疏血通注射液对高脂血症性急性胰腺炎患者血脂水平及转归的影响

目的：探究疏血通注射液辅助治疗高脂血症性急性胰腺炎病症的效果。方法90例高脂血症性急性胰腺炎(HAP)患者,随机分为观察组和对照组,每组45例。两组患者都给予常规治疗,观察组在此基础上添加疏血通注射液。对比两组患者治疗前后血清甘油三酯(TG),血液流变学, C反应蛋白(CRP),前白蛋白及血、尿淀粉酶(AMS)等各项指标变化情况;同时比较两组患者的急性生理与慢性健康评分(APACHEⅡ评分)及转归情况。结果经过治疗,观察组患者的血清TG、CRP、血浆比粘度、血小板聚集率、APACHEⅡ评分、全身炎症反应综合征(SIRS)发生率、病死率、转归率都比对照组明显下降(P<0.05)。结论疏血通注射液辅助治疗高脂血症性急性胰腺炎病症可以提升治愈率,疗效明显,可在临床上广泛应用。     

急性高脂血症性胰腺炎16例临床特征分析

目的探讨急性高脂血症性胰腺炎（hyperlipidemia acute pancreatitis,HLAP）的临床特点、实验室特征及治疗。方法回顾性分析16例急性高脂血症性胰腺炎患者的临床资料,并与同期的急性胆源性胰腺炎（acute biliary pancreatitis,ABP）患者进行对照研究,比较实验室指标,病情严重程度等方面的差异。结果与急性胆源性胰腺炎相比,急性高脂血症性胰腺炎的三酰甘油明显升高（P〈0.05）,血糖明显升高（P〈0.05）,CRP明显升高（P〈0.05）,但氧分压的下降与急性胆源性胰腺炎无统计学意义（P〉0.05）,急性胆源性胰腺炎血淀粉酶的升高较急性高脂血症性胰腺炎更明显（P〈0.05）。结论急性高脂血症性胰腺炎具有病情重、三酰甘油高、血糖高和血淀粉酶低等不同于急性胆源性胰腺炎的临床特征,降血脂、降血糖、早期器官功能维护及器官功能不全治疗有利于病情控制。     

高脂血症性急性胰腺炎的临床分析

目的探讨高脂血症(HL)与急性胰腺炎(AP)的关系。方法回顾大竹县红十字医院2000年1月至2009年12月收治的581例急性胰腺炎患者,分析脂肪肝、高脂血症与急性胰腺炎发病的关系。结果在581例AP中有48例高脂血症性急性胰腺炎(8.3%),与其他原因所致的胰腺炎相比,高脂血症性胰腺炎(HLAP)血三酰甘油(TG)升高明显(P<0.05),血总胆固醇(TC)升高不明显;糖尿病和脂肪肝发病率与其他原因所致的胰腺炎相比差异有统计学意义(P<0.05)。结论高三酰甘油血症和胰腺炎关系密切,是胰腺炎的一个独立危险因素,HLAP与其他原因所致的胰腺炎相比,其糖尿病和脂肪肝发病率明显增高。临床上降脂治疗对HLAP很重要。     

缺血性脑血管病患者血清TG含量的变化与临床研究

目的研究分析缺血性脑血管病患者血清三酰甘油(TG)含量的变化与临床意义。方法随机选择缺血性脑梗死患者200例,分为观察组和对照组各100例,检测血清TG含量并进行比较。结果动脉粥样硬化性血栓性脑梗死组血清TG含量明显升高,与对照组比较差异显著(P<0.05)。结论血清TG含量升高是缺血性脑血管病的危险因素,监测血清TG水平,并对其进行调控对降低脑血管病发生率有重要的临床实际意义。     

高脂血症与急性胰腺炎的相关性

目的 探讨高脂血症尤其是高甘油三脂血症(HTG)与急性胰腺炎的关系.方法 回顾性分析30例高脂血症伴急性胰腺炎(HL-AP)患者临床特点和脂肪肝、高脂血症与急性胰腺炎之间的关系.结果 高脂血症相关性急件胰腺炎常不伴有血、尿淀粉酶的明显升高;与其他原因所致急性胰腺炎相比,其脂肪肝、糖尿病发病率明显升高(P＜0.05);且重型急性胰腺炎较轻型急性胰腺炎的高密度脂蛋白(HDL)下降更为明显(P＜0.05).结论 高脂血症,尤其是HTG和急性胰腺炎之具有密切的相关性,HTG是引起急性胰腺炎的独立危险因素;HDL下降可作为预示HL-AP重症指标之一.     

高脂血症性急性胰腺炎27例临床诊治分析

目的分析高脂血症性急性胰腺炎(HLAP)的临床特点与诊治方法。方法回顾性分析我科2008年3月至2011年6月收治的27例HLAP与90例胆源性胰腺炎(ABP)患者的临床资料。结果与ABP组相比,HLAP组发病平均年龄较小,男性所占比例较大,差异均有统计学意义(P<0.05)。入院时,HLP组血甘油三酯(TG)、总胆固醇(TC)均高于ABP组(P<0.05),淀粉酶(AMY)低于ABP组(P<0.05)。10例HLAP经血液净化治疗后血脂水平明显下降。结论 HALP发病逐年增加,多发于中青年男性,HALP患者血脂水平明显高于ABP患者,血淀粉往往较低,以降血脂为主的综合治疗效果较为理想,血液净化治疗疗效明确。     

