氨氯地平与硝苯地平治疗原发性高血压的疗效比较

目的 观察氨氯地平、硝苯地平治疗原发性高血压的临床效果及安全性.方法 116例原发性高血压患者随机分为A组58例和B组58例,A组给予口服硝苯地平治疗,B组给予氨氯地平治疗,治疗4周后比较两组的疗效及不良反应发生率.结果 A组显效33例、有效10例、无效15例,总有效率74.14％；B组显效40例、有效12例、无效6例,总有效率89.66％；两组差异有统计学意义(x2=4.71,P=0.03)；B组不良反应发生率显著低于A组(x2 =6.04,P=0.01).结论 氨氯地平治疗原发性高血压疗效显著、不良反应少,具有推广价值.     

氨氯地平治疗老年人原发性高血压50例疗效观察

目的观察氨氯地平治疗老年人原发性高血压的临床疗效及不良反应。方法选择本院近年来诊治的老年人原发性高血压患者50例,均给予氨氯地平5mg,每日1次,治疗2周,如血压未达到显效标准增至10mg,每日1次,疗程4周。观察患者用药前、用药期间及用药后血压变化情况及不良反应。结果本组显效39例(78.0%),有效7例(14.0%),无效4例(8.0%),总有效率92.0%,治疗4周后SBP由(151.4±19.9)mmHg降至(130.2±14.5)mmHg,疗程结束后复查实验室指标均未出现明显变化。治疗期间3例患者出现一过性轻微不良反应,未影响继续治疗。结论氨氯地平药理作用温和,降压效果确切,服用方便,患者依从性好,用药安全性高,并对心、脑、肾等重要的靶器官有良好的保护作用,是理想的老年人原发性高血压降压药物,适用于原发性高血压患者长期治疗。     

硝苯地平联合美托洛尔治疗原发性高血压45例

目的:探讨硝苯地平联合美托洛尔治疗原发性高血压的临床疗效.方法:选择原发性高血压患者135例,随机分为3组,各45例,A组给予硝苯地平30～60 mg/d和倍他乐克100～200mg/d合用,治疗初期硝苯地平10 mg/次,口服,3次/d,倍他乐克50mg/次,口服,2次/d;B组单用硝苯地平,C组单用倍他乐克,剂量、用法同A组.疗程均为4周.结果:疗程结束时,3组临床总有效率分别为93.3%,80.0%,77.8%,A组明显优于B,C两组,差异有显著性(P＜0.05),且无明显的药物不良反应.结论:硝苯地平联合倍他乐克治疗原发性高血压,两药可取协同作用,降压效果好,值得推广应用.     

氨氯地平联用依那普利治疗老年高血压病疗效评价

目的观察氨氯地平与依那普利单用及联合应用治疗老年原发性高血压患者的临床疗效.方法100例老年高血压病患者随机分为2组.(1)氨氯地平组(n=50)口服氨氯地平 5 mg,每日1次;(2)依那普利组(n=50)口服依那普利 10 mg,每日1次.两组用药 2 wk后,降压未达显效者,氨氯地平组联用依那普利 10 mg,每日1次;依那普利组联用氨氯地平 5 mg,每日1次,再观察 2 wk.比较两组治疗前、后2、4 wk 血压情况.结果氨氯地平组2、4 wk 的降压总有效率分别为62%、94%;依那普利组2、4 wk 的降压总有效率分别为60%、96%,两组组内比较P＜0.01,组间比较无统计学意义(P>0.05).两组均有轻度不良反应.结论氨氯地平或依那普利单用治疗老年原发性高血压有效,两药联用可提高降压效果.在单一用药基础上加药,药物时序不同对疗效影响不大.     

左旋氨氯地平联合替米沙坦治疗2型糖尿病高血压疗效观察

目的:探讨单用左旋氨氯地平、替米沙坦与两药合用治疗2型糖尿病高血压患者的有效性及安全性。方法:2006年1月—2009年12月入选268例2型糖尿病高血压患者,随机分为A,B,C组,3组患者均口服降糖药,少数患者皮下注射胰岛素控制血糖,入选者在用药前停用其他降压药1周。A组:左旋氨氯地平2.5～5.0 mg,每日1次;B组:替米沙坦40 mg,每日1次;C组:左旋氨氯地平2.5 mg,每日早上1次,替米沙坦20～40 mg,每日晚上1次。治疗4～6周血压平稳,连续观察3个月,每日监测血压、心率,观察不良反应情况。结果:A组89例,平均年龄(61±8)岁,总有效率67.4%;B组89例,平均年龄(60±7)岁,总有效率60.6%;C组90例,平均年龄(59±9)岁,总有效率80%。3组相比,C组总有效率高,副作用少。结论:左旋氨氯地平联合替米沙坦治疗2型糖尿病高血压患者安全、有效、耐受性好。     

