重组人脑利钠肽联合多巴胺对心肾综合征伴低血压的疗效及对血清NT-proBNP水平的影响

目的:研究重组人脑利钠肽联合多巴胺对心肾综合征伴低血压的疗效及对血清NT-proBNP水平的影响。方法:收集2015年4月至2016年4月我院的90例心肾综合征伴低血压患者,按抽签法分为实验组和对照组,每组45例。对照组用多巴胺治疗,实验组在对照组基础上加用重组人脑利钠肽。观察两组治疗疗效,治疗前后血压、心率、心动图指标每搏输出量(SV)、左心室射血分数(LVEF)、左心室舒张末内径(LVEDD),N末端前体脑钠肽(NT-proBNP)、血肌酐(SCr)、胱抑素C(Cys C)水平的变化。结果:治疗后,实验组总有效率为93.33%,显著高于对照组(68.88%,P0.05);SBP、DBP、MAP、SV、LVEF均显著高于对照组(P0.05),HR、血清NT-proBNP、SCr水平显著低于对照组(P0.05);两组LVEDD比较差异无统计学意义(P0.05)。结论:重组人脑利钠肽联合多巴胺对心肾综合征伴低血压的疗效显著,可缓解心脏负荷,改善心肾功能,降低NT-proBNP水平,提高治疗安全性。     

炙甘草汤加五参颗粒联合西药治疗冠心病的临床疗效及其对患者血清hs-CRP、NT-proBNP水平和内皮功能的影响

目的:探究炙甘草汤加五参颗粒联合西药治疗冠心病的临床疗效及其对患者血清超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、N末端B型脑钠尿肽前体(NT-Pro-brain natriuretic peptide,NT-proBNP)水平和内皮功能的影响。方法:选取2015年12月至2017年10月在我院接受治疗的冠心病患者80例,随机分为观察组和对照组,每组各40例。对照组接受西药治疗,观察组在西药治疗的基础上联合炙甘草汤加五参颗粒治疗。比较两组临床疗效及治疗前后hs-CRP、NT-proBNP、一氧化氮(Nitric oxide,NO)和内皮素(Endothelin-1,ET-1)水平的变化。结果:观察组和对照组治疗后的总有效率分别为90%和72.5%,观察组明显优于对照组(P0.05)。治疗前,两组血清hs-CRP、NT-pro BNP、NO、ET-1水平比较差异无统计学意义(P0.05)。与同组内治疗前比较,两组治疗后血清NT-pro BNP、hs-CRP、ET-1水平均明显下降,血清NO水平均明显升高,且观察组血清NT-proBNP、hs-CRP、ET-1水平均明显低于对照组(P0.05),血清NO水平显著高于对照组(P0.05)。结论:在西药治疗的基础上加用炙甘草汤加五参颗粒治疗冠心病临床疗效明显优于单用西药治疗,可能与其显著降低炎症和改善内皮功能有关。     

左西孟旦联合脑心通胶囊治疗急性心力衰竭的疗效及对血清NT-proBNP，Galectin-3，ET-1及CystatinC水平的影响

目的:分析左西孟旦联合脑心通胶囊治疗急性心力衰竭的临床疗效及对血清氨基末端B型钠尿肽前体(NT-proBNP)、半乳糖凝集素(Galectin-3)、内皮素-1(ET-1)、半胱氨酸蛋白酶抑制剂C(CystatinC)水平的影响。方法:选取2015年3月至2016年6月我院收治的90例急性心力衰竭患者,按抽签法将患者随机分为观察组(n=45)和对照组(n=45),对照组患者给予单纯左西孟旦治疗,观察者患者在此基础上联合应用脑心通胶囊治疗。比较两组患者的临床疗效、心功能指标、血压、心率、不良反应的发生情况及治疗前后血清NT-proBNP、Galectin-3、ET-1和CystatinC水平的变化。结果:治疗后,观察组总有效率为93.33%,比对照组显著升高(77.78%)(P0.05)。两组治疗后患者的左室部分缩短(LVFS)、左心射血分数(LVEF)、每搏输出量(SV)水平均较治疗前增高,血压、心率及血清NT-proBNP、Galectin-3、ET-1、CystatinC水平均较治疗前明显下降,且观察组患者的LVFS、LVEF、SV水平明显高于对照组(P0.05),血压、心率及血清NT-proBNP、Galectin-3、ET-1、CystatinC水平明显低于对照组(P0.05)。结论:左西孟旦联合脑心通胶囊治疗能提高急性心力衰竭的治疗效果,显著降低血清NT-proBNP、Galectin-3、ET-1和CystatinC水平,安全性较高。     

