西药联合灌肠疗法治疗腹部手术后胃肠功能障碍的效果分析

目的：探讨西药联合灌肠疗法治疗腹部手术后胃肠功能障碍的效果。方法选取本院2010年5月∽2014年5月收治的80例腹部手术后出现胃肠功能障碍患者为研究对象,随机分成联合组与常规组,各40例,常规组采用常规西药进行治疗,联合组在常规组的基础上采用灌肠疗法进行治疗,比较两组治疗后的排气、排便、肠鸣音恢复时间,进食时间,肠胃功能障碍评分,住院时间等指标。结果两组治疗前胃肠功能障碍评分比较差异无统计学意义（P〉0.05）;治疗后,常规组的胃肠功能障碍评分明显高于联合组,差异有统计学意义（P〈0.05）;常规组胃肠功能恢复时间、进食时间、住院时间均长于联合组,差异有统计学意义（P〈0.05）。结论对腹部手术后出现胃肠功能障碍的患者行西药联合灌肠疗法,疗效显著,能有效缩短患者术后排气、排便、肠鸣音恢复时间,改善进食效果,缓解胃肠功能障碍症状,对改善患者生活质量、促进其早日回归正常生活等具有积极意义,值得临床推广应用。     

中西医联合治疗术后胃肠功能障碍的临床研究

目的:探究中西医联合治疗术后胃肠功能障碍的临床效果。方法:选取在某院接受治疗的72例术后胃肠功能障碍的患者,使用随机数字表法分为实验组与对照组各36例。对照组患者接受常规的西医疗法,实验组在西医疗法的基础上采用中西医联合治疗的办法,连续治疗两周,对比两组患者的胃肠功能恢复时间及治疗效果。结果:实验组患者在肠鸣时间、排气时间、排便时间等肠胃功能恢复指标上明显优于对照组,且实验组患者的治疗有效率为97.2%,明显优于对照组,具有统计学意义(P<0.05)。结论:中西医联合能够很好地治疗术后胃肠功能障碍。     

大黄对ICU重症急性胰腺炎患者胃肠功能的治疗价值

目的：研究大黄对ICU重症急性胰腺炎患者胃肠功能的治疗价值。方法将56例重症急性胰腺炎患者随机分成观察组与对照组，对照组仅运用传统方法治疗，治疗组除传统方法外运用大黄鼻饲和灌肠。观察指标包括腹痛缓解时间、血淀粉酶恢复正常时间、胃肠道功能恢复正常时间、腹腔内压力、APACHEⅡ评分、住院天数。结果观察组血清淀粉酶、腹腔内压力、APACHEⅡ评分降低显著（P〈0.05）；肠鸣音恢复时间、ICU住院时间较对照组明显缩短（P〈0.05）。结论大黄可促进重症急性胰腺炎胃肠功能的改善，减少住院时间，降低死亡率。     

生大黄灌肠对重症患者肠功能影响的临床观察

目的观察生大黄灌肠对重症患者肠功能障碍的改善情况。方法将70例肠功能障碍重症患者随机分为两组,对照组采用常规治疗,治疗组在常规治疗的基础上加用生大黄粉高位灌肠,两组用药时间均为7d。于入选后第1、3、7d,分别监测腹胀、排便、肠鸣音及大便潜血情况,并进行肠功能评分,记录患者28d转归情况。结果治疗组可促进重症患者的肠蠕动,增加肠鸣音,减少胃肠道出血;治疗组可改善重症患者肠功能评分,多器官功能障碍综合征的发生率明显低于对照组（P〈0.05）。结论生大黄灌肠可促进重症患者胃肠功能恢复,缩短重症病房住院时间,疗效确切,值得临床推广。     

开塞露灌肠治疗肝癌切除术后腹胀观察及护理

目的:探讨开塞露灌肠治疗肝癌切除术后腹胀的应用护理及效果;方法:将2012年12月-2016年12月肝癌切除术后并发腹胀60例患者随机分为两组,对照组30例给予传统开塞露20-40ml塞肛,实验组30例给予开塞露100-200ml灌肠;观察两组恢复肛门排气时间、肠鸣音时间、排便时间、排便及排气的次数、腹胀缓解情况;结果:实验组患者的肛门排气时间及排便时间、肠鸣音时间比对照组早,腹胀缓解比对照组快(P0.01)。结论:开塞露灌肠治疗肝癌切除术后并发腹胀比传统开塞露20-40ml塞肛,促进胃肠功能恢复,有效缓解腹胀有明显的效果。     

