舒芬太尼复合盐酸右美托咪定用于脊柱手术术后镇痛疗效观察

目的:观察舒芬太尼复合右美托咪定在脊柱手术术后镇痛的效果。方法:选取择期全麻脊柱手术自愿行经静脉患者自控镇痛(PCIA)患者40例,随机分为对照组和实验组,对照组给予生理盐水+舒芬太尼+止吐药静脉自控镇痛;实验组给予生理盐水+舒芬太尼+右美托咪定+止吐药静脉术后自控镇痛。观察患者术后48 h内疼痛视觉模拟评分法(VAS)评分,镇静评分标准(Ramsay)分级及不良反应的情况。结果:术后疼痛VAS评分实验组优于对照组(P<0.05),Ramsay分级差异无统计学意义,术后恶性呕吐发生率实验组明显低于对照组(P<0.05)。结论:舒芬太尼复合右美托咪定用于胸科手术术后静脉镇痛效果更好,且不良反应更少。     

右美托咪啶复合舒芬太尼自控静脉镇痛对剖宫产后的镇痛效果分析

目的右美托咪啶复合舒芬太尼自控静脉镇痛对剖宫产后的镇痛效果分析。方法将本院2015年3月~2017年3月行剖宫产并自愿采取术后镇痛的产妇124例编号,随机分为对照组单用舒芬太尼和实验组右美托咪啶复合舒芬太尼,每组62例,两组产妇一般资料比较差异无统计学意义(P>0.05)。于手术结束后2、6、12、24、48h内监测采用舒适评分(BCS)、视觉模拟评分法(VAS)、Ramsay镇静评分,记录患者自行按PCIA键给药的次数及术后48h的不良反应,如恶心、呕吐、心动过缓以及尿潴留。结果联合应用右美托咪啶以及舒芬太尼来进行剖宫产产后镇痛效果要优于单用舒芬太尼(P<0.05),且镇静效果差异无统计学意义(P>0.05),同时,与对照组比较,联合应用右美托咪啶以及舒芬太尼的PCA键按键次数明显减少(P<0.05),对照组产妇出现恶心、呕吐要多于研究组(P<0.05),而对照组产妇出现心动过缓要低于实验组(P<0.05)。结论右美托咪啶复合舒芬太尼自控静脉镇痛对剖宫产后可以减少疼痛,减少不良反应,降低心率。     

右旋美托咪定与舒芬太尼联合应用于术后静脉自控镇痛的效果观察

目的:探讨右旋美托咪定与舒芬太尼联合应用于术后静脉自控镇痛的效果.方法:选择2014年12月～2015年12月我院收治的全身麻醉手术患者,共计110例.对照组应用舒芬太尼术后静脉自控镇痛,研究组应用舒芬太尼联合右旋美托咪定术后静脉自控镇痛.根据VAS评分系统,对比两组患者术后6h、12h、24h、48h的疼痛情况.结果:研究组术后6h、12h、24h、48h的VAS评分均低于对照组(P＜0.05).结论:右旋美托咪定与舒芬太尼联合应用于术后静脉自控镇痛可以有效强化镇痛效果,满足患者的身心需求.     

右旋美托咪定联合舒芬太尼在术后静脉自控镇痛中的应用效果分析

目的探讨右旋美托咪定联合舒芬太尼在术后静脉自控镇痛(PCIA)中的应用效果。方法择取2014年5月至2015年5月我院收治的200例全麻手术患者作为研究对象,以随机数字表将其均分为2组,即研究组与对照组各100例。对照组在应用舒芬太尼给予PCIA镇痛,研究组应用舒芬太尼+右旋美托咪定给予PCIA镇痛。结果研究组术后6 h、12 h、24 h、48 h的VAS评分均低于对照组(P<0.05)。研究组术后PCIA镇痛中舒芬太尼的用量为(36.5±4.2)μg,低于对照组(41.5±4.8)μg(P<0.05)。研究组不良反应的发生率为4.00%,低于对照组12.00%(P<0.05)。结论右旋美托咪定联合舒芬太尼在PCIA镇痛中具有显著的应用效果,适于临床推广。     

