Methemoglobinemia resulting from absorption of nitrates

Three cases of toxic methemoglobinemia resulted from absorption of nitrate salts through burned skin areas. In addition to the unusual route of intoxication, this report emphasizes the occupational hazard of methemoglobinemia in workers exposed to nitrogen salts and the importance of rapid diagnosis and treatment. The diagnosis of methemoglobinemia should be suspected in any case of cyanosis refractory to oxygen therapy. Appropriate treatment should include oxygen, methylene blue, and exchange transfusion in clinically severe cases.     

Cyanosis following transesophageal echocardiogram

Topical anesthesia is routinely employed to facilitate diagnostic and therapeutic procedures that involve the oropharynx. Although this practice is usually safe, there is always the potential that methemoglobinemia might be induced by the topical anesthetic agent. The clinician should consider this possible complication when the patient experiences signs or symptoms of oxygen desaturation in the absence of another explanation. Because methemoglobinemia can be life-threatening, early recognition and treatment are extremely important.     

固体超强酸SO_4~(2-)/ZrO_2催化合成苯佐卡因

目的:探讨一种合成苯佐卡因的新方法。方法:以固体超强酸SO42-/ZrO2为催化剂,催化对氨基苯甲酸和乙醇发生酯化反应,合成苯佐卡因。结果:在固体超强酸SO42-/ZrO2催化作用下,对氨基苯甲酸和乙醇发生酯化反应生成苯佐卡因。当酯化反应反应时间为40min,催化剂质量为对氨基苯甲酸质量的6%时,酸质量和醇体积比值为2∶25时,苯佐卡因产率达91.2%。而且催化剂重复使用效果好。结论:该合成方法比传统方法具有产率高,反应平稳快速,催化剂容易分离,环境污染少等优点。     

高铁血红蛋白血症26例临床分析

[背景 ]食物中毒引起的高铁血红蛋白血症 ,包括青紫引起的肠原性紫绀及亚硝酸盐、硝酸盐、黄胺类、苯胺等多种药物或化学药品中毒 .它多发生在 3岁以上患儿 .[病例报告 ]临床表现为颜面青紫 ,尤以口唇、口周青紫为著 ,甲床青紫也较明显 ,此外还表现为全身皮肤青紫、恶心呕吐、腹痛及全身不适 .心肺检查正常 .严重者表现为青紫严重 ,精神差 ,头痛 ,头晕 ,周身乏力 ,腹疼 ,恶心呕吐 ,呼吸急促 ,无呼吸困难 ,心率加快 ,肺部听诊无异常 .[讨论 ]患儿应注意饮食卫生 ,规则服药 .     

Acute methemoglobinemia following attempted suicide by Dapson

This report describes the case of an otherwise healthy young adult female, with oral ingestion of 40 unknown tablets. Her clinical course included progressive bluish discoloration of lips and limbs, hemolysis and jaundice. A high PaO2 in the presence of cyanosis and dark blood lead to suspicion of methemoglobinemia. Laboratory results showed methemoglobin level to be 3.8 g/dL (38%). The etiology was traced to dapsone according to patient history; after 3 days it became evident that she had ingested 2 g dapsone in suicidal intent. The therapeutic and diagnostic approach in such patients is discussed. In conclusion, acute methemoglobinemia is an uncommon but potentially treatable disorder.     

Effectiveness of benzocaine in reducing deep cavity restoration and post-extraction stress in dental patients

Objectives:

To investigate the effectiveness of topical anesthetic, 20% benzocaine in relieving pain and stress in patients following deep cavity restoration and extraction of teeth under local anesthesia (LA).

Methods:

A prospective clinical trial was conducted from October 2014 until April 2015 at Taibah University, Al Madinah Al Munawarah, Kingdom of Saudi Arabia. Forty-five patients were included in the 20% benzocaine group, and 46 in the normal saline group. Evaluation of the dental stress was made pre-operatively and immediately post-operative treatment using the visual analogue scale (VAS). Furthermore, discomfort of the injections were recorded by the patients after each treatment on standard 100 mm VAS, tagged at the endpoints with “no pain” (0 mm) and “unbearable pain” (100 mm).

