环磷腺苷葡胺联合依那普利对慢性心力衰竭患者BNP的影响分析

目的探讨环磷腺苷葡胺联合依那普利对慢性心力衰竭患者血浆脑钠肽(BNP)的影响。方法将120例慢性心力衰竭患者随机分为两组,对照组各60例使用环磷腺苷葡胺治疗,研究组各60例使用环磷腺苷葡胺联合依那普利治疗,比较两组治疗前后血浆BNP水平及临床疗效。结果治疗后,研究组血浆BNP水平明显低于对照组(P <0.05)。研究组有效率为95.0%,明显高于对照组的83.3%(P <0.05)。结论慢性心力衰竭患者采用环磷腺苷葡胺联合依那普利治疗可有效降低血浆BNP水平,提升疗效。     

益心舒胶囊联合美托洛尔缓释片治疗冠心病室性早搏疗效观察

目的 分析益心舒胶囊和美托洛尔缓释片联合治疗冠心病室性早搏的临床效果.方法 选取2013年12月至2016年3月我院诊治的冠心病室性早搏患者160例,随机分为观察组和对照组各80例.对照组给予美托洛尔缓释片治疗,观察组给予益心舒胶囊和美托洛尔缓释片联合治疗.分析比较两组患者的临床疗效、不良反应发生率和治疗前后患者的全部窦性心搏RR间期的标准差(SDNN)、RR间期平均值标准差(SDANN)、相邻RR间期差值的均方根(RMSSD)和24h内早搏次数的变化.结果 治疗后,两组患者的SDNN、SDANN、RMSSD显著上升,24h内早搏次数明显下降,观察组患者的SDNN、SDANN、RMSSD大于对照组,24h内早搏次数小于对照组,临床疗效优于对照组,不良反应率小于对照组,差异均有统计学意义(P＜0.05).结论 益心舒胶囊联合美托洛尔缓释片治疗冠心病室性早搏疗效显著.     

氯沙坦联合环磷腺苷葡胺治疗肺气肿合并肺心病临床疗效观察

目的探讨氯沙坦联合环磷腺苷葡胺治疗肺气肿合并肺心病的临床效果。方法将80例肺气肿合并肺心病的患者随机分成观察组和对照组,两组患者均给予内科常规治疗,观察组在此基础上给予氯沙坦联合环磷腺苷葡胺治疗,对比观察两组患者治疗有效率及心功能指标变化。结果两组患者治疗效果满意,治疗有效率比较,观察组明显优于对照组,差异具有统计学意义（P〈0.05）;心功能指标均有所改善,且观察组优于对照组（P〈0.05）。结论氯沙坦联合环磷腺苷葡胺治疗肺气肿合并肺心病患者临床疗效显著,值得推广应用。     

氯沙坦与环磷腺苷葡胺联合治疗对肺心病患者肺功能与免疫功能的影响

目的探讨氯沙坦与环磷腺苷葡胺联合治疗对肺心病患者肺功能与免疫功能的影响。方法将肺心病患者67例随机分为两组,对照组患者予以常规内科治疗,观察组患者实施氯沙坦与环磷腺苷葡胺联合治疗,观察两组患者的治疗效果。结果治疗后观察组各项肺功能、各项心功能指标均明显优于对照组(P<0.05);治疗后观察组血清补体C_3含量明显优于治疗前(P<0.05),高于对照组(P<0.05)。结论氯沙坦与环磷腺苷葡胺联合治疗对肺心病患者肺功能与免疫功能的影响明显,值得推广。     

硝酸异山梨酯联合环磷腺苷葡胺治疗冠心病心绞痛的疗效观察

目的探讨硝酸异山梨酯联合环磷腺苷葡胺治疗冠心病心绞痛疗效。方法 2014年6月至2016年6月160例冠心病心绞痛患者,其中80例予硝酸异山梨酯治疗为对照组,另80例予硝酸异山梨酯联合环磷腺苷葡胺治疗为干预组。比较两组症状积分、心绞痛疗效和药物不良反应。结果治疗后,干预组证候积分为(6.39±1.59)分明显低于对照组(11.31±3.49)分(P <0.05)。干预组心绞痛有效率为88.7%,明显高于对照组73.7%(P <0.05)。两组药物不良反应比较无明显差异(P>0.05)。结论冠心病心绞痛采用硝酸异山梨酯联合环磷腺苷葡胺治疗可有效缓解心绞痛症状,临床应用价值高。     

福辛普利钠联合环磷腺苷葡胺治疗慢性心力衰竭的临床研究

目的探讨福辛普利钠片联合注射用环磷腺苷葡胺治疗慢性心力衰竭的临床疗效。方法选取2017年2月—2018年2月于红安县人民医院诊治的慢性心力衰竭146例患者作为研究对象,根据随机数字表法将患者分为对照组和治疗组,每组各73例。对照组静脉滴注注射用环磷腺苷葡胺,90 mg加入到5%葡萄糖注射液500 mL溶解,1次/d;治疗组在对照组治疗的基础上口服福辛普利钠片,1片/次,1次/d。两组患者均连续治疗15 d。观察两组患者的临床疗效,比较治疗前后两组的心功能指标、血液生化指标。结果治疗后,两组患者的总有效率分别为82.19%、94.52%,两组比较差异具有统计学意义(P0.05)。治疗后,两组左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)均显著升高,左心室收缩末期内径(LVESD)显著降低,同组治疗前后比较差异具有统计学意义(P0.05)。且治疗组患者心功能指标显著优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清去甲肾上腺素(NE)、N-端脑利钠肽前体(NT-pro BNP)、超敏C反应蛋白(hs-CRP)水平均显著降低,同组治疗前后比较差异具有统计学意义(P0.05)。且治疗组血液生化指标显著低于对照组,两组比较差异具有统计学意义(P0.05)。结论福辛普利钠片联合注射用环磷腺苷葡胺治疗慢性心力衰竭具有较好的临床疗效,可显著改善心功能和血清生化指标,不良反应轻微,具有一定的临床推广应用价值。     

