血清胱抑素C在妊娠期高血压疾病早期肾损害中特点分析

目的：探讨妊娠期高血压疾病早期肾损害中血清胱抑素C的特点。方法选择200例妊娠期高血压疾病患者作研究对象,均为我院产科2011年9月~2013年9月收治,按妊娠期高血压、轻度、重度子痫前期、慢性高血压合并子痫前期分组,收集血清,对肌酐（Scr）、Cys C等指标进行测量,就结果与同期产科收治的正常晚期妊娠孕妇的对照组100例进行比较。结果妊娠期高血压疾病组Scr指标、Urea指标、UA指标与健康对照组比较,均有程度不等的升高表现。其中重度子痫前期及对照组与子痫前期合并慢性高血压、轻度子痫前期、妊娠期高血压比较差异有统计学意义（P＜0.05）,后三组差异无统计学意义（P＞0.05）。CCr有下降表现,其中重度子痫前期和对照组与子痫前期合并慢性高血压、轻度子痫前期、妊娠期高血压组比较差异有统计学意义（P＜0.05）,而后三组差异无统计学意义（P＞0.05）。Cys C有程度不等的升高,各组间差异均有统计学意义（P＜0.05）,且随病情加重而升高明显。结论妊娠期高血压疾病早期肾损害中,Cys C为较好的对早期肾损害进行反映的指标,在妊娠期妇女中监测,特别是有高危因素的孕妇,可评估肾功能损害情况,及时明确诊断,并规范治疗,以改善妊娠结局,保障母婴生命安全。     

妊娠期高血压疾病患者血清胱抑素C和尿微量白蛋白检测的临床意义

目的探讨妊娠期高血压疾病（HDCP）患者血清胱抑素C（Cys-C）和尿微量白蛋白（UmAlb）联合检测的临床价值。方法选择HDCP患者143例,其中,妊娠期高血压68例,轻度子痫前期43例,重度子痫前期32例。另选择同期在本院产前体检的30例正常孕妇作为对照组。分别采血及尿液检测血Cys-C、尿素氮（BUN）、肌酐（Scr）和UmAlb水平并进行比较分析。结果妊娠期高血压组、轻度子痫前期组、重度子痫前期组三组患者血清Cys-C及UmAlb水平均显著高于对照组（P均〈0.01）;妊娠期高血压组、轻度子痫前期组、重度子痫前期组三组间Cys-C和UmAlb水平比较,差异均有统计学意义（妊娠期高血压组〈轻度子痫前期组〈重度子痫前期组,P均〈0.01）。重度子痫前期组血BUN和Scr水平均明显高于对照组（P〈0.01）,而妊娠期高血压组、轻度子痫前期组血BUN、Scr水平与对照组比较,差异均无统计学意义（P均＆gt;0.05）。结论血清Cys-C和UmAlb均为反映HDCP患者早期肾功能损害的敏感指标,两者联合检测对HDCP早期肾损害的诊断有重要价值。     

妊娠期高血压疾病患者血清瘦素水平的变化及意义

目的：研究瘦素在妊娠期高血压疾病患者血清中的表达及其在妊娠期高血压疾病发病中的作用。方法收集2012年10月~2014年6月在粤北人民医院住院的正常孕妇、妊娠期高血压患者、轻度子痫前期患者、重度子痫前期患者各20例,抽取空腹静脉血用放射免疫法测定血清瘦素含量。结果各组孕妇的血清瘦素水平与收缩压及舒张压均呈正相关(P<0.05),与重度子痫前期组相关性更明显(r=0.70)。各组孕妇的血清瘦素水平与体重指数均呈正相关(P<0.05),与对照组相关性更明显(r=0.69)。对照组、妊娠期高血压、轻度子痫前期、重度子痫前期组孕妇的血清瘦素含量分别为(20.1±8.1)、(20.2±8.4)、(28.8±8.1)、(40.6±10.3)ng/ml。对照组与妊娠期高血压组孕妇的血瘦素水平比较,差异无统计学意义(P>0.05);重度子痫前期组较轻度子痫前期组、妊娠期高血压组孕妇的血瘦素水平均增高,差异有统计学意义(P<0.05);轻度子痫前期组较妊娠期高血压组孕妇的血瘦素水平增高,差异有统计学意义(P<0.05)。结论瘦素参与妊娠期高血压疾病的发生、病情发展,并且在疾病进展中有升高的倾向,瘦素是妊娠期高血压疾病的发病机制之一。     

