肝硬化患者不同阶段对心功能影响的临床研究

目的观察Child-Pugh分级后各肝功能不同阶段肝硬化患者心功能的变化规律。方法选取肝硬化患者96例(实验组)根据肝功能child-Pugh分级方法分为:Ⅰ组26例,Ⅱ组32例,Ⅲ组38例,健康体检者31例(对照组)。彩色多普勒超声心脏检查其左心舒张末期内径(LVD),二尖瓣血流频谱E波峰值速度和A波峰值速度(E/A值),左心收缩末期内径(LVS),左房前后径(LAD),左室射血分数(LVEF)数据。结果 (1)肝硬化患者与正常组比较LVD、LVEF、LVS显著增加,LAD增大(P<0.01);(E/A)值下降(P<0.01)。(2)肝硬化患者各组与正常组比较LVEF:正常组<Ⅰ组(P<0.05);正常组<Ⅱ组和Ⅲ组(P<0.01);LVD、LVS、LAD正常组<Ⅱ组(P<0.05)Ⅲ组(P<0.01),正常组与Ⅰ组比较差异无统计学意义(P>0.05);E/A值正常组>Ⅰ组(P<0.05),Ⅱ组、Ⅲ组(P<0.01)。(3)肝硬化患者各组各项指标比较:Ⅰ组与Ⅱ组比较LVEF(P<0.01),LAD、LVD、LVS、E/A值均为(P>0.05)无显著性差异;Ⅰ组与Ⅲ组比较LVEF(P>0.05)无显著性差异,...     

脓毒症患者左心室功能改变及其临床意义探讨

目的探讨脓毒症患者左心室功能改变特征及其临床意义。方法采用前瞻性研究方法,以84例脓毒症患者为研究对象,20例健康查体者为对照组,脓毒症患者入院后行动态超声心动图检查,并测定血清IL-6和cTnT浓度,同时记录临床资料及临床转归。对照组测定血清IL-6和cTnT浓度。结果根据超声心动图检查结果将脓毒症患者左心室功能的改变分为3种类型:Ⅰ型(51例),表现:LVEDD正常,LVEF正常,E/A减低。Ⅱ型(18例),表现:LVEDD扩大,LVEF正常,E/A减低。Ⅲ型(15例),表现:LVEDD扩大,LVEF减低,E/A减低。三型患者性别、年龄、感染部位及病原体类别之间差别无统计学意义(P>0.05)。脓毒症患者IL-6浓度高于对照组(P<0.01),Ⅲ型患者IL-6和cTnT浓度高于Ⅰ、Ⅱ型(P<0.05);Ⅲ型患者休克、MODS发生率高于Ⅰ、Ⅱ型(P<0.05);病死率:Ⅲ型(73.33%)>Ⅰ型(21.57%)>Ⅱ型(0)(P<0.01)。结论脓毒症患者普遍存在左心室舒张功能减低,部分同时合并左心室收缩功能减低;IL-6和cTnT参与了左心室功能不全的发生;左心室收缩功能减低者预后差;左心室扩张不伴收缩功能...     

2型糖尿病患者血尿酸水平检测的临床意义

目的探讨2型糖尿病患者血尿酸水平检测的临床意义,及其与其他生化指标的相关性。方法选择我院2006年2月至2009年2月收治的2型糖尿病患者82例,并与32例健康者作对照,分别检测其血尿酸、TG、TC水平,并进行统计学分析。结果2型糖尿病组血尿酸水平显著升高,与正常对照比较,P<0.05。直线相关分析显示,血尿酸水平与TG呈明显正相关(r=0.2463,P<0.05),与TC无明显相关性(r=0.1204,P>0.05)。结论血尿酸水平的检测对2型糖尿病患者具有一定的临床指导作用。     

