异丙酚伍用不同剂量芬太尼麻醉用于胃镜检查的临床研究

目的研究异丙酚联合应用不同剂量的芬太尼在胃镜检查术中的麻醉作用.方法6 8例自愿接受麻醉下胃镜检查患者随机分为三组.A组为对照组(n=24),静注异丙酚2mg/kg;B组(n=24)静注异丙酚2mg/kg及1 μ g/kg芬太尼;C组(n=20)静注异丙酚2mg/kg及2μg/kg芬太尼.异丙酚均于45～60秒缓慢注入.观察三组患者诱导及苏醒时间、异丙酚用量及呼吸抑制情况.结果麻醉诱导时间B、C两组少于A组(P＜0.01),苏醒时间B组少于A组(P＜0.05).异丙酚用量B、C两组均少于A组(P＜0.01).呼吸抑制发生率A组41. 7%、B组45.8%、C组85.0%,A、B两组的发生率接近,无明显差异,但两组均与C组相差显著(P＜0.05).而呼吸抑制的平均时间B组为最短.结论异丙酚联合应用芬太尼用于胃镜检查术可加强镇痛,减少异丙酚用量.异丙酚联合应用1 μ g/kg芬太尼,是一种较为安全有效的配伍方法.     

不同剂量芬太尼复合丙泊酚用于人工流产术的麻醉效果

目的 比较不同剂量的芬太尼复合丙泊酚用于人工流产术的麻醉效果.方法 选择人工流产患者90例,按 随机原则分为3组:A组30例为对照组,B组30例,C组30例.A组静注丙泊酚2 mg/kg,B组静注丙泊酚2 mg/kg及芬太尼0.5 μg/kg,C组静注丙泊酚2 mg/kg及芬太尼1.0μg/kg.观察3组患者诱导及苏醒时间、丙泊酚用量及循环抑制情况.结果 麻醉诱导时间B、C两组少于A组(P＜0.05);苏醒时间B、C两组少于A组(P＜0.05),C两组少于B组(P＜0.05);丙泊酚用量B、C两组少于A组(P＜0.05),C组少于B组(P＜0.05).循环抑制情况3组间差异无统计学意义(P＞0.05).结论 丙白酚复合1.0μg/kg芬太尼用于人工流产手术可取得较好的麻醉效果.     

异丙酚复合芬太尼用于无痛人工流产术麻醉的效果观察

目的 观察芬太尼用于无痛人工流产术麻醉的安全性和有效性,并与异丙酚单独用于无痛人流术麻醉比较.方法 要求无痛人工流产术孕妇60例随机分为A、B组各30例,A组静脉滴注异丙酚2mg/kg+芬太尼1.0μg/kg,B组静脉滴注异丙酚2mg/kg.观察2组麻醉诱导时间、苏醒时间、异丙酚用量、呼吸抑制发生率及镇痛效果.结果 对麻醉的满意度A组为(100.0±0.0)分高于B组的(89.2±5.7)分,差异有统计学意义(P<0.05).A组诱导时间短于B组,异丙酚用量少于B组,差异均有统计学意义(P<0.05),而苏醒时间、呼吸抑制发生率2组差异无统计学意义(P>0.05).结论 异丙酚复合芬太尼用于无痛人工流产术麻醉可显著提高镇痛效果,缩短诱导时间,且麻醉药物用量少.     

异丙酚复合芬太尼用于无痛人工流产术麻醉的效果观察

目的观察芬太尼用于无痛人工流产术麻醉的安全性和有效性,并与异丙酚单独用于无痛人流术麻醉比较。方法要求无痛人工流产术孕妇60例随机分为A、B组各30例,A组静脉滴注异丙酚2mg/kg＋芬太尼1.0μg/kg,B组静脉滴注异丙酚2mg/kg。观察2组麻醉诱导时间、苏醒时间、异丙酚用量、呼吸抑制发生率及镇痛效果。结果对麻醉的满意度A组为（100.0±0.0）分高于B组的（89.2±5.7）分,差异有统计学意义（P〈0.05）。A组诱导时间短于B组,异丙酚用量少于B组,差异均有统计学意义（P〈0.05）,而苏醒时间、呼吸抑制发生率2组差异无统计学意义（P〉0.05）。结论异丙酚复合芬太尼用于无痛人工流产术麻醉可显著提高镇痛效果,缩短诱导时间,且麻醉药物用量少。     

异丙酚伍用雷米芬太尼用于无痛人工流产手术的麻醉

目的研究异丙酚伍用雷米芬太尼及单独使用异丙酚在无痛人工流产手术中的麻醉作用.方法ASAⅠ～Ⅱ级人工流产患者300例,随机分为两组,对照组150例用异丙酚2 mg/kg,静脉注射速度4 ml/10s;观察组先以雷米芬太尼0.75μg/(kg·min)静脉注射,然后接静注异丙酚2 mg/kg,速度为4 ml/10 s.观察二组患者诱导及苏醒时间,异丙酚用量及呼吸抑制情况.结果异丙酚用量观察组少于对照组(P＜0.01).呼吸抑制发生率对照组52%,观察组48%.两组的发生率接近,差异无显著性.结论异丙酚伍用雷米芬太尼用于人工流产手术麻醉可加强镇痛,减少异丙酚用量.     