右美托咪定联合舒芬太尼在胸腔镜下食道癌根治术术后自控镇痛中的应用效果

目的 探究右美托咪定联合舒芬太尼在胸腔镜下食遁癌根治术术后目控镇痛中的应用效果.方法 抽取2013年10月至2016年1月于本院择期行食管癌根治术的患者64例,根据麻醉方式不同分为对照组(n=32)和研究组(n=32).对照组给予舒芬太尼+生理盐水术后自控镇痛,研究组给予舒芬太尼+右美托咪定术后自控镇痛.对比术后不同时间段两组疼痛评分(VAS)、镇静评分(Ramsay),并统计两组不良反应发生率.结果 术后1h、4h、12 h、1d,研究组VAS评分分别为(2.29±0.46)分、(2.01±0.39)分、(1.32±0.26)分、(1.17±0.21)分,均明显优于对照组,差异有统计学意义(均P＜0.05);术后1h、4h,研究组Ramsay评分分别为(3.11 ±0.40)分、(2.71±0.40)分,均明显优于对照组,差异有统计学意义(均P＜0.05);研究组不良反应发生率(6.26％)明显低于对照组(31.26％),差异有统计学意义(P＜0.05).结论 在胸腔镜下食道癌根治术术后自控镇痛中联合应用右美托咪定及舒芬太尼效果显著,可有效提高镇痛及镇静效果,且能降低不良反应发生率.     

右美托咪定联合舒芬太尼对全麻腹部手术后的镇痛效果

目的 观察右美托咪定联合舒芬太尼对全麻腹部手术患者的术后镇痛效果.方法 将96例全麻下腹部手术患者随机分为观察组与对照组,各48例.对照组枸橼酸舒芬太尼1μg/(kg·d)、氢溴酸高乌甲素0.01 mg/(kg·d)、雷莫司琼0.6 mg加入生理盐水100 ml,术毕静脉自控镇痛泵镇痛;观察组盐酸右美托咪定1.92μg/(kg·d)、枸橼酸舒芬太尼0.48μg/(kg·d)、雷莫司琼0.6 mg加入生理盐水100 ml,术毕静脉自控镇痛泵镇痛.首次负荷量1.5 ml,之后1.5 ml/h泵入,持续镇痛48 h.结果 T1、T2、T3、T4时点,观察组VAS评分及Ramesay镇静评分均明显低于对照组,差异有统计学意义(P＜0.05);B时点,两组VAS评分及Ramesay镇静评分比较,差异无统计学意义(P＞0.05);观察组术后不良反应发生率低于对照组,但差异无统计学意义(P＞0.05).结论 右美托咪定联合舒芬太尼用于全麻腹部手术后可明显提高镇痛、镇静效果,舒芬太尼用量明显减少,降低不良反应发生率.     

右美托咪定预处理对老年肺癌根治术后舒芬太尼静脉自控镇痛时患者细胞免疫功能的影响

目的评价右美托咪定预处理对老年肺癌根治术后舒芬太尼静脉自控镇痛时患者细胞免疫功能的影响。方法择期行肺癌根治术患者60例,ASA分级Ⅰ~Ⅱ,年龄65~73岁,随机分为两组,每组30例。右美托咪定组(D组)术前予以右美托咪定0.5μg·kg-1泵注,对照组(C组)给予氯化钠注射液,两组麻醉诱导及维持方法相同,术后均予舒芬太尼静脉自控镇痛。记录术后视觉模拟量表评分(VAS)及患者自控静脉镇痛(PCIA)泵按压次数。检测给药前(T0)、划皮后1 h(T1)、术毕(T2)、术后1 d(T3)和术后3 d(T4)患者T淋巴细胞亚群水平。结果与C组相比,D组术后4、12、24、48、72 h五个时间点的VAS均降低,术后0~24 h、>24~48 h、>48~72 h PCIA泵按压次数减少,差异均有显著意义(P<0.05)。与T0时相比,C组T3时CD3+、CD4+和CD4+/CD8+明显降低(P<0.05)。与C组相比,D组T3时CD3+、CD4+和CD4+/CD8+细胞水平升高(P<0.05)。右美托咪定组和对照组不良反应发生率无显著差异(23%vs.17%,P>0.05)。结论右美托咪定预处理可增强术后镇痛效果,改善老年肺癌根治术后舒芬太尼静脉自控镇痛时患者细胞免疫功能。     

