BiPAP治疗慢性阻塞性肺疾病并呼吸衰竭的临床分析

目的:评价双水平气道正压无创通气(BiPAP)治疗慢性阻塞性肺疾病并呼吸衰竭的临床疗效.方法:将83例确诊为COPD呼吸衰竭患者随机分为两组.对照组,42例,采用常规治疗;治疗组,41例,在常规治疗的基础上同时给予BiPAP治疗.动态观察两组通气前及通气后4 h、24 h的临床表现、生命体征、动脉血气变化.结果:BiPAP治疗4 h后动脉血气明显改善,心率和呼吸频率降低,通气前后各项观察指标与对照组比较均显著好转 (P＜0.05).结论:BiPAP对COPD并呼吸衰竭患者的疗效肯定,是一种有效、简便、无创而实用的治疗方法.     

BiPAP无创通气治疗COPD急性加重合并Ⅱ型呼吸衰竭的临床观察

目的观察BiPAP无创正压通气治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭临床疗效。方法 48例AECOPD合并Ⅱ型呼吸衰竭住院患者随机分为常规治疗组(对照组)26例和BiPAP无创通气治疗组(治疗组)22例,对照组仅给予持续低流量吸氧、抗感染、支气管扩张剂、祛痰、抗炎等治疗;治疗组在对照组的治疗基础上,联合BiPAP无创正压通气;观察2组患者治疗前后动脉血气、呼吸频率、心率的变化。结果两组患者在治疗后动脉血气(pH值、PaCO2、PaO2)、呼吸频率和心率与治疗前比较均有明显改善,治疗组在降低二氧化碳分压(PaCO2)、提高氧分压(PaO2)、改善pH值、呼吸频率和心率方面较对照组患者效果更明显,差异有统计学意义(P<0.05)。结论联合BiPAP无创正压通气可有效改善AECOPD合并Ⅱ型呼吸衰竭患者的动脉血气及生命体征,可更有效改善患者病情,提高治疗有效率。     

无创通气对慢性阻塞性肺疾病合并呼吸衰竭的治疗作用

目的探讨双水平正压无创通气对慢性阻塞性肺疾病（COPD）合并呼吸衰竭的应用价值。方法48例COPD合并呼吸衰竭患者随机分为对照组和BiPAP呼吸机无创通气治疗组各24例，对照组常规治疗，治疗组除常规治疗外，加用BiPAP无创通气，监测治疗前后1h、12h、72h血气变化，比较两组血气变化结果。结果治疗组的血气较对照组明显改善。结论应用BiPAP无创通气能明显改善COPD合并呼吸衰竭患者的症状，提高PaO2、降低PaCO2。     

Bi-PAP治疗慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭的疗效探讨

目的 评价应用BiPAP双水平无创通气治疗COPD合并Ⅱ型呼吸衰竭患者的临床疗效.方法 研究组45例慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭患者在常规治疗基础上应用Bi-PAP治疗,对照组40例患者仅给予常规治疗.分别对两组患者治疗后48 h的心率和呼吸改善情况以及动脉血气变化情况进行分析比较.结果 治疗后48 h,与常规治疗组患者相比,研究组患者的心率和呼吸频率均显著改善,差异均有统计学意义(P<0.05);治疗后48 h,与常规治疗组患者相比,研究组患者的各项血气指标包括PaO2、PaCO2以及pH值均显著改善,差异均有统计学意义(P<0.05).结论 BiPAP双水平无创通气对COPD并发Ⅱ型呼吸衰竭患者有积极的治疗意义,值得临床推广应用.     

双水平无创呼吸机治疗慢性阻塞性肺疾病急性加重期并发呼吸衰竭的疗效观察

目的探讨双水平无创正压通气（BiPAP）治疗慢性阻塞性肺疾病急性加重期（AECOPD）并发Ⅱ型呼吸衰竭的疗效。方法 80例患者分为两组,试验组40例在常规治疗基础上加用BiPAP治疗,观察治疗前后患者呼吸、心率、血气指标变化和病情改善程度;对照组40例予以常规治疗。结果试验组经BiPAP治疗后患者呼吸、心率、血气指标变化和病情改善明显优于对照组（P〈0.05）。结论无创呼吸机是治疗AECOPD并发Ⅱ型呼吸衰竭的有效方法,可以改善通气及生命体征、缩短住院时间,降低气管插管率及病死率,疗效显著。     

