早期应用前列地尔治疗急性脑梗死临床疗效观察

目的：探讨前列地尔注射液（脂微球栽体制剂）对急性脑梗死患者的临床疗效。方法：将70例急性脑梗死病人随机分治疗组前列地尔（35例）组和对照组（35例）。观察两组患者治疗前后的神经功能恢复情况和病情程度。结果：对比两组患者在用药后第3、7和14天神经功能缺损评分和日常生活活动Brather指数与治疗前的差异均有统计学意义（P〈0．05）。与法舒地尔比较，前列地尔组患者神经功能恢复较早，且增幅明显。在用药后第7天和第14天两组增幅差异有显著性（P〈0．05）。两组用药后不良反应均轻微。结论：两组患者神经功能缺损评分明显下降。日常生活能力有较大的提高，但治疗组优于对照组。前列地尔对急性脑梗塞有较好的治疗作用。     

罗格列酮对糖尿病患者脑梗死后病情预后的影响

目的研究罗格列酮对糖尿病性脑梗死患者病情预后的影响。方法序贯收集80例糖尿病性脑梗死患者,46例患者发病前常规双胍类或磺脲类或皮下注射胰岛素控制血糖,34例患者发病前除常规双胍类或磺脲类或皮下注射胰岛素控制血糖外,还加用盐酸罗格列酮控制血糖,脑梗死发病后继续沿用之前的降糖方法,除根据血糖情况进行剂量调整外,不再加用其他类降糖药。脑梗死发生后其他治疗方法相同。结果治疗组神经功能缺损量表评分在治疗后第十四天和第二十一天分别为11.26±3.45和9.11±2.83,明显优于对照组的14.67±3.98和12.56±4.01（P〈0.05）;生活能力状态量表的评分在治疗后14d和21d分别为3.46±1.34和2.87±1.44,改善的程度明显优于对照组的3.93±1.56和3.35±1.73（P〈0.05）。结论盐酸罗格列酮对糖尿病性缺血性脑卒中神经功能恢复是有效的。     

大面积脑梗死患者血糖水平与近期预后的关系

目的探讨大面积脑梗死患者血糖水平与病情及近期预后的关系。方法将136例大面积脑梗死患者分为应激性高血糖组（A组）、糖尿病高血糖组（B组）和正常血糖组（C组），观察三组神经功能缺损的评分、近期预后情况。结果A组患者较C组神经功能缺损评分高、近期预后差（均P〈0．05），而与B组比较差异无统计学意义（均P〉0．05）。结论监测大面积脑梗死患者急性期血糖水平对判断病情、预后及指导治疗有重要意义。     

脑卒中后抑郁对康复疗效影响的临床观察

目的分析脑卒中后抑郁（post—stroke depression,PSD）对康复疗效的影响。方法选择收住于我院康复科的脑卒中患者,按照纳入标准和排除标准选择符合条件的患者199例。对入选患者进行汉密尔顿抑郁量表评定,确诊PSD患者91例作为PSD组,其余108例作为非PSD组。对2组康复治疗前、治疗后（6周）的神经功能缺损程度及日常生活活动能力进行评定。结果康复治疗前PSD组神经功能缺损程度评分明显高于非PSD组（P〈0．01）;康复治疗后,2组神经功能缺损程度评分均明显降低,但PSD组神经功能缺损程度评分仍然明显高于非PSD组（P〈0．01）;2组治疗前后差值比较,PSD组明显低于非PSD组（P〈0．01）。康复治疗前PSD组日常生活活动能力评分低于非PSD组（P〈0．05）;康复治疗后,2组日常生活活动能力评分均明显升高（P〈0．01）,但PSD组评分仍然明显低于非PsD组（P〈0．01）;2组治疗前后差值比较,PSD组也明显低于非PSD组（P〈0．01）。结论PSD组患者的神经功能缺损和日常生活活动能力的恢复程度较非PSD患者差,PSD对康复治疗效果有负面影响。     

疏血通注射液治疗急性脑梗塞50例

目的:观察疏血通注射液治疗急性脑梗塞的疗效.方法:将96例急性脑梗塞患者随机分为疏血通注射液组(治疗组)及对照组,观察两组治疗前后神经功能缺损评分及日常生活活动(ADL)量表记分的变化.结果:治疗组治疗后神经功能缺损评分减少值及ADL量表评分均显著高于对照组.结论:疏血通注射液能减轻急性脑梗塞患者的神经功能缺损症状,提高患者独立生活能力.     

