瑞芬太尼麻醉诱导期间美托洛尔对脑电双频指数的影响

目的：探讨美托洛尔对气管插管期间BIS的影响。方法：30例行气管插管患者均分为两组，均靶控异丙酚；试验组予美托洛尔；对照组予氯化钠溶液。观察诱导前、插管前、插管后1、3、5min MAP、HR及BIS的变化。结果：插管后1、3min对照组MAP、HR显著高于诱导前；插管后1、3min对照组BIS较插管前显著升高。结论：美托洛尔能抑制患者的心血管反应，降低BIS值。     

异丙酚伍用654-2在全麻诱导期间对心血管系统的影响

目的　观察异丙酚伍用 65 4-2在全麻诱导插管期间对心血管系统的影响 ,并与异丙酚组进行临床比较。方法 　择期手术病人 5 0例 ,随机分为两组 ,即异丙酚伍用 65 4-2组 (P组 )和异丙酚组 (T组 ) ,P、T组各 2 5例。诱导时两组均静注安定 2 mg· kg- 1 、芬太尼 4～ 5μg· kg- 1 ,待病人入睡后 ,P组以 3 0～ 60 s速度静注异丙酚 2 mg· kg- 1 、65 4-2 0 .1mg· kg- 1 ;T组以 3 0～ 60 s速度静注异丙酚 2 mg· kg- 1 ,然后两组均予琥珀酰胆碱 1.5～ 2 .0 mg· kg- 1静注后快速气管插管。应用美国产 40 5型无创心功能监测仪 ,分别在诱导前、诱导后、插管后 lmin、 5 min测定 SBP、DBP、MAP、HR各参数的变化。结果 　 T组的血压在诱导后明显降低 ,其血压下降比 P组显著 ,HR稍减慢 ,而 P组诱导后 HR明显增快。结论　异丙酚诱导后全身血压会发生急剧的降低 ,同时心率稍减慢 ,而异丙酚伍用 65 4-2可以减缓血压急剧下降并能增快心率。     

咪唑安定、芬太尼、异丙酚联合诱导时对镇静催眠作用的影响

目的采用权重配方法分析咪唑安定(Mid)、芬太尼(Fen)和异丙酚(Pro)联合诱导时在镇静、催眠上相互作用的性质.方法60例美国麻醉协会(ASA)分级Ⅰ-Ⅱ级的择期行腹腔镜手术的病人根据权重配方法设计,均匀分配至6个不同剂量水平不同的用药组(配伍组1～6),麻醉诱导为依次注入Mid(15 s),Fen(15 s),Pro(30 s)和罗库溴铵 0.6 mg·kg-1.Pro注入后3 min行气管插管.记录诱导前、异丙酚注入后1、2 min、插管即刻、插管后1、3、5、7 min的脑电双频谱指数(BIS)、平均动脉压(MAP)、心率(HR)值.结果配伍组1的诱导期BIS变化值较为理想.结论Mid、Fen和Pro在镇静催眠上呈相加作用,理想的诱导剂量为Mid 0.02 mg·kg-1、Fen 0.0025 mg·kg-1、Pro 0.8 mg·kg-1.     

艾司洛尔预防气管内插管心血管反应的临床观察

目的 观察艾司洛尔在气管内插管时的心血管作用.方法 全麻患者40例随机分为试验组和对照组各20例,将其在插管前后平均动脉压(MAP)和心率(HR)进行比较.结果 试验组插管前后MAP和HR变化差异无统计学意义(P>0.05).对照组插管后1、3min MAP高于诱导前,插管后1min HR高于诱导前,差异均有统计学意义(P<0.01).结论艾司洛尔能够减轻气管内插管的心血管反应.     

阿托品对靶控输注诱导气管插管时脑电双频指数的影响

目的评价阿托品对靶控输注诱导气管插管时脑电双频指数(BIS)的影响。方法入选行择期腹腔镜胆囊切除手术患者70例,随机分为阿托品组和对照组,每组各35例。2组均用靶控输注法诱导,首先微泵输入丙泊酚与瑞芬太尼,4 min后,阿托品组患者静脉推注阿托品10μg·kg-1,对照组推注同等容量0.9%Na Cl,10 min后开始气管插管。记录诱导开始15 min内患者的平均动脉压(MAP)、心率(HR)和BIS。结果与插管前即刻的BIS值比较,插管后1 min2组的BIS值均明显增高(P<0.05)。插管后3,5 min,阿托品组BIS值较对照组明显增高[(52.83±4.00)vs(48.92±3.00),(48.81±4.00)vs(46.53±4.20)](P<0.05)。插管前2 min、插管前即刻和插管后3,5 min,2组患者的MAP和HR比较差异有统计学意义(P<0.05)。结论靶控输注诱导气管插管时用阿托品会引起BIS值升高。     

