瑞舒伐他汀钙对脑梗死合并颈动脉粥样硬化老年患者血管内皮舒张功能与颈动脉硬化、超敏C反应蛋白水平的影响

目的：探究瑞舒伐他汀钙对脑梗死合并颈动脉粥样硬化老年患者血管内皮舒张功能与颈动脉硬化、超敏C反应蛋白水平的影响。方法：选取某院于2016年8月-2017年8月收治的118例脑梗死合并颈动脉粥样硬化老年患者作为本次研究对象，通过随机数字表法将研究对象随机分为常规治疗组（59例）和瑞舒伐他汀钙治疗组（59例）。常规治疗组患者实施常规治疗，瑞舒伐他汀钙治疗组在常规治疗的基础上服用瑞舒伐他汀钙。在进行12周的治疗后，比较两组患者的颈动脉硬化情况、血管内皮舒张功能、血脂情况以及超敏C反应蛋白水平。结果：2组患者治疗前的颈动脉硬化情况、血管内皮舒张功能、血脂情况以及超敏C反应蛋白水平比较差异无统计学意义（P>0.05），在治疗后两组患者IMT、动脉粥样斑块积分以及超敏C反应蛋白水平均有所降低，且瑞舒伐他汀钙治疗组患者治疗后IMT、动脉粥样斑块积分以及超敏C反应蛋白水平明显低于常规治疗组，其差异存在统计学意义（t=2.867、11.481、8.946，P<0.05）。在治疗后两组患者的FMD、NMD均有所升高，且瑞舒伐他汀钙治疗组患者治疗后的FMD明显高于常规治疗组，其差异存在统计学意义（t=7.428、2.042，P<0.05）。治疗后瑞舒伐他汀钙治疗组患者的LDL-C、TC以及TG水平明显低于常规治疗组，其差异存在统计学意义（t=15.457、11.582、11.010，P<0.05）。结论：在脑梗死合并颈动脉粥样硬化老年患者的临床治疗中实施瑞舒伐他汀钙治疗能够有效改善患者血管内皮舒张功能，降低血脂和炎症，同时也能缓解颈动脉硬化。     

瑞舒伐他汀钙治疗颈动脉粥样硬化斑块的疗效观察

目的观察瑞舒伐他汀钙治疗颈动脉粥样硬化斑块的疗效。方法将72例不同程度颈动脉粥样硬化斑块形成患者分成治疗组和对照组,对照组常规降糖、降压、饮食控制、服用阿司匹林肠溶片100mg,1次/d,治疗组在对照组治疗基础上服用瑞舒伐他汀钙10mg,每晚睡前1次,为期12个月。观察治疗前后血脂、颈动脉内膜中层厚度(IMT)、斑块面积、斑块总个数变化。结果治疗组治疗12个月后血清总胆固醇(TC)、血清甘油三酯(TG)、血清低密度脂蛋白胆固醇(LDL-C)水平下降,IMT值、斑块面积减小,与治疗前比较,差异有统计学意义(P<0.05),而血清高密度脂蛋白胆固醇(HDL-C)水平、斑块总个数变化不大(P>0.05)。结论瑞舒伐他汀钙是治疗颈动脉粥样硬化较好的选择,不但可以降低血脂水平,还能降低斑块面积,值得推广应用。     

瑞舒伐他汀治疗慢性肾脏病晚期颈动脉粥样斑块的临床研究

目的研究瑞舒伐他汀钙对慢性肾病晚期患者颈动脉粥样斑块的疗效。方法选取彩超证实存在颈动脉粥样斑块的慢性肾脏病4～5期患者90例,随机分为三组:A组给予瑞舒伐他汀钙5 mg.d-1,B组给予瑞舒伐他汀钙10 mg.d-1,C组给予阿托伐他汀钙10 mg.d-1,三组年龄和性别相匹配。比较治疗前及治疗12个月后总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白-胆固醇(LDL-C)、高密度脂蛋白-胆固醇(HDL-C)、超敏C反应蛋白(hs-CRP)、肝功能(ALT)、肌酸激酶(CK)水平以及颈动脉内膜中层厚度、粥样斑块数目、大小。结果三组治疗前血脂、hs-CRP水平及颈动脉粥样斑块情况无显著性差异(P0.05)。三组患者治疗前后比较,治疗后TC、TG、LDL-C、hs-CRP水平均明显下降(P0.01),HDL-C水平明显升高(P0.01),其中B组患者血脂及hs-CRP的变化水平较A、C组明显(P0.01);颈动脉中层厚度治疗后低于治疗前,但仅B组有统计学意义(P0.05),治疗前后斑块数目无明显改变,B组斑块治疗后较治疗前缩小,A、C组无明显变化。结论常规剂量的瑞舒伐他汀钙可通过调脂、抑制炎症反应等可能机制逆转慢性肾脏病晚期患者颈动脉粥样斑块,并具有良好的安全性。     