添加马来酸桂哌齐特治疗急性脑梗死的疗效观察

目的 研究分析添加马来酸桂哌齐特治疗急性脑梗塞的临床疗效。方法 将90例急性脑梗塞患者随机分成2组,每组45例,对照组采用急性脑梗塞的常规药物治疗,治疗组在对照组常规治疗的基础上给予马来酸桂哌齐特静脉滴注,14天后观察其疗效。结果 经14天的治疗后治疗组与对照组的神经功能缺损评分、日常生活能力评分及临床疗效比较有显著的统计学差异（P<0.05）。结论 在常规使用阿斯匹林片（75mg到100mg)的基础上加用马来酸桂哌齐特可有效的改善急性脑梗塞患者的神经功能缺损情况,提高日常生活能力,其对急性脑梗塞的疗效肯定。     

急性脑梗死患者早期康复治疗疗效观察

目的：评价早期康复治疗对急性脑梗死患者瘫痪肢体功能恢复及日常生活活动能力的影响。方法：选择急性脑梗死患者86例，随机分为康复组和对照组，康复组在药物治疗的基础上进行早期康复治疗，对照组为单纯药物治疗，分别于治疗前1天、治疗后28天各进行神经功能缺损评分（NDS）和日常生活活动能力（ADL）评定。结果：康复组NDS、MBI指数明显优于对照组（P〈0．01）。结论：早期进行康复治疗能明显改善急性脑梗死患者的日常生活活动能力。     

依达拉奉治疗急性脑梗死42例疗效分析

目的观察依达拉奉治疗急性脑梗死（ACI）的临床疗效及安全性。方法采用随机对照试验,选择发病72h内的ACI患者83例,分为依达拉奉治疗组42例和对照组41例,按两组治疗前后神经功能缺损（CSS）评分及日常生活能力量表（ADL）记分的变化为主要疗效判断标准进行对比分析。结果治疗第14天和第60天CSS评分、ADL评分治疗组和对照组比较差异均有统计学意义（P〈0．05）,各组治疗前、治疗第14天和第60天CSS评分、ADL评分差异有统计学意义（P〈0．01）,治疗组无明显不良反应。结论依达拉奉治疗急性脑梗死疗效确切,安全可靠。     

胰岛素治疗对脑出血后应激性血糖增高患者血清NSE水平的影响

目的 探讨小剂量胰岛素对脑出血后应激性血糖增高患者血清神经元特异性烯醇化酶（neuron-specific enolase,NSE）水平的影响及临床意义。方法 选2011年10月至2012年11月在辽宁医学院附属第三医院66例既往无糖尿病史、出血量15~30 mL的基底节脑出血且血糖值为7.8~11.1 mmol·L-1患者,随机分为胰岛素治疗组（n=34）及常规治疗组（n=32）。正常对照组（n=30）,为同期健康体检者。治疗组每2 h检测1次血糖,以预防低血糖。用ELISA法动态测定血清中NSE的水平,治疗期间脑血肿变化,及评定治疗组患者治疗期间神经功能缺损评分,并随访3个月后观察比较患者预后。结果 胰岛素治疗组及常规治疗组患者均在12 h内NSE水平较正常对照组开始升高（P〈0.01）,治疗组在24 h内差异无统计学意义;胰岛素治疗组在第3天达到峰值并开始下降,常规治疗组7 d达到峰值并开始下降,胰岛素治疗组在3 d内与常规治疗组比较不具有统计学意义,7 d后与常规治疗组比较有显著性差异（P〈0.01）;胰岛素治疗组21 d内均高于正常对照组,28 d与正常对照组差异无统计学意义;常规治疗组到28 d时NSE水平均高于正常对照组（P〈0.01）。治疗第14天、第28天,胰岛素治疗组血肿体积明显小于常规治疗组（P〈0.01）。在14 d、28 d的胰岛素治疗组的神经功能缺损评分与常规治疗组相比差异有统计学意义（P〈0.05）。3个月后随访,2组治疗组ADL分级比较差异有统计学意义（P〈0.05）。结论 脑出血继发应激性血糖增高患者早期应用胰岛素治疗可以保护神经元,改善神经功能缺损,减少神经细胞损害及脑出血后的继发性损伤,促进神经功能恢复,改善患者预后。     

丹参多酚酸治疗轻中度脑梗死的临床疗效观察

目的：探讨丹参多酚酸治疗轻中度脑梗死的临床效果。方法选取轻中度脑梗死患者106例,随机分为治疗组和对照组各53例。对照组予常规治疗,治疗组在对照组基础上加用丹参多酚酸治疗。治疗2周后观察2组神经功能缺损评分（NHISS 评分）、改良 Rankin 量表（Modified Rankin Scale）评分、日常生活活动能力量表（Barthel Index）评分。结果2组治疗后神经功能缺损评分、改良 Rankin 量表评分及日常生活活动能力量表评分与治疗前相比均有明显改善（P ﹤0.05）,且治疗组治疗后神经功能缺损评分与日常生活活动能力量表评分较对照组改善更为显著,差异均有统计学意义（P ﹤0.05）。结论丹参多酚酸治疗轻中度脑梗死临床疗效显著,值得临床推广应用。     

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.     

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.