左西孟旦、米力农及硝普钠治疗急性心力衰竭的效果比较

目的比较左西孟旦、米力农、硝普钠用于临床治疗急性心力衰竭效果的差异,为急性心力衰竭治疗方案的选取提供依据。方法将90例急性心力衰竭患者随机分为左西孟旦组、米力农组和硝普钠组各30例。观察3组疗效,治疗前后NT-proBNP水平,以及跟踪随访3月的病死率、心血管事件发生率和再次住院率。结果左西孟旦组显效率和总有效率高于米力农组和硝普钠组,差异有统计学意义（P〈0.05）。各组治疗前后NT-proBNP水平差异明显（P〈0.05）;且治疗后左西孟旦组的NT-proBNP水平明显低于米力农组和硝普钠组（P〈0.05）。左西孟旦组患者的病死率,心血管事件发生率,再次住院率明显低于米力农组和硝普钠组,差异均有统计学意义（P〈0.05）。结论左西孟旦治疗急性心力衰竭的效果明显优于米力农和硝普钠,且3个月内的不良事件率较低,预后较好,值得临床推广应用。     

硝普钠与多巴胺联合应用治疗顽固性心力衰竭临床疗效

目的：探讨硝普钠与多巴胺联合应用治疗顽固性心力衰竭临床疗效及对患者心功能的影响。方法：选择92例顽固性心力衰竭患者,根据收治顺序将所有患者分为观察组和对照组,每组46例,两组患者均给予利尿、吸氧等心力衰竭常规综合治疗,在此基础上,观察组患者给予硝普钠联合多巴胺治疗,治疗7d后对比观察两组临床疗效和治疗前后心率（HR）和左室射血分数(LVEF)等指标的变化。结果：观察组患者治疗后总有效率高于对照组,比较差异具有统计学意义（P＜0.05）;与治疗前比较,治疗后两组LVEF均显著升高,HR显著降低,比较差异具有统计学意义（P＜0.05）,观察组治疗后HR显著低于、LVEF显著高于对照组治疗后,比较差异具有统计学意义（P＜0.05）。结论：顽固性心力衰竭采用硝普钠与多巴胺联合治疗可以显著提高临床疗效,改善患者心功能,值得临床积极推广。     

硝普钠联合多巴胺治疗顽固性心力衰竭疗效观察

目的：探讨硝普钠联合多巴胺治疗顽固性心力衰竭的临床效果。方法80例顽固性心力衰竭患者随机分为观察组和对照组,各40例。对照组采用常规治疗,观察组在常规治疗基础上同时给予硝普钠联合多巴胺。观察两组患者心功能改善情况。结果观察组治疗5d后的左室射血分数、左室舒张末期内径和对照组比较,差异有统计学意义（P〈0.05）。观察组总有效率高于对照组,差异有统计学意义（P〈0.05）。结论硝普钠联合多巴胺能够显著改善顽固性心力衰竭患者心功能,疗效显著,值得借鉴。     

基于 CysC 水平分析米力农、左西孟旦和硝普钠治疗急性心力衰竭的效果差异

目的：基于 CysC（血清胱抑素 C）水平分析米力农、左西孟旦和硝普钠治疗急性心力衰竭效果差异,分析 CysC 与急性心力衰竭病情相关性。方法将120例急性心力衰竭患者随机分为米力农组,左西孟旦组和硝普钠组各40例。观察各组疗效,治疗前后血清 CysC 水平及预后。结果左西孟旦组的显效率及总有效率均明显高于米力农组和硝普钠组,差异均有统计学意义（P ＜0．05）。3组治疗后1、7d CysC 水平均低于治疗前,且左西孟旦组 CysC水平低于米力农组和硝普钠组,差异均有统计学意义（P ＜0．05）。 CysC 水平＞17．5mg/L 为高 CysC 组,CysC 水平＜17．5mg/L 为低 CysC 组。3组高 CysC 组的病死率,心血管率,返院率显著高于低 CysC 组,差异有统计学意义（P ＜0．05）;左西孟旦组患者病死率,心血管事件率,返院率均低于米力农组和硝普钠组,差异有统计学意义（P ＜0．05）。结论血清 CysC 水平可用于评定心力衰竭的病情。左西孟旦治疗急性心力衰竭的效果以及预后均优于米力农和硝普钠治疗,具有更高的临床价值。     

