胰肾联合移植术后并发症分析

目的总结胰肾联合移植的外科并发症的预防与治疗经验和教训。方法对2例糖尿病性肾病、尿毒症患者施行了胰肾联合移植术。胰腺外分泌引流应用膀胱引流式。免疫抑制剂应用OKT3 CsA MMF Pred四联序贯免疫抑制方案。应用小分子肝素、低分子右旋糖酐、丹参抗凝治疗。结果2例患者分别于术后6和3小时血糖降至正常 ,停用胰岛素 ,血肌酐于术后5和4天恢复正常。1例出现伤口血肿和移植肾输尿管坏死 ;1例出现移植胰胰尾轻度胰瘘。结论应注意胰肾联合移植手术外科并发症的预防。     

胰肾联合移植二例报告

目的 为了改善Ⅰ型糖尿病末期肾衰患者的治疗效果。方法 于１９９８年６月和１９９９年５月先后施行了２例胰肾联合移植术,免疫抑制方案采用激素、ＣｓＡ、骁悉（ＭＭＦ）及抗胸腺淋巴细胞球蛋白（ＡＴＧ）。结果 联合移植术后胰功能恢复正常,病人均于术后２４小时内停用胰岛素,一周内血肌酐及尿素降为正常。１例已有功能存活１３个月,另２例早期恢复良好,术后３周发生急性排斥,７周时死于复数菌败血症。结论 胰肾联合移植     

成功的胰肾联合移植1例报告

目的：用胰肾联合移植技术治疗非胰岛素依赖型糖尿病伴尿毒症病人。方法：2002年2月1例Ⅱ型糖尿病伴肾功能衰竭病人接受胰、十二指肠、肾一期联合移植，采用胰液空肠引流术式。结果：病人术后即停用胰岛素，肾功能术后第9天恢复正常，无外科并发症，现已存活5月余，移植胰和移植肾功能正常，未出现排斥反应，病人已参加日常工作。结论：胰肾联合移植治疗胰岛素依赖型糖尿病伴肾功能衰竭的病人，治疗效果确切、安全可靠。     

胰肾联合移植术后并发症分析

目的：总结胰肾联合移植的外科并发症的预防与治疗经验和教训。方法：对2例糖尿病性肾病,尿毒症患施行了胰肾联合移植术,胰腺外分泌引流应用膀胱引流式,免疫抑制剂应用OKT3＋CsA MMF Pred四联序贯免疫抑制方案,应用小分子肝素,低分子右旋糖酐,丹参抗凝治疗。结果：2例患分别于术后6和3小时血糖降至正常,停用胰岛素,血肌酐于术后5和4天恢复正常,1例出现伤口血肿和移植肾输尿管坏死,1例出现移植胰胰尾轻度胰瘘,结论：应注意胰肾联合移植手术外科并发症的预防。     

肝肾联合移植术后免疫抑制药物使用经验——附1例肝肾联合移植并脾切除术长期生存报告

目的通过我科成功实施的1例人同种异体肝肾联合移植并脾切除术,探讨肝肾联合移植术后免疫抑制剂的使用经验。方法1例乙肝后肝硬化合并肾功能不全患者患者行脾切除后加行改良不转流同种异体原位肝移植再加右髂窝肾移植治疗。术后免疫抑制剂采用环孢素A(C sA)、骁悉(MM F)和激素三联用药,其间曾应用普乐可复(FK 506)替代C sA 33d。结果手术过程顺利,术后未出现严重排异反应,移植肝和移植肾功能恢复良好。患者现已存活4年11个月,生活质量良好。结论肝肾联合移植采用C sA、MM F和激素三联用药的免疫抑制疗法疗效良好。     

胰肾联合移植术后患者在重症监护病房中的护理

目的探讨和总结胰肾联合移植的术后护理监测及护理特点,促进胰肾联合移植术后患者在重症监护病房中尽快恢复。方法该院2012年6月至2013年5月对3例胰肾联合移植术的患者进行术后心理护理、消毒隔离措施、生命体征监测、胰腺及肾脏功能监测,观察术后血糖及尿量、尿色、有无排斥反应等。结果通过对胰肾联合移植术后患者进行积极的护理监测,患者术后异常得到及时发现和处理,术后来发生护理并发症,生命体征平稳后迅速转出重症监护病房。结论胰肾联合移植术后患者引流管较多,监测项目多且复杂,通过积极仔细的术后监护,患者术后并发症显著下降,能尽早转出重症监护病房。     

超声在原位肝移植胰肾联合移植围手术期的作用

我院 1999年为 1例 41岁的男性肝病终末期患者 ,施行了原位肝移植 ,在围手术期共进行 B超检查 11次 ,彩超检查14次。为 1例 47岁的女性糖尿病合并肾功能衰竭的患者行胰肾联合移植术 ,在围手术期共进行 B超检查 4次 ,彩超检查5次。对移植器官的观测有一些共性的地方 ,如移植器官大小、形态和结构 ,移植血管并发症和外科并发症等。基于这些资料 ,结合文献报道 ,试论超声在肝移植、胰肾联合移植围手术期的作用。1　临床资料使用 Dornire5 2 0 0型彩色多普勒超声诊断仪 ,探头频率5 .0 MHz。用超声常规检查肝、脾、胰、肾、胸腹水 ,以及血管的…     

