Effects of single oral doses of bisoprolol and atenolol on airway function in nonasthmatic chronic obstructive lung disease and angina pectoris

Summary A randomized, placebo-controlled, double-blind crossover investigation in 12 patients with non-asthmatic chronic obstructive lung disease and co-existing stable angina pectoris was done to compare two ₁-selective adrenoceptor blocking agents, atenolol 100 mg and bisoprolol 20 mg. Systolic and diastolic blood pressures (SBP, DBP), heart rate (HR) as well as airway resistance (AWR, and less frequently forced expiratory volume in 1 s (FEV₁) and intrathoracic gas volume (ITGV) were measured in the sitting position before and at various times up to 24 h after drug intake.During the first 4 h both beta-blockers produced a significant reduction in HR in comparison to placebo (p<0.01). Atenolol 100 mg significantly increased AWR relative to placebo and bisoprolol (p<0.05). After 24 h, a significant reduction in HR (p<0.01) could only be demonstrated after bisoprolol, whereas atenolol alone led to a significant elevation in AWR relative to placebo and bisoprolol (p<0.05) at that time.It is concluded that bisoprolol appears to have a high degree of beta₁-selectivity, thus providing a wide split between beta₁- and beta₂-adrenoceptor blockade. Bisoprolol in its therapeutic dose range is expected to be relatively safe as regards bronchoconstriction in patients suffering both from hypertension and/or angina pectoris and chronic obstructive lung disease.     

Effect of endothelium on basal and α-adrenoceptor stimulated calcium fluxes in rat aorta

Summary The rate of unstimulated influx of Ca²⁺ into rat aorta smooth muscle, measured as uptake of ⁴⁵Ca, was inhibited in the presence of endothelium as compared to influx in the absence of endothelium. Efflux of ⁴⁵Ca from unstimulated prelabelled tissues was also reduced in the presence of endothelium. In normal physiological solution the rate of influx and efflux of Ca²⁺ stimulated by B-HT 920 (1 and 10 M), but not that stimulated by phenylephrine (30 nM and 1 M), was also reduced in the presence of endothelium. In the presence of the calcium entry blocker flunarizine (3 M), phenylephrine (1 M) stimulated efflux of Ca²⁺ was inhibited by the presence of endothelium. A correlation between inhibition of Ca²⁺ influx and modulation of -adrenoceptor agonist-induced contractions by endothelium could not be demonstrated, and methylene blue, an antagonist of endothelium mediated inhibition of B-HT 920 contractions, did not affect Ca²⁺ influx stimulated by the agonist. The effects of endothelium on Ca²⁺ influx and efflux are unlikely to be due to alterations by endothelium of diffusion of ⁴⁵Ca or the agonists in the vessel. The results demonstrate that an endothelial derived factor or factors can reduce calcium influx into smooth muscle cells and also modulate the release of calcium from cells, perhaps by affecting intracellular calcium pumping mechanisms. A reduction of calcium influx cannot be the sole explanation for the modulatory effect of endothelium on -adrenoceptor agonist-induced contractions but an effect on intracellular calcium metabolism may be important.     

The effects of a 5-HT1 receptor ligand isapirone (TVX Q 7821) on 5-HT synthesis and the behavioural effects of 5-HT agonists in mice and rats

The effects of 2-(4-(4-(2-pyrimidinyl)-1-piperazinyl)-butyl)-1,2-benzoisothiazol-3(2H)one-1,1-dioxide hydrochloride (isapirone, TVX Q 7821), a putative 5-HT₁ receptor antagonist, has been studied on various models of 5-HT receptor sub-type function. In mice TVX Q 7821 produced a dose-dependent inhibition of the hypothermia induced by 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) with an ED₅₀ of 5.3 mg/kg suggesting that TVX Q 7821 was an antagonist of the presynaptic (possibly somato-dendritic) 5-HT_1A receptor. TVX Q 7821 did not alter the locomotor response to the suggested 5-HT_1B agonist RU 24969. The rate of mouse brain 5-HT synthesis was accelerated by TVX Q 7821 (10 mg/kg). 5-HT₂ receptor-mediated head twitch behaviour induced by precursor loading with 5-HTP was unaffected by TVX Q 7821 (10 mg/kg) pretreatment 75 min earlier, but the head-twitch induced by the agonist 5-methoxy-N,N-dimethyltryptamine was enhanced by prior treatment with TVX Q 7821.In rats the hypothermia induced by 8-OH-DPAT was partially antagonised by TVX Q 7821 while the behavioural serotonin syndrome induced by 8-OH-DPAT (a possible post-synaptic 5-HT_1B-mediated effect) was unaffected by TVX Q 7821 as was the locomotion induced by RU 24969.The data suggest that TVX Q 7821 is a good presynaptic 5-HT_1A antagonist in mice, as indicated by the 8-OH-DPAT-induced hypothermia and 5-HT synthesis rate studies. It did not antagonise 5-HT_1B-mediated behaviour in mice or rats and appeared to have an antagonist action at pre- but not post-synaptic 5-HT_1A receptors in rats. Offprint requests to: G.M. Goodwin     

