紫外线照射自血回输疗法对梭曼染毒家兔全血胆碱酯酶活性的影响

目的 :探讨紫外线照射自血回输疗法 (AUVIB)对梭曼染毒家兔全血胆碱酯酶 (ChE)活性的影响。方法 :健康家兔 2 4只 ,随机分为 4组 :阴性对照组 ,中毒组 ,常规治疗组及AUVIB治疗组 ,观察染毒家兔血常规及胆碱酯酶活性变化。结果 :AUVIB治疗组ChE活性明显高于中毒组及常规治疗组 (P <0 .0 5 )。结论 :AUVIB疗法显著提高全血ChE活性 ,可应用于梭曼急性中毒的治疗。     

大鼠急性有机磷杀虫剂及其混剂中毒的单肌纤维肌电图研究

目的 探讨应用电刺激单肌纤维肌电图（SSFEMG）在不同刺激频率（5、10、20Hz)时检测神经－肌接头传导功能作为有机磷农药及其混剂中毒引起肌无力效应指标的意义。方法 利用SSFEMG技术观察有机磷类（乐果、辛硫磷）、氨基甲酸酯类（灭多威）农药及其混剂（辛硫磷＋灭多威、乐果＋灭多威）对大鼠神经－肌接头传导功能的影响，并在染毒前和染毒后1h测定大鼠全血胆碱酯酶（ChE)活力。结果 各染毒组大鼠肌无力发生的情况为：乐果5／9，辛硫磷5／10，灭多威0／9，辛硫磷＋灭多威8／8，乐果＋灭多威5／5；肌无力大鼠单肌纤维动作电位平均连续差（MCD）明显高于对照组，辛硫磷和乐果组中的肌无力大鼠MCD明显高于同线肌力正常者，差异均有显著性（P＜0．05）。刺激频率为10Hz和20Hz的SSFEMG检测结果与大鼠肌无力症状一致性均较好；肌无力的出现与ChE的抑制程度不完全一致。结论 有机磷所致肌无力与神经－肌接头传导功能异常关系密切，刺激频率为10Hz和20Hz的SSFEMG可用作有机磷农药所致肌无力的一个效应指标。     

Diisopropylfluorophosphate-induced depression of segmental monosynaptic transmission in neonatal rat spinal cord is also mediated by increased axonal activity

Involvement of dorsal and ventral root activity for the depressant action of diisopropylfluorophosphate (DFP) on synaptic transmission was examined using in vitro spinal cord/root preparations. Superfusion of DFP produced a dose-dependent depression of monosynaptic reflex (MSR) and maximal depression of about 80% occurred at 1000 μM. The concentration to produce 50% of the maximal inhibition was about 100 μM of DFP. The DFP (100 μM)-induced depression of MSR was reversed by atropine (0.5 μM) but not by mecamylamine (0.5 μM). Contrary to the action on MSR, DFP potentiated the ventral root potential and 1st peak of dorsal root potential. The maximal potentiation was about 25% of control in both the root potentials at 100 μM of DFP. However, the second peak of dorsal root potential was slightly depressed (10–20% of control) by DFP (1–1000 μM). Further, the cords treated with DFP (100 μM) showed significant decrease in the cholinesterase (ChE) activity (27% of control). Results suggest that the DFP-induced depression was mediated at least by two different mechanisms, one through the inhibition of ChE activity and the other through the activation axonal activity having inhibitory inputs to the segmental synaptic transmission. These inputs mediate their action through muscarinic receptors.     

前白蛋白、胆碱酯酶与胆汁酸对慢性乙型病毒性肝炎病理分级临床价值的研究

目的 明确前白蛋白(PAB)、胆碱酯酶(CHE)及胆汁酸(TBA)判断慢性乙型病毒性肝炎患者肝脏炎症分级及纤维化分期的价值。方法 检测72例经肝活检证实的慢性乙型病毒性肝炎患者血清PAB、CHE及TBA水平,并与肝活检组织炎症分级、纤维化分期进行对照研究。结果 肝脏病理组织炎症分为G1-G4级,纤维化分为S1-S4期。炎症轻重两组间ALT、PAB及CHE有显著性差异(P<0.01),TBA无显著性差异(P>0.05)。随着纤维化程度的加重,ALT变化无规律,PAB、CHE逐渐下降,TBA逐渐升高,且S4与S1、S2、S3比较有显著性差异(P<0.05)。ALT、PAB及CHE与炎症分级均有良好的相关性(P<0.01);CHE、TBA与纤维化分期存在良好的相关性(P<0.01),PAB与纤维化分期存在较弱的相关性(P<0.05)。结论 PAB、CHE较敏感反映慢性乙型病毒性肝炎患者肝脏的炎症程度,三个指标在一定程度上可以提示早期肝硬化。     

