少精子症患者精液沉淀物乳酸脱氢酶同工酶凝胶电泳分析

本文运用乳酸脱氢同工酶聚丙酰胺凝胶电泳分析法，分析比较了少精子症、弱精子症、精液正常者的精液沉淀物乳腺脱氢酶工酶百分比活性。结果显示：少精子症咭物ＬＤＨ－Ｃ４同工酶百分比活性４６％显著低于精液正常者的７１％及弱精子症患者的６７％；相对的、少精子症的ＬＤＨ５同工酶百分比活性１６％显著高于精液正常者的４．８％，和弱了症的６．３％，本文认为少精子症症者精液沉淀物ＬＤＨＣ４活性降低与其精液中的各灰细胞诸如     

碱性成纤维细胞生长因子用于治疗特发性少弱精子症的临床意义(附57例疗效观察)

为了探讨碱性成纤维细胞生长因子（ｂＦＧＦ）对特发性少弱精子症患者的作用,本研究对５７例确诊为将发性少弱精子症的患者用ｂＦＧＦ治疗,分别在治疗前后进行血生殖激素测定和精液质量分析。结果发现治疗后血生殖激素（ＰＲＬ、ＦＳＨ、ＬＨ、Ｔ）水平升高,精子密度及顶体酶活性显著提高（Ｐ〈０．０１）,精子活动力和成活率上升、畸形率下降（Ｐ〈０．０５）,生育能力提高。因此认为ｂＦＧＦ是治疗特发性少弱精子症的有效药物。     

氨基酸对未成熟心肌保护作用的实验研究

研究天门冬氨酸或（和）谷氨酸强化血停搏液对未成熟心肌的保护效果。将２４只出生３～４周新西兰幼兔随机均分成４组：Ｉ组为冷血停搏液组，Ｉ组天门冬氨酸（２０ｍｍｏｌ／Ｌ）强化组，ＩＩ组谷氨酸（２０ｍｍｏｌ／Ｌ）强化组，ＩＶ组谷氨酸加天门冬氨酸（各２０ｍｍｏｌ／Ｌ）强化组。结果表明，心功能指标心输出量（ＣＯ）恢复百分率ＩＶ组、Ｉ组明显少于Ｉ组（Ｐ＜０．０１）；左室收缩压（ＬＶＳＰ）恢复百分率Ｉ、ＩＩ、ＩＶ组明显少于Ｉ组（Ｐ＜０．０１）；左室舒张压（ＬＶＤＰ）及左室压力微分（ｄｐ／ｄｔ）恢复百分率Ｉ、ＩＩ、ＩＶ组优于Ｉ组（Ｐ＜０．０５）。乳酸脱氢酶（ＬＤＨ）和磷酸肌酶（ＣＫ）漏出量（Ｕ／Ｌ）中，ＬＤＨ漏出量Ｉ组优于Ｉ组（Ｐ＜０．０５），ＩＩ、ＩＶ组明显优于Ｉ组（Ｐ＜０．０１）；ＣＫ漏出量ＩＩ、ＩＶ组明显优于Ｉ组（Ｐ＜０．０１）。Ｉ、ＩＩ、ＩＶ组心肌含水量（％）明显优于Ｉ组（Ｐ＜０．０１）。Ｉ、ＩＩ、ＩＶ组心肌结构保护明显优于Ｉ组。结论：谷氨酸或（和）天门冬氨酸强化血停搏液能明显增强对未成熟心肌的保护作用。氨基酸强化组间之所以差别不显著可能与模型有关     

丹参对增生性瘢痕成纤维细胞形态的影响及增殖抑制初探

目的探索丹参治疗增生性瘢痕的机理。方法将培养的增生性瘢痕成纤维细胞加入含丹参的培养液中培养２４ｈ,与未加药者对照比较。结果①含丹参组成纤维细胞由长梭形变为圆形,而培养上清中的乳酸脱氢酶（ＬＤＨ）活性及ＭＴＴ（四甲基偶氮唑）比色法结果,用药组与对照组均无显著差异（Ｐ＞０．０５）;②流式细胞仪检测各时相细胞ＤＮＡ水平：用药组Ｇ０＋Ｇ１期细胞的百分比明显高于对照组（Ｐ＜０．０１）,而Ｇ２＋Ｍ期百分比则显著低于对照组（Ｐ＜０．０１）。结论丹参能改变增生性瘢痕成纤维细胞形态,而不影响其活力并抑制其增殖。     

