64层螺旋CT冠状动脉成像患者应用地西泮联合美托洛尔干预心率的效果观察

目的 观察64层螺旋CT冠状动脉成像患者应用地西泮联合美托洛尔干预心率的效果.方法 在造影检查前对受检者进行详细的健康教育,并让其在安静环境下休息15 min后,心率≥90次/min且≤110次/min的患者纳入研究.按预约检查先后顺序随机交替分组,观察组遵医嘱给予联合应用地西泮注射液及盐酸美托洛尔片;对照组单纯口服盐酸美托洛尔片.观察两组受检者心率控制时间及检查时心率波动范围、检查成功率.结果 观察组受检者心率控制时间明显比对照组短,检查过程中心率波动幅度>10次/min的发生率明显比对照组低,检查成功率明显比对照组高,差异均有统计学意义.结论 适当联合应用地西泮注射液及盐酸美托洛尔片可快速有效地控制受检者的紧张情绪,增强控制心率效果,优化工作流程,使设备、人力资源得到最大程度利用.     

Electroencephalographic effects and serum concentrations after intranasal and intravenous administration of diazepam to healthy volunteers

AIMS: To evaluate the electroencephalographic (EEG) effects, blood concentrations, vehicle irritation and dose-effect relationships for diazepam administered nasally. METHODS: The study had a cross-over design with eight healthy volunteers (one drop out). It consisted of four legs with four different administrations: intranasal (i.n.) placebo, 4 mg diazepam i.n., 7 mg diazepam i.n. and 5 mg intravenous (i.v.) diazepam. Polyethylene glycol 300 (PEG300) was used as a vehicle in the nasal formulations to solubilize a clinically relevant dose of diazepam. Changes in N100, P200 and P300 brain event-related potentials (ERP) elicited by auditory stimulation and electroencephalographic beta-activity were used to assess effects on neurological activity. RESULTS: The mean [95% confidence intervals] differences between before and after drug administration values of P300-N100 amplitude differences were -0.9 [-6.5, 4.7], -6.4 [-10.1, -2,7], -8.6 [-11.4, -5.8] and -9.6 [-12.1, -7.1] for placebo, 4 mg i.n., 7 mg i.n. and 5 mg i.v. diazepam, respectively, indicating statistically significant drug induced effects. The bioavailabilities of 4 and 7 mg i.n. formulations, were found to be similar, 45% [32, 58] and 42% [22, 62], respectively. CONCLUSION: The present study indicates that it is possible to deliver a clinically effective nasal dose of diazepam for the acute treatment of epilepsy, using PEG300 as a solubilizer.     

酶水解后高效液相色谱法测定尿中地西泮及其代谢物

目的：用酶水解葡萄糖酸苷结合物,HPLC法同时检测尿中地西泮及其代谢物。方法：尿样2ml,与一定量内标混合后,加β－葡萄糖醛酸苷酶0.5ml,55℃酶解2h,正己烷－二氯甲烷（5：3）5ml提取、挥干、50μl甲醇定容,HPLC进样检测。结果：各药物及代谢物的最低检测限均小于2ng/ml;在12.5-375ng/ml范围内成线性关系;相关系数r为0.9998;精密度在10.6%以下;回收率为92.7%-108.6%,均符合要求。结论：本法结果可靠,重现性好。可用于地西泮药物中毒或有关案例的分析检验。     

丹参注射液和纳洛酮治疗急性重度安定中毒疗效观察

目的 :观察复方丹参注射液和盐酸纳洛酮治疗急性重度安定中毒的疗效。方法 :70例急性重度安定中毒患者随机分为 2组。对照组 34例用传统方法治疗 ;治疗组 36例在对照组基础上 ,加用复方丹参注射液和盐酸纳洛酮治疗 ,观察患者意识恢复及自觉症状改善、消失的时间。结果 :在取得     

