COPD病人急性期雾化吸入β2激动剂和激素的观察及护理

对80例COPD急性期住院病人,采用压缩雾化机加入博利康尼2.5 mg 地塞米松5 mg 生理盐水3mL,经呼吸道雾化吸入治疗7 d.结果77例效果满意(96.3%),病人喘息、呼吸困难明显减轻,肺部听诊干鸣、湿啰音明显减少,SpO2上升至97%～99%,提示COPD急性期住院病人使用压缩雾化吸入β2激动剂和激素能取得显著的治疗效果.     

Studies on granulocyte preservation. III. Effect of agitation on granulocyte concentrates

The effect of agitation on granulocyte storage was examined. Granulocyte concentrates were obtained as buffy coats from fresh blood by centrifugation and stored for up to 48 hours at 22 degrees C with or without horizontal agitation (80 rpm). The cell counts, mean cell volumes, morphologic changes, phagocytosis, and bactericidal activity of the stored granulocytes did not differ significantly. However, chemotaxis was maintained better in granulocytes that were agitated. At 48 hours, the ability of unagitated cells to adhere to both immunoglobulin-coated and uncoated glass surfaces increased, and clumps were observed on the surfaces. These results seem to be related to the decrease in chemotaxis. The pH of unagitated sedimented cells was more acid. To avoid the decrease of this local pH, stored granulocytes need gentle agitation.     

Studies on digitalis. VI. The effect of heparin on serum protein binding of digitoxin and digoxin.

The aim of the present study was to investigate the nature of the previously reported changes in the serum protein binding of digitoxin and digoxin in uremic patients under treatment with hemodialysis. Kinetic studies on protein binding during hemodialysis showed that the free fraction of digitoxin rose from 2.6% to 6.9% after 5 min of hemodialysis and remained elevated during the dialyzing period. Free digoxin rose from hemodialysis and remained elevated during the dialyzing period. Free digoxin rose from 78.3% to 87.1% during the same period. In vitro hemodialysis experiments showed that such changes occurred only in vivo. Injection of heparin (5,000 IU) to control subjects produced similar kinetic changes in the protein binding of digitoxin and digoxin. Free fatty acids changed in the same way. These results indicate that the heparin-induced release of free fatty acids causes displacement of digitoxin and digoxin from their albumin-binding sites. Patients on hemodialysis have lower serum levels of digitoxin and cardioactive metabolites (mean, 8.9 ng/ml) than control patients (mean, 16.7 ng/ml) (p less than 0.005) on similar doses (mean, 0.085 mg/day). They should be maintained on the same digotoxin doses as uremic and control patients, but serum digitoxin levels should be adjusted to 10 to 15 ng/ml in hemodialysis patients compared to 15 to 25 ng/ml in uremic patients and in patients with normal renal function.