尼麦角林治疗老年血管性痴呆的疗效观察

目的：观察尼麦角林治疗老年血管性痴呆的临床疗效及安全性。方法：本科2008年3月～2010年10月共收治70例老年血管性痴呆患者（观察组）,在常规治疗的基础上给予尼麦角林30mg,3次/d,口服;同时回顾性分析仅采用常规治疗的70例老年血管性痴呆患者的临床资料（对照组）。治疗3个月后,比较两组治疗前后MMSE、WMS、SI和ADL评分改善情况。结果：观察组治疗前后MMSE、WMS、SI和ADL评分改善情况均明显优于对照组（P〈0.05）,差异有统计学意义,并且治疗过程中未发现有明显不良反应。结论：尼麦角林治疗老年血管性痴呆疗效可靠,并且无明显不良反应发生,适合临床广泛应用。     

尼麦角林与茴拉西坦治疗血管性痴呆临床研究

目的：探讨尼麦角林（Nicergoline）与茴拉西坦（Aniracetam）联合治疗轻中度血管性痴呆的疗效。方法：选取符合美国精神障碍诊断与统计手册DSM—Ⅲ诊断标准的血管性痴呆患者86例。随机分为尼麦角林组29例（尼麦角林30mg，poqd）；茴拉西坦组28例（茴拉西坦每次200mg，pobid）；联合治疗组29例（尼麦角林30mg，pobid及茴拉西坦200mg，pobid）。疗程均为12周。以简易精神状态检查（MMSE）、韦克斯勒记忆量表（WMS）、临床综合调查表（CGI）和日常生活能力量表（ADL）为评价指标，评价3组患者的疗效。结果：经12周治疗干预后，联合治疗组MMSE、WMS、SI及ADL较治疗前明显改善，P〈0．01。尼麦角林组上述四项指标亦改善明显，P〈0．05。而茴拉西坦组仅MMSE和ADL评分较前改善，P〈0．05。联合治疗组与尼麦角林组和茴拉西坦组比较，上述指标改善更明显，P〈0．05。而尼麦角林组与茴拉西坦组比较，仅MMSE有统计学差异意义显著，余P〉0．05。3组均无明显药物相关的不良反应。结论：尼麦角林联合茴拉西坦能更好地改善血管性痴呆患者的认知功能，无不良反应。     

尼麦角林治疗老年期痴呆的疗效观察

目的探讨尼麦角林治疗老年期痴呆的疗效。方法选择我院神经内科2010年11月至2011年11月通过MMSE,ADL测试,并且诊断为老年痴呆的患者76例,将老年期痴呆患者按随机单盲法分成研究组37例,对照组39例。对照组给予阿斯匹林口服、血塞通注射液、口服脑复康;治疗组在对照组的基础上给予尼麦角林治疗。两组都根据病情需要给予抗血小板以及降压降糖等基本治疗。两组用药6周前后均进行认知障碍程度检查和痴呆度评分。以简易精神状态检查（MMSE）和日常生活能力量表（ADL）为症状改善评价指标。结果两组治疗前后组内比较,MMSE与ADL均有改善,具有统计学意义（P〈0.05）;组间比较研究组在MMSE与ADL改善均优于对照组,差异有统计学意义（P〈0.05）。结论尼麦角林能改善老年期痴呆患者的认知功能和日常生活能力,有利于改善老年期痴呆的生活质量。     

丁咯地尔与尼莫地平治疗血管性痴呆的双盲对照研究

目的 :比较丁咯地尔与尼莫地平治疗血管性痴呆的临床疗效。方法 :70例血管性痴呆病人 ,以双盲随机对照研究方法分为尼莫地平组 35例 ,丁咯地尔组 35例。分别给尼莫地平 30mg ,丁咯地尔15 0mg ,po ,tid ,8wk为一个疗程。治疗后评价MMSE ,HDS ,ADL ,WMS ,CGI ,EI及不良反应。结果 :治疗后WMS ,MMSE ,ADL ,CGI ,EI评分尼莫地平组为 (5 9± 2 2 ,2 0± 6 ,30± 12 ,3.0± 0 .7,1.9±0 .7)分 ;丁咯地尔组为 (70± 18,2 2± 4 ,2 6± 9,2 .2±0 .9,2 .5± 0 .8)分 ,2组比较P <0 .0 5或P <0 .0 1,2组不良反应比较P >0 .0 5。结论 :丁咯地尔治疗血管性痴呆疗效较尼莫地平显著     

尼麦角林治疗血管性痴呆临床疗效观察

目的 对采用尼麦角林（即：脑通片）治疗血管性痴呆的临床疗效和安全性进行分析与探讨.方法 在本院选取60例患血管性痴呆的患者并采用随机分组的方法将其分为观察组和对照组两组,每组各30例.其中,对观察组患者使用尼麦角林,而对于对照组患者则使用胞二磷胆碱,对其治疗前后的MMSE和ADI进行对比并评分,检查其治疗前后的电解质、肝肾功能和血糖以及血常规还有心电图等并对比分析.结果 两组患者在治疗后的MMSE评分和ADI评分与治疗前相比较有明显的改善,其差异性显著.两组患者经治疗后均未发生严重的不良反应,但观察组的有效率和显效率分别为86.3％和67.65％,而对照组的有效率和显效率分别为66.84％和42.85％,经比较后两组差异有统计学意义（P＜0.05）.结论 采用尼麦角林对血管性痴呆患者进行治疗可明显改善患者的认知功能,提高其日常生活能力,是治疗血管性痴呆的有效药物,值得临床推广使用.     