小剂量螺内酯联合美托洛尔对慢性心力衰竭患者血浆NT-p roBNP、CRP水平及心功能的影响

目的:观察小剂量螺内酯联合美托洛尔对慢性心力衰竭患者血浆NT-p roBNP、CRP水平及心功能的影响.方法:将71例慢性心力衰竭(心衰)患者随机分为治疗组和对照组,均予常规抗心衰治疗,治疗组加服小剂量螺内酯联合美托洛尔,疗程12周.治疗前后用彩超测定心功能指标左心室射血分数(LVEF),ELISA法和散射比浊法测定血浆N2末端脑钠肽前体(NT-proBNP)、C反应蛋白(CRP)水平.结果:治疗后治疗组总有效率明显高于对照组,心功能指标LVEF明显升高,血浆NT-proBNP、CRP水平均明显下降,P均＜0.05;治疗组血浆NT-p roBNP与LVEF呈负相关(r=0.75,P＜0.05);血浆CRP水平与LVEF增加呈负相关(r=0.433,P＜0.05).结论:小剂量螺内酯联合美托洛尔治疗慢性心衰效果确切,其主要作用机制为降低血浆NT-proBNP、CRP水平和改善心功能.     

参附注射液对老年慢性心衰患者血清NT-proBNP、H-FABP及CRP 水平的影响

目的:探讨参附注射液对老年慢性心衰患者脑钠肽(NT-proBNP)、心脏型脂肪酸结合蛋白(H-FABP)及C-反应蛋白(CRP)的影响。方法:收集我院收治的慢性心力衰竭患者70例,随机分为对照组和实验组,每组各35例,对照组患者均给予相应常规对症治疗,实验组患者在对照组基础上给予参附注射液静脉滴注,治疗结束后观察并比较两组患者治疗前后血清NT-proBNP、H-FABP及CRP水平的变化以及治疗效果。结果:与治疗前相比,两组患者治疗后血清NT-proBNP、H-FABP及CRP水平与治疗前相比均降低(P0.05);实验组患者治疗后血清NT-proBNP、H-FABP及CRP水平与对照组患者相比较低(P0.05)。实验组临床总有效率与对照组相比较高,但差异无统计学意义(P0.05)。结论:参附注射液能够降低老年慢性心衰患者血清NT-proBNP、H-FABP及CRP水平,提高临床疗效。     

左西孟旦和米力农治疗难治性心力衰竭的疗效比较及对血清NT-proBNP、ET-1水平的影响

目的:观察和比较左西孟旦(LEV)与米力农(MIL)治疗难治性心力衰竭(RHF)的临床效果及对患者血清N末端B型利钠肽原(NT-proBNP)、内皮素(ET)-1水平的影响。方法:选取我院2015年1月~2017年4月收治的102例RHF患者,采取随机数字表法均分为两组。MIL组给予MIL治疗,LEV组予以LEV治疗。比较两组的临床疗效,治疗前后超声心动图指标[左室射血分数(LVEF)、二尖瓣舒张早期/舒张晚期峰值流速(E/A)、左室舒张末期内径(LVIDd)]、血清NT-proBNP、ET-1水平的变化及不良反应的发生情况。结果:治疗7 d后,LEV组总有效率较MIL组明显升高(P0.05)。与治疗前对比,两组治疗7 d后LVEF、E/A值均显著上升(P0.01),LVIDd值均显著下降(P0.01),且LEV组LVEF、E/A值均显著高于MIL组,LVIDd值均显著低于MIL组(P0.01)。两组治疗7 d后血清NT-proBNP、ET-1水平较治疗前均显著降低(P0.01),且LEV组血清NT-proBNP、ET-1水平均明显低于MIL组(P0.01)。LEV组不良反应的发生率较MIL组明显降低(P0.05)。结论:与米力农相比,左西孟旦治疗难治性心力衰竭能更有效缓解或消除患者症状体征、抑制心室重构、改善心功能,且安全性更高,可能与其显著降低血清NT-proBNP、ET-1水平有关。     