Acute renal dysfunction by cadmium injected with cysteine in relation to renal critical concentration of cadmium

In order to study the critical concentration of cadmium (Cd) in acute renal dysfunction following Cd, male mice were injected IV with Cd complexed with cysteine. The critical concentration was 10 g Cd/g wet weight in whole kidney and it was the same as that for Cdthionein (Cd-Th), which may suggest that the toxicity of Cd-Th is due to Cd ions liberated from Cd-Th in the kidneys. Renal Cd concentration was at first higher than the critical concentration, but decreased to the critical concentration by 24 h after administration. As an index for renal dysfunction, the uptake of p-aminohippurate (PAH) by renal cortical slices in vitro was sensitive, and showed the different time-course from those of urinary protein and glucose levels. The results suggest the usefulness of PAH uptake as an index. Incidental to the renal dysfunction, renal calcium levels exhibited a marked increase.     

Specular microscopy of hard contact lens wearers

Wide-field specular microscopy, slit-lamp examination, and pachometry were performed on 22 successful hard contact lens wearers and 22 controls matched for age, race, sex, and refractive error. A minimum of 600 cells per control and 1200 per contact lens wearer were manually digitized from the specular photomicrographs. Frequency distributions of cell areas were compared between the two groups using the parameters of mean, median, standard deviation, coefficient of variation, skewness and kurtosis. Slit-lamp examination was normal and there was no significant difference in corneal thickness between the patient group and the control group. Comparison of mean, median, and standard deviation also revealed no significant difference, but skewness (P less than .001), kurtosis (P less than .001) and coefficient of variation (P less than .004) were greater in the hard contact lens wear group. Hard contact lens wearing time correlated with increasing pleomorphism (P less than .05). Specular microscopy also revealed morphologic changes including deep stromal striae, intra- and extracellular "blackout" areas, and clustering of extremely small and large cells. The possible relationship between endothelial hypoxia and structural stromal changes are discussed.     

皮肤涂抹雌三醇对裸鼠甲状腺功能和肿瘤影响的效果观察

目的研究经皮涂抹外源性雌三醇(E₃)对裸鼠甲状腺功能及甲状腺移植瘤的影响。方法使用123只4周龄裸鼠,按体质量采用随机数字表法分为9组:①对照组、②低E₃组、③高E₃组、④乳头状甲状腺癌组(PTC组)、⑤乳头状甲状腺癌+高E₃组(PTC+高E₃组)、⑥滤泡状甲状腺癌组(FTC组)、⑦滤泡状甲状腺癌+高E₃组(FTC+高E₃组)、⑧未分化型甲状腺癌组(ATC组)和⑨未分化型甲状腺癌+高E₃组(ATC+高E₃组),均正常饮食饮水。除对照组、PTC组、FTC组和ATC组外,其余5组每日给予皮肤涂抹雌三醇乳膏,低E₃浓度为市售化妆品人均每日使用量中雌三醇含量的25倍、高剂量为100倍。40天后,收集各组裸鼠的24h尿样;尿碘采用砷铈催化分光光度法测定,尿E₃、血清E₃、血清甲状腺激素[游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)]和甲状腺抗体[甲状腺球蛋白抗体(TgAb)、甲状腺过氧化物酶抗体(TpoAb)],采用酶联免疫吸附实验[ELISA]测定。在接种肿瘤后的第4日起,每3 d测量肿瘤大小。结果①各组裸鼠血清E₃和尿E₃水平比较差异有统计学意义;其中FTC+高E₃组和ATC+高E₃组的血清E(310.22、14.18 pmol/L)和尿E(36.40、8.18 pmol/L)水平均分别显著低于FTC组和ATC组的血清E(326.52、22.80 pmol/L)和尿E(38.91、11.49 pmol/L)水平;而PTC+高E₃组仅血清E₃水平(12.17 pmol/L)显著低于PTC组(23.05 pmol/L);高E₃组的尿E₃水平显著低于低E₃组(6.92、8.94 pmol/L);低E₃组的尿E₃水平显著高于对照组(8.94、7.17 pmol/L),PTC组、FTC组和ATC组的血清E₃水平显著高于对照组和高E₃组(23.05、26.52、22.80比13.23、14.46 pmol/L)。②各组血清FT3水平比较差异没有统计学意义。各组血清FT4和TSH水平与对照组比较,差异均有统计学意义,其中各实验组的FT4水平均显著低于对照组,TSH水平均显著高于对照组,但PTC组与PTC组+高E₃组、FTC组与FTC+高E₃组、ATC组与ATC+高E₃组分别进行两两比较,FT4和TSH水平并差异无统计学意义。③各组裸鼠血清TgAb和TpoAb水平比较差异均有统计学意义。其中低E₃组、高E₃组、PTC+高E₃组、FTC组、ATC组和ATC+高E₃组的TgAb水平均显著高于对照组;各实验组的TpoAb水平均显著高于对照组。④各组裸鼠尿碘水平比较差异没有统计学意义。⑤各组裸鼠肿瘤体积大小比较差异均有统计学意义,PTC+高E₃组与PTC组比较,在接种肿瘤后的第7 d、16 d、25 d、28 d和37 d,肿瘤体积发生显著性差异(71.54、226.05、730.26、893.34、1242.12比49.87、325.50、551.28、664.38、967.78 mm³);FTC+高E₃组与FTC组比较,在接种肿瘤后的第25 d、28 d、37 d和40 d,肿瘤体积发生显著性差异(392.60、475.70、794.68、943.51比214.82、238.32、422.19、490.00 mm³);ATC+高E₃组与ATC组比较,在接种肿瘤后的第37 d和40 d,肿瘤体积发生显著性差异(217.53、432.10比577.19、1146.66 mm³)。结论外源性雌三醇能够诱导裸鼠发生甲状腺功能减退和抗体水平增高,同时对乳头状甲状腺癌和滤泡状甲状腺癌的生长有着促进作用,对未分化甲状腺癌的生长有抑制作用。     

