移植肾破裂的处理

目的　提高移植肾破裂的防治水平。方法　 6例移植肾破裂 ,手术前 2例 ,手术后 4例。 2例术前供肾破裂 ,采用切开移植肾破裂处包膜 +裂口内明胶海绵填塞 +肠线修补 +肠线编织肾袋收缩保护移植肾。 1例术后移植肾破裂早期 ,出血少 ,针对顽固性高血压采用“硝普钠”降压 ,配合常规抗排斥药物。 3例术后移植肾破裂出血量估计超过 10 0 0ml者 ,采用手术延长移植肾破裂处包膜 +裂口内明胶海绵填塞 +肠线修补 +肠线编织肾袋收缩保护移植肾。结果　 ( 1)手术前 2例手术后 4例 ,采用切开或者延长移植肾破裂处包膜 +裂口内明胶海绵填塞 +肠线修补 +肠线编织肾袋收缩保护移植肾并配合“硝普钠”降压的方法处理 ,均未再破裂出血 ,移植肾功能恢复良好。 ( 2 ) 1例术后移植肾破裂早期的患者 ,针对顽固性高血压采用“硝普钠”降压 ,配合常规抗排斥药物 ,非手术治疗成功。结论　 ( 1)采用手术切开或延长移植肾破裂处包膜 +裂口内明胶海绵填塞 +肠线修补 +肠线编织肾袋收缩保护移植肾可以有效治疗移植肾破裂。 ( 2 )移植肾破裂出血少的情况下 ,可以在密切观察下非手术治疗     

透明质酸钠预防粘连性肠梗阻术后再粘连临床观察

Objective To investigate the prevention of intestines adhesion about sodium hyaluronic acid in postoperative intestines adhesion.Methods Eighteen cases of adhesive intestine obstruction were done intestinal release or bowel resection.2～4mL sodium hyaluronic acid was put to the wound,anastigmatic and rough surface of peritoneal.Gastrointestinal decompression,anti-infective and infusion were taken after oper-ations.Followed up 8～24 months.Results Obstructive symptoms haven't happened,the effective rate is 100%.Only 2 cases have intermittent abdominal pain without obstruction,the incidence was 11%.Conclu-sion Sodium hylauronic acid is effective to prevent the adhesion of postoperative intestines adhesion,simp-ler use,fewer side-effects and great value to appliance.     

硝普钠结合控制性再灌注预防肺缺血再灌注损伤的实验研究

目的　探讨硝普钠结合控制性再灌注在预防肺缺血再灌注损伤中的作用及其机制。方法　将 1 4只猪随机分为对照组 (Ⅰ组 )和实验组 (Ⅱ组 )。对照组在去除肺动脉阻断 ,恢复自体血流前 ,给予控制性再灌注处理 (灌注液 :去白细胞∶改良Buckberg液 =4∶1 ,灌注压 1 8mmHg ,灌注时间 1 0min ,温度 37℃± 1℃ )。实验组在去除肺动脉阻断 ,恢复自体血流前 ,给予控制性再灌注 ,后经肺动脉以每分钟 1 .0 μg kg注入硝普钠 1 0min ,余处置同对照组。 0 .5 ,1和 2h后测血氧分压、肺血管阻力、肺顺应性及肺氧合功能变化 ,实验结束后 ,取肺组织测NO含量、MDA含量及肺含水量。结果　实验组的左肺氧合功能和肺顺应性明显好于对照组 (P <0 .0 5 )。肺循环阻力、丙二醛 (MDA)值及肺含水量均低于对照组 (P <0 .0 1 )。实验组肺中NO含量较对照组明显升高 (P <0 .0 1 )。结论　硝普钠结合控制性再灌注能明显降低肺缺血再灌注损伤 ,起到了较好的移植肺保护效果     

阿奇霉素和鱼腥草治疗小儿下呼吸道感染

目的　探讨静脉点滴阿奇霉素和鱼腥草治疗小儿下呼吸道感染的临床疗效及其安全性。方法　采用随机对照分组研究 ,观察组使用阿奇霉素 5～ 10mg/kg ,每日 1次 ,加鱼腥草 1～ 3ml/ (kg·d) ,每日 1次静脉滴注 ,疗程 5～ 7d。对照组选用头孢拉定 5 0～ 10 0mg/ (kg·d)加利巴韦林 10mg/ (kg·d)静脉滴注 ,每日 2次 ,疗程 5～ 7d。结果　观察组痊愈率和有效率分别为 72 .5 %和 89.8% ,而对照组的痊愈率和有效率分别为 4 5 .3%和 73.6 % (P <0 .0 1) ,观察组和对照组的不良反应发生率分别为 13.5 %和 10 .8% (P >0 .0 5 )。结论　阿奇霉素加鱼腥草静脉滴注治疗小儿下呼吸道感染临床疗效确切 ,不良反应较少     

