地塞米松复合氟哌利多预防气管内麻醉下妇科腹腔镜手术后恶心呕吐的效果

目的观察地塞米松复合氟哌利多预防气管内麻醉下妇科腹腔镜手术后恶心呕吐（PONV）的临床效果。方法80例妇科腹腔镜手术患者随机分为,观察组（麻醉诱导后静注DXM 10 mg,术毕拨管后静注氟哌利多1.25 mg）和对照组（与A组同样时点静注等量生理盐水）,每组40例,观察术后6 h、24 h PONV发生例数与严重程度。结果观察组PONV发生率和程度明显低于或弱于对照组（P〈0.05）。结论麻醉诱导后和术毕分别给予地塞米松和氟哌利多可以在一定程度上预防妇科腔镜手术后恶心呕吐发生。     

氟哌利多与托烷司琼预防腹腔镜阑尾切除术后恶心呕吐的疗效观察

目的:观察氟哌利多、托烷司琼预防腹腔镜阑尾切除术后恶心呕吐的临床疗效。方法:选择60例择期行全凭静脉麻醉下腹腔镜阑尾切除术的患者,随机分为A、B、C组,每组20例,分别在开始缝合前静脉注射0.9%氯化钠10mL(A组)、氟哌利多1.25mg(B组)、托烷司琼5mg(C组)。术毕清醒后拔管,观察记录术后24h患者发生恶心呕吐的情况。结果:B、C组的术后恶心呕吐发生率明显低于A组(P<0.05);B、C组比较差异无统计学意义(P>0.05)。结论:氟哌利多和托烷司琼均可显著降低腹腔镜阑尾切除术后恶心呕吐的发生率,二者疗效相当。     

氟比洛芬酯复合吗啡硬膜外腔镇痛对妇科术后镇痛效果的观察

目的：探讨氟比洛芬酯复合吗啡硬膜外腔多模式镇痛对妇科术后镇痛效果的观察。方法：选择ASAⅠ～Ⅱ级、择期全子宫切除患者90例,随机等分为A、B、C组（各30例）。A组：采用硬膜外腔自控镇痛（吗啡5mg＋罗哌卡因125mg＋氟哌利多2.5mg）,术毕时连接PCEA泵;B组：采用吗啡硬膜外腔镇痛,术毕时硬膜外注射吗啡2mg＋氟哌利多1.5mg,18h后硬膜外再追加吗啡2mg,拔出硬膜外导管;C组：采用吗啡单次硬膜外腔镇痛术复合氟比洛芬酯静脉镇痛,术毕硬膜外注射吗啡2mg＋氟哌利多1.5mg后拔出硬膜外导管,18h后静脉注射氟比洛芬酯100mg,8h后重复注射氟比洛芬酯100mg。观察记录3组的镇痛效果（VAS评分）和不良反应。结果：3组均能取得良好的镇痛效果,VAS评分无显著性差异（P〉0.05）。C组恶心、呕吐、皮肤瘙痒和尿潴留等不良反应的发生率组明显少于A、B组（P〈0.05）。结论：3组均取得了良好的镇痛效果,但是氟比洛芬酯复合吗啡硬膜外镇痛方式可明显减少不良反应的发生。     

恩丹西酮复合地塞米松或氟哌利多对妇科腹腔镜术后恶心呕吐的预防

目的：比较恩丹西酮分别复合地塞米松、氟哌利多对妇科腹腔镜术后恶心呕吐的预防作用。方法：择期腹腔镜妇科手术160例,随机均分为4组,于开始缝皮时,A组静注恩丹西酮4mg,B组静注恩丹西酮4mg＋地塞米松5mg,C组静注恩丹西酮4mg＋氟哌利多1.25mg,D组静注0.9%氯化钠溶液5ml。观察术后恶心呕吐情况。结果：A、B、C组恶心呕吐发生率明显低于D组（P〈0.05）,B、C组也明显低于A组（P〈0.05）,而B、C组间比较,差异无统计学意义（P〉0.05）。结论：恩丹西酮能有效预防妇科腹腔镜术后恶心呕吐的发生,分别复合地塞米松或氟哌利多更能有效地预防妇科腹腔镜术后恶心呕吐的发生。     

昂丹司琼复合氟哌利多预防妇科腹腔镜术后恶心呕吐的临床观察

目的:探讨昂丹司琼复合氟哌利多对妇科腹腔镜手术后恶心呕吐的预防作用.方法:选用120例妇科腹腔镜手术病人随机分成A、B、C、D四组,分别给予氟哌利多2 mg、昂丹司琼4mg、昂丹司琼4mg 氟哌利多2mg、生理盐水于诱导前10分钟静脉注射,观察术后24小时恶心、呕吐发生情况.结果:四组病人恶心发生率情况:A、B、C组恶心发生率明显低于D组(P<0.05),与A、B组比较,C组的恶心发生率明显降低(P<0.05).四组病人呕吐发生率情况:A、B、C组呕吐发生率明显低于D组(P<0.05),与A、B组比较,C组的呕吐发生率明显降低(P<0.05).结论:预注昂丹司琼联合小剂量氟哌利多可较好地预防腹腔镜妇科手术后恶心呕吐的发生率,比单独使用效果更好.     