全血胆碱酯酶在老年COPD患者中的表达研究和临床价值分析

目的探讨老年慢性阻塞性肺病（COPD）与全血胆碱酯酶的关系及相关临床意义。方法选取65例老年COPD患者作为观察组,80例健康老年人作为对照组,两组均清晨空腹抽取静脉血,采用IL-1620血气分析仪测定全血胆碱酯酶的水平。结果COPD患者bl—ChE各临床分级与对照组比较,差异有统计学意义（F=3．830,P=0．011）;两两比较,COPDII、III、IV级的bl-ChE水平低于对照组（P〈0．05或0．01）。e—ChE各临床分级与对照组比较,差异有统计学意义（F=6．328,P=0．042）;两两比较,COPDIII、IV级的e—ChE低于对照组（P〈0．05）。p-ChE各临床分级与对照组比较,差异无统计学意义（F=1．062,P=0．563）。COPDII、III、IV级治疗前后差异均有统计学意义（P〈0．05或0．01）,治疗后全血胆碱酯酶活力升高。结论全血胆碱酯酶可作为评价老年COPD的有效指标,有重要临床参考价值。     

仙人掌对家兔有机磷中毒解救情况的研究

目的探讨仙人掌对家兔有机磷中毒解救情况。方法选择6只成年家兔为研究对象并随机分为6组。采用10％敌百虫液灌胃和仙人掌、阿托品解救,观察家兔在给药解救后各时间点ChE活性的变化情况。结果与对照组比较,实验组家兔的中毒症状解救情况明显加快,ChE浓度亦存在差异,差异有统计学意义（F=12．963,P=0．024）。结论仙人掌对家兔有机磷中毒解毒有效且剂量越大解救时间越早效果越好。     

Erhebung des Ernährungszustandes — ein Bestandteil der klinischen Routine-Diagnostik: Cholinesterase-Aktivität als Ernährungsindikator

Summary Nutritional assessment has not yet been established as integral part of basic clinical diagnostic procedures everywhere, eventhough the prognostic relevance of malnutrition is well known. One of the reasons is the the lack of nutritional indicators, which are specific of and sensitive for changes of the nutritional status on the one hand, and routinely analyzed on the other. We report on the utility of serum cholinesterase, which has the shortest half-life of all plasma proteins, to identify malnourished patients. 54 internal inpatients with malignant diseases or in septic state were followed up prospectively with respect to courses of cholinesterase (CHE), albumin (ALB), transferrin (TRA), and body weight over periods of 4 weeks. A correct correlation to malnutrition was defined as plasma concentrations < reference ranges or continuous concentr. fall >10%. Based on 132 observations (65 with continuous weight loss, mean: –5.5% of original w.; 54 w. gain, mean +4,6%, 13 constant w.), changes of CHE had the highest correlation to weight changes (r=0.79,p<0.001), compared to the courses of TRA-or ALB-levels (r=0.65/0.68). Incorrect positive results (conc. fall or conc. < ref. range without weight loss): absolute levels — CHE 4%, ALB 4%, TRA 22%; conc. courses — CHE 0%, ALB 0%, TRA 6%. Incorrect negative: absolute c. — CHE 63%, ALB 30%, TRA 28%; courses — CHE 15%, ALB 19%, TRA 17%. The common determination of CHE and ALB-courses allowed a correct identification of malnutrition in 96% of all observations, with the same result as the courses of ALB + TRA. Because of its wide ref. ranges, the absolute CHE activity is useless for nutritional screening in contrast to ALB and TRA, but the follow-up of CHE-levels allows an excellent discrimination between good and bad nutritional status. The use of the CHE-course can be recommended as nutritional indicator, if TRA-analysis is not available.

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Abkürzungen ALB Albumin - CHE Cholinesterase - GEW Körpergewicht - OKG Optimales Körpergewicht - TRA Transferrin - MW Mittelwert - SD Standardabweichung - m männlich - w weiblich Herrn Prof. Dr. W. Kaufmann zur Vollendung des 65. Lebensjahres gewidmet.     

卡巴拉汀治疗血管性痴呆的开放性多中心随机对照研究

目的评价重酒石酸卡巴拉汀治疗血管性痴呆(VD)的疗效和安全性。方法多中心、随机、开放、对照试验。5个城市7家医院共98例VD患者[简易精神状态检查(MMSE)10～26分],随机进入对照组(n=48)和卡巴拉汀治疗组(n=50),为期12周,受严重急性呼吸综合征(SARS)影响,13例脱落,最终对照组37例,治疗组48例。对照组应用改善血液循环的药物,治疗组在应用改善血液循环的药物的同时服用卡巴拉汀4.5～6.0mg/d。在患者入组时(基线期)和12周末进行疗效评价,采用MMSE、血管性痴呆评估量表认知分量表(VaDAScog)、日常生活能力量表(ADL)及阿尔茨海默病评估量表非认知分量表(ADASnoncog),评估患者在认知功能、日常生活能力及精神行为症状三方面的变化;以总体印象变化量表(ADCSCGIC)评估总体疗效。安全性检查包括每2～4周评估生命体征和在基线及研究终点进行实验室检查。结果治疗组在记忆力、定向力、注意力、结构运用能力等认知领域的测验分数有所改善,与对照组相比,治疗组的MMSE总分(12周末20.2±4.8,基线18.9±4.8,P=0.003)和数字倒背成绩(12周末3.5±1.5,基线4.2±1.8,P=0.01)提高;两组的日常生活能力较基线均无明显变化(P>0.05);治疗组妄想症状减轻(P=0.03),爱流泪现象减少(P=0.06)。总体印象评估治疗组65.1%的患者有改善,多于对照组(40.1%),两组差异接近统计学显著水平(P=0.06)。对照组和治疗组的总不良事件概率分别为8.1%～10.4%,两组差异无统计学意义。药物对患者生命体征及实验室指标无影响。结论卡巴拉汀可以改善VD患者的认知功能和行为症状,且安全性和耐受性良好,可作为VD治疗的候选药物。     

Interactions of morphine and nalorphine with physostigmine on operant behavior in the rat

Morphine and nalorphine were tested alone and in combination with physostigmine (0.0625 mg/kg) in rats trained under a continuous avoidance schedule with an escape contingency. When tested alone, nalorphine increased avoidance rate in doses up to 32 mg/kg but exerted no other effects. Morphine, 1 mg/kg, increased avoidance response rate while higher doses produced a graded depression of all behavior. In the presence of physostigmine, nalorphine produced a well-defined graded depression of avoidance responding and increased the number of shocks received by the animals over a 16-fold dose range. Physostigmine failed to potentiate the prominent depressant effects of morphine in the same test situation. The finding that in the presence of cholinesterase inhibition nalorphine acts as a depressant of operant behavior in the rat supports existing evidence that cholinergic mediation should be considered as a factor in some of the actions of strong analgesics.Publication No. 1028 of the Division of Basic Health Sciences of Emory University. This investigation was supported by USPHS Grants SO-1-FR05364 and MH12870-04.A preliminary report of this investigation appeared in Fed. Proc, 30, 390 (1971).Postdoctoral trainee of NIH Graduate Pharmacology Training Grant GM-179 during part of this work.     

Regional pre- and postganglionic sympathetic activity during experimental paraoxon poisoning

The effects of 0.4 or 0.8 mg paraoxon/kg i.v. on circulation and regional pre- and postganglionic sympathetic activity were studied in anaesthetized rabbits. At both doses, the discharges of the preganglionic efferents increased slowly, whereas the changes in activity of postganglionic efferents differed. Concomitantly with a transient initial rise in blood pressure a temporary increase of discharges to the skeletal muscles and to the intestine was observed which is attributed to spontaneous firing of the regional ganglionic cells. After injection of 0.4 mg/kg there occasionally occurred a second pressor reaction conditioned by enhancement of preganglionic activity and facilitated transmission in certain sympathetic ganglia.After injection of the higher dose, postganglionic activity generally decreased except for the discharges of gastrointestinal efferents, which increased. Arterial blood pressure, cardiac output and total peripheral resistance fell markedly. A shock syndrome occurred which could be controlled by atropine injection if timely. From the results it was concluded that the higher dose of paraoxon blocked synaptic transmission in the paravertebral ganglia of the sympathetic trunk, and facilitated impulse transmission in the prevertebral abdominal ganglia.The authors dedicate this work in gratitude to Professor Dr. R. Domenjoz, on the occasion of his seventieth birthday