前列地尔联合替米沙坦治疗糖尿病肾病疗效观察

目的 观察前列地尔注射液（脂微球载体制剂）联合替米沙坦治疗2型糖尿病肾病的临床疗效.方法 将2型糖尿病肾病患者80例随机分为治疗组和对照组各40例.对照组予替米沙坦治疗,治疗组在对照组的基础上加用前列地尔治疗.观察治疗前后2组在血肌酐、血尿素氮、24h尿蛋白定量及内皮素水平的变化,并观察2组不良反应发生情况.结果 治疗组治疗后血肌酐、血尿素氮、内皮素、24h尿蛋白定量均低于治疗前,差异均有统计学意义（P＜0.05）.对照组治疗后血肌酐、尿素氮、内皮素与治疗前比较差异无统计学意义（P＞0.05）.24h尿蛋白水平低于治疗前,差异有统计学意义（P＜0.05）.治疗后治疗组24h尿蛋白水平低于对照组,差异有统计学意义（P＜0.05）.2组均未出现严重不良反应.结论 前列地尔联合替米沙坦治疗2型糖尿病肾病可减轻尿蛋白,延缓肾病恶化,改善糖尿病肾病患者的生活质量.     

替米沙坦联合依那普利治疗肾性高血压84例

目的研究替米沙坦联合依那普利治疗肾性高血压的临床疗效和安全性。方法将168例肾性高血压患者随机分为观察组和对照组,各84例。对照组单纯应用依那普利治疗,观察组采用替米沙坦联合依那普利治疗,比较两组患者的治疗效果和安全性。结果治疗8周后观察组患者收缩压（SBP）和舒张压（DBP）均明显降低,与对照组患者比较差异有统计学意义（P〈0．05）。观察组患者血尿素氮、血肌酐及24h尿蛋白定量均明显降低,内生肌酐清除率明显升高,与对照组同期比较差异有统计学意义（P〈0．05）。结论替米沙坦联合依那普利治疗肾性高血压可有效降低患者血压,保护患者肾功能。     

肾康注射液联合左卡尼丁注射液治疗慢性肾功能不全失代偿期的临床效果

目的：探讨肾康注射液联合左卡尼丁注射液治疗慢性肾功能不全失代偿期的临床效果。方法选取2010年1月—2014年10月某院收治的慢性肾功能不全患者98例,随机分为对照组（51例）与观察组（47例）。对照组患者予以临床常规治疗,观察组患者在对照组基础上加用肾康注射液联合左卡尼丁注射液治疗。观察两组患者治疗前后的肾功能指标（内生肌酐清除率、血肌酐、血尿素氮）、心功能分级〔采用美国纽约心脏病学会（ NYHA）心功能分级标准〕及不良反应发生情况。结果治疗前两组患者内生肌酐清除率、血肌酐、血尿素氮水平比较,差异无统计学意义（ P>0.05）,治疗后观察组患者内生肌酐清除率大于对照组,血肌酐、血尿素氮水平低于对照组,差异有统计学意义（P<0.05）;治疗前两组患者心功能分级比较,差异无统计学意义（P>0.05）,治疗后观察组患者心功能分级优于对照组,差异有统计学意义（ P<0.05）;两组均未发生严重不良反应。结论肾康注射液联合左卡尼丁注射液治疗慢性肾功能不全失代偿期的临床效果显著,可改善患者肾功能及心功能,且不良反应小。     

百令胶囊联合替米沙坦对慢性肾小球肾炎患者肾功能的改善作用

目的:探讨百令胶囊联合替米沙坦对慢性肾小球肾炎的治疗效果及对肾功能的影响.方法:选择我院2015年7月~2016年11月收治的86例慢性肾小球肾炎患者,以随机数字表法分组,观察组与对照组各43例,对照组在常规治疗基础上接受替米沙坦治疗,观察组在常规治疗基础上使用百令胶囊联合替米沙坦治疗,对两组治疗后疗效与肾功能进行观察.结果:观察组与对照组治疗后总有效率分别为93.02%、74.42%,差异有统计学意义(P<0.05);治疗前,两组尿素氮(BUN)、血肌酐(Scr)、24h尿蛋白定量无明显差异(P>0.05),观察组治疗后各指标明显优于对照组,差异有统计学意义(P<0.05).结论:百令胶囊联合替米沙坦治疗慢性肾小球肾炎效果满意,可有效改善肾功能,具有推广价值.     

血府逐瘀汤联合替米沙坦治疗2型糖尿病肾病的疗效观察

目的观察血府逐瘀汤联合替米沙坦治疗2型糖尿病肾病的疗效。方法选择2型糖尿病肾病患者80例,随机分为两组,对照组40例接受常规治疗和替米沙坦40～80mg,d,治疗组在对照组治疗基础上加服血府逐瘀汤加减方剂治疗,比较两组的疗效及各项生化指标。结果治疗组疗效优于对照组,差异有统计学意义（P〈0．05）,治疗组经治疗后尿蛋白排泄率,24h尿蛋白定量、血肌酐、血尿素氮下降,与对照组治疗后比较,差异有统计学意义（P〈0．05）。结论血府逐瘀汤联合替米沙坦治疗糖尿病肾病其改善。肾功能和疗效作用优于单用替米沙坦治疗．     