中药敷脐对腹部术后胃肠功能失常的疗效观察

目的探讨中药敷脐对腹部手术病人胃肠功能恢复的影响。方法将120例经腹部手术患者随机分为实验组和对照组。对照组行常规治疗,治疗组在常规治疗的基础上于术后1h脐部外敷中药,观察其术后肠蠕动恢复时间、自然排气时间。结果治疗组在肠鸣音恢复时间、自然排气时间、胃肠减压时间、胃肠功能恢复时间等方面均优于对照组(P<0.05及P<0.01)。结论中药敷脐疗法对腹部术后患者能促进胃肠功能恢复。     

中药敷脐结合针刺疗法恢复腹部术后胃肠功能的临床研究

目的：探讨中药敷脐结合针刺疗法恢复腹部术后胃肠功能的效果。方法：将本院2009年2月～2010年2月期间106例腹部手术后进行胃肠功能恢复治疗的患者随机分为治疗组和对照组,治疗组在常规治疗的基础上采取中药敷脐结合针刺疗法,对照组采用常规疗法,观察两组患者术后肠鸣音恢复时间及肛门排气时间。结果：治疗组术后肠鸣音的恢复时间为（8.3±2.9）h,肛门排气时间为（30.4±10.9）h,与观察组[（15.5±4.3）h,（62.7±22.6）h]相比均存在显著差异,t=2.987和2.824,P〈0.05,提示差异有统计学意义。结论：中药敷脐结合针刺疗法能促进腹部手术患者术后胃肠功能恢复,能显著提高患者恢复速度和效果,值得临床推广应用。     

重症感染和感染性休克患者ICU治疗时间的影响因素Logistic分析

目的探讨重症感染和感染性休克患者ICU治疗时间的影响因素。方法选取2016年5月至2018年5月于我院ICU进行治疗的重症感染或感染性休克患者120例,研究影响ICU治疗时间的主要影响因素。结果 Logistic单因素分析显示,年龄、侵入性操作、术后引流管放置、手术时间、SOFA评分、APACHE-Ⅱ、MODS、DIC以及乳酸水平均为影响ICU治疗时间的影响因素(P <0.05);Logistic多因素分析显示,MODS、DIC、乳酸水平、APACHE-Ⅱ以及SOFA评分均为影响ICU治疗时间的影响因素(P <0.05)。结论 MODS、DIC、乳酸水平、APACHE-Ⅱ、乳酸水平以及SOFA评分均为影响ICU治疗时间的影响因素,在对ICU患者进行治疗的过程中,应注重把握以上因素对患者自生产生的不利影响,对其病情的进展进行有效控制,使患者面临的安全风险得以有效降低。     

足三里穴位注射甲氧氯普胺对胰腺炎患者胃肠功能恢复的影响及护理体会

目的观察足三里穴位注射甲氧氯普胺对重症胰腺炎患者胃肠功能恢复的影响。方法 158例重症胰腺炎患者随机分成试验组和对照组,各79例。对照组给予常规治疗;试验组在对照组治疗基础上行双侧足三里穴位注射甲氧氯普胺各10mg,每天1次。观察2组患者肛门排气、排便以及肠鸣音恢复时间。结果试验组肛门排气时间、排便时间、肠鸣音恢复时间均短于对照组,差异均有统计学意义（P〈0.05）。结论足三里穴位注射甲氧氯普胺能有效促进胰腺炎患者胃肠功能恢复。     

重症感染患者ICU治疗时间的影响因素探究

目的：探讨重症感染患者ICU治疗时间的相关临床影响因素,并分析其应用价值。方法：选取我院2014年10月-2015年11月收治的重症感染患者68例,将ICU治疗时间大于48小时的35例患者作为组A,将ICU治疗时间小于48小时的33例患者作为组B,分析并比较两组患者的临床观察指标差异。结果：两组患者的APACHE-?评分、SOFA评分、乳酸水平、多器官功能障碍综合征(MODS)发病率、心率（HR）、弥散性血管内凝血(DIC)发病率指标对比,差异具有统计学意义(P<0.05)。APACHE-?评分、SOFA评分、乳酸水平、MODS发病率、心率、DIC发病率均为影响重症感染患者ICU治疗时间的危险因素。结论：重症感染患者ICU治疗时间影响因素诸多,重视并加强关注APACHE-?评分、SOFA评分、乳酸水平、MODS发病率、DIC发病率,采取相应处理措施以缩短患者治疗时间。     

Interaction of estrone and estradiol with DNA and protein of liver and kidney in rat and hamster in vivo and in vitro

