观察输液泵调整催产素滴速在足月妊娠引产中的应用

目的 评价在足月妊娠引产中应用输液泵对催产素滴速进行调整的效果和价值.方法 本研究样本为我院收治的足月妊娠引产产妇188例,以2016年2月至2017年2月为样本选择时间段,所有产妇均静脉滴注催产素进行引产,采用抽签方式进行分组,94例予以输液泵对催产素滴速进行调整的产妇设置为实验组,而94例予以人工调节催产素滴速的产妇设置为对照组,对2组产妇的引产效果进行比照和评价.结果 相比于对照组,实验组产妇的引产成功率得以显著提升(P<0.05);同时相比于对照组产程时间,实验组产妇产程时间得以显著缩短(P<0.05);而2组产妇的强制性宫缩发生率、急产发生率、产后出血发生率、剖宫产率无统计学意义(P>0.05).结论 在足月妊娠引产中应用输液泵对催产素滴速进行调整效果显著,不但可提升催产效率,促进产程缩短,同时方便给药,准确调节药量,缩短输液时间,对人力物力进行节省,在临床上值得应用和推广.     

宫颈扩张球囊联合人工膜及静滴催产素在足月妊娠引产中的效果观察

目的足月妊娠引产产妇应用宫颈扩张球囊、人工膜与催产素联合效果分析。方法选取2018年3月至2019年3月本院诊治110例足月妊娠引产产妇临床资料,按随机数表分两组,对照组予催产素静滴,研究组予宫颈扩张球囊、人工膜与催产素联合方案,分析两组引产效果指标、分娩方式及并发症情况。结果治疗后,研究组Bishop宫颈(8.96±0.61)分、临产时间(13.26±5.18)h、总产程(6.54±1.22)h及住院时间(4.32±1.38)d,均比对照组少(P <0.01);研究组顺产87.27%比对照组多(P <0.01);且研究组发生产后出血、羊水浑浊等并发症5.45%比对照组少(P <0.05)。结论足月妊娠引产产妇应用宫颈扩张球囊、人工膜与催产素联合治疗,能促进宫颈成熟度,缩短临床及总产程时间,提高产妇顺产发生率,降低并发症。     

米索前列醇与催产素用于足月妊娠低宫颈引产疗效对比分析

目的:比较米索前列醇与催产素用于足月妊娠低宫颈引产的临床疗效。方法:选取168例有引产指征的足月妊娠低宫颈评分产妇作为研究对象,随机分为实验组和对照组,分别给予米索前列醇和催产素引产。结果:实验组顺产率及引产成功率显著高于对照组,实验组分娩第1产程、第2产程、总产程均显著低于对照组,但是术后2h出血量显著高于对照组,差异均有统计学意义(P0.001)。结论:米索前列醇用于足月妊娠低宫颈评分引产可有效提高引产成功率和降低剖宫产率。     

间苯三酚联合催产素在产妇自然分娩中的作用

目的评价间苯三酚联合催产素在产妇自然分娩中作用。方法选择单胎头位足月妊娠产妇76例。随机分为观察组和对照组。观察组产妇有规则宫缩,肛诊宫口开大≤3cm时,予以间苯三酚40mg肌注,并予以低浓度催产素静滴以调整宫缩。对照组产妇仅给予低浓度催产素静滴。观察两组产妇第一、二、三产程时间、分娩方式和产科并发症。结果观察组第一产程时间明显短于对照组(P<0.01)。两组产妇第二、三产程时间的比较无明显统计学差异(P>0.05)。观察组的剖宫产率明显低于对照组(χ2=8.49,P<0.01)。观察组的胎儿窘迫、新生儿窒息和宫颈水肿的发生率明显低于对照组(均P<0.05)。两组产后出血的发生率比较无明显统计学差异(P>0.05)。结论催产素与间苯三酚联合应用可缩短分娩时间,降低剖宫产率,减少了胎儿窘迫、新生儿窒息和宫颈水肿的发生率,安全性较好。     

