硝普钠与硝酸甘油治疗急性左心衰竭疗效对比

目的观察硝普钠、硝酸甘油治疗急性左心衰竭的临床疗效。方法 63例急性左心衰竭患者,男48例,女15例,随机分成硝普钠治疗组31例,硝酸甘油治疗组32例,对比两组治疗效果。结果治疗后两组均能有效控制血压、心率、呼吸,有效改善心衰症状（P〈0.05）,组间比较总有效率差异无统计学意义（P〉0.05）,但硝普钠组患者心衰症状改善时间明显缩短,组间比较差异有统计学意义（P〈0.05）。结论硝普钠治疗急性左心衰竭更具有优势。     

新一代口服直接凝血酶因子Ⅱa抑制剂AZD0837

凝血因子Ⅱ在凝血级联反应中处于下游的关键位置,被激活后形成凝血酶而催化纤维蛋白原产生纤维蛋白导致凝血,因此其为血栓形成的关键因素。抑制凝血酶可以延长凝血时间,减少血栓形成风险。英国AstraZeneca公司研发的新一代口服直接凝血酶因子Ⅱa抑制剂AZD0837可用于治疗和预防心房颤动引起的卒中和深静脉血栓的发生。目前已经公布的临床前、临床Ⅰ期和Ⅱ期实验数据显示,其具有优于华法林的治疗效果,因此具有巨大的市场潜力。     

综合抗凝治疗预防老年性下肢骨折深静脉血栓的临床研究

目的:探讨对老年人下肢骨折围手术期应用低分子肝素钠配合间歇充气加压装置预防深静脉血栓(DVT)形成的安全性和有效性。方法:回顾分析2009年1月—2011年6月收治的177例下肢各类型骨折老年患者,术前超声多普勒证实双下肢均无DVT,围手术期均应用低分子肝素钠配合间歇充气加压装置预防治疗。结果:177例患者围手术期出现有症状深静脉血栓4例,发生率为2.26%;出现致命性肺栓塞1例,发生率为0.56%。结论:老年患者下肢骨折围手术期应用低分子肝素钠配合间歇充气加压装置综合防治,可显著降低下肢深静脉血栓形成的发生率。     

氢氧化钠在中心静脉导管感染中的应用

目的探讨氢氧化钠在中心静脉导管感染中的应用。方法对123例次中心静脉导管感染患者,选用浓度为1.0mol/L的标准氢氧化钠溶液,注入导管中,反复冲洗2～3次,至中心静脉导管清亮为止。结果经过临床观察,112例次治疗成功,患者体温恢复正常,导管继续应用,总有效率95.12%。结论氢氧化钠对于中心静脉导管引起的感染发热,具有溶解导管内药物颗粒沉积物和繁殖的细菌,清除致热源,控制感染和发热的作用。     

孟鲁司特钠治疗儿童感染后咳嗽的临床疗效观察

目的:观察白三烯受体拮抗剂孟鲁司特钠治疗儿童感染后咳嗽的临床疗效。方法:我院2010年4月～2011年4月诊治的感染后咳嗽患儿129例,随机分为对照组、布地奈德治疗组和孟鲁司特钠治疗组共三组,分别给予阿奇霉素干混悬剂、阿奇霉素干混悬剂联合布地奈德及阿奇霉素干混悬剂联合孟鲁司特钠治疗,观察三组咳嗽症状评分变化、显效时间及有效率。结果:与对照组比较,孟鲁司特钠和布地奈德可以明显改善感染后咳嗽患儿的咳嗽症状评分、缩短显效时间、提高总有效率(P<0.05),但孟鲁司特钠治疗组和布地奈德治疗组两者间比较差异无统计学意义(P>0.05)。结论:孟鲁司特钠治疗儿童感染后咳嗽疗效明确、依从性好,值得临床推广。     

固体分散技术提高枸橼酸莫沙必利片溶出度的研究

目的考察固体分散技术对枸橼酸莫沙必利片的体外溶出度的影响。方法以聚维酮K30为载体制备枸橼酸莫沙必利片固体分散体,紫外分光光度法对其体外溶出度进行测定。结果聚维酮K30-枸橼酸莫沙必利比例大于2∶1(w/w)时所得枸橼酸莫沙必利片5 min累积溶出量接近100%,而市售品溶出缓慢,5 min累积溶出量约为50%,30min累积溶出量约为90%。结论采用固体分散技术制备的枸橼酸莫沙必利片能显著提高枸橼酸莫沙必利的溶出速率。     

Flunarizine blocks voltage-gated Na(+) and Ca(2+) currents in cultured rat cortical neurons: A possible locus of action in the prevention of migraine