[6,7-³H] Estrone (E) and [6,7-³H]estradiol-17 (E₂) have been synthesized by reduction of 6-dehydroestrone and 6-dehydroestradiol with tritium gas. Tritiated E and E₂ were administered by oral gavage to female rats and to male and female hamsters on a dose level of about 300 g/kg (54 mCi/kg). After 8 h, the liver was excised from the rats; liver and kidneys were taken from the hamsters. DNA was purified either directly from an organ homogenate or via chromatin. The radioactivity in the DNA was expressed in the units of the Covalent Binding Index, CBI = (mol chemical bound per mol DNA-P)/(mmol chemical administered per kg b.w.). Rat liver DNA isolated via chromatin exhibited the very low values of 0.08 and 0.09 for E and E₂, respectively. The respective figures in hamster liver were 0.08 and 0.11 in females and 0.21 and 0.18 in the males. DNA isolated from the kidney revealed a detectable radioactivity only in the female, with values of 0.03 and 0.05 for E and E₂, respectively. The values for male hamster kidney were < 0.01 for both hormones. The minute radioactivity detectable in the DNA samples does not represent covalent binding to DNA, however, as indicated by two sets of control experiments. (A) Analysis by HPLC of the nucleosides prepared by enzyme digest of liver DNA isolated directly or via chromatin did not reveal any consistent peak which could have been attributed to a nucleoside-steroid adduct. (B) All DNA radioactivity could be due to protein contaminations, because the specific activity of chromatin protein was determined to be more than 3,000 times higher than of DNA. The high affinity of the hormone to protein was also demonstrated by in vitro incubations, where it could be shown that the specific activity of DNA and protein was essentially proportional to the concentration of radiolabelled hormone in the organ homogenate, regardless of whether the animal was treated or whether the hormone was added in vitro to the homogenate.Carcinogens acting by covalent DNA binding can be classified according to potency on the basis of the Covalent Binding Index. Values of 10³–10⁴ have been found for potent, 10² for moderate, and 1–10 for weak carcinogens. Since estrone is moderately carcinogenic for the kidney of the male hamster, a CBI of about 100 would be expected. The actually measured limit of detection of 0.01 places covalent DNA binding among the highly unlikely mechanisms of action. Similar considerations can be made for the liver where any true covalent DNA binding must be below a level of 0.01. It is concluded that an observable tumor induction by estrone or estradiol is unlikely to be due to DNA binding.Paper presented at the Satellite Symposium of the European Society of Toxicology, Rome, March 29, 1983     

Penetration and action of edoxudine in vitro and in vivo

The penetration of 5-ethyl-2'-deoxyuridine (edoxudine, Aedurid) from gel base with and without the addition of urea and other adjuvant has been studied in an in vitro model using guinea pig skin. The formulation of 3% edoxudine gel with 5% urea showed the best results. In vivo experiments on hairless mice infected intracutaneously with herpes simplex virus type 1 also showed this formulation's good efficacy as compared to other formulations.     

Mechanisms of antiplatelet and antithrombotic activity of midazolam in in vitro and in vivo studies

Dopamine regulates various physiological functions in the central nervous system and the periphery. Dysfunction of the dopamine system is implicated in a wide variety of disorders and behaviors including schizophrenia, addiction, and attention-deficit hyperactivity disorder. Medications that modulate dopamine signaling have therapeutic efficacy on the treatment of these disorders. However, the causes of these disorders and the role of dopamine are still unclear. Studying the dopamine system in a model organism, such as Caenorhabditis elegans, allows the genetic analysis in a simple and well-described nervous system, which may provide new insight into the molecular mechanisms of dopamine signaling. In this review, we summarize recent findings on pharmacological and biochemical properties of the C. elegans dopamine receptors and their physiological role in the control of behavior.     

Extraction and determination of prednisolone in drugs and excipients in ointments and creams and the uniformity of distribution in prednisolone ointment

For the purpose of measuring the contents of prednisolone in low concentrated ointments and creams an instruction was elaborated that includes several steps of extraction, in the resulting solution of which the assay of the steroid by Blue Tetrazolium reaction will be done. The procedure permits the determination of prednisolone in presence of most of usual ingredients of ointment bases except wool alcohols. Also no influence is given by some remedies combined with prednisolone for topical application except coal tar solution. The results confirm a correct reflection of the steroid contents declared respectively the recovery of the steroid added to various ointment bases. Introducing discussion to content uniformity concerning low concentrated ointments is made, and some deviations are shown.     