尿NGAL与妊高症肾损伤的相关分析

目的探讨尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平与妊娠期高血压肾损伤疾病病情进展的关系。方法选择我院2014年9月~2016年4月间住院治疗并分娩的妊娠期高血压患者60例为观察组(妊娠期高血压患者27例,轻度子痫前期患者15例,重度子痫前期患者6例,子痫期患者12例);选择60例妊娠期健康孕妇为对照组。分别检测患者入院24h内和产后72h的尿NGAL、血肌酐(Cr)及血清胱抑素C(Cys-C)水平,分析其与妊娠期高血压肾损伤疾病的严重程度及临床表现的关系。结果入院24h各组尿NGAL、血Cr含量均高于产后72h,Cys-C水平低于产后72h,差异具有统计学意义(P<0.05);除妊娠期高血压组和轻度子痫前期组,各亚组间尿NGAL、血Cr含量差异均有统计学意义(P<0.05);Cys-C含量妊娠期高血压组、轻度子痫前期组以及子痫期组之间差异均有统计学意义(P<0.05);尿NGAL与妊娠期高血压肾损伤的严重程度呈正相关。结论检测尿NGAL水平可以早发现、早诊断、早治疗妊娠期高血压肾损害,对于临床决策、母婴健康及治疗子痫相关并发症的发生有重要意义。     

妊娠期高血压疾病对母儿的影响及围生期处理

目的 探讨妊娠期高血压疾病对母儿的影响及围生期处理.方法 选取178例妊娠期高血压疾病患者作为观察组,同时抽取同期分娩的血压正常且蛋白尿阴性患者178例作为对照组,对两组临床资料进行对比研究.结果 观察组与对照组的FGR各25例和1例,两组比较差异有统计学意义(P＜0.01).重度子痫前期的新生儿77例中胎儿生长受限(FGR)为20例,与妊娠期高血压及轻度子痫前期比较差异有统计学意义(P＜0.01);重度子痫前期非足月产21例,为25.33%,与上三组比较差异有统计学意义(P＜0.01);胎龄≥37周存活率为100%,与上三组比较差异有统计学意义(P＜0.01).结论 妊娠期高血压疾病尤其重度子痫前期,严重影响母婴健康;妊娠期高血压疾病发生后应积极有效地预防向重度子痫前期的转化,防止母儿并发症的发生.     

妊娠期高血压疾病孕妇生化指标及母儿并发症分析

目的 分析妊娠期高血压疾病孕妇生化指标及母儿并发症。方法 选取2017年4月～2019年12月于我院分娩的孕妇226例为研究对象,依据妊娠期高血压分类标准,将其分为妊娠期高血压组78例、轻度子痫前期组75例、重度子痫前期组73例,均进行生化指标检测,观察三组生化指标检测结果,并对母儿并发症发生情况进行回顾性分析。结果 TP、ALB等肝功能相关指标水平三组组间比较差异有统计学意义(P 0.05),其余指标比较差异无统计学意义(P 0.05);三组肾功能相关指标水平组间比较差异无统计学意义(P 0.05),血脂相关指标中,HDL-C组间比较差异有统计学意义(P 0.05);与妊娠期高血压组、轻度子痫前期组产妇比较,重度子痫前期组产妇产期胎盘早剥、子痫、产后出血、早产、胎儿窘迫等母儿并发症发生率更高,差异有统计学意义(P 0.05)。结论 TP、ALB等肝功能相关指标水平高低与妊娠期高血压产妇子痫严重程度密切相关,重度子痫前期孕产妇的母儿并发症发生率较高,提示医师应定期对孕产妇进行生化检验,积极采取措施补救,降低母儿并发症发生,提升母婴生命质量。     

表皮生长因子在妊娠期高血压疾病的水平变化及检测价值

目的 通过检测妊娠期高血压疾病(HDCP))患者血清表皮生长因子(EGF)水平变化,探讨EGF在HDCP发生、发展过程中的作用及其临床检测价值.方法 采用ELISA法测定97例HDCP患者(HDCP组)和35例正常妊娠妇女(对照组)血清EGF水平,分析EGF水平变化对HDCP的影响.结果 HDCP组患者血清EGF水平显著低于对照组(P＜0.01);重度子痫前期患者血清EGF水平显著低于妊娠期高血压患者组(P＜0.01);妊娠期高血压、轻度子痫前期及重度子痫前期患者组随病情加重血清EGF水平依次降低,且差异具有统计学意义(P＜0.01).结论 HDCP患者血清EGF水平显著降低,此可能在HDCP发生、发展过程中起重要作用,检测血清EGF水平可作为判定病情的重要指标.     