瑞芬太尼预防气管插管所致心血管反应的观察

目的:比较不同剂量国产瑞芬太尼持续输注减弱气管插管引起的心血管反应的效果和安全性。方法:140例ASA I级整形外科患者,随机分为0．1(n=40),0．2(n=40),0．3(n=20),0．4(n=20)．0．5μg·kg-1·min-1(n=20)5个剂量组。用1μg·kg-1瑞芬太尼静脉注射后分别静注0．1～0．5μg·kg-1·min-1瑞芬太尼,静注丙泊酚、罗库澳铵后气管插管。记录诱导前5 min,诱导后1,2,3 min,插管后1,2,3,4 min的心率(HR)和血压。结果:5组患者诱导后2,3 min,插管后备时间收缩压和平均动脉压均下降,部分时间点舒张压显著下降(P<0．05)。插管后0．1μg组HR显著加快,0．2μg{组HR变化不明显,0．3-0．5μg·kg-1·min-1组插管后HR轻微短暂增快,但很快下降接近基础值。结论:瑞芬太尼维持输注0．2-0．5μg·kg-1·min-1能有效地减弱气管插管引起的心血管反应。     

艾司洛尔预防气管插管时心血管副反应的临床观察

目的　探讨艾司洛尔预防气管插管时心血管副反应的效果。方法　将ASA - 级无呼吸、心血管或内分泌系统疾病择期手术患者4 0例,随机分为观察组(用艾司洛尔)和对照组(未用艾司洛尔)。采用咪唑安定-异丙酚-芬太尼-罗库溴胺-艾司洛尔快速静脉诱导气管插管,插管后机械通气,吸入异氟醚维持麻醉。监测无创血压(NIBP)、心率(HR)、血氧饱和度(Sp O2 ) ,并记录给药前,插管即刻,插管后1min,5 min平均动脉压(MAP) ,心率(HR)指标。结果　观察组插管后1min MAP同对照组差异有非常显著性(P<0 .0 1) ,插管后1m inНR差异也有显著性(P<0 .0 5 )。结论　全麻诱导时使用艾司洛尔能有效预防气管插管心血管副反应。     

艾司洛尔对气管插管心血管反应的影响及护理观察

目的评估艾司洛尔对气管插管心血管反应的预防作用。方法 80例ASAⅠ~Ⅱ级、全身麻醉下行妇科腹腔镜手术患者,随机分为对照组(C组)和艾司洛尔组(E组),每组40例,分别于气管插管前3 min缓慢静脉推注生理盐水5 ml和艾司洛尔5 ml(1 mg/kg),观察插管后1、3、5 min的平均动脉压(MAP)、心率(HR)变化。结果气管插管后1、3 min E组MAP和HR均显著低于C组,差异有统计学意义(P<0.05)。结论气管插管前3 min缓慢静脉推注艾司洛尔1 mg/kg,显著减轻了气管插管的心血管反应,有利于气管插管的护理。     

乌拉地尔与艾司洛尔预防全麻插管应激反应的观察与比较

目的 :观察与比较乌拉地尔、艾司洛尔用于预防全麻插管应激反应的效果。方法 :将 45例ASAⅠ～Ⅱ级无心血管病史全麻病人 ,随机分成 3组 ,每组 15例。A组 (对照组 ) ,B组 (乌拉地尔组 ) ,C组 (艾司洛尔组 )。插管前分别静注 0 .9%氯化钠5mL(A组 ) ,乌拉地尔 0 .5mg·kg-1(B组 ) ,艾司洛尔 2mg·kg-1(C组 )。 3组均以芬太尼、利多卡因、依托咪酯、琥珀胆碱静注诱导后行气管内插管。观察各组诱导前、诱导后 1min及插管后 1,5 ,10min的HR、SBP、DBP及MAP值。结果 :对照组在插管后 1,5 ,10min的HR、MAP均明显高于用药的B、C组 (P <0 .0 5或P <0 .0 1)。用药组间相比 ,插管后B组与C组血压升高幅度有显著性降低 (P <0 .0 5或P <0 .0 1) ;插管后C组与B组心率上升幅度明显降低 (P <0 .0 5或P <0 .0 1)。结论 :气管插管前静注乌拉地尔与艾司洛尔均能有效预防插管引起的应激反应。乌拉地尔预防高血压作用优于艾司洛尔 ,艾司洛尔预防心率增快优于乌拉地尔。     

乌拉地尔与艾司洛尔在经鼻蝶入路垂体瘤切除术中对血流动力学的影响

目的观察乌拉地尔和艾司洛尔在经鼻蝶入路垂体瘤切除术中对血流动力学的影响。方法48例ASAⅠ~Ⅱ级择期经蝶垂体瘤切除术患者,随机分成四组:A组(n=13,乌拉地尔以3μg·kg-1·min-1泵入);B组(n=11,艾司洛尔200μg·kg-1·min-1);C组(n=14,乌拉地尔1.5μg·kg-1·min-1+艾司洛尔100μg·kg-1·min-1);D组(n=10,生理盐水对照组)。分别记录用药前,用药后3min、5min,鼻中隔分离、垂体瘤切除和术毕时的HR、SBP、DBP、MAP。结果在用药5min时A、B、C三组的SBP、DBP、MAP下降最明显(P<0.05),B、C两组的HR下降最明显(P<0.05);鼻中隔分离时,四组患者的HR、SBP、DBP、MAP均有升高,A、B、C组SBP、DBP、MAP与用药前相比无统计学差异,A组HR与用药前相比有统计学差异,D组的HR、SBP、DBP、MAP与用药前及A、B、C三组相比差异显著(P<0.05)。结论乌拉地尔、艾司洛尔单独及两药小剂量复合持续输注,均能有效抑制经蝶垂体瘤切除术中血流动力学的剧烈变化。     

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.