Cardiovascular effects of Leu-enkephalin in the nucleus tractus solitarius of the rat

Microinjections of Leu-enkephalin into the dorsal vagal complex induced hypotension and bradycardia. Both naloxone, given at a dose conferring selectivity for μ receptors, and the S antagonist ICI 154,129 prevented the cardiovascular effects of Leu-enkephalin. Naloxone was also found to decrease the gain of the baroreflex. These results suggest that Leu-enkephalin is involved in cardiovascular regulation through activation of δ-, and possibly μ-, opioid receptors in the dorsal vagal complex.     

Clinical index to predict bacteraemia caused by staphylococci

Abstract. Objectives. To define risk factors associated with bacteraemia caused by Staphylococcus aureus or coagulase-negative staphylococci; and to use them to define patients in need of empiric anti-staphylococcal antibiotic treatment. Design, Derivation set: observational, prospective study; validation set: retrospective analysis of a prospectively collected database. Setting. Derivation set: Beilinson Medical Centre, Petah Tiqva, Israel—a 900-bed university hospital. Validation set: St Thomas's Hospital, London, UK—an 800-bed teaching hospital. Subjects. All episodes of bacteraemia detected at Beilinson Medical Centre between March 1988 and September 1990 (derivation set, n = 1410), and at St Thomas's Hospital during 1987–1990 (validation set, n = 1040). Interventions. None. Main outcome measures. Percentage of staphylococcal bacteraemia in groups of patients defined by the models. Results. The following factors were associated with Staphylococcus aureus bacteraemia: focus of infection (whether high or low risk), haemodialysis, intravenous drug abuse and infection acquired in the orthopaedic ward. A logistic model was used to divide the derivation set into three groups with percentages of Staphylococcus aureus bacteraemia of 1.8%, 13.2% and 33.7% (P < 0.0001); and the validation group 2.5%, 18.2% and 53.2% (P < 0.0001). Factors associated with coagulase-negative staphylococcal bacteraemia were: central or peripheral intravenous catheter as the focus of infection, a preterm neonate, the presence of a central intravenous catheter, low temperature, and a low white blood cell count. A second model including those factors was used to divide the derivation set into three groups with percentages of coagulase-negative staphylococcal bacteraemia of 1.9%, 22.8%, and 43% (P < 0.0001). In the validation set, the percentages were 2.9%, 22.4% and 31.0% (P < 0.001). Conclusions. The present study defines groups at high risk for staphylococcal bloodstream infection, in which empiric treatment should include an anti-staphylococcal drug.     

聚对苯乙炔（PPV）及其衍生物的研究进展

评价了ＰＰＶ系列衍生物的电学性质、非线性光学性质及其应用。     

Subkapsularës leberhämatom bei HELLP-syndrom

Zusammenfassung Das HELLP-Syndrom (Hemolysis, Elevated Liver enzymes, Low Platelets) tritt als Komplikation einer Schwangerschaftspräeklampsie auf und kann zu ausgedehnten subkapsulären Leberhämatomen führen. Wegen der Rupturgefahr der Hämatome besteht eine lebensbedrohende Notfallsituation für Mutter und Ungeborenes. Anhand von 2 Fallbeispielen wird das interdisziplinäre Vorgehen diskutiert. Mit Diagnosestellung der subkapsulären Leberhämatome sollte die notfallmäßige Entbindung durch Sectio erfolgen. Dann kann die chirurgische Entscheidung für eine konservative, abwartende Therapie mit Intensivüberwachung oder für eine Notfalloperation im Falle einer Leberkapselruptur ohne vermeidbares Risiko getroffen werden.

---

Subcapsular liver hematoma with HELLP-syndrome — an interdisciplinary urgency

Summary The HELLP-syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets), known as a complication during pregnancy, is associated with preeclampsia and may cause subcapsular liver hematomas. In case of hepatic rupture the lives of mother and unborn are threatened. Therefore, an interdisciplinary diagnostic and therapeutic approach is discussed and compared to two examples. The diagnosis of subcapsular liver hematoma must lead to urgent delivery through Cesarean section. Thereafter, the surgeon may decide between observation on an intensive care unit and urgent operation in case of hepatic rupture, without endangering the unborn.

     

Prediction of outcome from intensive care after gastroenterologic emergency

Prognostic factors determining the outcome from intensive care were studied in 952 patients admitted to 25 Finnish ICUs after gastroenterologic emergency. Logistic regression analysis was used to create predictive models based on the APACHE II–system. The models were constructed by using data from a random two–thirds of the study population and validated in the remaining independent one–third together with the original APACHE II–index. The Acute Physiology Score, age, and a pre–existing liver disease were the three most important determinants of outcome. The inclusion of the TISS score describing the intensity of treatment into a model did not enhance the accuracy of the prediction. Our models were better calibrated than the original APACHE II–equation when tested by the goodness–of–fit –statistics. These statistical models may help the clinicians to predict the outcome for an individual patient by providing them information about the relative impacts of predictive factors or about the probability of death. These probabilities should be interpreted cautiously, taking into acount the limitations of statistical methods. This is especially important when assessing the highrisk patients. Their number in our study was too low for accurate outcome prediction.     

