清胰汤对重症急性胰腺炎营养状况的疗效观察

目的:观察中药清胰汤在重症急性胰腺炎患者的营养代谢中的治疗作用。方法:收集2006年7月～2010年7月收治的急性反应期SAP病人80例,分为清胰汤治疗组(治疗组)42人和常规治疗组(对照组)38人,观察、比较病人入院时、3d、7d、14d后的总蛋白、白蛋白、前白蛋白的血清水平变化。结果:治疗组和对照组的血清总蛋白、白蛋白、前白蛋白水平在住院第7d均上升,治疗组上升更快,两组比较在第7d、14d有显著性差异(P0.05)。结论:SAP患者早期能量消耗剧烈,患者表现为能量失衡状态。中西医结合治疗可以更好的维持早期SAP患者的营养状态。     

Glutamate receptors localize postsynaptically at neuromuscular junctions in mice

Dlg (Discs Large) is a multidomain protein that interacts with glutamate receptors and potassium channels at Drosophila neuromuscular junctions (NMJs) and at mammalian central nervous system synapses. Dlg also localizes postsynaptically at cholinergic mammalian NMJs. We show here that α‐amino‐3‐hydroxy‐5‐methylisoxazole‐4‐proprionate (AMPA) receptor subunits, together with glutamate, are present at the mammalian NMJ. Both AMPA and NMDA (N‐methyl‐D‐aspartate) glutamate receptor subunits display overlapping postsynaptic localization patterns with Dlg at all NMJs examined in normal mice. Kir2 potassium channels also localize with Dlg and glutamate receptors at this synapse. Localization of the components of a glutamatergic system suggests novel mechanisms at mammalian neuromuscular synapses. Muscle Nerve 39: 343–349, 2009     

Behavioral effects of 6-bromoflavanone and 5-methoxy-6,8-dibromoflavanone as anxiolytic compounds

Benzodiazepines (BDZs) are the most used psychoactive drugs in the pharmacotherapy of anxiety. A large number of structurally different classes of ligands are also active in the modulation of anxiety, showing high affinity for the benzodiazepine binding site (BDZ-bs) of the GABA (A) receptor complex. Various synthetic derivatives of natural flavonoids have been found to have very potent anxiolytic properties. This study was undertaken to provide a behavioral characterization of two novels halogenated flavonoids, 5-methoxy-6, 8-dibromoflavanone (FV1), and 6-bromoflavanone (FV2). These compounds were tested and compared to diazepam (0.5 mg/kg) and to the natural flavonoid chrysin (1 mg/kg) as a standard of activity. When injected in mice (0.5, 1 mg/kg i.p) both synthetic flavonoids increased the locomotor activity and the exploratory skills of the animals, as measured in the open-field and in the hole-board tests. Both compounds, indeed, had a clear anxiolytic activity in the elevated plus-maze, as measured by an increased number of entries and the percentage of time spent in the open arms. At the tested doses, both compounds did not induce sedative action or compulsive behaviour. These results encourage making deeper investigations on this field.     

The Influence of Superabsorbent Polymers and Nanosilica on the Hydration Process and Microstructure of Cementitious Mixtures

Superabsorbent polymers (SAPs) are known to mitigate the development of autogenous shrinkage in cementitious mixtures with a low water-to-cement ratio. Moreover, the addition of SAPs promotes the self-healing ability of cracks. A drawback of using SAPs lies in the formation of macropores when the polymers release their absorbed water, leading to a reduction of the mechanical properties. Therefore, a supplementary material was introduced together with SAPs, being nanosilica, in order to obtain an identical compressive strength with respect to the reference material without additives. The exact cause of the similar compressive behaviour lies in the modification of the hydration process and subsequent microstructural development by both SAPs and nanosilica. Within the present study, the effect of SAPs and nanosilica on the hydration progress and the hardened properties is assessed. By means of isothermal calorimetry, the hydration kinetics were monitored. Subsequently, the quantity of hydration products formed was determined by thermogravimetric analysis and scanning electron microscopy, revealing an increased amount of hydrates for both SAP and nanosilica blends. An assessment of the pore size distribution was made using mercury intrusion porosimetry and demonstrated the increased porosity for SAP mixtures. A correlation between microstructure and the compressive strength displayed its influence on the mechanical behaviour.     

Perfluorocarbon induced intra-arrest hypothermia does not improve survival in a swine model of asphyxial cardiac arrest

Background

Pulseless electrical activity is an important cause of cardiac arrest. Our purpose was to determine if induction of hypothermia with a cold perfluorocarbon-based total liquid ventilation (TLV) system would improve resuscitation success in a swine model of asphyxial cardiac arrest/PEA.

Methods

Twenty swine were randomly assigned to control (C, no ventilation, n = 11) or TLV with pre-cooled PFC (n = 9) groups. Asphyxia was induced by insertion of a stopper into the endotracheal tube, and continued in both groups until loss of aortic pulsations (LOAP) was reached, defined as a pulse pressure less than 2 mmHg. The TLV animals underwent asphyxial arrest for an additional 2 min after LOAP, followed by 3 min of hypothermia, prior to starting CPR. The C animals underwent 5 min of asphyxia beyond LOAP. Both groups then underwent CPR for at least 10 min. The endpoint was the resumption of spontaneous circulation maintained for 10 min.

