外伤性脑水肿无创动态监测的临床研究

目的探讨并评价”无创性脑电阻抗扰动系数测定”在脑外伤颅内压监测临床应用中的可行性。方法分别测定20名健康志愿者和动态监测80例脑外伤患者的脑电阻抗扰动系数,观察其变化,通过多媒体图像分析系统计算头颅CT上血肿和血肿周围水肿的体积,并进行相关分析。结果①健康志愿者左、右大脑半球脑电阻抗扰动系数一致,无明显差异。②脑外伤合并脑水肿患者的脑电阻抗扰动系数明显升高。随着脑水肿的加剧,颅内压增高,从脑电阻抗扰动系数可以容易反应出来;随着手术清除颅内血肿或保守治疗后颅内血肿的逐渐吸收,患者的康复,脑水肿缓解,颅内压逐渐降低,扰动系数逐步下降。患者伤后1、3天患者脑电阻抗扰动系数明显升高,到7天时脑电阻抗扰动系数逐步下降。结论脑电阻抗扰动系数测定可较敏感地反映脑外伤患者脑水肿的变化。扰动系数越高,提示脑水肿越重。该方法为临床上进行动态、床旁连续无创性脑水肿监测提供了新的有意义的手段。     

The effect of GABA-ergic agents on oxidative phosphorylation in the brain mitochondria in traumatic edema]

The condition of oxidative phosphorylation in the rat brain mitochondria was studied polarographically in dynamics of the brain traumatic edema. It was found that 24 hours after the trauma the rate of oxidation in mitochondria decreased and the degree of conjugation in the respiratory chain compensatorily increased. Piracetam (1 g/kg), phenibut (50 mg/kg) and to a lesser degree sodium oxybutyrate (0.2 g/kg) prevented the 'changes and enhanced the compensatory capacities of mitochondria during the development of traumatic edema of the brain.     

The influence of solid lipid nanoparticles on skin hydration and viscoelasticity--in vivo study.

Effects on skin hydration and viscoelasticity are important criteria during the development of novel cosmetic formulations. This study focuses on the in vivo performance of a conventional o/w cream and of the same cream enriched with solid lipid nanoparticles (SLN). Influences on skin hydration and viscoelastic properties were investigated with validated devices (Corneometer and Cutometer). After an application period of 4 weeks, significant changes in skin hydration were detected for both formulations. The SLN-enriched cream was significantly more effective than the conventional cream (+24% for the cream and +31% for the SLN-cream). The viscoelastic parameters UF and UA/UF remained almost unchanged, which is attributed to the young age of the volunteers. At this stage, SLN represent a promising compound for hydrating new cosmetic formulations.     

有创机械通气对创伤性神经源性肺水肿的临床观察

目的 分析有创机械通气对创伤性神经源性肺水肿的临床疗效.方法 纳入我院67例符合重症颅脑损伤及神经源性肺水肿病例,常规脱水降颅内压,保持气道通畅,行有创插管并呼吸机辅助呼吸.观察机械通气前后的临床症状、体征及血气分析、氧合指数及肺损伤评分.结果 机械通气后67例患者临床症状和体征明显改善,24 h后氧合指数和肺损伤评分明显改善(P＜0.05).结论 有创机械通气能明显改善创伤性神经源性肺水肿的临床症状.     

Drug influence on the acute thrombophlebitic edema (author's transl)

The effect of benzopyrones on edema formation in acute thrombophlebitis was investigated in dogs. Thrombophlebitis was produced by the ligation of the femoral vein and the injection of turpentine oil. The benzopyrones delayed edema formation and sped its regression. Protein concentration in lymph and tissue fluid of the edematous extremity was not significantly higher than in the same fluids of the intact limb, and no significant differences were observed in lymphatic and tissue fluid protein concentrations between the treated and untreated animals. It is concluded that the benzopyrones have their main effect on edema in acute thrombophlebitis by causing proteolysis and enhancing the removal of protein from the tissue fluid.     

The influence of ascorbic acid on nickel-induced hepatic lipid peroxidation in rats.

We studied the effect of oral ascorbic acid treatment on nickel sulfate-induced lipid peroxidation in the liver of Wistar strain male albino rats. Lipid peroxide and glutathione levels and the activities of the antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) were estimated in liver. Nickel sulfate administration significantly increased the level of lipid peroxides and decreased glutathione, SOD, CAT, and GSH-Px activities in liver. The simultaneous administration of ascorbic acid with nickel sulfate resulted in a remarkable improvement of lipid peroxide, glutathione, SOD, CAT, and GSH-Px status in liver in comparison with rats treated with nickel alone. Nickel sulfate has an adverse effect on hepatic lipid peroxidation in animals, but simultaneous treatment with ascorbic acid offers a relative protection against nickel-induced hepatotoxicity.     

