Influence of moderate hypothermia on cerebral oxygenation in pigs with intracranial hypertension

BACKGROUND: Moderate hypothermia is one of the effective therapeutic methods for head injury in recent years, there are many mechanisms of moderate hypothermia for brain protection, and its influence on cerebral oxygenation is also one of them. OBJECTIVE: To observe the influence of moderate hypothermia on cerebral oxygenation of animals with acute intracranial hypertension, and further investigate the protective mechanism of moderate hypothermia. DESIGN: A randomized controlled trial. SETTING: Department of Neurosurgery, Renji Hospital affiliated to the Medical College of Shanghai Jiao Tong University. MATERIALS: Twenty healthy little pigs, either male or female, weighing 4.5–5.5 kg, were used. Neurotrend-typed multiparameter monitoring system (Diametrics Company, British); CMA/100 micro-injection pump (Carnegie Company, Sweden). METHODS: The experiment was conducted in the Changzheng Hospital affiliated to the Second Military Medical University of Chinese PLA in November, 2001. The pigs were randomized into two groups: the normothermia group (control group, n =10) and moderate hypothermia group (n =10). ① Bilateral femoral arteries were separated, one was connected to pressometer for monitoring mean arterial pressure (MEP), and the other for analysis of blood gases [including peripheral blood pH value, arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of carbon dioxide (PaCO2), HCO3–]. ② Rectal temperature was monitored with mercurial thermometer. ③ Intracranial pressure was monitored using Camino optic ICP probe placed in the subdural space. ④ Neurotrend multiparameter monitoring sensor was inserted into the white matter for about 4 cm to determine cerebral perfusion pressure (CPP, CPP=MAP(ICP), brain tissue partial oxygen pressure (PO2), partial pressure of carbon dioxide (PCO2), HCO3– and brain temperature. The rectal temperature of animals in the moderate hypothermia group was lowered to 34 ℃ using ice bags, and the body temperature was maintained at 33–35 ℃ for 2 hours. The changes of the parameters were observed continuously, and the pigs in the normothermia group were not treated with cooling. MAIN OUTCOME MEASURES: ① MAP, ICP, rectal temperature, CCP; Indexes of cerebral oxygenation detected with Neurotrend-typed multiparameter monitoring system; ② Results of blood gases analysis in the moderate hypothermia group. RESULTS: All the 20 pigs were involved in the analysis of results. ① MAP, ICP, rectal temperature, CCP and indexes of cerebral oxygenation: In the moderate hypothermia group, the ICP after cooling was obviously lower than that before cooling [(3.31±1.19), (5.33±0.95) kPa, P < 0.05], CCP was higher, brain tissue PCO2 [(12.03±1.73), (10.59±2.01) kPa, P < 0.05], and brain tissue pH value was higher [(7.03±1.63), (9.40±1.30) kPa, P < 0.05], whereas the brain temperature was decreased as compared with that before cooling [(34.9±0.3), (37.2±0.2) ℃, P < 0.05]. ② Results of blood gases analysis in the moderate hypothermia group: There were no significant differences in the parameters of peripheral arterial blood gases analysis before and after cooling in the moderate hypothermia group (P > 0.05) CONCLUSION: Moderate hypothermia will not impair the cerebral oxygenation, and it can reduce brain tissue CO2 and decrease brain tissue acidosis.     

阿魏酸及其衍生物在肾脏病中的应用

阿魏酸（ferulic acid），化学名称为4-羟基-3-甲氧基苯丙烯酸，是植物界中广泛存在的一种酚酸，它与细胞壁中的蛋白质和多糖结合，构成细胞壁的骨架。阿魏酸普遍存在于川芎、当归、阿魏、木贼、升麻、樟白皮及酸枣仁等中药材中，是这些中药重要的有效成分之一。近年来，人工合成了一系列的阿魏酸衍生物，通过对其药理活性进行观察和筛选，得到一些药理作用强且毒副作用较低的化合物，其中有一部分已被应用于临床，并且取得了良好的治疗效果，比如阿魏酸钠（sodium ferulate，SF）和阿魏酸哌嗪（piperazine ferulate）。     