Comparative in vivo and in vitro studies of phenytoin protein binding and in vitro lipolysis in plasma of pregnant and nonpregnant rats

This investigation was designed to determine the cause of the changes in drug protein binding that occur in rat plasma, particularly in plasma from pregnant animals, during in vitro drug-protein binding measurements. In vivo estimates of phenytoin binding in plasma were obtained from steady-state CSF-plasma concentration ratios in pregnant and nonpregnant rats. Immediate ultrafiltration of heparin- or EDTA-anticoagulated plasma yielded phenytoin free fraction values that were in good agreement with in vivo estimates for nonpregnant rats but that were about one-third higher than in vivo estimates for pregnant animals. In vitro free fraction values tended to increase during incubation of plasma and/or during equilibrium dialysis. The concentrations of the four major endogenous free fatty acids were similar in plasma of pregnant and nonpregnant rats if determined immediately after blood collection. Six hours of incubation at 37 degrees C caused fatty acid concentrations to increase about fivefold and twofold in heparin-anticoagulated plasma from pregnant and nonpregnant animals, respectively. The corresponding increases in EDTA-anticoagulated plasma were only about twofold and 1.14-fold, respectively. These changes were associated with decreased plasma protein binding of phenytoin. The in vivo differences between pregnant and nonpregnant rats with respect to phenytoin binding in plasma are not due to differences in fatty acid concentrations, but the in vitro differences are due primarily to corresponding differences in free fatty acid concentrations if extensive in vitro lipolysis occurs.     

Mathematical modelling of in situ and in vitro efflux of ciprofloxacin and grepafloxacin

The efflux process due to p-glycoprotein-like mechanisms of ciprofloxacin (CIP) and grepafloxacin (GRX) has been studied "in situ" in rats and "in vitro" in Caco-2 cells. The results were modelled by a curve fitting procedure which allowed the characterization of the passive (Pd) and carrier mediated parameters (Vm and Km) from the raw data without initial velocities estimation. CIP absorption in rat was characterized as a passive diffusion at the assayed concentrations. Although the involvement of an efflux transporter cannot be ruled out, its relevance in the transport of the fluoroquinolone is negligible. In GRX absorption, an efflux process is implicated and it is detected in both absorption models. GRX permeability depends on the intestinal segment, reflecting the previously reported different expression level of the efflux transporters along the gut in rat. A first attempt to correlate the "in vitro" and the "in situ" data has been done. The mathematical model has been constructed using very simplistic assumptions and it will require further refinement but, nevertheless, the results are promising and demonstrate that a good modelling approach helps to identify the system critical parameters and how the system behaviour change when the parameters are modified as it happens when we move from the "in vitro" to the "in situ" level. Predicted versus experimental permeability values show a good correlation, demonstrating that the relevance of the secretion process "in situ" in rat can be predicted from the "in vitro" cell results.     

Comparison of in vitro and in vivo developmental toxicity and pharmacokinetics of phenytoin in the rat

The rat whole embryo culture was compared to an in vivo experiment with regard to embryotoxicity as well as exposure characteristics, using phenytoin as a model compound. Intra-embryonic concentrations and their embryotoxic effects were determined on gestation day 11 after in vitro administration of 50-150 microg/ml or in vivo gavage of 500-1500 mg/kg body-weight on gestation day 10. In addition, exposure kinetics were studied in vivo after a single oral dose on gestation day 10, and developmental defects on gestation day 21 were scored. The embryotoxic effects observed on gestation day 11 were more pronounced after in vitro exposure in comparison to in vivo exposure at similar intra-embryonic concentrations. Exposure of phenytoin on gestation day 10 in vitro via the culture medium resulted in general embryotoxicity on gestation day 11, whereas in vivo effects as determined on gestation day 11 were minimal. Plasma concentrations of phenytoin increased and plateaued around 35 microg/ml during the 48 hr monitoring period. Plasma concentration curves and pharmacokinetic parameters did not show remarkable differences between the dose groups, indicating that absorption is the limiting factor at the dose range used. Although the developmental effects were minimal as observed in vivo on gestation day 11, specific malformations (defects encompassing the urogenital. craniofacial and skeletal systems) were observed on gestation day 21. These findings show that with similar intra-embryonic concentrations of phenytoin the embryotoxicity in rat whole embryo culture was not comparable with the in vivo embryotoxicity as determined on gestation day 11. This discrepancy may at least partly be explained by differences in exposure characteristics.     

Comparison of pulmonary and hepatic glucuronidation and sulphation of ethanol in rat and rabbit in vitro

1. Pulmonary and hepatic UDP-glucuronyltransferase and sulphotransferase activities in subcellular fractions from rats and rabbits were determined, comparing ethanol with known substrates for these enzymes.

2. No ethyl glucuronide formation was detected with either hepatic or pulmonary microsomal incubations.

3. Chromatographic, autoradiographic and scintillation counting analysis indicated that ethanol is sulphated by rat and rabbit pulmonary cytosol, although this activity was approx. 2–6% of that in liver.

4. Rat hepatic and pulmonary sulphotransferase activities with β-naphthol were approx. 13 and 60 times higher than with ethanol, respectively.

5. Rabbit hepatic and pulmonary sulphotransferase activities with both substrates were higher than those in rat.