氯沙坦钾氢氯噻嗪联合硝苯地平控释片在老年顽固性单纯收缩期高血压治疗中的应用分析

目的研究硝苯地平控释片和氯沙坦钾氢氯噻嗪联合应用对老年顽固性单纯收缩期高血压(ISH)的临床疗效及安全性。方法选取2017年1月～2018年1月于我院就诊的老年顽固性(ISH)114例,随机分为A组、B组、C组,每组38例,A组服用硝苯地平控释片,B组服用氯沙坦钾氢氯噻嗪片,C组两种药物联合,比较治疗前后血压、尿素氮、肌酐、血清胱抑素C、肾小球滤过率(e GFR)、尿微量白蛋白变化及不良反应发生率等指标。结果 C组显效率、总有效率高于A组和B组(P均0.05)。与治疗前相比,三组治疗后均e GFR升高,B组、C组m ALB、Cys C下降(P均0.05)。治疗后比较,A组较B组e GFR下降,m ALB、Cys C升高(P均0.05)。C组较A组和B组e GFR升高(P均0.05),不良反应发生率比较,三组差异无统计学意义(P均 0.05)。结论与单药治疗相比,硝苯地平控释片和氯沙坦钾氢氯噻嗪联合治疗老年顽固性ISH疗效好、安全性高。     

硝苯地平控释片联合氯沙坦钾治疗糖尿病肾病高血压和尿蛋白的临床观察

目的探讨硝苯地平控释片、氯沙坦钾单独治疗和联合治疗对糖尿病肾病合并高血压和蛋白尿的影响。方法 90例2型糖尿病肾病合并高血压患者随机分为3组(每组30例),分别给予硝苯地平控释片30mg及氯沙坦钾50mg,1次/d,疗程均为12周,治疗后观察降压效果及尿蛋白肾功变化。结果三组治疗后均能显著降低血压及尿蛋白,但联合治疗组降低尿蛋白的幅度及降压幅度比单用硝苯地平控释片、氯沙坦钾明显高(P值均<0·01)结论硝苯地平控释片和氯沙坦钾长期治疗糖尿病肾病患者均有良好的降低血压和降24h尿蛋白的作用,两者联合起协同效应。     

硝苯地平控释片联合小剂量酒石酸美托洛尔治疗原发性高血压疗效观察

目的：探讨硝苯地平控释片联合应用小剂量倍他乐克治疗原发性高血压的疗效及安全性。方法：将96例原发性高血压患者随机分为3组,每组32例。A组给予硝苯地平控释片联合小剂量倍他乐克;B组给予硝苯地平控释片;C组给予卡托普利联合倍他乐克;规律药物治疗4周,定期监测血压、心率、心电图、肾功能、血糖及用药后不良反应情况。结果：3组药物对原发性高血压均有较好的治疗效果,硝苯地平控释片联合小剂量倍他乐克有效率达93.5%;硝苯地平控释片有效率为79.3%;卡托普利联合倍他乐克组有效率为93.1%。A组与C组比较,差异无统计学意义,P〉0.05,A组与B组和C组与B组相比较,差异有统计学意义（P〈0.01）。结论：硝苯地平控释片联合应用小剂量倍他乐克治疗原发性高血压效果优于单独应用硝苯地平控释片治疗,与卡托普利联合倍他乐克治疗效果相似,但临床副作用较少。     

硝苯地平控释片与维拉帕米缓释片降压疗效比较

目的探讨硝苯地平控释片与维拉帕米缓释片降压疗效比较。方法将我院218例高血压患者按随机分为硝苯地平控释片组（A组）110例和维拉帕米缓释片组（B组）108例,比较2组血压控制效果。结果治疗后平均血压和平均心率均低于治疗前;A组平均血压和平均心率低于B组,差异均有统计学意义（P〈0．05）。A组总有效率85．8％显著高于B组的69．0％,差异有统计学意义（P〈0．05）。结论硝苯地平拉释片对治疗高血压有良好的疗效,且耐受性好,可作为高血压一线用药。     

硝苯地平联合依那普利治疗老年原发性高血压35例的疗效观察

目的：对硝苯地平控释片联合依那普利治疗重度老年人原发性高血压疗效进行观察。方法：60岁老年住院患者105例,采用随机方法分成A、B、C3组。A组单独使用硝苯地平控释片;B’组单独口服依那普利;C组硝苯地平缓释片联用依那普利。然后进行效果比较,观察其临床疗效、症状体征及不良反应。结果：硝苯地平控释片联用依那普利在降低效果和安全性方面优于对照组（P〈0．01）。结论：硝苯地平控释片联用依那普利治疗原发性高血压,疗效显著,安全性高。     

