太原市产妇与新生儿促甲状腺激素水平相关分析

目的　探讨产妇血清促甲状腺激素 (TSH)水平及其新生儿脐血 TSH水平之间的关系。方法　应用放射免疫分析 (RIA)测定了太原市 10 0例顺产产妇血清 TSH含量 ,同时用免疫放射分析 (IRMA)测定了其健康新生儿脐血 TSH含量。结果　产妇血清 TSH均值为 (4.9± 1.4) m U/ L,新生儿脐血 TSH均值为 (8.0±4.9) m U / L ,产妇与其新生儿 TSH水平之间呈显著正相关关系。结论　通过对产妇的 TSH水平的监测 ,可评估新生儿碘营养水平 ,预防和减少甲减弱智儿的出生     

孕妇甲状腺球蛋白水平检测在碘缺乏病预防中的价值研究

目的 :探讨孕妇甲状腺球蛋白 (TG)水平和促甲状腺素 (TSH)水平之间的关系。方法 :应用免疫放射分析(IRMA)法检测了 10 0例碘缺乏地区孕妇的 TG和 TSH水平 ,并选择 10 0例非缺碘地区孕妇作为对照。结果 :研究组孕妇 TG均值为 17.6 ng/ m L± 4.6 7ng/ m L,对照组为 14.45 ng/ m L± 4.43ng/ m L(P<0 .0 5 )。研究组孕妇 TSH均值为 5 .36 m U / L± 2 .2 0 m U / L ,对照组为 4.6 9m U / L± 1.34 m U / L (P<0 .0 5 )。两组孕妇 TG水平和其 TSH水平呈显著正相关。结论 :孕妇的 TG水平可作为妊娠期预防碘缺乏的监测指标     

脐血清检测T_4 TSH筛查先天性甲状腺功能低下及影响因素的探讨

本文筛查了青岛地区2007例新生儿脐血清T_4、TSH。结果如下:T_4平均值为9.589±2.969μg/L,TSH平均值为9.568±6.440mIU/L。青岛地区先天性甲状腺功能低下发病率为1/1003.5,且新生儿T_4、TSH值与孕妇年龄、孕周、新生儿体重、性别均无显著性关系。     

甲状腺功能低下与亢进大鼠模型的几项生化指标的检测

目的:探讨甲状腺功能低下(甲低)及甲状腺功能亢进(甲亢)模型大鼠的甲状腺功能改变对血钙和血磷的影响。方法:制备甲低及甲亢大鼠模型,测定其血清T3、T4、TSH、钙、磷的含量变化。结果:甲低大鼠血清T3、T4和TSH浓度分别为0.27±0.08nm o l/L、25.87±2.83nm o l/L和3.36±0.42mU/L,与对照组血清T3(0.97±0.11nm o l/L)和T4(68.74±7.57nm o l/L)相比较,均明显降低(P<0.0001),有极显著差异;而血清TSH较对照组TSH含量(1.72±0.43mU/L)显著升高(P<0.0001)。甲亢大鼠T3(9.24±1.56 nm o l/L)和T4(155.73±13.98nm o l/L)含量比对照组均显著升高(P<0.0001),而TSH含量仅为0.37±0.06mU/L,与对照组相比明显降低(P<0.0001)。对照组血钙(C a2+)和血磷(HPO42-)含量分别为2.37±0.30mm o l/L和2.56±0.10mm o l/L;甲低组血钙为2.27±0.15mm o l/L,血磷为2.33±0.10mm o l/L;甲亢组血钙含量为6.17±1.42mm o l/L,血磷含量为3.84±1.13mm o l/L。结论:甲亢大鼠血钙和血磷含量较正常大鼠明显升高。甲低大鼠血清钙、磷含量与对照组大鼠比较均有所下降,但无统计学意义。     

