围产期急慢性缺氧新生儿血清尿酸水平与脑肾功能损伤的关系

目的：应用围产期急、慢性缺氧新生儿血清尿酸水平判断新生儿脑肾功能损伤程度。方法：选择2003—10／2004—11在北京市海淀区妇幼保健院出生的轻度窒息新生儿34例为轻度窒息组，重度窒息新生儿31例为重度窒息组。选择本院同期住院的明确诊断为重度妊娠期高血压综合征(pregnancy induced hypertension syndrome，PIH)孕妇所分娩的新生儿30例为母亲重度PIH组。选择本院同期出生的正常新生儿30例为对照组。分别测定所有患儿及正常新生儿血清尿酸、尿素、肌酐水平，并行脑结果：轻、重度窒息组、母亲重度PIH组血清尿酸水平明显高于对照组（P&;lt;0．01)；重度窒息组和母亲重度PIH组新生儿血清尿酸水平[(349．76&;#177;128．41)，(330．70&;#177;176．14)μmol／L]明显高于轻度窒息组[(246.95&;#177;109．19)μmol／L](P&;lt;0．01，0．05)。重度窒息组新生儿异常和可疑EEG所占比率明显高于对照组、母亲重度PIH组(P&;lt;0．01)，重度窒息组EEG异常率明显高于轻度窒息组(P&;lt;0．05)。结论：有围产期急慢性缺氧史的新生儿血清尿酸水平较高，其含量对判断缺氧程度和脑、肾等脏器损伤程度具有重要意义。     

缺氧缺血性脑病新生儿胆红素与血红素加氧酶1的变化

目的:观察新生儿缺氧缺血性脑病发生过程中胆红素与血红素加氧酶1活性的变化,探讨两者在缺氧缺血性脑病发生发展中的作用。方法:选择1998-01/2003-12西安交通大学第一医院产科出生并收住新生儿病房的患儿200例。纳入标准:①窒息儿根据新生儿生后Apgar评分0-3分为重度窒息,4～7分为轻度窒息。②缺氧缺血性脑病患儿临床诊断符合新生儿缺氧缺血性脑病标准。③高胆红素血症的诊断标准符合足月儿胆红素>205μmol/L。④新生儿黄疸诊断标准血清胆红素>85μmol/L时,临床出现肉眼黄疸。依据缺氧缺血程度分为2组,窒息组和缺氧缺血性脑病组。窒息组分为轻度、重度2个亚组,缺氧缺血性脑病组分为轻度,中度,重度3个亚组,每个亚组40例,对照组选择同期出生的健康新生儿40例,与窒息组和缺氧缺血性脑病组患儿的胎龄和出生体质量差异无显著性。取患儿股静脉血4mL,采用生化分析仪测定窒息组和缺氧缺血性脑病组患儿的胆红素值,并在急性期(3d内)和恢复期(10d内)用464nm和530nm双波长分光光度法测定样品反应物中胆红素生成量代表血红素加氧酶1活性,以每秒每升血清生成胆红素量为单位(μkat/L)。同时测定正常对照组新生儿的胆红素值和血红素加氧酶1活性。对样本均数比较采用方差分析。结果:①胆红素水平:轻度窒息组明显高于重度窒息组和对照[(325.62±39.1),(243.64±37.6),(305.70±51.3)μmol/L,F=10.89,P<0.01]。轻度、重度缺氧缺血性脑病组胆红素水平接近[(89.4±8.1),(86.7±3.9)μmol/L]。②胆血红素加氧酶1活性:重度窒息组急性期血红素加氧酶1活性值明显高于轻度窒息组急性期和恢复期,重度窒息组恢复期和对照组(F=38.63,P<0.01);重度缺氧缺血性脑病组急性期血红素加氧酶1活性明显高于恢复期,也明显高于轻度和中度缺氧缺血性脑病组(急性期和恢复期)(F=8.93,P<0.01)。③黄疸发生率:轻度窒息组发生高胆红素血症22例,生理性黄疸12例,黄疸发生率85%;重度窒息组发生高胆红素血症6例,生理性黄疸3例,黄疸发生率23%。对照组发生高胆红素血症20例,生理性黄疸12例,黄疸发生率80%。缺氧缺血性脑病组无高胆红素血症发生,轻度缺氧缺血性脑病组发生生理性黄疸6例,黄疸发生率15%;重度缺氧缺血性脑病组发生生理性黄疸5例,黄疸发生率13%。结论:当不同程度缺氧缺血使新生儿脑损伤时,血红素加氧酶1活性增加致胆红素的抗氧化作用途径开放,胆红素水平降低。提示胆红素水平、血红素加氧酶1活性能反映缺氧缺血性脑病患儿的病情严重程度,对缺氧缺血性脑病的诊断及预测预后具有一定的参考价值。     

