糖基缺乏性转铁蛋白在酒精滥用监测中的应用

酒精滥用是全世界共同面临的严重问题.估计在欧美国家总人口中大约有10%患有与酒精滥用有关的疾病[1].2002年中国人均商业酒产量较1952年水平已经增长了近50倍;酒精依赖现象同时也显著增加,并从精神疾病中的第九位上升到第三位[2].1993年对国内5城市饮酒的流行病学调查结果表明,普通人群的饮酒发生率为61.1%,年饮酒量为3.62 L,且酒消耗量以13%的速度增加[3].     

熵指数监测联合肌松监测在儿童全麻手术中的应用研究

目的研究熵指数监测联合肌松监测在儿童全身麻醉(全麻)手术中的应用。方法 82例儿童行气管插管全麻患儿,随机分为对照组和实验组,各41例。对照组采用常规检测,实验组采用熵指数监测联合肌松监测。比较两组患儿手术麻醉前(T0)、切皮时(T1)、手术15 min(T2)、手术30 min(T3)和手术结束(T4)的血压、心率水平及术中体动反应、知晓发生情况和睁眼时间、拔管时间。结果对照组患儿收缩压T1时(123±10)mm Hg(1 mm Hg=0.133 kPa)明显高于T0时的(97±9)mm Hg, T4时(113±9)mm Hg明显高于T3时的(87±13)mmHg,差异具有统计学意义(P<0.05)。T0、T1、T2、T3、T4时,实验组患儿相邻时间点的收缩压和心率水平比较差异均无统计学意义(P>0.05)。两组患儿T0、T1、T2、T3、T4时的舒张压水平比较差异均无统计学意义(P>0.05)。对照组患儿心率T1时(124±10)次/min显著高于T0时的(97±6)次/min, T4时(132±10)次/min显著高于T3时的(91±8)次/min,差异具有统计学意义(P<0.05)。实验组术中体动反应发生率为7.3%,显著低于对照组的31.7%,差异具有统计学意义(P<0.05)。两组患儿术中知晓率均为0。实验组患儿的睁眼时间(6.3±2.4)、拔管时间(12±4)min均明显短于对照组的(9.7±1.6)、(18±5)min,差异具有统计学意义(P<0.05)。结论熵指数监测联合肌松监测有利于稳定患儿在手术中不同时段的血压和心率,减少全麻患儿在手术中的体动反应,缩短了睁眼时间和拔管时间,具有较高临床价值,值得推广。     

基于脉搏指数连续心输出量监测的整体护理在重症心力衰竭患者中的应用

目的：观察在重症心力衰竭患者中实施基于脉搏指数连续心输出量监测整体护理的应用价值。方法：纳入2020年1月—2021年12月于重症加强护理病房(ICU)治疗的重症心力衰竭患者72例,随机分为观察组与对照组,每组36例。对照组予以常规护理措施,观察组在此基础上予以基于脉搏指数连续心输出量监测的整体护理。监测两组患者血流动力学指标及血清N-末端脑钠肽前体(NT-proBNP)和心肌肌钙蛋白I/T(cTnI/T)水平,并记录治疗期间并发症发生情况。结果：干预前两组患者各项指标比较差异无统计学意义(P>0.05)。干预后观察组患者心率(HR)、体循环阻力指数(SVRI)、血管外肺水(EVLW)及肺毛细血管通透指数(PVPI)较对照组降低,心脏指数(CI)、全心射血分数(GEF)以及全心舒张末期容积指数(GEDI)较对照组升高,且观察组患者NT-proBNP,cTnI/T水平以及并发症发生率低于对照组(P<0.05)。结论：基于脉搏指数连续心输出量监测的整体护理有助于进一步改善ICU重症心力衰竭患者的心功能,降低并发症发生风险。     

