小剂量维库溴铵预防琥珀胆碱所致术后肌痛(附75例分析)

我们用小剂量维库溴铵对抗琥珀胆碱诱导插管时的肌颤反应 ,解除术后肌痛问题 ,效果满意 ,报告如下。1　资料与方法75例择期上腹部手术病人 ,年龄 1 8～ 53岁 ;男 48例 ,女2 7例 ;ASA ～ 级。术前无神经肌肉系统疾病 ,随机分为三组 ,每组 2 5例 ,全部采用芬太尼 4μg/ Kg、 2 .5%硫喷妥钠6mg/ Kg、琥珀胆碱 2 mg/ Kg诱导插管。A组不另给药 ;B、C组诱导前 3分钟分别预注安定 1 0 mg、维库溴铵 0 .0 2 mg/ Kg。插管后观察三组的肌颤反应 ,同时监测心率、血压变化 ,术后随访肌痛情况 ,资料统计以 t检验或 x2 检验 ,P<0 .0 5为差异显著。2…     

异丙酚平抑气管内插管心血管反应的临床观察

目的：探讨异丙酚平抑气管内插管内血管反应的临床效果和安全性,方法40例ASAⅠ-Ⅱ级手术病人随机分为二组,每组20例,异丙酚组：静脉注射异丙酚2mg/kg;硫喷妥钠级组;静脉注射硫喷妥钠6－8mg/kg,速率均为0．5ml/s;二组均配伍氟－芬合剂、琥珀胆碱,进行快速诱导气管插管,于诱导前、插管前及插管后1、3、5min测定SP、DP、SpO2.结果（1）异丙酚组：插管后各时点与插管前比较,SP和DP无明显变化不明显;硫喷妥钠组：插管后各时点SP和DP较皇管前明显升高（P＜0．01）.(2)组间相比,异丙酚组插管后1min和3min的SP、DP和HR与硫喷妥钠组同期比较,差异有显著性（P＜0．01）。结论异丙酚在全麻诱导插管期间,平抑心血管的不良反应是确切的。     

异丙酚和硫喷妥钠静脉麻醉用于喉显微手术的临床对比研究

为观察异丙酚的临床药理效应．对42例在支撑喉镜下行喉显微手术病人分别施行异丙酚（P组)和硫喷妥钠(T组)全凭静脉麻醉各21例．静滴芬太尼0．3mg·kg-1 3min后，P组静注异丙酚2mg·kg-1．T组静注硫喷妥钠5mB-kg-1诱导。持续静清异丙酚(P组)0.2mg.kg-1.min-1或硫喷妥钠(T组)0．3mg·kg-1,min-3维持麻醉．使用琥珀胆碱气管插管和维持肌松。结果表明．异丙酚和硫喷妥钠全凭静脉麻醉均适用于喉显微手术的麻醉。与硫喷妥钠相比，异丙酚麻醉更能有效地抑制气管插管和置入支撑喉镜时的高血压反应．术中血漉动力稳定，停药后意识和肌张力恢复更快。     

限时法给予罗库溴胺用于诱导气管插管的临床观察 (附40例分析)

目的比较琥珀胆碱和限时法使用罗库溴胺用于诱导气管插管时的条件及血流动力学变化,以选择更好的诱导药物.方法40例全麻病人随机分为两组.Ⅰ组(n=20)为异丙酚诱导后即刻静注1.5 mg/kg琥珀胆碱.Ⅱ组(n=20)为异丙酚诱导前20秒静注1 mg/kg罗库溴胺,异丙酚诱导后60秒行气管插管.结果气管内插管条件两组间差异无显著性意义(P＞0.05).诱导后,两组血压、心率均明显下降;插管后即刻及插管后1分钟血压增高,心率增快,组间比较无显著性差异;插管后3分钟两组血压、心率均恢复到诱导前水平.结论限时法使用罗库溴胺可使插管条件达到琥珀胆碱的水平,适用于琥珀胆碱禁用时的气管插管.     