缺氧缺血性脑病新生儿血清钠的监测意义

目的探讨窒息后新生儿血清钠水平与新生儿脑损害的关系。方法存在轻-重度窒息及宫内缺氧史的283例新生儿,通过临床表现及CT确诊为新生儿缺氧缺血性脑病(H IE)。于入院24h内测其血清钠浓度。结果重度窒息组与轻度窒息组的血清钠浓度分别为(124±7)mmol/L、(134±6)mmol/L,t=4.89,P<0.05。轻度窒息124例,其中发生低钠血症为18例;重度窒息为8例,发生低钠血症为20例,χ2=4.89,P<0.05。发生低钠血症与窒息程度呈正相关性。早产儿组与足月儿组血清钠水平分别为(129±4)mmol/L,(130±7)mmol/L,t=2.294,P<0.05。轻、中、重度H IE三组患儿平均血清钠浓度为(134±4)mmol/L、(131±7)mmol/L、(123±5)mmol/L,中度与轻度H IE之间比较t=7.57,P<0.05;重度与中度H IE之间比较t=8.07,P<0.05。结论重度窒息既可以导致H IE,又可以引起低钠血症,而严重的低钠血症,又能加重缺氧缺血性脑损伤的程度;所以测定血清钠水平对指导治疗H IE及评估预后具有重要的临床意义。     

高压氧治疗新生儿缺氧缺血性脑病血清相关因子变化的探讨

目的了解高压氧(HBO)治疗中、重度新生儿缺氧缺血性脑病(HIE)后血清神经元特异性烯醇化酶(NSE)、血浆内皮素(ET)的变化,探讨高压氧治疗对新生儿HIE的保护作用。方法81例HIE患儿,其中15例为轻度组、66例为中重度,又将中重度HIE患儿随机分为高压氧治疗组(32例)、同期治疗对照组(34例)。另外12例为正常新生儿组。在治疗前后分别用酶联免疫分析法检测血清NSE、放射免疫分析法检测血浆ET。结果中重度HIE66例(高压氧治疗组和对照组)治疗前血清NSE犤分别为(15.4±4.2)和(16.3±5.1)μg/L犦、血浆ET水平犤分别为(80±16)和(78±19)ng/L犦,均高于轻度HIE组与正常新生儿组犤分别为(6.86±0.64)μg/L和(54.52±10.54)ng/L犦。治疗后两组NSE和ET明显降低,分别为(6.4±1.7)、(9.8±3.5)μg/L和(49±6)、(55±9)ng/L与各自治疗前相比差异亦有显著性意义(t=0.41～5.07,P<0.001),但高压氧治疗组血清NSE、血浆ET下降程度与对照组比较差异有显著性意义(t=9.31～13.18,P<0.001)。结论高压氧早期治疗中、重HIE可能通过降低ET水平,而减轻脑血管床的阻力,维持HIE损伤后脑的正常血流灌注,稳定细胞生成的内环境,减轻继发性脑损伤,达到脑保护作用。     