肺泡鄄动脉氧分压差和氧合指数动态监测在小儿重症肺炎中的应用价值

目的:探讨肺泡鄄动脉氧分压差(A-aDO2 )和氧合指数(OI)动态监测在小儿重症肺炎中的应用价值。方法:选取2013年6月至2015年12月我院收治的重症肺炎患儿63例作为观察组,按照APACHE-Ⅱ评分分为观察组A(<20分)、观察组B(20分≤评分<40分)和观察C组(≥40分),另选取20例同期健康儿童作为对照组。比较观察组A、观察组B、观察组C以及对照组A-aDO2和OI水平。观察组所有患儿给予常规治疗,观察治疗后6 h、12 h、24 h 和48 h A-aDO2和OI的动态变化。依据患儿预后情况将其分为存活组和死亡组,比较两组A-aDO2/体表面积和OI/体表面积水平。结果:观察组A、观察组B、观察组C和对 照组A-aDO2/体表面积和OI/体表面积水平比较差异均有统计学意义(P<0.05),且每两组间也存在显著差异(P<0.05);治疗后各时间点观察组间A﹣aDO2/体表面积和OI/体表面积水平比较差异均有统计学意义(P<0.05),且每两个时间点间也存在显著差异(P<0.05);本组患儿病死率为11.11%,治疗前存活组A﹣aDO2/体表面积水平显著低于死亡组,而OI/体表面积水平显著高于死亡组,差异均有统计学意义(P<0.05)。观察组A、B、C病死率分别为5.00%、8.00% 和22.22%。结论:A﹣aDO2和OI动态监测可以评估病情严重程度和预后,指导临床治疗,对死亡风险判断也有指示作用。     

超声监测下腔静脉扩张指数联合肺部超声在AECOPD合并脓毒症机械通气治疗中的应用价值分析

目的 探讨超声监测下腔静脉扩张指数(IVC-DI)联合肺部超声(LU)在慢性阻塞性肺疾病急性加重期(AECOPD)合并脓毒症需行机械通气治疗患者中的临床应用价值。方法 92例AECOPD合并脓毒症接受机械通气治疗患者,采用随机数字表法分为CVP组(31例)、CVP-IVC组(31例)和IVC-LU组(30例)。CVP组通过监测中心静脉压(CVP)指导液体治疗, CVP-IVC组依据CVP和IVC-DI指导液体治疗, IVC-LU组依据IVC-DI和LU指导液体治疗。比较三组患者的液体治疗量、呼吸力学参数[气道平台压(Pplat)、肺静态顺应性(Cst)]、氧合指数(OI)、炎症指标[C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)]及临床预后指标[急性生理功能和慢性健康状况评分系统Ⅱ(APACHE Ⅱ)评分、机械通气时间、入住重症加强护理病房(ICU)时间及肾脏替代治疗率]。结果 第3个24 h, IVC-LU组的液体治疗量低于CVP组(P<0.05);第4、5个24 h, IVC-LU组的液体治疗量低于CVP组和CVP-IVC组(P<0.0...     

右美托咪定联合脑电双频指数监测在小儿全身麻醉清醒拔管中的临床应用

目的:探讨右美托咪定联合脑电双频指数监测对全身麻醉患儿苏醒期喉罩拔除时机的指导作用及对患儿并发症发生情况的影响.方法:选取石家庄市第三医院于2018年7月至2020年7月收治的择期行全身麻醉手术的患儿150例,进行脑电双频指数监测,将全部患儿按照随机数字表法分为对照组(75例,脑电双频指数为60～65时拔除喉罩)和观察...     

Application of sialic acid/polysialic acid in the drug delivery systems

The properties of modified biomaterial are gaining more and more importance in drug delivery systems. Sialic acid (SA) and polysialic acid (PSA) serve as endogenous substances, which are non-immunogenic and biodegradable. At the same time, SA modification of the drugs/carriers can enhance the uptake of tumor cell and retention in brain; PSA modification can reduce the immunogenicity of the proteins or polypeptides and increase circulation time of the modified drugs/carriers in the blood, thus achieving active targeting effect. These properties offer a variety of opportunities for applications in drug delivery systems. This article summarizes the biological functions of SA and PSA and presents the technologies of SA/PSA modified small molecule drugs, proteins and carriers in drug delivery systems.     

Serum desialotransferrin in the detection of alcohol abuse. Definition of a Tf index

Different molecular forms of transferrin (Tf) have been separated in sera from alcoholics and controls by isoelectric focusing on ultrathin polyacrylamide gels using a semi narrow pH range. The main fraction focused at pH 5.4 (Tf5.4) and minor components appeared among controls at pH 5.7 (Tf5.7). This fraction was increased among alcoholics and was sometimes accompanied by a fraction focusing at pH 5.9 (Tf5.9). Fractions were quantified by densitometry following immunofixation. Significant differences in the ratios Tf5.4/Tf and Tf5.7/Tf between the groups were obtained, but no difference could be determined in the total Tf. We used the ratio Tf5.7/Tf5.4 called Tf index to distinguish alcoholics from controls. The sensitivity, the specificity and the global predictive value of this test were 0.82, 1 and 0.88 respectively. These results seems to indicate that the Tf index is more reliable for the detection of alcohol abuse than liver enzymes such as gammaglutamyl transferase (gamma GT) or glutamate dehydrogenase (GDH).     

Towards the prevention of alcohol abuse

Mortality resulting from alcohol abuse in young French people is too high in spite of prevention campaigns for road safety in particular. There are problems in identifying alcohol abuse in young people in preventive medicine or alcohol care services. This study was carried out in alcohol centres; data from patients under 25 are analysed and compared to a same-age group of young adults who are consulting in preventive medicine centres. In comparison with older people, these two groups of young adults presented similar characteristics, a lower educational grade, a precocity of psychotropic substance consumption, a preference for beers and spirits consumed episodically or during weekends, more frequent use of tobacco and cannabis, and, finally, greater frequency of drunkenness. The consequent risks of accidents are higher, on road use particularly. Therefore, early identification of alcohol abuse and training for professionals who work in socioeducational settings should be developed to improve the response to these new behaviours. The preventive medicine centres are appropriate for the detection of risk behaviours associated with alcohol or with polysubstance use. Local programs should be set up not only to delay the age of the first intake but to decrease the consumption peak.     

Towards the prevention of alcohol abuse

Mortality resulting from alcohol abuse in young French people is too high in spite of prevention campaigns for road safety in particular. There are problems in identifying alcohol abuse in young people in preventive medicine or alcohol care services. This study was carried out in alcohol centres; data from patients under 25 are analysed and compared to a same-age group of young adults who are consulting in preventive medicine centres. In comparison with older people, these two groups of young adults presented similar characteristics, a lower educational grade, a precocity of psychotropic substance consumption, a preference for beers and spirits consumed episodically or during weekends, more frequent use of tobacco and cannabis, and, finally, greater frequency of drunkenness. The consequent risks of accidents are higher, on road use particularly. Therefore, early identification of alcohol abuse and training for professionals who work in socioeducational settings should be developed to improve the response to these new behaviours. The preventive medicine centres are appropriate for the detection of risk behaviours associated with alcohol or with polysubstance use. Local programs should be set up not only to delay the age of the first intake but to decrease the consumption peak.     

Neurobiology of alcohol abuse.

Excessive consumption of beverage alcohol (ethanol) is a major health concern worldwide. Understanding the mechanisms by which ethanol affects neural functioning, after both acute and chronic exposure, has become a major goal in the study of alcoholism. With such an understanding, we should be able to institute more effective treatments and preventative measures for alcohol abuse problems. Recent studies have found, contrary to earlier assumptions, that ethanol has selective, dose-dependent effects on various neurotransmitter systems within the CNS. These effects are observed at all levels of analysis, from molecular to behavioral. This review by Herman Samson and Adron Harris covers these recent findings, with the intent of generating questions that will focus further research efforts.     

The relationship between prenatal care,personal alcohol abuse and alcohol abuse in the home environment

Aims: Nearly one-fourth of African-American women receive no prenatal care during the first trimester of pregnancy. The aim of the current study is to identify factors that underlie inadequate prenatal care among African-American women. Maternal alcohol abuse has been examined as one risk factor for inadequate prenatal care, but findings have been inconsistent, perhaps because (a) alcohol use during pregnancy is substantially under-reported and (b) studies have not considered the wider social network in which maternal alcohol use takes place. The current study attempts to clarify relationships between personal alcohol use, alcohol use in the home environment, and prenatal care in a sample of post-partum women.

Methods: Participants were 107 low-income, primarily African-American women. All participants completed a computer-based screening which assessed personal and environmental alcohol use, prenatal care and mental health.

Findings: Environmental alcohol use was related to delayed prenatal care while personal alcohol use was not. More specifically, after controlling for demographic variables, the presence of more than three person-episodes of binge drinking in a woman's home environment increased the odds of seriously compromized prenatal care by a factor of seven.

Conclusions: Findings suggest the need to further assess environmental alcohol use and to examine the reliability of personal alcohol use measures.     

Experimental approaches to the evaluation of alcohol abuse and dependence development.

In rats, a complex longitudinal analysis of alcohol intake behaviour and electrophysiological sleep pattern was performed during different periods of stable voluntary alcohol consumption. By the sleep pattern, the existence of alcohol abuse and dependence development could be confirmed. Acute ethanol withdrawal was shown to be the obligatory and necessary element in alcohol abuse and dependence evaluation. The proposed behavioural and sleep pattern models might be used in the search for anti-alcoholic drugs in combination with the study of alcoholic aging processes.     

Multivariate analysis of behaviour related to alcohol abuse in rats

The ethanol withdrawal procedure was used to measure the alcohol abuse in rats after 2 months' access to a sweet ethanol solution. Alcohol abuse was found to be predicted by the initial level of the rat's locomotor asymmetry. The initial consumption of ethanol solutions was not found to be associated to the probability of alcohol abuse.