欧洲标准变应原联合化妆品筛选变应原对女性面部皮炎患者的斑贴试验

目的 采用欧洲标准变应原联合化妆品筛选变应原对女性面部皮炎患者进行斑贴试验,筛查主要致敏原.方法 对门诊女性面部皮炎患者采用化妆品筛选变应原联合欧洲标准变应原进行斑贴试验,按国际接触性皮炎研究组推荐标准判读结果.结果 41例女性患者进行了38种化妆品筛选变应原和26种欧洲标准变应原的斑贴试验.其中阳性率最高的化妆品筛选变应原计有乌洛托品(12.20%)、硫柳汞(9.76%)、双咪唑烷基脲(7.32%)及DMDM海因(7.32%),阳性率最高的欧洲标准变应原计有硫酸镍(22.20%)、甲醛(14.63%)、对苯二胺(9.76%)及香料混合物(9.76%).结论 硫酸镍,甲醛、乌洛托品、硫柳汞、对苯二胺、香料混合物、双咪唑烷基脲、DMDM海因等是女性面部皮炎患者主要致敏原.     

欧洲标准变应原联合化妆品筛选变应原对女性面部皮炎患者的斑贴试验

目的采用欧洲标准变应原联合化妆品筛选变应原对女性面部皮炎患者进行斑贴试验,筛查主要致敏原。方法对门诊女性面部皮炎患者采用化妆品筛选变应原联合欧洲标准变应原进行斑贴试验,按国际接触性皮炎研究组推荐标准判读结果。结果41例女性患者进行了38种化妆品筛选变应原和26种欧洲标准变应原的斑贴试验。其中阳性率最高的化妆品筛选变应原计有乌洛托品（12．20％）、硫柳汞（9．76％）、双咪唑烷基脲（7．32％）及DMDM海因（7．32%）,阳性率最高的欧洲标准变应原计有硫酸镍（22．20％）、甲醛（14．63％）、对苯二胺（9．76％）及香料混合物（9．76％）。结论硫酸镍、甲醛、乌洛托品、硫柳汞、对苯二胺、香料混合物、双咪唑烷基脲、DMDM海因等是女性面部皮炎患者主要致敏原。     

苏州工业园区皮炎湿疹类皮肤病斑贴试验结果分析

目的 了解并分析苏州工业园区皮炎湿疹类皮肤病患者接触性变应原及其特点。方法 选择2021年 8月-2023年10月就诊于本院皮肤科门诊的102例皮炎湿疹类皮肤病患者为研究对象,采用斑贴试验诊断盒 分析患者的接触性变应原情况。结果 102例皮炎湿疹类皮肤病患者中,斑贴试验阳性率为43.13%,阳性率 由高至低依次为硫酸镍（21.57%）、氯化钴（16.67%）、重铬酸钾（15.69%）、氯化镍（13.73%）,脂肪酸 硫酸钠（13.73%）等;男女患者的斑贴试验阳性率比较,差异无统计学意义（P ＞0.05）。结论 硫酸镍、 氯化钴、重铬酸钾、氯化镍、脂肪酸硫酸钠是苏州工业园区皮炎湿疹类患者的主要接触性致敏原。     

面部皮炎患者斑贴试验结果分析

目的:通过斑贴试验研究面部皮炎的病因与诊断。方法:对临床诊断为面部皮炎的41例患者进行问卷调查和斑贴试验(瑞典产标准接触变应原系列)。结果:两次判读结果阳性率分别为78.05%、68.29%,统计学显示有显著性差异(P<0.05)。阳性率居前的分别是硫酸镍(31.71%)、重铬酸钾(26.83%)、对苯类(19.51%)、芳香混合物(14.63%)、甲醛(12.20%)。出现强阳性反应最多的是硫酸镍(19.51%)。结论:面部皮炎患者应常规行斑贴试验,金属制品、化妆品、染料、建材等在引发面部皮炎中起重要作用。斑贴试验阴性者可能与刺激、光照、I型变态反应等有关,应综合分析。两次判读法可减少假阳性与假阴性的发生,值得推广。     

面部皮炎患者123例斑贴试验分析

目的：回顾分析笔者科室123例面部皮炎患者斑贴试验结果,以明确常见致敏化妆品成分及所致疾病种类.方法：对笔者科室门诊以“面部皮炎”为表现的患者进行化妆品系列变应原斑贴试验（49种变应原）,按国际接触性皮炎研究组推荐标准判读结果,并对结果进行统计分析.结果：共回顾分析123例面部皮炎患者斑贴试验结果,试验阳性患者79例,阳性率64.2％;排在前3位的致敏物质主要是乳化剂和防腐剂：山梨糖醇酐倍半油酸酯（13.82％）、卡松CG （8.94％）、阿莫醇（5.69％）;临床诊断中炎症性疾病,如：接触性皮炎、敏感皮肤、激素依赖性皮炎等斑贴试验阳性率80％,而色素异常性疾病,如：黑变病等阳性率约60％.结论：化妆品中山梨糖醇酐倍半油酸酯、卡松CG等是引起化妆品接触性皮炎的主要致敏成分,导致多种炎症性皮肤病和色素异常性皮肤病的发生.     