自拟痛风散治疗2型糖尿病合并痛风的临床观察

目的探讨自拟痛风散治疗2型糖尿病合并痛风的临床效果。方法分析我院收治的109例2型糖尿病合并痛风患者,分为2组进行对比。结果西药组总有效率83.3%,中药组总有效率为92.7%.中药组总有效率明显高于西药组,有显著的的统计学差异性(P<0.05)。2组血糖治疗前后无显著性差异(P>0.05);中药组治疗后血尿酸较西药组明显下降,有显著性的统计学差异(P<0.05)。结论降糖药和自拟痛风散治疗糖尿病合并痛风能有效改善临床症状,不良反应少,是一种安全、有效的治疗方法。     

瑞芬太尼在老年患者麻醉中的应用

目的探讨瑞芬太尼在老年患者麻醉中的应用。方法采用回顾性分析的方法,分析我院收治的老年患者100例麻醉的临床资料。结果观察组和对照组组内HR、SBP及DBP诱导后与麻醉前比较;插管后与诱导后比较;均具有明显差异(P<0.05)。观察组插管后和切皮的HR、SBP及DBP均明显低于对照组(P<0.05);观察组苏醒时间均明显优于对照组(P<0.05)。但是,观察组的VAS评分高于对照组(P<0.05)。结论瑞芬太尼在老年患者手术中应用安全、有效、可行,值得临床推广使用。     

胰岛素强化治疗糖尿病肾病的疗效观察

目的探讨胰岛素强化治疗糖尿病肾病的疗效。方法对90例糖尿病肾病患者,分为治疗组和对照组。2组患者行常规治疗的基础上,给予胰岛素泵持续皮下注射24～66U/d,2组均治疗4周。在治疗前及治疗后第4周均抽静脉血测定ACR、FPG、2hPG、TC、TG、C肽和24h尿微量白蛋白。结果治疗组与对照组ACR、FPG、2hPG、TC、TG、C肽和尿微量白蛋白各项指标与治疗前比较,均有显著的差异(P<0.05),这7个指标治疗组与同期对照组比较,差异具有显著性(P<0.05)。结论胰岛素泵治疗糖尿病肾病疗效显著,值得临床推广。     

腹部闭合性肝损伤30例诊治分析

目的了解腹部闭合性肝损伤的治疗方法,总结临床治疗闭合性肝损伤的经验。方法对30例腹部闭合性肝损伤患者的临床诊治资料进行回顾性分析。结果手术治疗组与非手术治疗组在治愈率,并发症发生率及输血量上均存在显著差异,P<0.05。结论非手术治疗对Ⅰ-Ⅱ级肝损伤的治疗效果比较突出,而手术治疗对Ⅲ级以上的肝损伤的治疗效果较好。     

玛丽斯特普服务规程临床应用效果分析

目的研究分析玛丽斯特普服务规程临床应用的效果。方法选择2005年1月～2008年9月120例宫内节育器嵌顿和异位需要手术治疗而无手术禁忌症者,选择2007年1月～2008年9月意外妊娠来我院行人流术130例、宫颈糜烂光热治疗100例,分别随机分为MSI服务规程研究组,ⅠA组60例、ⅡA组65例、ⅢA组50例;常规护理组ⅠB组60例、ⅡB组65例、ⅢB组50例。分析比较各两组患者的焦虑水平、健康知识掌握和满意度。结果研究组术后焦虑水平明显低于对照组,研究组治疗前分别为(42.8±3.56)、(43.8±4.45)、42.5±4.15)(分);治疗后分别为(28.8±3.81)、28.2±3.76)、(27.9±4.02),对照组治疗前后变化不明显。研究组患者健康知识掌握分别为(28.6±3.80)、29.1±3.32)、(27.3±3.72)(分),对照组分别为(19.3±3.71)、(20.2±3.6)、(18.5±3.66)。研究组满意度均为100%,对照组分别为81.3%、80.6%、80.8%。经统计学处理,差异有统计学意义(P<0.05)。结论MSI临床应用降低了患者的焦虑水平,提高了患者的健康意识和满意度。     