Results:

There were statistically significant differences between the mean stress scores for patients in the benzocaine and normal saline groups post-operatively (p=0.002). There were significant differences between the mean pain scores for patients in the post buccal injection (p=0.001), post palatal injection (p=0.01), and the post inferior alveolar nerve block groups (p=0.02). Buccal, palatal, and inferior alveolar nerve block injections were more painful for patients in the normal saline group than the benzocaine group.

Conclusion:

This investigation has demonstrated that post-operative stress associated with deep cavity restoration and dental extractions under LA can be reduced by the application of topical anesthetic (20% benzocaine) at the operative site for intra-oral injections.Anxiety is one of the most common causes of dental fear.1 There have been 3 stable and reliable factors, which contribute to dental fear. The first factor is related to patterns of dental avoidance and anticipatory anxiety, the second, related to fear, which is associated to specific dental stimuli and procedures, and the third is concerned with physiologic arousal during dental treatment.2 Fear develops through the interaction of 3 phenomena, those which are instinctive, dependent on maturation, and developed through learning from individual and social experience.3 It is unusual for modern local anesthetics to fail completely unless they have been injected incorrectly, but it is common for patients to retain some sensation of pressure around the tooth. Dental stress and anxiety may lead them to interpret this as pain, and cooperation is lost.4,5 Application of topical anesthetic for post-operative pain relief has not usually been considered as a part of routine clinical dental practice. However, infiltration local anesthesia (LA) has been used in other surgical disciplines with good effect.6,7 The field of anesthesia has witnessed many developments throughout the last century, and a number of different techniques and agents have been developed. Anesthesia has become an essential procedure in every surgical operation and treatment. In practice, topical anesthesia including cocaine, amethocaine, lignocaine, and prilocaine is applied to skin, eye, ear, nose, and mouth. Their application was reported to be useful and effective for reducing pain sensation.8 When used to produce topical anesthesia, they usually have a rapid onset of action (5-10 minutes [mins]), and a moderate duration of action (30-60 mins). A rapid onset of action of 5 mins or less has also been reported for 10% and 20% benzocaine gels for the relief of spontaneous toothache pain.9 Various preparations of lignocaine are available as aqueous solutions (4%), or in water-miscible bases, such as gels, ointments, creams, and sprays (2-10%). Intact skin works as a barrier preventing the diffusion of local anesthetics so high concentrations of anesthetic agents (for example, 20% benzocaine or 4% lignocaine) are required.8 The use of LA in dentistry is standard practice. No studies were found in the literature, which looked at the possibility of using benzocaine soaked rolls/swabs to reduce the post operative stress in adult patients following simple dental extractions, or deep cavity restoration. This study concentrated on the effectiveness of topical anesthetic 20% benzocaine for relieving pain of local anesthetic injection, and post-operative stress in patients following extraction of teeth, or deep restoration under LA.     

醋酸地塞米松复合膜的制备和临床应用

目的探讨醋酸地塞米松复合膜的制备和临床应用。方法用醋酸地塞米松和苯佐卡因等制成复合膜。采用单盲法观察其临床疗效。结果治疗组中显效率25％(5／20)、有效率60％(12／20)、总有效率为85％。结论本药膜制作简单。使用方便，对口腔溃疡愈合有明显的促进作用。     

杀虫脒急性中毒症状高铁血红蛋白血症的探讨

目的探讨杀虫脒急性中毒是否全数或多数出现高铁血红蛋白血症。方法采用氰化高铁血红蛋白光电比色法测定杀虫脒急性中毒大鼠、家兔、家鸽及亚硝酸钠急性中毒家鸽血样中高铁血红蛋白的含量。结果上述杀虫脒急性中毒动物的血样中高铁血红蛋白的含量均属正常范围，而亚硝酸钠急性中毒家鸽血样中高铁血红蛋白的含量明显增加，二巯基丙磺酸钠不能还原由亚硝酸钠所致的高铁血红蛋白。结论杀虫脒急性中毒并非全数或多数出现高铁血红蛋白血症，高铁血红蛋白血症也并非是杀虫脒急性中毒死亡的主要原因。     

普鲁卡因静脉麻醉对患者高铁血红蛋白含量的影响

本文对33例静脉普鲁卡因麻醉前后患者血液高铁血红蛋白(MHb)含量的影响做了观察。结果表明:静脉给予普鲁卡因后1小时患者血液内 MHb 的含量明显高于用药前,有显著性差异(P<0.001);而停药时 MHb 的含量与用药前无显著差异(P>0.1)。提示麻醉医师,用静脉普鲁卡因麻醉后1～2小时内要注意患者血液 MHb 增高而出现紫绀现象。     

Genetic disorders of human red blood cells.