安定配合硬膜外阻滞镇痛分娩的临床研究

目的:探讨产程活跃期应用安定加低浓度、小剂量、局麻药甲磺酸罗哌卡因及舒芬太尼实施自控镇痛泵镇痛分娩方法及对产程和母婴的影响。方法:实验组采取活跃期安定缓慢静脉推注联合低浓度、小剂量的1.192%甲磺酸罗哌卡因复合舒芬太尼实施硬膜外阻滞,微量自控泵给药的镇痛分娩;对照组自然分娩;两组比较分析。结果:实验组产妇第一产程平均时间(186.46±8.52)min、自然分娩率增91.25%、剖宫产率6.25%。产妇身心状态评估:宫缩时表情自然73例,心率、血压平稳,宫缩无影响。对照组产妇第一产程平均时间(270.68±12.34)min、自然分娩率66.25%、剖宫产率28.75%,产妇身心状态评估表情自然12例(P<0.01);心率、血压增快,具有统计学意义(P<0.05)。结论:安定配合硬膜外阻滞镇痛分娩的效果好,能缩短产程,降低剖宫产率,保持产妇良好的心态,提高产科质量,是比较理想的分娩镇痛方法。     

Selective breeding of mice for differential sensitivity to diazepam

A selective breeding study for differential sensitivity to diazepam was carried out from an outbred stock of Swiss albino mice. Mice were selected and mated according to their sleep times in response to a low hypnotic dose of 35 mg/kg diazepam. Only brother/sister mating was allowed for subsequent generations. Over six generations of two-way selection, it appears that upward selection for increased sleep time to diazepam was more effective, with a realized heritability of .7, compared to .3 for downward selection. It is concluded that a mouse line has been established that exhibits a relatively long sleep duration in response to diazepam administration.     

Putative endogenous ligands to the benzodiazepine receptor: What can they tell us?

The endogenous ligand for the benzodiazepine receptor has not been convincingly demonstrated, nor is it clear what role this drug receptor actually plays in brain function. A number of putative endogenous ligands for the benzodiazepine receptor have been identified and reported in the literature. These putative ligands, at various stages of purification, have been typically identified by their ability to displace ³H-diazepam in a radioreceptor binding assay. Taken together, these studies provide useful information on the role that the benzodiazepine receptor and its ligand might play in brain function. The purpose of this paper is to review this area of research and attempt to provide a unifying hypothesis. In summary, calling this bioactive site the benzodiazepine receptor may be a misnomer, as it appears to effect both anxiogenic and anxiolytic activities involved in the maintenance of homeostatic levels of vigilance. Moreover, it can be suggested that endogenous ligands of reciprocal action could exist, mediating each function (relaxation and vigilance) and, thereby, maintain a balance of neural activity.     

Diazepam binding inhibitor-like immunoreactivity(51–70): distribution in human brain, spinal cord and peripheral tissues

We have used specific radioimmunoassay to describe the distribution of diazepam binding inhibitor-like immunoreactivity (DBI-IR(51–70)) in human post-mortem tissues. In brain, highest concentrations were found in the cerebellum, amygdala, hippocampus, hypothalamus and substantia nigra. In the spinal cord, DBI-IR(51–70) was evenly distributed. In peripheral tissues, highest concentrations were found in the liver and kidney. Chromatographic analysis revealed several molecular forms of DBI-IR(51–70) the major form being of greater molecular weight and hydrophobicity than the synthetic fragment peptide. In peripheral tissues, but not in the CNS, a small peak of immunoreactivity was indistinguishable form the synthetic peptide. DBI-IR(51–70) is therefore widespread, but tissue processing may be different.     

Human behavioral pharmacology of benzodiazepines: Effects on repeated acquisition and performance of response chains

One scientific concern with benzodiazepine is their effects on learning (acquisition). One procedure that permits a detailed study of learning processes is the repeated acquisition of behavioral chains procedure. The repeated acquisition of behavioral chains allows for the repeated study of learning in individual subjects and also permits a comparison with comparable performance behavior. This paper reviews the effects of acute and chronic benzodiazepines on the repeated acquisition and performance of response chains. With acute administration, diazepam, alprazolam, and triazolam are all found to produce dose-related increases in percent errors in the acquisitions component, while generally not affecting percent errors in the performance component. Diazepam showed less activity than either alprazolam or triazolam. With chronic administration, acquisition showed tolerance to the errors-increasing effects of diazepam at a slower rate than did performance. Clinical implications of these findings are discussed.