小剂量米索前列醇在足月分娩应用中的效果观察

目的探讨小剂量米索前列醇宫颈后穹隆用药在足月妊娠引产应用中的效果及安全性。方法选取2005年4月至2011年5月来我院接诊的待产产妇80例,随机分为观察组和对照组。观察组40例用小剂量米索前列醇置于宫颈后穹隆引产;对照组40例静滴催产素,连续用药2d。记录两组引产时间、总产程、产后出血量及新生儿体质量。结果观察组的引产有效率为97.5%,较对照组的引产有效率87.5%差异明显;观察组引产时间和总产程较对照组短,P<0.05;两组产后出血和新生儿体质量方面差异无显著性,P>0.05。结论小剂量米索前列醇能引起规律宫缩,又能促进宫颈成熟,用于足月妊娠引产效果良好,是一种方便、有效而又安全的方法。     

欣普贝生与催产素用于足月胎膜早破引产的效果比较

目的观察欣普贝生对于足月胎膜早破孕妇促宫颈成熟的有效性和安全性。方法将80例妊娠足月、胎膜早破,宫颈Bishop评分≤6分、无阴道分娩禁忌证、单胎头位孕妇随机分为两组。40例以阴道放置欣普贝生促宫颈成熟为研究组,40例用小剂量催产素引产为对照组。比较两组孕妇的宫颈Bishop评分、用药至临产时间、总产程、阴道分娩率及对母儿的影响。结果研究组宫颈成熟度明显增高,用药至临产时间、总产程缩短,阴道分娩率升高,两组比较差异有统计学意义(P<0.05)。两组间新生儿窒息的发生率、产后出血量差异无显著性(P>0.05)。结论欣普贝生可安全、有效地用于足月胎膜早破孕妇促宫颈成熟。     

间苯三酚用于产妇分娩扩张宫颈126例的效果评价

目的探讨间苯三酚在产妇分娩扩张宫颈中的效果评价。方法将2012年1月至2012年10月的252例产妇随机分为治疗组126例和对照组126例,在宫口开大1～1.5 cm时,治疗组使用间苯三酚80 mg,对照组给予地西泮10 mg,均静脉注射,统计两组产妇分娩产程、产后出血量,观察期宫颈扩张情况,计算剖宫产率及新生儿窒息率等。结果两组患者在总产程、剖宫产率、新生儿窒息率、用药后宫颈扩张及不良反应发生情况方面具有显著性差异(P<0.05),治疗组优于对照组。结论在产妇分娩扩张宫颈时应用间苯三酚的效果确切、安全可靠,应加大临床推广力度。     

米索前列醇用于足月妊娠低宫颈评分引产与催产素引产疗效对比与分析

目的：探讨米索前列醇应用于足月妊娠低宫颈评分引产产妇的临床效果。方法104例足月妊娠低宫颈评分引产产妇随机分为研究组46例和对照组58例,研究组产妇应用米索前列醇引产,对照组产妇应用催产素引产。结果研究组产妇剖宫产率明显低于对照组,顺产率、引产成功率明显高于对照组,数据经统计学比较具有显著差异（ P ＜0 ．05）;研究组产后出血量明显低于对照组,2组经统计学比较具有显著差异（ P ＜0．05）。结论米索前列醇应用于足月妊娠低宫颈评分产妇的引产具有较高的成功率和安全性,可降低剖宫产率。     

间苯三酚联合缩宫素在足月妊娠引产中促宫颈成熟的作用

目的:对间苯三酚联合缩宫素在足月妊娠引产中促宫颈成熟的作用进行探讨.方法:在本科住院或门诊无临产先兆的足月妊娠孕妇200例,根据入院编号平均分组,单号为实验组,双号为对照组,各100例,实验组先用5%葡萄糖250mL+间苯三酚120mg静脉滴注,接着用5%葡萄糖500mL+缩宫素2.5单位静脉滴注;对照组用5%葡萄糖500mL+缩宫素2.5单位静脉滴注.结果:实验组引产成功率以及用药至临产时间均优于对照组,P<0.05,两组在出血率、 新生儿窒息率以及羊水情况方面均没有显著差异,P>0.05.结论:间苯三酚联合缩宫素在足月妊娠引产中促宫颈成熟的作用效果确切,值得推广.     

