Octreotide in the treatment of acute gastrointestinal hemorrhage caused by ruptured esophageal varices

AIMS: To asses the value of octreotide in the control of acute bleeding esophageal varices in a retrospective study. METHODOLOGY: Fourty two patients admitted for esophageal variceal bleeding confirmed at endoscopy were recruited. An initial 50 micrograms bolus of octreotide followed by a two day continuous infusion of 25 micrograms/h were evaluated for the control of bleeding. RESULTS: Twenty nine patients were endoscopic stigmata of recent bleeding and thirteen were active bleeding at emergency endoscopy. Octreotide was found to be effective regarding hemostasis at 48 hours and on day 7 after the index bleeding episode. 30-day mortality was 11.9%. Echec of octreotide was significantly associated with severity of cirrhosis (p<0.03). CONCLUSION: These results suggest that octreotide is effective in the treatment of esophageal variceal bleeding and it is a valuable adjuvant treatment in association with endoscopic management.     

国产生长抑素十四肽治疗肝硬化上消化道出血的疗效分析

上消化道出血是肝硬化最常见的并发症,出血后难以止血或多次出血是肝硬化患者死亡的重要原因,病死率高达30％～50％,在出血后1周内的死亡率达70％。此类患者治疗关键在于止血和预防再出血。     

壬基酚对仔鼠脑组织的脂质过氧化损伤

母鼠孕9~15 d灌胃壬基酚(nonylphenol,NP)0、50、100、200 mg/kg,检测F1仔鼠垂体和海马组织超氧化物歧化酶(SOD)活力及脂质过氧化产物丙二醛(MDA)含量,透射电镜观察脑超微结构的变化。结果显示,NP暴露组脑组织SOD活力降低,MDA含量升高,存在量效关系(P<0.05);电镜下见线粒体肿胀呈空泡样变,染色质浓缩成块状聚集。提示壬基酚可透过胎盘屏障致仔鼠脑组织脂质过氧化损伤。     

依布哂啉对酒精致大鼠过氧化损伤的抑制效果

目的　了解合成的依布哂啉 (Ebs)对过氧化损伤的抑制效果。方法　用 5 0g/ (kg·d)酒精及Ebs 0 5～2 5 0g/ (kg·d)给大鼠灌胃 ,于第 3周末及第 6周末各观察 1次血浆谷胱苷肽过氧化物酶 (GPx)活性和血清脂质过氧化物 (LPO)含量及比值。结果　与酒精组比较 ,第 3周末 5 0mg/ (kg·d)以上Ebs组GPx活性增高和LPO含量减少 ,第 6周末 0 5mg/ (kg·d)及以上组GPX活性和LPO含量变化均呈极显著剂量反应关系 (P均 <0 0 1) ,GPx与LPO比值上升明显。结论　合成的Ebs具有抗氧化损伤的抑制作用 ,其有效剂量为 5 0mg/ (kg·d) (3周 )和 0 5mg/ (kg·d)(6周 )。     

烧伤膏治疗透明敷贴致新生儿皮疹的疗效观察

目的了解美宝湿润烧伤膏在治疗外周静脉留置针透明敷贴引起皮肤损伤方面的临床效果。方法将83例使用静脉留置针透明敷贴引起皮疹的新生儿分为观察组和对熙组,观察组43例,对照组40例,观察组在行常规皮肤护理后给予外涂美宝湿润烧伤膏,对照组行常规皮肤护理,比较两组总有效率。结果观察组应用美宝湿润烧伤膏治疗皮肤受损,治疗第2、4天有效率分别为90．7％、97．7％;对照组常规治疗第2、4天有效率分别72．5％、85％,观察组总有效率优于对照组,比较差异有统计学意义（P〈0．05）。两组分度治愈率比较,观察组轻、中度治愈率分别为100％、53．8％,对照组轻、中度分别为82．6％、14．3％,总治愈率观察组为79．1％,对照组为52．5％。观察组治愈率优于对照组,比较差异有统计学意义（X^2=6．544,P=0．011〈0．05）。结论对于外周静脉留置针透明敷贴引起的新生儿皮肤损伤应用美宝湿润烧伤膏进行治疗,能有效的缩短治疗时间,提高治愈率,且用药方便,无毒副作用．值得临床进一步实践和推广。     

