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1.
BackgroundCalcium chloride is commonly used in emergency departments in the treatment of a variety of emergencies. Historically, administration via central venous catheters has been preferred owing to its high osmolarity and vesicant properties. Although preferred, central access may not always be available in time-sensitive, emergent situations leading to many instances of peripheral administration. The objective of this analysis was to evaluate the charted safety of peripheral venous administration of 10% calcium chloride.MethodsA single-center retrospective chart review was performed in patients who received 10% calcium chloride in the adult emergency department evaluating for the incidence of infusion-related adverse events. Patients were excluded if they were less than 18 years of age or had a lack of catheter documentation during 10% calcium chloride administration or if the 10% calcium chloride was documented as given through a central venous catheter.ResultsA total of 72 administrations were evaluated. Patients were predominantly male (67%), with a median age of 55 years and body mass index of 29.2. The primary outcome demonstrated that 4 infusion-related adverse events occurred (6%) with grade 1 (n = 1) and grade 0 (n = 3) documented incidence of infusion-related adverse events. None of the documented incidence of infusion-related adverse events resulted in permanent tissue injury, and all patients had conservative management.DiscussionThis study demonstrated that administration of 10% calcium chloride via peripheral venous catheters may be feasible and seemed to carry a low incidence of documented complications. Further prospective studies are needed to confirm study observations.  相似文献   
2.
背景 高盐饮食是高血压、脑卒中及心血管疾病危险因素,血压变异性(BPV)是可靠的心血管事件和死亡的独立预测因子,目前摄盐量与BPV关系的研究较少。目的 探讨宁夏地区社区高血压人群摄盐量与BPV的关系。方法 于2015年1月-2017年1月在银川市某社区采用机会性筛查、重点人群筛查、健康体检筛查等筛查方法选取605例高血压患者为研究对象。通过问卷调查和体格检查收集患者人口统计学指标、疾病史、心血管疾病相关行为等资料,采集空腹静脉血检测三酰甘油、总胆固醇(TC)、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇(HDL-C)、空腹血糖等指标,并对其进行24 h动态血压监测。采用称重法计算患者每日盐摄入量,按摄盐总量分为低摄盐组332例和高摄盐组273例。比较低摄盐组和高摄盐组基本情况、实验室检查指标、动态血压监测结果,采用多元线性回归分析BPV的影响因素。结果 低摄盐组和高摄盐组性别、体质指数(BMI)、吸烟情况、饮酒情况、运动频率及心血管病家族史比较,差异有统计学意义(P<0.05)。高摄盐组HDL-C、TC低于低摄盐组(P<0.05)。低摄盐组和高摄盐组白天平均收缩压(dSBP)、白天平均舒张压(dDBP)、白天平均动脉压(dMAP)、夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP)、夜间平均动脉压(nMAP)、24 h平均收缩压(24 hSBP)、24 h平均舒张压 (24 hDBP)、24 h平均动脉压(24 hMAP)比较,差异无统计学意义(P>0.05)。高摄盐组白天收缩压标准差(dSBPSD)、白天平均动脉压标准差(dMAPSD)、24 h 收缩压标准差(24 hSBPSD)、24 h舒张压标准差(24 hDBPSD)、24 h平均动脉压标准差(24 hMAPSD)高于低摄盐组(P<0.05)。多元线性回归分析结果显示,在未调整的模型,调整性别、年龄、民族、BMI模型,调整性别、年龄、民族、BMI、吸烟情况、饮酒情况、劳动强度、运动频率、糖尿病史、心血管病家族史模型中,摄盐量均是dSBPSD、dMAPSD的影响因素(P<0.05)。结论 高血压患者摄盐量是dSBPSD、dMAPSD的影响因素,指导高血压患者合理限盐饮食,对控制患者血压水平和BPV具有重要的临床意义。  相似文献   
3.
目的:探讨丁苯酞氯化钠注射液联合奥扎格雷钠注射液治疗急性进展性脑梗死的临床疗效。方法:对儋州市人民医院2017年6月至2019年5月收治的116例急性进展性脑梗死患者进行回顾性研究,根据治疗方式的不同分为观察组、对照组,每组58例。对照组患者采用奥扎格雷钠注射液治疗,观察组患者采用丁苯酞氯化钠注射液联合奥扎格雷钠注射液治疗。比较两组患者临床疗效,治疗前后美国国立卫生院卒中神经功能缺损评分量表(national institutes of health stroke scale,NIHSS)评分、Barthel指数及凝血因子水平变化和不良反应发生情况的差异。结果:观察组患者的总有效率为89.66%(52/58),明显高于对照组的74.14%(43/58),差异有统计学意义(P<0.05)。治疗后,两组患者NIHSS评分明显低于治疗前,Barthel指数明显高于治疗前;且观察组患者NIHSS评分明显低于对照组,Barthel指数明显高于对照组,上述差异均有统计学意义(P<0.05)。治疗后,两组患者活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)及国际标准化比值(INR)水平均明显高于治疗前,纤维蛋白原(FIB)水平明显低于治疗前;且观察组患者APTT、PT及INR水平明显高于对照组,FIB水平明显低于对照组,上述差异均有统计学意义(P<0.05)。观察组、对照组患者不良反应发生率[13.79%(8/58)vs.10.34%(6/58)]的差异无统计学意义(P>0.05)。结论:丁苯酞氯化钠注射液联合奥扎格雷钠注射液治疗急性进展性脑梗死的临床疗效显著,可有效减轻患者神经功能受损现象,改善凝血功能。  相似文献   
4.
