前列腺素E1联合缬沙坦治疗糖尿病肾病的疗效观察

目的探讨前列腺素E1联合缬沙坦治疗糖尿病肾病（DN）的临床疗效。方法将72例3期及4期DN患者随机分为观察组和对照组各36例,两组患者均给予相同基础治疗,对照组给予前列腺素E1治疗,观察组给予前列腺素E1联合缬沙坦治疗,观察两组患者治疗前后UAER及ACR变化情况。结果两组患者治疗后UAER水平均明显低于治疗前（P〈0．叭）;观察组治疗后UAER水平明显低于对照组（P〈0．05）;两组患者治疗后ACR值均明显低于治疗前（P〈0．01）;观察组治疗后ACR值明显低于对照组（P〈0．05）。结论前列腺素E1联合缬沙坦治疗DN,比单用前列腺素E1更显著减少DN患者尿蛋白排泄。     

凯时治疗老年人病毒性肝炎疗效观察

目的：探讨前列腺素E1对老年人病毒性肝炎的疗效。方法：回顾分析19例应用前列腺素E1脂微球载体制剂（凯时）或前列腺素E1治疗的老年病毒性肝炎，并随机选择同期未使用前列腺素E1治疗的15例患者作为对照，2组均在肝安，能量合剂静滴的基础上，治疗组加用凯时10ug或前列腺素E1 100ug,对照组加用门冬氨酸钾镁20mL，两药均溶于5％葡萄糖溶液滴，qd，疗程均为4周，结果：治疗组疗效优于对照组（P＜0．05），其血清胆红素的降低显著优于对照组（P＜0．01），ALT及PTA均低于对照组，结论：凯时对老年人病毒性肝炎有较好疗效。     

山莨菪碱联合前列腺素E1治疗糖尿病周围神经病变39例临床观察

目的观察山莨菪碱联合前列腺素E1治疗糖尿病周围神经病变（DPN）的临床疗效。方法将DPN患者76例随机分为2组，治疗组39例，给予山莨菪碱联合前列腺素E1治疗；对照组37例，给予维生素B1、B12注射液治疗，疗程均为30d，分别测定2组治疗前后血流动力学、血糖、糖化血红蛋白、纤维蛋白原、胆固醇、甘油三酯、神经传导速度（NCV），观察临床疗效。结果治疗组总有效率为82．1％，对照组为51．5％，治疗组明显高于对照组（P〈0．05）。治疗组治疗后血流动力学指标、空腹血糖、餐后2h血糖、甘油三酯、总胆固醇及NCV均有显著改善（P〈0．05）。结论山莨菪碱联合前列腺素E1治疗DPN疗效显著。     

中药分型治疗更年期综合征95例疗效观察

目的探讨中药分型加减治疗更年期综合征的有效方法。方法将190例患者随机分为两组对比观察，治疗组应用中药分型加减治疗。每日1剂，对照组应用更年康治疗，4周后评价疗效。结果治疗组95例中痊愈率21．1％（P〈0．05）；治疗组治疗前后各主要症状评分比较均有显著差异（P〈0．05～0．01）。且明显优于对照组（P〈0．05～0．01）；并发现有明显提高患者血清雌二醇水平作用（P〈0．05）。结论中药分型加减治疗更年期综合征疗效可靠。     

凯时治疗重型肝炎合并肝肾综合征的疗效观察

目的观察前列腺素E1脂微球载体制剂（凯时）治疗重型肝炎合并肝肾综合征的临床疗效。方法重型肝炎合并肝肾综合征的患者70例随机分为观察组和对照组各35例。对照组给予常规保肝与综合治疗;治疗组在对照组基础上加用凯时治疗。观察比较2组疗效以及肝肾功能指标水平。结果观察组总有效率为88.6%显著高于对照组的65.8%,差异有统计学意义（P〈0.01）。治疗后2组TBIL、ALT、AST、r-GT、AKP均较治疗前明显改善,且观察组优于对照组,差异均有统计学意义（P〈0.05和P〈0.01）;治疗后观察组BUN和Cr较治疗前改善,且优于对照组,差异有统计学意义（P〈0.05和P〈0.01）。结论凯时治疗重型肝炎并肝肾综合征疗效较好,且不良反应小,值得临床推广应用。     

