34例窒息新生儿肾功能测定分析

为了解窒息新生儿肾损害发生情况 ,比较不同的窒息程度与肾损害的关系 ,对54例新生儿做了血、尿 β2-MG和BUN、Cr的测定 ,现报道如下。1资料和方法1.1临床资料 :窒息组34例来自我院新生儿病房 ,符合孕期37～42周 ,及生后1分钟Apgar评分≤7分 ,其中男19例 ,女15例。据出生时 (1分钟、3分钟、5分钟三项评分中最低一项 )Ap gar评分分为轻度窒息组(Apgar评分4分 -7分)23例 ,重度窒息组 (Apgar评分0分 -3分 )11例 ,对照组为本院妇产科同期分娩的无窒息的足月顺产新生儿20例 ,Apgqr评分均为10分 ,男9例 ,女11例 ,两组新生儿出生体重、胎龄差…     

新生儿窒息复苏过程中应用不同氧浓度的临床效果及脑保护作用分析

目的 研究新生儿窒息(AON)复苏过程中应用不同氧浓度的临床效果及脑保护作用。方法 180例新生儿窒息患儿,随机分为低氧浓度组、中氧浓度组和高氧浓度组,三组新生儿窒息复苏过程中分别给予低氧浓度(21%)、中氧浓度(45%)和高氧浓度(100%),比较三组新生儿不同时间的Apgar评分及复苏效果、脑损伤情况。结果 低氧浓度组的Apgar评分在出生后1、5、10 min分别为(4.52±0.85)、(6.65±1.02)、(8.58±0.95)分;中氧浓度组的Apgar评分在出生后1、5、10 min分别为(4.93±0.78)、(7.12±0.81)、(9.18±1.30)分;高氧浓度组的Apgar评分在出生后1、5、10 min分别为(4.02±1.08)、(6.08±1.22)、(8.05±1.15)分。低氧浓度组及中氧浓度组各时间点的Apgar评分均明显高于高氧浓度组,差异有统计学意义(P<0.05)。三组患儿复苏成功率均为100%。低氧浓度组脑损伤率为18.3%,中氧浓度组为11.7%,高氧浓度组为35.0%,低氧浓度组及中氧浓度组的脑损伤率低于高氧浓度组,差异有统计学意义(P<0.05)。结论 在新生儿窒息复苏过程中,实施中氧浓度进行复苏,可加快新生儿进行自主呼吸,降低脑损伤发生率,具有更好的脑保护作用,对今后临床治疗新生儿窒息具有指导作用。     

157例新生儿窒息的复苏体会

目的 总结1999年10月～2001年10月我院157例窒息新生儿复苏的体会。方法 采用复苏ABCDE法对窒息儿进行复苏。结果 157例窒息新生儿中,抢救存活155例(占98.73％)。仅2例(1.27％)早产低体重窒息儿,抢救无效死亡。155例患儿5分钟Apgar评分均5分以上,10分钟Apgar评分均8分钟以上,其中92例转儿科观察治疗,均痊愈出院。结论 熟练掌握ABCDE复苏技术,可以有效地提高复苏的成功率。     

157例新生儿窒息的复苏体会

目的总结1999年1 0月～2 001年10月我院1 57例窒息新生儿复苏的体会.方法采用复苏ABCDE法对窒息儿进行复苏.结果1 5 7例窒息新生儿中,抢救存活1 55例(占98.7 3%).仅2例(1.27%)早产低体重窒息儿,抢救无效死亡.1 55例患儿5分钟Apgar评分均5分以上,10分钟Apgar评分均8分钟以上,其中92例转儿科观察治疗,均痊愈出院.结论熟练掌握ABCDE复苏技术,可以有效地提高复苏的成功率.     

新生儿窒息血气分析指标变化与血清神经系统相关性蛋白的分析研究

目的观察窒息新生儿的血气分析指标与血清神经系统相关性蛋白水平的变化,分析各指标与窒息的相关性。方法收集我院2016年4月～2018年3月足月的窒息后复苏新生儿60例作为病例组,根据Apgar评分分为轻度窒息(n=36)和重度窒息(n=24)两个亚组,同期足月健康新生儿60例作为对照组,均于生后2h内抽取桡动脉血进行血气分析,并采用电化学发光法检测血清神经元特异性烯醇化酶(NSE)和S100蛋白,建立直线回归方程,采用Spearman相关性检验血气分析指标、NSE和S100蛋白与新生儿窒息的相关性。结果轻度窒息、重度窒息组、对照组三组间氧合指数、PH值、NSE、S100蛋白差异均有统计学意义(P 0.05)。重度组PO_2、PCO_2与对照组、轻度窒息组差异均有统计学意义(P 0.05)。而轻度窒息、对照组PO_2、PCO_2差异无统计学意义(P 0.05)。PO_2与NSE、S100蛋白呈弱正相关,PCO_2与NSE、S100蛋白呈弱负相关,氧合指数、PH值与NSE、S100蛋白呈中度负相关,NSE与NSE、S100蛋白呈中度正相关,S100蛋白呈高度正相关。结论动脉血气分析中PH值和氧合指数变化可较敏感的反映窒息新生儿脑损伤程度。     

