Effect of uremia on rates of ethanol disappearance from the blood and on the activities of the ethanol-oxidizing enzymes.

The effect of uremia on ethanol metabolism was investigated. Uremia was induced in male Spraque-Dawley rats by removal of approximately 85 per cent of the renal mass. Control animals had a sham operation. The mean activity of alcohol dehydrogenase was markedly increased in the uremic rats to 2.12 +/- 0.13 (S.E.M.) mumoles per milligram of protein per hours as compared with a control value of 1.39 +/- 0.13 mumoles per milligram of protein per hour (p less than 0.001). There were no changes in the activity of the microsomal ethanol oxidizing system, in catalase activity present in the microsomes, or in the rates of ethanol disappearance from the blood. Uremia resulted in decreases in microsomal cytochrome -450, but no changes in cytochrome b5, NADPH-cytochrome c reductase, or in the activities of aniline hydroxylase and aminopyrine demethylase. The increase in alcohol dehydrogenase activity could not be reproduced by incubation of liver from a normal rat with uremic rat plasma, uremic human serum, or urea. Also, the increase in the enzyme activity was not associated with changes in leucocyte ascorbic acid levels. The cause and physiologic significance of the increase in alcohol dehydrogenase activity in uremia remain to be elucidated.     

Reduced beta-adrenoceptor sensitivity in the elderly.

The effect of age on sensitivity to both isoproterenol and propranolol has been investigated in 27 male volunteers aged 21 to 73 yr. The dose of isoproterenol (given as a rapid intravenous injection) required to increase the resting heart rate by 25 bpm (I25) increased with age. The I25 was repeated during an intravenous infusion of propranolol and the dose ratio (I25 after propranolol divided by the control I25) determined. This was related to the concentration of free propranolol in plasma. It was found that the effectiveness of any given free concentration diminished progressively with age. These data are consistent with a diminished responsiveness of the beta-adrenoceptor to both agonist and antagonist drugs with advancing years.     

Effects of cyclopentyladenosine on isoproterenol response in adult and senescent cardiac tissue from Fischer 344 rats

To characterize age-related changes in beta-adrenergic responsiveness and to test the hypothesis that an increase in the effects of adenosine contribute to impaired beta-adrenergic responsiveness, Fischer 344 rat right atria (RA), left atria (LA), and left ventricular trabeculae carnae were exposed to the beta-receptor agonist isoproterenol (ISO), followed by four doses of the selective adenosine A(1) receptor agonist cyclopentyladenosine (CPA). Spontaneous contractile rates of adult RA were inhibited more than senescent RA by CPA. Contractility (+dF/dt) of adult LA was reduced more than senescent LA by CPA. Left trabeculae carnae tissue responded weakly to CPA, but senescent tissue was less responsive than adult tissue. Senescent atrial A(1) receptor density was 56% greater than in adult tissue, whereas the density in senescent ventricles was 39% lower than in adult tissue. No significant difference in antagonist affinities (K(d)) of A(1) receptor was observed between adult and senescent atria. In addition, agonist competition curves indicated a significant increase in senescent atrial and a decrease in senescent ventricular tissue in the affinity of agonist for high-affinity A(1) receptors with no difference in dissociation constant (K(i)). No significant age-related differences in atrial or ventricular tissues occurred in either the antagonist affinity (K(d)) or density (B(max)) of the beta-adrenergic receptors. CPA was found to inhibit ISO-stimulated adenylate cyclase activity more in senescent than in adult atrial and ventricular membrane preparations. We conclude that age-related differences in functional response to ISO and CPA, A(1) receptor density, and ISO-stimulated adenylate cyclase activity differ in atrial and ventricular myocardium.     

急性缺血性卒中影像学检查的建议——美国心脏协会的科学声明（上）

卒中是一种常见、严重的疾病,仅美国每年的新发病例就高达795000例,并已成为全世界人类死亡和残疾的主要病因。10年前,重组型组织纤溶酶原激活剂（recombinant tissue plasminogen activator,rt—PA）被批准用于治疗急性缺血性卒中。rt—PA应用指南建议,应在卒中发病后3h内静脉给予rt—PA,给药前应行头部CT检查,排除颅内出血。     

急性缺血性卒中影像学检查的建议——美国心脏协会的科学声明（中）

2．3核磁共振血管成像（MRA） 2．3．1背景和方法：在头部MRI检查中常结合MRA,用于急性卒中患者病情评估以指导治疗决策的制定^[19]。日前,有几种不同的MRA技术用于脑血管成像,包括二维时间飞跃（timeof-flight,TOF）序列、三维TOF序列、     