冠心病患者的血浆大内皮素与N末端脑钠肽水平及其与心功能的关系

目的:探讨冠心病(CHD)患者血浆大内皮素(Bigendothelin-1,Big ET-1)与N末端脑钠肽(NT-pro BNP)的水平及其与心功能的关系。方法:选择本院2014年1月-2014年5月收治的60例CHD患者为观察组,及同期接受体检的60例健康志愿者作为对照组,测定并比较两组的血浆大内皮素与N末端脑钠肽水平以及不同心功能分级CHD患者的血浆大内皮素与N末端脑钠肽水平的差异,分析血浆大内皮素与N末端脑钠肽水平与CHD患者心功能的关系。结果:观察组患者血浆Big ET-1和NT-pro BNP的水平均显著高于对照组,差异具有统计学意义(P0.05)。随着CHD患者的心功能分级的增加,其血浆Big ET-1和NT-pro BNP的水平逐渐升高,且各组之间比较差异均具有统计学意义(P0.05)。血浆Big ET-1、NT-pro BNP水平与CHD患者的心功能之间存在明显的正相关性(P0.05)。结论:CHD患者的血浆Big ET-1与NT-pro BNP水平均异常升高,且与患者的心功能呈正相关,监测其水平对判断CHD的病情及心功能可能具有重要的临床参考价值。     

rh-BNP联合阿托伐他汀治疗急性心梗后心衰的临床疗效及对患者血清cTn-I、Myo、CK-MB水平的影响

目的:研究重组人脑利钠肽(rh-BNP)联合阿托伐他汀治疗急性心梗后心衰的临床效果及对患者血清心肌肌钙蛋白(cardiac troponin,cTn-I)、肌红蛋白(Myoglobin,Myo)、肌酸激酶同工酶(CK-MB)水平的影响。方法:选择我院2017年2月～2019年1月收治的72例急性心梗后心衰患者,按随机数字表法分为观察组38例,对照组34例。对照组给予阿托伐他汀治疗,观察组在对照组基础上另加rh-BNP,观察和比较两组的临床疗效,治疗前后血清cTn-I、Myo、CK-MB水平的变化及治疗后不良反应的发生情况。结果:治疗后,观察组总有效率明显高于对照组(P0.05),血清cTn-I、Myo、CK-MB水平均显著低于对照组[(0.23±0.10) vs.(0.16±0.08)、(27.54±3.86) vs.(21.62±2.54)、(70.82±9.25) vs.(61.28±8.33)](P0.05)。观察组治疗后不良反情况总发生率为7.89%,明显低于对照组(26.47%,P0.05)。结论:与单用阿托伐他汀治疗相比,静脉注射rh-BNP联合阿托伐他汀治疗急性心梗后心衰可显著提高临床疗效和安全性,有效减低血清cTn-I、Myo、CK-MB水平。     

西格列汀对老年2型糖尿病合并轻中度慢性心衰患者hs-CRP及NT-proBNP的影响

目的:探讨使用西格列汀对老年2型糖尿病合并轻中度慢性心衰患者外周血超敏C反应蛋白(high-sensitivity C-reactive Protein,hs-CRP)、N-端B型脑钠肽前体(N-terminal pro-B-type natriuretic peptide,NT-proBNP)的影响。方法:将我院90例老年2型糖尿病合并轻中度慢性心衰患者随机分成观察组和对照组分别46例和44例。两组患者均给予常规抗心衰治疗,对照组予以格列吡嗪控释片降糖,观察组予以西格列汀口服降糖治疗。检测试验前后患者血清hs-CRP及NT-proBNP的水平,并常规检测血压、血脂、糖化血红蛋白、血糖及肝肾功能等指标。结果:两组治疗后HbA1c水平与治疗前比较均有下降,差异均有统计学意义(P0.05);西格列汀组的hs-CRP、NT-proBNP水平治疗后分别下降至6.67±0.85 mg/L,1412.27±92.28 pg/m L,与治疗前比较差异均有统计学意义(P0.05);治疗后西格列汀组的hs-CRP、NT-proBNP水平与对照组比较差异有统计学意义(P0.05)。结论:2型糖尿病合并轻中度慢性心功能不全患者服用西格列汀除有效降糖外还能一定程度地降低hs-CRP和NT-proBNP水平,提示其潜在改善心脏功能的作用。     

