缬沙坦对高血压患者血压及左心室肥厚的影响

目的 :观察血管紧张素Ⅱ1型受体拮抗剂—缬沙坦对高血压及左心室肥厚的影响。方法 :32例原发性高血压合并左心室肥厚的病人口服缬沙坦 80～ 16 0mg·g-1,qd ,共 2 4周 ,服药前后分别测量血压及用彩色Doppler超声心动图仪行心脏超声检查。结果 :32例患者血压由 (2 1.7± 1.4) /(13.1± 0 .7)kPa降为 (17.3± 1.1) /(11.2± 0 .6 )kPa ,P <0 .0 1;左室重量指数(LVMI)由 (136 .8± 14.6 )g·m-2 降至 (110 .2± 11.5 )g·m-2 ,P <0 .0 5。结论 :缬沙坦在降低血压的同时 ,对左心室肥厚亦有逆转作用     

超声心动图对冠心病左心室舒张顺应性的探讨

本文对冠心病56例及正常人68例用 M 型超声心动图进行左心室舒张顺应性的探讨。冠心病组 dV/dP=1.07±0.41,dV/dP·1/V=0.014±0.003与正常组 dV/dP=1.51±0.46,dV/dP·1/V=0.026±0.004相比有统计学意义(P<0.001)。冠心病组 dP/dV=1.08±0.41,dP/dV·1/P=0.098±0.020与对照组 dP/dV=0.72±0.22,dP/dV·1/P=0.090±0.028比较也有统计学意义(P<0.05～0.001)。本研究提示利用 M 型超声心动图考察左心室舒末顺应性是切实可行的,而且简便易重复。冠心病时左心室舒末压容关系已有显著改变,左心腔顺应性减退,硬度增加,并且发生于收缩功能改变之前。ΔV/ΔP,ΔP/ΔV 可以做为简便的考察心室舒张顺应性的指标。     

氯沙坦钾治疗老年收缩期高血压并左室肥厚疗效观察

选择老年单纯收缩期高血压 (OISH)并左室肥厚 (L VH)患者 39例 ,服用氯沙坦钾 12周前后测定动态血压、超声心动图左室质量指数 (L VMI)、血脂及肝肾功能。疗程后 2 4h SBP由 15 0± 14mm Hg降至 12 5± 11mm Hg(P<0 .0 0 1) ,2 4h DBP由74± 8m m Hg降至 70± 12 mm Hg(p<0 .0 5 ) ;L VMI由 146± 35 g· m- 1 降至 12 3± 2 9g· m- 1 (p<0 .0 1) ;无明显副作用。提示氯沙坦钾是治疗 OISH患者并 L VH的理想药物。     

贝那普利逆转高血压病心脏重构的作用

目的 :观察贝那普利降压疗效及逆转心脏重构的作用。方法 :高血压病人 90例 (男性 58例 ,女性 32例 ;年龄 57a±s 10a)采用贝那普利 5～ 2 0mg·d- 1(分 1～ 2次口服 )× 6wk后观察降压疗效 ,对其中 38例伴左室肥大及左房增大者都连续服药2 4wk ,以彩色多普勒超声心动图观察心脏重构有否改善。结果 :90例高血压病人治疗 6wk以后收缩压下降 3.8kPa± 1.2kPa ,舒张压下降 3.2kPa±1.1kPa ,经t检验差别均有非常显著意义 (P <0 .0 1) ;36例服药 2 4wk复查超声心动图左室后壁厚度、室间隔厚度、左室重量及左房内径均缩小 ,差别有非常显著意义 (P <0 .0 1)。结论 :贝那普利在降压同时有显著逆转高血压病人心脏重构作用     

秋水仙碱对肾间质纤维化防治作用的形态学观察

目的　观察秋水仙碱对肾间质纤维化的保护作用。方法　 2 6只SD大鼠随机被分成 3组 :假手术组 (n =6 ) ;对照组 (n =10 ) ;治疗组 (n =10 ) ,单侧输尿管结扎 (UUO)基础上予秋水仙碱10 0 μg/(kg·d)腹腔注射 ,每周 5天。 3周后处死所有大鼠并进行形态学研究。 结果　治疗组肾小管间质浸润的炎症细胞数为 (1738 4 4± 910 87)个 /mm2 ,明显少于对照组 (6 32 2 0 5± 1198 18)个 /mm2 ,(P <0 0 0 1) ;肾间质纤维化指数前者也明显低于后者 (分别为 2 2 6 7± 17 6 1及 72 92± 9 86 ,P <0 0 0 1) ;肾小管损伤程度对照组和治疗组分别为 (2 4 7± 0 4 7)分和 (1 4 3± 0 6 5 )分 ,后者明显轻于前者 (P <0 0 5 )。结论　秋水仙碱对肾间质纤维化有较好的防治作用。     

