Clinical value of obtaining sputum and cough swab samples following inhaled hypertonic saline in children with cystic fibrosis

Prompt detection and treatment of lower respiratory tract infection are essential in the management of patients with cystic fibrosis (CF), who often have signs or symptoms of respiratory infection without any pathogens being isolated from sputum or cough swab specimens. The aims of this study were to assess the efficacy and clinical value of obtaining sputum and oropharyngeal cough swab samples following induction with hypertonic saline (HS) in this group of patients. Forty-three outpatients with CF, mean age 7.2 years (range, 1.8-12.9 years), were recruited over a 2-year period. Nebulized salbutamol was administered, followed by 6% HS. Sputum was preferentially obtained before and after HS induction if possible. If the patient was not able to expectorate, oropharyngeal cough swabs were taken instead. Four patients were able to expectorate sputum before and 19 after HS induction. The procedure was tolerated in 41 of 43 patients. Pathogens were isolated from 13 patients' HS-induced samples, but not from their corresponding preinduced specimens, and 4 patients' preinduced specimens cultured organisms which were not identified from their HS-induced samples. Significant changes were made in the management of 13 (30.2%) patients directly resulting from the positive culture of pathogens only from HS-induced samples. Cultures from oropharyngeal cough swab or expectorated sputum specimens following inhalation of HS provide additional microbiological information which is of clinical value and may lead to changes in patient management.     

异种全厚板层角膜移植术后局部应用高渗葡萄糖的研究

目的 研究局部应用50%葡萄糖降低异种全厚板层角膜移植术后炎性反应的作用.方法 18周龄的健康雄性新西兰白兔16只随机分成两组,每组各8只.两组均进行猫兔异种全厚板层移植术:A组(实验组)手术后给予50%葡萄糖滴眼每日2次,复方氯霉素滴眼液滴眼每日3次;B组(对照组)术后仅给复方氯霉素滴眼液滴眼.每日3次.术后每日在裂隙灯显微镜下观察植片存活情况,治疗及观察时间均为3个月.各组于术后1,2,3月各取2只兔的术眼角膜进行病理学检查.结果 术后半个月内,A、B两组植片透明、无明显浑浊.术后20 d部分植片开始出现排斥反应,在3个月内,A、B两组全厚角膜植片的排斥反应指数差异显著.在无排斥反应的正常兔角膜中组织学及电子显微镜下的结构特征清晰;但在出现排斥反应的兔角膜中有明显的角膜水肿和炎性细胞浸润.结论 异种全厚板层角膜移植术后局部应用50%葡萄糖滴眼能减少术眼水肿,降低炎性反应,延长角膜植片成活时间.     

Recipient hypertonic saline infusion prevents cardiac allograft dysfunction

Objective

Hypertonic saline (HTS) has potent immune and vascular effects. We assessed recipient pretreatment with HTS on allograft function in a porcine model of heart transplantation and hypothesized that HTS infusion would limit endothelial and left ventricular (LV) dysfunction following transplantation.

高渗盐水对手术伤口愈合的影响及其免疫机理的探讨

本研究比较了高渗盐水和生理盐水处理，对手术小鼠细胞免疫功能和伤口愈合的影响。结果表明，高渗盐水处理组小鼠腹壁切口裂开的张力（１４９．０±９．１ｍｍＨｇ）明显高于生理盐水处理组（１２４．１±９．２ｍｍＨｇ）；高渗盐水处理组的迟发型超敏反应（ＤＴＨ）程度（０．０７３ｇ±０．０２５ｇ）和淋巴细胞增殖能力（刺激指数１８．０±９．６）均明显高于生理盐水处理组（分别为０．０４５ｇ±０．００９ｇ和８．５±７．６）。体外实验还发现，提高培养液中氯化钠的浓度，术后２４ｈ淋巴细胞的活性增加，表明高渗盐水处理具有提高术后小鼠细胞免疫功能及促进伤口愈合的作用     

低血容量性休克大鼠心肌细胞Ca2+浓度及膜电位的变化

目的 旨在探讨低血容量性休克大鼠心肌细胞Ca2 浓度及其膜电位的变化.方法 选用Wistar大鼠84只,随机分成休克高渗复苏组(HES组)、生理盐水复苏组(NS组).建立休克模型,按7个时相(休克前、休克、复苏后5、15、30、60、90min)处死大鼠.取心室肌细胞培养传代,用Fluo-4/AM为游离钙荧光探针、JC-1荧光染色,流式细胞仪分别检测不同时相心肌细胞Ca2 浓度及线粒体膜电位.结果 HES组在休克、复苏后5、15、30min各时间点心肌细胞Ca2 浓度较休克前明显升高,其膜电位较休克前显著降低(P＜0.01);在复苏后60、90min心肌细胞Ca2 浓度及线粒体膜电位与休克时比较差异有显著性意义(P＜0.01);NS组在休克、复苏后各个时相与休克前比较心肌细胞Ca2 浓度均明显升高,其膜电位明显下降(P＜0.01);复苏后各时间点与休克时比较差异无显著性意义(P＞0.05);HSE组和NS组在休克后60、90min心肌细胞Ca2 浓度及其膜电位差异有显著性意义(P＜0.01).结论 低血容量性休克可诱发大鼠心肌细胞Ca2 浓度升高,线粒体膜电位下降,导致心肌细胞电生理活动障碍;高渗盐溶液不但可改善低血容量休克时心肌细胞Ca2 浓度,而且能有效地稳定其线粒体膜电位;而生理盐水对心肌细胞Ca2 浓度及其膜电位的作用不显著.     

