A comparison of the actions of different bronchodilators in asthma

The actions of the following pressurized bronchodilators were compared by administration to 24 asthmatics: (1) Medihaler Iso Forte, (2) Alupent, (3) Medihaler-duo, (4) Bronchilator, and (5) Prenomiser Plus. These contained one or more of the following: isoprenaline, orciprenaline, isoetharine, phenylephrine, atropine methonitrate, and thenyldiamine. The dose was a single discharge from the container. The response was assessed by calculating the mean percentage change in F.E.V. at intervals after inhalation.     

Mixing of antacids with stomach contents

An investigation was carried out into the readiness with which magnesium trisilicate mixture BPC, Andursil suspension (Geigy) and 0·33 M aqueous sodium citrate mixed with gastric contents, to evaluate their suitability for use as an antacid before the induction of anaesthesia in obstetric patients. Laboratory investigations demonstrated that magnesium trisilicate and Andursil did not mix adequately with gastric contents, whereas sodium citrate mixed readily. A clinical investigation of sodium citrate revealed significant improvement in the mixing of gastric juice with the antacid if the patient was turned into the right lateral position following its administration (p <0·05), but highly significant improvement followed a rotation through 360° (p<0·005). It was thought that these findings were caused by the division of the stomach into two sacs, a phenomenon confirmed by radiological studies and the use of a pig's stomach as a model of the human stomach.     

Comparison of antacids on the binding of bile salts

Following a gastric operation (and occasionally in other patients), biliary reflux may damage the stomach mucosa. If severe damage occurs, a diverting Roux-en-Y procedure may be required. In most cases, nonoperative treatment is successful. Since bile salts have been implicated as a cause of mucosal injury, we evaluated the efficacy of antacids in binding these salts. Several bile salts were mixed with certain antacids and with cholestyramine resin, and the adsorption was determined. Cholestyramine resin absorbed 90% to 97% of the bile salts. At a pH of 7, magaldrate (Riopan) absorbed the dihydroxy-bile salts as well as cholestyramine resin, but the other antacids we tested showed poor adsorption. The ability of antacids to bind bile salts must be considered when treating bile salt-induced injury with these substances.     

Phosphate-binding properties and electrolyte content of aluminum hydroxide antacids

The phosphate-binding capacities of 19 liquid and solid aluminum hydroxide gel antacids were determined in vitro under varying pH conditions. The resulting data provide a basis explaining the phosphate-binding characteristics observed when patients are treated with long-term aluminum hydroxide therapy. No antacid, liquid or solid, showed significant binding at pH 1.0. Maximum phosphate binding (expressed as phosphorus; P) was observed at pH 2.0 and 3.0 for most antacids and decreased markedly at alkaline pH. The liquid antacids showed a significantly greater phosphate-binding capacity than did tablets or capsules (p less than 0.01). At pH 2.0, the liquid antacids bound a mean of 22.3 mg P/5 ml. At pH 8.0 binding was reduced to a mean of 7.3 mg P/5 ml. Significant interbrand differences were observed. At pH 2.0, the solid antacids bound a mean of 15.3 mg P/tablet or capsule. At pH 8.0, binding was reduced to a mean of 5.8 mg P/tablet or capsule. Interbrand differences, while substantial, were less than those observed among the liquid antacids. Variations in sodium and potassium content were clinically insignificant for most of the antacids in this study, while the differences in phosphate-binding properties were sufficient to warrant attention in the patient with renal failure.     