2种注射方案治疗糖尿病的效果比较

目的比较2种注射方案治疗糖尿病的临床效果。方法选取临床糖尿病患者50例,将其随机分为2组,1组用长效胰岛素类似物联合速效胰岛素类似物多次皮下注射(Ⅰ组),另一组用胰岛素泵持续皮下注射速效胰岛素类似物(Ⅱ组),每组25例,观察空腹血糖、餐后2h血糖、餐前、睡前及夜间血糖、HbA1c目标值,共观察4周。结果 2组均在治疗第2天血糖就明显下降,治疗4周时空腹血糖、餐后2h血糖及HbA1c,均较治疗前有显著下降(P<0.01),胰岛素泵组血糖下降更早些。结论 2种注射方法均能获得较好的效果,能有效的控制血糖,比较而言,Ⅱ组使用胰岛素泵的患者,其依从性要优于Ⅰ组。     

血清抵抗素及其基因299G/A多态性与腹型肥胖的相关性研究

目的探讨血清抵抗素水平及其抵抗素基因多态性位点299G/A与腹型肥胖的相关性。方法测量125例非糖尿病的腹型肥胖患者及85例对照者的身高、体重、腰围、血压,检测血清空腹血糖、空腹胰岛素、抵抗素和总胆固醇、甘油三酯、高密度脂蛋白胆固醇、载脂蛋白A、载脂蛋白B、抵抗素基因299G/A多态性,胰岛素抵抗指数HOMA-IR=FPG×FINS/22.5。结果 (1)腹型肥胖组与对照组相比,各主要指标的均数±标准差如下:Resistin分别为(3.761±1.608)ng/mLvs(3.048±1.233)ng/mL(P<0.05);FINS分别为(9.827±4.431)mIu/Lvs(6.574±4.181)mIu/L(P<0.05);HOMA-IR分别为(3.761±1.608)vs(3.048±1.233)(P<0.05)。(2)以Resistin为应变量的多元逐步回归方程:Y=-2.541+0.302X1+0.196X2+0.026X3(X1为胰岛素,X2为胰岛素抵抗指数,X3为腰围,P<0.01)。(3)腹型肥胖组抵抗素基因299G/A位点A等位基因频率显著高于对照组。结论腹型肥胖者血清抵抗素水平显著升高与H...     

Insect antifeedant properties of anthranoids from the genusVismia

Vismiones and ferruginins, representatives of a new class of lypophilic anthranoids from the genusVismia were found to inhibit feeding in larvae of species ofSpodoptera, Heliothis, and inLocusta migratoria.     

Direct observation of freeze-thaw instability of latex coatings via high pressure freezing and cryogenic SEM

Despite its industrial importance, the subject of freeze-thaw (F/T) stability of latex coatings has not been studied extensively. There is also a lack of fundamental understanding about the process and the mechanisms through which a coating becomes destabilized. High pressure (2100 bar) freezing fixes the state of water-suspended particles of polymer binder and inorganic pigments without the growth of ice crystals during freezing that produce artifacts in direct imaging scanning electron microscopy (SEM) of fracture surfaces of frozen coatings. We show that by incorporating copolymerizable functional monomers, it is possible to achieve F/T stability in polymer latexes and in low-VOC paints, as judged by the microstructures revealed by the cryogenic SEM technique. Particle coalescence as well as pigment segregation in F/T unstable systems are visualized. In order to achieve F/T stability in paints, latex particles must not flocculate and should provide protection to inorganic pigment and extender particles. Because of the unique capabilities of the cryogenic SEM, we are able to separate the effects of freezing and thawing, and study the influence of the rate of freezing and thawing on F/T stability. Destabilization can be caused by either freezing or thawing. A slow freezing process is more detrimental to F/T stability than a fast freezing process; the latter actually preserves suspension stability during freezing. Presented at the 82nd Annual Meeting of the Federation of Societies for Coatings Technology, October 27–29, 2004 in Chicago, IL. Tied for first place in The John A. Gordon Best Paper Competition.     

