赖诺普利与依那普利对高血压的疗效比较

９２例原发性Ⅰ和Ⅱ期高血压病人采用随机、单盲方法，分２组治疗。一组用赖诺普利，ｐｏ，２０－８０ｍｇ／ｄ，另一组用依那普利，ｐｏ，１０－４０ｍｇ／ｄ，疗程均为４ｗｋ。降压总有效率和降压幅度：赖诺普利是８９％和２．９／２．０ｋＰａ，依那普利是９７％和３．１／２．１ｋＰａ，２药降压均显著（Ｐ＜０．０１），降压疗效相仿（Ｐ＞０．０５）。不良反应发生率是２９％和３４％，其中最多是干咳。结果提示赖诺普利治疗轻、中度高血压有效、安全。     

原发性高血压患者血管紧张素转换酶基因多态性及危险因素的关？…

目的 研究中国人群中原发性高血压患血管紧张素转换酶（ＡＣＥ）基因多态性及其危险因素的关系。方法 对社区人群调查中确诊的１１２例原发性高血压患，和相同数量，性别、年龄相的健康人询问与原发性高血压有关的因素，测量空腹血脂及坐位血压，应用聚合酶链反应（ＰＣＲ）检测ＡＣＥＩ／Ｄ基因多态性。结果 两组ＡＣＥ基因Ｉ／Ｄ多态性构成有显性差异（Ｐ〈０．０５）。病例组ＤＤ基因型高于对照组（３０．４％ｖｓ１８．     

赖诺普利对原发性高血压胰岛素敏感性的影响

目的：观察赖诺普利对原发性高血压（ＥＨ）病人胰岛素敏感性的影响。方法：将５６例ＥＨ病人分成２组。赖诺普利组３１例（男性１６例,女性１５例,年龄４９ａ±ｓ１０ａ）,给赖诺普利１０～２０ｍｇ,ｐｏ,ｑｄ×４ｗｋ;氢氯噻嗪组２５例（男性１３例,女性１２例,年龄５０ａ±１１ａ）给氢氯噻嗪２５～５０ｍｇ,ｐｏ,ｔｉｄ×４ｗｋ。结果：赖诺普利组降压总有效率为９４％与氢氯噻嗪组（９２％）相仿（Ｐ＞０．０５）。赖诺普利组空腹血糖与胰岛素均有明显降低（Ｐ＜０．０１）。代表胰岛素敏感性１／（ＦＰＧ×ＦＩＮＳ）的试验显著提高的差别有非常显著的意义（Ｐ＜０．０１）,而在氢氯噻嗪组则均无此反应。结论：赖诺普利具有提高ＥＨ病人胰岛素敏感性的作用。     

高血压病患者的代谢紊乱及药物干预研究

目的探讨非洛地平（ＦＭ）与苯那普利（ＢＥ）对高血压病患者胰岛素抵抗（ＩＲ）及代谢的影响。方法测定１２２例高血压患者和３８例正常血压作对照组（ＮＳ）的胰岛素敏感性指数（ＩＳＩ）及血脂等水平,根据ＩＳＩ值,把高血压分为高血压Ⅰ组（６８例）与高血压醇Ⅱ组（５４例）,再分别把高血压Ｉ组和高血压Ⅱ组各随机分为非洛地平（ＦＭ）组与苯那普利（Ｂ）组,治疗８周后再测定ＩＳＩ及血脂等变化。结果（１）Ⅰ组的ＩＳＩ明显低于 Ⅱ组及阳组（Ｐ＜０．０５）,而 Ⅱ组的ＩＳＩ与ＮＳ组之间差异无显著意义（Ｐ＞０．０５）;（２）两药治疗后血压均较治疗前显著降低（Ｐ＜０．０１）;（３）Ⅰ组经两药治疗后ＩＳＩ值均明显升高（Ｐ＜０．０１）,Ⅱ组经两药治疗后ＩＳＩ无显著变化（Ｐ＞０．０５（４）两药治疗后,Ⅰ组各项代谢指标均无显著变化（Ｐ＞０．０５）。结论ＦＭ与ＢＥ均可明显改善高血压Ⅰ组患者的ＩＲ,两药短期治疗对其它代谢指标无影响。     

