1,6-二磷酸果糖治疗婴幼儿肺炎心衰疗效观察

应用脉冲多普勒超声心动图对３０例使用１，６－二磷酸果糖的肺炎心衰患儿进行心室舒缩功能指标的观测，并以２０例常规治疗的心衰患儿及２０例正常儿为对照组，评价１，６－二磷酸果糖的疗效。结果表明，１，６－二磷酸果糖能明显改善ＰＥＰ、ＰＥＰ／ＥＴ、ＰＥＰ／Ｒ－Ｒ、ＦＶＩ和ＳＶ等心室收缩功能指标及ＰＦＶＥ、Ｅ／Ａ、ＰＦＶＡ等心室舒张功能指标，使心功能恢复正常。１，６－二磷酸果糖对肺炎心衰引起的心肌缺血、缺氧有保护作用。     

防治果糖二磷酸钠致痛的效果比较

目的研究利百素凝胶对防治果糖二磷酸钠（FDP）致痛的效果.方法将36例静脉滴注FDP的患者随机分成盐水组、湿敷组、利百素组3组,每组各12例,每例均输注FDP 100 ml,20 min内输完,1次/天,每组共84例次.盐水组用生理盐水50 ml于输注FDP前、后输入.湿敷组用1：1的75%酒精与2%的利多卡因混合液,湿敷于穿刺点上方.利百素组在静脉穿刺前15～30min、输注FDP前、后,共3次在穿刺局部及沿静脉血管走向外涂一薄层利百素,观察记录疼痛情况.结果盐水组与湿敷组、盐水组与利百素组疼痛发生率差异有极显著意义（P＜0.01）.湿敷组与利百素组疼痛发生率差异有显著意义（P＜0.05）.结论利百素凝胶对防治FDP致痛效果显著、安全.     

1,6—二磷酸果糖对手术后应激病人应用全肠外营养支持效果的影响

本文在胃癌行全胃或胃大部切除术引起的中等程度应激病人，随机分组对比观察了全肠外营养或ＴＰＮ加用１，６－二磷酸果糖的效果。结果显示，与单纯ＴＰＮ相比，ＴＰＮ加用ＦＤＰ后血清皮质醇和胰高血糖素等应激激素水平有所下降，尿中３－甲基组氨酸排出减少，累积氮平衡增加。     

Changes in the infectivity, pyruvate kinase activity, acid phosphatase activity and P-glycoprotein expression in glibenclamide-resistant Leishmania mexicana

We previously demonstrated susceptibility of Leishmania sp. to glibenclamide, a K⁺-ATP transport blocker which interacts with members of the superfamily of adenosine 5′ triphosphate-binding cassette transporters. In order to characterize the molecular differences between a sensitive Leishmania strain, NR(Gs), and an experimentally selected glibenclamide-resistant strain, NR(Gr), specific biochemical and functional parameters have been evaluated both in the wild type and in the resistant strain. Most noteworthy, NR(Gr) exhibit an increased expression of P-glycoprotein and a decreased activity of functional key enzymes such as acid phosphatase, a prominent virulent factor of the parasite, and pyruvate kinase, a key control enzyme for both carbohydrate and protein metabolism. The specific biochemical, metabolic and functional changes observed in the resistant strain correlated with a reduced infectivity of stationary phase NR(Gr) in J774 macrophages and suggested a mechanism to overcome the effect of glibenclamide. Received: 21 January 2000 / Accepted: 1 March 2000     

1,6-二磷酸果糖治疗脑梗死43例疗效观察

目的 :观察 1 ,6 -二磷酸果糖 (FDP)对急性脑梗死的疗效。方法 :按照 1 986年“脑血管病会俄修订的诊断标准 ,选择 43例脑梗死为观察组 ,在基层治疗前提下 ,给FDP1 0g静点 ;另选择 42例具有可比性的病例为对照组。观察比较两组疗效指标。结果 :观察组以NFD明显低于对照组。结论 :FDP通过诸多作用 ,对急性脑梗死有显著疗效     

血中纤维蛋白降解产物和D—二聚体水平对硅沉着病早期诊断意义 …

目的：探讨纤维蛋白降解产物（ＦＤＰ）和Ｄ－二聚体（Ｄ－Ｄｉｍｅｒ）两项指标在硅沉着病（原称矽肺）早期诊断中的意义和价值。方法：用ＥＬＩＳＡ法测定正常人、接尘工人和不同期别的硅沉着病病人血中ＦＤＰ和Ｄ－Ｄｉｍｅｒ含量变化并测定其他指标。结果：硅沉着病早期ＦＤＰ和Ｄ－Ｄｉｍｅｒ水平很高,随着硅沉着病的晋期,ＦＤＰ和Ｄ－Ｄｉｍｅｒ水平逐渐下降。结论：ＦＤＰ和Ｄ－Ｄｉｍｅｒ作为硅沉着病早期诊断指标具有一下     