The influence of folic acid on the frequency of epileptic attacks

Summary A double blind trial of folic acid against placebo was carried out on out-patients with epilepsy treated with Phenytoin. There was a minimum period on treatment of one year. While the group receiving folic acid in the treatment period showed a significant improvement in seizure frequency, the placebo group also showed some improvement. It is concluded that the improvement while on folic acid was not due to the folic acid treatment alone. The subjective well-being of patients was not influenced by folic acid therapy.     

The effects of an alpha hydroxy acid (glycolic acid) on hairless guinea pig skin permeability.

The barrier integrity of hairless guinea pig skin after treatment with an alpha hydroxy acid was assessed through in vivo topical application of an oil-in-water emulsion containing 5 or 10% glycolic acid at pH 3.0. The control was a commercial moisturizing lotion, pH 7.8. A dosing regimen for the glycolic acid formulations that was tolerated by the hairless guinea pigs and significantly decreased stratum corneum turnover time was determined using the dansyl chloride staining technique. Once-daily dosing of hairless guinea pig skin for 3 weeks with the glycolic acid formulations resulted in approximately a 36-39% decrease in stratum corneum turnover time compared with the control lotion. After this treatment, hairless guinea pigs were sacrificed for the in vitro measurement of the percutaneous absorption of [14C]hydroquinone and [14C]musk xylol. No significant differences in the 24-hour absorption of either test compound were found for skin treated with the control lotion or the glycolic acid formulations. There were also no significant differences found in the absorption of [3H]water through skin from the different treatment groups. Although no increase in skin penetration occurred after treatment with the glycolic acid formulations, histology revealed approximately a twofold increase in epidermal thickness. Also the number of nucleated cell layers nearly doubled in skin treated with 5% and 10% glycolic acid compared with the control lotion and untreated skin. These studies demonstrate that substantial changes in the structure of hairless guinea pig epidermis can occur without significant effect on skin permeability of two model compounds.     

托拉塞米治疗创伤性蛛网膜下腔出血后脑水肿疗效观察

目的观察托拉塞米治疗创伤性蛛网膜下腔出血后脑水肿的疗效。方法将26例创伤性蛛网膜下腔出血患者随机分为两组,在给予相同常规综合治疗的同时,治疗组给予托拉塞米20mg及20%甘露醇125mL,对照组给予呋塞米20mg及20%甘露醇125mL,两组均间隔6h给药,7d后逐渐减量。腰椎穿刺测量用药前后颅内压力变化情况,抽取静脉血送检电解质,及记录24h尿量。结果于疗程相同时间段,治疗组颅内压降低明显低于对照组,24h尿量显著多于对照组;治疗组电解质紊乱发生率低于对照组。结论托拉塞米协同甘露醇治疗创伤性蛛网膜下腔出血后脑水肿效果理想。     

The influence of cholic acid and dehydrocholic acid on the biliary excretion of unconjugated and conjugated sulfobromophthalein in rats.

Urethane anesthetized Wistar rats with biliary fistulas were infused during 100 min with sulfobromophthalein (BSP), the glutathione conjugate of sulfobromophthalein (BSP-GSH), cholic acid (CA) and dehydrocholic acid (DCA). The dyes (594 nmol/100 g/min) and the bile acids (1200 nmol/100 g/min) were infused separately, and in combination as well. When BSP was infused, CA and DCA increased the maximal excretion of total BSP (conjugated plus unconjugated) from 1400 to 4100 and 3300 nmol/100 g/10 min. The bile flow observed with BSP plus CA was not significantly different from that with BSP plus DCA. The biliary excretion of total BSP was higher throughout with CA than with DCA because CA increased the biliary concentration of PSP while DCA did not. The bile flow attained with CA alone was significantly lower than that with BSP plus CA. The current data provide arguments for abandoning the view that choleresis per se is the crucial determinant for BSP excretion. When BSP-GSH was infused instead of BSP, the excretion rate of the dye was not altered by the additional infusion of CA whereas it was significantly reduced by DCA. The maximal biliary concentration of BSP-GSH fell from 25.9 nmol/mul to 15.3 and 9.4 nmol/mul with CA and DCA, respectively. Both CA and DCA impaired the hepatic uptake of BSP and BSP-GSH. During the infusion with CA, BSP plus CA and BSP-GSH plus CA the biliary excretion rates of bile acids did not differ significantly from each other. This favours the view that the transfer for CA from the liver to bile is different from that for BSP and BSP-GSH. A fraction of bile fluid "independent of choleretics" (viz. of bile salts, BSP and BSP-GSH) is estimated and discussed in view of the different types of infusion.     