盐酸贝那普利联合硝苯地平控释片不同给药时间的降压疗效观察

目的探讨盐酸贝那普利联合硝苯地平控释片不同给药时间的降压疗效。方法选取2011年3月~2013年3月我院进行治疗的高血压患者115例,按照随机数字分为A、B、C三组。结果三组加服比索洛尔5mg的比率比较,差异不显著(P0.05)。各组的24hSBP、24hDBP、24hMABP、dSBP、dDBP、dMABP、nSBP、nDBP、nMABP与治疗前血压比较,均显著下降,差异显著(P0.05)。三组血压下降值比较,A组与C组间nSBP、nDBP、nMABP比较差异显著(P0.05);B组与C组间nDBP、nDBP、nMABP比较差异显著(P0.05)。平滑指数比较,A组与C组nSBP、nDBP、nMABP差异显著(P0.05),B组与C组nSBP、nDBP、nMABP比较差异显著(P0.05)。结论依那普利与硝苯地平联合用药能更好地控制老年患者的血压,降压效果十分优越,具有极高的临床应用价值。     

硝苯地平控释片联合强力定眩片治疗高血压疗效观察

目的 探讨硝苯地平控释片联合强力定眩片治疗阴虚阳亢型1、2级原发性高血压的临床疗效.方法 将96例阴虚阳亢型1、2级原发性高血压患者随机分成对照组和观察组.对照组给予硝苯地平控释片30 mg,1次/d;观察组给予硝苯地平控释片30 mg,1次/d,强力定眩片6片,3次/d,两组均治疗12周.治疗结束后,测量患者的血压,计算血压疗效以及中医证候疗效.结果 两组治疗后收缩压、舒张压较治疗前均明显降低(P＜0.05),观察组的总有效率85.4％,明显高于对照组的64.6％(P＜0.05);观察组的证候疗效总有效率为89.5％,明显高于对照组的58.3％ (P＜0.05).结论 硝苯地平控释片联合强力定眩片治疗阴虚阳亢型1、2级原发性高血压,比单独应用硝苯地平控释片更利于血压达标,可更好地控制临床症状.     

硝苯地平控释片联合依拉普利治疗原发性高血压的临床疗效

目的观察硝苯地平控释片联合依拉普利治疗原发性高血压的疗效及安全性。方法将102例原发性高血压患者随机按1：1分为A组和B组。两组均给予硝苯地平控释片30mg,qd;2周后血压下降未达显效患者,硝苯地平控释片加量至60mg．qd;在此基础上．A组另给予依拉瞢利片10mg．qd。两组疗程均为6周。治疗期间观察血压、血糖、血脂、肝肾功能等指标。结果102例患者全部完成临床观察,A组显效率为72．55％,总有效率（显效＋有效）为92．16％;B组显效率为56．86％,总有效率为80．39％;两组治疗前后相比有显著变化（P〈0．01）．组间也明显差异（P〈0．05）。与治疗前相比。两组患者的收缩压（SBP）和舒张压（DBP）均有明显下降（P〈0．001）;但A组血压降至正常范围内（≤140／90mmHg）达84．31％,而B组为62．75％,组间有明显差异（P〈0．005）。结论硝苯地平控释片与依拉普利片联合应用治疗原发性高血压疗效好、不良反应低。明显优于单用硝苯地平控释片。     

拉西地平或硝苯地平与引达帕胺合用降压疗效观察

目的研究和评价拉西地平片或硝苯地平控释片与引达帕胺合用降压疗效。方法120例1、2级原发性高血压患者随机分为A(n=40)、B(n=38)、C(n=42)3组。全部患者开始均服用引达帕胺2.5mg,每晚1次,B组合用硝苯地平控释片20mg,每晚1次,C组合用拉西地平片4mg,每晚1次,然后每周依据血压调整一次药物剂量,尽量使血压控制在140/90mm Hg以下,最大剂量控制在A组引达帕胺2.5mg 2次/d,B、C组2.5mg,2次/d;拉西地平片4mg,2次/d,硝苯地平控释片20mg,2次/d,8周为一疗程。观察3组治疗前、后偶测血压变化、药物不良反应、心电图和生化指标。结果降压总有效率、血压下降幅度B、C组显著优于A组(P<0.01),C组显著优于B组(P<0.05)。治疗前后生化指标无明显改变。结论拉西地平片或硝苯地平控释片合用引达帕胺降压总有效率显著优于单用引达帕胺,且治疗前后生化指标无明显改变。     

缬沙坦联合硝苯地平治疗高血压合并糖尿病的疗效观察

目的 观察缬沙坦联合硝苯地平控释片治疗高血压合并糖尿病的临床疗效.方法 147例高血压合并糖尿病患者按照随机数字表法分为观察组(73例)与对照组(74例),对照组单用硝苯地平控释片治疗,观察组应用缬沙坦联合硝苯地平控释片治疗,比较两组患者的血压变化及肾功能状况.结果 治疗后两组血压状况均有较大改善,观察组收缩压以及舒张压的改善情况较为显著,与对照组比较差异有统计学意义(P＜0.05);且观察组血肌酐水平及尿微量白蛋白排泄率优于对照组,差异均有统计学意义(均P＜0.05);两组降压治疗情况:观察组53例显效,17例有效,3例无效,总有效率95.9％;对照组31例显效,24例有效,19例无效,总有效率为74.3％,两组总有效率差异有统计学意义(x2=33.427,P＜0.05).结论 缬沙坦和硝苯地平控释片为高血压合并糖尿病患者理想的降血压药物,两药联合互补,可以有效增强降压效果,显著降低肾功能损害.     

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.