盐酸多奈哌齐联合尼麦角林治疗老年性痴呆43例

目的 观察尼麦角林对老年性痴呆患者的临床治疗效果及安全性. 方法 86例老年性痴呆患者分为治疗组和对照组各43例. 对照组给予盐酸多奈哌齐5 mg,qd,4周后加至10 mg,qd,疗程为24周; 治疗组盐酸多奈哌齐用法同对照组,同时给予尼麦角林片 20 mg,tid,疗程为24周. 两组患者其他治疗相同,包括常规治疗,如给予拜阿司匹林、降压、降糖、降脂等治疗,治疗期间停用其他胆碱酶抑制药及其他促智药. 两组分别在治疗前、治疗后12,24周进行检查,简易精神状态量表(MMSE)评分检测老年性痴呆患者的认知功能,日常生活自理能力评分(ADL评分)检测患者的日常生活能力. 结果 对照组在12,24周MMSE评分分别为(21.5±2.7),(23.2±2.9)分,治疗组分别为(24.1±2.9),(26.3±3.2)分; 对照组在12,24周ADL评分分别为(19.8±5.9),(16.2±5.8)分,治疗组分别为(16.7±5.5),(13.5±6.1)分,治疗组与对照组比较,均差异有统计学意义(P<0.05),治疗组与本组治疗前比较,均差异有统计学意义(P<0.05). 结论 尼麦角林联合盐酸多奈哌齐治疗老年性痴呆安全有效,治疗作用较盐酸多奈哌齐单一用药更有效.     

银杏叶提取物联合尼莫地平治疗血管性痴呆的疗效及安全性

目的探讨银杏叶提取物联合尼莫地平对血管性痴呆患者认知功能和行为能力的临床疗效及安全性。方法将82例血管性痴呆患者随机分为两组,在治疗前和治疗12周后进行简易精神状态量表(MMSE)和日常生活活动能力量表(ADL)的评分并比较两组的评分结果。结果联合用药组MMSE评分为(21.7±4.8)分,ADL评分为(26.4±10.3)分;对照组分别为(17.8±4.5)分和(30.1±12.4)分,差异有统计学意义(P<0.05)。结论银杏叶提取物能有效改善血管性痴呆患者的认知功能及日常生活能力,与尼莫地平联合治疗的效果优于单独使用,且安全性较高。     

谷红注射剂联合尼麦角林治疗血管性痴呆的临床疗效

目的探讨谷红注射剂联合尼麦角林治疗血管性痴呆（VD）的临床疗效。方法将VD患者120例，随机分为联用组和单用组，每组各60例。在常规药物治疗的基础上，单用组给予尼麦角林20mg，po，tid；联用组则在单用组基础上给予谷红注射剂20mL＋0．9％氯化钠溶液250mL，ivgtt，qd。治疗8周后，比较2组治疗前后简易智力状况检查量表（MMSE）、韦克斯勒记忆量表（WMS）、日常生活能力量表（ADL）和社会内向量表（SI）的评分情况。结果联用组治疗前后MMSE、WMS、SI和ADL评分改善情况均明显优于单用组，差异有统计学意义（P〈0．05）。结论谷红注射剂联合尼麦角林治疗VD的临床疗效确切。     

中西医结合联合情感关怀改善血管性痴呆患者认知水平的临床研究

目的 研究中西医结合治疗联合情感关怀改善血管性痴呆患者认知水平的临床效果.方法 将本院2014年6月至2016年8月收治的50例血管性痴呆患者随机分为对照组25例(采用尼莫地平与其他传统药物治疗)与治疗组25例(采用尼莫地平、脑栓通、针刺治疗联合情感关怀).比较两组患者治疗前后认识水平变化.结果 治疗后,两组MMSE、ADL评分均有所提高,但对照组MMSE、ADL评分分别为(20.1±2.8)分、(41.2±11.7)分,均低于治疗组[(25.0±5.3)分、(53.7±10.7)分],差异有统计学意义(P＜0.05).结论 采用中西医结合治疗联合情感关怀能有效改善血管性痴呆患者的认知功能,提高生活质量.     

尼麦角林治疗血管性痴呆优于吡拉西坦

目的：比较尼麦角林与吡拉西坦对血管性痴呆的疗效。方法：８０例血管性痴呆病人随机分为２组。尼麦角林组４２例（男性２８例，女性１４例，年龄６８±ｓ７ａ），服用尼麦角林片１０ｍｇ，ｔｉｄ，治疗８ｗｋ。吡拉西坦组３８例（男性２６例，女性１２例，年龄６９±８ａ），服用吡拉西坦１．２ｇ，ｔｉｄ，治疗８ｗｋ。结果：尼麦角林组总有效率为７９％，吡拉西坦组为５５％（Ｐ＜０．０５）；记忆商数（ＭＱ）和长谷川痴呆量分（ＨＤＳ）尼麦角林组分别增值１２±１１分和７±６分，吡拉西坦组分别增值５±８分和４±４分，２组间比较Ｐ＜０．０５，未见不良反应。结论：尼麦角林治疗血管性痴呆的临床疗效显著优于吡拉西坦     

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.     

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.