缺氧缺血性脑病新生儿胆红素与血红素加氧酶1的变化

目的：观察新生儿缺氧缺血性脑病发生过程中胆红素与血红素加氧酶1活性的变化，探讨两者在缺氧缺血性脑病发生发展中的作用。方法：选择1998-01／2003-12西安交通大学第一医院产科出生并收住新生儿病房的患儿200例。纳入标准：①窒息儿根据新生儿生后Apgar评分0-3分为重度窒息，4～7分为轻度窒息。②缺氧缺血性脑病患儿临床诊断符合新生儿缺氧缺血性脑病标准。③高胆红素血症的诊断标准符合足月儿胆红素&;gt;205μmol／L。④新生儿黄疸诊断标准血清胆红素&;gt;85μmol／L时，临床出现肉眼黄疸。依据缺氧缺血程度分为2组，窒息组和缺氧缺血性脑病组。窒息组分为轻度、重度2个亚组，缺氧缺血性脑病组分为轻度，中度，重度3个亚组，每个亚组40例．对照组选择同期出生的健康新生儿40例．与窒息组和缺氧缺血性脑病组患儿的胎龄和出生体质量差异无显著性。取患儿股静脉血4mL，采用生化分析仪测定窒息组和缺氧缺血性脑病组患儿的胆红素值，并在急性期(3d内)和恢复期(10d内)用464nm和530nm双波长分光光度法测定样品反应物中胆红素生成量代表血红素加氧酶1活性，以每秒每升血清生成胆红素量为单位(μkat／L)。同时测定正常对照组新生儿的胆红素值和血红素加氧酶1活性。对样本均数比较采用方差分析。结果：①胆红素水平：轻度窒息组明显高于重度窒息组和对照[(325．62&;#177;39．1)，(243．64&;#177;37．6)，(305．70&;#177;51.3)μmol／L，F=10．89，P&;lt;0．01]。轻度、重度缺氧缺血性脑病组胆红素水平接近[(89．4&;#177;8．1)，(86．7&;#177;3．9)μmol／L]。②胆血红素加氧酶1活性：重度窒息组急性期血红素加氧酶l活性值明显高于轻度窒息组急性期和恢复期，重度窒息组恢复期和对照组(F=38．63，P&;lt;0．01)；重度缺氧缺血性脑病组急性期血红素加氧酶1活性明显高于恢复期，也明显高于轻度和中度缺氧缺血性脑病组(急性期和恢复期)(F=8．93，P&;lt;0．01)。③黄疸发生率：轻度窒息组发生高胆红素血症22例，生理性黄疸12例，黄疸发生率85％；重度窒息组发生高胆红素血症6例，生理性黄疸3例，黄疸发生率23％。对照组发生高胆红素血症20例，生理性黄疸12例，黄疸发生率80％。缺氧缺血性脑病组无高胆红素血症发生，轻度缺氧缺血性脑病组发生生理性黄疸6例，黄疸发生率15％；重度缺氧缺血性脑病组发生生理性黄疸5例，黄疸发生率13％。结论：当不同程度缺氧缺血使新生儿脑损伤时，血红素加氧酶1活性增加致胆红素的抗氧化作用途径开放，胆红素水平降低。提示胆红素水平、血红素加氧酶1活性能反映缺氧缺血性脑病患儿的病情严重程度，对缺氧缺血性脑病的诊断及预测预后具有一定的参考价值。     