非胰岛素依赖型糖尿病患者血浆D-二聚体的变化及其意义

为探讨非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者凝血及纤溶活性，采用ＥＬＩＳＡ双抗体夹心法测定了３５例ＮＩＤＤＭ患者的血浆Ｄ－二聚体。结果：ＮＩＤＤＭ患者血浆Ｄ－二聚体水平为１．６３ｍｇ／Ｌ±０．１４ｍｇ／Ｌ），明显高于正常对照组（０．３３ｍｇ／Ｌ±０．０９ｍｇ／Ｌ）（Ｐ＜０．０５）；有血管病变组Ｄ－二聚体为２．６２ｍｇ／Ｌ±０．６８ｍｇ／Ｌ，高于无血管病变组（０．６９ｍｇ／Ｌ±０．６８ｍｇ／Ｌ），差异有显著性（Ｐ＜０．００１）；血浆Ｄ－二聚体与ＦＢＧ、ＴＣ、ＴＧ相关分析表明Ｄ－二聚体与ＦＢＧ、ＴＧ呈正相关（分别为ｒ＝０．５８，Ｐ＜０．００１；ｒ＝０．０３５，Ｐ＞０．２；ｎ＝１４），与ＴＣ呈负相关（ｒ＝－０．０４５，Ｐ＞０．２，ｎ＝１４）。８例ＮＩＤＤＭ患者治疗后血浆Ｄ－二聚体较治疗前显著降低，分别为１．１１±０．８１，３．６５±１．２２，Ｐ＜０．０５）。提示ＮＩＤＤＭ患者体内存在高凝和继发纤溶活性亢进，血浆Ｄ－二聚体是反映ＮＩＤＤＭ患者高凝和缺血性疾病的诊断、疗效观察的良好指标。     

培哚普利治疗45例老年人高血压病的临床观察

对Ⅰ期与Ⅱ期老年人高血压病（４５例）和Ⅰ期与Ⅱ期非老年人高血压病（４３例）应用培哚普利治疗并进行比较。结果表明两组在治疗后均有显著的降压效果（Ｐ＜０．０１），但是两组之间的降压总有效率和降压幅度均无显著性差异（Ｐ＞０．０５）。在治疗期间仅有的不良反应是干咳，其发生率在老年组为６．７％，非老年组则为７％（Ｐ＞０．０５）。提示培哚普利治疗Ⅰ期与Ⅱ期老年人高血压病的疗效较好而且安全。     

血管紧张素转换酶基因插入／缺失多态性与冠心病关系的初步研究

目的：研究中国汉族人群血管紧张素转换酶（ＡＣＥ）基因插入／缺失（Ｉ／Ｄ）多态性与冠心病的关系。方法：应用聚合酶链反应（ＰＣＲ）检测４０例冠心病和５０例配伍对照组的血管紧张素转换酶（ＡＣＥ）基因型，同时测血压、血脂、体重指数等指标。结果：冠心病组与对照组ＡＣＥ基因型分布无显著性差异；ＤＤ型对ＤＩ型和ＩＩ型优势比ＯＲ＝１．５２，９５％可信区间为０．５５～４．２２，Ｐ〉０．０５。结论：ＡＣＥ基因Ｉ／Ｄ多     

