Reduction in Internal Carotid Arterial Blood Flow Velocity in Children During Antiepileptic Drug Therapy with Clinical Dosages

Summary: We studied the effect of antiepileptic drugs (AEDs) on internal carotid artery (ICA) blood flow velocity, as an index of total cerebral blood flow (CBF). The subjects were 45 newly diagnosed children with febrile convulsion or epilepsy who were seizure-free for a period long enough not to affect the results. They had no neurologic deficit, received fixed monotherapy, and were examined by a noninvasive Doppler ultrasound method, in comparisonwith 13 age-matched normal volunteers with no AED. In 30 patients, the measurements were performed before and after AED administration [10 with phenobarbital (PB), 10 with carbamazepine (CBZ), and 10 with valproate (VPA)], and performed before and after AED discontinuation in the remaining 15 patients (all with PB). Normal volunteers underwent the two consecutive examinations with a mean interval equal to that of the entire patient group, and there was no difference in velocity values between the measurements. In patients receiving CBZ or VPA, a significant reduction was noted in blood flow velocity after drug administration. Although velocity values in the patients receiving PB did not change after drug administration, they were significantly increased after complete discontinuation. In the present study, a slight but significant reduction in CBF caused by AED administration at therapeutic doses in children was suggested.     

血压家庭相似性研究

本文报道了北京市房山区１１４７人血压家庭相似性研究结果。亲子代回归法得出的血压遗传度估计值为０．４２（收缩压）和０．４８（舒张压），全同胞相关法得出的血压遗传度估计值为０．３７（收缩压）和０．５３（舒张压）。两种方法得出的遗传度估计值相差不大，这一结果提示血压的遗传符合加性多基因模型。本文报道的血压遗传度没有区分遗传效应和共同生活环境效应。此外，本文强调了将血压作为数量性状采用数量遗传学方法进行遗传度估计的合理性和有效性。     

窒息新生儿生后24小时血糖的检测结果分析

目的 :探讨窒息新生儿生后 2 4小时血糖的变化及意义。方法 :93例新生儿于生后 2 4小时内、治疗前抽血送检 ,2 0例正常新生儿于生后次日清晨抽血送检。血糖由全自动生化分析仪进行分析。结果 :(1)重度窒息组血糖明显高于轻度窒息组及对照组。(2 )死亡儿血糖明显高于存活儿 (P <0 .0 0 1) ,且高血糖发生率亦高 (P <0 .0 0 1)。(3)重度窒息儿高血糖发生率明显高于轻度窒息儿 (P <0 .0 0 1)。结论 :窒息早期由于应激 ,儿茶酚胺及皮质醇分泌增加 ,促使血糖升高 ,与病情和预后有一定联系。病情越重 ,血糖越高 ,预后越差     

Plasma Norharman (β-Carboline) Levels are Elevated in Chronic Alcoholics

Based on the hypothesis that condensation products of neurotransmitters with aldehydes are involved in the pathogenesis of alcoholism, aromatic beta-carbolines (norharman and harman) were measured in the blood plasma of alcoholics and nonalcoholics. The identity of the extracted compounds was confirmed by various elution conditions of the high performance liquid chromatography (HPLC), newly developed radioreceptor assays, and the mass spectrum of norharman. The levels of norharman and harman in nonalcoholics were unchanged after a load with ethanol (1 g/kg body weight). The norharman levels of the alcoholics were significantly higher than that of the nonalcoholic controls (99.5 +/- 26.6 pg/ml vs. 26.9 +/- 10.7 pg/ml; p less than 0.001) and did not change significantly during a 3-week detoxication period. In the subgroup of alcoholics with delirium or hallucinosis, a slight increase of norharman during detoxication could be detected while in alcoholics with vegetative withdrawal symptoms norharman levels dropped slightly over time (p = 0.07). No difference was found with respect to harman between nonalcoholics and alcoholics. These results suggest disturbed regulatory processes in the formation and/or metabolism of norharman in alcoholics. Further investigations are needed to reveal a possible marker function of norharman in alcoholic patients.     