异丙酚用于稳定高血压脑出血病人围麻醉期血流动力学的临床研究

目的：研究异丙酚用于稳定高血压脑出血病人围麻醉期血流动力学的效果及安全性。方法：32例病人随机分为两组，I组用硫喷妥钠等诱导插管，术中分次静注芬太尼和潘库溴铵并吸入异氟醚维持麻醉；Ⅱ组用异丙酚等诱导，术中在I组维持方式的基础上静注异丙酚，使血压控制于一定水平。监测两组病人在诱导前（T0）、诱导后（T1）、插管时（T2）、开颅时（T3）、拔管时（T4）血压和心率的变化。结果：Ⅱ组病人T1、T2、T3、T4与T0对比血压均明显下降，心率均有所升高，且基本均能维持稳定，I组病人血压和心率在T2和T4期间升高较明显，术中波动也较大。结论：异丙酚能有效控制高血压脑出血病人气管插管、拔管及手术刺激引起的心血管反应，维持围麻醉期血流动力学的稳定。     

异丙酚和硫贲妥钠用于静脉快速诱导插管的临床观察

异丙酚起效快,作用时间短,苏醒快,目前已广泛应用于麻醉诱导与维持[1]。我们将其与硫贲妥钠在麻醉诱导插管时进行比照,观察其在麻醉诱导、气管插管时的心血管应激反应,现报道如下。 1 对象与方法 1.1 30例择期全麻手术病人,年龄20~52岁,男16例,女14例,ASAⅠ-Ⅱ级。随机均分为异丙酚组(Ⅰ组)及硫贲妥钠组(Ⅱ组)。 1.2 术前30min肌注苯巴比妥钠0.1g,阿托品0.5mg。Ⅰ组面罩吸氧去氮后,静脉注射芬太尼4ug/kg(60s),异丙酚2mg/kg(60s)、琥珀胆碱2mg/kg,1min后行气管插管。Ⅱ组,附表 麻醉诱导、气管插管过程中的血压、心率变化…     

全麻诱导期对交感神经系统兴奋性影响的初步观察

全麻喉镜暴露声门行气管插管,机械性刺激可引起植物神经系统机能紊乱。为探讨国内常用硫贲妥钠加琥珀胆碱(简称硫组)及安定、硫贲妥钠加琥珀胆碱(简称安组)诱导麻醉方法对交感神经系统功能有否不同影响,本文于此两组用药进行气管内插管,观察插管前后指容、皮电、心率及动脉血压的变化,进行对比证实其对交感神经系统兴奋性的影响。     

高血压脑出血开颅血肿清除术两种不同麻醉诱导用药的比较

目的　探讨异丙酚和硫喷妥钠在高血压脑出血开颅血肿清除术麻醉诱导期对血流动力学的影响。方法　选择高血压脑出血病人 40例 ,随机分为异丙酚诱导组 (A组 2 0例 )和用硫喷妥钠诱导组 (B组 2 0例 ) ,记录插管前后SBP、DBP、HR变化。结果　两组在诱导后插管前SBP、DBP均降低 (P <0 0 1) ,A组HR减慢 (P <0 0 5 ) ,B组HR增快 (P <0 0 5 ) ;插管后A组各项指标平稳 ,B组SBP、DBP升高 (P <0 0 5 ) ,HR增快 (P <0 0 1)。结论　异丙酚能更好地抑制气管插管所致的心血管反应 ;而硫喷妥钠则适用于合并心动过缓的病人麻醉诱导。     

异丙酚在无抽搐电休克治疗中的临床应用

目的对比研究国产异丙酚和硫喷妥钠在无抽搐电休克治疗中对患者呼吸、循环的影响和麻醉作用。方法200例拟行无抽搐电休克治疗的精神病患者随机分为两组,分别给予异丙酚或硫喷妥钠静脉麻醉。全麻诱导后,给予琥珀胆碱,肌松后行电休克治疗。记录基础、给药后2分钟、电治疗2～3秒、电治疗结束、意识恢复时的SBP、DBP、MAP、HR、SpO2、动态心电图。结果与硫喷妥钠组相比,异丙酚麻醉行无抽搐电休克治疗,对患者呼吸、循环影响更小,麻醉效能更安全。结论异丙酚在无抽搐电休克治疗中,效果优于硫喷妥纳。     

异丙酚与硫喷妥钠用于全麻诱导的临床观察

比较异丙酚与硫喷妥钠用于全麻诱导对心血管副反应的影响 :2 0例行食道癌根治术的病人 ,ASA ～ 级 ,随机分为两组 ,分别以芬太尼 +异丙酚 ( 组 )或硫喷妥钠 ( 组 ) +司可林诱导。观察 SBP,DBP,HR,( SP) O2 ,ECG变化。结果插管即刻 组SBP,DBP升高 ,持续 2～ 3min; 组 DBP升高 ,持续3min,HR增快 ,持续 4min。提示异丙酚与硫喷妥钠用于全麻诱导时心血管副反应均较轻 ,且异丙酚不增快心率     

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.     

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.     

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.