替米沙坦联合维持性血液透析治疗尿毒症合并高血压患者的临床研究

目的观察替米沙坦联合维持性血。液透析对尿毒症合并高血压患者的临床疗效。方法入选136例尿毒症合并高血压患者,按入院顺序随机分为对照组和联合组,每组68例,对照组予以常规维持性血液透析治疗,联合组在常规维持性血液透析治疗基础上加用替米沙坦（40～80mg.d-1）治疗,观察12周。比较两组患者治疗前后血压和肾功能（血尿素氮、血肌酐、估计肾小球滤过率、血尿酸、尿微量白蛋白、尿β2微求蛋白）的变化。结果治疗前两组患者的血压没有明显的差异（P〉0.05）,治疗12周后,两组患者的血压与本组治疗前比较均有下降（P〈0.05）,与对照组比较,联合组的血压下降更明显（P〈0.05）。治疗前后两组患者的肾功能指标差异没有统计学意义（P〉0.05）,但联合组与本组治疗前比较有好转的趋势（P〈0.05）。结论替米沙坦联合维持性血液透析治疗可有效控制尿毒症合并高血压患者的血压,从而保护患者的肾功能。     

补阳还五汤加减治疗慢性肾小球肾炎的效果观察

目的：探讨补阳还五汤加减治疗慢性肾小球肾炎的临床效果。方法选取2011年4月—2013年4月就诊于我院的慢性肾小球肾炎患者178例,随机分为观察组和对照组,每组89例。对照组应用常规西药治疗,观察组应用补阳还五汤加减治疗,比较两组患者的治疗总有效率、24h尿蛋白定量、血肌酐、尿素氮等。结果观察组治疗总有效率为93.3%（83/89）,对照组为70.8%（63/89）;观察组治疗总有效率高于对照组,差异有统计学意义（P〈0.05）。两组治疗前24h尿蛋白定量、血肌酐、尿素氮与治疗后比较,差异有统计学意义（P〈0.05）。治疗后两组24h尿蛋白定量比较,差异无统计学意义（ P〉0.05）,治疗后两组血肌酐、尿素氮比较,差异有统计学意义（ P〈0.05）。结论补阳还五汤加减治疗慢性肾小球肾炎效果确切,有助于改善患者肾功能。     

替米沙坦辅治早期糖尿病肾病的疗效观察

目的观察替米沙坦辅治早期糖尿病肾病（DN）的临床疗效。方法将48例DN患者随机分为治疗组和对照组,各24例。对照组给予基础治疗,治疗组在基础治疗上加服替米沙坦,每次80mg,每天1次。2组疗程均为12周,比较2组临床疗效及肾功能。结果治疗组总有效率为83.3%高于对照组的62.5%,差异有统计学意义（P〈0.05）;治疗组治疗后的24h尿蛋白定量、血尿素氮（BUN）及血肌酐（SCr）较治疗前明显降低,差异均有统计学意义（P〈0.05）。结论替米沙坦辅治早期DN,在减少尿蛋白、改善肾功能方面有确切疗效,可有效地控制和延缓DN病情的发展,有效保护肾功能。     

尿毒清颗粒联合羟苯磺酸钙治疗慢性肾衰竭的疗效及对结缔组织生长因子、骨形态发生蛋白-7的影响

目的 探讨尿毒清颗粒联合羟苯磺酸钙治疗慢性肾衰竭的疗效及对结缔组织生长因子（CTGF）、骨形态发生蛋白-7（BMP-7）的影响。方法 采用回顾性总结研究方法,2016年4月—2018年1月选择在安阳市第六人民医院进行维持性血液透析的慢性肾衰竭患者92例,根据治疗方法的不同分为观察组与对照组各46例,对照组给予羟苯磺酸钙治疗,观察组在对照组治疗的基础上给予尿毒清颗粒治疗,两组都治疗观察3个月,记录CTGF、BMP-7变化情况。结果 观察组的总有效率为97.8%,高于对照组的87.0%,对比差异有统计学意义（P<0.05）。治疗后两组血清血尿素氮（BUN）与肌酐（Scr）值都显著高于治疗前（P<0.05）,治疗后观察组显著低于对照组（P<0.05）。治疗后两组血清CTGF值显著降低、BMP-7值显著升高,对比差异有统计学意义（P<0.05）,治疗后观察组与对照组对比差异也有统计学意义（P<0.05）。治疗后观察组的人际关系敏感、抑郁、焦虑、精神病性、敌对性、恐怖、偏执、躯体化、强迫症状等评分低于对照组,对比差异有统计学意义（P<0.05）。结论 尿毒清颗粒联合羟苯磺酸钙治疗慢性肾衰竭能提高治疗效果,调节CTGF和BMP-7分泌平衡,改善患者的肾肾功能,提高患者的生活质量。     

替米沙坦联合通心络胶囊对早期糖尿病肾病的疗效观察

目的探讨替米沙坦联合通心络胶囊对早期糖尿病肾病的治疗效果以及临床意义。方法将2006年3月至2011年5月我院内分泌科94例出现早期糖尿病肾病患者随即分为观察组和对照组,每组47例,2组患者均行常规降血糖治疗。观察组给予替米沙坦联合通心络胶囊药物治疗,对照组给予替米沙坦治疗。比较2组患者治疗前后相关肾功检查以及血糖情况。结果 （1）治疗前观察组患者平均空腹静脉血血糖、糖化血红蛋白、24h尿糖、24h尿蛋白、血肌酐与对照组比较,差异无统计学意义（P〉0.05）。（2）治疗8周后观察组平均空腹静脉血血糖与对照组比较,差异无统计学意义（P〉0.05）,但糖化血红蛋白、24h尿糖、24h尿蛋白、血肌酐低于对照组（P〈0.05）。结论替米沙坦联合通心络胶囊对早期糖尿病患者起到改善肾功,防止因糖耐量受损引起的肾小球血管硬化等糖尿病肾病,具有重要的临床治疗意义。     

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.     

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.