The influence of drug partition coefficient on follicular penetration: in vitro human skin studies.

The aim of this study was to employ the novel skin sandwich system in order to quantify the influence of the octanol-water partition coefficient on follicular drug absorption in human skin. To this end, seven different drugs - estradiol, corticosterone, hydrocortisone, aldosterone, cimetidine, deoxyadenosine and adenosine - exhibiting a wide range of log octanol-water partition coefficients (logK(o/w)) but relatively similar molecular weights were selected as candidate solutes. Application of the skin sandwich technique yielded an interesting relationship between % follicular contribution and logK(o/w). The follicular contribution to total flux was small (4 and 2%) for the two most lipophilic drugs but varied between 34 and 60% for the remaining drugs of intermediate and low logK(o/w) values. Lipophilicity seems to be an important modulator of drug absorption into follicular orifices only above a critical logK(o/w) threshold. Below this critical logK(o/w) value, lipophilicity does not apparently influence the follicular contribution in an obvious way and the process is probably governed by other molecular properties. Identification of these other active properties would require performing this kind of a study on a much larger set of candidate drugs.     

脂肪间充质干细胞分泌组对颅脑创伤后 大鼠脑水肿的影响

摘要：目的 探讨脂肪间充质干细胞分泌组（ASC-ST）对大鼠颅脑创伤（TBI）后继发脑水肿的影响及其潜在机 制。方法 将 70 只 SD 大鼠随机分为 Sham 组（n=18）、TBI 组（n=26）和 TBI+ST 组（n=26）。应用电子颅脑损伤仪 （eCCI）建立TBI大鼠模型,Sham组只开骨窗;TBI组经尾静脉注射0.3 mL生理盐水,TBI+ST组经尾静脉注射0.2 mL ASC-ST 和 0.1 mL 生理盐水,连续注射 7 d。在 TBI 后 3、7、14 和 21 d 对 TBI 和 TBI+ST 组 8 只大鼠行神经功能评分 （mNSS）;每组选取6只大鼠在TBI后3、7和14 d行头颅核磁（MRI）测量表观弥散系数（ADC）;采用干湿比重法测量脑 水含量并提取损伤周围脑组织总RNA,采用实时定量多聚酶链反应（qRT-PCR）检测肿瘤坏死因子（TNF）-α、白细胞 介素（IL）-1β和IL-6的mRNA 表达水平。结果 TBI 后14、21 d时,TBI+ST 组mNSS 评分均低于TBI 组（P＜0.05）。 TBI后3 d,TBI组和TBI+ST组损伤周围皮层（IC）和损伤对侧皮层（CC）的ADC值均高于Sham组（P＜0.05）;TBI后7 d,TBI+ST组IC和损伤侧海马（IH）的ADC值均低于TBI组（P＜0.05）;TBI后14 d,TBI+ST组IC和CC的ADC值均低于 TBI组（P＜0.05）。TBI后3 d和7 d,TBI+ST组大鼠脑组织水含量与TBI组差异无统计学意义（P＞0.05）;TBI后14 d, TBI+ST组大鼠脑组织水含量低于TBI组（P＜0.05）。TBI后3 d,Sham组大鼠损伤周围脑组织中IL-6表达显著低于 TBI组和TBI+ST组,TBI+ST组TNF-α表达显著低于Sham组和TBI组,TBI组高于Sham组;TBI+ST组与TBI组IL-1β 表达均低于Sham组（均P＜0.05）。TBI后7 d,TBI+ST组与Sham组IL-6表达均低于TBI组,TBI+ST组低于Sham组; TBI组TNF-α表达高于Sham组;TBI组IL-1β表达高于其余两组,Sham组高于TBI+ST组（均P＜0.05）。TBI后14 d, TBI+ST组与Sham组IL-6表达均低于TBI组;TBI+ST组TNF-α表达仍低于其他组;TBI组IL-1β表达仍高于其余两组 （均P＜0.05）。结论 ASC-ST可通过减少TBI后炎症反应和炎性因子表达,显著改善大鼠TBI后脑水肿状况和神经 功能预后,是一种具有较高临床推广价值的生物治疗药物。     

The influence of pyruvic acid on the pharmacokinetics of sulphadiazine in rabbits

