原发性高血压患者心率变异性的临床分析

目的：探讨原发性高血压（EH）患者自主神经功能变化。方法：对43例原发性高血压患者和20例正常人进行Holter记录，分析对比心率变异性（heart rate variability,HRV)指标。结果：EH患者HRV的时域指标（SDNN、SDNNi、RMSSD）及频域指标（TP、LF、HF）较正常对照均明显降低（P＜0．001－0．05），以RMSSD、HF降低最为显著。EH患者LF／HF较正常对照明显升高（P＜0．05），SDANN与对照组比较差异无显著性（P＞0．05）。EH患者中，重度高血压组的时域、频域的多项指标较轻、中度高血压组降低（P＜0．01－0．05）。极高危组的HRV多项指标亦较非极高危组减低（P＜0．01－0．05）。结论：原发性高血压患者存在迷走神经活性明显降低，同时伴有交感神经活性的相对增强。HRV的减低可能为预后不良的一个重要指标。     

糖尿病、高血压与血脂紊乱对心率变异性的影响

目的 探讨糖尿病、高血压、血脂紊乱对心率变异性（HRV）的影响。方法 对单纯33例糖尿病、30例高血压及76例血脂紊乱患者，进行24h HRV时域、频域分析，同时与34例无明显临床疾病、肥胖或超重及血脂异常的正常成人进行HRV的差异比较。结果 1．糖尿病和高血压组与正常组比较HRV各指标除FL／HL均降低（P〈0．05）；血脂异常组HRV各指标除FL／HL也均低于正常组，但仅HF有统计学差异（P〈0．05）。2．血脂异常组与糖尿病及高血压组比：反映交感神经张力的SDNN，SDANN，SDNNindex，LH均降低（P均〈0．05），而反映迷走神经张力的RMSSD、PNN50及HF也降低，仅糖尿病与血脂异常组HF有统计学意义（P〈0．05）；3．糖尿病组HRV各指标均低于高血压组，但无统计学差异。校正年龄、性别、吸烟、We，SBP，DBP，FPG，UA，FATc，Te，TG，HDL-c，LDL-c后上述差异仍存在。结论 糖尿病、高血压与血脂异常、正常人间存在HRV差异。糖尿病和高血压血脂紊乱HRV各指标减低，提示存在交感神经活性增加，迷走神经活性降低，自主神经的功能紊乱可能是糖尿病、高血压血脂紊乱患者心血管事件增加的原因之一。     

心率变异评价2型糖尿病合并高血压患者的自主神经功能

目的通过检测心率变异（HRV）探讨2型糖尿病合并高血压患者的自主神经功能变化。方法选择确诊2型糖尿病无高血压的24例住院患者为2型糖尿病组（T2DM）,2型糖尿病合并高血压的患者22例为T2DM并高血压组（T2DM-HT）,非糖尿病、高血压病的住院患者20例为对照组（Con）,全部患者进行24 h动态心电图及HRV分析。结果 T2DM及T2DM-HT组患者HRV的各时域指标均小于对照组（P〈0.05）,而与T2DM组相比,T2DM-HT组患者HRV各时域指标进一步降低（P〈0.05）。结论 T2DM患者存在HRV的降低,而高血压则进一步加重HRV的降低,提示高血压促进T2DM患者自主神经病变的发生发展。     

慢性充血性心力衰竭患者的心率变异性分析

目的：探讨慢性充血性心力衰竭（CHF）患者的心率变异性（HRV）的变化。方法：用24d,时动态心电图分析51例心力衰竭患者、27例心功能代偿的心血管病患者、25例健康人的HRV指标。比较3组HRV指标与心功能NYHA分级和关系。结果：心功能代偿组SDNN、SDANN较对照组显著下降（P〈0.01,P〈0．05）SDNNi、rMSSD和pNN50与对照组差异无显著性（P〉0．05）;CHF组的HRV各指标均显著低于对照组（P〈0．01）。心功能≥Ⅲ级者较Ⅱ级HRV各项指标显著降低（P〈0．01）,各种病因SDNN、SDANN较对照组显著下降（P〈0．01）,但各种病因间差异无显著性（P〉0．05）。结论：CHF患者HRV指标下降的变化与心功能损害程度相关,但原发病之间HRV指标下降无差异。     

Ⅱ型糖尿病患者心率变异时域分析的临床价值探讨

对60例Ⅱ型糖尿病患者HRV时域分析各项指标（SDNN、SDSD、SDANN、RMSSD及PNN50）进行了测定，并与60例正常成人进行对比分析。结果显示Ⅱ型糖尿病患者HRV各项时域分析指标均明显低于正常对照组（P＜0．01）。表明HRV各项时域指标的测定，有利于评价Ⅱ型糖尿病患者的自主神经病变。     

