硬膜外神经阻滞麻醉无痛分娩的临床观察

目的观察硬膜外神经阻滞麻醉无痛分娩效果。方法选择我院2014年3月至2017年3月收治的产妇100例,按照信封法分为对照组(n=50)和观察组(n=50),对照组产妇进行自然分娩,观察组产妇进行硬膜外神经阻滞麻醉无痛分娩,比较两组产妇镇痛效果、分娩情况和新生儿结局。结果观察组产妇镇痛有效率88.00%显著高于对照组产妇的16.00%;观察组剖宫产、阴道助发生率产及第一产程均明显低于对照组(P<0.05),产后出血量与对照组无明显差异(P>0.05);观察组新生儿总不良结局发生率10.00%与对照组的16.00%无显著差异(P>0.05)。结论硬膜外神经阻滞麻醉无痛分娩可以有效缓解产妇分娩疼痛,有利于产妇分娩。     

无痛分娩加缩宫素应用于产程的疗效观察

目的观察无痛分娩加缩宫素对孕产妇产程及分娩预后的影响及其效果。方法随机抽取100例自愿应用无痛分娩的临产妇为观察组,同期同样条件未应用无痛分娩的100例孕产妇为对照组,比较两组孕产妇产程、分娩方式、分娩结局等。结果观察组产妇行无痛分娩加缩宫素治疗,较于对照组其产程显著缩短(P<0.05),其有效镇痛率、剖宫产率、并发症发生率亦显著优于对照组,且差异均有统计学意义手术率(P<0.05)。结论无痛分娩加用缩宫素可有效缩短产程,并对减轻产妇痛苦及改善分娩结局具有重要促进作用,具有较高临床推广应用价值与前景。     

探讨无痛分娩的临床应用与护理

目的探讨分娩镇痛和自然分娩的临床应用及产程观察和护理新进展。方法选择2012年5月至2013年5月足月孕妇420例,根据自愿的原则,将患者随机分成实验组和观察组,实验组采用硬膜外麻醉无痛分娩;对照组实行阴道自然分娩。分别观察两组产程时间、分娩方式,娩后新生儿的评分情况、分娩并发症等。结果实验组疼痛评分显著低于对照组（P〈0．01）;实验组在产程时间,继发宫缩乏力方面及应用缩宫素情况与对照组比较没有显著差异（P〉0．05）;两组产妇分娩方式对胎儿或新生儿的影响无明显差异（P〉0．05）。结论无痛分娩对母婴影响小,无痛效果显著,能明显缩短产程,降低了阴道助产率和剖宫产率,对新生儿及出血量无明显差异,值得临床推广应用。     

产科无痛分娩技术的应用与临床效果探究

目的:研究并探讨无痛分娩技术在产科应用的临床效果。方法:于2016年6月1日~8月31日,某院产科共有800例产妇分娩,按照产妇是否实施无痛分娩,将产妇分为对照组(500例,传统分娩)、观察组(300例,无痛分娩),比较两组产妇的产程时间、剖宫产率、会阴切开率、产后出血量以及新生儿Apgar评分。结果:与对照组相比,观察组产妇的产程时间明显缩短(P<0.05),其剖宫产率、会阴切开率、产后出血量明显更低(P<0.05),且观察组新生儿的Apgar评分升高(P<0.05)。结论:在产科分娩中应用无痛分娩技术,可有效促进分娩的完成,促进阴道自然分娩,减少产后出血的发生,改善妊娠结局。     

应用气囊仿生技术助产降低剖宫产率的临床研究

目的研究气囊仿生技术助产对剖宫产率的影响,旨在促进自然分娩降低剖宫产率,提高产科质量。方法将住院的240名初产妇随机分为气囊仿生助产组（观察组）和常规分娩组（对照组）各120例,观察记录两组产妇的剖宫产率和阴道助产率、自然分娩产程时间、产后2h内出血量等几方面资料,并进行比较分析。结果观察组产妇剖宫产数、阴道助产数、产后2h内出血量与对照组相比较显着降低;观察组产妇自然分娩的初产妇活跃期和第二产程时间与对照组相比较显着缩短,两组相比较差异有统计学意义（P〈0．05）。结论气囊仿生技术助产能明显缩短产程,提高初产妇阴道自然分娩率,降低剖宫产率和阴道助产率,减少产后2h出血量,是一种简便、有效、安全、适宜的现代助产技术,提高了产科质量,值得应用和推广。     

缩宫素联合卡孕栓治疗阴道分娩产后出血的效果观察

目的：探讨缩宫素和联合卡孕栓治疗阴道分娩产后出血的效果。方法：选取我院产科选择阴道分娩的120例有产后出血高危因素的产妇,采取随机数字表法进行分组,两组各60例。对照组使用缩宫素,观察组在此基础上加用卡孕栓。比较分娩结局。结果：观察组最后一个产程的时间、最后一个产程的出血量、产后2h出血量均低于对照组,差异显著(P<0.05);观察组产后子宫底下降速度高于对照组,恶露持续时间短于对照组,组间对比差异显著(P<0.05);观察组不良反应总发生率为5.00%,与对照组的6.67%对比,差异不显著(P>0.05)。结论：缩宫素这一药物和卡孕栓治疗能够缩短时间,降低出血,促进产后恢复,且安全性良好。     