观察舒芬太尼联合右美托咪定对胸科手术术后镇痛的疗效

目的探究胸科手术术后镇痛的应用舒芬太尼联合右美托咪定的临床效果。方法此次实验对象全部选自2016年7月至2018年8月期间本院接收的60例胸科手术患儿,按照随机表法分成研究组(n=30)和对照组(n=30),对照组单独使用舒芬太尼,研究组在此基础上联合右美托咪定,将两种镇痛结果分析对比。结果研究组和对照组在中术后4 h、8 h、12 h、24 h、48 h的VAS评分和术后不良反应发生率差异上,有统计学意义(P <0.05);研究组术后4 h、8 h的Ramsay镇静评分和对照组差异较大,有统计学意义(P <0.05)。结论胸科手术术后应用舒芬太尼联合右美托咪定的镇痛效果良好,优于单独使用舒芬太尼,且产生的不良反应较少,具有较高的安全性。     

右美托咪定联合布托啡诺用于心脏外科术后患者的镇痛效果研究

目的探讨右美托咪定联合布托啡诺用于心脏外科术后患者的镇痛效果。方法选取威海市中心医院2019年6月至2020年8月择期行心脏外科手术的患者63例为研究对象, 根据镇痛方式不同将其分为丙泊酚+舒芬太尼组(n=21)、右美托咪定+舒芬太尼组(n=23)和右美托咪定+布托啡诺组(n=19), 比较三组患者术后镇痛满意度、视觉模拟评分法评分、血流动力学(心率、呼吸频率、收缩压、舒张压)变化及不良反应发生情况。结果右美托咪定+布托啡诺组患者术后镇痛满意率为94.7%(18/19), 明显高于丙泊酚+舒芬太尼组的61.9%(13/21)和右美托咪定+舒芬太尼组的60.8%(14/23)(χ2=6.16、6.57, 均P < 0.05);右美托咪定+布托啡诺组患者拔管4 h、12 h、24 h、48 h视觉模拟评分法评分均明显低于丙泊酚+舒芬太尼组和右美托咪定+舒芬太尼组(均P < 0.05);右美托咪定+布托啡诺组拔管时、拔管后5 min心率、呼吸频率、收缩压、舒张压均低于丙泊酚+舒芬太尼组和右美托咪定+舒芬太尼组(均P < 0.05);右美托咪定+布托啡诺组患者术后不良反应率[...     

右美托咪定或舒芬太尼复合罗哌卡因硬膜外分娩镇痛的比较

目的比较右美托咪定、舒芬太尼复合罗哌卡因硬膜外分娩镇痛的效果。方法选择80例足月单胎的初产妇,随机分为两组,每组40例。右美托咪定组采用0.1%罗哌卡因+0.5μg·m L-1右美托咪定100 m L硬膜外分娩镇痛,舒芬太尼组采用0.1%罗哌卡因+0.5μg·m L-1舒芬太尼100 m L硬膜外分娩镇痛。观察各组产妇镇痛效果、产程时间、生命体征,新生儿Apgar评分、脐动脉血血气分析等。结果两组产妇产程时间、Bromage评分及分娩方式比较,差异均无显著意义(P>0.05),右美托咪定组产妇镇痛后疼痛VAS评分低于舒芬太尼组(P<0.05)。两组新生儿Apgar评分无显著差异(P>0.05),右美托咪定组新生儿脐动脉血氧分压低于舒芬太尼组(P<0.05),但两组血氧分压均在正常范围内。未见严重不良反应发生。结论右美托咪定复合罗哌卡因硬膜外分娩镇痛优于舒芬太尼复合罗哌卡因,且不影响产程,对母婴无不良影响。     

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.     

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.     

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.     

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.