小剂量氟哌利多在预防妇科腹腔镜术后恶心呕吐的效果观察

目的:探讨腹腔镜手术中给予小剂量氟哌利多对术后恶心呕吐(postoperative nausea and vomiting,PONV)的预防效果.方法:选择200例ASA Ⅰ～Ⅱ级择期妇科腹腔镜手术患者,随机分为两组:术中给予氟哌利多组(F组)和对照组(D组).两组患者的麻醉诱导方法、麻醉维持药物及术中输液管理方法均相同,F组术毕前30 min给予氟哌利多1 mg,D组术毕前30 min给予生理盐水1mL.观察术后24h内恶心呕吐的发生情况、氟哌利多不良反应及其他全麻并发症.术中心电图监测有异常者和术后苏醒延迟、呼吸道梗阻、血流动力学不稳定(低血压或高血压)、术中知晓等并发症者剔除本研究.结果:两组患者均未出现锥体外系反应等氟哌利多的不良反应,两组患者PONV发生率F组为12.9％,D组为38.5％,比较两组差异有极显著性(P＜0.01);PONV程度分级构成比比较两组差异有极显著性(P＜0.01).结论:术中给予小剂量氟哌利多能显著降低PONV发生率,减轻恶心呕吐的程度,是一种安全、有效、经济的预防PONV的措施,值得在基层医院推广应用.     

昂丹司琼用于胃癌根治术后静脉自控镇痛对恶心呕吐的影响

目的观察昂丹司琼用于胃癌根治术后静脉自控镇痛（pafients-controlled intravenous analgesia,PCIA）对术后恶心呕吐的影响。方法根据术后静脉自控镇痛给药方式不同将胃癌根治术病人90例随机分为3组，A组（昂丹司琼组，n=31）：芬太尼1mg＋昂丹司琼16mg；B组（氟哌利多组，n=30）：芬太尼1mg＋氟哌利多5mg；C组（对照组，n=29）：芬太尼1mg。将上述各组药物加等渗盐水配成100ml。输注速率为2ml／h．单次自控量为2ml。锁定时间15min，维持时间48h。观察病人术后48h恶心、呕吐次数、疼痛程度及镇静评分。结果3组间镇痛评分无显著性差异（P〉0．05）；A组镇静评分小于B组（P〈0。05）；A组及B组术后恶心、呕吐发生率明显小于C组（P〈0．05）。结论昂丹司琼用于胃癌根治术后静脉自控镇痛对术后恶心、呕吐有预防作用，效果与氟哌利多无差异，但对术后镇静作用小于氟哌利多。     

地塞米松预防整形美容术后PCA恶心呕吐的临床观察

目的：观察地塞米松对美容术后芬太尼静脉自控镇痛（PCA）后发生恶心呕吐的预防效果。方法：选择静脉复合全麻及静吸复合全麻下行整形美容术患者为观察对象,共817例,术毕接PCA泵行芬太尼静脉PCA（PC IFA）。将患者随机分成A、B两组,A组425例,B组392例。A组予氟哌利多2.5 mg加入静脉泵中;B组予地塞米松8 mg于静脉诱导前静推,并于镇痛泵中加入地塞米松10 mg,氟哌利多2.5 mg。于术后24 h观察有无恶心、呕吐。结果：A组术后恶心、呕吐发生率高于B组,差异有统计学意义（P〈0.05）。结论：地塞米松较传统用氟哌利多能更有效地防治PC IFA引起的恶心呕吐。     

妇科患者硬膜外麻醉术后托烷司琼止吐的疗效观察

目的观察妇科手术患者硬膜外麻醉后托烷司琼、氟哌利多、甲氧氯普胺预防恶心呕吐（PONV）的临床效果。方法选择150例择期妇科手术患者,随机分成3组,每组50例。A组手术结束前15min静脉缓慢注射托烷司琼5mg;B组手术结束前15min缓慢注射氟哌利多5mg;C组术后肌内注射甲氧氯普胺5mg/次,每天2次。观察比较3组术后24hPONV的发生情况。结果 3组患者术后24hPONV总发生率分别为10.0%、30.0%、56.0%,A组术后PONV总发生率与B组和C组比较差异均有统计学意义（P〈0.05）。结论托烷司琼用于预防妇科手术硬膜外麻醉患者PONV,效果明显优于氟哌利多和甲氧氯普胺,值得临床推广。     

阿扎司琼预防心脏手术术后镇痛所致恶心呕吐的效果分析

目的：观察阿扎司琼在心外科术后预防镇痛所致恶心呕吐的效果。方法选取2012年11月～2013年11月84例美国麻醉协会（ASA）Ⅰ或Ⅱ级择期心外科手术患者,随机分为四组,阿扎司琼A1、A2组、氟哌利多B组和对照组C组,每组各21例,术后镇痛泵中均给予舒芬太尼。结果镇痛治疗后6、12、24、48 h四组VAS评分均在1～4分之间,差异无统计学意义;B组镇静评分较高,术后12 h评分显著高于其他三组（P＜0.05）。48 h恶心、呕吐发生率以C组最高（P＜0.05）,A1、A2组恶心、呕吐发生率低于B组,但是差异无统计学意义（P＞0.05）。结论在患者自控镇痛治疗中阿扎司琼可有效减少恶心、呕吐的发生率,效果优于氟哌利多,但镇静作用不明显。     

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.