仙人掌粉对糖尿病大鼠血糖的影响

目的　研究仙人掌对糖尿病血糖的影响。方法　采用四氧嘧啶造成大鼠实验性糖尿病模型 ,然后将高、中、低 3种剂量的仙人掌粉加入到基础饲料中进行实验观察。结果　仙人掌粉高 (10g kg·d)、中 (5 .0g kg·d)剂量组均可显著降低糖尿病大鼠空腹血糖 ,并且高剂量组具有显著改善糖尿病大鼠尿量增加的作用。各剂量组对正常大鼠血糖无明显影响。结论　仙人掌粉能有效降低四氧嘧啶所导致的糖尿病大鼠的血糖、尿量     

青霉素过敏引发咽喉部急性水肿1例

患者，姜某，女性，18岁。2001年10月16日因发热咳嗽来院就诊，经检查确诊为上呼吸道感染。于15：30，在按操作常规进行青霉素皮试，试验结果为阴性后，给予5％葡萄糖200ml，青霉素800万静点。大约30分钟后，患者自觉胸闷，呼吸不畅，咽部有阻塞感，立即拔下青霉素液体急来我科就诊。当时见患者急性发热病容，神志清，语言流利，体温38℃，脉搏92次，分，血压100／70mmHg。     

你会与丈夫共享『性福』吗?

婚姻是男女双方共同生活的契约,性是夫妻之间感情交流的一种方式,正常的性生活不仅能让心情愉悦舒畅,有益身心健康,而且能防止或减少多种妇科疾病的发生。科学研究证实,男子精液含有一种与青霉素媲美的重要抗菌物──精液胞浆素。但在日常生活中,不少女士因缺乏性生活经验,不知在床上如何取悦丈夫,与丈夫共享“性福”。有的只是机械地从录像片里搬来某些手法运用在丈夫身上。殊不知,每个人都是不同的个体,是无法生搬硬套用录像片的方式来进行床第之事的。为此,专家提醒女士注意以下事项,尽情与丈夫共享“性福”。1.观察掌握丈夫喜欢的性交方…     

青霉素临床应用中的不安全因素

青霉素因高效、低毒在临床实践中至今仍广泛应用。但除了人们熟悉的过敏性休克外，人们对其它的不安全因素——不良反应容易忽视，本文将简述青霉素的某些不良反应的特点、规律，旨在更合理、规范的应用青霉素，以减少不良反应的发生。     

医院变压吸附式制氧设备的使用和管理

本文结合医院情况简述了变压吸附式制氧设备的安装质量控制、安全操作和维护保养,指出变压吸附式制氧是今后医院制氧方式的一个发展方向.     

410例药疹临床分析

通过对410例药疹临床分析，发现最常见致敏药物分别为头孢菌素和氨苄青霉素类、解热镇痛类、狂犬疫苗、磺胺类和四环素类等，表现多为猩红热样型、麻疹样型、等麻疹型及粘膜水肿或溃烂型。     

Kv2.1钾通道在神经元缺氧损伤中的潜在药理学作用

 目的观察钾通道阻断剂四乙铵(TEA)对缺氧缺血损伤整体、离体模型的保护作用,阐明Kv2.1电压依赖性钾通道在缺氧缺血细胞损伤中发挥的作用。方法应用大鼠暂时性大脑中动脉阻塞(tMCAO)脑缺血模型验证TEA对脑缺血损伤的保护作用。采用膜片钳技术观察氧糖剥夺(OGD)对稳定转染Kv2.1钾通道的人胚胎肾293(HEK293)细胞膜电位以及TEA对OGDKv2.1-HEK293细胞钾电流的影响。MTT法观察OGD对Kv2.1-HEK293的损伤及TEA的保护作用。结果TEA(5μg·kg^-1)侧脑室注射可以显著减小tMCAO大鼠的脑梗死体积;应用转基因细胞的研究证实Kv2.1-HEK293对OGD损伤的敏感性明显提高;OGD可以降低Kv2.1-HEK293细胞膜电位;TEA(10mmol·L^-1)能显著抑制OGDKv2.1-HEK293钾电流,同时使其所受的细胞损伤降低。结论钾通道阻断剂TEA对整体和离体缺氧缺血损伤模型均发挥细胞保护作用,这种保护作用与对Kv2.1的阻断密切相关;提示Kv2.1可能是抗脑缺血药物开发的潜在靶点。