凝血及纤溶因子水平对新生儿弥散性血管内凝血的诊断价值

目的探讨血浆凝血酶-抗凝血酶复合物(TAT)、D-二聚体(D-D)、纤维蛋白原降解产物(FDP)检测在早期诊断新生儿弥散性血管内凝血(DIC)中的价值。方法将收治的105例危重患者作为研究组,所有患儿新生儿危重病例评分小于或等于90分;其中诊断为pre-DIC患儿57例;另选同期在妇产科出生的60例健康新生儿作为对照组。对弥散性血管内凝血前状态(pre-DIC)患儿采用小剂量肝素治疗,对比各组血浆D-D、TAT、FDP水平。结果与对照组相比,危重患儿血浆D-D、TAT、FDP水平明显升高,两组间相比差异有统计学意义(P0.05);治疗后pre-DIC患儿血浆D-D、TAT、FDP水平降低至正常水平内,与治疗前相比差异有统计学意义(P0.05)。相关性分析显示血浆D-D、TAT、FDP水平与危重病例评分呈明显负相关关系(P0.05);D-D、TAT、FDP联合检测能够明显提高诊断的敏感性和特异性。结论血浆D-D、TAT、FDP检测可以作为新生儿DIC早期诊断和干预治疗的依据。     

Coagulofibrinolytic changes in patients with disseminated intravascular coagulation associated with post-cardiac arrest syndrome― Fibrinolytic shutdown and insufficient activation of fibrinolysis lead to organ dysfunction

Introduction

Post-cardiac arrest syndrome (PCAS) is often associated with disseminated intravascular coagulation (DIC), thus leading to the development of multiple organ dysfunction syndrome (MODS). The aim of this study was to examine the pathophysiological relationships between coagulation, fibrinolysis and fibrinolytic shutdown by evaluating the levels of coagulofibrinolytic markers, including soluble fibrin, thrombin-activatable fibrinolysis inhibitor (TAFI), tissue plasminogen activator-plasminogen activator inhibitor-1 complex (tPAIC), plasmin-alpha2 plasmin inhibitor complex (PPIC), neutrophil elastase and fibrin degradation product by neutrophil elastase (EXDP).

Materials and Methods

Fifty-two resuscitated patients were divided into two groups: 22 DIC and 30 non-DIC patients.

Results

The levels of soluble fibrin, PPIC, tPAIC, EXDP and neutrophil elastase in the DIC patients with PCAS were significantly higher than those observed in the non-DIC patients. The values of the tPAIC and JAAM DIC scores were found to be independent predictors of increased SOFA scores in the DIC patients. The MODS patients demonstrated significantly higher levels of soluble fibrin and tPAIC; however, the levels of TAFI and EXDP were identical between the patients with and without MODS. In addition, positive correlations were observed between the levels of tPAIC and EXDP in the patients with non-MODS; however, no correlations were observed between these markers in the MODS patients.

Conclusions

Thrombin activation and fibrinolytic shutdown play important roles in the development of organ dysfunction in PCAS patients. Neutrophil elastase-mediated fibrinolysis cannot overcome the fibrinolytic shutdown that occurs in DIC patients with PCAS, thus resulting in the development of MODS.     

Common carotid arteritis and polymyalgia with Mycoplasma pneumoniae infection

A few pediatric cases with brain vasculitis most frequently affecting the middle cerebral artery have been reported in association with Mycoplasma pneumoniae infection, but involvement of the common carotid artery (CCA) before the bifurcation has not been reported to date. We report herein a case of 10-year-old boy with common carotid arteritis and polymyalgia associated with Mycoplasma pneumoniae infection. His fever and cough began 2 weeks before, and his right upper and lower extremity pains began 2 days before admission. He had initially been treated with clarithromycin followed by tosufloxacin, but his symptoms persisted. His M. pneumonia–specific antibody titer was high on admission (1:10240 by particle agglutination method) and the gene of M. pneumoniae was detected in a throat swab specimen by the loop-mediated isothermal amplification method with initial high levels of serum interleukin-8, tumor necrosis factor-α, and interleukin-18 along with elevated blood levels of complements. On the 5th day of hospitalization, vascular echograms of the extremities and neck showed increasing intima-media thickness of bilateral CCAs without stenosis and/or thrombosis and T2-weighted with lipid suppression magnetic resonance imaging of the neck showed high signal intensity of bilateral CCA walls. Coagulation studies were unremarkable and no autoantibodies were detected as far as tested. He was successfully treated by intravenous administration of prednisolone and was stable without any neurological sequelae 17 months after the onset without medication. His particle agglutination titer decreased to 1:5120, and serum interleukin-8, tumor necrosis factor-α, interleukin-18, and complement levels returned to normal.