纳洛酮对缺氧大鼠皮质神经元细胞内钙的影响

目的:观察缺氧对大鼠皮质神经元细胞内钙的影响及纳洛酮的保护作用。方法:实验于2003年在军事医学科学院神经生物学研究室进行。取体外培养12d的Wistar大鼠皮质神经元细胞,随机分为3组:①正常对照组:细胞置于36℃,含体积分数为0.9的空气、体积分数为0.1的CO2的培养箱内培养30h。②缺氧组:细胞移至4000cm3的恒温(36℃)密闭容器内,连续充以无氧气体(体积分数为0.9氮气、体积分数为0.1的CO2),在缺氧条件下培养6h后改在常氧下继续培养24h。③纳洛酮组:在缺氧前24h在培养液中加入1μmol/L的纳洛酮,其他处理同缺氧组。用流式细胞仪检测不同时间段培养的神经元细胞内钙。结果:3组在缺氧前神经元细胞内钙差别不显著(P>0.05)。培养6h后缺氧组和纳洛酮组神经元细胞内钙明显高于正常对照组(7.94±0.13,6.68±0.33,3.39±0.36,P<0.01),且缺氧组高于纳洛酮组(P<0.01)。缺氧6h及再复氧24h纳洛酮组细胞内钙仍明显低于缺氧组(8.67±0.61,11.59±1.34,P<0.01),但两组均高于正常对照组(3.48±0.28,P<0.01)。结论:缺氧6h复氧24h时神经元细胞内钙显著升高,证实犤Ca2+犦i水平和神经细胞的缺氧损害密切相关,且恢复氧供并不能纠正犤Ca2+犦i异常。应用纳洛酮后,在缺氧条件下和缺氧后复氧期间的犤Ca2+犦i升高幅度较缺氧组明显减小,说明纳洛酮对缺氧的神经元犤Ca2+犦i具有一定的稳定作用,可以减轻神经元犤Ca2+犦i的升高,进而对神经元细胞起到保护作用。     

豆粉对糖尿病大鼠血糖血脂的调节作用

目的:观察具有降糖、降脂作用的鹰嘴豆对糖尿病大鼠血糖及血脂的影响。方法:实验于2003-10/12在新疆医科大学公共卫生学院营养与食品卫生教研室完成。32只糖尿病大鼠依据血糖水平随机分为4组:模型组、鹰嘴豆精粉高、中、低剂量组,每组8只;另取健康大鼠8只设为对照组。对照组给予普通饲料,模型组给予高脂饲料,其它3组分别给予含有不同剂量鹰嘴豆精粉饲料,下午5时喂饲1次/d,记录每日进食量及饮水量,每周称量体质量、测定空腹血糖1次,4周末于空腹12h后眼眶取血测定各项血脂指标及胰岛素,并在麻醉状态下处死大鼠称量肝、脾、胸腺重量。结果:纳入40只大鼠均进入结果分析。①血糖比较:应用鹰嘴豆精粉1周后,低剂量组明显低于模型组犤(15.15±6.86,19.73±5.51)mmol/L,(P<0.01)犦;应用鹰嘴豆精粉2周后,高剂量组明显低于模型组犤(15.81±4.57,23.78±4.34)mmol/L,(P<0.01)犦。②三酰甘油含量:高剂量组明显低于模型组犤(6.29±3.84,15.18±3.06),(P<0.01)犦;中剂量组明显高于正常组犤(5.86±4.67,0.39±0.23),(P<0.01)犦。③高密度脂蛋白含量:中剂量组明显低于模型组犤(2.01±1.08,8.43±4.26)mmol/L,(P<0.01)犦;高剂量组明显低于模型组犤(2.53±1.16,8.43±4.26)mmol/L,(P<0.01)犦。④肝质量:中剂量组明显高于正常组犤(9.54±1.69,6.92±1.37)g,(P<0.05)犦。结论:鹰嘴豆精粉可降低糖尿病大鼠血糖和血清三酰甘油的水平,对血清总胆固醇的含量未见明显影响,而有降低血清高密度脂蛋白胆固醇的趋势,这种特殊现象有待进一步认识与验证。     