THE CAIMA SYSTEM

CAIMA is the abbreviation of Computer-Assisted Instant Monitoring drug Administration. CAIMA works on the principle of closed-loop negative feedback. Special programs have been designed to meet the needs of: a) Patients' safety, b) Response level desired, c) Output necessary for actuating the injecting pump. The pump forces the drug solution to enter the body with high precision. The author shows 8-year experience of using CAIMA system in laboratory and in hospital operating rooms. Experimental studies revealed that: CAIMA system attenuates the overshots and undershots usually present in reaction to drug administration, thus saves the drug and thereby causes less side-efiffeets, while the recovery is also much shortened. CAIMA system provides a greater tolerance to extra-stimuli and preserves the body original reactive sensitivity to drug. The homeostasis in animals is better kept with CAIMA than without. Clinically, the arbitrary hypotension during brain surgery with sodium nitroprusside and the control of muscle relaxation in general surgery with muscle relaxants have been successful using CAIMA system.     

亚硝酸钠与AFB1相互作用对遗传物质影响的实验研究

以正常人外周血淋巴细胞的ＳＣＥ率作为细胞遗传学指标，研究了Ｎａ＿２ＳｅＯ＿３与ＡＦＢ＿１相互作用对细胞遗传物质的影响。结果表明，一定浓度的Ｎａ＿２ＳｅＯ＿３（１０￣（－５）ｍｏｌ）对ＡＦＢ＿１所诱发的ＳＣＥ有明显的抑制作用，但当浓度达到１０￣（－２）ｍｏｌ时，细胞增殖受到抑制，到１０￣（－１）ｍｏｌ时细胞出现毒性现象。提示Ｎａ＿２ＳｅＯ＿３具有抑变和细胞毒性双相作用。所以在Ｎａ＿２ＳｅＯ＿３与ＡＦＢ＿１相互作用的ＳＣＥ实验中应避免Ｎａ＿２ＳｅＯ＿３的浓度过高而损伤培养的细胞。     

Short-term indomethacin administration does not impair excretion of acute potassium load in humans

Maintenance treatment with prostaglandin synthesis inhibitors often causes some degree of hyperkalemia, indicating impaired potassium (K) excretion. Hypoaldosteronism probably is a mediating factor, but it is unknown whether these drugs also impair renal K excretion directly. Indomethacin, for example, stimulates NaCl reabsorption in Henle's loop, and thus may impair K excretion by decreasing distal NaCl delivery. We therefore studied the effect of 1 day administration of indomethacin (50 mg tid) on the excretion of a single oral KCl (1 mmol kg-1 body weight) in six healthy volunteers taking a 40 mmol sodium diet. To allow analysis of renal sodium handling, clearance studies were performed during water loading. In this acute setting, indomethacin had no effect on plasma K, and did not decrease plasma aldosterone. However, indomethacin clearly reduced NaCl excretion. Nonetheless, the excretion of the K load was entirely normal. Excretion of the K load was accompanied by increased clearance of phosphate and uric acid, and natriuresis. Data derived from the maximal free water clearance were compatible with increased delivery to and decreased reabsorption from the diluting segment. Occurrence of these effects was not prevented by indomethacin, although overall NaCl excretion remained less than observed without indomethacin. Indomethacin reduced prostaglandin E2 excretion substantially. Apparently, in normal man indomethacin does not impair K excretion directly, even though it greatly reduces NaCl excretion. Moreover, the effects of K on renal NaCl handling, probably contributing to the excretion of a K load, are not dependent on renal prostaglandins.     

尼莫地平片溶出度的研究

采用转篮法对尼莫地平国产市售片，进口片和自制片在不同介质、不同转速和ＰＨ条件下的溶出度进行测试。结果表明，介质对尼莫地平溶出具有很大的影响，而最佳测定方法是以０．１％的十二烷基硫酸钠水溶液为介质，转速１５０ｒ／ｍｉｎ。     

Sodium Valproate-lnduced Cardiovascular Abnormalities in the JchlCR Mouse Fetus

Sodium valproate was administered to Jcl:ICR mice in order to evaluate teratogenicity in the cardiovascular system. A single dose of 600mg/kg of sodium valproate was injected intraperitoneally on gestational day 6, 7, 8 or 9. On day 18 of gestation, dams were laparotomized to observe incidence and type of cardiovascular abnormality in live fetuses. Cardiovascular abnormalities were found most frequently in the group treated on day 7, being recognized in 86% of litters (19/22) and in 29% of live fetuses (70/238). Among these, there were 28 cases of transposition of the great arteries, 13 of double outlet right ventricle, 11 of endocardial cushion defect, 9 of ventricular septal defect, 5 of tricuspid atresia, and 4 of hypoplastic left heart syndrome.     

川芎素对大鼠脑缺血再灌注时突触后致密物质-95活性的影响

应用神经行为学评估、脑梗死容积测量和Western blot分析,探讨研究阿魏酸钠(SF)的神经保护作用及其对局灶性脑缺血损伤时突轴后致密物质-95(PSD-95)活性的影响,证实SF明显改善再灌注24 h神经功能缺陷和减少脑梗死容积,显著增强再灌注后PSD-95表达,表明SF可能通过加强PSD-95活性来改善缺血性损伤.