定量脑电图在新生儿脑功能研究中的应用

在对脑功能的研究中原始常规脑电图结果的解读专业性强,易受个人主观因素的影响,在临床和科研应用中具有一定的局限性。定量脑电图(qEEG)的出现对脑功能的研究有了质的飞跃,它是原始脑电图的延伸,除了具有客观、及时、无创和可动态随访等优点,更大优势是能用定量的方法反映脑能量大小和脑功能状态,可作为临床脑功能、脑损伤研究的重要方法。近年来,有很多学者用定量脑电图技术研究脑疾病,并取得了一定的进展,该文对这种技术在新生儿脑功能研究的进展进行综述。     

基于微信的健康信念教育在哮喘儿童家庭教育中的应用效果

目的 探讨微信平台下的健康信念教育在哮喘儿童家庭教育中的应用效果。方法 选择2019年1月—2020年4月在本院就诊的哮喘患儿92例,按随机数表法分为两组,每组46例。予以对照组常规门诊治疗和护理,在此基础上予以观察组微信平台下的健康信念教育。对比两组干预前、干预6个月后的患儿哮喘控制、肺功能与父母疾病管理能力,并记录急性发作与再住院情况。结果 观察组患儿哮喘控制情况优于对照组,(Z=2.641,P=0.008)。两组干预前FVC(用力肺活量,forced vital capacity)、PEF(呼气峰值流速,peak expiratory flow)、FEV1(第1 s用力呼气容积,Forced expiratory volume in one second)及父母疾病管理能力比较,差异无统计学意义(P＞0.05);观察组患儿干预后FVC为(3.90±1.13)L、PEF为(162.16±29.10)L/min、FEV1(2.94±0.97)L,父母疾病管理能力为(41.52±5.19)分,分别高于对照组的(2.77±0.98)L、(144.62±26.05)L/min、(1.52±0.74)L、(34.56±4.27)分,(t=5.124、3.046、7.894、7.024,P值均＜0.001)。观察组患儿急性发作(1.20±0.39)次、再住院(0.87±0.21)次,少于对照组的(2.35±0.70)次、(1.14±0.53)次,(t=9.374、3.212,P值均＜0.001)。结论 微信平台下的健康信念教育在哮喘儿童家庭教育中应用价值确切,能提高哮喘控制效果,减少急性发作与再住院,改善患儿肺功能,利于提高父母疾病管理能力。     

腰硬联合麻醉与全麻对老年腹部手术患者术后短期认知功能的影响

目的 探讨腰硬联合麻醉(CSEA)与全麻对老年腹部手术患者术后认知功能的影响。方法 选取本院2018年5月—2019年5月收治的82例老年腹部手术患者,按随机数表法分为观察组和对照组,各41例。观察组应用CSEA,对照组则采用全身麻醉。比较两组的麻醉相关指标,术后6 h、12 h、24 h的精神功能状态以及患者术后短期认知功能障碍的发生率。结果 观察组麻醉起效时间(min)、完全清醒时间(min)分别为(8.19±1.04)、(28.67±5.60)与对照组的(10.17±2.12)、(37.25±6.12)比较差异有统计学意义(P<0.05);观察组视觉模拟评分(VAS)(3.51±1.12)与对照组的(4.27±1.15)比较差异有统计学意义(P<0.05);观察组患者术后6 h、12 h、24 h时的MMSE评分分别为(22.27±1.46)、(26.23±1.26)、(28.19±1.24),均高于对照组的(21.46±1.35)、(24.68±1.23)、(26.37±1.19)(P<0.05);观察组短期内POCD的发生率为4.88%,低于对照组的24.39%,差异有统计学意义(P<0.05)。结论 对老年腹部手术患者采用CSEA,不仅能缩短麻醉起效时间和完全清醒的时间,减轻疼痛,而且对患者精神功能的影响小,可有效减少短期内认知功能障碍发生率。