托伐普坦治疗顽固性心力衰竭合并低钠血症的效果观察

目的：探讨托伐普坦治疗顽固性心力衰竭合并低钠血症的效果。方法选取2014年8~12月河南省人民医院收治的60例心力衰竭患者作为研究对象,随机分为观察组和对照组,各30例。对照组采用常规治疗,观察组在对照组的基础上给予口服托伐普坦治疗。比较两组治疗前后的尿量、血钠、NT-proBNP及左心室射血分数（LVEF）、左室舒张末期内径（LVEDD）及E/A比值。结果观察组治疗后的尿量为（2635依856）ml/24 h,显著多于对照组的（1360依390）ml/24 h,差异有统计学意义（P<0.05）。观察组治疗后的体重下降（0.95依0.65）kg/d,显著多于对照组的（0.30依0.45）kg/d,差异有统计学意义（P<0.05）。观察组治疗后的血钠水平显著高于对照组治疗后,差异有统计学意义（P<0.05）。观察组治疗后的NT-proBNP水平显著低于对照组治疗后,差异有统计学意义（P<0.05）。观察组治疗后的LVEF、E/A比值显著高于对照组治疗后,差异有统计学意义（P<0.05）。观察组治疗后的LVEDD显著低于对照组治疗后,差异有统计学意义（P<0.05）。结论托伐普坦治疗顽固性心力衰竭合并低钠血症的效果显著,能有效增加血钠浓度和增加尿量,改善心功能。     

硝普钠与米力农治疗急性心力衰竭的效果对比

目的对比硝普钠与米力农治疗急性心力衰竭的临床效果。方法选取70例急性心力衰竭患者为研究对象,根据治疗方法不同将其分为硝普钠组与米力农组,比较两组治疗效果。结果两组患者总有效率比较,无明显差异(P>0.05);两组患者治疗后心率、心功能指标均明显优于治疗前(P<0.05),但两组间比较,无明显差异(P>0.05);硝普钠组不良反应发生率高于米力农组(P<0.05)。结论硝普钠与米力农治疗急性心力衰竭具有理想的治疗效果,其中米力农的治疗安全性更高。     

硝普钠联合多巴胺持续静脉泵入治疗老年顽固性心力衰竭的临床疗效及安全性

目的分析、研究硝普钠联合多巴胺持续静脉泵入治疗老年顽固性心力衰竭的临床疗效与安全性,促进老年顽固性心力衰竭患者早日康复。方法选取2012年6月至2013年6月我院收治的老年顽固性心力衰竭患者88例,随机将88例患者分为观察组(44例)、对照组(44例)。观察组:采用硝普钠联合多巴胺持续静脉泵入治疗法;对照组:采用临床常规治疗法。观察并比较两组患者治疗后治疗有效率与患者满意程度。结果疗程结束后,观察组患者治疗有效率、不良反应率、满意度均明显优于对照组,(P<0.05)差异具有统计学意义。结论采取硝普钠联合多巴胺持续静脉泵入治疗老年顽固性心力衰竭的临床治疗效果显著、安全性高,有利与减少患者痛苦,值得临床广泛推广及应用。     

冻干重组人脑利钠肽与硝普钠治疗顽固性心力衰竭的临床研究

目的分析探讨冻干重组人脑利钠肽与硝普钠治疗顽固性心力衰竭的临床效果。方法选取78例顽固性心力衰竭患者作为研究对象,将其随机分成对照组和治疗组,每组39例,对照组患者采取常规方法加硝普钠进行治疗,治疗组则给予冻干重组人脑利钠肽与硝普钠联合常规方法进行治疗,治疗结束后对两组患者的临床疗效进行对比分析。结果治疗组的总有效率为87.18%,对照组的总有效率为69.23%,两组数据差异存在统计学意义(P<0.05)。结论采用硝普钠联合冻干重组人脑利钠肽治疗顽固性心力衰竭具有显著的疗效,可有效的改善心脏功能,缓解临床症状,明显提高患者生活质量。     

米力农联合多巴胺在老年顽固性心力衰竭治疗中的应用价值分析

目的研究米力农联合多巴胺在老年顽固性心力衰竭治疗中的应用价值。方法选取我院在2012年12月~2014年12月收治的58例老年顽固性心力衰竭患者,按照治疗方法将其分为两组(各29例),观察组以米力农+多巴胺治疗,对照组以常规措施治疗。结果观察组患者治疗总有效率(89.7%)显著高于对照组(69.0%),两组患者治疗前LVEDD、LVEF、E/A、SV、CI等心脏超声指标及NT-pro BNP水平比较差异无统计学意义(P>0.05),治疗后两组患者均有所改善,但观察组患者的改善程度均明显优于对照组,差异有统计学意义(P<0.05),且观察组不良反应发生率(3.4%)显著低于对照组(24.1%),差异有统计学意义(P<0.05)。结论米力农+多巴胺可有效改善老年顽固性心力衰竭患者临床症状,降低不良反应发生率,临床价值显著,可推广应用。     

硝普钠联合多巴胺治疗顽固性心力衰竭的疗效分析

目的 探讨硝普钠联合多巴胺治疗顽固性心力衰竭的临床疗效.方法 采用随机分组方法将90例患者分为治疗组和对照组,治疗组在常规综合治疗的基础上给予硝普钠联合多巴胺持续泵入治疗,对照组仅采用常规综合治疗.结果 治疗组和对照组疗效总有效率分别为95.6％和66.7％,治疗组总有效率高于对照组,两组差异有统计学意义（P＜0.05）.结论 在常规综合治疗的基础上应用硝普钠联合多巴胺治疗顽固性心力衰竭疗效显著,值得临床推广.     

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.