RADIOFREQUENCY ABLATION USING HYPERTONIC SALINE SOLUTION INSTILLATION： AN EX VIVO STUDY

Objective To determine whether radiofrequency ablation using hypertonic saline solution instillation can increase the extent of thermally mediated coagulation in ex vivo pig liver tissue. Methods Fifty-six radiofrequency ablation lesions were produced in fresh ex vivo pig＇s liver. According to different saline solutions, the lesions were divided into six groups： 25% acetic acid, 18% NaCl, 10% NaCl, 5% NaCl, 0.9% NaCl, and distilled water. After radiofrequency ablation, the lesions size and morphology were measured and compared.Results Using different instillation, the volume of coagulation necrosis was different： 25% acetic acid 〉18% NaCl 〉10% NaCl 〉5% NaCl 〉0.9% NaCl〉distilled water. Conclusion Radiofrequency ablation using hypertonic saline solution instillation can increase the volume of radiofrequency ablation induced necrosis.     

高晶体-高胶体渗透压混合液对原代培养星状胶质细胞糖代谢的影响

目的　观察星状胶质细胞在不同浓度高晶体 -高胶体渗透压混合液 ( HHS)中葡萄糖的代谢状况。方法　原代培养大白鼠胚胎的海马星状胶质细胞 ,暴露于不同浓度 HHS混合液 15分钟后测其细胞内 [1 4 C]脱氧葡萄糖 - 6-磷酸的含量。结果　暴露于 0 .0 5 %、0 .1%和 0 .2 5 % HHS混合液 15分钟后 ,胞内脱氧葡萄糖 - 6-磷酸的含量在 15分钟和 60分钟时明显增加 ( P<0 .0 5 ) ,与同一时间的对照值相比也明显升高 ( P<0 .0 5 )。 1天和 7天时星状胶质细胞内脱氧葡萄糖 - 6-磷酸的含量恢复至实验前对照值的水平 ( P>0 .0 5 )。结论　星状胶质细胞在暴露于不同浓度的高晶体 -高胶体渗透压混合液 15分钟后 ,在 60分钟内对葡萄糖的吸收增加 ,1天后即可恢复正常的葡萄糖代谢状态     

高渗氯化钠注射液治疗卒中后脑水肿的临床疗效观察

探讨(7%)高渗氯化钠注射液治疗卒中后脑水肿患者的治疗效果。将卒中后脑水肿患者分成两组,观察组50例,对照组50例,两组患者均接受内科常规治疗,观察组予高渗氯化钠注射液抗脑水肿,对照组予20%甘露醇抗脑水肿,观察治疗前后临床积分、头颅CT的变化以及不良反应发生情况。观察组的临床疗效优于对照组,且不良反应的发生率少于对照组。结论高渗氯化钠注射液治疗卒中后脑水肿优于甘露醇,且不良反应发生率较甘露醇组少。     

Aortic baroreceptor deafferentation diminishes saline-induced drinking in rats

The effect of bilateral surgical deafferentation of the baroreceptors in the aortic arch and carotid sinus on experimentally induced water intake was investigated in rats. Drinking was induced by subcutaneous administration of one of the following agents: hypertonic saline, polyethylene glycol, isoproterenol and angiotensin II, or by 18 h of water deprivation. Hypertonic saline-induced drinking was significantly attenuated after bilateral denervation of either the aortic arch plus the carotid sinus or the aortic arch alone. However, this diminished response disappeared when hypertonic saline was given in subsequent tests. The initial drinking deficit following hypertonic saline was independent of the time elapsed since the animals had undergone surgery. All other thirst challenges tested resulted in water intake that was not statistically different from sham-operated control groups. It is concluded that aortic baroreceptor deafferentation initially results in a diminished drinking response following hypertonic saline, possibly due to interruption of afferent information originating in osmosensitive areas in the aortic arch. A role of arterial baroreceptors in the regulation of non-osmotically induced water intake is not supported by the present data.     

Treatment of Encainide Proarrhythmia with Hypertonic Saline

We report a case of successful treatment of encainide-induced ventricular tachycardia with 3% hypertonic saline. To our knowledge, no other report exists in the literature of this treatment for proarrhythmic ventricular tachycardia from a type 1C agent. Metabolic consequences of the treatment included severe hypernatremia, hyperosmolarity, hypocalcemia, and hypophosphatemia, which were reversible over 24 hours. In spite of the risks, treatment of incessant ventricular tachycardia induced by type 1C agents with hypertonic saline may be life saving.