Gaseous homeostasis during low-flow anaesthesia

The object of this clinical study was to investigate the circle system gas homeostasis during low-flow anaesthesia using a technique designed to keep a constant inspired oxygen fraction of 0.30. Denitrogenation was adequately accomplished with mask preoxygenation, 10 l/min, for 1 min and an initial fresh gas flow of 5 l/min for 6 min after intubation. There was no need to wash out accumulated nitrogen at intervals, since the already low nitrogen concentration in the system tended to decrease after 1 h. The fresh gas flow of nitrous oxide to oxygen ratio and the inspiratory to end-expiratory oxygen concentration difference both reflected the uptake of nitrous oxide. The calculated rates of uptake of nitrous oxide, a subject of controversy, were in accordance with those found by Severinghaus and Barton & Nunn.     

瘦素、胆囊收缩素、血脂与胆石类型关系探讨

目的探讨瘦素（leptin）、缩胆囊肽（CCK）、血脂、胆固醇与Gs和HS两类胆石病关系。方法比较检测339例胆囊结石（Gs），67例肝胆管结石（HS）病员，20例正常对照者血清leptin、CCK、胰岛素、肝功能、血脂、脂蛋白等，评价各检测指标间关系。结果GS组leptin、CCK、BMI、胆固醇、甘油三酯、白蛋白、GGT、APO-a显著高于HS组（P〈0．05）；GS组内leptin与CCK、BMI、胰岛素、转氨酶、胆红素、胆固醇呈正相关（P〈0．05）；HS组内leptin与CCK、BMI、胰岛素、转氨酶、胆红素呈正相关（P〈0．01），与白蛋白、APO-a呈负相关（P〈0．05）。结论Leptin参与调控脂质代谢，两类胆石Leptin、血脂等存在明显差别，从调控脂质代谢角度探讨Leptin在两类胆石中的作用可能对阐明胆石成因具有价值。     

血浆置换治疗97例重型肝炎并发症的防治

目的探讨血浆置换治疗重型肝炎时并发症的发生原因及防治措施。方法回顾血浆置换治疗97例重型肝炎时出现的并发症的有关资料，分析各种并发症发生的原因。结果26．6次治疗中共出现并发症131次，发生率达49.3％。按发生率高低依次为皮疹、麻木和（或）搐搦、血压下降、胸闷、失衡综合征、置管处渗血、体外循环凝血及置管处渗液。结论血浆置换治疗重型肝炎时并发症的发生率高，但经处理均能缓解，可以在严密监护下实施。     

胸骨浆细胞肉芽肿1例报告

浆细胞肉芽肿临床较少见,常发生于肺、眼眶及消化道等部位,发生于骨则罕见。大部分骨的浆细胞肉芽肿发生于颞骨,发生于胸骨者尚少见报道。现将我院胸骨浆细胞肉芽肿1例报告如下。     

人红细胞胆固醇含量的增龄变化

用胆固醇酶联试剂显色法检测１８９例健康成人红细胞胆固醇和血浆胆固醇含量，结果表明，健康成人的Ｅ－Ｃｈ含量随增龄而升高，并呈直线相关；Ｐ－Ｃｈ含量也随增龄而升高，并呈直线相关；Ｅ－Ｃｈ含量呈直线正样关。提示Ｅ－Ｃｈ含量检测可作为反映机体衰老程度的一项客观指标。     

Vascular Access for Therapeutic Plasma Exchange

Abstract: Adequate venous access is an essential component of therapeutic plasma exchange (TPEX). The simplest kind of venous access is venipuncture of antecubital veins, but this technique may be limited by venous size or scarring following the procedure, requiring the placement of a specialized vascular access device (VAD). VADs provide reliable central venous access and may remain in place for several weeks or months, depending on the VAD and the venous site chosen. Their use, however, is potentially limited by the risk of complications. We discuss indications for insertion, choice of catheter and access site, and complications of VAD placement for TPEX.     