产前应用地塞米松对早产儿缺氧缺血性脑损伤的影响

目的:探讨产前预防性使用肾上腺皮质激素对早产儿缺氧缺血性脑损伤(hypoxic-ischemicbraindamage,HIBD)的影响。方法:对42例早产儿HIBD病例进行研究,比较产前用药组(n=44)与未用药组(n=38)HIBD早产儿血糖(微量血糖仪测定)、血清可溶性黏附分子1(solubleintercellularadhesionmolecule1,sICAM-1)(ELASA法),S-100B(化学发光免疫法),纠正胎龄40周时新生儿行为神经测定(neonatalbehaviorneurologicassessment,NBNA)的变化情况。结果:产前用药组微量血糖、纠正胎龄40周时NBNA犤(2.7±0.4)mmol,38.1±4.6犦高于未用药组犤(2.7±0.4)mmol/L,35.0±3.2犦(t=5.21,P<0.01;t=5.21,P<0.05)。产前用药组血清sICAM-1,S-100B犤(225.3±55.9)ng/L,(2.2±1.5)μg/L犦低于未用药组犤(270.3±53.9)ng/L,(3.8±2.5)μg/L犦(t=8.20,9.25,P<0.01)。结论:产前预防性应用肾上腺皮质激素对早产儿HIBD具有保护作用,可能与血糖升高及血清sICAM-1降低有关。     

超声治疗对冠心病患者血中一氧化氮和α颗粒膜蛋白140的影响

目的:探讨冠心病患者超声治疗前后一氧化氮和α颗粒膜蛋白140含量测定及临床意义。方法:选用未使用抗血小板药治疗的冠心病患者进行超声治疗,用采用硝酸还原酶法和ELISA双抗体夹心法测定治疗前后一氧化氮和α颗粒膜蛋白140含量。结果:冠心病患者超声治疗前血清一氧化氮水平犤(40.9±12.7)μmol/L犦较对照组犤(21.4±5.3)μmol/L犦显著性升高(P<0.01),治疗后血清一氧化氮水平犤(19.5±9.2)μmol/L犦接近正常对照组;冠心病患者超声治疗前血浆α颗粒膜蛋白140含量犤(29.34±5.36)μg/L犦明显高于正常对照组犤(12.08±4.85)μg/L犦(P<0.01),治疗后有所下降犤(25.53±6.51)μg/L犦,但无显著性意义。且患者超声治疗前后血清一氧化氮和血浆α颗粒膜蛋白140呈显著正相关。结论:冠心病患者体内存在血小板活化,一氧化氮和血小板活化可能共同参与了冠心病发展过程,超声治疗冠心病可能的机制是通过一氧化氮和α颗粒膜蛋白140多种因素共同作用的结果。     

肥胖者血清肿瘤坏死因子α与胰岛素水平的关系--附30例报告

研究肥胖者空腹、餐后血清肿瘤坏死因子α(tumornecrosisfactorα,TNFα)与胰岛素水平的变化。方法:肥胖组和正常对照组各30例,分别于空腹及馒头(100g)餐后2小时抽取肘静脉血,以放射免疫法测定血清TNFα及胰岛素的含量。结果:肥胖组空腹、餐后TNFα水平比较无统计学差异,对照组餐后TNFα水平犤(0.15±0.02)μg/L犦较空腹犤(0.13±0.03)μg/L犦明显升高,P<0.01;肥胖组空腹TNFα水平犤(0.17±0.03)μg/L犦较对照组高,P<0.01;两组餐后TNFα水平比较无统计学差异,但肥胖组餐后胰岛素水平犤37(8～160)mU/L犦较对照组犤15(9～60)mU/L犦高,P<0.05。结论:肥胖者体内存在胰岛素与TNFα调节机制失衡,这一失衡可能导致和加重胰岛素抵抗。     

Interaction of peptidoglycans with anti-IgGs and with complement.