左旋氨氯地平联合替米沙坦治疗2型糖尿病高血压疗效观察

目的:探讨单用左旋氨氯地平、替米沙坦与两药合用治疗2型糖尿病高血压患者的有效性及安全性.方法:2006年1月-2009年12月入选268 例2型糖尿病高血压患者,随机分为A,B,C组,3组患者均口服降糖药,少数患者皮下注射胰岛素控制血糖,入选者在用药前停用其他降压药1周.A组:左旋氨氯地平2.5～5.0 mg,每日1次;B组:替米沙坦40 mg,每日1次;C组:左旋氨氯地平2.5 mg,每日早上1次,替米沙坦20～40 mg,每日晚上1次.治疗4～6周血压平稳,连续观察3个月,每日监测血压、心率,观察不良反应情况.结果:A组89 例,平均年龄(61±8) 岁,总有效率67.4%;B组89 例,平均年龄(60±7) 岁,总有效率60.6%;C组90 例,平均年龄(59±9) 岁,总有效率80%.3组相比,C组总有效率高,副作用少.结论:左旋氨氯地平联合替米沙坦治疗2型糖尿病高血压患者安全、有效、耐受性好.     

氨氯地平联合螺内酯治疗原发性高血压65例

目的 观察氨氯地平联合螺内酯治疗原发性高血压疗效.方法 130例患者随机分为观察组和对照组各65例,对照组口服氨氯地平2.5 mg,4次/d,晨起服用,一周后改为5 mg,4次/d;观察组在此基础上加服螺内酯20 mg,2次/d,疗程8周,观察两组降压效果.结果 观察组总有效率93.8%,对照组总有效率81.5%,两组比较差异显著.结论 氨氯地平联合螺内酯降压效果良好,不良反应少.     

苯磺酸左旋氨氯地平治疗原发性高血压40例临床疗效

目的：观察苯磺酸左旋氨氯地平治疗原发性高血压的临床降压效果及不良反应。方法：40例门诊原发性高血压病人选用苯磺酸左旋氨氯地平治疗,2．5mg／d口服,1次／d,疗程8周。结果：治疗第2周和第8周总有效率分别为85．0和95．0％,不良反应发生率7．5％。结论：苯磺酸左旋氨氯地平降压效果良好,平稳,不良反应少。     

盐酸贝尼地平联合酒石酸美托洛尔治疗原发性高血压疗效观察

目的：探讨盐酸贝尼地平联用酒石酸美托洛尔治疗原发性高血压的临床疗效。方法：56例原发性高血压患者随机分为两组。A组30例,服用：盐酸贝尼地平4mg,晨起后服用,每日1次;酒石酸美托洛尔12.5mg,每日2次。B组26例,盐酸贝尼地平每日4mg,晨起后一次服。每周监测3次血压、心率情况,4周后观察降压疗效和不良反应。结果：A组显效16例,有效12例,无效2例,总有效率93.3%;B组显效10例,有效9例,无效7例,总有效率73.1%;两组降压效果比较差异有统计学意义（P〈0.05）。A组头晕2例,胸闷1例,不良反应发生率10.0%;B组面红2例,心悸2例,头痛3例,不良反应发生率34.6%,B组中有2例患者因不能耐受不良反应而自行停药。两组不良反应发生率比较差异有统计学意义（P〈0.05）。结论：盐酸贝尼地平联用酒石酸美托洛尔治疗原发性高血压可能增加疗效,并减少不良反应。     

不同剂量氢氯噻嗪联合氨氯地平治疗老年高血压疗效比较

目的观察不同剂量氢氯噻嗪联合氨氯地平治疗老年原发性高血压的疗效及安全性。方法 72例老年轻中度原发性高血压患者停用降压药2周,随机分为治疗组(A组)36例,给予氨氯地平5mg、氢氯噻嗪25mg口服,每日1次;对照组(B组)给予氨氯地平5mg、氢氯噻嗪12.5mg口服,每日1次,共治疗12周。观察两组的血压、血生化指标及心肌肥厚状况的变化情况。结果两组治疗后血压均较治疗前明显下降(P<0.01),且两组中伴心肌肥厚的患者超声心动图均有明显改善,但两组间比较无统计学差异(P>0.05)。A、B两组降压总有效率分别为94.5%、89.9%,两组间比较无统计学意义(P>0.05)。A组低血钾发生率显著高于B组(P<0.05),两组其他不良反应发生率相似,生化指标比较无统计学意义。结论应用小剂量氢氯噻嗪联合氨氯地平治疗老年轻中度原发性高血压安全、有效,且可以协助逆转心肌肥厚。     

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.     

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.     

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.