血清Lp-PLA2、Hcy、mALB、NAG、CysC联合检测在妊娠期高血压疾病早期肾脏损伤中的诊断价值

目的 探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)、同型半胱氨酸(Hcy)、血清胱抑素-C(CysC)、尿微量白蛋白(mALB)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)联合检测在妊娠期高血压疾病早期肾脏损伤中的诊断价值。方法 前瞻性选取2019年3月至2020年9月我院收治的82例妊娠期高血压疾病的患者,根据孕妇病情程度分成妊娠期高血压组(n=27,血压≥140/90 mmHg,尿蛋白阴性)、轻度子痫前期组(n=26,血压≥140/90 mmHg,尿蛋白≥0.3 g/24h)和重度子痫前期组(n=29,血压≥160/100 mmHg,尿蛋白≥2.0 g/24h)。根据内生肌酐清除率(Ccr)水平将82例妊娠期高血压疾病患者分成肾功能异常组(Ccr80 ml/min)42例和肾功能正常组(Ccr≥80 ml/min)40例。统计各项指标水平与患者病情、肾功能的关系,用ROC曲线分析其联合检测的诊断价值。结果 重度子痫前期组血清Lp-PLA2、Hcy和CysC和尿mALB和NAG水平均比轻度子痫前期组和妊娠期高血压组高(P 0.05),轻度子痫前期组血清Lp-PLa2、Hcy和CysC和尿mALB和NAG水平比妊娠期高血压组高(P 0.05)。肾功能异常组血清Lp-PLA2、Hcy和CysC和尿mALB和NAG水平比肾功能正常组高(P 0.05)。ROC曲线分析显示,血清Lp-PLA2、Hcy、mALB、NAG、CysC联合检测在妊娠期高血压疾病早期肾脏损伤中的诊断价值AUC为0.928,灵敏度为92.86%(39/42),特异度为95.00%(38/40),准确度为93.90%(77/82)。结论 血清Lp-PLA2、Hcy、CysC、尿mALB、NAG水平随着妊娠期高血压疾病的病情严重程度有明显相关,联合检测对妊娠期高血压疾病早期肾脏损伤的诊断有较高价值。     

妊娠期高血压疾病290例临床分析

目的 探讨妊娠期高血压疾病的相关高危因素、并发症及其与母婴预后的关系. 方法 回顾性分析290例妊娠高血压疾病患者的临床资料. 结果 290例妊娠期高血压疾病患者中,初产妇185例（占63.8%）,经产妇105例（占36.2%）,两组差异有统计学意义（χ^2=5.84,P＜0.05）;居民98例（占33.8%）,农民及外来务工人员192例（占66.2%）,两组差异有统计学意义（χ^2=98.5,P＜0.05）.文化程度低,多无系统产前检查（F=13.8,P＜0.05）、重度子痫前期及子痫的发病率明显增高（F=8.5,P＜0.05）.重度子痫前期及子痫组的各种并发症发生率及剖宫率明显高于妊娠期高血压组（χ^2=11.7、30.6、23.6、17.7,均P＜0.05）和轻度子痫前期组（χ^2=8.0、5.7、11.8、5.27,均P＜0.05）.重度子痫前期及子痫组的胎儿生长受限、胎儿窘迫、新生儿窒息、早产、围生儿死亡等发生率明显高于妊娠期高血压组（χ^2=29.5、14.7、12.0、29.3,均P＜0.05）和轻度子痫前期组（χ^2=20.1、10.8、14.4、4.6,均P＜0.05）. 结论 加强孕期保健,防治妊娠期高血压疾病并发症,适时终止妊娠是降低孕产妇、围生儿死亡率的关键.     

妊娠期高血压疾病对母婴结局的影响

目的探讨妊娠期高血压疾病对母婴结局的影响。方法 256例孕妇,根据血压情况分为高血压组74例和非高血压组182例。高血压疾病患者中重度子痫前期24例,轻度子痫前期21例,妊娠期高血压29例。比较两组母婴并发症发生情况:早产、剖宫产、产后出血、新生儿黄疸、新生儿高胆红素血症等发生率。结果高血压组孕产妇早产(17.6%)、剖宫产(79.7%)、产后出血率(12.2%)均比非高血压组高,且差异具有统计学意义(P<0.05);重度子痫前期组孕产妇出现早产(50.0%)高于轻度子痫组(4.7%)和妊娠期高血压组(0),且差异具有统计学意义(P<0.05)。结论妊娠期高血压可增加产妇的早产率、剖宫产率、产后出血率及新生儿的并发症发生率,因此,孕期保健,及时确诊妊娠期高血压和及时有效的治疗至关重要。     

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.     

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.     

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.