药物洗脱支架治疗多支血管病变的疗效及安全性

目的 探讨药物洗脱支架(DES)和DES 金属裸支架(BMS)治疗冠脉多支血管病变的疗效和安全性.方法 经冠脉造影证实≥2支血管病变的冠心病患者297例,置入DES(DES组)174例,置入DES BMS(DES BMS组)123例.对比分析两组基线临床及造影资料,术后随访1～3.5年主要心脏事件(MACE)发生率.结果 DES组患者心肌梗死、糖尿病史比例高于DES BMS组(P＜0.05);与DES BMS组相比,DES组术中靶病变血管直径较小、长度较长(P＜0.05);术后总MACE发生和靶病变血运重建(TLR)率DES组显著低于DES BMS组(P＜0.01);两组间心脏性死亡及非致死心梗发生率无显著差异.结论 治疗多支血管病变采用DES优于DES BMS,可获得较高的收益与风险比,长期疗效及安全性有待进一步研究.     

国产药物洗脱支架治疗冠心病的疗效观察

目的评价国产雷帕霉素药物洗脱支架(Firebird)应用于冠心病的临床疗效及安全性,并与同期应用进口雷帕霉素(Cypher)支架比较。方法选择2007年2月至2009年6月期间接受支架治疗的冠心病患者110例,其中58例植入Firebird支架,52例植入Cypher支架,两组患者在年龄,性别组成,吸烟比例,糖尿病比例,血压、总胆固醇水平,急性心肌梗死、不稳定型心绞痛、稳定型心绞痛数据对比,冠状动脉病变支数,左心室射血分数均无统计学上的差异。对比两组间支架植入的手术成功率、术中并发症及近期疗效。结果两组心脏事件、再狭窄及靶血管再次血运重建发生率无统计学意义,支架植入成功率两组均为100%,Firebird组术中无复流1例。结论Firebird雷帕霉素药物洗脱支架与cypher雷帕霉素药物洗脱支架的临床近期疗效相似。应用Firebird支架治疗冠心病是安全和有效的。     

Excel支架治疗冠心病合并糖尿病患者的安全性和有效性

目的通过与进口雷帕霉素药物洗脱支架(Cypher)比较,观察国产雷帕霉素药物洗脱支架(Excel)在冠心病合并糖尿病患者中应用的安全性和有效性。方法回顾性分析择期PCI并置入雷帕霉素药物洗脱支架的冠心病合并糖尿病患者135例,根据置入支架的种类,分为Excel组(试验组)和Cypher组(对照组)。术前术后常规用药,术后进行随访,观察患者术中并发症的发生情况及术后1个月、3个月、半年,1年临床主要不良心脏事件(MACE)的发生情况,并于术后1年进行冠脉造影随访,观察冠状动脉病变情况。结果一般临床资料情况:2组在性别、年龄、身高、体重、危险因素(高血压、血脂异常、吸烟史、饮酒史)、临床表现(稳定型心绞痛、不稳定型心绞痛、急性心肌梗死、陈旧性心肌梗死的患病例数)、冠状动脉病变类型(A型、B型、C型)、冠脉病变支数、置入支架情况(支架的直径、长度)上比较,差异无统计学意义(P>0.05)。术中并发症情况:试验组与对照组在冠脉急性闭塞、冠脉穿孔、冠脉夹层、恶性心律失常、死亡方面均发生0例,2组患者置入支架的安全性相似。术后1年内的随访:2组1年内复发心绞痛急性心肌梗死心源性死亡比较差异无统计学意义(P>0.05)。结论 Excel支架治疗冠心病合并糖尿病患者的安全性和有效性与Cypher支架相似,但仍需大样本随机对照临床研究加以进一步证实。     

应用西罗莫司药物洗脱支架治疗老年冠心病的疗效观察

目的 探讨国产西罗莫司药物洗脱支架在老年冠心病患者中应用的疗效和安全性.方法 对在该院接受国产西罗莫司药物洗脱支架Firebird治疗的107例老年冠心病患者,观察术后即刻效果、住院期间并发症及6个月随访结果.结果 成功植入175个Firebird支架,支架植入即刻成功率98.9%,住院期间支架内血栓1例(0.9%)致死亡,随访6个月,无心肌梗死、死亡发生,复发心绞痛6例,支架再狭窄发生率为2.6%,6个月主要心脏不良事件(MACE)发生率为2.8%.结论 老年冠心病患者应用国产西罗莫司药物洗脱支架安全有效.     