小儿先天性左向右分流型心脏病的介入治疗

目的　评价应用Amplatzer封堵器进行介入治疗小儿先天性心脏病的效果、安全性。方法　超声心动图确诊的动脉导管未闭 (PDA)、房间隔缺损 (ASD)及膜部室间隔缺损 (膜部VSD)患者 4 9例 ,在透视或 /和经胸超声心动图 (TTE)指引下置入Amplatzer封堵器 ,术后 2 4小时 ,1、3、6、12个月及以后每年分别TTE、ECG和X线胸片检查评价治疗效果。结果　 16例ASD球囊测量缺损伸展径为 13～ 2 8(平均 19 3± 4 9)mm ,选择封堵器直径 13～ 30 (平均 2 0 6± 5 1)mm ;2 5例PDA造影测量PDA最窄处直径为 2～ 7 7(平均 3 9± 1 5 )mm ,选择封堵器直径 4～ 12 (平均 6 6± 1 9)mm ;8例膜部VSD造影测量VSD直径 3 4～ 8(平均 4 7± 2 3)mm ,选择封堵器直径 6～ 10 (平均 7 8±1 7)mm。技术成功率为 10 0 % ,术中未发生任何并发症 ,无急诊手术病例。术后即刻造影或TTE显示 10例存在残余分流 ,3个月TTE示所有病例无残余分流和再通 ,心室内径均有不同程度的缩小 ,肺动脉压下降。结论　应用Amplatzer封堵器介入治疗小儿先天性心脏病 ,具有操作简单、安全、损伤小、成功率高等优点 ,适合于儿童继发孔型ASD、各种类型的PDA及膜部VSD的介入治疗     

辛伐他汀对冠心病的抗炎作用

目的 :观察辛伐他汀对冠心病病人C反应蛋白 (CRP)、肿瘤坏死因子α(TNF α)、白细胞介素6 (IL 6 )和白细胞介素 8(IL 8)的抑制效应。方法 :冠心病病人 6 0例 ,分为辛伐他汀组和对照组 ,每组30例。对照组给予阿司匹林泡腾片、培哚普利、美托洛尔等治疗 ,辛伐他汀组在此基础上服用辛伐他汀 2 0mg ,po ,qn。疗程均 8wk。结果 :治疗后辛伐他汀组血清中CRP ,TNF α ,IL 6和IL 8浓度明显降低 [(5 .0±s 0 .6 )mg·L- 1vs (3.7± 0 .6 )mg·L- 1,(6 .4± 1.4 )ng·L- 1vs (5 .6± 1.4 )ng·L- 1,(4.4± 1.2 )ng·L- 1vs (4.2± 1.2 )ng·L- 1,(2 8±7)ng·L- 1vs (2 7± 7)ng·L- 1,P <0 .0 5或P <0 .0 1],而对照组则无明显改变 (P >0 .0 5 )。结论 :辛伐他汀能够降低冠心病病人血清中CRP和炎症因子 ,显示其抗炎作用     