两种不同麻醉方式下施实PPH手术的临床对比研究

目的比较不同麻醉方式下施实吻合器痔上黏膜环切术(procedure for prolapse and hemorrhoids,PPH)的麻醉效果。方法将84例接受PPH的患者随机分为2组。对照组在腰硬联合麻醉下行PPH治疗;治疗组在局麻下行PPH治疗。分别对手术时间、疼痛感、手术费用等各方面进行比较。结果治疗组患者的手术时间、手术费用及术后尿潴留发生率方面均优于对照组。术中、术后疼痛感评分方面2组无差异。结论对于PPH手术,局麻是安全可行的,且较腰硬联合麻醉下行PPH治疗具有手术时间短、费用低、尿潴留减少等优势。     

The use of radiotelemetry techniques for the in vivo assessment of antacids

The use of the pH radio pill for the assessment of antacid effect has been evaluated. The correlation between the pH pill and a conventional pH electrode system was high (r2 = 0.997). The records of in vivo pH against time allow unique measurements of antacid efficacy (defined as the integrated area under the pH against time curve) and duration of action to be obtained. Using a free pill, antacid assessments were performed in 13 subjects in the left lateral position. The effects of repeated antacid administrations were studied in five subjects using a pH pill which was prevented from leaving the stomach by tethering it to the teeth. These longer studies were performed in the sitting position. The efficacy (p less than 0.02) and duration of action (p less than 0.02) of sodium citrate 0.3 M were less in those subjects in whom the pill was tethered. The differences between the results of the studies using either a free or a tethered pill can be attributed to posture. The overall duration of action of sodium citrate 15 ml was short, the mean (SEM) value being 42.4 (4.5) minutes in the left lateral position and 21.2 (4.0) minutes in the upright position.     

Network meta-analysis of the treatment efficacy of different lasers for peri-implantitis

Lasers in Medical Science - The aim of this study was comparing different lasers with conventional non-surgical treatment (CNT) for the management of peri-implantitis, regarding probing depth (PD),...     

Cimetidine, carbenoxolone sodium, and antacids for the prevention of experimental stress ulcers.

Cimetidine, an H2-receptor, antagonist, and carbenoxolone sodium, a drug used to stimulate gastric mucus synthesis and increase the life span of gastric epithelial cells, were studied to determine their possible prophylactic effect on the formation of stress ulcers, gastric transmucosal potential difference and gastric pH in rats, using a restraint stress model. The number of ulcers substantially decreased in the rat groups receiving either cimetidine or carbenoxolone pretreatment for two or more days before stress. When the drugs were used in combination, there was an additive effect, since there was a significant decrease in ulcer formation even after half a day of pretreatment. When antacids were used, there was also decreased ulcer formation with half a day of pretreatment. Gastric pH was significantly increased from control levels in all the groups treated with antacid, cimetidine and carbenoxolone. Both cimetidine and carbenoxolone, either alone or in combination, prevented the decrease in potential difference that was produced in the untreated stressed rats. This study suggests that either cimetidine or carbenoxolone, and particularly their combination, may be a useful prophylactic regimen for the prevention of stress ulceration in patients subjected to severe stress.     

不同剂量瑞马唑仑用于宫腔镜手术的安全性和有效性

目的 比较三种剂量瑞马唑仑和丙泊酚用于宫腔镜手术的安全性和有效性。
方法 选择择期全麻下行宫腔镜手术患者180例,年龄18~60岁,ASA Ⅰ—Ⅲ级。采用随机数字表法将其分为四组：C组、R1组、R2组和R3组,每组45例。所有患者静脉注射舒芬太尼5 μg后,C组静脉注射丙泊酚1～2 mg/kg进行麻醉诱导,待改良警觉/镇静评分（MOAA/S）为0分后予以5 mg·kg^-1·h^-1静脉泵注维持;R1组、R2组和R3组均静脉泵注瑞马唑仑6 mg·kg^-1·h^-1进行麻醉诱导,MOAA/S为0分后,R1组、R2组和R3组分别调整剂量为0.5、1.0和1.5 mg·kg^-1·h^-1术中维持。记录镇静起效时间、术中补救镇痛例数以及苏醒时间。记录入室平静时（T₀）、麻醉诱导后MOAA/S为0分时（T₁）、术中SBP最低时（T₂）、麻醉苏醒（T₃）后HR、SBP和DBP。记录术中知晓、体动、多巴胺使用例数、呼吸抑制、肌震颤、头痛、注射痛、瘙痒、恶心、呕吐、咳嗽、出汗、寒战和苏醒后眩晕等不良事件的发生情况。
结果 R1组、R2组和R3组镇静起效时间明显长于C组（P＜0.05）,R2组、R3组术中补救镇痛率明显低于R1组（P＜0.05）,R2组和R3组苏醒时间明显长于C组和R1组（P＜0.05）。T₁时R1组、R3组HR明显快于C组（P＜0.05）。T₁、T₂时R1组、R2组和R3组SBP和DBP均明显高于C组（P＜0.05）。R1组术中体动发生率明显高于R2组、R3组（P＜0.05）,R1组、R2组和R3组术中多巴胺使用率和注射痛发生率明显低于C组（P＜0.05）。
结论 以瑞马唑仑6 mg·kg^-1·h^-1静脉诱导、1.0 mg·kg^-1·h^-1麻醉维持应用于宫腔镜手术时相对于应用丙泊酚对循环系统影响更小,注射痛发生率更低,可安全、有效地应用于此类手术患者。     

