类保幼激素对三带喙库蚊幼期发育的影响

本文报告用亚致死剂量的 S—31183(类保幼激素)处理三带喙库蚊幼虫对其发育影响的研究,结果表明处理后蛹期死亡率明显高于幼虫期,并且与剂量大小有关。S—31183处理幼虫并不影响幼虫的发育时间,但可使幼虫化蛹时蜕皮受阻与羽化受到一定的抑制。     

备劳特联合爱喘乐雾化吸入治疗儿童哮喘急性发作的疗效观察

目的 :观察氧雾化吸入备劳特和爱喘乐治疗儿童哮喘急性发作的疗效。方法 :选择 15 8例哮喘急性发作患儿作为研究对象 ,分为观察组和对照组。观察组采用氧驱动雾化吸入备劳特和爱喘乐 ;对照组静脉滴注氨茶碱和地塞米松。结果 :观察组显效率 87.3% (96 /110 ) ,总有效率 99.1% (10 9/110 ) ,临床治愈率 94 .5 % (10 4 /110 ) ;对照组显效率 2 2 .9% (11/48) ,总有效率 6 0 .4 % (2 9/48) ,临床治愈率 5 4 .2 % (2 6 /48)。观察组显效率、总有效率及临床治愈率皆显著高于对照组 ,差异有高度统计意义 (P <0 .0 1)。观察组治疗后心率较治疗前明显下降 ,差异有统计意义(P <0 .0 5 )。结论 :采用氧驱动雾化吸入备劳特和爱喘乐能快速、有效地控制哮喘发作。     

Moving beyond empiric continuous positive airway pressure (CPAP) trials for central sleep apnea: a multi-modality titration study

There is no universally accepted method to determine effective therapy for central sleep apnea (CSA). Continuous positive airway pressure (CPAP) applied acutely most often does not eliminate apneas and hypopneas. We hypothesized that the application of two or more therapeutic modalities after the diagnostic phase of polysomnography, a multi-modality titration study (MMTS), would identify a successful CSA treatment more often than a standard split-night study (SNS) and obviate the need for additional polysomnograms to determine a successful therapy. We retrospectively analyzed polysomnograms of patients diagnosed with CSA at our Sleep Disorders Center. We defined a therapy trial that resulted in an apnea–hypopnea index < 10 with at least one treatment modality as a therapeutic success. One hundred fifteen patients with CSA were studied. Sixty-six patients (57.4%) underwent a SNS, and 49 patients (42.6%) underwent a MMTS. SNS yielded only 8/66 (12.1%) successes on the first night, whereas a MMTS yielded 19/49 (38.8%) successes (p = 0.001, two-tailed Fishers exact). Patients who underwent a SNS eventually had similar rate of success as patients studied with MMTS (60.6 vs 63.3%, NS), but required more testing. Adaptive servo-ventilation was the most successful modality tested, yielding 36/46 (78.3%) successes. Trials of additional modalities following a failed trial of CPAP often produce a successful option that may guide therapy in patients with CSA. This approach may lead to establishing the diagnosis and treatment plans faster, while reducing unnecessary testing.     

地氟醚低流量洗入紧闭环路麻醉的摄取规律

目的 研究地氟醚高浓度、低流量洗入时的摄取规律。方法 择期全麻下行上腹部手术的ASA I-Ⅱ级患者80例,随机分为A、B两组,洗入期:A组新鲜气流量为:氧气0.7 L/min;B组新鲜气流量为:氧气0.4 L/min,氧化亚氮 0.3 L/min。两组Tec-6地氟醚蒸发器刻度均为18％。维持期:两组新鲜气流量均不变,蒸发器刻度均改为8％。结果 A组平均洗入时间为（4.56±0.68）min,B组平均洗入时间为（4.05±0.52）min,二者无统计学差异（P>0.05）。两组间各时点 FA/FI均无显著差异（P>0.05）。结论 低流量洗入地氟醚、氧化亚氮时,氧化亚氮并不影响地氟醚的体内摄取过程。地氟醚低流量洗入紧闭环路麻醉安全可行。     

清咽雾化液治疗咽喉炎的临床研究

清咽雾化液为紫红色澄明灭菌溶液，经９５例急慢性咽喉炎临床治疗观察，其临床痊愈率与显效率为８１．０４％，与对照组比较有显著差异。药效研究具有抗炎消肿、镇咳祛痰、改善微循环、增强免疫功能等作用。其可以提高患者唾液中ＩｇＧ水平，且具有统计学差异。     