硝酸异山梨酯静脉滴注对冠心病病人血管内皮功能的影响

目的 :观察硝酸异山梨酯静脉滴注对冠心病病人血管内皮功能的影响。方法 :6 4例冠心病病人随机分为 2组 ,硝酸异山梨酯组 (32例 )予硝酸异山梨酯 2 0mg ,iv ,gtt,qd ;复方丹参组 (32例 )予复方丹参 2 0mL ,iv ,gtt ,qd。均连续用药 4wk。结果 :硝酸异山梨酯组治疗后 6 酮前列腺素F1α(99± 6 9)ng·L- 1]、一氧化氮 [(134± 88) μmol·L- 1]均较治疗前 [(75± 5 8)ng·L- 1,(91± 85 ) μmol·L- 1]上升 ,血组织型纤溶酶原激活物抑制物 [(0 .6 4± 0 .2 7)×10 3AU·L- 1vs (0 .5 4± 0 .2 4 )× 10 3AU·L- 1]、凝血烷B2 [(111± 2 31)ng·L- 1vs (71± 14 6 )ng·L- 1]、内皮素 1[(98± 6 2 )ng·L- 1vs (80± 4 7)ng·L- 1],浓度均下降 (P <0 .0 5 ,P <0 .0 1)。复方丹参组无此变化 (P >0 .0 5 )。结论 :硝酸异山梨酯静脉滴注可改善冠心病病人血管内皮功能     

原发性高血压患者颈动脉内-中膜厚度及粥样斑块的特点及临床分析

目的　探讨原发性高血压患者颈总动脉内 -中膜厚度及颈动脉的斑块的特点及其与危险因素之间的关系。方法　原发性高血压患者 5 4例 ,分作无器官损害组 (A组 ) 38例及合并器官损害组 (B组 ) 16例 ,另设正常对照组 (C组 ) 18例 ,超声波检测颈总动脉内 中膜厚度 (intima mediathickness,IMT)及颈内、颈外动脉与颈总动脉分叉处斑块情况 ,并测定血总胆固醇、甘油三酯、低密度脂蛋白胆固醇及高密度脂蛋白胆固醇、血糖等指标。结果　A组及B组的颈总动脉内 中膜厚度显著大于C组 [C组 (0 . 4 5± 0 . 16 )mm ,A组 (0 . 6 7± 0 .2 0 )mm ,B组 (0 . 94± 0 . 2 8)mm ,三组之间两两比较差异均有统计学意义 ,P <0 . 0 1];B组的IMT显著大于A组 ;三组间颈动脉斑块严重程度差异有统计学意义 (χ2 =2 1 78,P <0 . 0 1) ;患者IMT值与颈动脉斑块严重程度呈正相关 (r =0 6 2 ,P <0 . 0 1) ,与颈动脉的斑块数呈正相关 (r =0 . 5 1,P <0 . 0 1) ;多元线性回归分析示 ,高血压患者的IMT与年龄及原发性高血压年数相关性较强 (r =0 .6 17,F =12 . 32 ,P <0 . 0 1)。结论　高血压可使颈总动脉内 -中膜厚度 (IMT)增加 ,从而引起动脉粥样硬化 ,而且损害随原发性高血压病程增加而加重 ;超声检测可作为一种简便的手段早期检测到动?     

抗血小板药物对急性心肌梗死患者的临床观察

目的评估氯比格雷(Clopidogrel)与阿司匹林(Aspirin)对急性心肌梗死(acute myocardial infarc-tion,AMI)临床和血小板聚集性的影响。方法97例AMI患者被随机分为治疗组48例联用氯比格雷与阿司匹林和对照组49例单用阿司匹林治疗4周。观察复发心绞痛、心功能改善程度、死亡率等临床指标。治疗前后心电图梗死部位ST段、血小板最大聚集率及血液肝肾功能、白细胞、血小板和出、凝血时间等有关指标变化,行统计学分析。结果再发心绞痛治疗组∶对照组为10%∶20%;心功能改善的总频数为36·7%∶22·4,χ2=3·638,P=0·045;死亡率为4%∶8%。心电图梗死部位ST段治疗组由(0·36±0·13)mV降为(0·13±0·08)mV,对照组由(0·35±0·14)mV降为(0·16±0·90)mV,两组比较,t=3·012,P=0·04。腺苷(ADP)诱导血小板聚集率治疗组由(74·54±8·99)%降至(34·09±9·23)%,对照组由(72·30±7·78)%降至(56·54±6·92)%,两组比较,t=13·42,P<0·001。胶原(Coll)诱导血小板聚集率治疗组(82·09±6·31)%降至(77·20±6·17)%,t=3·949,P<0·001,对照组差异不显著(t=1·93,P=0·06)。两组均少见大出血、血小板减少性紫癜等严重副作用。结论AMI患者存在血小板聚集性增强,联用氯比格雷治疗能减少再发心绞痛、改善心功能、减少死亡率,改善心肌的再灌注,进一步抑制血小板的聚集性。     

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.