个体化治疗与护理在老年血液透析相关性低血压中的应用

目的探讨个体化治疗和护理对防治老年血液透析相关性低血压的效果。方法 50例血液透析的老年患者,先后接受常规和个体化两种透析方案,每种方案为期12周。结果应用常规标准透析法1886例次,发生低血压401例次(21.3%);应用个体化透析1952例次,发生低血压171例次(8.8%)。两组差异有统计学意义。结论我们在透析治疗过程中个体化采用高低钠序贯透析与低温透析,降低了透析相关性低血压的发生率。     

个体化血液透析治疗小儿肾功能衰竭临床研究

目的 探讨儿童CKD-5期维持血液透析患者个体化血液透析管理的方法,以减少透析中低血压、高血压、低血糖、心律失常的发生.方法 对我院血液净化中心2005年1月至2007年5月间治疗的30例儿童CKD-5期患者实施5个月的个体化透析方案管理比较实施个体化血液透析管理前后透析并发症的发生率、心力衰竭发生率、血浆白蛋白及血红蛋白的变化.结果 30例患者透析中出现高血压、低血压、心绞痛、心律失常、低血糖等并发症明显减少(P<0.05);透析期间高血钾、心力衰竭的发生率也明显减少(P相似文献   

个体化饮食处方对血液透析患者的影响

目的 探讨个体化饮食处方对血液透析患者的影响.方法 应用个体化饮食处方对48例血液透析患者进行饮食指导,通过对比其前后的营养状况指标、透析前血液相关指标、相关并发症发生率及满意度来了解处方的效果.结果 12个月后,患者的营养状况及透析前血液相关指标改善(P＜0.01), 相关并发症发生率下降(P＜0.05),护士工作满意度提高(P<0.05).结论 个体化饮食处方对血液透析患者的影响是有益的.     

个体化透析对高血压维持性血液透析水钠平衡及血压的影响

目的：观察个体化透析模式对高血压维持性血液透析患者水钠平衡及血压的影响,分析其临床疗效。方法选取40例需长期透析治疗的高血压肾衰患者为研究对象,先采用标准透析液透析3个月,再使用个体化低钠透析3个月,记录两种透析模式下患者的居家血压,体质量变化及低血压、肌肉痉挛等不良反应发生率。结果与标准透析相比,个体化透析期间5例患者减少降压药物种类或剂量,2例停止口服降压药物。个体化透析期间患者平均收缩压和舒张压均低于标准透析期,具有统计学意义（P ＜0．05）。生物电阻抗检测结果提示个体化低钠透析期间包括细胞外液、细胞内液、总体水与标准透析期间差异不明显（P ＞0．05）,但个体化低钠透析期间患者体质量净增加低于标准透析（P ＜0．05）。结论个体化血液透析可降低高血压维持性血液透析患者钠负荷、容量负荷,有效降低血压,临床安全性较高。     

剖宫产后个体化护理的效果评价

目的：对剖宫产后个体化护理干预的应用效果进行分析。方法选取本院于2011年10月~2013年12月收治剖宫产者82例，随机分为两组，对照组40例给予常规护理，观察组42例给予个体化护理，对比两组护理效果及并发症情况。结果观察组乳房胀痛率、腹胀率及出血率均显著低于对照组，术后2 h、24 h出血量显著少于对照组，住院时间显著短于对照组。结论在剖宫产后给予个体化护理干预可有效降低患者出血率及并发症发生率，护理效果理想，值得在临床中推广。     

个体化护理对糖尿病肾病血液透析患者心血管并发症的影响

目的探讨个体化护理对糖尿病肾病血液透析患者心血管并发症的影响。方法将我院接受诊治的50例糖尿病肾病血液透析患者分为各25例的观察组与对照组,对照组在透析期间给予常规护理,观察组在此期间给予个体化护理,比价两组心血管并发症发生率及满意度评分。结果观察组透析期间的心血管并发症发生率为12.0%,对照组为40.0%,观察组的心血管并发症发生率明显少于对照组(P<0.05)。护理后观察组的满意度评分为(4.72±0.21)分,对照组为(3.82±0.45)分,观察组的满意度评分明显高于对照组(P<0.05)。结论个体化护理在糖尿病肾病血液透析患者中的应用能减少心血管并发症的发生,改善护患关系,从而有利于预后的改善。     

个体化运动处方对血糖控制不良糖尿病的疗效分析

目的：探讨个体化运动处方对血糖控制不良糖尿病的治疗效果。方法：应用个体化运动处方对社区中血糖控制不良的糖尿病患者进行干预。结果：糖尿病患者通过个体化运动处方干预12个月后,空腹血糖、餐后血糖、糖化血红蛋白恢复正常的比例增加,与干预前相比,差异有统计学意义（P〈0.05）。结论：运动是一项有效控制糖尿病患者血糖的治疗手段,长期中等强度的运动能降低糖尿病的危险因素水平,对预防糖尿病并发症的发生有重要作用。     

个体化护理在甲状腺手术患者护理中的应用评价

目的探讨给予甲状腺患者个体化护理的临床应用效果。方法随机选取2012年6月至2013年5月入住我院的甲状腺患者144例作为研究对象,分为观察组和对照组各72例,观察组给予个体化护理方式进行护理,对照组给予传统常规护理方式进行护理。观察两组患者手术前后抑郁、焦虑评分及术后发生并发症情况。结果观察组手术前后不良情绪如抑郁、焦虑评分均比对照组低,差异显著,具有统计学意义(P<0.05);观察组并发症发生率(2.8%)显著低于对照组(15.3%),差异具有统计学意义(P<0.05)。结论给予甲状腺患者个体化护理方式能有效减轻患者对手术的恐惧心理,增加患者对护理配合度且减少术后多种并发症的发生,有效提高患者术后生活质量,值得临床广泛应用。     

个体化护理对老年高血压患者血压及并发症的影响分析

目的 探讨个体化护理对老年高血压患者血压及并发症的影响。方法 78例原发性高血压患者,随机分为观察组和对照组,各39例。对照组采用常规护理,观察组给予个体化护理。观察两组患者血压控制效果及并发症的情况。结果 观察组总有效率97.4%高于对照组的76.9%,差异有统计学意义(P<0.05)。观察组心律失常、血肌酐水平升高发生率高于对照组,差异有统计学意义(P<0.05)。结论 个体化护理能够提高老年高血压患者血压控制效果,减少并发症的发生,值得临床借鉴。     

个体化护理在控制老年高血压患者血压及并发症中的效果观察

目的研究个体化护理在控制老年高血压患者血压及并发症中的效果。方法将我院2010年1月至2013年1月收治的96例老年高血压患者随机分为两组,其中对照组48例采用常规护理,治疗组48例在此基础上应用个体化护理。比较两组患者血压及并发症控制情况。结果对照组患者收缩压和舒张压分别为（139．8±8．7）mmHg、（97．3±8．8）mmHg均明显高于治疗组患者的（124．5±9．7）mmHg、（84．2±7．1）mmHg,差异具有统计学意义（P〈0．05）;对照组并发症发生情况与治疗组对比,差异具有统计学意义（P〈0．05）。结论通过对老年高血压患者采用个体化护理,能够有效控制患者血压及并发症的发生,值得临床推广应用。     

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.