Carbohydrate-energy restriction may protect the rat brain against oxidative damage and improve physical performance

Chronic energy restriction, alpha-tocopherol supplementation and their interaction with exhaustive exercise were investigated. Eleven-week-old male Wistar rats (n 6x 10) were fed either a control (C), a 30 % carbohydrate-energy-restricted control (R) or an alpha-tocopherol-supplemented (S) diet for 5 months. The animals in each diet were divided into exercised (E) and non-exercised (NE) groups. Before killing, the exercised rats were required to run to exhaustion (39 (se 6), 69 (se 11) and 18 (se 2) min for the C, R and S groups, respectively). Lipid peroxidation (thiobarbituric acid-reactive substances; TBARS), protein damage (reactive carbonyls) and alpha-tocopherol were determined in gastrocnemius, liver, brain and/or plasma. There was no difference in lipid peroxidation between the R and C groups, but in liver and muscle peroxidation appeared significantly lower in the S than the other two diets. TBARS in the brain were similar in all groups. On the other hand, reactive carbonyls showed that both the R and S diets reduced protein damage in the brain, while exhaustive exercise increased it. For liver and muscle, however, reactive carbonyl levels were similar in all groups. alpha-Tocopherol supplementation increased the vitamin concentrations in liver, muscle and plasma, but exercise decreased them in plasma and brain. Carbohydrate-energy restriction increased (P=0.0025) resistance to exhaustive exercise considerably without depleting stores of alpha-tocopherol or exacerbating oxidative damage in monitored tissues. It is concluded that while exhaustive exercise promotes a tissue-specific oxidative damage detectable only in brain proteins, both experimental diets tended to ameliorate this condition.     

氟化钠致大鼠肾脏脂质过氧化损伤及亚硒酸钠的保护作用

目的研究氟化钠（ＮａＦ）对大鼠肾脏脂质过氧化作用的影响及亚硒酸钠（Ｎａ２ＳｅＯ３）对氟肾脏毒性的保护作用。方法大鼠经饮水加入ＮａＦ（１５ｍｍｏｌ／Ｌ）或／和Ｎａ２ＳｅＯ３（１５μｍｏｌ／Ｌ）染毒１２０天,观察氟在机体的蓄积、排泄,尿酶活性及肾脏脂质过氧化水平的变化。结果氟染毒后,大鼠血氟水平、尿氟水平、骨氟含量,尿谷氨酰转肽酶（γＧＴ）、Ｎ乙酰βＤ氨基葡萄糖苷酶（ＮＡＧ）、琥珀酸脱氢酶（ＳＤＨ）活性及肾脏活性氧自由基（ＯＦＲＳ）相对浓度、脂质过氧化降解产物丙二醛（ＭＤＡ）含量均显著升高,谷胱甘肽过氧化物酶（ＧＳＨＰｘ）活性及ＧＳＨ含量显著下降。同时补加亚硒酸钠,可促进尿氟排泄,降低血氟水平及骨氟含量,降低尿酶γＧＴ、ＮＡＧ、ＳＤＨ活性和肾脏ＯＦＲＳ、ＭＤＡ含量,同时提高肾脏ＧＳＨＰｘ活性,但对ＧＳＨ含量影响不显著。结论氟化钠引起肾脏损伤与其诱导脂质过氧化作用增强有关,亚硒酸钠对氟化钠致肾脏毒性具有拮抗作用。     

Effects of dietary sulfur-containing amino acids on oxidative damage in rat liver caused by N-nitrosodimethylamine administration

