帕拉米韦三水合物氯化钠注射液在健康人体的耐受性研究

 目的：研究单次和多次静脉滴注帕拉米韦三水合物氯化钠注射液在健康人体内的耐受性和安全性。方法：单次给药试验共入选26名健康志愿者,分为5个剂量组,由初始剂量150 mg开始,在耐受性较好的情况下,逐渐增加至300,450,600,750 mg。连续给药试验在单次给药试验结束后进行,共入选20例健康志愿者,分为150和300 mg两个剂量组,连续5 d,qd。试验中多次进行生命体征、心电图、体格检查及实验室检查,并严密观察不良事件。结果：与研究药物有关的不良事件主要为部分实验室检查值异常和心电图异常,不良事件的程度均为轻度,均未经处理而恢复正常。试验中未发生严重不良事件。结论：中国健康受试者单次静脉滴注150~750 mg和连续5 d, 每天单次静脉滴注150~300 mg的帕拉米韦三水合物氯化钠注射液是安全的,能耐受的。     

聚乙二醇胸腺素α1注射液的Ⅰ期临床耐受性研究

目的:观察聚乙二醇胸腺素α1注射液在健康志愿者的安全性和耐受性。方法:单次给药剂量组的36名健康志愿者分别接受7个剂量组(0.16,0.8,1.6,3.2,4.8,6.4,9.6 mg)的聚乙二醇胸腺素α1注射液,多次给药剂量组的16名健康志愿者分别接受2个剂量组(3.2和4.8 mg,每周1次,连续给药4周)的聚乙二醇胸腺素α1注射液,观察受试者的生命体征、实验室检查、心电图检查结果的变化,记录试验期间发生的不良事件。结果:单次给药试验中,3.2 mg组发生1例ALT升高的不良事件,程度为中度,可能与药物有关;9.6 mg组发生4例注射部位硬结的不良事件,判断为皮下注射不完全吸收所致。多次给药试验中,4.8 mg组发生1例第1次给药后头晕、心悸的不良事件,退出试验,与受试者主观因素有关,与药物无关。其余受试者给药前后的生命体征、实验室检查、心电图检查均未见有临床意义的改变。结论:聚乙二醇胸腺素α1注射液单次给药0.16~6.4 mg和连续4周,3.2~4.8 mg,每周1次,中国健康志愿者安全耐受。     

奥兰替胃康片Ⅰ期临床耐受性试验

目的:观察奥兰替胃康片(枳实总黄酮苷提取物)在健康志愿者中的安全性和耐受性。方法:单次给药组38名健康志愿者分为7个剂量组,分别给予奥兰替胃康片100,300,600,1 000,1 600,2 400和3 000 mg(1片,n=4;3片,n=4;6片,n=6;10片,n=6;16片,n=6;24片,n=6;30片,n=6)。多次给药组12名健康志愿者分为2个剂量组,分别给予奥兰替胃康片200 mg(2片,n=6)或400 mg(4片,n=6),tid,连续给药7 d。观察受试者的临床症状和体征、生命体征、实验室检查、心电图检查、腹部彩色B超及不良事件。结果:共32名健康志愿者完成了耐受性试验。单次、多次试验均未发生严重不良事件。单次给药试验和多次给药试验中,受试者均未出现有临床意义的体格检查、实验室检查、心电图检查异常。单次给药1 000mg组发生了5例不良事件,很可能与试验药物有关;1 600,2 400,3 000 mg组停止进行试验。多次给药试验中无不良事件发生。结论:奥兰替胃康片在100~600 mg范围内用药的安全性和耐受性良好。单次给药的最大耐受剂量为600 mg。多次给药每次200~400 ...     

