腹部外科患者术后肺功能的变化

目的：探讨腹部外科手术对肺功能的影响。方法：应用床旁肺功能仪及血气分析仪对３５例腹部外科患者（腹腔感染组１６例,择期手术组１９例）于术前、术后的用力肺活量９ＦＶＣ）、第１秒时间肺活量比（ＥＶ １．０％）、动脉血氧分压（ＰａＯ２）、动脉血二氧化碳分压（ＰａＯ２） 、血氧饱和度（ＳａＯ２）等肺功能指标进行监测。结果：择期手 术后１天、３天ＦＶＣ、ＰａＯ２较术前明显降低（Ｐ〈０．０５）,术后５天基本恢复正     

室上性心动过速射消融术后动态心电图观察

为３０例ＰＳＶＴ患者ＲＦＣＡ术后２４小时动态心电图进行分析，结果心律失常检出１６例（５３．３％），有ＳＴ－Ｔ改变检出１２例（４０％），无ＳＴ－Ｔ改变１８例（６０％）１２例有ＳＴ－Ｔ改变者６例（５０％）有ＣＰＫ改变，而１８例ＳＴ－Ｔ改变只有１例（５．６％）有ＣＰＫ变化，二者比较有显著性差异（Ｐ〈０．００５），随访１２例有ＳＴ－Ｔ改变者全部恢复正常，综上可以认为，２４小时动态心电图是ＰＳＶＴ患者ＲＦＣ     

PTCA术后心率变异动态演变与再狭窄的关系

目的 观察经皮腔内冠脉成形术（ＰＴＣＡ）后再狭窄与再狭窄患者的心率变异（ＨＲＶ）变化，探讨 ＰＴＣＡ术对心脏处太神经活动的影响及ＨＲＶ变化与再狭窄的关系。方法 对ＰＴＣＡ术患者５１例，其中再狭窄者３４例，无再狭窄者１７例，分别于术前１周、术后１周、术后６个月记录２４ｈ心电信号并进行ＨＲＶ时域法和频域法分析。结果 （１）所有患者ＰＴＣＡ术后１周ＨＲＶ值均较术前降低（Ｐ〈０．０５）；（３）ＰＴＣＡ术后     

卡维地洛抗实验性心律失常作用

目的　评价卡维地洛（ＣＶＤ）抗实验性心律失常作用,并与β受体阻断剂普萘洛尔（ＰＲＯ） 进行比较。方法　采用氯仿致小鼠室颤（ＶＦ） , 哇巴因、乌头碱致豚鼠、大鼠心律失常,肾上腺素致豚鼠心律失常, 以及结扎大鼠冠状动脉诱发心律失常等５ 种模型。结果　与溶媒对照组相比, ＣＶＤ１ ｍｇ·ｋｇ－１ 显著降低氯仿诱发的小鼠ＶＦ 发生率〔１８－７５ ％（３／１６） ｖｓ８１－２５％ （１３／１６）,Ｐ＜ ０－０１〕,此作用与ＰＲＯ 相似。１ ｍｇ·ｋｇ－１ ＣＶＤ 和ＰＲＯ 均显著提高致室早（ＶＥ） , 室速（ＶＴ）, ＶＦ, 心搏停止（ＣＡ） 所需哇巴因和乌头碱用量（ Ｐ＜０－０１ ｖｓ 溶剂对照组） ;ＣＶＤ 对抗哇巴因的致心律失常作用较等剂量ＰＲＯ 显著（ Ｐ＜ ０－０１ ,ＣＶＤ ｖｓ ＰＲＯ）。ＣＶＤ 剂量依赖性地显著缩短ｉｖ 肾上腺素４０ μｇ·ｋｇ－ １ 所致心律失常持续时间,有效减少结扎冠脉诱发的缺血性心律失常ＶＴ,ＶＦ,ＣＡ 的发生率并缩短ＶＴ 的持续时间。结论　ＣＶＤ 具有抗多种实验性心律失常作用,该作用在等剂量时至少与ＰＲＯ 相近,或强于ＰＲＯ。ＣＶＤ的这种作用最终将有益于接受其治疗的原发性高血压、冠心病、充血性心力衰竭患者     