Human red blood cells (RBCs) are subject to an enormous degree of genetic diversity. The variability that occurs may result in anemia, cyanosis, polycythemia, or may cause no hematologic alterations. Genetic abnormalities affecting hemoglobin include the sickling disorders, the unstable hemoglobinopathies, hemoglobinopathies associated with polycythemia or with methemoglobinemia, and the alpha- and beta-thalassemias. The most common enzymatic abnormality of RBCs is glucose-6-phosphate dehydrogenase deficiency, but defects of many other enzymes leading to hemolytic anemia have been identified. Deficiences of RBC enzymes may also be important in the diagnosis of nonhematologic disease and in the evaluation of dietary status.     

氮卓斯汀喷雾剂联合曲安奈德喷雾剂治疗季节性变应性鼻炎的临床观察

目的：探讨鼻用氮卓斯汀喷雾剂联合鼻用曲安奈德喷雾剂对季节性变应性鼻炎的治疗效果。方法：随机选取门诊120例季节性变应性鼻炎患者分为治疗A组和对照B、C组,治疗组42例应用鼻用氮卓斯汀喷雾剂联合鼻用曲安奈德喷雾剂联合治疗,对照B组38例,应用鼻用氮卓斯汀喷雾剂治疗;对照C组40例,应用鼻用曲安奈德喷雾剂治疗。疗程3个月,共120天。结果：A组治疗季节性变应性鼻炎效较好,总有效率达93.75%,明显优于对照组（P〈0.05）。结论：鼻用氮卓斯汀喷雾剂联合鼻用曲安奈德喷雾剂对季节性变应性鼻炎的治疗安全有效。     

诺通鼻喷雾剂治疗慢性鼻炎的临床疗效观察

目的观察诺通鼻喷剂在治疗慢性鼻炎中消除或缓解鼻塞症状的效果,探寻治疗慢性鼻炎的有效药物。方法慢性单纯性鼻炎、肥厚性鼻炎患者共100例,分别用诺通鼻喷剂（诺通组）和1%麻黄素滴鼻剂（麻黄素组）进行治疗,对比疗效。结果诺通组总有效率为90.8%,麻黄素组为74.3%。诺通组69.2%起效时间在1min以内,66.2%维持时间在5h以上;麻黄素组68.6%起效时间在3min以内,65.7%维持时间在3h以内。结论诺通鼻喷剂缓解鼻塞迅速,维持时间长,疗效显著,明显优于1%麻黄素滴鼻剂,是一种治疗慢性鼻炎的有效药物。     

地塞米松和速尿超声雾化吸入治疗小儿支气管哮喘的临床研究

目的 :观察地塞米松和速尿超声雾化吸入治疗小儿支气管哮喘的疗效。方法 :在吸氧、补液、抗感染、纠正酸碱平衡紊乱等治疗的基础上 ,采用地塞米松和速尿超声雾化吸入。结果 :地塞米松和速尿超声雾化吸入治疗组的总有效率为 93.33% ,明显高于对照组。结论 :地塞米松和速尿超声雾化吸入治疗小儿支气管哮喘 ,安全方便 ,有效率高 ,具有较高的实用价值 ,值得推广应用     

吡啶硫锌气雾剂与羟基喜树碱软膏治疗银屑病临床对比观察

目的:评价吡啶硫锌气雾剂治疗银屑病的疗效和安全性.方法:将48例银屑病患者随机分为试验组吡啶硫锌气雾剂和对照组羟基喜树碱软膏,疗程均为28天.结果:治疗组与对照组有效率分别为86.4%和68.2%,两组有效率比较无显著性差异(P=0.150).吡啶硫锌气雾剂治疗组不良反应发生率低且反应轻微.结论:吡啶硫锌气雾剂治疗银屑病疗效确切,安全性好.     