炙甘草汤对糖尿病性心肌病心律失常发生率和心率变异性及QT离散度的影响

目的研究炙甘草汤对糖尿病性心肌病心律失常发生率和心率变异性及QT离散度的影响。方法收集60例糖尿病心肌病患者作为研究对象,患者随机分为对照组(n=28)和治疗组(n=32)。2组采用控制血糖、降血压、降血脂、抗心力衰竭、心绞痛等基础治疗。对照组给予普罗帕酮口服治疗,治疗量为100~200 mg/次,3~4次/d,7 d为1个疗程,连续服用4周。治疗组在以上药物基础上加用炙甘草汤水煎取汁400 ml,分早晚2次温服,1剂/d,2周为1疗程。2组患者采用动态心电图观察治疗前后各种心律失常的发生率、心率变异性(HRV):全部窦性心搏RR间期的标准差(SDNN)、RR间期平均值标准差(SDANN)、相邻RR间期差值的均方根(RMSSD)、相邻NN之差>50 ms的个数占总窦性心搏个数的百分比(PNN50)及QT离散度(QTd)。结果 2组治疗后传导阻滞、室性心律失常、房性心律失常、窦性心律失常、交界性心律失常的发生率与治疗前比较,差异有统计学意义(P<0.05),治疗组治疗后传导阻滞、室性心律失常、房性心律失常、窦性心律失常、交界性心律失常的发生率与对照组比较,差异有统计学意义(P<0.05)。对照组治疗后SDNN、SDANN、QTd水平与治疗前比较差异有统计学意义(P<0.05),治疗组治疗后SDNN、SDANN、RMSSD、RNN50、QTd水平与治疗前比较差异有统计学意义(P<0.05)。治疗组治疗后SDNN、SDANN、RMSSD、RNN50、QTd水平与对照组比较差异有统计学意义(P<0.05)。结论炙甘草汤可以减少糖尿病心肌病患者心律失常的发生,对心脏自主神经功能有明显改善作用。     

心欣舒胶囊联合环磷腺苷葡胺治疗病毒性心肌炎的临床研究

目的探讨心欣舒胶囊联合环磷腺苷葡胺治疗病毒性心肌炎的临床疗效。方法选取2015年3月—2016年3月延安大学附属医院收治的病毒性心肌炎患者76例,随机分为对照组和治疗组,每组各38例。对照组静脉滴注注射用环磷腺苷葡胺,180 mg加入到5%葡萄糖溶液250 m L,1次/d。治疗组在对照组基础上口服心欣舒胶囊,5粒/次,3次/d。两组患者均治疗30 d。观察两组的临床疗效,比较血清心肌酶谱和血清学指标的变化。结果治疗后,对照组和治疗组的总有效率分别为78.95%、94.74%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者CK-MB、CPK、LDH和AST均明显降低,同组治疗前后差异有统计学意义(P0.05);且治疗组这些观察指标的降低程度明显低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者TNF-α和IL-6水平明显降低,而SOD水平明显升高,同组治疗前后差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论心欣舒胶囊联合环磷腺苷葡胺治疗病毒性心肌炎具有较好的临床疗效,可明显减轻心肌细胞损伤,降低炎症反应,具有一定的临床推广应用价值。     

环磷腺苷葡胺治疗充血性心力衰竭疗效观察

目的观察环磷腺苷葡胺冶疗充血性心力衰竭疗效。方法 78例充血性心力衰竭的患者被随机分成治疗组(39例),对照组(39例),两组常规治疗相同。治疗组给予环磷腺苷葡胺120mg加入5%葡萄注射液100ml,1次/d静脉滴注,疗程7～10d。比较两组治疗前、后心功能改善情况。结果治疗组临床疗效明显高于对照组(P<0.05)。治疗组的左室射血分数治疗后有显著改善(P<0.01),较对照组亦有显著改善(P<0.05)。结论环磷腺苷葡胺治疗充血性心力衰竭有一定疗效。     

稳心颗粒联合胺碘酮治疗急性心肌梗死心律失常的效果观察

目的:观察稳心颗粒联合胺碘酮治疗急性心肌梗死心律失常的效果。方法:选取某院收治的急性心肌梗死并发心律失常患者108例,随机分为对照组和观察组各54例,对照组给予胺碘酮治疗,观察组在其基础上口服稳心颗粒,比较两组疗效、不良反应,治疗前后PNN50、RMSSD、SDNN及SDANN等心率变异性指标。结果:观察组总有效率明显高于对照组,治疗后PNN50、RMSSD、SDNN、SDANN均明显高于对照组,差异有统计学意义;两组不良反应无差异。结论:稳心颗粒联合胺碘酮治疗急性心肌梗死心律失常的效果显著,可明显提高心率变异性,且安全性好。     

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.     

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.     

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.     

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.