Results

Seven of 9 animals achieved resumption of spontaneous circulation (ROSC) in the TLV group vs. 5 of 11 in the C group (p = 0.2). The mean pulmonary arterial temperature was lower in total liquid ventilation animals starting 4 min after induction of hypothermia (TLV 36.3 ± 0.2 °C vs. C 38.1 ± 0.2 °C, p < 0.0001). Arterial pO₂ was higher in total liquid ventilation animals at 2.5 min of CPR (TLV 76 ± 12 mmHg vs. C 44 ± 2 mmHg; p = 0.03).

Conclusion

Induction of moderate hypothermia using perfluorocarbon-based total liquid ventilation did not improve ROSC success in this model of asphyxial cardiac arrest.     

APACHEⅡ评分对重症急性胰腺炎患者行高容量血液滤过治疗时机选择的价值

目的探讨以APACHEⅡ评分标准衡量高容量血液滤过(HVHF)治疗重症急性胰腺炎(SAP)的治疗时机以及对疗效的影响。方法回顾性分析解放军第324医院、西南医院、新桥医院自2006年1月至2011年12月行HVHF治疗的113例SAP患者,根据HVHF治疗前患者APACHEⅡ评分标准分A组(20～24分)、B组(25～29分)、C组(≥30分),按照APACHEⅡ评分标准作为HVHF治疗的时机,对比分析3组的病死率、平均ICU住院时间、平均机械通气时间、平均连续血液滤过治疗时间,并将HVHF治疗前和治疗24h后的APACHEⅡ评分和SOFA评分、血浆IL-1β值、氧合指数、血浆肌酐(Cr)值、平均动脉压(MAP)等结果进行比较。结果 (1)C组HVHF治疗前APACHEⅡ和SOFA评分、血浆IL-1β值及病死率均明显高于A、B两组(P<0.01),B组HVHF治疗前APACHEⅡ评分、血浆IL-1β值及病死率均明显高于A组(P<0.01);(2)B组平均ICU住院时间、平均机械通气时间、平均连续血液滤过治疗时间均明显长于A组(P<0.05);(3)3组HVHF治疗24h后血浆IL-1β值、氧合指数、Cr值、MAP均明显改善,但C组IL-1β值仍高于A、B两组(P<0.01),B组IL-1β值仍高于A组(P<0.01);A、B两组HVHF治疗24h后APACHEⅡ和SOFA评分显著降低(P<0.01),C组变化差异无统计学意义(P>0.05)。结论 HVHF对SAP有良好的辅助治疗效果;APACHEⅡ评分对HVHF的治疗时机有指导意义,早期(APACHEⅡ评分为20～29分)HVHF可明显改善SAP的预后,当APACHEⅡ评分20～24分时行HVHF的疗效更好。     

经皮胆囊、腹腔置管引流和灌洗治疗SAP的体会

目的探讨经皮胆囊、腹腔穿刺置管引流、腹腔灌洗治疗重症急性胰腺炎（SAP）的方法和临床效果。方法2000年3月-2008年9月共有24例SAP患者运用经皮胆囊、腹腔穿刺置管引流、腹腔灌洗技术行非手术综合治疗。结果24例SAP患者行此方法治疗,9例发生并发症,2例死亡,余均治愈,治愈者平均住院42d。结论运用经皮胆囊、腹腔穿刺置管引流、腹腔灌洗技术治疗SAP操作简便,疗效肯定,可明显降低并发症发生率及病死率。     

重症急性胰腺炎28例手术治疗体会

目的探讨SAP手术治疗的临床价值及把握时机。方法回顾性分析手术治疗28例SAP的资料及后续治疗情况。结果28例患者均经手术引流治疗,治愈22例,死亡6例,病死率21.43%。结论对于SAP,不能片面夸大非手术治疗作用,及时行外科手术仍是治疗的重要手段。     

Short-term inhalation toxicity studies with peroxyacetyl nitrate in rats

The inhalation toxicity of peroxyacetyl nitrate (PAN) was examined in acute (single exposure), sub-acute (4-week repeated exposure) and subchronic (13-week repeated exposure) studies in rats. The 4-h LC₅₀ was found to be 95 ppm.In the 4-week study rats were exposed to 0, 0.9, 4.1 or 11.8 ppm PAN vapour for 6 h/day, 5 days/week. Exposure to 11.8 ppm caused abnormal behaviour, growth retardation, mortality, elevated haemoglobin contents, haematocrit values and erythrocyte counts, increased lung weights and severe inflammatory changes and epithelial hyper- and metaplasia in the respiratory tract. At 4.1 ppm minimal behavioral disturbance, transient growth depression, slightly increased lung weights and mild histopathological changes in the respiratory tract were found. At 0.9 ppm no treatment-related alterations were detected.In the 13-week study rats were exposed to 0, 0.2, 1.0 or 4.6 ppm PAN vapour for 6.5 h/day, 5 days.week. Exposure to 4.6 ppm resulted in changes similar to those found at 11.8 ppm in the 4-week experiment, but no mortality occurred. At 1.0 ppm minimal irritation of the mucous membranes in the nasal cavity was the only PAN-related effect observed. No treatment- related changes were seen at 0.2 ppm. It was concluded that the no-toxic- effect level is between 0.2 and 1.0 ppm, and very probably close to the upper value.