舒芬太尼联合低浓度罗哌卡因腰硬联合麻醉用于分娩镇痛对母婴结局的影响

目的 探讨舒芬太尼联合低浓度罗哌卡因腰硬联合麻醉用于分娩镇痛对母婴结局的影响.方法 采用前瞻性研究法,选择2014年12月至2015年12月本院收治的200例初产妇为研究对象.根据随机数字表法将200例初产妇随机分为观察组(n=100)和对照组(n=l00),观察组产妇给予舒芬太尼联合低浓度罗哌卡因腰硬联合麻醉,对照组产妇不进行任何镇痛处理,仅采取心理疏导,对两组产妇的产程时间、镇痛效果(VAS)、产后出血量、分娩情况、不良反应发生率和皮质醇及一氧化氮的水平进行比较.结果 观察组第一产程(364.7±187.6) rain,第二产程(53.6+ 10.7) rain,第三产程(10.15±4.83)min;产妇T1时间点VAS评分(6.23±1.19),T2时间点(1.25±0.39);产后出血量(264.8±74.6)ml.对照组第一产程(323.2±104.7) rain,第二产程(55.9±8.5) rain,第三产程(10.27±5.04) min;产妇T1时间点VAS评分(6.04±1.36),T2时间点(7.84±1.63);产后出血量(281.9±80.5) ml.观察组产妇的VAS评分明显低于对照组,差异有统计学意义(P＜0.05);产程时间、产后出血量两组比较差异无统计学意义(P＞0.05).观察组自然产率为79％,阴道助产率为7％,剖宫产率为14％;对照组自然产率为50％,阴道助产率为10％,剖宫产率为40％;观察组剖宫产率明显低于对照组,自然产率高丁对照组产妇,差异均有统计学意义(均P＜ 0.05),阴道助产率在两组之间比较差异无统计学意义(P＞0.05).观察组新生儿黄疸率为3％,低体重儿比例为1％,巨大儿占比例1％;对照组新生儿黄疸率为5％,低体重儿比例为3％,巨大儿占比例2％;观察组出现黄疸、低体重、巨大儿的比例在两组之间比较差异无统计学意义(P＞0.05).观察组产妇出现皮肤瘙痒比例为14％,低血压及呼吸抑制出现率为0％,恶心呕吐出现率为7％,下肢发麻出现率为3％,尿潴留出现率为4％;对照组产妇出现皮肤瘙痒、下肢发麻、低血压及呼吸抑制出现率为0％,恶心呕吐出现率为1％,尿潴留出现率为6％;观察组产妇出现皮肤瘙痒和恶性呕吐的比例高于对照组产妇(P＜0.05),但均于分娩结束后消失.观察组患者T1时间点皮质醇水平为(817±146) ng/ml,T2时间点为(742±105) ng/ml,T3时间点为(703-124) ng/ml;对照组患者T1时间点皮质醇水平为(825±103)ng/ml,T2时间点为(859±117) ng/ml,T3时间点为(914±138)ng/ml.观察组患者T1时间点一氧化氮水平为(92.6±17.5) umol/L,T2时间点为(93.5±18.7) umol/L,T3时间点为(96.4±10.3) umol/L;对照组患者T1时间点一氧化氮水平为(91.7±13.2) umol/L,T2时间点为(82.7±17.2) umol/L,T3时间点为(80.6±12.7)umol/L.观察组皮质醇的水平明显降低,对照组皮质醇的水平明显升高,而一氧化氮的水平明显降低,差异均有统计学意义(均P＜ 0.05),而观察组一氧化氮的水平无明显变化.结论 舒芬太尼联合低浓度罗哌卡因腰硬联合麻醉用于分娩镇痛可明显减轻产妇的分娩疼痛,提高自然产率,降低剖官产率,对产妇及新生儿均无安全隐患,在临床上具有较好的应用价值.     