检测胞浆抗原用于急性白血病免疫分型

目的:探讨胞浆抗原在急性白血病免疫分型中的临床意义。方法:用流式细胞仪检测42例初治急性白血病患者胞浆抗原CyCD_3,CyCD_(22),CyCD_(79a)和MPO。结果:T—ALL阳性胞浆抗原主要表达在CyCD_3,阳性率占88.9％。B—ALL阳性胞浆抗原主要表达在CyCD_(79a),AML主要表达CyMPO。结论:CyCD_3和CyCD_(79a),及MPO可分别作为T—ALL,B—ALL和AML系列特异性标志,对正确诊断白血病提供非常有价值的依据。     

血浆纤维蛋白原水平在颅脑损伤病人中的变化及其意义

目的探讨血浆纤维蛋白原水平与急性单纯闭合颅脑损伤患者严重程度的相关意义。方法检测180例于伤后24h内到院的急性闭合颅脑损伤患者的格拉斯哥昏迷评分、纤维蛋白原含量。结果颅脑损伤病人血浆中纤维蛋白原水平明显降低;颅脑损伤越严重,血浆中纤维蛋白原含量越低,颅脑损伤越轻,纤维蛋白原含量越高,预后越好。结论血浆中纤维蛋白原水平与颅脑损伤严重程度存在明显相关性,可作为颅脑损伤严重程度的判断参考指标。     

肾脏疾病患者治疗前后血浆内皮素水平动态变化及其意义

目的 为了探讨肾脏疾病患者血浆内皮素水平与肾脏疾病病情程度的关系,为肾脏疾病治疗效果的评价提供依据.方法 采用放射免疫分析(RIA)观察了77例肾脏疾病患者治疗前后血浆内皮素水平的动态变化,并与60例正常对照组比较.结果 正常对照组血浆内皮素浓度为43.1±15.2ng/L,肾脏疾病患者治疗前血浆内皮素水平为161±83.8ng/L,治疗后为97.4±52.7ng/L,均高于正常对照组(P值均<0.001).肾脏疾病治疗后内皮素水平明显下降(P<0.001),与BUN,Cr水平的下降具有一定的相关性(相关系过分别为0.54,0.55).结论血浆内皮素水平随着肾脏疾病严重程度的增加而升高,血浆内皮素水平可作为肾脏疾病治疗效果评定的指标之一     

Determinants of plasma concentrations of nicotine and cotinine during cigarette smoking and transdermal nicotine treatment

Objective: Interindividual variability in plasma concentrations of nicotine and its proximate metabolite, cotinine, is considerable during smoking and transdermal nicotine treatment, even among individuals taking in nominally similar doses of nicotine. This report explores the determinants of this variability and the utility of baseline (smoking) plasma concentrations to predict concentrations during transdermal nicotine treatment. Methods: Data were analysed from a smoking cessation study (n = 466), and from a pharmacokinetic study (n = 12). Multiple regression models examined the relationships of plasma concentrations to individual characteristics such as smoking pattern, absorbed dose of nicotine, and pharmacokinetic parameters. Results: Plasma concentrations of nicotine and cotinine were highly variable in both studies. Indirect estimates of plasma clearance (baseline plasma concentration divided by cigarettes per day) together with other factors could account for 18 to 33% of the variability during transdermal nicotine treatment in the smoking cessation study. In contrast, 75 to 99% was accounted for by direct measurements of plasma clearances and systemic dose of nicotine in the pharmacokinetic study. Conclusion: Plasma concentrations of nicotine and cotinine during transdermal nicotine treatment are poorly predicted by clinical history or baseline plasma concentrations. This is a result of inadequate characterisation of highly variable individual pharmacokinetic parameters and absorbed dose of nicotine. Considering the interindividual variability of plasma nicotine and cotinine concentrations together with the lack of clinical end-points for transdermal nicotine dosing, it seems logical to investigate the utility of a therapeutic drug monitoring approach for transdermal nicotine treatment – particularly for high dose regimens (> 22 mg per 24 hours). Received: 7 May 1996 / Accepted in revised form: 21 August 1996