Th2 cells have evolved to protect from large helminth infections and to exert tissue protective functions in response to nonmicrobial noxious stimuli. The initiation, maintenance, and execution of these functions depend on the integration of diverse polarizing cues by cellular sensors and molecular programs as well as the collaboration with cells that are coopted for signal exchange. The complexity of input signals and cellular collaboration generates tissue specific Th2 cell heterogeneity and specialization. In this review, we aim to discuss the advances and recent breakthroughs in our understanding of Th2 cell responses and highlight developmental and functional differences among T cells within the diversifying field of type 2 immunity. We will focus on factors provided by the tissue microenvironment and highlight factors with potential implications for the pathogenesis of allergic skin and lung diseases. Especially new insights into the role of immunometabolism, the microbiota and ionic signals enhance the complexity of Th2 cell regulation and warrant a critical evaluation. Finally, we will discuss how this ensemble of established knowledge and recent breakthroughs about Th2 immunobiology advance our understanding of the pathogenesis of allergic diseases and how this could be exploited for future immunotherapies.  相似文献   
5.
Imbalances between cellular K+ efflux and influx are considered to be involved in cerebral ischemia-reperfusion (I/R) injury. High-potassium pretreatment alleviates this injury, but the underlying molecular mechanism is unclear. In this study, we sought to investigate whether high-potassium preconditioning enhances cerebral tolerance to I/R injury through an anti-apoptotic mechanism. Adult male Sprague-Dawley rats were randomly divided into four groups (n = 40/group): a sham-operated group, normal saline group (3.2 ml/kg saline, intravenous (IV)), and low-dose and high-dose potassium chloride (KCl) groups (40 and 80 mg/kg KCl solution, IV, respectively). Subsequently, the rats underwent 90 min of middle cerebral artery occlusion (MCAO) followed by 24 hr of reperfusion (MCAO/R). Neurological deficit scores, 2,3,5-triphenyltetrazolium chloride (TTC) staining, hematoxylin and eosin staining, and TUNEL assay were used to assess neural injury. The expression of apoptotic proteins, brain potassium levels, mitochondrial function and oxidative stress were detected to explore the potential mechanism. After 24 hr of reperfusion, in both KCl treatment groups, neurological deficits and the cerebral infarct volume were reduced, and the apoptosis index of neurons was decreased. Furthermore, high-potassium preconditioning increased brain K+, adenosine triphosphate (ATP), cytochrome c oxidase (COX) levels, reduced malondialdehyde level, improved Na+/K+-ATPase, succinic dehydrogenase and superoxide dismutase activities, upregulated anti-apoptotic protein expression, and downregulated pro-apoptotic protein expression. This study suggests that high-potassium preconditioning enhanced cerebral tolerance to I/R injury in a rat MCAO/R model. The protective mechanism may involve apoptosis inhibition via preservation of intracellular K+ and improvement of mitochondrial function.  相似文献   
6.
7.
许明星  郑传东  杨鹏  杨娜 《西部医学》2021,33(3):342-346+351
【摘要】目的 研究硫喷妥钠对氯化钴(CoCl2)诱导的大鼠心肌细胞H9c2缺氧损伤的保护作用及潜在机制。方法 对H9c2细胞进行CoCl2处理建立缺氧损伤模型(模型组),分别采用125、250、500 nmol/L的硫喷妥钠处理600 μmol/L CoC2的DMEM培养液培养H9c2细胞,分别记为药物1、2、3组,对照组为不含CoCl2的DMEM培养液培养H9c2细胞。CCK8法和流式细胞术分别检测细胞存活率和凋亡率,Western blot测定P21和Caspase 3蛋白水平,分光光度法测定H9c2细胞中丙二醛(MDA)含量、超氧化物歧化酶(SOD)活性,qRT PCR检测CoCl2诱导后H9c2细胞miR 664 1 5p的表达水平。结果 与对照组相比,模型组心肌细胞H9c2中MDA、P21和Caspase 3含量升高,细胞存活率降低,凋亡率升高,miR 664 1 5p含量和SOD活性均降低,差异均具有统计学意义(均P<005);与模型组相比,药物2组和药物3组H9c2细胞中MDA、P21和Caspase 3含量降低,细胞存活率升高,凋亡率降低,miR 664 1 5p含量和SOD活性均上升,差异均具有统计学意义(均P<005);过表达miR 6641 5p可抑制CoCl2诱导的H9c2细胞凋亡,提高细胞存活率;抑制miR 664 1 5p能减弱硫喷妥钠对CoCl2诱导的心肌细胞缺氧损伤的保护作用。结论硫喷妥钠通过miR 664 1 5p提高CoCl2诱导的大鼠心肌细胞H9c2存活率,抑制细胞凋亡,减轻细胞损伤。  相似文献   
8.