诺欣妥对难治性心力衰竭患者心室重构及预后的影响研究

目的:探讨诺欣妥对难治性心力衰竭患者心室重构及预后的影响。方法:选择2017年9月～2017年12月复旦大学附属闵行医院心内科收治入院的难治性心衰患者150例并将其随机分为两组,每组各75例。所有患者均给予指南导向药物治疗(GDMT),治疗组在此基础上给予诺欣妥,起始剂量50 mg/次,2次/d,每隔2-4周倍增一次,直至剂量达到维持剂量200 mg/次,2次/d。所有患者均连续治疗4周。比较两组患者治疗前后左心室结构及功能改变、血清神经内分泌激素及脑钠肽(NT-proBNP)水平的变化、治疗期间的不良反应及随访期间的预后转归。结果:治疗后,治疗组左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)均较治疗前显著降低,左室射血分数(LVEF)较治疗前显著升高,且均明显优于对照组(P0.05)。治疗后,两组患者血清肾素(RA)、血管紧张素(AngⅡ)及NT-proBNP水平均较治疗前明显降低,且治疗组以上指标均显著低于对照组(P0.05)。两组不良反应的发生率比较差异无统计学意义(P0.05)。治疗组心衰再住院率、心源性死亡率显著低于对照组(P0.05)。结论:诺欣妥用于治疗难治性心衰可有效改善患者心功能,逆转心脏重构,降低住院率及病死率,且不增加不良反应。     

六种藓类植物茎的比较解剖学研究

通过对6种藓类植物,即褶叶青藓(Brachythecium salebrosum(Web.et Mohr.)B.S.G.)、湿地匐灯藓(Plagiomnium acutum(Lindb.)Kop.)、侧枝匐灯藓(Plagiomnium maximoviczii(Lindb.)Kop.)、大凤尾藓(Fissidensnobilis Griff.)、大羽藓(Thuidium cymbifolium(Doz.et Molk.)B.S.G.)和大灰藓(Hypnum plumaeforme Wils.)嫩茎和老茎的石蜡切片和显微观察发现,同一藓类植株的嫩茎和老茎,茎结构稳定,不同种藓类植物茎横切面具有不同特征.植物体茎横切面形状、表层细胞的层数、细胞大小和细胞壁厚薄、皮层细胞大小和形状、中轴的有无以及比例等特征可以作为藓类植物的分科分类依据之一.     

Cause of Senescence of Nine Sorts of Flowers

The levels of endogenous phytohormones and respiratory rate in nine sorts of flowers such as Cymbidium faberi Rolfe, Nopalxochia ackermannii Kunth and others were investigated both at full bloom and senescence and meanwhile the effect of exogenous phytohormones on prolonging the blossoms and promoting ethylene production were tested. There is a high content of endogenous ethylene in all the long-lived flowere, about 3–16 folds higer than the short-lived ones. There is a high level of ABA at full blooming flowers of short-lived flowers, in which there is no or only some cytokinins in it, but the ratio of CTK (6BA+zeatin)/ABA is smaller(l.7). The endogenous ABA reached a much higher level at senescence in all nine sorts of flowers, so it is reasonable to consider that it is ABA which plays an important role of regulation in controlling flower's senescence. There is a much higher level of GA3 and zeatin in the long-lived flowers which is not demonstrated in the shortlived ones. The respiratory rate is one of the factors controtling the longevity of flowers, but it does not play a decided role. Application of 6BA and zeatin prolongs distinctly orchid’s longevity, however exogenous IAA through the promotive action on ethylene production, evidently extends the longevity of the flowers of the Nopalxochia ackermannii Kunth.     