Although flunarizine (FLN) has been widely used for migraine prophylaxis with clear success, the mechanisms of its actions in migraine prophylaxis are not completely understood. It has been hypothesized that migraine is a channelopathy, and abnormal activities of voltage-gated Na(+) and Ca(2+) channels might represent a potential mechanism of cortical hyperexcitability predisposing to migraine. The aim of the present study was to investigate the effects of FLN on Na(+) and Ca(2+) channels of cultured rat cortical neurons. Sodium currents (I(Na)) and calcium currents (I(Ca)) in cultured rat cortical neurons were monitored using whole-cell patch-clamp recordings. Both I(Na) and I(Ca) were blocked by FLN in a concentration-dependent manner with IC(50) values of 0.94μM and 1.77μM, respectively. The blockade of I(Na) was more powerful at more depolarizing holding potentials. The steady-state inactivation curve of I(Na) was shifted towards more hyperpolarizing potentials by FLN. FLN significantly delayed the recovery from fast inactivation of I(Na). Furthermore, the action of FLN in blocking I(Na) was enhanced at higher rates of channel activation. Blockades of these currents might help explain the mechanism underlying the preventive effect of FLN on migraine attacks.     

Serotonergic system involvement in the inhibitory action of estrogen on induced sodium appetite in female rats

This study of the participation of the serotonergic system in the inhibitory effect of estrogen on induced sodium appetite in female rats explores sodium appetite induced by Furosemide and low sodium diet treatment (DEP) in normally cycling rats and in ovariectomized rats with and without estradiol replacement (OVX, OVX + E₂) . We also analyzed the neural activity of serotonergic neurons of the dorsal raphe nucleus (DRN) as well as the activity of other brain nuclei previously found to be involved in sodium and water balance in sodium depleted animals without access to the intake test. For this purpose, we examined the brain Fos, Fos-serotonin and Fos-vasopressin immunoreactivity patterns in diestrus (D), estrus (E), OVX and OVX + E₂ rats subjected to DEP.Female rats in E and OVX + E₂ exhibited a significant decrease in induced sodium intake compared with females in D and OVX. This estrogen-dependent inhibition on induced sodium appetite (approximately 50% reduction) can be correlated with changes in Fos activation observed in the organum vasculosum of the lamina terminalis (OVLT) and DRN, in response to sodium depletion. Given our previous observations in males, the expected sodium depletion-induced activity of the OVLT was found to be absent in OVX + E₂ females, while the usual inhibitory tonic activity of serotonergic neurons of the DRN, instead of decreasing after sodium depletion, increases or remains unchanged in OVX + E₂-DEP and E-DEP females, respectively.Regarding urinary water and sodium excretion 3 h after furosemide treatment, E-DEP and OVX + E₂-DEP animals excreted smaller volumes of more highly concentrated urine than depleted D and OVX rats. Twenty hours after sodium depletion, the same groups of animals also showed a significant increase in the number of Fos-AVP immunoreactive neurons within the supraoptic nucleus, compared with D-DEP.In summary, our results demonstrate an estrogen-dependent inhibition of induced sodium appetite in normally cycling rats and ovariectomized animals with estradiol replacement, which may involve an interaction between excitatory neurons of the OVLT and inhibitory serotonergic cells of the DRN. The main finding is thus serotonergic system involvement as a possible mechanism in the inhibitory action of estrogen on induced sodium appetite.     

Lipopolysaccharide reduces sodium intake and sodium excretion in dehydrated rats

The objective of this study was to find out if lipopolysaccharide (LPS) administered intraperitoneally affects sodium and water intake and renal excretion in dehydrated rats. LPS (0.3-5 mg/kg b.w.) inhibited 0.3 M NaCl intake induced by subcutaneous injection of the diuretic furosemide (FURO, 10 mg/kg b.w.) combined with the angiotensin converting enzyme inhibitor, captopril (CAP, 5 mg/kg b.w.). Only the highest doses of LPS (2.5 and 5 mg/kg) inhibited water intake induced by FURO/CAP. LPS (0.6 mg/kg) reduced urinary volume and sodium excretion, but had no effect on mean arterial pressure or heart rate of rats treated with FURO/CAP. LPS (0.3-5.0 mg/kg) abolished intracellular thirst and reduced by 50% the urine sodium concentration of rats that received 2 ml of 2 M NaCl by gavage. LPS (0.3-5.0 mg/kg) also reduced thirst in rats treated with FURO alone (10 mg/rat sc). The results suggest that LPS has a preferential, but not exclusive, inhibitory effect on sodium intake and on intracellular thirst. The inhibition of hydro-mineral intake and the antinatriuresis caused by LPS in dehydrated rats may contribute to the multiple effects of the endotoxin on fluid and electrolyte balance and be part of the strategy to cope with infections.     

Tablets of the potassium citrate may cause a stone-like image: a case report

An 8-year-old girl with left proximal ureteral stone (4 mm) was referred to our hospital to treat with shock wave lithotripsy (SWL). Fifteen days after the first SWL session, a plain film of kidneys, ureters and bladder (KUB) demonstrated a new stone-like opacity (10 mm) on the left kidney location other than previous stone of 4 mm. We counseled with her parents and learned that she took a potassium citrate tablet 2 h before. Potassium citrate is a radio-opaque drug and may cause a stone-like image during the stone management. Urologists should consider this particularity of potassium citrate in patients using this drug to avoid unnecessary interventions. To our knowledge, this is the first case in the literature.