依那普利与非洛地平缓释片治疗原发性高血压的临床疗效观察

目的探讨依那普利与非洛地平缓释片治疗高血压的临床疗效。方法原发性高血压患者192例,均给予依那普利与非洛地平缓释片治疗;其中96例给予依那普利与非洛地平缓释片作为治疗组,96例给予非洛地平缓释片作为观察组。结果与观察组相比,治疗组血压达标率有统计学意义。结论原发性高血压依那普利与非洛地平缓释片联合应用比单用非洛地平缓释片降压治疗临床效果更好。     

硝苯地平控释片与非洛地平缓释片治疗难治性高血压的疗效比较

目的：评价硝苯地平控释片与非洛地平缓释片治疗难治性高血压的效果。方法：60例难治性高血压,经氢氯噻嗪、美托洛尔、厄贝沙坦联合治疗8周后仍未达标者随机分为两组,分别加用硝苯地平控释片30mg/d或者非洛地平缓释片5mg/d,4周后若仍未达标则剂量加倍继续服用4周,分别于服药后0,2,4,6,8周测量坐位血压。结果：治疗8周后,硝苯地平控释片组血压下降16.3/11.2±12.6/7.7mmhg,非洛地平缓释片组血压下降15.1/9.8±12.2/7.8mmhg,硝苯地平控释片组达标率83.3%,非洛地平缓释片组达标率80%。结论：硝苯地平控释片与非洛地平缓释片均能有效控制难治性高血压的血压水平,但降压效果比较无统计学意义。两组降压达标率比较无统计学意义。     

单硝酸异山梨酯与盐酸贝尼地平对老年单纯收缩期高血压的降压作用

目的观察单硝酸异山梨酯(ISMN)与盐酸贝尼地平对老年单纯收缩期高血压(ISH)患者的降压作用.方法96例ISH患者随机分为单硝酸异山梨酯组(31例)、贝尼地平组(33例)、联合用药组(32例).其中单硝酸异山梨酯组采用ISMN口服20 ng,bid;贝尼地平组予以盐酸贝尼地平片4 mg·d-1;联合用药组合用ISMN与贝尼地平内服.疗程均为8周.结果ISMN组用药后收缩压(SBP)显著下降(P＜0.01),舒张压(DBP)用药前后差异无显著性(P＞0.05);贝尼地平组SBP、DBP用药后均有显著下降(P＜0.01);联合用药组用药后SBP下降非常显著(P＜0.01),与贝尼地平组比较,差异亦非常显著(P＜0.01),但DBP仅有轻度下降(P＜0.05).ISMN组与联合用药组的脉压(PP)均明显减小,与贝尼地平组比较,差异均有显著性(P＜0.01).用药期间未见ISMN与贝尼地平的严重不良反应.结论ISMN能降低ISH患者的SBP,而对DBP影响不大,从而使PP减小,有利于ISH患者的降压治疗.ISMN合贝尼地平是治疗老年ISH较理想的联合用药.     

盐酸贝尼地平联合酒石酸美托洛尔治疗原发性高血压疗效观察

目的：探讨盐酸贝尼地平联用酒石酸美托洛尔治疗原发性高血压的临床疗效。方法：56例原发性高血压患者随机分为两组。A组30例,服用：盐酸贝尼地平4mg,晨起后服用,每日1次;酒石酸美托洛尔12.5mg,每日2次。B组26例,盐酸贝尼地平每日4mg,晨起后一次服。每周监测3次血压、心率情况,4周后观察降压疗效和不良反应。结果：A组显效16例,有效12例,无效2例,总有效率93.3%;B组显效10例,有效9例,无效7例,总有效率73.1%;两组降压效果比较差异有统计学意义（P〈0.05）。A组头晕2例,胸闷1例,不良反应发生率10.0%;B组面红2例,心悸2例,头痛3例,不良反应发生率34.6%,B组中有2例患者因不能耐受不良反应而自行停药。两组不良反应发生率比较差异有统计学意义（P〈0.05）。结论：盐酸贝尼地平联用酒石酸美托洛尔治疗原发性高血压可能增加疗效,并减少不良反应。     

硝苯地平缓释片与非洛地平缓释片治疗不同高血压临床研究

目的:对比分析硝苯地平缓释片与非洛地平缓释片治疗不同高血压的临床疗效.方法:回顾性分析2014年2月~2016年8月我院接治的248例不同血压水平的高血压患者临床资料.结果:观察1组、对照1组的总有效率分别为82.18%、80.20%,差异无统计学意义(P>0.05);观察2组的总有效率为78.26%,高于对照2组的47.83%,差异有统计学意义(P<0.05).治疗后,观察1组、对照1组的DBP、SBP相比差异无统计学意义(P>0.05);观察2组的DBP为(90.08±9.83)mmHg,SBP为(147.92±8.22)mmHg,均低于对照2组,差异均有统计学意义(P<0.05).结论:若为轻中度高血压,则硝苯地平缓释片与非洛地平缓释片具有相似的治疗效果;若为重度高血压,硝苯地平缓释片的治疗效果优于非洛地平缓释片.     