雷公藤服用者精液中乳酸脱氢酶及其同功酶C4活性的研究

本文对１９例中药雷公藤服用者精子、精浆中乳酸脱氢酶（ＬＤＨ）及同功酶Ｃ４（ＬＤＨＣ４）的活性进行了测定分析。     

左旋精氨酸对体外循环缺血再灌注损伤心肌的保护作用

目的 探讨左旋精氨酸对体外循环（ＥＣＣ）下心肌缺血再灌注损伤的防护作用。方法 １６例ＥＣＣ下行心脏手术患者分成对照组和治疗组,分别于主动脉阻断前、开放后２小时、４小时、８小时测定血浆一氧化氮（ＮＯ）水平、乳酸脱氢酶（ＬＤＨ）和肌酸磷酸激酶（ＣＰＫ）活性。结果 主动脉开放后不同时点,对照组ＮＯ水平显著下降,ＬＤＨ,ＣＰＫ活性明显增强,与阻断前比较差异均有显著性（Ｐ〈０．０５和Ｐ〈０．０１）;治疗组Ｎ     

精子特异性LDH－C_4的测定及临床意义

精子特异性ＬＤＨ－Ｃ_４的测定及临床意义南京军区南京总医院临床免疫科庄恭南综述武建国审校自１９６３年Ｂｌａｎｃｏ和Ｇｏｌｄｂｅｒｇ等在多种哺乳动物和鸟类睾丸组织及精子中发现乳酸脱氢酶同工酶－Ｃ４（ＬＤＨ－Ｃ４）以来，ＬＤＨ－Ｃ４在精子的发生、代谢、获?..     

人精液穿透精子密度直接计数的实验研究及临床观察

首次建立人精液穿透精子密度直接计数方法,它是一种反映精子穿透女性宫颈粘液（ＣＭ）的定量分析。本法精密度高,作者对穿透精子密度为５５．０×１０９／Ｌ,２７．０×１０９／Ｌ的精液进行重复试验,ＣＶ分别为３．９６％和５．８１％,平均４．８８％。准确性好,通过对精子灭活样本试验,结果直接计数未见精子。本实验与精子尾部低渗肿胀试验（ＨＯＳ）、精液成活精子数（伊红法）和Ⅲ级活力精子数（ＷＨＯ精子活力四级分类法）皆呈正相关,ｒ分别为０．７４５、０．７６０、０．８５０,Ｐ值均＜０．００１;与精液精子密度不相关,ｒ＝０．２５５,Ｐ＞０．０５。正常男子穿透精子密度≥１１．０×１０９／Ｌ。     

男性不育症病人的精液分析与性激素检测的探讨

本文测定了４０例正常生育男性和５０例不育男性的精液分析，以及血清ＦＳＨ、ＬＨ、ＰＲＬ的浓度，按照精子密度分为正常组、少精症组和无精症组。我们观察到正常组、少精症组、无精症组之间的精液液化时间、ｐＨ、量的差异均无显著性（Ｐ＞０．０５）．而精子的活动率与正常形态精子却有明显的不同，精子的活动率差，其畸形精子的百分率就高，且呈非常显著的关系。少精症组与无精症组中的ＦＳＨ、ＬＨ、ＰＲＬ的浓度明显高于正常组（Ｐ＜０．０５），而无精症组的ＦＳＨ、ＬＨ、ＰＲＬ值又明显高于少精症组（Ｐ＜０．０５）。当ＦＳＨ、ＬＨ明显升高时，精子的活动率、密度的百分率明显下降（Ｐ＜０．０１）。本文结果是无精症组血清ＰＲＬ与正常组有显著性差异（Ｐ＜０．０５），而少精症组则无明显差异（Ｐ＞０．０５）。     

己酮可可碱和2—脱氧腺苷提高冷冻复温后精液质量的研究

在光学显微镜下观察和测定了己酮可可碱（ＰＦ）和２－脱氧腺苷（２－ＤＡ）在体外对冷冻复温后精液精子的活率、活力及其毛细管穿透值的影响。结果显示ＰＦ和２－ＤＡ均能提高冷冻复温后精子的活率、活力及其毛细管穿透值，其最适浓度分别为４．０ｍｍｏｌ／Ｌ和２．０ｍｍｏｌ／Ｌ，与对照组比较均有显著性差异（Ｐ〈０．０１）。两组间比较，２－ＤＡ优于ＰＦ（Ｐ〈０．０１）。提示ＰＦ与２－ＤＡ合用不具有协同作用，反而有相互     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

Systemic analgesia adapted to the children's condition

A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions.