小剂量咪唑安定复合异丙酚静脉麻醉用于胃镜检查的观察

目的探讨麻醉状态下消化内镜检查的可行性。方法选择接受胃镜检查患者100例,随机分为二组,ASAI～II级,麻醉组50例予以咪唑安定0.06mg/kg、异丙酚1.5～2mg/kg静脉注射,50例为对照组。观察患者检查前、检查中、检查后的血压、心率、血氧饱和度,观察手术操作时间,清醒时间、不良反应及患者的满意度。结果麻醉组不良反应发生率明显降低(P<0.01),检查中血压、心率较检查前均有不同程度下降,患者的满意度和愿意再次接受检查的比例明显高于对照组(P<0.01)。结论小剂量咪唑安定复合异丙酚静脉麻醉应用于胃镜检查安全可行,可明显减轻痛苦和不良反应。     

小剂量芬太尼与丙泊酚复合麻醉应用无痛胃镜检查120例临床体会

目的探讨应用小剂量芬太尼与丙泊酚复合麻醉实施无痛胃镜检查的临床价值和体会。方法对120例自愿接受无痛胃镜患者实施芬太尼与丙泊酚复合麻醉,记录血压、心率、血氧饱和度,待患者清醒后询问遗忘程度及复诊率。结果麻醉深度能满足胃镜检查的需要,有7例患者给药后血压、心率、血氧饱和度均有不同程度下降,处理后恢复正常,所有患者均在10min内苏醒,且对胃镜检查过程无记忆,自觉舒适,愿意再次接受无痛胃肠镜检查的占99.2%。结论小剂量芬太尼与丙泊酚复合麻醉实施无痛胃肠镜检查是一种安全、舒适、有效的方法,值得临床推广应用。     

异丙酚静脉麻醉辅助胃镜检查的临床研究

目的：应用异丙酚静脉麻醉辅助胃镜检查,以良好的镇静、镇痛效果增加患者接受检查的依从性,提高入镜一次检查成功率,减少胃镜检查并发症发生。方法：将400例患者按自愿分为2组：麻醉组200例静脉注射异丙酚至患者进入4级镇静状态后进行胃镜检查;对照组按常规进行胃镜检查。比较两组检查前、检查开始后1min、检查开始后5min和检查结束后各个阶段的心率、血压和血氧饱和度变化以及检查反应、并发症和入镜一次检查成功率。结果：麻醉组在检查开始后1min时血压有明显变化（P〈0．01）,但波动在正常范围内;而心率和血氧饱和度在各时段的变化差异均无统计学意义（P〉0．05）。但对照组血压在检查开始1、5min时段,心率在各时段均有明显变化（P〈0．01）,麻醉组各种并发症病例明显少于对照组（P〈0．01）,麻醉组的入镜一次成功率明显高于对照组（P〈0．01）;麻醉组病人依从性、复检接受率明显高于对照组（P〈0．01）。结论：异丙酚静脉麻醉辅助胃镜检查安全无痛苦、并发症明显著少于普通胃镜检查,乐于被病人接受。     

异丙酚静脉麻醉减少胃镜检查的并发症

目的 探讨应用异丙酚静脉麻醉减少胃镜检查并发症的可行性和安全性。方法 将2160例胃镜检查患者分为2组：麻醉组(1290例)静脉注射异丙酚至患者进入4级镇静状态后进行胃镜检查;对照组(1121例)按常规进行胃镜检查。比较两组检查前、检查开始后1、5、20min和检查结束后的血压、心率、血氧饱和度以及检查反应、合并症和入镜一次检查成功率。结果 检查过程中,麻醉组的血压在1min时有明显变化(P＜0.01),而心率和血氧饱和度在各时段的变化均无显著性差异(P＞0．05)。但对照组血压在1、5min时段,心率在各时段,均有明显变化(P＜0．01),而且变化幅度大于麻醉组。麻醉组并发精神神经反应和操作损伤的病例明显少于对照组(P＜0．01),麻醉组的入镜一次检查成功率明显高于对照组(P＜0．01)。结论 异丙酚辅助胃镜检查是安全有效的,其并发症明显少于普通胃镜检查。     

无痛胃镜检查术中丙泊酚的应用和护理

目的 探讨丙泊酚在无痛胃镜检查术中的效果及护理方法.方法 选取2015年4~7月行胃镜检查的80例作为研究对象,随机分为对照组与观察组,对照组进行常规胃镜检查,观察组采用丙泊酚静脉麻醉下胃镜检查,两组患者均进行术前、术中、术后护理,记录检查过程中患者心率、呼吸、血压、血氧饱和度的变化,对检查结果进行分析.结果 在胃镜检查中,观察组发现1例患者通气不足, 2例患者的血压、心率和血氧饱和度出现一过性降低的情况.对照组发现6例患者通气不足,呼吸浅而慢,血氧饱和度出现快速降低的情况,有8例患者在检查中出现血氧饱和度、心率和血压降低的现象.与对照组比较,观察组发生的不良后果较少 (P<0.05).结论 丙泊酚行无痛胃镜检查具有确切的麻醉效果,患者舒适安全,值得在临床上推广应用.     

高血压病患者无痛胃镜检查术探讨

目的探讨联合应用异丙酚和小剂量芬太尼在高血压病患者无痛胃镜检查术中的有效性和安全性。方法398例有胃镜检查适应症的高血压病患者分为两组,其中200例给予异丙酚及芬太尼静脉复合麻醉为试验组,198例行常规操作为对照组,观察两组患者的反应及血压、心率、呼吸、血氧饱和度的变化。结果试验组在检查过程中血压、心率、及呼吸均较检查前明显下降(P<0.05),但在检查结束后基本恢复正常,血氧饱和度在检查前、中、后无差异(P>0.05)。结论异丙酚和芬太尼静脉复合麻醉应用于高血压病患者胃镜检查,是一种安全、有效的方法。     

老年高血压患者静脉麻醉胃镜检查安全性分析

目的 观察老年高血压患者静脉麻醉胃镜检查的安全性.方法 对50例老年高血压患者采用静脉麻醉下胃镜检查,观察麻醉中及苏醒时血压、心率、血氧饱和度变化情况及不良反应发生情况,并与老年无高血压组比较.结果 检查过程中两组血压、心率、血氧饱和度均有不同程度下降(P均<0.05),术后恢复基本正常水平(P>0.05).所有接受静脉麻醉的患者均顺利完成胃镜检查,术后对检查过程无痛苦记忆.结论 在严格控制适应证的条件下,适当剂量的静脉麻醉下老年高血压患者胃镜检查是安全、可行的.     

无痛胃镜检查116例临床观察

目的：探讨无痛胃镜检查的优势与安全性。方法：胃镜检查患者116例给予丙泊酚和咪达唑仑静脉麻醉,行无痛胃镜检查,观察患者清醒时问及检查前、中、后血压,心率和血氧饱和度变化。120例子常规胃镜检查（不给任何镇静药）,比较两组患者胃镜检查中反应和感受。结果：无痛胃镜组99．14％患者无不适,而对照组为35％（P〈0．01）。无痛胃镜组患者咳嗽、躁动、恶心呕吐和咽喉不适的发生率明显低于对照组,且胃镜操作时间及患者清醒时间均较对照组短。无痛胃镜组检查中有血压下降,但检查结束后迅速恢复至检查前水平。结论：无痛性胃镜检查,是一种安全、有效的方法。     

异丙酚联合小剂量咪唑安定在肠镜检查中的应用

目的:研究异丙酚和小剂量咪唑安定在肠镜检查中麻醉效果和患者的满意程度。方法:将进行胃镜检查30例。随机分为对照组(n=15)和麻醉组(n=15),对照组患者常规进行肠镜检查;麻醉组患者静脉注射咪唑安定(1.5～2.0mg)和异丙酚(1.5mg/kg),患者意识消失后,立即进行肠镜检查。两组患者在胃镜检查中均监测血压、心率、氧饱和度的变化,检查后询问患者的满意程度。结果:麻醉组心率和血压与对照组相比均有明显下降(P<0.05);两组氧饱和度差异无统计学意义(P>0.05);麻醉组满意程度高于对照组(P<0.05)。结论:异丙酚联合小剂量咪唑安定进行肠镜检查是一种安全有效、舒适、易被接受的无痛肠镜检查。     

咪唑安定和丙泊酚在胃镜检查中的镇静作用

目的探讨咪唑安定和异丙酚在胃镜检查和治疗中应用的可行性。方法无痛胃镜组使用咪唑安定和丙泊酚(异丙酚)静脉麻醉下完成胃镜检查,术中检测心率、血压和血氧饱和度,并与常规胃镜组作对照。结果两组对比,术中心率、血压和血氧饱和度差异无统计学意义,无痛胃镜组患者无恶心、呕吐、躁动等不适主诉。结论咪唑安定和丙泊酚静脉麻醉下胃镜检查和治疗是一种安全无痛苦的方法。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.