Objective

Hypertonic saline (HTS) has potent immune and vascular effects. We assessed recipient pretreatment with HTS on allograft function in a porcine model of heart transplantation and hypothesized that HTS infusion would limit endothelial and left ventricular (LV) dysfunction following transplantation.

Methods

Heart transplants were performed after 6 hours of cold ischemic storage. Recipient pigs were randomized to treatment with or without HTS (7.5% NaCl) before cardiopulmonary bypass (CPB). Using a myograft apparatus, coronary artery endothelial-dependent (Edep) and -independent (Eind) relaxation was assessed. LV performance was determined using pressure-volume loop analysis. Pulmonary interleukin (IL)-2, IL-6, and tumor necrosis factor (TNF)-α expression was measured.

Results

Weaning from CPB and LV performance after transplantation were improved in HTS-treated animals. Successful weaning from CPB was greater in the HTS-treated hearts (8 of 8 vs 2 of 8; P < .05). Mean LV functional recovery was improved in the HTS-treated animals, as assessed by preload recruitable stroke work (65 ± 10% vs 27 ± 10%; P < .001) and end-systolic elastance (55 ± 7% vs 37 ± 4%; P < .001). Treatment with HTS resulted in improved Edep (mean maximum elastance [Emax], 56 ± 5% vs 37 ± 7%; P < .001) and Eind (mean Emax%, 77 ± 6% vs 52 ± 4%; P < .001) vasorelaxation compared with control. Pulmonary expression of IL-2, IL-6, and TNF-α increased following transplantation, whereas HTS therapy attenuated IL production (P < .001). Transplantation increased plasma TNF-α levels and LV TNF-α expression, whereas HTS prevented this up-regulation (P < .001).

Conclusions

Recipient HTS pretreatment preserves allograft vasomotor and LV function, and HTS therapy limits CPB-induced injury. HTS may be a novel recipient intervention to prevent graft dysfunction.  相似文献   
9.

Background

We have recently shown that human epididymis protein 4 (HE4) levels correlate with the severity of cystic fibrosis (CF) lung disease. However, there are no data on how HE4 levels alter in patients receiving CFTR modulating therapy.

Methods

In this retrospective clinical study, 3 independent CF patient cohorts (US-American: 29, Australian: 12 and Irish: 19 cases) were enrolled carrying at least one Class III CFTR CF-causing mutation (p.Gly551Asp) and being treated with CFTR potentiator ivacaftor. Plasma HE4 was measured by immunoassay before treatment (baseline) and 1–6?months after commencement of ivacaftor, and were correlated with FEV1 (% predicted), sweat chloride, C-reactive protein (CRP) and body mass index (BMI).

Results

After 1?month of therapy, HE4 levels were significantly lower than at baseline and remained decreased up to 6?months. A significant inverse correlation between absolute and delta values of HE4 and FEV1 (r?=??0.5376; P?<?.001 and r?=??0.3285; P?<?.001), was retrospectively observed in pooled groups, including an independent association of HE4 with FEV1 by multiple regression analysis (β?=??0.57, P?=?.019). Substantial area under the receiver operating characteristic curve (ROC-AUC) value was determined for HE4 when 7% mean change of FEV1 (0.722 [95% CI 0.581–0.863]; P?=?.029) were used as classifier, especially in the first 2?months of treatment (0.806 [95% CI 0.665–0.947]; P?<?.001).

Conclusions

This study shows that plasma HE4 levels inversely correlate with lung function improvement in CF patients receiving ivacaftor. Overall, this potential biomarker may be of value for routine clinical and laboratory follow-up of CFTR modulating therapy.  相似文献   
10.
The use of hypoxia models in cell culture has allowed the characterization of the hypoxia response at the cellular, biochemical and molecular levels. Although a decrease in oxygen concentration is the optimal hypoxia model, the problem faced by many researchers is access to a hypoxia chamber or a CO2 incubator with regulated oxygen levels, which is not possible in many laboratories. Several alternative models have been used to mimic hypoxia. One of the most commonly used models is cobalt chloride‐induced chemical hypoxia because it stabilizes hypoxia inducible factors 1α and 2α under normoxic conditions. This model has several advantages, and currently, there is a substantial amount of scattered information about how this model works. This review describes the characteristics of the model, as well as the biochemical and molecular bases that support it. The regulation of hypoxia inducible factors by oxygen and the role of CoCl2 are explained to understand the most accepted bases of the CoCl2‐induced hypoxia model. The different current hypotheses that explain the establishment of hypoxic conditions using CoCl2 are also described. Finally, based on the different observations reported in the literature, we provide a critical review about the scope and limitations of this widely used chemical hypoxia model to be informative to all researchers interested in the field.  相似文献   
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