A nocturnal nasogastric feeding programme in cystic fibrosis adults

Fourteen adult patients (mean age 22.5 years, range 18–35) with cystic fibrosis undertook nocturnal nasogastric feeding for a mean period of 14.7 (range 6–18) months consuming an average of 1042 ml of a high energy feed on five nights of each week. Following this protocol all patients gained weight (mean weight gain 5.4 kg, range 2–17). For the group as a whole, lung function remained stable during the period of feeding; however a significant correlation between improvement in lung function and weight gain was demonstrated. Hyperglycaemia during feeding in this adult population was common (9/14, 64%) but was easily controlled with insulin therapy.     

各种肝病的肝纤维化标志改变的探讨

目的 :探讨各种肝病患者血清肝纤维化标志的改变 ,甘草酸二胺注射液对肝脏炎症、纤维化指标的作用。方法 :用放免法检测透明质酸 (HA)、层粘蛋白 (LN)、Ⅲ型前胶原多肽 (PCⅢ )。结果 :急性肝炎的三种肝纤指标均升高 (P <0 0 5 )。急黄肝高于急无黄肝 (P <0 0 5 )。慢性肝炎 1 1 2例 ,三项肝纤指标显著高于正常对照 (P <0 0 5 )。慢肝重度显著高于慢肝轻度 (P<0 0 0 1 )。肝硬化的三项肝纤指标又显著高于慢肝 (P <0 0 0 1 ) ,其它肝病的肝纤指标也升高。 2 5例慢肝用甘草酸二胺注射液治疗 2月 ,ALT、AST、GGT显著降低 (P <0 0 1 )。三项肝纤指标中HA降低较显著 (P =0 0 5 ) ,LN和PCⅢ虽有降低 ,但差异不明显 (P =0 4 5 9,P =0 1 92 )。结论 :各种肝病的三项肝纤维化指标均升高 ,以慢肝重度 ,肝硬化升高明显。甘草酸二胺注射液治疗有抗炎及改善肝纤维化的作用     

Activation of guinea pig eosinophil respiratory burst by leukotriene B4: role of protein kinase C

Leukotriene B4 (LTB4) and the protein kinase C activator, 4-beta-phorbol dibutyrate (PDBu), both induced a pronounced and concentration-dependent stimulation of hydrogen peroxide (H2O2) generation by purified guinea pig peritoneal eosinophils in the concentration range 1 nM-1 microM. The LTB4 response was inhibited competitively by the specific LTB4 receptor antagonist, U-75302, with a KB of 25 nM, while the concentration-response curves for both stimuli were shifted rightwards (3.8-fold and 2.8-fold for LTB4 and PDBu, respectively) by the competitive protein kinase C inhibitor, 1-O-hexadecyl-2-O-methylglycerol at a concentration of 300 microM. LTB4 appears, therefore, to induce respiratory burst in eosinophils via a receptor-mediated mechanism involving protein kinase C.     

N－（4－乙氧苯基）苯甲酰胺类化合物的合成及抗炎、抗变态反应活性研究

Ｎ┐（４┐乙氧苯基）苯甲酰胺类化合物的合成及抗炎、抗变态反应活性研究周玉新１）党永红刘建飞２）徐颖刘百里（沈阳药科大学制药系，沈阳１１００１５）郑文义（东北第六制药厂，沈阳１１００４３）１９８１年，刘百里等〔１，２〕发现和研制的新药益肤酰胺，经药理实...     

脑电双频指数用于门诊无痛内镜检查的临床研究

目的　观察脑电双频指数 (BIS)监测对门诊无痛内镜检查病人麻醉过程及恢复的意义。方法　 12 0例择期在丙泊酚 芬太尼静脉麻醉下行胃镜检查的门诊病人 ,随机分为BIS监测组 (A组 )与常规监测组 (B组 ) ,每组 6 0例。静脉给予芬太尼 1μg/kg、丙泊酚 0 5mg/kg负荷量后 ,丙泊酚的维持量A组根据BIS值 (4 5～ 6 0 )调节 ,B组仅根据临床体征调节。记录丙泊酚用量、术中反应、胃镜检查时间及留观时间等。结果　两组间一般资料及麻醉前MAP、HR、SpO2 、BIS均无显著性差异(P >0 0 5 )。丙泊酚用量A组明显少于B组 ,留观时间A组显著短于B组 (P <0 0 1)。MAP在麻醉诱导入睡后和插镜时两组均有下降 ,但A组降幅低于B组 (P <0 0 1)。不良反应发生率A组明显少于B组 (P <0 0 1)。结论　BIS监测用于门诊麻醉对预防麻醉药用量不足或逾量 ,减轻血液动力学改变 ,避免术中肢动与知晓有重要意义 ,有利于提高麻醉安全 ,减少并发症。