高脂血症性急性胰腺炎与糖尿病、微循环障碍关系的探讨

目的 探讨高脂血症性急性胰腺炎与糖尿病、微循环障碍的关系,观察高甘油三酯(TG)血症、高血糖对急性胰腺炎病情的影响。方法 选取我院收治的急性胰腺炎病例105例,按病因分为高脂血症性胰腺炎(HLAP)组与其他病因组,比较两组患者体温、白细胞、血细胞压积(HCT)、血黏度(高切、低切)、D-二聚体等血生化指标的差异及局部和全身并发症出现的情况;观察HLAP患者降脂治疗后体温、WBC、TG下降规律及APACHE-Ⅱ、Glasgow评分变化;6个月后观察患者病情恢复情况。结果 HLAP与其他病因组比较,其血黏度、HCT、D-二聚体明显升高,局部及全身并发症出现较多,两组比较差异有统计学意义(P 0.05);连续血液滤过(CBP)治疗后患者病情恢复较快;远期随访HLAP复发率较高,出现继发性糖尿病患者较多,且腹腔包裹性积液吸收较差,两组比较差异有统计学意义(P 0.05)。结论 高TG血症、高血糖影响急性胰腺炎病情及预后,胰腺微循环障碍是急性胰腺炎发生和发展的主要致病因素。     

急性胰腺炎的糖尿病发病率与风险因素的研究

目的 探讨急性胰腺炎的糖尿病发病率与风险因素.方法 50例急性胰腺炎患者,分成急性胰腺炎继发糖尿病的观察组和无血糖升高的对照组,测定并比较两组血钙、总胆固醇(TC)、甘油三酯(TG)、血清白蛋白,并行胰腺CT扫描进行分级.结果 观察组重症患者44.00%高于对照组16.00%,差异显著 (P<0.05).结论 急性胰腺炎有较高的继发糖尿病的风险,对于急性胰腺炎患者要注意血糖、TG、TC的监测,从而及时发现因胰岛功能紊乱而出现的糖尿病.     

氧化苦参碱联合乌司他丁治疗老年重症急性胰腺炎的疗效分析

目的探讨氧化苦参碱联合乌司他丁治疗老年重症急性胰腺炎的临床疗效。方法选取2014年5月至2017年5月在我院就诊的80例老年重症急性胰腺炎患者,随机分为观察组(氧化苦参碱+乌司他丁)和对照组(乌司他丁)各40例。对比两组临床疗效。结果观察组总有效率95.00%,与对照组总有效率82.50%,显著升高(P<0.05)。治疗前两组血糖、血钙、血清淀粉酶、白细胞水平比较,差异无统计学意义(P>0.05)。治疗后两组血糖、血清淀粉酶和白细胞水平均显著低于治疗前(P<0.05),血钙水平显著高于治疗前(P<0.05),且观察组血糖、血清淀粉酶和白细胞均显著低于对照组(P<0.05),血钙水平显著高于对照组(P<0.05)。结论氧化苦参碱联合乌司他丁治疗老年重症急性胰腺炎疗效显著,值得临床推广。     

急性脑卒中患者医院获得性肺感染与临床营养学指标相关性分析

目的 探讨急性脑卒中患者医院获得性肺感染(HAP)与临床营养学指标的相关性.方法 连续选择近期住院的急性脑卒中117例,入选对象在入院后7～10 d内接受了临床营养学指标采集和检测.结果 117例急性脑卒中患者中,住院期间发生HAP者55例(47.01%),未发生HAP者62例(52.99%).发生HAP组的体重指数、三头肌皮褶厚度、上臂中点围、血清白蛋白、血清前蛋白和总淋巴细胞计数均明显明显低于未发生HAP组(P均<0.01～0.05).结论 急性脑卒中合并HAP患者临床营养学指标较差.     

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.

     

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.     

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.     

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.     

Glycofection: The Ubiquitous Roles of Sugar Bound on Glycoplexes

Glycofection (transfection by using sugar-substituted polylysine) was assessed in order to provide an alternative to viral vectors for the transfer of genes into vascular smooth muscle cells. A rabbit vascular smooth muscle cell line (Rb-1 cells) was selectively transfected by using glycoplexes (glycosylated polylysine/pSV2LUC complexes) in the presence of 10 mu M of the fusogenic peptide GALA. A sugar-specific transfection was obtained when the glycofection was conducted for 1 h with glycoplexes containing either alpha Gal, alpha -Glc, alpha -GalNAc, beta -GlcNAc, or beta -GalNAc residues. The gene expression was high after transfection, with glycoplexes bearing alpha Gal, alpha -GalNAc, or beta -GalNAc residues that were weakly internalized, and low with glycoplexes carrying Lact or Rha residues that were well taken up by cells. These results suggest that 1) glycofection can be a good approach for a selective transfer of genes intovascular smooth muscle cells, 2) an efficient uptake of the glycoplexes is not the unique limiting step for an efficient transfection, and 3) the sugar-dependent trafficking of the glycoplexes inside the cells may account for the transfection efficiency.     

直肠癌下切缘病理组织学分析

目的探讨直肠癌逆向浸润与下切缘的安全距离的关系。方法对36例直肠癌Miles手术和Dixon手术后标本的肿瘤下缘1.0cm、2.0cm、3.0cm的肠壁及对应的系膜病理组织学检查,观察直肠癌逆向浸润或转移的距离。结果36例直肠癌标本距癌肿下缘1.0 cm、2.0cm、3.0cm的肠壁及对应的系膜病理组织学检查均为阴性,结论直肠癌远恻逆向浸润或转移未见超过1.0cm,因此认为保肛手术时切除肿瘤远侧肠管(包括系膜)2.0cm是安全的。