Inhibitory effect of fluoride on the secretion of insulin

Summary The oral administration of sodium fluoride (NaF) (40 μmol/100 body weight [bw]) to fasting rats produced an immediate fall in insulin levels and the consequent increase in glycemia. These phenomena were observed with plasma fluoride concentrations 5–15 μM. Glycemia and insulin returned to normal levels within 4–5 hours, together with the washing out of fluoride from plasma and soft tissues. The insulin secretion of isolated Langerhans islets, perifused with solutions containing 5, 10, or 20 μM fluoride, was found to be significantly inhibited as a function of fluoride levels, both with basal and stimulatory concentrations of glucose. One hour after the intake of 60 mg of NaF, fasting human volunteers showed increased fluoride (5–15 μM) together with a significant fall of plasma insulin levels.     

Demonstration of dilatation of peripheral airways

Summary. To investigate the ability of various lung-function tests to demonstrate dilatation of peripheral airways, ten asthmatics inhaled increasing doses of a f2-agonist by two different and controlled techniques. Low inspiratory flow with a long post-inspi-ratory pause favoured peripheral deposition, and a high inspiratory flow with a short post-inspiratory pause favoured central deposition of drug in the airways. Ordinary spirometry, maximum expiratory flow rates after breathing air as well as a helium-oxygen mixture, a single breath N₂-test and resistance of the respiratory system were obtained before and after each of five terbutaline doses with both inhalation techniques. By using a double-dummy technique, the study could be performed double blinded. Effects were compared at doses giving equal effects on PEF, assumed to represent equal deposition of bronchodilator and effects on central airways. At such ‘iso A PEF doses’, particularly FVC and the slope of phase III of the N₂-test improved more following the slow inhalation technique. It is concluded that changes in those tests reflect dilatation in peripheral airways in asthmatics.,     

Clinical experience with minimal flow xenon anesthesia

Xenon is a more potent anesthetic than nitrous oxide, and gives more profound analgesia. This investigation was performed to assess the potential of xenon for becoming an anesthetic inspite of its high manufacturing cost. Seven ASA I—-II patients undergoing cholecystectomy (n = 4), hernia repair (n = 2), or mammoplasty (n=l) were studied. Denitrogenation by 15–20 min of oxygen breathing under propofol anesthesia was followed by fentanyl–supplemented xenon anesthesia administered via an automatic minimal flow system which held the oxygen concentration at 30%. Xenon anesthesia lasted 76–228 min and 8–14 1 of xenon (ATPD) was used, of which 5.6–8.1 1 was expended during the first 15 min. Anesthesia appeared to be satisfactory, and the patients woke up rapidly after xenon was discontinued. The automatic system made minimal flow xenon anesthesia easy to administer, but nitrogen accumulation is still a problem. Assuming a xenon price of 10 US $ per litre, the average cost for xenon was about 65 US $ for the first 15 min and then about 25 USS for each subsequent hour of anesthesia.     

Characterization of Aerosols of Human Recombinant Deoxyribonuclease I (rhDNase) Generated by Jet Nebulizers

Recombinant human deoxyribonuclease I (rhDNase) is a new therapeutic agent developed to improve clearance of purulent sputum from the human airways. It is delivered by inhalation. Four jet nebulizers, T Up-Draft II (Hudson), Customized Respirgard II (Marquest), Acorn II (Marquest), and Airlife Misty (Baxter), were evaluated in vitro for their ability to deliver aerosols of rhDNase. The aerosols were generated from 2.5-mL aqueous solutions of rhDNase, at concentrations of either 1 or 4 mg/mL. In all experiments, the Pulmo-Aide Compressor (De Vilbiss) was used to supply the air to the nebulizers. Between 20 and 28% of the rhDNase dose initially placed in the nebulizers was delivered to the mouthpiece in the respirable range (1-6 µm). Evaluation of the rhDNase following nebulization in all four devices indicated that there was no loss in enzymatic activity and no increase in aggregation. Circular dichroism spectrophotometry indicated there was no change in either the secondary or the tertiary structure in rhDNase following nebulization. These results show that all four nebulizers are essentially equivalent in their ability to deliver respirable doses of rhDNase in an intact, fully active form. Changing the concentration of the solution in the nebulizer from 4 to 1 mg/mL rhDNase leads to a proportional reduction in the respirable dose delivered to the mouthpiece.