Comparison of the efficacy of different antibiotics strategy on peritoneal dialysis-related peritonitis

Objective To compare the efficacy of different antibiotics strategy, introperitoneal (IP) cefazolin plus third-generation cephalosporin versus IP Vancomycin plus third-generation cephalosporin on peritoneal dialysis (PD)-related peritonitis. Methods All episodes of PD-associated peritonitis happened in prevalent PD patients between January 2008 and December 2012 were recruited from the PD Center of Peking University First Hospital. According to their empiric antibiotics scheme, episodes were divided into group A (where IP cefazolin plus third-generation cephalosporins were administrated) and group B (where IP Vancomycin plus third-generation cephalosporins were administrated). Multivariable logistic regression model was used to explore the influence of different empiric antibiotics scheme on peritonitis outcome. Results Patients in Group B had significantly lower level of serum albumin (33.5±6.0 vs 35.3±5.2 g/L) and cholesterol (4.6±1.3 vs 4.9±1.1 mmol/L) than those in group A. In group A, the percentage of gram-positive bacteria was similar to group B (43.2% vs 43.3%, P＝0.96), but gram-negative bacteria was numerically lower (16.9% vs 24.7%, P＝0.08). Different empiric antibiotics strategy was not independent predictor of peritonitis outcome [OR＝1.07, 95%CI(0.45, 2.56), P＝0.87]. Conclusion Both cefazolin and vancomycin can be selected as first-line empiric antibiotic covering gram-positive organisms in the treatment of PD related peritonitis.     

Combined treatment with ranitidine and saline antacids prior to obstetric anaesthesia

Ranitidine 150 mg was given to 126 patients requiring elective Caesarean section under general anaesthesia: 43 women had ranitidine alone, 43 had this supplemented by a pre-induction dose of sodium citrate and 40 patients had ranitidine plus sodium bicarbonate. All three sub-groups provided satisfactory gastric pH and volume. Ranitidine 150 mg was given orally every 6 hours to women in labour. Of 221 patients requiring general anaesthesia during labour, 103 women received 30 ml 0.3 M sodium citrate and 118 women, 20 ml of 8.4% sodium bicarbonate 10 minutes before induction of anaesthesia. In the citrate sub-group there was one patient with a gastric pH less than 2.5 (mean pH 6.2, SEM 0.13 range 2.1-8.4). In the bicarbonate sub-group the lowest gastric acidity was 3.8 (mean pH 8.3, SEM 0.11 range 3.8-9.83).     

不同药物组合治疗骨质疏松症的临床疗效观察

目的 比较两种不同药物组合治疗骨质疏松症的疗效.方法 将170例原发性骨质疏松症患者随机分为对照组85例和治疗组85例,对照组给予维生索D+钙剂,治疗组采用降钙素+维生索D+钙剂治疗,比较两种药物组合的疗效.结果 对照组在3w左右临床症状缓解;治疗组在1w左右缓解症状.治疗6个月后,临床症状改善显效或有效的患者中对照组32例(37.6％)、治疗组70例(82.3％).治疗组明显好于对照组(P＜0.05).对照组治疗1年时各部位骨密度(BMD)值无明显改变,而治疗组各部位的BMD值均较治疗前明显增加,并高于对照组(P＜0.05).结论 降钙素+维生索D+钙组合的疗效明显好于维生素D+钙剂的疗效.     