Effects of dietary protein and S-containing amino acids on oxidative damage were investigated in rat liver. After feeding rats for 3 weeks from weaning, lower GSH levels and higher metallothionein (MT) levels were found in the liver of rats fed on a 10% soyabean-protein-isolate (SPI)-based diet than those fed on a 10% casein-based diet. After injection of N-nitrosodimethylamine (NDMA) at 20 mg/kg body weight, increases in lipid peroxide, determined as thiobarbituric-acid reactive substances (TBARS), and gamma-glutamyltransferase (GGT) activity in the liver were observed in the 10% SPI diet group. By supplementing the 10% SPI diet with 0.3% cystine or methionine, GSH levels were increased, while MT levels were decreased, and elevation in TBARS levels after NDMA injection was diminished. On the other hand, increase in GGT activity could be prevented only by methionine supplement. On a 20% SPI or casein diet, TBARS concentration and GGT activity were not altered after NDMA injection with concomitant increase in GSH levels and decrease in MT levels. These results indicate that sufficient amounts of methionine and cystine in a diet are important to protect the liver from oxidative damage after NDMA administration, and GSH plays a primary role in the cellular protective function when compared with MT.     

成人下呼吸道病毒感染所致肺损伤及治疗措施

近些年,病毒感染在局部地区甚至世界范围内广泛传播,影响了人们的身体健康,甚至危及生命。SARS、禽流感及甲型H1N1流感,均引起人类普遍的恐慌。如何采取有效的措施遏制病毒所致肺损伤,是医务工作者一直探索的目标。笔者就下呼吸道常见病毒对肺的影响及治疗措施进行综述。     

氯丙醇对小鼠淋巴细胞DNA损伤作用

目的 观察1,3-二氯-丙醇(1,3-DCP)3-氯-1,2-丙二醇(3-MCPD)对小鼠外周血淋巴细胞DNA损伤.方法 56只昆明种小鼠随机分为正常对照组和1,3-DCP、3-MCPD各3组,剂量分别为10,20,40 mg/kg,灌胃染毒每d 1次,连续7d.染毒后,取外周血淋巴细胞进行彗星实验.结果 染毒1,3-DCP,低、中、高剂量组小鼠淋巴细胞DNA损伤率分别为22.90%,46.75%和73.80%明显高于正常对照(P<0.05);中、高剂量组淋巴细胞DNA迁移度分别为(8.056±2.291),(9.378±3.658)μm,均明显高于对照组(P<0.05).染毒3-MCPD,各剂量组小鼠淋巴细胞DNA损伤率与对照组比较,差异无统计学意义(P>0.05).结论 1,3-DCP对雄性小鼠外周血淋巴细胞具有DNA损伤作用,而3-MCPD则无明显影响     

二甲基甲酰胺中毒对机体健康损害的研究进展

二甲基甲酰胺(N, N-Dimethylformamide, DMF)是重要的化工原料和性能优良的溶剂, 广泛应用于工业企业。DMF可经呼吸道和皮肤进入机体, 造成以肝脏最为突出的, 以及肾脏、心脏等多器官的损害, 发生DMF急性中毒或慢性损伤。就DMF中毒的接触方式、潜伏期、各器官(系统)损害的临床表现以及中毒治疗的研究进展作一综述, 以期提高临床对于二甲基甲酰胺中毒的认识。     

三聚氰胺致大鼠肾损伤及恢复期的变化

目的探讨三聚氰胺致大鼠肾损伤后停止染毒,肾损伤的自然恢复情况。方法将40只健康清洁级Wistar雄性大鼠随机分为三聚氰胺染毒组(25 mg/kg)和对照组,每组20只。采用饲料掺入法进行染毒,连续染毒4周。分别于染毒4周末和恢复2、6、12周末,测定血清测定尿素氮、肌酐含量,并观察肾组织的病理学改变。结果与对照组比较,染毒4周及恢复2、6周时染毒组大鼠血清尿素氮、肌酐水平显著升高,差异均有统计学意义(P<0.01);而恢复12周时染毒组大鼠血清尿素氮、肌酐水平无显著改变。肉眼观察可见,染毒组大鼠肾脏体积增大,外观呈特征性土黄色沙石样;肾组织少见毛细血管网,弥漫性分布的点片状结晶体阴影;肾小管、肾盂中存在大量结晶体,肾小管上皮坏死脱落。恢复12周后,肾脏呈暗红色,表面凸凹不平;肾组织再生修复。结论三聚氰胺染毒可对大鼠肾组织造成损伤;停止染毒后不给予任何药物干预,损伤的肾组织能够自然修复再生,肾功能基本恢复正常。     

781例初治肺结核患者抗结核组合药物间歇疗法肝损害的调查

目的 调查抗结核药物对合并HBV感染的结核病患者肝功能损害的特点,补充和完善实施DOTs策略的内容.方法 研究采用历史性队列研究方法,回顾性分析2004年6月至2005年10月住院治疗的781例初治结核病患者病历资料,分为HBsAg(+)组和HBsAg(-)组.结果 781例调查对象肝功能损害率为20.74%,其中HBsAg(+)组121例(74.69%),HBsAg(-)组41例(25.31%),经统计学分析,HBsAg(+)组发生肝损害率、ALT、AST平均值比HBsAg(-)组高;HBsAg(+)组最早出现肝功能损害为治疗的第7天,HBsAg(-)组最早出现肝功能损害为治疗的第16天,HBsAg(+)组的平均时间比HBsAg(-)组早18.09 d;HBsAg(+)组肝功能恢复的平均时间为57.02 d,HBsAg(-)组为27.56 d,HBsAg(+)组比HBsAg(-)组晚29.46 d.结论 合并HBV感染的结核病患者抗结核药物肝损害发生率高于未合并HBV感染的患者;HBV感染程度越严重,肝损害发生率越高,且发生时间提早,损害程度严重.     

1例络氨铜中毒引起多脏器功能损害的治疗体会

络氨铜虽具有高效、低毒、低残留等特点,但中毒后仍有可能引起溶血性贫血及心、肝、肾、脑等毒性损害。通过对1例络氨铜中毒引起多脏器功能损害患者的临床表现及救治经过分析发现,络氨铜中毒早期予以血液灌流、输注洗涤红细胞、保护重要脏器等治疗手段可提高救治效果。     

职业中毒所致呼吸系统损害的特点及其防治的再认识

通过对职业病危害因素中可以损害呼吸系统的毒物种类、作用机制、临床特点等进行归纳、分析、理解,特别是对最新的职业性急性化学物中毒性呼吸系统疾病诊断标准进行详细介绍、综合分析与理解,并对几种常见的职业中毒性呼吸系统疾病的治疗对策新进展作较详细的阐述,其内容结合我国劳动者接触职业病危害因素的现状以及加强呼吸系统防护的重要性提出了应对思维的策略,该文对于从事职业病临床工作和相关科研人员具有一定的现实指导意义,同时对于如何加强劳动者保护提供了有益思考。     

Changes in protein fractions of milk obtained from cows with mastitis caused by Staphylococcus aureus. Preliminary studies

The effect was studied of cow udder infection with S. aureus on changes of milk proteins. The tested milk was derived from two cows of the black-white lowland breed aged 5 years in the second stage of lactation. Proteins soluble and insoluble at pH 4.6 were characterized by means of starch-urea and polyacrylamide gel electrophoresis. The solution of nitrogen compound reacting with ninhydrin and soluble at pH 4.6 was separated by gel filtration, thin-layer chromatography and high-voltage paper electrophoresis, thin-layer chromatography and high-voltage paper electrophoresis. In the milk of the infected cow degradation of alpha s, beta and kappa casein, and increased content of gamma immunoglobulin. In whey proteins a rise was observed of serum albumin content and a decrease of beta-lactoglobulin and alpha lactoalbumin. In the solution after precipitation of casein at pH 4.6 in the milk of the infected cow a greater number of fractions reacting with ninhydrin was found. The observed range of degradation changes in milk protein in the infected cow (S. aureus) suggests that it has a negative effect on the technological, nutritional and hygienic value of milk.