异丙酚不同诱导速度在无痛人工流产术中麻醉效果的观察

目的：观察异丙酚不同诱导速度对无痛人工流产术的麻醉效果及不良反应。方法：将90例孕妇随机分为A、B、C3组各30例,静脉注射2μg/kg芬太尼后以不同诱导速度注入异丙酚,A组诱导速度为6mg/（kg·min）,B组诱导速度为3mg/（kg·min）,C组诱导速度为2mg/（kg·min）,观察麻醉效果、心电监护数据、异丙酚总用量、呼吸抑制情况、苏醒时间等。结果：麻醉效果,C组24例优,A、B组分别29例优,C组麻醉效果与A、B组比较,差异有统计学意义（P〈0.05）;呼吸抑制情况：C组仅1例发生呼吸抑制,A组和B组分别有10例和4例发生呼吸抑制,C组与A、B组比较,差异有统计学意义（P〈0.05）。结论：异丙酚以较快速度诱导患者苏醒快,异丙酚用量少,但呼吸抑制也相应增加,建议临床以3mg/（kg·min）的速度诱导麻醉效果好且安全。     

瑞芬太尼复合异丙酚在关节脱位手法复位中的应用体会

目的:观察和比较瑞芬太尼复合异丙酚麻醉用于关节脱位手法复位的效果。方法:40例行肩关节或髋关节手法复位的患者分为两组,每组20例,A组采用单纯异丙酚静注2mg/kg,麻醉效果欠佳者追加单纯异丙酚;B组采用静推0.07μg/kg瑞芬太尼后,静注异丙酚1mg/kg,麻醉效果欠佳者追加单纯异丙酚。观察血流动力学变化、语言刺激下苏醒时间,定向力恢复时间,异丙酚总用量。结果:A组异丙酚用量明显高于B组(P<0.05),定向力恢复时间A组明显长于B组(P<0.05),语言刺激下睁眼时间A组明显长于B组(P<0.05),血流动力学指标两组比较差异无统计学意义(P>0.05)。结论:瑞太尼复合异丙酚麻醉用于关节脱位手法复位术苏醒迅速,镇疼效果强,手术医师满意度高,是值得推广的麻醉方法。     

异丙酚与布托啡诺和芬太尼分别配伍下应用于无痛人工流产手术中的临床效果比较

目的：观察布托啡诺和芬太尼分别复合丙泊酚用于无痛人流手术的临床麻醉效果比较。方法随机选择ASAⅠ～Ⅱ级,自愿施行人工流产术的孕妇120例,随机分为A、B、C三组,每组40例, A组：单纯静脉注射异丙酚2.5 mg/kg,B组：静脉注射异丙酚2.5 mg/kg＋布托啡诺10μg/Kg, C组：静脉注射异丙酚2.5 mg/kg＋芬太尼2μg/kg,观察三组患者诱导时间,苏醒时间及异丙酚的用量。结果 B组及C组诱导时间均快于A组（P〈0.05）,苏醒时间B组快于C组,且于A组相比无明显差异（P〉0.05）。结论异丙酚与布托啡诺用于人工流产手术麻醉,不仅可以减少异丙酚的用量,及并发症的发生,而且能达到满意的镇痛效果,术后苏醒快且安全,诱导无呛咳。     

氟比洛芬对全身麻醉用药量影响的研究

目的探讨术前使用氟比洛芬对全身麻醉用药量的影响。方法 75例接受同类手术的患者随机分成3组,每组25例。手术中静脉吸入复合维持麻醉。A组麻醉诱导前未使用氟比洛芬。B组麻醉诱导前静脉注射氟比洛芬1mg/kg。C组麻醉诱导前静脉注射氟比洛芬2mg/kg。手术中吸入笑气的浓度不变,根据血流动力学指标调节静脉麻醉药用量。记录手术时间、血流动力学指标、异丙酚与雷米芬太尼用量。结果 3组患者的一般情况、手术时间相同。A组手术中异丙酚的用量为(183.491±29.82)mg,雷米芬太尼用量为(563.45±9.61)μg。B组手术中异丙酚的用量为171.18±34.82mg,雷米芬太尼的用量为496.44±69.07μg。C组异丙酚的用量为(143.2±29.03)mg,雷米芬太尼的用量为(363.60±51.86)μg。与A组相比,C组患者手术中异丙酚与雷米芬太尼用量减少(P<0.05)。结论术前静脉注射氟比洛芬1mg/kg对手术中麻醉药用量影响不大。而静脉注射2mg/kg能明显减少手术中麻醉药用量。     

酒石酸布托啡诺复合异丙酚在无痛胃肠镜术中的应用

目的观察酒石酸布托啡诺复合异丙酚用于无痛胃肠镜的有效性与安全性。方法选择门诊胃肠镜检患者180例,随机分为A组(单纯异丙酚组)、B组(芬太尼+异丙酚组)和C组(酒石酸布托啡诺+异丙酚组)。依次观察比较三组患者血流动力学变化、麻醉效果、异丙酚总用量、苏醒时间以及副作用发生情况。结果 B、C两组患者在血流动力学变化、麻醉效果、异丙酚用量、苏醒时间等方面均无统计学差异(P>0.05),而C组呼吸抑制发生率少于B组(P<0.05);B、C两组的麻醉效果、异丙酚用量以及苏醒时间等方面均优于A组,具有统计学意义(P<0.05)。结论酒石酸布托啡诺复合异丙酚用于胃肠镜检查镇痛、镇静效果好,副作用少,尤在呼吸抑制方面优于芬太尼复合异丙酚。     

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.     

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.