龙胆科药用植物化学成分的研究现状

龙胆科植物在我国的分布范围很广,且多数为药用植物,其多数种属的药用植物,至今其化学成分尚未被系统研究。综述了目前龙胆科药用植物的化学成分的研究现状及一般提取方法,对近年来发现的环烯醚萜及裂环烯醚萜类化合物进行了总结,为本科药用植物的更深入研究提供了参考。     

The effects of glutamine of the maintenance of embryogenic cultures of Cryptomeria japonica

Summary Embryogenic tissues of sugi (Cryptomeria japonica) were induced on a modified Campbell and Durzan (CD) medium containing 1 μM 2,4-dichlorophenoxyacetic acid (2,4-D) and 600 mg l⁻¹ glutamine, and subcultured in the medium of the same composition for over 1 yr. This resulted in a mixed culture of embryogenic and non-embryogenic cells. When embryogenic cells were isolated and cultured independently, their capacity to form embryogenic aggregates was lost. Thus, the non-embryogenic cells present within a mixed culture system were essential to the formation of embryogenic aggregates. When embryogenic tissues were isolated and cultured independently on a high glutamine-containing (2400 mg l⁻¹) medium, dry weights and endogenous levels of glutamine increased, and the tissue could generate a large number of embryogenic aggregates. Amino acid analysis of embryogenic and non-embryogenic cells from the maintenance culture indicated a higher level of glutamine was present in the latter. The high endogenous level of glutamine in the non-embryogenic portion of mixed cell masses may be the supplier of glutamine for maintaining the embryogenic property of the tissues.     

Specificity of action of piperidylcholine derivatives as substrates of cholinesterases of various origin

The review deals with study of enzymologic properties of a novel highly specific acetylcholinesterase substrate, N-(β-acetoxyethyl) piperidinium iodomethylate (“piperidylcholine”), and its 30 derivatives that were tested as effectors of cholinesterases of mammals and various species of Pacific squids. It was proven for the first time that responsible for specificity of action was structure of cyclic ammonium grouping of the alcohol part of molecule of the ester substrate. Analysis of specificity is performed based on enzymatic hydrolysis parameters—activity of catalytic center of cholinesterases and bimolecular constant of the reaction rate that are determined at optimal and low substrate concentrations. Among the specially synthesized group of thioester compounds there is revealed one more highly specific acetylcholinesterase substrate—N-(β-acetoxyethyl) piperidinium.     

真菌类遗传学分析的知识结构教学

本文以认知结构理论为指导,讨论了真菌类遗传分析与高等动植物遗传分析的内在联系,认为利用这种内在联系进行教学可收到好的效果并说明了作者的具体教学过程。 Abstract:In the paper, the relationship between genetic analysis of Fungi and genetic analysis of high animal and plant was discussed.A good results were obtained when we adopted this method in the teaching.     

医疗机构合理用药评价模型的构建研究

目的 针对医疗机构的合理用药水平进行评价研究。方法 根据医疗机构合理用药的具体要求,构建医疗机构合理用药评价指标体系,采用基于模糊群决策的方法和多指标评价分析法构建医疗机构合理用药评价模型。结果 构建了基于模糊群决策的医疗机构合理用药评价模型,并通过实例分析证明了评价模型的可行性。结论 建立的基于模糊群决策的医疗机构合理用药评价模型能够对医疗机构的合理用药水平进行科学评价,为提高医疗机构合理用药水平奠定基础。     

Photoregulation of seed germination of wild-type and of an aurea-mutant of tomato

Seed germination of an aurea mutant of tomato ( Lycopersicon esculentum Mill.) is promoted by continuous irradiation with red, far-red or long-wavelength far-red (758 nm) light as well as by cyclic irradiations (5 min red or 5 min far-red/25 min darkness). Far-red light applied immediately after each red does not change the germination behaviour. Seed germination of the isogenic wild-type, cv. UC-105, is promoted by continuous and cyclic red light while it is inhibited by continuous and cyclic far-red light and by continious 758 nm irradiation. Far-red irradiation reverses almost completely the promoting effect of red light. The promoting effect (in the aurea mutant) and the inhibitory effect (in the wild-type) of continuous far-red light do not show photon fluence rate dependency above 20 nmol m⁻² s⁻¹. It is concluded that phytochrome controls tomato seed germination throgh low energy responses in both the wild type and the au mutant. The promoting effect of continuous and cyclic far-red light in the au mutant can be attributed to a greater sensitivity to P_fr.