血浆内源性地高辛样因子在肾病综合征中的变化

目的：了解肾病综合征患者血浆内源性地高辛样因子（endogenous digoxin—like factor，EDF）水平的变化及意义。方法：肾病综合征患者62例，根据血压及尿蛋白分为：肾病综合征正常血压组；肾病综合征高血压组；肾病综合征恢复期组；健康人67例为对照组。用放免分析法检测以上各组血浆EDF水平。结果：（1）与正常对照组相比，肾病综合征正常血压组血浆EDF水平明显降低（P〈0．05），肾病综合征高血压组和肾病综合征恢复期组血浆EDF水平明显增高（P〈0．05或P〈0．01）。（2）肾病综合征正常血压组血浆EDF水平与尿蛋白呈负相关r=-0．581，P〈0．01）。（3）肾病综合征高血压组血浆EDF水平与尿蛋白呈负相关，与平均动脉血压呈正相关（R=0．797，P〈0．01）。结论：肾病综合征患者血浆EDF水平下降可能是该病高度浮肿的又一因素；血容量、血压是影响血浆EDF水平的重要因素。     

缬沙坦对原发性高血压患者窦性心率震荡及心率变异性的影响

目的：探讨缬沙坦对原发性高血压（EH）患者窦性心率震荡（HRT）和心率变异性（HRV）的影响。方法：45例轻中度EH患者（观察组）予缬沙坦胶囊80 mg,po qd,若血压控制不佳,加至160 mg·d~（-1）,连用12周。另选择同期年龄、性别相匹配健康体检者30例作为对照组。比较治疗组治疗前后血压、心率及HRT、HRV相关指标,并与对照组比较。结果：观察组患者收缩压和舒张压均控制于正常范围（P〈0.05或0.01）,而治疗前后心率无明显改变（P〉0.05）。治疗前,观察组患者初始值（T0）和起始时间（TT）明显高于对照组,斜率（TS）明显低于对照组（P〈0.01）;治疗后,其TO和TT均较前明显下降,TS较前明显上升（P〈0.01）。治疗前,观察组患者标准差（SDNN）、每5min时段正常RR间期标准差的平均值（SDANN）和相邻RR之差的均方根值（RMSSD）均明显低于对照组,低频（LF）/高频功率（TF）比值明显高于对照组（P〈0.01）;治疗后,其SDNN、SDANN和RMSSD均较前明显上升,LF/TF比值较前明显下降（P〈0.05）。结论：EH患者存在HRT和HRV指标异常,缬沙坦除具有良好降压作用外,还能明显改善患者的自主神经调节功能紊乱,减轻心脏功能受损,有利于减少恶性心血管事件发生,改善患者预后。     

高血压合并阻塞性睡眠呼吸暂停综合征对患者心率变异及血压昼夜节律的影响

目的 探讨高血压合并阻塞性睡眠呼吸暂停综合征(OSAS)对患者心率变异(HRV)及血压昼夜节律的影响.方法 根据是否合并OSAS,将42例高血压患者分为合并组与单纯组各21例.比较两组之间HRV时域指标与频域指标、非杓型昼夜血压曲线的比例及夜间平均血氧水平、呼吸紊乱指数(AHI)的差异.结果 与单纯组相比,合并组的非杓型昼夜血压曲线比例及HRV时域指标与频域指标明显增加,夜间平均血氧水平显著降低(P值均＜0.05),而AHI则明显升高(P＜0.01).结论 OSAS导致高血压患者HRV增强,血压昼夜节律多呈非杓型.     

高血压合并2型糖尿病患者心率变异与颈动脉内中膜厚度的相关性分析

目的探讨高血压（EH）合并2型糖尿病（T2DM）患者心率变异（HRV）的改变及其与颈动脉内中膜厚度（IMT）的关系。方法选择27例高血压患者、22例高血压合并2型糖尿病患者和25例健康人进行24h动态心电图监测和颈动脉内中膜厚度测量。结果高血压组、高血压合并2型糖尿病组的SDNN、SDANN、RMSSD、SDNNidex较正常对照组均有明显减低（P〈0．01）,高血压合并2型糖尿病组较高血压组也有显著差异（P〈0．05）。高血压或高血压合并2型糖尿病伴颈动脉内中膜增厚者HRV参数较无增厚者有进一步的下降,而且HRV参数与IMT呈负相关。结论心率变异性分析可以作为早期发现高血压和（或）合并2型糖尿病患者心脏自主神经损伤的有价值的指标,HRV也是颈动脉粥样硬化的独立相关因素,可对大血管并发症作出早期的预测．有助于及时治疗,改善预后。     

原发性高血压病人心率变异时域分析的临床价值

目的 探讨心率变异（HRV）时域分析对原发性高血压病人的临床意义。方法 测定60例原发性高血压病人HRV时域分析各项指标：SDNN,SDSD,SDANN,RMSSD及PNN50与60例正常人进行对比分析。结果 原发性高血压病人各项时域分析指标均明显低于正常对照组（P＜0．01）。结论 HRV各项时域指标的测定,有利于评价原发性高血压病人的自主神经病变,也为临床预后的估计、药物的筛选提供了依据。     

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.     

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.