复方环丙沙星喷鼻水剂的研制和质量控制

目的为了扩大环丙沙星的临床应用，满足五官科的临床需要。方法把环丙沙星、盐酸麻黄碱等，制成喷鼻水剂，不含抛射剂，放入鼻腔喷雾器内，通过手揿加压，非定量喷雾给药。结果所配制剂稳定，质量可控，使用方便，疗效显著。结论这一制剂不仅适用于医院小量配制，也适用于药厂批量生产。     

口腔科综合治疗台水路污染状况及干预效果分析

目的：通过监测了解口腔综合治疗台水路污染状况,探讨消毒方法及消毒频率,为综合治疗台水路污染控制提供依据。方法：在综合治疗台水路系统消毒前和消毒后第1、2、3、4天随机采集综合治疗台的水源水、手机喷水和三用枪出水的水样进行细菌计数和菌种鉴定,每月1次,重复6次。结果：工作中手机喷水与三用枪出水采样监测,两者比较差异有统计学意义（P〈0.05﹚,消毒后第1、2、3天两者比较无统计学意义（P〉0.05﹚,消毒后第4天与第1天两者比较差异有统计学意义（P〈0.05﹚。结论：口腔综合治疗台水路系统污染较严重,500 mg/L含氯消毒液对综合治疗台水路有较好的消毒效果,可常规应用于口腔综合治疗台水路的消毒处理,以降低医院感染的风险。     

空气相对湿度对喷雾干燥生产的影响

我国南北方相对湿度差别较大,相对湿度大,绝对湿含量过高会给喷雾干燥生产带来不利影响,如不调节进风温度有可能造成塔壁挂粉严重、产品水分含量超标、生产效率降低.相对湿度是设计喷雾干燥系统的重要参数.现以RGYP01-500型立式压力喷雾干燥塔生产奶粉为例进行阐述.     

抗感染喷剂对大鼠皮肤创伤修复模型修复面积及EGF表达的影响

目的:观察抗感染喷剂对大鼠皮肤创伤修复模型修复面积及肉芽组织中表皮生长因子(EGF)表达的影响。方法:30只SD大鼠随机分为模型组、对照组、治疗组,每组10只。采用全层皮肤切除制作创伤修复动物模型。造模后0d、1d、3d、5d、7d测量伤口未愈面积,采用原位杂交法检测EGF表达强度。结果:造模后第5d、7d治疗组、对照组修复面积及EGF表达强度与模型组比较有显著性差异。结论:抗感染喷剂能有效促进创伤皮肤组织愈合。     

复方菊冰喷雾剂的毒性试验研究

目的考察复方菊冰喷雾剂的急性毒性、局部刺激性以及蟾蜍口腔黏膜纤毛毒性。方法采用最大给药量试验观察鼻腔给药后动物短期内出现的急性毒性反应,包括呼吸状况、行为活动、精神状态等;参照中药新药指导原则考察复方菊冰喷雾剂的局部刺激性,并对相关组织进行病理切片检查;在光学显微镜下观察在体、离体蟾蜍口腔上腭纤毛在药物溶液作用下的持续摆动时间,考察复方菊冰喷雾剂的纤毛毒性大小。结果复方菊冰喷雾剂以最大给药浓度2.0mL/kg给予大鼠双侧鼻腔滴鼻无明显的急性毒性反应出现;局部刺激性实验中动物一般状况良好,未发生全身反应及死亡情况;组织病理学检查未见异常;对在体和离体蟾蜍口腔黏膜上腭纤毛的功能有一定的损伤作用。结论复方菊冰喷雾剂无明显急性毒性、局部刺激性,但有抑制蟾蜍口腔黏膜纤毛摆动的作用。     

两种鲑鱼降钙素喷鼻剂对鼻黏膜纤毛毒性的初步考察

目的：考察两种鲑鱼降钙素喷鼻剂对鼻黏膜纤毛的毒性。方法：以离体蟾蜍上腭黏膜为模型,研究了进口与国产鲑鱼降钙素喷鼻剂对鼻黏膜纤毛持续摆动时间的影响。结果：进口与国产鲑鱼降钙素喷鼻剂对纤毛持续运动时间无明显影响。结论：两种鲑鱼降钙素喷鼻剂对鼻黏膜纤毛运动时间的影响不大。