雌孕激素联合补充治疗与脑卒中的预防

目的　探讨低剂量雌孕激素联合补充治疗对脑卒中的预防作用。方法　绝经过渡期及绝经后妇女84例随机设激素补充治疗组和对照组 ,采用酶免法测定治疗前后血脂和雌二醇 (E2 )水平。结果　治疗前后 E2、高密度脂蛋白 (HDL)增高 ,低密度脂蛋白 (L DL)、总胆固醇 (TC)降低 ,差异显著 (P<0 .0 5 ) ,甘油三酯 (TG)变化不明显。结论　低剂量雌激素对血脂谱产生有利影响 ,可降低脑卒中的发生     

亲属活体部分小肠移植术后早期并发症的防治

目的探讨亲属活体部分小肠移植术后早期并发症的防治。方法为3例短肠综合征患者和1例肠神经节缺失导致小肠无功能患者施行亲属活体部分小肠移植术,供、受者HLA配型均有4个以上抗原相合,供肠均取自回肠末端,长度为(150±10)cm,应用他克莫司、霉酚酸酯及甲泼尼龙预防排斥反应。术后采取抗凝、改善微循环、输注人白蛋白等措施调控患者的出、凝血功能,预防血管吻合口血栓形成和出血,给予法莫替丁或奥美拉唑预防应激性溃疡；给予头孢三代为主的抗生素、更昔洛韦以及氟康唑预防细菌、病毒及真菌感染,并注重对体表易感染部的消毒和护理；术后鼓励患者多下床活动,早期给予谷氨酰胺,尽早将营养支持治疗过渡为肠内营养,以促进移植肠功能的恢复。结果术后3d,1例患者发生肺部鲍曼不动杆菌感染,经抗生素治疗后控制。1例术后5 d移植肠系膜根部出现血肿,手术清除血肿。2例消化道分泌物及大便中发现真菌生长,给予氟康唑治疗后好转。4例在术后20 d左右均发生急性排斥反应,经加大FK506的用量,并以甲泼尼龙冲击治疗后逆转。4例患者,2例获得长期存活,至今分别存活6年8个月和3年2个月,另2例分别于术后5个月、35 d因感染死亡。结论小肠移植术后早期的并发症较多,与小肠的生理结构有关,术后早期并发症的成功防治是临床小肠移植成败的关键。     

Elevations of neuropeptide Y-like immunoreactivity and catecholamines in plasma on increased intracranial pressure in the pig

Graded increases of intracranial pressure (ICP) in anaesthetized pigs induced elevations of plasma levels of neuropeptide Y (NPY)-like immunoreactivity (LI) and catecholamines, simultaneously with hypertension and tachycardia. Plasma adrenaline (ADR) increased at a lower ICP-level than did the plasma levels of noradrenaline (NA) and NPY-LI. At the maximal ICP elevation, 22.9 kPa (172 mmHg), plasma NPY-LI was increased about 10-fold, from 48 +/- 8 pmol/l in the basal state, while NA and ADR concentrations increased more than 100-fold. At this maximal ICP-level the plasma levels of NPY-LI were correlated to the concentrations of both NA (r = 0.87, P less than 0.01) and ADR (r = 0.92, P less than 0.001). Plasma NPY-LI continued to increase to about 1000 pmol/l, 10 min after the maximal elevation of ICP was discontinued, while the catecholamines then had declined considerably. A slight cardiac release of NPY-LI was observed at the maximal elevation of ICP. The half-life of NPY-LI in plasma was about 6 min upon systemic infusion. At plasma levels similar to those obtained upon maximal ICP elevation, exogenous NPY caused slight vasoconstriction in the spleen and skeletal muscle, but had no effects on coronary blood flow or systemic blood pressure. This suggests that NPY mainly exerts local actions after release from nerve endings, while levels of circulating NPY in plasma must be very high to influence blood flow in some organs. It is concluded that elevation of ICP results in hypertension and tachycardia related to elevated plasma levels of NPY-LI and catecholamines.(ABSTRACT TRUNCATED AT 250 WORDS)     

N—酰化壳聚糖膜性能的研究

讨论了一系列N-酰化壳聚糖膜的抗张强度、透水性、VB_(12)的透过性、透氧性以及血液相容性。N-已酰化壳聚糖膜具有良好的血液相容性。在制膜过程中,加入分子量为1500的聚乙二醇为致孔剂,则可使N-己酰化壳聚糖膜的渗透性有较大提高。同时保持较好的血液相容性和强度。     

Stimulation-induced setting of postural muscle tone in the decerebrate rat

These studies demonstrate the presence of pontomedullary areas in the rat brainstem which, when stimulated electrically, serve to set postural muscle tone in the hindlimbs. Low amplitude stimulation of the dorsal tegmental field (DTF) was found to inhibit postural muscle tone and, in some rats, was found to decrease mean arterial pressure. Low amplitude stimulation of the ventral tegmental field (VTF) was found to increase postural muscle tone and, in all cases tested, was found to increase mean arterial pressure.