得普利麻对胰肾联合移植术后患者的镇静护理

目的 总结胰肾联合移植术后患者应用得普利麻镇静的护理。方法 对8例胰肾联合移植患者术后当日行呼吸机辅助通气，用得普利麻镇静时，意识和呼吸的观察，呼吸道的护理、预防感染的护理。结果 8例胰肾联合移植患者术后用得普利麻镇静期间，经严密的意识及呼吸状况的观察，保持呼吸道通畅，充分吸痰，防止呼吸道及肺部感染，并且定时翻身叩背，严密隔离和执行无菌操作原则。而得普利麻的输入则以微量泵匀速注入，以维持最佳镇静效果，并防止镇静过深等护理。8例患者均安全平稳过渡此期。结论 得普利麻对胰肾联合移植患者术后机械通气时有确切的镇静作用。     

胰液空肠引流式全胰十二指肠肾一期联合移植(病例报告及文献复习)

目的总结胰液空肠引流改良术式胰、肾联合移植的临床体会。方法对1例胰岛素依赖型糖尿病并发尿毒症患者施行胰液空肠引流改良术式全胰、十二指肠及肾一期联合移植。术后早期采用皮质激素、霉酚酸酯(MMF)、他克莫司(FK506)和环磷酰胺进行免疫治疗,维持免疫抑制采用FK506和MMF二联方案。结果术后第5天移植肾、胰功能恢复良好,血肌酐、尿素氮和空腹血糖降至正常,第24天完全停用胰岛素;术后第6天FK506浓度过高致肾中毒、第9天细菌培养阳性和第19天并发消化道出血,均经相应治疗痊愈。结论胰液空肠引流改良术式全胰、十二指肠及肾联合移植是治疗胰岛素依赖型糖尿病并发尿毒症的有效方法,优于胰液膀胱引流术式。     

替硝唑注射液在肝肾胰联合移植伴连续性肾脏替代治疗患者体内的药代动力学

目的在连续性肾脏替代治疗期间,观察肝、肾、胰联合移植患者静脉滴注替硝唑(抗厌氧菌感染药)的药物动力学特点。方法选择1例肝、肾、胰联合移植患者,替硝唑静脉滴注,用反相高效液相色谱法测定血浆中替硝唑浓度。结果替硝唑的t1/2β为20.96h,CL为1.47L·h-1,AUC为166.15mg·h·L-1,各项参数均较正常人均延长。结论替硝唑在肝、肾、胰联合移植患者体内代谢较慢,易造成蓄积;用连续性肾脏替代治疗,可促进药物代谢;但仍有蓄积可能,建议进行治疗药物监测。     

甲胺磷皮肤染毒在家兔体内的毒物代谢动力学及药物代谢-药物效应同步模型的应用

用气相色谱法测定生物样品中甲胺磷(MAP)研究了iv,pc和sc MAP在家兔体内的毒物代谢动力学,以全血胆碱脂酶抑制率为毒效学指标对MAP的药物代谢-药物效应同步模型进行了初步探讨。MAP7.05mg·kg~1 iv呈三室开放模型,pc和sc50％MAP乳剂均呈一级吸收一室模型。MAP经皮肤吸收较快,不到3h吸收相基本结束,吸收率F约为45％。sc MAP乳剂,吸收速度比pc快10倍,吸收率F高达98％,提示完整皮肤具有一定的屏障作用MAP呈周身分布,周室富集,消除较快,t_1/2小于8h,物质蓄积作用弱,存在肾外消除途径。MAP pc全血胆碱酸酶抑制率相对于血MAP浓度存在一个逆时针方向的时滞环。胆碱酯酶抑制率的I_(max)为60.9％～65.8％,IC_(50)为0.83～0.94μg·ml~1,k_(co)为0.243～0.293 h~1。     

RP-HPLC同时测定人体外血浆中7种苯二氮类镇静催眠药的浓度

目的:建立RP-HPLC法同时测定人体外血浆中的7种苯二氮类镇静催眠药(奥沙西泮、氯硝西泮、硝西泮、三唑仑、艾司唑仑、阿普唑仑、地西泮)在人血浆中的含量。方法:以非那西丁为内标,色谱柱为Agilent Zorbax SB-C18(5μm,150 mm×4.6 mm),流动相为甲醇-水,梯度洗脱,流速为1 mL.min-1,检测波长230 nm。结果:7条标准曲线在检测范围内均呈良好线性(r≥0.9998);7个待测成分的检测限均低于0.19 ng,定量限均低于0.52 ng;高、中、低3个水平质控样品的日内和日间精密度的RSD均小于3.1%,提取回收率为84.1%～98.9%。结论:本文所建立的人体外血浆中7种苯二氮类镇静催眠药同时定量的方法准确、可靠,可为临床该类药物的快速检测提供参考。     

“It Just Depends on the Environment”: Patterns and Decisions of Substance Use and Co-use by Adolescents

Abstract

This study used rich qualitative data to examine the role that social and physical contexts play in decision making related to simultaneous use of alcohol and marijuana among adolescents. In-depth, semi-structured interviews were conducted with 13 adolescents who used alcohol and marijuana within several hours of each other. Decisions about whether to use alcohol and marijuana simultaneously as well as use patterns (e.g., the sequence in which substances were used) were informed by the context and the desired effect of the substance(s). Also, simultaneous alcohol and marijuana use was described as occurring in multiple contexts, both destination and transitional. Interventions designed to reduce simultaneous alcohol and marijuana use could benefit from paying attention to substance use contexts.     