奥兰替胃康片I期临床耐受性试验

 　目的：观察奥兰替胃康片（枳实总黄酮苷提取物）在健康志愿者中的安全性和耐受性。方法：单次给药组38名健康志愿者分为7个剂量组,分别给予奥兰替胃康片100,300,600,1 000,1 600,2 400和3 000 mg (1片,n=4;3片,n=4;6片,n=6;10片,n=6;16片,n=6;24片,n=6;30片,n=6)。多次给药组12名健康志愿者分为2个剂量组,分别给予奥兰替胃康片200 mg（2片,n=6）或400 mg（4片,n=6）,tid,连续给药7 d。观察受试者的临床症状和体征、生命体征、实验室检查、心电图检查、腹部彩色B超及不良事件。结果：共32名健康志愿者完成了耐受性试验。单次、多次试验均未发生严重不良事件。单次给药试验和多次给药试验中,受试者均未出现有临床意义的体格检查、实验室检查、心电图检查异常。单次给药1 000 mg组发生了5例不良事件,很可能与试验药物有关;1 600,2 400,3 000 mg组停止进行试验。多次给药试验中无不良事件发生。结论：奥兰替胃康片在100~600 mg范围内用药的安全性和耐受性良好。单次给药的最大耐受剂量为600 mg。多次给药每次200~400 mg,tid,连续7 d安全且耐受性好。推荐的II期临床试验的给药方案为每次400 mg,tid。     

舒络粉针剂Ⅰ期临床耐受性试验

目的:观察舒络粉针剂在健康志愿者中的安全性和耐受性。方法:单次给药剂量组32例健康志愿者被分为7个剂量组,各组例数分别为2,4,6,6,6,4,4,分别给予舒络粉针剂2.0,6.0,8.0,10.0,12.0,14.0,16.0 g.d-1。多次给药剂量组12例健康志愿者被分为2个剂量组,每组6例,分别给予舒络粉针剂6.0 g或10.0 g,qd,连续给药7 d。观察受试者的生命体征、实验室检查、心电图检查及不良事件。结果:共44例健康志愿者完成了耐受性试验。单次、多次试验中均未发生严重不良事件及过敏反应。生命体征、大小便常规、肝功能、肾功能、凝血功能及心电图均未发现异常。44例受试者中发生4例(6例次)不良事件,其中3例为白细胞减少,与试验药物可能有关。结论:舒络粉针剂在2.0～16.0 g.d-1范围内用药的安全性和耐受性良好,单次给药的最大耐受剂量为16.0 g.d-1。多次给药6.0 g及10.0 g.d-1,qd,连续给药7 d的耐受性较好。推荐II期临床试验的给药方案为6.0～10.0 g.d-1。     

枸橼酸爱地那非片Ⅰ期临床耐受性研究

目的:观察构橼酸爱地那非片在健康人体的安全性和耐受性.方法:单次给药试验共入选28例健康男性志愿者,随机分为4个剂量组.由初始剂量30 mg开始,在耐受性较好的情况下,逐渐增加至60,90,120 mg.连续给药试验在单次给药试验结束后进行,共入选36例健康男性志愿者,随机分为3个剂量组,递增剂量分别为30,45,60 mg,qd,连续3 d.观察临床症状体征并严密观察记录试验期间发生的不良事件.结果:单次给药试验与研究药物有关的不良事件主要为视觉异常(发生率35.7%),面色潮红(发生率21.4%),头痛或头晕(发生率17.9%)等;连续给药试验与研究药物有关的不良事件为面色潮红(发生率7.4%),头痛或头晕(发生率7.4%).试验中未发生严重不良事件,所有不良事件的程度均为轻度,均未经处理均自行消失.给药后生命体征、实验室检查和眼科检查均未见有临床意义的改变.结论:中国男性健康受试者单次口服30～120 mg的构橼酸爱地那非片和连续3 d,30～60 mg qd的枸橼酸爱地那非片安全耐受.     

