Bilibed婴儿蓝光床治疗早产儿高胆红素血症的观察与护理

目的:观察Bilibed婴儿蓝光床治疗早产儿高胆红素血症的疗效及护理。方法:采取临床随机分组对照方法,选择90例符合光疗指征的早产儿高胆红素血症的患儿分成两组,对照组45例,采用单面光疗治疗;治疗组45例,采用Bilibed婴儿蓝光床治疗;观察光疗前后两组血清总胆红素、临床反应和护理问题。结果:两组早产儿在光疗后组间的总胆红素值和间接胆红素值的比较差异无显著性(P>0.05);但对照组出现的临床反应及护理问题明显多于治疗组。结论:Bilibed婴儿蓝光床治疗早产儿高胆红素血症安全有效。     

婴儿蓝光床治疗新生儿黄疸疗效观察

婴儿蓝光床是治疗新生儿高胆红素血症 (简称高胆 )的一种新型的光疗仪器 ,我院将瑞士 Bilibed婴儿蓝光床与国产双面蓝光箱进行疗效观察对照 ,现将对照比较报告如下。1　对象与方法1.1　对象 :住我院的新生儿高胆红素血症患儿 (足月儿血清总胆红素浓度≥ 2 0 5 .2 μmol/ L,早产儿≥ 2 65 .5 μmol/ L)3 2例 ,其中足月儿 18例 ,早产儿 14例 ,随机分为两组 ,A组 17例为观察组 ,B组 15例为对照组 ,均母乳喂养 ,各组的性别、胎龄大小 ,出生体重之间差异均无显著性 ( P >0 .0 5 )。1.2　方法 :在综合治疗基础上 ,观察组 17例 ,应用 Bilibed蓝…     

两种不同光疗方式治疗新生儿高胆红素血症疗效的比较

目的 比较两种光疗方式治疗新生儿高胆红素血症的疗效和副作用.方法 选择80例符合光疗指征的新生儿高胆红素血症患儿,分为两组,Ⅰ组使用双面蓝光治疗,Ⅱ组使用蓝光床进行光疗.观察胆红素的变化及副作用.结果 光疗后两组间的总胆红素和间接胆红素差异均有统计学意义(P＜0.01);两组光疗前后总胆红素和间接胆红素比较均有显著降低(均P＜0.01).Ⅰ组和Ⅱ组24 h间接胆红素下降率分别是29%和21%,差异有统计学意义;光疗副作用Ⅰ组多于Ⅱ组.结论 双面蓝光的光疗效果优于蓝光床光疗的疗效,但副作用也大,应根据不同情况选择光疗方式.     

三种光疗方法治疗新生儿高胆红素血症疗效比较

目的观察3种光疗方法的疗效和副作用。方法选择120例新生儿高胆红素血症符合光疗指征的患儿分3组,A组采有双面蓝光箱治疗,B组采用蓝光毯治疗,C组采用蓝光床治疗。观察胆红素的变化及光疗副作用。结果光疗前3组间的总胆红素和间接胆红素比较差异均无显著性(P>0.05),光疗后3组间的总胆红素和间接胆红素比较差异均有显著(P<0.01);A组与B、C组对比有显著差异;光疗副作用A组多于B、C组。结论双面蓝光籍的光疗效果优于蓝光毯及蓝光床,但副作用大;应根据不同情况采取相应光疗方式。     

不同光疗持续时间的蓝光照射治疗对新生儿高胆红素血症疗效的影响

目的：探讨不同光疗持续时间的蓝光照射治疗对新生儿高胆红素血症疗效的影响,为临床提供治疗方案的选择和参考依据。方法足月高胆红素血症患儿90例,随机分为A、B、C三组,每组30例,均采用单面蓝光治疗仪进行光疗治疗。A组24 h内蓝光照射8 h,停16 h;B组24 h内蓝光照射12 h,停12 h;C组为持续24 h光疗,停24 h,三组均以3 d为1个疗程,统计其疗效。结果三组治疗后总疗效比较差异无统计意义（P〈0.05）, C组不良反应发生率20.0%较A组6.7%、B组10.0%高,差异有统计学意义（P＜0.05）。结论三组不同光疗时间治疗新生儿高胆红素血症疗效相似,但是间断光疗治疗不良反应发生率更低,其中8h/d间断光疗更具有临床实践优势。     