79例肺癌术前肺功能与术后并发症的初步分析

７９例肺癌术前肺功能与术后并发症的初步分析山西省人民医院呼吸科（０３００１２）何晓蕴山西省人民医院肺功能室卢常芳太原市人民医院郝沛顺本文就７９例肺癌患者行肺切除术前肺功能与术后并发症的发生情况做一初步分析。资料与结果７９例肺癌患者中男性６１例，女性１８例，男：女约为３．４１：１。年龄３０～７７岁，平均为５７．８岁，其中行一侧肺切除术１４例；双叶肺切除术１０例，单叶肺切除术５５例。术前均用日本株式会社福田产业公司的ＣＳＡ—１６００ｓＤ型肺功能检测仪进行肺功能的测定，按照ＭＶＶ（最大通气量）％＜８０％和通气储量（８７％为据，将患者区分为手术慎重组和手术可以组，所有资料的统计学处理采用ｔ检验计算出Ｐ值，手术可以组与手术慎重组相比ＭＶＶ％和通气储量％有显著差异，见表１。手术慎重组术后有并发症者１２例，发生率为７０．６％。手术可以组并发症者１０例，发生率为１６．１％。术后并发症除手术慎重组中１例因并发脑梗塞，另１例并发ＤＩＣ（弥漫性血管内凝血）死亡外，均表现为肺部感染和／或肺不张。手术有并发症和无并发症的术前肺功能比较见表２。有并发症者手术慎重组和手术可以组术前肺功能比较见表３。讨论１．术前肺功能异常，术后的肺部并发     

不同冠脉病变支数患者经皮腔内冠脉成形术前术后心率变异性的对比分析

通过心率变异性（ＨＲＶ）时域和频域分析法，对经冠造显示不同冠脉病变支数并行经皮腔内冠状动脉成形术（ＰＴＣＡ）扩张成功的６６例患者，分别于ＰＴＣＡ术前术后１周进行ＨＲＶ分析。其中单支病变２１例，双支２８例，三支１７例。结果显示：①ＰＴＣＡ术后１周心率变异性较术前有所改善，但未达统计学意义（Ｐ＞０．０５）。②ＰＴＣＡ术前、术后冠脉单支、双支、三支病变各组间患者ＨＲＶ均无显著差异（Ｐ均＞０．０５）。提示冠心病患者ＨＲＶ的改变可能与神经体液因素对窦房结功能的调控失衡有关。而与冠脉病变支数无关。ＰＴＣＡ术后近期患者ＨＲＶ改善不明显，其机制尚不清楚     

不同冠脉病变支数患者经皮腔内冠脉成形术前后心率变异性的对比…

通过心率变异性（ＨＲＶ）时域和频域分析法，对经冠造显示不同冠脉焦支数并行经皮腔内冠状动脉成形术（ＰＴＣＡ）扩张成功的６６例患者，分别于ＰＴＣＡ术前术后１周进行ＨＲＶ分析。其中单支为２１例，双支２８例，三支１７例，结果显示：（１）ＰＴＣＡ术后１周心率异性较术前前所改善，但未统计学意义（Ｐ〉０．０５），（２）ＰＴＣＡ术前，术后冠脉单支，双支，三支病变各组间患者ＨＲＶ均无显著差异（Ｐ均〉０．０５）。提示     

彩色多普勒超心动图在主动脉窦瘤手术前后的应用

目的 探讨彩色多普勒超声心动图（ＣＤＥ）在主动脉窦瘤（ＡＳＡ）手术前后的应用价值。方法 对２９例患者术前术后进行ＣＤＥ检查。结果 ＣＤＥ对２８例主动脉窦瘤破裂（ＲＡＳＡ）作出正确诊断,准确率为９６．６％;对合并症室缺（ＶＳＤ）确诊１２例,准确率６６．７％;ＣＤＥ估计破口直径与手术所测相近;术后ＣＤＥ准确检查出１例窦瘤补片开裂,并进行再次手术。结论 ＣＤＥ是ＲＡＳＡ术前评价和术后随访具有价值的无创技术。     

茶碱改善慢性阻塞性肺疾病患者通气功能的定量分析

１０名慢性阻塞性肺疾病（ＣＯＰＤ）患者口服两个不同剂量的茶碱,分别达到两个稳态,测定谷浓度值,同时测定最大肺活量（ＦＶＣ）,一秒钟用力呼气量（ＦＥＶ１）。提高茶碱稳态浓度前后的ＦＶＣ值无显著差异,揭示在常规剂量下茶碱对ＣＯＰＤ病人通气功能的改善是有限的。引用公式：ＦＶＣ＝Ｃｓｓ×ｍ＋ｉ,预测病人ＦＶＣ值与实测值差异无显著性（Ｐ＞０．０５）。不同稳态浓度的ＦＶＣ值可用此公式预测。     

连续性肾脏替代治疗在心脏术后急性肾衰中的应用

目的研究连续性静脉－静脉血液透析滤过（ＣＶＶＨＤＦ）治疗以及术后并发急性肾功能衰竭（ＡＲＦ）的疗效。方法对４例心脏术后并发ＡＲＦ的患，采用ＰＲＩＳＭＡ（Ｈｏｓｐａｌ）床旁血透机行连续静脉静脉血液透析滤过。结果对４例患，死亡３例，存活１例。用ＣＶＶＨＤＦ治疗３０ ｍｉｎ后，平均动脉压显上升，心率则显减慢。治疗８ｈ后，血清Ｎａ＾＋、ＣＬ＾－、Ｃａ＾２＋和动脉血气中ｐＨ值均无显变化，但血清ＢＵ     

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.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

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.