BiPAP呼吸机治疗COPD并Ⅱ型呼吸衰竭60例疗效观察

目的探讨双水平气道正压通气(BIPAP)呼吸机无创通气治疗慢性阻塞性肺疾病(COPD)并Ⅱ型呼吸衰竭的疗效。方法将COPD合并Ⅱ型呼吸衰竭患者60例随机分成(观察组和对照组)。对照组30例用鼻导管持续低流量吸氧,观察组30例加用BiPAP呼吸机通气治疗,观察治疗前后临床症状、动脉血气等指标的变化。结果观察组经BiPAP呼吸机治疗后患者血氧饱和度及血气分析等指标改善明显优于对照组(P<0.05)。结论无创机械通气治疗能够显著改善COPD合并Ⅱ型呼吸衰竭患者动脉血气指标和呼吸状况。     

BiPAP治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭的疗效分析

目的研究双水平气道正压力通气(BiPAP)呼吸机在慢性阻塞性肺疾病(COPD)急性加重合并Ⅱ型呼吸衰竭中的临床疗效。方法 46例COPD急性加重并Ⅱ型呼吸衰竭患者随机分为常规治疗组(对照组)及无创正压通气组(治疗组),对照组给予常规氧疗、药物治疗;治疗组除常规治疗外加用BiPAP呼吸机辅助通气,比较两组之间治疗前后心率、呼吸频率及动脉血气等指标。结果经治疗2、24h后,治疗组在心率、呼吸频率、动脉血气分析各项指标上均有明显改善,较对照组有显著性差异(P<0.05)。结论 BiPAP治疗慢性阻塞性肺疾病(COPD)急性加重合并Ⅱ型呼吸衰竭能更有效的提高PaO2、降低PaCO2、呼吸频率,减少有创机械通气,是治疗呼吸衰竭的有效手段。     

无创正压通气在慢性阻塞性肺疾病合并肺性脑病时的临床应用

目的探讨无创双水平正压通气(BiPAP)治疗慢性阻塞性肺疾病合并肺性脑病的临床疗效。方法选择慢性阻塞性肺疾病合并肺性脑病患者80例,随机分为对照组和治疗组,对照组采用常规治疗,治疗组在常规治疗基础上采用无创BiPAP治疗,观察两组患者治疗48h后临床症状改善情况,记录两组治疗前后血气指标。结果治疗组临床症状改善情况和治疗前后血气指标变化情况均优于对照组(P<0.01)。结论在常规治疗基础上,采用无创BiPAP治疗慢性阻塞性肺疾病并肺性脑病临床效果显著,值得推广应用。     

BiPAP无创通气治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭中的临床效果

目的探讨BiPAP无创通气治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭中的临床效果。方法选择我院2012年2月至2013年2月慢性阻塞性肺疾病急性加重期患者共60例,上述患者随机发分为观察组和对照组。两组患者入院后均给予抗生素抗感染、止咳类药物、祛痰类药物以及其他对症处理等,对照组患者给予鼻导管持续低流量吸氧,观察组患者给予BiPAP呼吸机辅助通气。观察两组患者治疗前和治疗48h后的动脉血气指标改变情况;记录两组患者气管插管情况。结果观察组治疗后pH值、PaO2和PaCO2和对照组治疗后比较,差异有统计学意义(P<0.05)。观察组患者中1例患者行气管插管,发生率为3.3%;对照组患者中10例行气管插管,发生率为33.3%;观察组气管插管发生率低于对照组,差异有统计学意义(P<0.05)。结论 BiPAP无创通气治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭疗效显著,值得借鉴。     

BiPAP呼吸机对慢性阻塞性肺疾病急性加重期合并呼吸衰竭35例疗效分析

目的探讨BiPAP呼吸机对慢性阻塞性肺疾病急性加重期合并呼吸衰竭的治疗效果。方法选择我院2010年10月至2012年10月慢性阻塞性肺疾病急性加重期患者35例,所选患者均符合慢性阻塞性肺疾病诊断标准,均处于急性加重期,上述患者随机分为观察组和对照组。两组均给予基础治疗,对照组同时给予鼻导管吸氧,观察组同时给予无创正压通气治疗。观察两组患者治疗前和治疗24h后动脉血气改变情况。结果观察组通气24h后pH值、PaO2和PaCO2和对照组通气24h后比较,差异有统计学意义(P<0.05)结论 BiPAP呼吸机下通气治疗能够显著改善慢性阻塞性肺疾病急性加重期合并呼吸衰竭患者呼吸状况,改善动脉血气指标,治疗效果显著,值得借鉴。     

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.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

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.