甲状腺功能亢进症治疗中护理干预的应用效果分析

目的 探讨针对性护理在甲状腺功能亢进症治疗中的临床应用效果.方法 收集2015年4月至2016年6月入院的80例甲状腺功能亢进症患者随机分为两组,对照组患者给予入院指导、治疗期间注意事项、健康宣教、施药操作与床边护理等传统护理,实验组患者则在传统护理的基础上加施服药前准备、心理干预、饮食干预、行为干预等针对性护理,比较两组患者干预前后心理状态、甲状腺激素、肝功能水平与护理满意度.结果 实验组患者干预后SAS[(45.27±5.48)]与SDS评分[(44.11±5.09)]组间比较均显著低于对照组[(51.36±5.75),(50.05±4.87)];实验组患者干预后TSH水平[(4.45±1.08)mU/L组间比较显著高于对照组[(2.36±0.93) mU/L],TT3[(2.25±0.82) nmol/L]、Tr4[(95.45±12.77)nmol/L]、FT3[(4.85±0.94) pmol/L]、FT4[(10.74±2.65) pmol/L]、ALT[(24.86±5.74) U/L]、ALP[(24.30±6.79) U/L]、AST[(24.26±6.17) U/L]与r-GT水平[(22.45±6.81) U/L]组间比较均显著低于对照组[(4.03±0.88) nmol/L,(130.57±14.81) nmol/L,(7.87±1.07) pmol/L,(20.40±3.72)pmol/L,(31.47±6.16) U/L,(33.52±7.57) U/L,(32.75±7.27) U/L,(33.38±7.28) U/L],差异有统计学意义(P＜ 0.01);实验组患者护理满意度明显优于对照组,差异有统计学意义(P＜0.05).结论 针对性护理在甲状腺功能亢进症治疗中的临床应用效果显著,可提高满意度,具有借鉴意义.     

某区35767例新生儿先天性甲状腺功能减低症筛查结果的分析

目的通过对抚顺地区2010年~2012年35767例新生儿进行先天性甲状腺功能减低症筛查指标-TSH值的统计分析,制定抚顺地区TSH检测项目的切值,确保先天性甲低的早期发现、早期治疗,将此疾病对患儿的损伤降到最低。方法采用时间分辨荧光免疫法检测新生儿血斑中的TSH含量。结果采用8μU/m L作为TSH筛查切值,通过筛查及复诊共检出CH患者6例,高TSH血症患者2例,无漏诊报告。正常初生儿99%分位数值为7.25μU/m L。结论抚顺地区新生儿TSH切值低于试剂盒参考值,以8.0μU/m L作为筛查切值较为合理。     

不同手术时机行胆囊切除术治疗急性胆囊炎的临床研究

目的 探讨不同手术时机行胆囊切除术对急性胆囊炎患者应激反应、免疫功能及预后的影响,为急性胆囊炎手术时机选择提供临床依据.方法 收集急性胆囊炎患者109例,根据发病至手术的时间进行分组,分为早期组(n=64)、延期组(n=45).所有患者均采用腹腔镜下胆囊切除术治疗,早期组于发病后＜ 48h实施手术,延期组于发病后48～72 h实施手术.比较两组患者入院时(T1)、手术前1h(T2)、术后第1d(T3)、术后第3d (T4)时的血清超氧化物歧化酶(SOD)、丙二醛(MDA)及CD3+、CD4+水平变化;同时记录术后并发症(包括水肿、化脓、坏疽、穿孔、死亡)发生情况.结果 早期组T1、T2、T3、T4时的SOD、MDA水平分别为[(78.9±10.2) U/ml、(78.9±10.2) U/ml、(110.2±6.5)U/ml、(56.0±5.1) U/ml]、[(6.5±0.9) mmol/L、(6.5±0.9) mmol/L、(8.6±1.3) mmol/L、(5.2±0.8)mmol/L],延期组分别为[(78.5±9.9) U/ml、(92.7±11.5) U/ml、(140.7±9.8) U/ml、(70.9±8.7)U/ml]、[(6.4±1.0) mmol/L、(7.3±1.2) mmol/L、(10.5±1.6) mmol/L、(5.9±1.1) mmol/L];延期组SOD、MDA水平T2、T3时逐渐升高,T4时开始降低(P＜0.05);早期组SOD、MDA水平T3较T1、T2时明显升高,T4时开始降低(P＜0.05);早期组SOD、MDA水平T2、T3、T4时明显低于延期组(P＜0.05).早期组T1、T2、T3、T4时的CD3+、CD4+水平分别为[(56.1±9.4)％、(56.1±9.4)％、(46.5±7.2)％、(65.9±9.1)％]、[(32.6±8.4)％、(32.6±8.4)％、(29.7±7.2)％、(45.8±9.0)％],延期组分别为[(55.7±9.5)％、(50.7±8.8)％、(41.2±6.3)％、(52.2±8.5)％]、[(32.7±8.8)％、(29.1±8.0)％、(24.8±6.5)％、(36.2±5.1)％].延期组CD3+、CD4+水平T2、T3时开始降低(P＜0.05),T4时较T1时明显升高;早期组CD3+、CD4+水平T3较T1、T2时明显降低,T4时较T1时明显升高(P＜0.05).早期组CD3+、CD4+水平T2、T3、T4时明显高于延期组(P＜0.05).早期组术后水肿、化脓发生率分别为20.3％、54.7％,明显高于延期组的0％、13.3％(P＜0.05),而坏疽、穿孔、病死发生率分别为18.8％、4.7％、0％,明显低于延期组的57.8％、28.9％、6.7％(P＜0.05).结论 对急性胆囊炎,腹腔镜胆囊切除术应尽早进行,其最佳手术时间应在48 h内,如此可减轻机体产生过于强烈的应激反应及免疫功能损伤,从而降低术后严重并发症的发生风险.     