急性失代偿性心力衰竭患者血清肌钙蛋白T水平检测的价值

目的：研究肌钙蛋白T的水平变化在急性失代偿性心力衰竭患者预后的价值。方法：选取急诊重症监护室收治的68例急性失代偿性心力衰竭患者,按照cTnT的水平分为cTnT阳性组（27例）和cTnT阴性组（41例）。观察两组患者室性期前收缩发生率、APACHEⅡ评分、在ICU入住时间、住院时间、住院病死率、随访出院后6个月内再入院率及6个月死亡率。结果：两组治疗期间利尿剂、扩血管药物使用、多巴胺和（或）多巴酚丁胺的使用和两组患者6个月随访期间死亡率比较差异无统计学意义（P〉0.05）。入院时APACHEⅡ评分、在ICU入住时间、住院时间、住院病死率及出院后6个月内再入院率比较均显示差异有统计学意义（P〈0.05）。结论：肌钙蛋白T水平是与治疗无关的危险因素之一。伴有肌钙蛋白T升高的急性失代偿性心力衰竭患者有较高的室性期前收缩发生率、较长的住院时间、短期预后差,监测cTnT水平对急性失代偿性心力衰竭患者的病情评估和短期预后有重要作用。     

Major complications after 400 continuous popliteal sciatic nerve blocks for post‐operative analgesia

Background: A continuous popliteal sciatic nerve block (CPSNB) has been performed with increasing frequency for post‐operative analgesia after foot surgery. Major complications associated with the placement of a perineural catheter remain rarely studied. The aim of this study was to prospectively determine the incidence of major complications (neurological and infectious) in post‐operative adult patients with a continuous popliteal catheter inserted by the anatomical posterior approach for analgesia after foot surgery. Methods: All popliteal catheters were placed pre‐operatively under sterile conditions with the aid of a nerve stimulator technique. The primary outcome measure was the incidence of major complications including infection and neuropathy. As a secondary outcome, adverse effects as well as other complications were also evaluated. Data were expressed as median [25th–75th percentiles]. Results: A total of 400 patients were included in the study during a 2‐year period. The median time the catheter remained indwelling was 47 h [23, 54]. Major complications included three events (0.75%) with one infection (0.25%) and two neuropathies (0.50%). Three blocks were unsuccessful and the catheter insertion was difficult in 12 patients (3%). During the CPSNB procedure, one patient reported slight paraesthesia during stimulation. Patient satisfaction was scored at 4 for 89%, 3 for 6% and 2 for 5% on the analogue scale. Conclusions: Major complications after the use of CPSN are not in fact rare. The incidence of severe neuropathy or infection complications is, respectively, 0.50% and 0.25%. However, the insertion of CPSN could be considered effective and is associated with only a few minor complications.     

三维适形放疗结合252锎中子腔内后装照射治疗中晚期食管癌的临床研究

目的：探讨三维适形放疗结合锎（252Cf）中子腔内后装照射治疗中晚期食管癌的疗效、不良反应及晚期并发症。方法：92例中晚期食管癌患者全部采用三维适形放疗结合锎（252Cf）中子腔内后装照射治疗。三维适形放疗总剂量为45Gy-54Gy,分25-30次,5-6周完成;腔内照射3-4Gy/次,1次/周,共2-4次,总吸收剂量10Gy-16Gy。结果：治疗结束3个月进食梗阻缓解率为95%。近期疗效：完全缓解（CR）27%,部分缓解（PR）69.6%。1、2、3年局部控制率分别为82%、51%、32%;1、2、3年生存率分别为：78%、35%、18%;急性放射性食管炎发生率为54%;晚期食管狭窄发生率9%;食管穿孔发生率2%。结论：中晚期食管癌采用三维适形放疗结合锎（252Cf）中子腔内后装照射能够迅速而持久地缓解进食梗阻症状,提高局部控制率及生活质量,近期疗效显著,放疗不良反应未见明显增加。     

广西鼠疫指示动物犬血清IHA、ELISA检测鼠疫F1抗体的一致性研究

目的 了解应用IHA、ELISA检测鼠疫F1抗体的一致性,评价方法的优劣,以便更好地制订鼠疫监测的方法及防治策略.方法 对广西鼠疫监测点隆林、西林县的犬血清使用IHA及ELISA两种试验方法,并进行一致性研究,评价IHA与ELISA方法的可靠性.结果 IHA检测鼠疫F1抗体阳性率为0,ELISA检测鼠疫F1抗体的总阳性率为4.4%(12/273);IHA与ELISA之间的一致性为95.6%,其Kappa值等于0,呈轻度一致.结论 间接血凝试验方法特异、操作简便是传统的鼠疫监测手段之一;酶联免疫吸附试验具有敏感性高、特异性强、操作简便等特点,且与间接血凝试验有轻度一致性,适宜在鼠疫监测中推广应用.