T组合复苏器在产房中新生儿窒息复苏中的应用效果观察

目的探讨T组合复苏器（T-piece）在产房中新生儿窒息复苏中的临床效果观察。方法在产房中诊断新生儿窒息患儿36例,随机分为对照组与观察组,各18例,对照组新生儿给予正压人工通气选择自动充气式复苏气囊,观察组新生儿给予正压人工通气选择T组合复苏器正。观察复苏过程中两组新生儿出生后1、5、10 min Apgar评分及进行X线胸片检查发生肺气漏的情况进行分析比较。结果两组新生儿出生后1、5、10 min Apgar评分比较差异无统计学意义（P〉0.05）;观察组新生儿气漏的发生率比对照组低,差异有统计学意义（P〈0.05）。结论产房中新生儿窒息复苏过程中应用T组合复苏器更简单、更有效、易操作,两组复苏成功率差异无统计学意义（P〉0.05）,但T组合复苏器能保持恒定一致的吸气峰压和呼气末正压,复苏时输出的压力恒定、准确、可靠,可有效减少或避免肺气漏的发生。     

空气复苏窒息新生儿的临床疗效

目的比较空气与纯氧复苏窒息新生儿的临床效果。方法 70例窒息足月新生儿随机均分为空气复苏组(A组,先行空气复苏,如失败则改为纯氧复苏)和纯氧复苏组(B组,直接行纯氧复苏)。观察并记录出生1-、5-和10-min的Apgar评分、出生时脐动脉血气分析、第1次啼哭的时间、建立自主呼吸的时间、出生5min时的心率、达到SpO2>90%的时间、复苏失败率及1周内窒息新生儿死亡率。结果 A组第1次啼哭的时间和建立自主呼吸的时间较B组短[(1.43±0.62)minvs.(1.92±0.71)min和(4.93±1.46)min vs.(6.12±1.55)min](P<0.05);两组出生1-、5-和10-min的Apgar评分、出生时脐动脉血气分析指标、5min时心率、达到SpO2>90%的时间和复苏失败率均无统计学差异(P>0.05)。两组复苏的新生儿1周内均存活。结论空气复苏可用于足月窒息新生儿,近期效果与纯氧复苏相似。     

新生儿缺氧缺血性脑病神经元烯醇化酶与新生儿行为神经评分的研究

目的探讨新生儿缺氧缺血性脑病(HIE)时血清神经元特异性烯醇化酶(NSE)浓度和新生儿行为神经评分(NBNA)的动态变化以及二者与脑损伤程度相关性及其关系。方法选择2005年5月至2009年5月胶南市人民医院儿科56例HIE患儿和27例正常新生儿,分别在生后24 h,第3~5天,第7天采集股静脉血,分离血清,用电化学发光免疫检测法测定血清中NSE浓度。结果临床分度HIE组血清NSE浓度均高于对照组水平(P<0.01),HIE各组NBNA均低于对照组水平(P<0.01)。结论血清NSE浓度变化与新生儿HIE程度呈密切正相关,与新生儿行为神经评分呈负相关;血清NSE浓度变化与NBNA评分是评估新生儿HIE时脑损伤的早期特异敏感指标,对临床进行早期干预和估计预后具有重要意义。     

护理干预用于新生儿窒息复苏的效果

目的探讨护理干预用于新生儿窒息复苏的效果。方法 2011年1月至2013年1月我院诊治的新生儿窒息复苏60例,根据不同的护理方法将其分为对照组（常规护理）和观察组（护理干预）,每组各30例,对两组新生儿阿氏评分（Apgar评分）、适应能力（NACS）评分、病死率进行观察和比较。结果与对照组相比,观察组Apgar评分≥8分比例、N A C S评分总分明显升高,病死率显著降低,差异有统计学意义。结论对于新生儿窒息复苏,有效的护理干预能够明显提高新生儿的适应能力,降低病死率。     

新生儿窒息的新法复苏及护理

新生儿窒息是胎儿娩出后1分钟仅有心跳而无呼吸或未建立规律呼吸的状态。窒息程度以出生后1分钟Apgar评分为准。0-3分为重度窒息；4～7分为轻度窒息。以后每隔5分钟评分一次．若5分钟评分仍〈3分，新生儿死亡率及留下脑后遗症的机会明显增加。因此，对窒息新生儿的抢救不但要争分夺秒，还要熟练掌握正确的复苏方法，才能及时进行有效的抢救。现总结我院新法复苏及护理体会。     

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.