秦皇岛地区面部皮炎患者的临床特征及其发病因素的相关分析

目的:探究秦皇岛地区面部皮炎患者的临床特征以及发病的相关因素。方法:选取2017年7月-2019年7月于秦皇岛军工医院皮肤科门诊诊断为面部皮炎的患者186例,由专业医师对所有患者进行现场问卷调查,并对患者进行斑贴试验和皮肤点刺试验。结果:患者临床分型多为接触性皮炎57例(30.65%)和激素依赖性皮炎39例(20.97%)。面部皮损分布多为全面部(45.16%)和面颊部(20.97%),面部临床表现多为红斑(76.34%)和脱屑(52.15%)。自觉症状多为瘙痒(84.41%)和泛红(69.35%);斑贴试验阳性率81.72%,阳性率较高的变应原分别为芳香混合物36例(23.68%)、硫酸镍32例(21.05%)、甲醛29例(19.08%);皮肤点刺试验阳性率32.79%,阳性率较高的过敏原分别为花粉29例(47.54%)、屋尘螨24例(39.34%)、粉尘螨23例(37.70%)。结论:秦皇岛地区面部皮炎患者的临床分型以接触性皮炎和激素依赖性皮炎为主,面部皮损多为全面部和面颊部,面部临床表现多为红斑和脱屑,自觉症状多为瘙痒和泛红。面部皮炎发病因素为:化妆品、香水、沐浴露等日常用品中的芳香混合物,勺子、手表、首饰、拉链等合金中的硫酸镍,房屋装修过程中的甲醛和某些服装厂家使用含甲醛的染色助剂或非法使用甲醛进行防腐处理的海产品等以及花粉、屋尘螨和粉尘螨等。     

化妆品皮肤损伤989例分析

目的 探讨化妆品皮肤损伤状况和病因及发生规律。方法 对989例化妆品皮肤损伤进行了临床观察，并用辨敏牌标准筛选斑贴试验试剂盒对患者做斑贴试验。结果 临床表现主要为接触性皮炎(70．58％)，其次是色素沉着(11．02％)、痤疮样损害(7．99％)、光感性皮炎(1．01％)、混合性皮损(9．40％)。可疑致病化妆品种类189种。989例患者中阳性者653例，阳性率66．03％。结论 斑贴试验对接触性皮炎、色素沉着类化妆品皮肤损伤有确定的指导、防治意义，化妆品皮肤损伤应进行斑贴试验。     

等候肾移植者群体反应性抗体的变化及HLA致敏途径对其的影响

目的 探讨等候肾移植者群体反应性抗体(PRA)阳性率的变化及HLA致敏途径对其的影响.方法 对1991年1月至2010年12月间来自51个肾移植中心的8926例等候肾移植者10 555例次血液样本PRA检测的结果进行分析.1991～1998年组采用补体依赖的细胞毒性试验技术检测PRA; 1999～2010年组采用酶联免疫吸附试验技术检测PRA.搜集患者的临床资料,分析输血、妊娠和移植对PRA阳性率的影响.结果 8926例中PRA阳性者为1324例(14.83％),其中1991-1998年的PRA平均阳性率为18.17％ (513/2823),1999 2010年的结果为13.29％(811/6103),差异有统计学意义(P＜0.01).1324例PRA阳性者中,PRA为1％～30％者占71.83％;PRA≥30％者占28.17％.既往有血液成分输血史者的PRA阳性率为31.77％,无输血史者的PRA阳性率为1.21％,差异有统计学意义(P＜0.01).女性患者中,有妊娠史者的PRA阳性率为24.64％;无妊娠史者的PRA阳性率为7.19％,差异有统计学意义(P＜0.01).初次移植者的PRA阳性率为13.35％,既往有肾移植经历的受者的PRA阳性率为40.62％,差异有统计学意义(P＜0.01).结论 近20年大多数PRA阳性者其PRA＜30％.输血和肾移植史是导致PRA阳性的重要影响因素;妊娠史是PRA阳性的关联因素.     

过敏性鼻炎变应原皮肤点刺试验结果分析

目的了解过敏性鼻炎常见的变应原.方法应用"阿罗格"30种变应原皮试液、生理盐水阴性对照和组胺阳性对照对868例疑似过敏性鼻炎患者进行皮肤点刺试验,以测定其致敏的变应原.结果 609例(70.2%)有阳性反应,其中68例有哮喘病史.单一变应原阳性62例,2种及以上变应原阳性547例,以吸入性变应原为主.609例阳性病例中屋尘螨阳性率最高(525例,86.2%),其次是粉尘螨(488例,80.1%).结论屋尘螨、粉尘螨是过敏性鼻炎常见的变应原."阿罗格"变应原皮肤点刺试验对过敏性鼻炎的诊断及防治有重要的参考和指导意义.     

健康人群镍斑贴试验研究

目的:了解健康人群镍接触过敏情况。方法:对38名健康志愿者进行人体皮肤封闭型硫酸镍斑贴试验。结果:38名受试者中,8名(21.05%)镍斑贴试验阳性。其中,男性阳性率为14.29%(1/7),女性阳性率为22.58%(7/31)。男性与女性的镍斑贴试验阳性率比较无明显差异(P0.05)。结论:镍接触过敏在健康人群中很常见,重视镍过敏相关教育,对预防镍变应性接触性皮炎有重要的意义。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

Systemic analgesia adapted to the children's condition

A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions.