Changes in the incidence and duration of ventricular fibrillation in dependence on the extraneuronal accumulation of isoprenaline in the perfused rat heart

Summary The relationship between the accumulation of isoprenaline and the incidence and duration of ventricular fibrillation was investigated in the perfused rat heart. Isolated rat hearts were perfused with ³H-isoprenaline (1 mol/l) for 30 min at a constant flow rate of 6.5 ml/min at a temperature between 40 and 41° C. Electrocardiograms were recorded during the perfusion period and the isoprenaline content of the tissue was measured after the perfusion. The accumulation of isoprenaline was significantly increased and the duration of ventricular fibrillation was significantly prolonged by the presence of tropolone (100 mol/l). When extraneuronal uptake inhibitors such as normetanephrine (100 mol/l), 3-O-methylisoprenaline (100 mol/l) or phenoxybenzamine (1 mol/l) were added to the perfusion fluid containing ³H-isoprenaline (1 mol/l) and tropolone (100 mol/l), the accumulation of isoprenaline was sifnificantly decreased, the incidence of ventricular fibrillation was significantly reduced and the duration of ventricular fibrillation was significantly shortened. There was a significant correlation for dependence of duration of ventricular fibrillation on the isoprenaline content of rat hearts perfused with various extraneuronal uptake inhibitors in the presence of tropolone (correlation coefficient [r]=0.62, P<0.001).These results indicate that the accumulation of isoprenaline in perfused rat hearts relates to the occurrence and duration of ventricular fibrillation.This study was supported in part by a Grant-in-Aid for Scientific Research (59570980) from the Ministry of Education, Science and Culture, Japan     

Model-independent assessment of accumulation kinetics based on moments of drug disposition curves

Summary The bounds of the accumulation profile can be predicted on the basis of the mean disposition residence time (MDRT) of a drug. The time to reach 90% of the plateau level (t _0.9) is less than 3.7 MDRT. This prediction can be improved if, in addition, the variance of disposition residence time (VDRT, CV _D ² =VDRT/MDRT²), or the terminal exponential coefficient (), is known. For CV _D ² 1 or MDRT1, the time to reach steady state (t_0.9) approaches 2.3 MDRT (limiting case of monoexponential drug disposition curve). Conditions are stated under which can be regarded as the principal determinant of the accumulation rate.     

人体测量指标预测肥胖儿童非酒精性脂肪肝的研究

目的 研究人体测量指标对儿童肥胖伴非酒精性脂肪肝的预测作用,探讨不同指标筛查非酒精性脂肪肝的切点值。方法 选取自2018年6月—2019年12月在西安交通大学第二附属医院小儿内分泌门诊就诊的94例肥胖儿童为研究对象,进一步分为肥胖伴非酒精性脂肪肝组与肥胖不伴非酒精性脂肪肝组,52例正常儿童为对照组。测量身高(H)、体重(W)、腰围(WC)、臀围(HC)和血甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C);行肝脏B超的检查。计算体质指数(BMI)、腰臀比(WHR)、腰高比(WHtR)、腹部体积指数(AVI)、脂质蓄积指数(LAP)和内脏脂肪指数(VAI)等指标。通过绘制人体测量指标的受试者工作特征曲线(ROC曲线)评估人体测量指标与肥胖儿童非酒精性脂肪肝的相关性,并比较各项人体测量指标的曲线下面积(AUC)确定切点值。结果 肥胖组BMI、WC、WHR、WHtR、AVI、LAP、VAI及TG均高于对照组(t=23.090、21.068、12.547、22.855、17.578、8.159、5.394、6.183,P＜0.001)。肥胖伴非酒精性脂肪肝组BMI、WC、AVI、LAP、VAI均高于肥胖不伴非酒精性脂肪肝组(t=2.180、2.389、2.362、3.643、2.839,P＜0.05)。人体测量指标的ROC曲线下面积按从大到小的顺序依次为 LAP、VAI、 WC、 AVI、 BMI。对肥胖伴非酒精性脂肪肝的联合诊断指标进行筛查效能分析结果显示,LAP+AVI 曲线下面积为0.706(95%CI:0.595~0.817,P＜0.001);AVI+VAI 曲线下面积为0.685(95%CI:0.570~0.800,P＜0.01);BMI+WC 曲线下面积为0.652(95%CI:0.537~0.768,P＜0.05)。联合指标的ROC曲线下面积从大到小为LAP+AVI、AVI+VAI、BMI+WC。结论 LAP联合AVI对儿童肥胖伴非酒精性脂肪肝具有较好的筛查作用。     

加味瓜蒌枳实汤联合哌拉西林钠他唑巴坦钠对痰热蕴肺型卒中相关性肺炎患者的免疫功能和血清炎症因子水平的影响

目的：探究加味瓜蒌枳实汤联合哌拉西林钠他唑巴坦钠对痰热蕴肺型卒中相关性肺炎(SAP)患者的免疫功能和血清炎症因子水平的影响。方法：将80例痰热蕴肺型SAP患者随机分为对照组与观察组,各40例,对照组SAP患者在基础治疗上加用哌拉西林钠他唑巴坦钠,观察组患者在对照组治疗基础上加用加味瓜蒌枳实汤,连续治疗2周,并比较两组SAP患者治疗前后的临床治疗效果、免疫指标、炎症指标及肺功能情况。结果：与本组治疗前比较,两组SAP患者治疗后X射线片病灶、肺啰音、咳嗽、发热、痰色、便秘评分均明显降低(P<0.05);两组SAP患者的第1秒内用力呼气量占呼气量的比例(FEV1/FVC)、第1秒用力呼气容积百分比(FEV1%)均明显改善(P<0.05)。与对照组治疗后比较,观察组患者的FEV1/FVC、FEV1%改善更明显(P<0.05)。与本组治疗前比较,两组SAP患者经治疗后中性粒细胞与淋巴细胞比值(NLR值)均明显降低(P<0.05);与对照组治疗后比较,观察组患者的NLR值明显降低(P<0.05)。与本组治疗前比较,两组SAP患者在治疗后的血清降钙素原(PCT)、超敏C...     

揿针穴位埋针对社区H型高血压 痰湿壅盛证的临床疗效研究

摘 要：目的： 探讨揿针穴位埋针对社区 H型高血压痰湿壅盛证的临床疗效,为 H型高血压的治疗提供参考。方法： 将 80例H型高血压痰湿壅盛证患者按照随机单盲法分为对照组（n=40）和治疗组（n=40）。对照组给予含马来酸依那普利叶 酸片（依叶片）的降压方案进行治疗。治疗组在对照组基础上给予揿针穴位埋针法进行治疗,连续治疗 28天后进行临床疗 效比较。结果： 治疗后,治疗组患者Hcy水平、中医证候积分较对照组显著降低;且治疗组证候积分比对照组显著减少;治 疗组患者血脂水平较对照组显著改善。结论： 在依叶片降压方案治疗的基础上,给予揿针穴位埋针可显著改善 H型高血压 痰湿壅盛证患者的血压、Hcy和血脂水平,且安全性较高,对肝肾功能无影响。     

自制穿刺床引流治疗肺底积液的临床应用研究

目的 自制穿刺床引流治疗肺底积液的可行性及临床意义。方法 使用穿刺床对１１例１２个肺底积液,２例,包裹性胸腔积液病人,在Ｘ光电视透视监测下穿刺引流,其中２例肿瘤所致肺底各病人下抽液后注入抗癌药治疗。结果 １２例肺底积液的１６次穿刺引流均获一次性成功,抽液量在８０～１５５０ｍｌ之间。胸膜内注药的２例患者,胸腔积液料得到满意控制。结论 自制穿刺床透用于流动型肺底积液、其它游离性胸腔积液及部分包裹性积液     