胰肾联合移植的体会

目的　总结胰肾联合移植的经验与教训。方法　回顾性分析 1例胰肾联合移植治疗的全过程和并发症。结果　糖尿病合并肾功能损害的病人 ,围手术期的并发症很多 ,有些并发症很凶险。手术顺利完成 ,移植的胰腺和肾脏功能都很好。绝大多数的并发症均被控制 ,只是口腔顽固性溃疡没有好办法 ,可能跟免疫抑制过量有关。术后 6 5 d发生大面积脑梗死 ,可能跟栓子脱落有关。结论　胰肾联合移植围手术期并发症的处理是管理的重点 ,应注意免疫抑制剂的个体化。     

Simultaneous RPHPLC Determination of Nitazoxanide and Ofloxacin in Combined Tablet Dosage Form

A simple, precise, accurate, rapid and reproducible reverse phase high performance liquid chromatographic procedure was developed for simultaneous determination of nitazoxanide and ofloxacin in tablet dosage form at a single wavelength. The mobile phase used was a combination of acetonitrile:0.25M potassium dihydrogen phosphate buffer (80:20) with 0.5%v/v of triethylamine and the pH was adjusted to 2.5 by adding orthophosphoric acid. The detection of the combined dosage form was carried out at 320 nm and flow rate was set to 1ml/min. Linearity was obtained in the concentration range of 5 to 25 μg/ml of nitazoxanide and ofloxacin with correlation coefficients of 0.9987 and 0.9995, respectively. The results of the analysis were validated statistically and recovery studies confirmed the accuracy of the proposed method.     

HPLC method development and validation for simultaneous detection of Arabinoside-C and doxorubicin

This paper describes a new validated high performance liquid chromatography (HPLC) method for the simultaneous determination of two anti-cancer drugs, Arabinoside-C (Ara-C) and doxorubicin hydrochloride (DOX). A simultaneous determination method saves cost and time as both drugs can be injected into a single HPLC system without the need to change or re-equilibrate with a new mobile phase. The objective of the study is to develop a simultaneous determination method of two anti-cancer drugs, Ara-C and DOX. The mobile phase consisted of a mixture (45:55) of acetonitrile:ammonium hydrogen phosphate aqueous solution (0.01?M) at pH 6.2 at a flow rate of 0.3?ml/min, with UV detection at 252?nm. Separation was achieved on a C-18 column (5 µm: 250?mm?×?4.6?mm) maintained at 30°C in a column oven. The method was linear between 325?ng/ml and 10 µg/ml for Ara-C and 625?ng/ml and 20 µg/ml for DOX. The limit of detection (LOD) was 20?ng/ml for Ara-C and 60?ng/ml for DOX. The developed HPLC method achieved good precision and accuracy as well as limit of quantitations. The developed and validated method is suitable to be used for routine analysis of Ara-C and DOX.     

HPTLC Method for the Simultaneous Estimation of Valsartan and Hydrochlorothiazide in Tablet Dosage Form

A simple, precise, accurate and rapid high performance thin layer chromatographic method has been developed and validated for the simultaneous estimation of valsartan and hydrochlorothiazide in combined dosage forms. The stationary phase used was precoated silica gel 60F₂₅₄. The mobile phase used was a mixture of chloroform: methanol: toluene: glacial acetic acid (6:2:1:0.1 v/v/v/v). The detection of spots were carried out at 260 nm. The method was validated in terms of linearity, accuracy, precision and specificity. The calibration curve was found to be linear between 300 to 800 ng/spot for valsartan and 100 to 600 ng/spot for hydrochlorothiazide. The limit of detection and the limit of quantification for the valsartan were found to be 100 and 300 ng/spot respectively and for hydrochlorothiazide 30 and 100 ng/spot respectively. The proposed method can be successfully used to determine the drug content of marketed formulation.     

高效液相色谱法同时测定食品中8种水溶性维生素

本文建立了高效液相色谱法同时测定维生素B1、B2、吡哆醇、吡哆醛、吡哆胺、烟酸、烟酰胺、B128种水溶性维生素的分析方法。该法采用梯度洗脱反相高效液相色谱法,KR100-5C18(250×4.6mmid,5μm)色谱柱,流动相A为乙腈,B为10mmol/L已烷磺酸钠水溶液(pH2.3),检测波长为256、280、360nm,流速1.0mL/min。结果表明,各种维生素含量测定方法的线性关系良好,R20.9994～0.9999,回收率92.7%～99.9%,RSD0.44%～5.20%。本方法操作简便,精密度好,结果准确可靠。