解磷注射液救治急性有机磷农药中毒34例临床报告

将急性有机磷农药中毒患者69例随机分为2组,一组主要应用解磷注射液治疗(新疗法34例),另一组(35例)主要应用阿托品治疗。两组治愈率分别为97.1％及77.1％,疗效比较差异显著(P<0.05)。新疗法的优点是起效快,作用持久,疗程短(两组比较P<0.001),副反应轻,值得推广应用。并就应用方法及注意事项等作了探讨,也强调了早期足量用药的重要性。     

核桃仁泥外敷治疗肌肉注射后皮下硬结的疗效观察

采用核桃仁泥外敷治疗１３８例（实验组）肌肉注射后皮下硬结，并与４０例（对照组）采用新鲜土豆片外敷硬结法比较。结果表明：实验组患者治疗１５天后Ⅰ度和Ⅱ度硬结治愈率分别为８１．１３％和４２．２５％，总有效率达９２．０３％，明显优于对照组（Ｐ＜０．００１）。     

6种中药制剂治疗急性脑梗死的成本-效果分析

目的：运用药物经济学的方法对在我院应用的6种中药注射液进行成本-效果分析。方法：271例急性脑梗死患者依据药物治疗方案不同分为6组，即血塞通组、舒血宁组、苦碟子组、疏血通组、川芎嗪组、丹红组，分别观察疗效，并运用药物经济学的方法进行成本-效果分析。结果：疏血通组的成本为3 419.90元，总有效率最高（91.84%），6组间增量成本-效果最低。因此疏血通组是较为合理、经济的方案。     

喜炎平注射液联合维生素K3治疗小儿秋季腹泻的疗效观察

目的观察喜炎平与维生素K3联合治疗小儿秋季腹泻的疗效.方法将89例秋季腹泻患儿随机分为2组.治疗组采用喜炎平与维生素K3联合治疗,对照组则采用利巴韦林治疗,疗程5d.结果治疗组的总有效率为93.3%,显著优于对照组的65.9%(X2=10.37,P＜0.01).结论喜炎平与维生素K3联合治疗小儿秋季腹泻值得进一步推广.     

Large volume injection and infiltration system

Summary A system which can be used for injection or infiltration of large volumes of fluid is described. This consists of a syringe which fills automatically from a reservoir through an inlet/outlet valve.     

参麦注射液治疗心绞痛的临床观察

目的　探讨参麦注射液对冠心病 (CHD)心绞痛的治疗作用。方法　 80例患者分为两组 ,每组 4 0例 ,在常规治疗的基础上 ,对照组应用丹参注射液进行治疗 ,治疗组应用参麦注射液进行治疗。结果　治疗组有效 39例 (97.5 % ) ,心电图改善 38例 (95 .0 % ) ,对照组分别为 31例 (77.5 % )和 2 9例 (72 .5 % ) ,组间比较具有显著性差异 (P <0 .0 1)。结论　参麦注射液对冠心病心绞痛疗效显著 ,且安全、无明显副作用     

复方麝香注射液联合脑血肿引流术治疗中老年高血压脑出血疗效观察及费用对比

目的:探讨复方麝香注射液联合微创手术治疗中老年高血压脑出血的临床疗效.方法:将78例接受微创治疗的患者随机分组,两组均采用内科综合治疗.手术对照组在综合治疗基础上加用微创手术进行脑血肿引流;中西医结合组在微创手术治疗后加用复方麝香注射液(10～20 ml/d)静脉滴注1周.结果:中西医结合组显效率(66.67%)、有效率(82.05%)均明显高于手术对照组(46.15%和69.23%,P均<0.05),存活患者日常生活能力也明显优于手术对照组(P<0.05),意识恢复时间明显短于手术对照组(P<0.05),并发症的发生率(15.38%)明显低于手术对照组(38.46%,P<0.01),病死率(5.13%)明显低于手术对照组(10.26%,P<0.01),平均住院天数[(18.29±4.93)d]明显少于手术对照组[(26.23±5.82)d,P<0.05],平均住院费用[(5 916.23±826.39)元]明显少于手术对照组[(8 168.35±1 021.21)元,P<0.05].结论:脑血肿引流术后加用复方麝香注射液治疗中老年高血压脑出血,可降低病死率,减少并发症,降低病残程度,提高生存患者的生活质量,缩短住院时间,降低治疗费用.     

Epidural block for obstetrics: Comparison of bolus injection of local anesthetic with gravity flow technique

Study Objective: To test the hypothesis that slow administration of local anesthetic into the epidural space by gravity flow reduces the incidence of signs and symptoms of unintended injection.