慢性乙型肝炎患者血清AST/ALT比值与甲状腺激素的关系探讨

目的本研究旨在观察慢性乙型肝炎患者血清中天冬氨酸转氨酶(AST)/丙氨酸转氨酶(ALT)比值与甲状腺激素的关系及其在体内的变化规律,进一步探讨慢性乙型肝炎患者肝损情况与甲状腺分泌功能的关系。方法收集来自我院消化内科2009年8月至2011年11月160例确诊为慢性乙型肝炎患者的血清标本作为观察组,分别检测样本中天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、总三碘甲状腺原氨酸(T3)、总甲状腺素(T4)、促甲状腺素(TSH))的含量,同时设立以同期进行健康体检的30例体检者作为对照组。结果观察组与对照组的AST/ALT比值分别为(1.07±0.63)和(1.44±0.29),观察组的甲状腺激素中总三碘甲状腺原氨酸(T3)和总甲状腺素(T4)分别为(1.78±0.57)ng/mL和为(11.77±3.19)μg/Dl,促甲状腺素(TSH)为(1.79±1.42)mU/L;对照组分别为(1.31±0.18)ng/mL和(9.46±0.99)μg/dL,(2.34±0.99)m U/L,两组各指标比较均有统计学差异(P<0.01)。结论慢性乙型肝炎患者除AST/ALT比值异常外,还同时伴有不同程度的甲状腺激素指标异常,其原因可能与慢性乙型肝炎应用干扰素治疗时甲状腺功能受损有关。     

早产儿血清微量元素的检测及意义

目的　研究早产儿血微量元素的含量及补充微量元素的意义。方法　采用日立 7170 A型全自动生化分析仪 ,测定 6 2例早产儿、 4 4例正常足月儿血清微量元素锌、铁、铜的含量 ,并对其中 4 2例血清微量元素水平降低的早产儿进行补充微量元素后的纵向观察。结果　足月儿血清锌、铁、铜值分别为 2 0 .86± 5 .32 μmol/ L、 2 3.84± 5 .6 6 μmol/L、 2 2 .6 7± 4 .5 3μm ol/ L ,早产儿血清锌、铁、铜值分别为 17.6 3± 4 .4 6μmol/ L、 19.75± 4 .2 4μmol/ L、19.2 6± 6 .2 1μmol/L ,早产儿血微量元素水平明显低于足月儿 (P<0 .0 1)。经微量元素治疗两周后 ,早产儿血清锌、铁、铜值均明显升高 ,达足月儿水平。结论　早产儿血清微量元素锌、铁、铜水平均低于足月儿 ,常规补充微量元素能恢复早产儿血清微量元素水平     

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.