不同光疗方式对新生儿高胆红素血症疗效的影响

目的探讨不同光疗时间及方式对新生儿高胆红素血症疗效的影响。方法将97例高胆红素血症患儿随机分为3组。间歇光疗组32例,每天光疗8h,休息16h。持续光疗A组38例,持续光疗24h。持续光疗B组27例,持续光疗72h。结果3组血清总胆红素光疗前比较差异无统计学意义（P〉0．05）,光疗后与光疗前比较均有统计学意义（P〈0．01）。间歇光疗组与持续光疗A组光疗后总胆红素水平比较差异无统计学意义（t=1．936,P=0．057）,间歇光疗组与持续光疗B组比较差异有统计学意义（t=2．784,P=0．007）,持续光疗A组与持续光疗B组比较差异无统计学意义（t=0．948,P=0．347）。间歇光疗组与持续光疗A组副作用比较差异无统计学意义（P〉0．05）,间歇光疗组与持续光疗B组副作用有显著差异（P〈0．05）。结论3种光疗方式治疗高胆红素血症均有效,24h持续光疗可迅速降低血清总胆红素水平,无明显副作用,且能缩短患儿的住院时间,可代替8h间歇光疗法,72h持续光疗疗效显著,但副作用发生率高,仅能适用于重症、无换血条件的单位。     

光疗对新生儿血清钙影响

目的探讨蓝光治疗新生儿高胆红素血症对血清钙的影响。方法将90例新生儿高胆红素血症患儿按胎龄分为足月儿及早产儿两组,足月儿50例,早产儿40例,测定光疗前后血清钙水平,比较两组低钙血症的发生率。结果足月儿和早产儿光疗后血清总钙和游离钙均下降（P〈0.01）,早产儿低钙血症的发生率为50.0%,足月儿为28.0%,两组比较有显著性差异（P〈0.05）。结论新生儿接受光疗时易发生低钙血症,其中早产儿比足月儿发生率更高,光疗时应监测血钙浓度,必要时补钙。     

不同蓝光照射方式对新生儿高胆红素血症疗效比较

目的 探讨不同蓝光照射方式对新生儿高胆红素血症的疗效.方法 将86例高胆红素血症的患儿分为两组,即A组和B组,分别给予持续光照疗法和间歇光照疗法,观察两组胆红素下降及副作用的发生情况.结果 两组患儿治疗后血胆红素水平均明显降低(均P<0.01),B组副作用的发生率明显低于A组(P<0.01).结论 间歇光疗疗效好、副作用小.     

蓝光床与传统光疗箱治疗新生儿黄疸的疗效比较

目的 比较蓝光床与传统光疗箱治疗新生儿黄疸的疗效.方法 符合光疗指征并且直接胆红素基本在正常范围仅以间接胆红素升高为主的新生儿黄疸40例予以蓝光床治疗,48例予以传统光疗箱治疗,两组均每天照射12 h,连续3 d,药物治疗应用苦黄、门冬酸钾镁、人体白蛋白等,两组资料无差异,观察两者疗效.结果 蓝光床治疗组血清总胆红素下降66±34μmol·L-1,传统光疗箱治疗组新生儿黄疸血清总胆红素下降79±25μmol·L-1.结论 两种方法治疗后总胆红素均明显下降,疗效显著,但两种仪器之间的退黄效果比较差别不明显,前者相比具方便、副作用少等特点.     

间歇和持续蓝光照射治疗新生儿高胆红素血症临床疗效分析

目的:观察间歇光疗和持续光疗治疗新生儿高胆红素血症的疗效及对患儿产生的不良反应.方法:将所选180例患儿随机分为2组,分别为间歇光疗组、持续光疗组,对间歇蓝光照射与持续蓝光照射治疗的情况进行分析.结果:2组蓝光照射同组治疗前后血清间接胆红素比较,差异有统计意义(P<0.05);但治疗后组间比较差异无统计意义(P>0.05).2组蓝光照射治疗后不良反应比较差异有高度统计意义(P＜0.01).结论:间歇蓝光照射能达到持续蓝光照射同样的效果,而且间歇蓝光照射不良反应的发生率较持续蓝光照射明显降低,值得临床推广.     

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.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

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.