Ⅱ型糖尿病患者的胰岛素抵抗

为了探讨Ⅱ型糖尿病患者动脉硬化的关键因素，我们观察了９２例Ⅱ型糖尿病患者的体重指数、胰岛素面积、胰岛素敏感指数、血脂及并发冠心病和高血压病的发病率。结果显示：９２例Ⅱ型糖尿病患者中胰岛素敏感指数与ＨＤＬ－Ｃ／ＴＣ（ｒ＝－０．３２２，Ｐ＜０．００１）和ＬＤＬ－Ｃ／ＨＤＬ－Ｃ（ｒ＝０．３４６，Ｐ＜０．００１）相关较胰岛素面积（ｒ＝－０．２３８，Ｐ＜０．０５；ｒ＝０．２４０，Ｐ＜０．０５）和体重指数（ｒ＝－０．０９２，Ｐ＞０．０５；ｒ＝０．０７２，Ｐ＞０．０５）显著。且胰岛素抵抗组冠心病５７．６％和高血压病３６．４％的发病率也显著高于高胰岛素血症组４８．８％、３３．９％（Ｐ＜０．０５）和肥胖组４８．１％、３３．３％（Ｐ＜０．０５）。提示胰岛素抵抗是Ⅱ型糖尿病患者发生动脉硬化的关键因素之一。     

血管紧张素转换酶基因多态性与心肌梗死关系的研究

本研究对８０ 例心肌梗死患者和８０ 例健康人的血管紧张素转换酶（ＡＣＥ）活性，及ＡＣＥ基因插入（ Ⅰ）／缺失（Ｄ）多态性进行了研究。结果表明ＭＩ组Ｄ 等位基因频率５０．３ 和ＤＤ 基因型频率０．３０ 显著高于对照组的０．３１ 和０．１０。ＭＩ组和正常人ＤＤ、ＤＩ、ＩＩ基因型的血清ＡＣＥ活性依次显著增高，因此ＡＣＥ基因多态性可能是我国人ＭＩ发病的独立危险因素之一。     

血管紧张素转换酶基因多态性与心肌梗关系的研究

本研究对８０例心肌梗死患者和８０例健康人的血管紧张素转换酶（ＡＣＥ）活性；及ＡＣＥ基因插入（Ｉ）／缺失（Ｄ）多态性进行了研究。结果表明ＭＩ组Ｄ基因频率５０．３和ＤＤ基因型频率０．３０显著高于对照组的０．３１和０．１０。ＭＩ组和正常人ＤＤ、ＤＩ、ＩＩ基因型的血清ＡＣＥ活性依次显著增高，因此ＡＣＥ基因多态性可能是我国人ＭＩ发病的独立危险因素之一。     

Degraded and undegraded carrageenans and experimental gastric and duodenal ulceration

The prevention of histamine-induced gastric and duodenal ulceration in the guinea-pig has been examined using a series of undegraded and degraded carrageenans. Undegraded carrageenans were active at lower doses than degraded carrageenans. The high viscosity of the undegraded carrageenans in solution prevented their use in larger doses. Degradation of carrageenan without serious loss of sulphate, gives a product which allows the dose to be increased to an extent that its effect more than offsets the slight loss in activity caused by the degradation. No single feature of carrageenan structure can be related to anti-ulcer activity although degradation, and hence reduction of molecular size, generally reduces activity. Sulphate contents over 30% have little apparent effect on activity; κ-carrageenans were not consistently different in anti-ulcer activity from Λ-carrageenans. This contrasts with the antipeptic activity of carrageenans where κ-carrageenans are less active than their Λ-counter-parts. As with antipeptic activity, the degree of anti-ulcer activity is probably determined by a combination of structural features which includes molecular size and polyanionic properties.     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Alcohol and Substance Use and Abuse in Women and Children

No abstract available for this article.     

Glucosidase and fucosidase inhibitors and Advances in nucleosides and nucleotides.

The American Chemical Society Symposium "Glucosidase and fucosidase inhibitors" took place on 1 April 1998 and was organized by Professors Zbigniew J Witczak (UConn, School of Pharmacy, CT, USA), Kuniaki Tatsuta (Waseda University, Tokyo, Japan) and Waldemar Priebe, MD (Anderson Cancer Center, University of Texas, USA). Professor Witczak provided introductory remarks including the status of existing glucosidase inhibitors, and chaired the morning session, which consisted of six lectures. The symposium was well received, and was particularly attractive for those interested in networking, as attendance was about sixty. In addition, some participants and attendees presented posters on the subject during the regular poster session organized by the Division of Carbohydrate Chemistry.