Design: Prospective, randomized study.

Setting: Teaching hospital.

Patients: 600 ASA physical status I and II parturients scheduled for labor and delivery or elective cesarean section.

Interventions: After identification of the epidural space with pulsations of an air-fluid column, parturients for vaginal delivery (n = 380) were randomized to receive a test dose of 3 ml 3% 2-chloroprocaine with epinephrine 20 μg, two doses of 7 ml bupivacaine 0.03 % with sufentanil 1 μg/ml and epinephrine 2 μg/ml by either gravity flow (Group 1) given over 30 seconds or by bolus injection (Group 2) given over 5 seconds through the epidural needle; parturients for Cesarean delivery (n = 220) were randomized to receive a test dose and two doses of 6 ml lidocaine 2 % with sufentanil 1 μg/ml and epinephrine 2 μg/ml by either gravity flow or by bolus injection through the epidural needle. Changes in maternal heart rate (HR) and blood pressure, signs of intravascular injection, and adverse effects of epidural bupivacaine-sufentanil were recorded after each dose.

Measurements and Main Results: Gravity flow administration (Group 1) was associated with a smaller increase in mean maternal HR (p < 0.001), less hypotension (p < 0.01), sedation (p < 0.01), nausea (p = 0.01), and segmental spread (p < 0.0001) than were corresponding doses given by traditional bolus injection (Group 1) for vaginal or Cesarean deliveries. The incidence of systemic toxicity was zero of 300 (0%) with gravity flow and 4 of 300 (1.3%) by bolus injection, p = 0.12, Fisher's exact test. No patient in either group had an accidental intrathecal injection.

Conclusion: Gravity flow administration of local anesthetic-opioid solution during epidural block for obstetrics was associated with fewer signs of systemic drug absorption and cardiovascular perturbations than was the traditional bolus injection. This study supports the current opinion that slow administration of local anesthetic during epidural black contributes to fewer adverse events.     

Insulinoma: Selective arterial calcium injection performed to confirm localization and complete resection

A case of insulinoma is reported in a patient in whom selective arterial calcium injection (SACI) tests were performed both to confirm tumor localization before surgery and to confirm complete tumor removal during surgery. An 18-year-old woman with hypoglycemic episodes was diagnosed with an insulinoma in the pancreatic body demonstrated by celiac arteriography. In a preoperative SACI test, calcium was injected into the splenic artery (SpA), gastroduodenal artery (GDA), and superior mesenteric artery (SMA). Serum immunoreactive insulin (IRI) and proinsulin levels were measured in hepatic venous samples. IRI was markedly increased after the injection of calcium into the GDA and SMA, while there was no response in IRI levels when calcium was injected into the SpA. Therefore, no occult insulinoma was revealed in the distal area fed by the SpA, although the presence of insulinoma was uncertain in the proximal pancreas. In the intraoperative SACI test, calcium was injected into the celiac artery. Insulin (determined by enzyme immunoassay) and proinsulin levels were measured in portal venous samples before and after resection of the tumor. After resection, these levels decreased in response to the calcium stimuli, confirming complete removal of the insulinoma. The SACI test was helpful to localize the insulinoma and was useful to confirm the complete removal of the tumor.     

Mechanisms underlying the antidopaminergic effect of clonazepam and melatonin in striatum

Intrastriatal injection of the GABA_A antagonist, bicuculline, caused about a 75% decrease in the inhibitory effect of the central-type benzodiazepine (BZ) agonist, clonazepam or the indoleamine hormone, melatonin, on apomorphine-induced rotation in a 6-hydroxydopamine model of dopaminergic supersensitivity. Pretreatment with the peripheral-type BZ antagonist, PK 11195 (intrastriatally or intraperitoneally), also attenuated the antidopaminergic effect of these drugs but with much less potency than bicuculline. However, the combination of both bicuculline and PK 11195, injected directly into the striatum, completely blocked the antidopaminergic action of clonazepam or melatonin. These results indicate that the antidopaminergic action of clonazepam and melatonin in the striatum involves two distinct mechanisms: (1) a predominant GABAergic activation via the BZ/GABA_A receptor complex, and (2) a secondary mechanism linked to a PK 11195- sensitive BZ receptor pathway. Recent studies indicate that PK 11195 blocks BZ-induced inhibition of the adenylyl cyclase-cyclic AMP pathway in the striatum. Since cyclic AMP has been implicated in the rotational behaviour of 6-hydroxydopamine-lesioned animals, it is possible that the antidopaminergic action of clonazepam and melatonin also involves suppression of this second messenger. All rights reserved.