普罗布考联合阿托伐他汀治疗高龄老年患者颈动脉硬化斑块的疗效观察

目的 本研究评估普罗布考联合阿托伐他汀治疗高龄老年患者颈动脉硬化斑块的临床疗效.方法 本研究共纳入110例高龄老年颈动脉硬化患者,随机分为观察组(n=55)和对照组(n=55),对照组单用阿托伐他汀治疗,观察组在对照组治疗的基础上,加用普罗布考治疗,观察周期为12周,比较两组治疗前后血清血脂、超敏CRP、颈动脉内膜中层厚度(IMT)以及斑块面积的变化.结果 随访12周后,最终共有105例患者纳入统计.治疗后两组患者总胆固醇、低密度脂蛋白胆固醇、超敏CRP水平均较基线水平明显下降(P<0.05),两组患者颈动脉IMT、斑块面积均较基线水平明显减少;与对照组相比,观察组治疗后总胆固醇、低密度脂蛋白胆固醇、超敏CRP水平明显下降(P<0.05),颈动脉IMT、斑块面积均明显减少(PWTBZ<0.05).结论 普罗布考联合阿托伐他汀治疗高龄老年颈动脉硬化较单用阿托伐他汀疗效更佳.     

阿托伐他汀对脑动脉硬化患者血浆黏稠度及斑块大小的影响

目的:观察阿托伐他汀治疗脑动脉硬化对患者血浆黏稠度及斑块大小的影响,探讨阿托伐他汀治疗脑动脉硬化的应用价值.方法:以在我院神经内科就诊的86例脑动脉硬化患者为研究对象,按就诊日期奇、偶数分为对照组(45例,给予银杏叶胶囊等常规药物)和观察组(41例,在对照组的基础上给予阿托伐他汀钙片),治疗1个月后观察血浆黏稠度、脑血管斑块面积及颈动脉内膜中膜厚度(IMT),并评价治疗效果.结果:观察组治疗1个月后血浆黏稠度、脑血管斑块面积、IMT厚度及治疗效果明显优于对照组,差异显著(P<0.01).结论:阿托伐他汀治疗老年脑动脉硬化具有显著疗效,有助于降低血浆黏稠度,值得临床推广.     

普罗布考联合瑞舒伐他汀对高脂血症患者颈动脉斑块及炎性因子的影响

目的观察普罗布考联合瑞舒伐他汀对高脂血症合并颈动脉斑块患者颈动脉内膜-中膜厚度(IMT)、斑块面积以及炎性因子IL-6和TNF-α的影响,以探讨普罗布考和瑞舒伐他汀联合使用在治疗高脂血症颈动脉斑块患者的优势所在。方法选取该院2009年10月-2011年8月高脂血症合并颈动脉斑块患者230例,并随机分为常规治疗组(120例)和联合治疗组(110例)。另选取30例健康自愿者为对照组。常规治疗组患者予以瑞舒伐他汀10 mg口服,每晚一次;联合给药组患者予以瑞舒伐他汀口服的基础上予以普罗布考250 mg,每日2次。6个月末行颈动脉超声检查,观察颈动脉IMT和颈动脉斑块面积的变化,并检测治疗前后血浆炎性因子IL-6和TNF-α的变化。结果联合治疗组患者经治疗后6个月末,颈动脉IMT及斑块面积均较常规治疗组降低,差别有统计学意义(P0.05),血浆炎性因子IL-6和TNF-α水平较常规治疗组降低(P0.05)。结论普罗布考和瑞舒伐他汀两种药物联合使用较单独使用瑞舒伐他汀能更有效地缩小高脂血症患者颈动脉斑块面积,降低炎性因子IL-6、TNF-α水平,值得在临床中进一步推广。     