西尼地平与非洛地平治疗高血压病疗效及对自主神经功能的影响

目的 比较原发性高血压患者使用西尼地平与非洛地平的降压效果及对自主神经功能的影响。方法 轻中度原发性高血压患者随机分为西尼地平组(n=38，西尼地平10mg，每日1次)与非洛地平组(n=36，非洛地平5mg，每日1次)，治疗3个月后，比较两组血压与心率的改变，用动态心电图进行能量光谱分析。结果 西尼地平与非洛地平均有良好降压作用，但西尼地平对心率无明显的影响，而非洛地平增加心率，并使白天与夜晚R-R间期低频／高频(LF/HF)比率明显增加，西尼地平仅在白天有增加。结论 西尼地平对轻中度原发性高血压有良好降压疗效，且不增加交感神经活性，为有利于防止心脏事件发生的新型钙通道阻滞剂。     

苯那普利与非洛地平缓释片对高血压病人24h动态血压的影响

目的研究苯那普利与非洛地平缓释片对高血压的效果.方法采用随机分组法将62例高血压病人分为两组A组31例晨800顿服苯那普利片10 mg;B组31例晨800顿服非络地平缓释片5 mg.连续4周,观察治疗前后24 h动态血压变化及降压疗效.结果(1)苯那普利和非络地平缓释片均能明显降低高血压病人的24 h平均血压,总有效率分别为83.1%和88.2%.两者相比差异无显著性(P＞0.05).(2)苯那普利和非络地平缓释片降低SBP的谷峰比值(TP)比率分别为(62.3±12.8)%和(65.2±13.1)%,降低DBP的TP比率分别为(68.6±18.3)%和(77.2±12.6)%,两者差异无显著性(P＞0.05).结论苯那普利和非络地平缓释片治疗高血压病均有效,谷峰比较满意.     

盐酸贝尼地平对单纯原发性高血压病左心室肥厚逆转的疗效观察

目的探讨盐酸贝尼地平对逆转单纯原发性高血压病左心室肥厚的效果。方法将140例对单纯原发性高血压病左心室肥厚患者随机分为治疗组和对照组各70例,治疗组予盐酸贝尼地平、对照组则予硝苯地平缓释片进行治疗,比较两组效果。结果治疗组在降低左心室室壁厚度、左心室重量、左心室重量指数、降压效应及不良反应发生率均明显优于对照组,差异有统计学意义（P〈0.05）。结论盐酸贝尼地平能有效逆转单纯原发性高血压病左心室肥厚。     

盐酸贝尼地平治疗原发性高血压的多中心临床研究

目的评价盐酸贝尼地平治疗原发性高血压病患者的疗效和安全性。方法用多中心随机单盲平行对照试验方法。贝尼地平(试验组)112例,氨氯地平(对照组)105例。结果治疗8周后,2组血压均有明显下降,与用药前比较差异均有统计学意义(P<0.001)。总有效率为贝尼地平77.68%,氨氯地平83.81%,2组间比较差异无统计学意义(P>0.05)。药物不良反应发生率为贝尼地平42.86%,氨氯地平41.60%,2组比较差异无统计学意义(P>0.05)。结论盐酸贝尼地平治疗原发性高血压安全、有效。     

依拉地平与非洛地平治疗原发性高血压的临床效果观察

目的：观察依拉地平与非洛地平治疗原发性高血压的临床疗效。方法将24例原发性高血压患者随机分为试验组和对照组各12例。试验组用依拉地平治疗,对照组采用非洛地平治疗。比较2组治疗效果,用药前和用药第2、4、8周血压水平。结果2组临床疗效差异无统计学意义（P＞0．05）。2组用药前、治疗2周、4周收缩压、舒张压水平差异无统计学意义（P＞0．05）。治疗后8周,2组收缩压、舒张压均低于用药前,且试验组低于对照组,差异均有统计学意义（ P＜0．05）。结论依拉地平胶囊治疗轻、中度原发性高血压临床疗效与非洛地平缓释片相似,安全有效,并在治疗8周后,降压效果更好。     

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.