This report describes the interaction of peptidoglycan (Streptococcus group A, Staphylococcus epidermidis and Micrococcus lysodeikticus) with 2 serum mediator systems, namely with the anti-IgG system and with complement. The observation that the majority of rabbits hyperimmunized with A-variant streptococcal vaccine produced anti-group carbohydrate antisera containing anti-IgGs and antibodies directed to peptidoglycan suggested that the production of these 2 latter antibodies was related. This view was supported by the finding of a monoclonal 7S anti-IgG with antibody specificity for the pentapeptide of peptidoglycan as evidenced by inhibition of the coprecipitation of 7S anti-IgG with antigen-antibody complexes by the pentapeptide. Inhibition of the anti-idiotype reaction by the pentapeptide provided further evidence for the antibody specificity of 7S anti-IgG for peptidoglycan. When added to normal human sera all peptidoglycan preparations inhibited the hemolytic activity of the sera. Consumption of C3 in C2 deficient serum and consumption of C2 in normal serum indicated the activation of both known complement pathways. Activation of the classical pathway of complement was more efficient since 50 mug of peptidoglycan consumed approximately 70% of C2 per ml normal serum whereas more than 2 mg of the same preparations was required to inactivate 17-24% of C3 in C2 deficient sera. Each of the different peptidoglycan preparations consumed similar amounts of complement in all 20 sera tested. This finding suggested that activation of the classical complement pathway by peptidoglycan was not mediated by anti-peptidoglycan antibodies present in only 20-40% of normal human sera.     

异病酚静脉全麻下复合氯胺酮或曲马多行纳屈酮快速阿片脱毒的效果比较

Toreleasetheseverewithdrawalsymptomsoftheheroinad-dicts,weinjecttheNaloxineinthegeneralanesthesia.160volun-teersreceivedRODwereperformedunderthecombinedanesthesiawithpropofol,midazolamandketamine.1Subjectsandmethods1.1Subjects160volunteerswhoaccordingwiththediagnosticstandardoftheICD-10abouttheopiate-addiction,male:145,fe-male15.Age:(30±6),theeldestwas45yearsold.Themeanbodyweightwasabout(58±8)kg.Educationalbackground:pri-maryschool118cases,juniorhighschool:24casesandseniorhighschool/seco…     

The comparison of effects of rapid opiate detoxification with ketamine complex and with tramadol and naltrexone under general anesthesia with propofol

Objective To release the heroin addicts‘ sufferings,we made rapid opiate detoxification by injecting naloxine under the general anesthesia.Method 160 volunteers were divided at randon into two groups:Group A were performed under the combined anesthesia with propofol,midazolam and kelamine.Group B were performed under the combined anesthesia with propofol with midazolam and tramadol.The vital signs were recorded and the withdrawal syndrome of the volunteers were assessed during the whole process.Result All of the withdrawal symptoms scores 24 hours after ROD in group B were lower than its pre-treatment;The symptoms of the thirs,tsleeping disturbance,nausea and vomiting,skeletal muscular pains and anorexia scores in group A were also lower than its pre-treatment;and no too much differeence belween group A and group B.But tearing,anxiety and diarrhea scores in group A were almost the same as the pre-treatment and higher than group B.Both groups received of the naloxone treatment smoothly,and remained in the hospital for about 3 days.Conclusion The effect of rapid opiate detoxification of naltrexone with the ketamine or tramadol under anesthesia is obvious.The tramadol is better than others.     

替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的观察与护理

[目的]总结替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的观察与护理。[方法]对25例无法手术切除的晚期结直肠癌病人采用替吉奥胶囊联合亚叶酸钙、奥沙利铂方案进行治疗,同时加强心理护理、毒副反应的观察与护理等。[结果]治疗过程中出现Ⅰ级和Ⅱ级神经毒性8例,恶心、呕吐、食欲下降12例,骨髓抑制5例,变态反应1例,经处理后均好转;1例病人死亡,其余病人均顺利进行治疗。[结论]加强替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的护理,可保证治疗的顺利进行。     