不同麻醉方法用于隆乳术的效果观察

目的:观察隆乳术采用不同麻醉方法的麻醉效果及适用性。方法:90例行隆乳术患者分为3组;Ⅰ组是静脉全麻加局部麻醉,Ⅱ组为硬膜外麻醉,Ⅲ组为单纯局部麻醉组;观察麻醉效果及对血流动力学的影响。结果:三组患者麻醉效果各有不同;脉搏氧饱和度无明显变化,Ⅰ组、Ⅱ组血压及心率轻度降低,Ⅲ组则明显增高;Ⅱ组大部分患者出现血压下降(14例)、心动过缓(11例)。结论:静脉全麻加局部麻醉与高位硬膜外阻滞麻醉均可安全、有效地应用于隆乳手术麻醉;但高位硬膜外阻滞对生理功能影响较大,术毕需要住院观察以保证患者生命安全,尽量不予采用。     

Basal ganglia haemorrhages: efficacy and limits of different surgical strategies

To assess the role of surgery in patients with spontaneous basal ganglia haemorrhages, we evaluated poor outcome (mortality and prolonged unawareness) one month after 'open' surgery in patients with haematomas larger than 30 cm(3). One hundred and twenty-seven patients were traced over a 5-year period. Excluding deeply comatose patients (Glasgow Coma Scale [GCS] 3-4, n?=?39), we analysed the remaining 88 patients, dividing them into two homogeneous groups according to the modality of treatment: aggressive or palliative. Multivariate analysis was applied both to the overall population and to the two groups in order to determine factors prognostic for poor outcome. Aggressive treatment was defined as surgery as the first-choice treatment modality aimed at 'complete' evacuation. Palliative treatment was defined as delayed surgery and/or surgery aimed at clot removal only to obtain internal decompression. Efficacy was assessed in patients having the same initial GCS score in both groups. Factors significantly associated with outcome were preoperative complications, volume, timing of operation, residual clots and postoperative complications. Outcomes were significantly better for aggressive surgery (17% vs. 68%, p?相似文献   

The efficacy of three different methods of transtracheal ventilation

The ability of three different techniques of transtracheal ventilation to reverse hypoxia and provide pulmonary ventilation were examined. Five swine were anaesthetized with isoflurane in oxygen, their tracheas were intubated, and their lungs mechanically ventilated to produce a PaCO2 of 35-40 mmHg. A 14-gauge catheter was inserted percutaneously into the trachea caudad to the tip of the tracheal tube. The animals were then left apnoeic until their oxygen saturation fell to 60 per cent. At this point, attempts were made to ventilate and oxygenate the animals through the tracheal catheter with one of three systems (Jet--50 psi [2585 mmHg] driving pressure controlled with a thumb operated valve, Flush-fresh gas outlet of an anaesthetic machine with flow controlled by the flush button, or Circle--standard anaesthesia circle system with pressures greater than 60 mmHg). Arterial blood gas determinations were made every minute for five minutes after beginning transtracheal ventilation. Both the Jet and Flush modes resulted in a mean PaO2 greater than 250 mmHg within one minute of their initiation whereas the PaO2 with the Circle system never exceeded 180 mmHg even at five minutes. The Flush and Jet modes produced a decrease in the PaCO2 (from 80 mmHg to 35-45 mmHg) over the five minutes. In contrast, it was not possible to provide adequate ventilation with the Circle system as evidence by an increasing PaCO2 (from 80 mmHg to less than 110 mmHg at five minutes).(ABSTRACT TRUNCATED AT 250 WORDS)