经方治疗类风湿性关节炎效果分析及《黄帝内经》对本病治疗的探析

目的评价经方治疗类风湿性关节炎的疗效及安全性。方法类风湿性关节炎患者60例,按治疗方法不同分为两组：治疗组（中西医结合治疗组）30例,对照组（西医治疗组）30例,两组均治疗4周（1个疗程）,观察两组疗效及有无不良反应。结果治疗组总有效率90．0％,明显高于对照组70．0％（P〈0．05）;两组治疗后ESR、CRP、RF及各免疫球蛋白含量均低于治疗前（P〈0．05）;治疗组治疗后优于对照组（P〈0．05）;且治疗组不良反应发生率较低（P〈0．05）。结论经方加减治疗类风湿性关节炎不良反应较少,安全有效。     

乌司他丁联合连续性血液滤过治疗多器官功能障碍综合征53例临床观察

目的观察乌司他丁（UT）和连续性血液滤过（CVVH）治疗多器官功能障碍综合征（MODS）临床疗效。方法103例MODS患者随机分为两组：对照组50例采用常规及CVVH治疗；治疗组53例在对照组的基础上加用乌司他丁。观察两组患者治疗前后APACHEⅡ评分，观察肿瘤坏死因子-α（TNF-α）、血栓素B2（TXB2）、6-酮-前列腺素F1A（6-keto—PGF1a）、肾功能的变化以及ICU住院天数、cVVH应用时间和患者死亡风险率。结果两组患者治疗后APACHEⅡ评分均明显下降；血清TNF-α、TXB2均较治疗前显著下降（P〈0．05），血清6-keto—PGF1a均显著上升（P〈0．05），但治疗组上述指标均优于对照组（P〈0．05）。两组患者死亡率无显著差异，但治疗组患者ICU住院天数及CVVH应用时间均优于对照组（P〈0．01）。结论UT联合CVVH治疗MODS可取得更好疗效。     

前列腺素E1治疗慢性乙型肝炎黄疸的观察

目的观察前列腺素E1治疗慢性乙型肝炎重度黄疸的疗效。方法在综合治疗基础上，分别使用前列腺素E1（治疗组）和门冬氨酸钾镁（对照组）治疗慢性乙型肝炎重度黄疸患者各35例，并观察其症状、体征及肝、肾功能等，疗程4周。结果治疗组的症状、体征及肝功能指标及总有效率，均显著优于对照组，两组比较差异有显著意义（P〈0．05）。结论前列腺素E1治疗慢性乙型肝炎重度黄疸能显著地促进黄疸消退和改善肝功能。     

前列腺素E1在全身炎症反应综合征治疗中的应用

目的：探讨前列腺素E1（PGE1）在阻断全身炎症反应综合征（SIRS）向多器官功能障碍综合征（MODS）发展中的作用及其机制。方法：65例SIRS患者随机分为治疗组（n=36）和对照组（n=29）。对照组采用常规综合治疗，治疗组在对照组用药基础上加用PGE1 100μg/次静滴，8小时一次，连用7天。两组同时检测血清白介素-6（IL-6）、IL-10、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）水平，并观察SIRS的变化。结果：治疗组T、RR、HR及WBC改善情况均明显优于对照组（P〈0．05或P〈0．01）；血清CRP、IL-6和TNF-α水平均较对照组下降更为明显（P〈0．01），IL-10较对照组明显升高（P〈0．05）；转为MODS明显减少（P〈0．05），病死率明显降低（P〈0．05）。结论：PGE1可通过上调抗炎因子和下调促炎分子，调控机体炎症反应，阻断SIRS向MODS发展。     

益气养血、温经通络法治疗糖尿病足55例临床观察

目的观察中医益气养血、温经通络法治疗糖尿病足的疗效。方法103例糖尿病足患者随机分为治疗组55例和对照组48例。2组均给予糖尿病足基础治疗,治疗组加用益气养血、温经通络中药口服;对照组应用前列腺素E。静脉滴注。观察2组疗效、足背动脉血流动力学、腓总神经传导速度。结果治疗组总有效率为85．5％高于对照组的70．8％,差异有统计学意义（P〈0．05）;2组治疗前后的左、右足背动脉平均速度、内径、血流量变化差异均有统计学意义（P〈0．05）,治疗组经治疗后右侧内径宽于对照组,差异有统计学意义（P〈0．05）;2组治疗后腓总神经传导速度较治疗前明显增高,差异均有统计学意义（P〈0．05）,且治疗组高于对照组,差异有统计学意义（P〈0．05）。结论中医益气养血、温经通络法治疗糖尿病足病疗效确切,值得临床推广应用。     

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.

---

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.     

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.