缩腺液治疗扁桃体炎的疗效观察及其护理

扁桃体炎是儿童常见病、多发病,传统药物治疗可暂缓症状,但不能根治;手术治疗痛苦大、出血多、费用高,常合并有并发症。我科运用缩腺液治疗扁桃体炎3 0例收到了良好的效果。现报告如下。1　对象与方法1.1　对象　本科于2 0 0 2年—2 0 0 3年共收治扁桃体炎病人5 0例,年龄为7岁～2 0岁,分两组进行。缩腺液治疗组3 0例,男13例,女17例;其中重度12例,中度9例,轻度9例;对照组2 0例,男9例,女11例;其中重度8例,中度7例,轻度5例。两组病人年龄、性别、病情严重程度基本一致,差异无统计学意义(P >0 .0 5 )。1.2　方法　对照组采用药物治疗,静脉输注…     

艾滋病合并结核病及马尔尼菲青霉病患者的护理

目的 通过分析艾滋病合并结核病及马尔尼菲青霉病患者的临床资料,提高对三病并存的护理认识.方法 分析并总结26例艾滋病合并结核病及马尔尼菲青霉病住院患者的临床特点、治疗及护理方法.结果 本组患者治愈5例,好转13例,死亡8例.存活患者随访6～30个月均未复发.结论 三病并存时临床表现复杂,无特异性,护理难度大,应仔细观察病情,及早诊治,精心护理,对改善预后有重要意义.     

艾滋病合并结核病及马尔尼菲青霉病患者的护理

目的通过分析艾滋病合并结核病及马尔尼菲青霉病患者的临床资料,提高对三病并存的护理认识。方法分析并总结26例艾滋病合并结核病及马尔尼菲青霉病住院患者的临床特点、治疗及护理方法。结果本组患者治愈5例,好转13例,死亡8例。存活患者随访6～30个月均未复发。结论三病并存时临床表现复杂,无特异性,护理难度大,应仔细观察病情,及早诊治,精心护理,对改善预后有重要意义。     

An electroencephalographic comparison of alfentanil with other narcotics and with thiopental

Using aperiodic analysis, we compared the EEC produced by alfentanil with the EEGs produced by two other opiates—fentanyl and sufentanil—on the one hand and with the EEG produced by a barbiturate—thiopental—on the other hand. Alfentanil and thiopental were injected over 1 minute: fentanyl and sufentanil were injected over 10 to 15 minutes. From the aperiodic analysis we derived up to seven single-number variables computed over 30- or 60-second epochs. All the opiates induced EEGs that were qualitatively similar to each other, although the maximum or minimum values tended to be greater and the time course more rapid with alfentanil than with the other two opiates. This finding may have been related to the fact that we injected relatively more alfentanil and administered it more rapidly. The EEGs produced by alfentanil and thiopental differed markedly, both qualitatively and quantitatively. The total power at 1 Hz and cumulative power at 3 Hz went to higher peak values with alfentanil, the latter tending to decrease with thiopental. The total number ot waves per epoch went to lower peak values with alfentanil; there was little change with thiopental. The frequency below which 90% ot the power resides went to considerably lower peak values with alfentanil than with thiopental. Finally, total power at 10 to 12 Hz (alpha waves; and average power at 17 to 19 Hz (beta waves) went to very high peak values with thiopental, but decreased with alfentanil. In spite ot differences in the opiate studies in the timing ot injection and the relative amount ot drug injected, the variables that proved useful in their response to fentanyl and sutentanil also proved useful with altentanil. In contrast, almost all variables showed a difference in response between alfentanil and thiopental. Supported in part by Janssen Pharmaceutics, Inc. Pisacataway, NJ, and by Diatek Corporation, and the Veterans Administration Medical Center, San Diego, CA.     

Experience with the treatment of atrial fibrillation with cordarone and digoxin

Paraxysmal and recent cardiac fibrillations have been treated in 42 patients with cordaron combined with digoxin. The arrest of fibrillation was achieved for 5 days in 29 patients (69%) suggesting high efficacy of the combination.