曲马多对母婴乳酸盐和新生儿神经行为的影响

目的　研究曲马多对母婴血乳酸盐和新生儿神经行为与适应能力评分 (NACS)的影响。方法　 6 0例足月妊娠剖宫产产妇随机分三组 :T0 组 ,2 0例 ,肌注 0 9%氯化钠 2ml;T1组 2 0例 ,肌注曲马多 1 5mg/kg ;T2 组 ,2 0例 ,肌注曲马多 2mg/kg。各组肌注后开始麻醉 ,三组均采用脊麻与硬膜外联合阻滞。观察指标 :新生儿生后 15min的Apgar评分及新生儿生后 15min的NACS ;胎儿娩出时采脐动、静脉血和母体动脉血各 2ml,行血乳酸值测定及血气分析。结果　三组新生儿Apgar评分无明显差异 ,T0 组NACS明显高于T1组 (P <0 0 5 )和T2 组 (P <0 0 1) ;T2 组脐动、静脉血乳酸值明显高于T1组 (P <0 0 5 )和T0 组 (P <0 0 1) ;母体乳酸值三组间无明显差异 ;T2 组母体和脐动、静脉血PaCO2 明显高于T0 组 (P <0 0 1) ,T2 组脐动、静脉血SaO2 明显低于T0 组 (P <0 0 5 )。结论　剖宫产术前肌注曲马多 1 5mg/kg对新生儿无明显不良影响。但 2mg/kg曲马多肌注具有呼吸抑制作用 ,使脐动、静脉血乳酸盐增加 ,对新生儿NACS有一过性影响     

Effects of malnutrition on the erythrocyte fatty acid composition and plasma vitamin E levels of Pakistani children

Abstract Erythrocyte fatty acids and plasma vitamin E concentrations were determined in 47 grade 2 and 21 grade 3 malnourished Pakistani children (ages 4–56 months). Data were compared with those of 26 age- and sex-matched apparently healthy controls. Evaluation with three statistical approaches revealed that both grade 2 and grade 3 malnourished children had decreased erythrocyte ω6 fatty acids and to a lesser extent decreased ω3 fatty acids. These decreases were compensated for by increased ω9 fatty acids. The patients tended to have lower plasma vitamin E concentrations. We conclude that malnourished Pakistani children have low essential fatty acid status, notably those of the ω6 series. The combination of low erythrocyte 22:6ω3 and a low 22:5ω6/22:4ω6 ratio in grade 2 patients suggests low Δ4-desaturation activity, which may be due to impaired peroxisomal β-oxidation.     

Ventrolateral medullary lesions block the antinociceptive and cardiovascular responses elicited by stimulating the dorsal periaqueductal grey matter in rats

In rats anaesthetised with Saffan (Glaxovet), inhibition of the tail flick reflex evoked by electrical stimulation in the dorsal periaqueductal grey matter (PAG) was accompanied by an increase in blood pressure, tachycardia, vasodilatation in hind limb muscle, an increase in respiration, pupillodilatation and widening of the palpebral fissure. Stimulation deeper in the PAG and in the tegmentum ventral to it produced analgesia but without this pattern of autonomic changes. The antinociceptive, cardiovascular and respiratory effects of PAG stimulation were abolished by bilateral lesions in the ventrolateral medulla in the area which lies ventromedial to the facial nucleus (i.e., in nucleus paragigantocellularis lateralis, RPGL). Lesions in nucleus raphe magnus (NRM), or bilateral lesions of nucleus reticularis gigantocellularis (RG) and paragigantocellularis (RPG) or a combination of a lesion in RPGL with one in NRM or the contralateral RG or RPG did not block the effects of stimulating in the dorsal PAG. These findings are discussed in relation to the role of the PAG in mediating behavioural responses to stress.     

Projections from the diencephalon and mesencephalon to nucleus paragigantocellularis lateralis in the cat

The distribution of labelled cells in the diencephalon and mesencephalon has been mapped following injections of horseradish peroxidase into nucleus paragigantocellularis lateralis in the cat. Most of the labelled cells were found ipsilateral to the injection site. A group of small and medium-sized labelled perikarya (11-40 microns in diameter) was present in the caudal part of the periaqueductal grey matter (A3-P2) and in the adjacent tegmentum. Small, round or fusiform cells (8-25 microns were labelled in the tuberal region of the hypothalamus in the dorsomedial hypothalamus and in the lateral hypothalamic area. It is suggested that the cardiovascular responses which can be elicited by stimulation in these regions of the periaqueductal grey and hypothalamus are mediated via a relay on to spinally projecting neurones in nucleus paragigantocellularis lateralis which synapse on sympathetic preganglionic neurones in the intermediolateral cell column.     

Descending projections from the ventrolateral medulla and cardiovascular control

Antidromic responses were evoked in neurones in nucleus paragigantocellularies lateralis (PGL) by stimulation of the ipsilateral ventrolateral white matter or the contralateral dorsolateral white matter at T13-L1 in the cat. Estimated conduction velocities in the spinally projecting axons ranged from 5.0–61 m/s.Stimulation of cell bodies in PGL, by microinjection ofd,l-homocysteic acid, usually produced a rise in blood pressure accompanied by tachycardia or bradycardia and either dilatation or constriction in the hindlimb muscle vasculature.It is suggested from this other and evidence that tonically active neurones in PGL may play a role in setting the resting level of blood pressure but that the output of these and other cells in the nucleus may also be modified to generate different patterns of cardiovascular adjustment.     

Constitutive expression of platelet glycoproteins by the human leukemia cell line K562

The human leukemia cell line K562 was derived from a patient with chronic granulocytic leukemia. This cell line has subsequently been shown to possess phenotypic markers typical of erythroid and myeloid cells. Using a rabbit antiserum directed against purified platelet glycoproteins (PGPs), we have obtained evidence for the constitutive expression of PGPs on the surface of K562 cells. PGPs expressed have been tentatively identified as IIa and III based on their apparent migration in a 7% sodium dodecylsulfate polyacrylamide gel. K562 may become an important tool for the study of early events involved in megakaryocytic differentiation.     

Percutaneous transluminal angioplasty: the treatment of choice for renovascular hypertension due to fibromuscular dysplasia

Twenty-three renal artery stenoses in 21 hypertensive patients, caused by fibromuscular dysplasia, were treated with percutaneous transluminal angioplasty (PTA). Follow-up over a period of 1 to 30 months, including angiography, renal vein renin assay, and radionuclide flow studies, was performed in 8 patients, each with one stenosis. Dilatation was initially successful in all cases and was successfully repeated in 1 case. The mean systolic pressure decreased by 61.81 mm Hg and the mean diastolic pressure by 36.28 mm Hg in response to treatment. Thirteen patients were cured, 8 were felt to have better control of blood pressure on medication, and there was no failures. This study demonstrates that PTA is a clinically effective method of treating renovascular hypertension due to fibromuscular dysplasia.