催产素联合地西泮在低宫颈评分引产中的应用

目的观察催产素联合地西泮应用促宫颈成熟的安全性和有效性。方法将246例低宫颈评分患者随机分成观察组和对照组,观察组采用催产素联合地西泮,对照组单用催产素,比较两组临产时间,总产程,产后出血量,新生儿评分,分娩方式等。结果观察组引产成功率高,观察组与对照组临产发动的时间,总产程明显缩短(P<0.05)产后出血量,新生儿评分,分娩方式无明显差异(P>0.1)。结论对于低宫颈评分患者采用催产素联合地西泮的引产方法安全有效。     

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.

     

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.     

2-(Acetoxyphenyl)-(Z)-styryl sulfides as cyclooxygenase inhibitors

2-(Acetoxyphenyl)-(Z)-styryl sulfides are described as selective cyclooxygenase-2 (COX-2) inhibitors, useful for treating inflammation and COX-2-mediated disorders including neoplasia. 2-(Acetoxyphenyl)-(Z)-styryl sulfide is claimed to be the most potent COX inhibitor in the series with a COX-2 selectivity ratio of 33. This compound is also claimed to be superior to celecoxib (Celebrex^®, Pfizer) in inhibiting cell growth of colorectal carcinoma cells. In this evaluation, the COX inhibitory activity of this compound is compared to that previously disclosed for diarylheterocycles and 2-(acetoxyphenyl)alkyl sulfides. The validity of the DLD-1 cell line in the growth inhibition studies is questioned based on recent literature reports indicating the lack of COX-2 expression in this cell line.     

Sleep-disordered breathing with chronic opioid use

Chronic opioid use for pain relief or as substitution therapy for illicit drug abuse is prevalent in our societies. In the US, retail distribution of methadone and oxycodone has increased by 824 and 660%, respectively, between 1997 and 2003. μ-Opioids depress respiration and deaths related to illicit and non illicit chronic opioid use are not uncommon. Since 2001 there has been an emerging literature that suggests that chronic opioid use is related to central sleep apnoea of both periodic and non-periodic breathing types, and occurs in ～ 30% of these subjects. The clinical significance of these sleep-related abnormalities are unknown. This review addresses the present knowledge of control of ventilation mechanisms during wakefulness and sleep, the effects of opioids on ventilatory control mechanisms, the sleep-disordered breathing found with chronic opioid use and a discussion regarding the future research directions in this area.     

Drug targets for cognitive enhancement in neuropsychiatric disorders

The investigation of novel drug targets for treating cognitive impairments associated with neurological and psychiatric disorders remains a primary focus of study in central nervous system (CNS) research. Many promising new therapies are progressing through preclinical and clinical development, and offer the potential of improved treatment options for neurodegenerative diseases such as Alzheimer's disease (AD) as well as other disorders that have not been particularly well treated to date like the cognitive impairments associated with schizophrenia (CIAS). Among targets under investigation, cholinergic receptors have received much attention with several nicotinic agonists (α7 and α4β2) actively in clinical trials for the treatment of AD, CIAS and attention deficit hyperactivity disorder (ADHD). Both glutamatergic and serotonergic (5-HT) agonists and antagonists have profound effects on neurotransmission and improve cognitive function in preclinical experiments with animals; some of these compounds are now in proof-of-concept studies in humans. Several histamine H3 receptor antagonists are in clinical development not only for cognitive enhancement, but also for the treatment of narcolepsy and cognitive deficits due to sleep deprivation because of their expression in brain sleep centers. Compounds that dampen inhibitory tone (e.g., GABA_A α5 inverse agonists) or elevate excitatory tone (e.g., glycine transporter inhibitors) offer novel approaches for treating diseases such as schizophrenia, AD and Down syndrome. In addition to cell surface receptors, intracellular drug targets such as the phosphodiesterases (PDEs) are known to impact signaling pathways that affect long-term memory formation and working memory. Overall, there is a genuine need to treat cognitive deficits associated with many neuropsychiatric conditions as well as an increasingly aging population.