产妇无痛分娩的临床分析与产科学研究

目的研究分析产妇在清醒、无痛苦状态中分娩状况与临床意义。方法两组各772例,观察组试用PCEA泵硬外布比卡因、利多卡因联合用药进行无痛分娩,对照组不予麻醉镇痛,自然分娩,观察其镇痛效果、产程时间、分娩方式、产后失血量,新生儿出生Apgar评分。结果观察组772例产妇显效746例,占96.6%,总有效率100%,观察组第一、二产程明显缩短(P<0.01),第三产程两组无差异。观察组剖宫产82例(10.6%),阴道助产140例(18.1%),对照组剖宫产204例(26.4%),阴道助产184例(23.8%),两组显著差异(P<0.05)。两组产妇出血量及新生儿Apgar评分无差异(P>0.05)。结论采用PCEA泵硬外布比卡因、利多卡因联合用药进行无痛分娩,镇痛效果显著,剖宫产率及阴道助产率低,缩短第一、二产程及总产程,产妇出血量及新生儿Apgar评分无影响,值得在临床上推广应用。     

低浓度罗哌卡因复合芬太尼用于分娩镇痛的临床观察

目的:探讨低浓度罗哌卡因复合芬太尼用于产妇自控分娩镇痛(PCEA)的效果及对分娩的影响。方法:选择38例单胎足月头位、无麻醉禁忌证及产科并发症的初产妇为观察组,于宫口开大3 cm进入活跃期时行硬膜外穿刺置管注入0.125%罗哌卡因+芬太尼1.5μg/mL混合液进行产妇自控镇痛,首次经导管注入镇痛合剂8~12 mL,持续给药6 mL,追加剂量6 mL,镇痛时间15 min,总量26 mL/h。随机选择同期非镇痛分娩的健康、单胎、足月临产初产妇50例为对照组,对照组按产科常规处理,观察两组产妇的镇痛效果、产程时间、分娩方式、新生儿Apgar评分及产后出血量。结果:观察组产妇的镇痛有效率达94.74%,第一产程活跃期比对照组明显缩短,差异有显著性(P<0.05),观察组缩宫素使用明显多于对照组,差异有显著性(P<0.01),两组产妇第二产程、第三产程、阴道分娩率、阴道助产率、剖宫产率、产后出血及新生儿评分无显著差别。结论:低浓度罗哌卡因复合芬太尼硬膜外置管用于产妇自控分娩镇痛效果确切;能加快活跃期,缩短第一产程;增加缩宫素使用率;不增加阴道助产率、剖宫产率;不影响产后出血及新生儿评分。     

间苯三酚联合缩宫素对需引产分娩的初产妇产程进展和分娩结局的影响

目的 探讨间苯三酚联合缩宫素应用对于需引产分娩的初产妇产程进展、产妇及新生儿分娩结局的影响.方法 选取2019年1月至2020年12月在合肥市第三人民医院需引产分娩的足月单胎初产妇60例,采用随机数字表法分为观察组与对照组,每组30例,对照组单用缩宫素治疗,观察组应用缩宫素联合间苯三酚治疗,收集产妇的产程进展、产后出血量、宫颈或阴道裂伤发生率、产时羊水Ⅲ度发生率、阴道分娩率和新生儿Apgar评分等,并对两组数据进行比较.结果 观察组第一产程、总产程时间分别为(407.9±125.4)min、(450.5±131.0)min,均显著短于对照组的(663.3±218.2)min、(722.1±223.4)min(P<0.05).两组阴道分娩率、产后出血量、宫颈或阴道裂伤发生率、产时羊水Ⅲ度发生率的差异无统计学意义(P>0.05).结论 间苯三酚联合缩宫素静滴,可缩短产程,且不影响母婴安全.     

分娩球联合自由体位在分娩中的应用效果

目的观察分娩球联合自由体位在分娩中的应用效果。方法选择2016年3月-2018年12月在咸宁市中心医院/湖北科技学院附属第一医院分娩的产妇168例,根据助产方式不同分为观察组和对照组,每组84例。观察者产妇采用分娩球结合自由体位助产,对照组产妇采用传统方式助产,比较2组产妇的产程时间、分娩方式、产后出血量、新生儿Apgar评分及母婴不良结局。结果观察组产妇第一产程及总产程时间均短于对照组,阴道分娩率高于对照组,剖宫产率低于对照组,产后出血量少于对照组(P<0.05);2组产妇第二产程时间、第三产程时间、阴道助产率及新生儿Apgar评分比较差异均无统计学意义(P>0.05)。观察组产妇母婴不良结局总发生率为10.7%,低于对照组产妇的21.4%(χ~2=14.527,P<0.05)。结论分娩球联合自由体位在产妇分娩中具有较好的应用效果,对于促进产程进展,提高阴道分娩率,降低母婴不良事件发生率具有重要意义,可在临床推广应用。     

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.     

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.     

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.