病变的发生率在B组和C组间差异无统计学意义。结论 与糖代谢正常的ACS患者相比，合并糖代谢异常的ACS患者有更高的高敏C反应蛋白水平，冠脉病变更为严重。     

急性冠脉综合征糖代谢异常与冠状动脉病变程度的关系探讨

目的：探讨急性冠脉综合征（ACS）患者糖代谢异常与冠状动脉病变程度的关系。方法：对190例急性冠脉综合征患者做葡萄糖耐量试验,根据血糖水平依次分为糖耐量正常A组、糖耐量异常B组、糖尿病C组。利用冠状动脉造影确定冠状动脉病变严重程度。结果：在ACS患者中,合并糖代谢异常的患者占总数的71.6%,约占2/3;糖代谢异常组的冠状动脉造影显示病变更为严重,多支血管病变的发生率明显高于糖耐量正常组;多支血管病变的发生率在糖耐量异常和糖尿病组间差异无统计学意义。结论：合并糖代谢异常的ACS患者冠脉病变程度更为严重。     

急性冠脉综合征中糖代谢异常与血浆P选择素、冠脉病变程度的关系

目的 探讨急性冠脉综合征(ACS)患者血糖异常与血浆P选择素和冠状动脉病变程度的关系.方法 ACS患者116例,其中单纯ACS组40例、ACS合并糖调节异常组(糖耐量受损组/空腹血糖受损)34例、ACS合并2型糖尿病组42例,单纯2型糖尿病组26例,正常对照组26例.采用ELISA法测定各组血浆可溶性P选择素水平.结果 单纯ACS组、ACS合并糖调节异常组、ACS合并2型糖尿病组、单纯2型糖尿病组P选择素水平均高于正常对照组,其中ACS合并糖调节异常组、ACS合并2型糖尿病组P选择素水平均高于单纯ACS组(P＜0.05).ACS合并糖调节异常组以及ACS合并2型糖尿病组多支冠状动脉病变的发生率以及冠状动脉狭窄的严重程度均明显高于单纯ACS组(P＜0.05).结论 糖代谢紊乱的ACS患者较糖耐量正常的ACS患者具有更严重的血小板活化状态.ACS合并糖代谢异常患者冠脉病变程度更严重、范围更广泛,临床预后更差.     

急性冠脉综合征患者糖化血红蛋白水平与预后的关系

目的 探讨急性冠脉综合征（ACS）患者糖化血红蛋白水平情况及其对ACS患者预后的影响.方法 将102例急性冠脉综合征患者根据糖化血红蛋白水平分为糖化血红蛋白正常组（A组）（HbAlc＜6.5％,n=31例）、糖化血红蛋白低危组（B组）（6.5％＜HbAlc＜7.5％,n=36例）、糖化血红蛋白高危组（C组）（HbAlc＞7.5％,n=35例）3组,分别观察各组入院时、3个月后12个月后的极低密度脂蛋白（VLDL）、C反应蛋白（CRP）、体重指数（BMI）、射血分数（EF）及相关心血管不良事件,如心绞痛、严重心律失常、再发心肌梗死、肺部感染等并发症发生情况.结果 ①A、B组及C组患者入院时VLDL、CRP、BMI及EF值差异无统计学意义（P＞0.05）,而3个月后及12个月后C组EF值较入院时未明显改善（P＞0.05）;②住院及随访12个月期间C组心血管不良事件心绞痛发生率、肺部感染发生率及死亡率较人院时明显增高（P＜0.05）.且HbAlc与心绞痛、严重心律失常、再发心肌梗死、肺部感染及死亡均呈正相关（r=0.412、0.271、0.319、0.251、0.134）.结论 糖化血红蛋白异常可不同程度地升高急性冠脉综合征患者心血管不良事件的发生率.     

糖耐量异常对冠心病支架植入术后主要心脏事件的影响

目的 探讨糖耐量异常对冠心病支架植入术后冠心病患者主要心脏事件的影响.方法 215例冠状动脉造影资料齐全的支架术后的患者,分为合并2型糖尿病(2-DM)组(A组)、糖耐量异常组(B组)、糖代谢正常组(NDM)(C组),比较三组在住院期间和随访期间发生典型心绞痛、非致死性心肌梗死、心源性死亡和靶血管重建等主要心脏事件(MACE)的发生率.结果 A组与B组主要心脏事件发生率显著高于C组(P＜0.01);A组与B组间差异无统计学意义;A组再狭窄发生率高于B组(P＜0.01).结论 冠心病合并糖耐量异常患者与冠心病合并糖尿病患者一样,有较高的心脏事件发生率,故对合并糖耐量异常的冠心病患者应及早干预,积极控制血糖.     

急性冠脉综合征患者血糖变异性与冠脉病变程度相关性分析

目的：探讨急性冠脉综合征患者血糖变异性与冠脉病变程度的相关性。方法回顾性分析2012年4月~2013年12月我院收治的160例ACS患者的临床资料,将所有患者按照是否合并糖尿病分为A组80例,该组均为ACS合并糖尿病患者;B组80例,该组均为ACS不合并糖尿病患者。比较两组患者基本临床特征、冠脉狭窄分数、血糖变异系数及住院期间不良事件发生率,并用多元逐步回归分析预后的影响因素。结果 A组患者的TC、HDL-C水平与B组的比较明显降低,而纤维蛋白原水平及高血压患者比例与B组的相比则较高,差异有统计学意义（P＜0.05）;A组患者冠脉狭窄分数、血糖变异系数及严重心律失常、心衰、心源性休克及死亡发生率与B组的比较均明显升高,差异有统计学意义（P＜0.05）。糖尿病、HDL-C、血糖变异系数、高血压病程及平均血糖水平均为死亡率的影响因素（P＜0.05）。结论 ACS患者住院期间的血糖变异性会影响其近期预后,临床医生应对ACS患者血糖加强监测力度,保持血糖平稳,使ACS患者的预后改善。     

空腹血糖水平与急性冠脉综合征患者预后的相关性研究

目的探讨空腹血糖（FPG）水平与急性冠脉综合征（ACS）患者预后的相关性。方法依据患者入院次日的FPG水平将386例ACS患者分为3组：A组112例,FPG2.8～6.9mmol/L;B组178例,FPG7.0～11.09mmol/L;C组96例,FPG〉11.1mmol/L。对3组住院期间恶性心血管事件的发生情况进行比较。结果 B组严重心律失常、心力衰竭发生率与A组比较,差异有统计学意义（P〈0.05或P〈0.01）,但两组心源性休克和心源性猝死发生率比较,差异无统计学意义（P〉0.05）。C组所有恶性心血管事件发生率与A组和B组比较,差异均有统计学意义（P〈0.05或P〈0.01）。结论 ACS患者的FPG水平与近期预后密切相关,应加强对ACS患者的血糖监测及有效控制。     

新型抗精神病药物阿立哌唑对糖代谢影响及与糖化血红蛋白的关系

目的：探讨新型抗精神病药物阿立哌唑与氯氮平对患者糖代谢的影响及其与糖化血红蛋白（HbA1c）的关系。方法：选择本院2006年10月～2010年10月收治的精神分裂症患者140例,根据用药情况分为A组80例,B组60例,A组患者给予阿立哌唑治疗,B组患者给予氯氮平治疗,测定患者治疗前、治疗3个月后的空腹血糖（FBG）与口服糖耐量2 h血糖（PBG）,及治疗后不同糖化血红蛋白水平的患者血糖变化情况。结果：两组治疗前PBG、FBG水平差异无统计学意义,治疗后两组FBG差异无统计学意义,治疗后A组内HbA1c正常者与B组内HbA1c正常者PBG差异无统计学意义,A组HbA1c异常者与B组HbA1c异常者治疗后PBG差异有统计学意义,后者明显高于前者,也明显高于本组治疗前水平。结论：阿立哌唑对精神病患者糖代谢影响较小,用药方便值得借鉴。     

急性冠脉综合征合并抑郁临床分析

目的：通过对急性冠脉综合征合并抑郁患者的临床分析,探讨其与预后的关系及预防的意义。方法：采用抑郁自评量表（SDS）、汉密尔顿抑郁量表（HRSD）对176名患者进行评估后,分为单纯急性冠脉综合征（ACS）组与ACS合并抑郁组,比较两组的心血管事件发生率并分析抑郁与各心血管事件的关系。结果：ACS合并抑郁患者的67例（占38．06％）,ACS合并抑郁患者中,短阵室性心动过速、心室颤动、心力衰竭、再发心肌梗死、心脏性死亡的发生率分别为10．44％,16．41％,29．85％,10．52％,11．84％,ACS合并抑郁患者心血管事件总发生率82．08％,单纯急性冠脉综合征患者109例,发生心血管事件26例,发生率20．15％。较ACS合并抑郁患者心血管事件发生率明显减少（P〈0．05）。结论：ACS合并抑郁患者,心血管事件发生率明显增加,抑郁与心血管事件的发生呈正相关。     

急性冠脉综合征合并糖代谢异常临床分析

临床上,急性冠脉综合征（ACS）患者合并糖代谢异常十分常见,对此加以研究有利于更好地进行ACS的防治。本文对比分析155例ACS患者血糖、胰岛素、血脂、高敏C反应蛋白（hs-CRP）及冠状动脉造影（CAG）检测结果,探讨ACS合并糖代谢异常患者临床及冠脉病变特征。     

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.     

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.