进口或国产雷帕霉素支架治疗非左主干分叉病变对比分析

目的研究应用进口或国产雷帕霉素支架治疗非左主干分叉病变的临床疗效。方法入选接受冠状动脉（冠脉）双支架术治疗的冠脉非左主干真性分叉病变患者75例,随机选用进口或国产雷帕霉素药物洗脱支架治疗,完成6个月的临床随访,记录死亡、心绞痛、心功能不全、再发心梗、靶病变重建（TLR）或支架内血栓形成的发生率。结果 75例患者均完成了6个月的临床随访,死亡、再发心梗、再发胸痛、TLR、支架内血栓、心功能不全和MACE发生率在Firebird支架组分别为0%、0%、8.1%、0%、0%、2.7%、10.8%;在Cypher支架组分别为0%、0%、7.9%、0%、0%、2.6%、10.5%。两组间不良事件的差异无统计学意义（P〉0.05）。结论冠心病患者的真性分叉病变均成功置入国产雷帕霉素支架,与进口雷帕霉素支架相比,不良事件的差异无统计学意义。国产雷帕霉素支架在非左主干分叉病变治疗中是安全可靠的。     

应用西罗莫司药物洗脱支架治疗老年冠心病的疗效观察

目的 探讨国产西罗莫司药物洗脱支架在老年冠心病患者中应用的疗效和安全性.方法 对在该院接受国产西罗莫司药物洗脱支架Firebird治疗的107例老年冠心病患者,观察术后即刻效果、住院期间并发症及6个月随访结果.结果 成功植入175个Firebird支架,支架植入即刻成功率98.9%,住院期间支架内血栓1例（0.9%）致死亡,随访6个月,无心肌梗死、死亡发生,复发心绞痛6例,支架再狭窄发生率为2.6%,6个月主要心脏不良事件（MACE）发生率为2.8%.结论 老年冠心病患者应用国产西罗莫司药物洗脱支架安全有效.     

国产药物洗脱支架治疗急性冠脉综合征的近期疗效观察

目的评价急性冠脉综合征（ACS）患者置入国产药物洗脱支架（DES）和金属裸支架（BMS）的围手术期及手术后近期临床预后的差异。方法 65例ACS患者,其中ST段抬高型急性心肌梗死23例,非ST段抬高型急性心肌梗死10例,不稳定型心绞痛32例,分为DES组和BMS组,对77支病变血管共置入97枚支架,观察记录患者住院期间和随访期间的临床资料,比较2组主要不良事件（MACE）和再次血管重建的发生率。结果 2组患者术前基本情况、手术成功率均无差异,在住院和随访期间,2组均无MACE发生。再狭窄率DES组为1/35（2.8%）,BMS组为2/30（6.7%）。2组差异有显著性（P〈0.05）。结论 ACS的患者经皮冠脉介入术置入药物支架安全有效,在预防血管再狭窄方面DES明显优于BMS。     

应用西罗莫司药物洗脱支架治疗老年冠心病的疗效观察

目的 探讨国产西罗莫司药物洗脱支架在老年冠心病患者中应用的疗效和安全性.方法 对在该院接受国产西罗莫司药物洗脱支架Firebird治疗的107例老年冠心病患者,观察术后即刻效果、住院期间并发症及6个月随访结果.结果 成功植入175个Firebird支架,支架植入即刻成功率98.9%,住院期间支架内血栓1例(0.9%)致死亡,随访6个月,无心肌梗死、死亡发生,复发心绞痛6例,支架再狭窄发生率为2.6%,6个月主要心脏不良事件(MACE)发生率为2.8%.结论 老年冠心病患者应用国产西罗莫司药物洗脱支架安全有效.     

置入国产雷帕霉素药物洗脱支架冠心病患者双联抗血小板治疗效果的研究

目的探讨对置入国产雷帕霉素药物洗脱支架的冠心病患者采用双联抗血小板(DAPT)治疗的临床治疗效果。方法对80例置入Firebird支架冠心病患者进行观察,将其中40例DAPT治疗1年的患者分为对照组,将40例DAPT治疗超过1年的患者分为观察组,两年半后电话随访,记录两组患者的恢复情况。结果观察组患者的心血管不良事件明显低于对照组,有统计学意义(P<0.05);两组患者的出血率无明显差异(P>0.05)。结论对置入Firebird支架冠心病患者长期使用DAPT治疗可以降低心血管不良事件,减轻并发症,减轻患者疼痛。     

国产和进口药物洗脱支架对比研究

目的对比研究国产雷帕霉素洗脱支架和进口雷帕霉素洗脱支架临床应用疗效.方法本研究总结了我科自2003年12月至2005年1月79例患者,分Cypher支架和Firebird支架两组,其中Cypher支架组30例,Firebird支架组49例.79例者共植入CyPher支架38枚,植入Firebird支架58枚.结果两组患者平均年龄,男性比例,吸烟史、高血压、高血脂、糖尿病,稳定性心绞痛、不稳定性心绞痛、陈旧心肌梗死数据对比,P值均＞0.05,统计学无差异性.两组患者靶血管特征,P值均＞0.05,统计学分析无差异性.两组患者平均靶血管直径和平均靶病变长度对比Cypher支架组比Firebird支架组为:(2.59±0.14)m比(2.61±0.17)mm,(22.31±4.18)mm比(21.80±5.07)mm,P值均＞0.05,统计学分析无差异性.临床随访3个月,两组患者均无急性和亚急性支架内血栓形成,无再发心肌梗死及死亡.再发心绞痛、再次血运重建和主要心血管事件MACE对比,P值均＞0.05,统计学无差异性.结论国产和进口雷帕霉素药洗脱支架近期疗效相似.     

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.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

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.     

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.