Vinflunine (20′,20′-difluoro- 3′,4′-dihydrovinorelbine), a novel Vinca alkaloid, which participates in P-glycoprotein (Pgp)-mediated multidrug resistance in vivo and in vitro

Vinflunine (VFL) is a novel derivative of vinorelbine (NVB, Navelbine®), which has shown markedly superior antitumor activity to NVB, in various experimental animal models. To establish whether this new Vinca alkaloid participates in P-glycoprotein (Pgp)-mediated multidrug resistance (MDR), VFL-resistant murine P388 cells (P388/VFL) were established in vivo and used in conjunction with the well established MDR P388/ADR subline, to define the in vivo resistance profile for VFL. P388/VFL cells proved cross-resistant to drugs implicated in MDR (other Vinca alkaloids, doxorubicin, etoposide), but not to campothecin or cisplatin and showed an increased expression of Pgp, without any detectable alterations in topoisomerase II or in glutathione metabolism. The P388/ADR cells proved cross-resistant to VFL both in vivo and in vitro, and this VFL resistance was efficiently modulated by verapamil in vitro. Cellular transport experiments with tritiated-VFL revealed differential uptake by P388 sensitive and P388/ADR resistant cells, comparable with data obtained using tritiated-NVB. In various in vitro models of human MDR tumor cells, whilst full sensitivity was retained in cells expressing alternative non-Pgp-mediated MDR mechanisms, cross resistance was identified in Pgp-overexpressing cells. Differences were, however, noted in terms of the drug resistance profiles relative to the other Vincas, with tumor cell lines proving generally least cross-resistant to VFL. Overall, these results suggest that VFL, like other Vinca alkaloids, participates in Pgp-mediated MDR, with tumor cells selected for resistance to VFL overexpressing Pgp, yet MDR tumor cell lines proved generally less cross resistant to VFL relative to the other Vinca alkaloids.     

Impaired dopamine function and muscular rigidity induced by 6-aminonicotinamide in rats

Summary In corpus striatum, 6-aminonicotinamide (6-AN), 10 mg/kg i.p., lowered the concentration of dopamine and markedly reduced the disappearance of dopamine after synthesis inhibition with -methyl-p-tyrosine. In the dopamine-rich part of the limbic system, the formation of DOPA after decarboxylase inhibition with 3-hydroxybenzylhydrazine was decreased.In diencephalon, 6-AN altered neither the steadystate level nor the utilization of noradrenaline.The data suggest that the muscular rigidity induced by 6-AN may be associated with disruption of dopaminergic transmission.     

Presynaptic dopamine receptors: Insensitivity to kainic acid and the development of supersensitivity following chronic haloperidol

Summary The effects of kainic acid lesions and chronic haloperidol treatment on rat striatal dopaminergic presynaptic receptors were studied. Following the -butyrolactone-induced inhibition of dopaminergic impulse flow, and after dopa decarboxylase inhibition, dopa accumulation and its reversal by dopamine agonists was measured in vivo.³H-apomorphine (a dopamine receptor ligand with purported presynaptic specificity) was used for in vitro binding experiments. Presynaptic dopamine receptors, as assessed by both methods, were unaffected by intrastriatal kainic acid injection 5–6 days before sacrifice. Seven days after termination of chronic haloperidol treatment (28 days, 0.5 mg/kg/day s.c.) both an increased apomorphine response using the dopa accumulation method and an increase in³H-apomorphine binding were observed, indicating the development of presynaptic dopamine receptor supersensitivity.     

论温病证治之热、郁、瘀

温病之病机，多为热、郁、瘀。三者之间由热致郁、由郁致瘀，循序渐变，环环相联，极易形成热郁或热瘀；热与郁当区分无形郁热或有形郁结。治疗以清热、解郁、化瘀三法兼顾，卫气阶段主清热散郁并举；营血阶段重散热化瘀同治；治热防郁，治郁防瘀。郁与瘀当区分无形郁滞或有形郁结，治疗采取相应消散法。对于临床辨治颇具指导意义。