创新药吡非尼酮胶囊在中国健康人体耐受性和安全性研究

目的：评价中国健康受试者单次和多次口服1.1类创新药吡非尼酮胶囊后的人体耐受性和安全性。方法：依据动物实验结果推算起始和最大剂量，以健康受试者为研究对象，从安全起始剂量开始，进行单次和多次给药耐受性试验。采用随机单中心临床研究，统一餐后给药。单次给药耐受性试验：36例，随机分成6个剂量组：200 mg（2例），400 mg（4例），800 mg（6例），1 200 mg（8例），1 800 mg（8例），2 400 mg（8例）；多次给药耐受性试验：12例，分成2个剂量组：400 mg（6例），600 mg（6例），每天3次，连续给药7 d。观察受试者用药前后症状、生命体征、实验室检查变化（包括血尿常规、肝肾功能、心电图等）、并记录药品不良事件。结果：单次和多次给药耐受性试验的受试者用药前后生命体征和心电图无显著变化，实验室检查等表明无器质性损伤。依据试验终止标准，20例受试者完成4个剂量组的单次耐受性研究。其中单次给药耐受性试验有12例，多次给药耐受性试验有7例受试者在口服药物后出现轻中度恶心、呕吐、烧心、食欲不振、头晕和头痛等不良事件，未经处理自行缓解。本试验过程中未发生严重不良事件。结论：中国健康人体对吡非尼酮胶囊单次（200~1 200 mg）或多次（400~600 mg，tid×7 d）给药的安全性和耐受性良好，将为临床合理应用提供依据。     

塞克硝唑阴道泡腾片Ⅰ期临床耐受性研究

目的:评价塞克硝唑阴道泡腾片在健康已婚女性中单次和多次给药的安全性、耐受性。方法:按GCP要求设计试验方案。单次给药耐受性试验中将20例受试者按体重分层随机分至125,250,500, 750 mg共4个剂量组中,每组分别为4,6,6,4例,从最低剂量组开始给药。根据单次给药耐受性试验结果开始多次给药耐受性试验。多次给药耐受性试验入选12例受试者,按体重分层随机分为2组,应用不同剂量塞克硝唑阴道泡腾片,每曰1次,连用7 d。结果:多次给药耐受性试验中2组给药剂量为250, 500 mg·d~(-1)。单次给药耐受性试验中,各组受试者入选时各项指标均正常,条件均衡具较好可比性。试验中无不良反应发生,也未见其他有临床意义的改变。多次给药耐受性试验中亦未见严重不良反应,仅500 mg·d~(-1)组有3例出现轻度外阴烧灼感,0．5 h内自行消失。结论:单次应用塞克硝唑阴道泡腾片,最大剂量至750 mg,多次用药250 mg·d~(-1)比较安全、耐受性较好。     

单次静滴乳酸卡德沙星注射液在中国健康人体的安全耐受性研究

目的：在中国健康成年志愿者中评价单次静滴乳酸卡德沙星注射液的安全性与耐受性。方法：用区组随机化设计,选择18～40岁健康成人24名,每组12人,男女各半,进行单次3h和2h恒速静脉滴注乳酸卡德沙星氯化钠注射液400mg的2种滴注速度的安全性评价。观察试验期间发生的药物不良事件及临床症状、体征、实验室指标变化,用方差分析进行数据统计处理。结果：各组入选受试者给药前各项指标测定值均在正常范围。给药后尿常规、血常规、血生化、心电图等亦未见有临床意义的异常改变。仅1例出现轻度的腹痛、腹泻等可能与药物相关的轻度一过性药物不良反应。试验中未见严重的药物不良反应。结论：2h恒速静脉滴注乳酸卡德沙星氯化钠注射液400mg比较安全,耐受性较好。     

异甘草酸镁注射液正常人体耐受性试验

目的:评价异甘草酸镁注射液在健康志愿者中的安全性和耐受性,为临床制订安全、有效的给药方案提供参考。方法:36名健康志愿者随机分为4组,分别参加单次静脉滴注异甘草酸镁注射液100mg、200mg、300mg组以及每次200mg,qd,持续7d的连续给药组。观察临床症状、生命体征、心电图、血尿常规、肝肾功能等指标变化。结果:单次给药后即刻、1h、8h、24h受试者的生命体征和实验室指标与给药前比较均未发现异常变化;连续给药组给药后第4d、第8d受试者生命体征和实验室指标与给药前比较均在正常值范围内。结论:正常人体对异甘草酸镁注射液具有良好的耐受性,推荐每日剂量为100mg~200mg。     

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.