During the past few years, acetylation polymorphism has been shown to be a proven, established fact, and N-acetyltransferase, an enzyme that transfers an acetyl group to the substrate, has been recognized as the main factor in acetylation polymorphism. In a recent study, a significant difference between the acetylation phenotype and plasma pyruvic acid (PA) concentration in rabbits was found. In this report, the influence of PA on the pharmacokinetics of sulphadiazine (SDZ), a drug that has been used in pharmacogenetic studies of acetylation, was studied. By using a loading dose of 300 mg kg^?1, and an infusion rate of 7.5 mg min^?1 of kg^?1 of PA, the concentration of PA reached a steady state (C_ss∽100 μg mL^?1) in 30 min. During PA infusion in rapid-acetylation rabbits, no significant changes were found in any of the pharmacokinetic parameters for SDZ. However, differences were found in the β half-life, AUC, clearance, and k₁₀ of SDZ in slow acetylators: the β half-life decreased from 115.74 ± 12.47 min to 62.96 ± 4.36 min (p < 0.001); AUC decreased from 10 617.38 ± 1179.81 μg mL^?1 to 6217.14 ± 391.32 μg min mL^?1 (p < 0.001); clearance increased from 0.0044 ± 0.0008 L min^?1 kg^?1to 0.0068 ± 0.0007 L min^?1 kg^?1 (p < 0.001); and k₁₀ increased from 0.0090 ± 0.0009 min^?1 to 0.0193 ± 0.0028 min^?1 (p < 0.005). The reason for this may be that PA influences the elimination of SDZ in slow-acetylation rabbits.     

The influence of the sennosides on absorption of glycyrrhetic acid in rats

In the course of our clinical studies of Kampo medicine (traditional Japanese medicines), we observed the pharmacokinetic interactions between two herbs. When Onpito (TJ-8117, Kampo medicine) containing licorice and rhubarb was administered orally to human subjects, we observed that the AUC(0-lim) and Cmax of glycyrrhetic acid (GA) in plasma were lower than those treated with other Kampo medicines containing licorice. In this study, we demonstrate the pharmacokinetic interactions of GA derived from glycyrrhizinic acid (GL) in licorice and anthraquinones derived from rhubarb. To our knowledge, this is the first report to investigate the pharmacokinetic interactions between two herbs. When GL was orally co-administrated to rats with a non-effective dose of sennoside A having purgative activity, the AUC(0-lim) and Cmax of GA decreased. In addition, sennoside A did not affect the metabolism of GL by the intestinal bacteria in vitro. In the examination using an in situ loop of rat colon, the remaining ratio of GA rose drastically by the co-administration of sennoside A, sennidin A and rhein. Observed inhibition activity of these anthraquinones on GA absorption depended on the concentration of the components added. The maximum inhibition ratio was approximately 75% by rhein, 60% by sennoside A and 25% by sennidin A. We conclude that the decrease of the pharmacokinetic parameters of GA in human plasma observed in the clinical study of TJ-8117 is attributable to an interactive action of absorption from the intestinal tract by anthraquinones contained in or derived from rhubarb.     

负压引流治疗创伤性大面积皮肤缺损的疗效观察

目的 观察持续封闭负压引流(VSD)技术治疗创伤性大面积皮肤缺损的临床效果.方法 对2007年1月至2010年1月临床收治的40例创伤性大面积皮肤缺损行手术清创,应用持续封闭负压引流敷料覆盖创面,吸引器持续吸引治疗一周后,拆除敷料行二期植皮术.结果 接受VSD治疗的患者中37例在一次使用后直接植皮均成活,3例患者行2次VSD治疗后植皮亦成活,创面均痊愈,无一例出现伤口感染或创伤性骨髓炎.结论 VSD能彻底清除创面的分泌物和坏死组织,刺激肉芽生长,明显缩短创伤性皮肤软组织缺损的治疗时间,减轻换药痛苦,效果显著.     

The influence of cosolvents and substrate substituents on the sorption of benzoic acid derivatives by polyamides.

The sorption of some substituted benzoic acid derivatives by polyamides (nylons) from aqueous solution has been examined and the influence of their nature together with those of the cosolvent and polymer have been assessed. In all cases the sorption isotherms were linear and could be expressed by a simple distribution law, enabling the influence of cosolvent concentration to be predicted. The sorption of a series of p-substituted benzoic acids and some of their esters is related to their solubility except where the p-substituent is capable of hydrogen-bonding with the polymer. The extent of the interaction is also dependent upon the amide frequency of the polymer.