瑞舒伐他汀强化降脂对缺血性脑卒中血脂及颈动脉粥样硬化斑块的影响

目的分析研究瑞舒伐他汀强化降脂对缺血性脑卒中血脂(TC)及颈动脉粥样硬化斑块(IMT)的影响。方法 50例缺血性脑卒中患者作为研究对象,随机分为对照组和观察组,各25例。对照组给予瑞舒伐他汀片10 mg/次,1次/d;观察组给予瑞舒伐他汀片20 mg/次,1次/d,持续治疗6个月,比较两组治疗前后血脂水平及颈动脉粥样硬化斑块的变化。结果观察组和对照组治疗后的血脂水平及颈动脉粥样硬化斑块较治疗前均有明显减退,两组治疗前血脂水平及颈动脉粥样硬化斑块情况比较,差异无统计学意义(P>0.05),两组治疗后的血脂水平及颈动脉粥样硬化斑块变化差异有统计学意义(P<0.05)。结论瑞舒伐他汀强化降脂治疗缺血性脑卒中的疗效显著,既可以起到良好的调脂作用,也可降低颈动脉粥样硬化颈动脉内膜-中层厚度(CMT),缓解了颈动脉粥样硬化斑块的进展。     

不同剂量阿托伐他汀治疗老年颈动脉内膜中层增厚或斑块形成的临床观察

目的 比较不同剂量的阿托伐他汀治疗老年颈动脉内膜中层(IMT)增厚或板块形成的疗效差异。方法 90例IMT增厚或斑块形成的老年患者,随机分为低剂量组和高剂量组,各45例。低剂量组给予阿托伐他汀10 mg,q.d.治疗;高剂量组给予阿托伐他汀20 mg,q.d.治疗,连续使用6个月。观察、比较两组治疗前后的血脂、IMT厚度或斑块大小变化及不良反应情况。结果 经治疗后,两组血脂与治疗前相比差异有统计学意义(P<0.01),高剂量组降低更加明显,差异具有统计学意义(P<0.05)。两组患者颈总动脉IMT与治疗前相比,差异具有统计学意义(P<0.01);组间比较差异无统计学意义(P>0.05)。高剂量组不良反应发生率明显高于低剂量组,差异具有统计学意义(P<0.05)。结论 阿托伐他汀对颈动脉内膜中层增厚或板块形成的老年患者,可显著降低血脂,改善颈动脉内膜中层增厚和斑块形成。提高剂量可增加降血脂的功效,但改善颈动脉内膜增厚效果提高不明显,同时高剂量会使不良反应的发生率增加,因此临床选择较小剂量使用。     

观察不同剂量阿托伐他汀治疗2型糖尿病合并颈动脉硬化的临床疗效

目的:对不同剂量阿托伐他汀治疗2型糖尿病合并颈动脉硬化的临床疗效进行分析,为临床用药提供参考。方法:随机选取2012年8月~2013年9月我院收治的2型糖尿病合并颈动脉硬化患者87例,将其平均分为甲、乙、丙三组,每组各29例;分别给予三组患者每天睡前服用20mg、40mg、80mg阿托伐他汀,并对所有患者的临床资料、治疗方法及治疗疗效进行回顾性分析。结果:经治疗后,不同剂量阿托伐他汀治疗2型糖尿病合并颈动脉硬化的临床疗效不同,甲组患者颈动脉硬化情况有所改善,但不明显;乙组患者颈动脉硬化情况较甲组明显的改善;丙组颈动脉硬化情况较甲组及乙组明显改善,甲、乙两组与丙组比较有差异具有统计学意义(P<0.05)。结论:应用阿托伐他汀治疗2型糖尿病合并颈动脉硬化效果确切,且随着剂量增加,颈动脉硬化改善更明显,口服大剂量阿托伐他汀值得在高危糖尿病患者中推广和应用。     

瑞舒伐他汀与辛伐他汀对脑梗死患者颈动脉粥样斑块的影响

目的:比较瑞舒伐他汀与辛伐他汀对脑梗死患者颈动脉粥样斑块的影响。方法:选择我院脑梗死合并颈动脉粥样斑块的住院患者100例,按数字随机法均分为治疗组与对照组,治疗组在常规脑梗死基础治疗上,口服瑞舒伐他汀;对照组在常规脑梗死基础治疗上口服辛伐他汀。6个月后评定患者的血脂变化,并采用颈动脉超声观察患者颈动脉粥样硬化斑块内膜-中膜厚度(IMT)。结果:治疗后,2组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平均显著降低(P<0.05),对照组的甘油三酯(TG)与治疗前比较无显著性差异(P>0.05),IMT厚度缩小程度较对照组显著(P<0.05)。2组均未见明显不良反应发生。结论:瑞舒伐他汀治疗脑梗死患者颈动脉斑块较辛伐他汀疗效显著,且安全性较好。     

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.     

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.

     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.     

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.