Ethanol and (−)-α-Pinene: Attractant Kairomones for Bark and Ambrosia Beetles in the Southeastern US

In 2002–2004, we examined the flight responses of 49 species of native and exotic bark and ambrosia beetles (Coleoptera: Scolytidae and Platypodidae) to traps baited with ethanol and/or (−)-α-pinene in the southeastern US. Eight field trials were conducted in mature pine stands in Alabama, Florida, Georgia, North Carolina, and South Carolina. Funnel traps baited with ethanol lures (release rate, about 0.6 g/day at 25–28°C) were attractive to ten species of ambrosia beetles (Ambrosiodmus tachygraphus, Anisandrus sayi, Dryoxylon onoharaensum, Monarthrum mali, Xyleborinus saxesenii, Xyleborus affinis, Xyleborus ferrugineus, Xylosandrus compactus, Xylosandrus crassiusculus, and Xylosandrus germanus) and two species of bark beetles (Cryptocarenus heveae and Hypothenemus sp.). Traps baited with (−)-α-pinene lures (release rate, 2–6 g/day at 25–28°C) were attractive to five bark beetle species (Dendroctonus terebrans, Hylastes porculus, Hylastes salebrosus, Hylastes tenuis, and Ips grandicollis) and one platypodid ambrosia beetle species (Myoplatypus flavicornis). Ethanol enhanced responses of some species (Xyleborus pubescens, H. porculus, H. salebrosus, H. tenuis, and Pityophthorus cariniceps) to traps baited with (−)-α-pinene in some locations. (−)-α-Pinene interrupted the response of some ambrosia beetle species to traps baited with ethanol, but only the response of D. onoharaensum was interrupted consistently at most locations. Of 23 species of ambrosia beetles captured in our field trials, nine were exotic and accounted for 70–97% of total catches of ambrosia beetles. Our results provide support for the continued use of separate traps baited with ethanol alone and ethanol with (−)-α-pinene to detect and monitor common bark and ambrosia beetles from the southeastern region of the US.     

Many Drugs of Abuse May Be Acutely Transformed to Dopamine,Norepinephrine and Epinephrine In Vivo

It is well established that a wide range of drugs of abuse acutely boost the signaling of the sympathetic nervous system and the hypothalamic–pituitary–adrenal (HPA) axis, where norepinephrine and epinephrine are major output molecules. This stimulatory effect is accompanied by such symptoms as elevated heart rate and blood pressure, more rapid breathing, increased body temperature and sweating, and pupillary dilation, as well as the intoxicating or euphoric subjective properties of the drug. While many drugs of abuse are thought to achieve their intoxicating effects by modulating the monoaminergic neurotransmitter systems (i.e., serotonin, norepinephrine, dopamine) by binding to these receptors or otherwise affecting their synaptic signaling, this paper puts forth the hypothesis that many of these drugs are actually acutely converted to catecholamines (dopamine, norepinephrine, epinephrine) in vivo, in addition to transformation to their known metabolites. In this manner, a range of stimulants, opioids, and psychedelics (as well as alcohol) may partially achieve their intoxicating properties, as well as side effects, due to this putative transformation to catecholamines. If this hypothesis is correct, it would alter our understanding of the basic biosynthetic pathways for generating these important signaling molecules, while also modifying our view of the neural substrates underlying substance abuse and dependence, including psychological stress-induced relapse. Importantly, there is a direct way to test the overarching hypothesis: administer (either centrally or peripherally) stable isotope versions of these drugs to model organisms such as rodents (or even to humans) and then use liquid chromatography-mass spectrometry to determine if the labeled drug is converted to labeled catecholamines in brain, blood plasma, or urine samples.     

Novel polyurethane coating technology through glycidyl carbamate chemistry

Glycidyl carbamate chemistry combines the excellent properties of polyurethanes with the crosslinking chemistry of epoxy resins. Glycidyl carbamate functional oligomers were synthesized by the reaction of polyfunctional isocyanate oligomers and glycidol. The oligomers were formulated into coatings with several amine functional crosslinkers at varying stoichiometric ratios and cured at different temperatures. Properties such as solvent resistance, hardness, and impact resistance were dependent on the composition and cure conditions. Most coatings had an excellent combination of properties. Studies were carried out to determine the kinetics of the curing reaction of the glycidyl carbamate functional oligomers with multifunctional and model amines. Detailed kinetic analysis of the curing reactions was also undertaken. The results indicated that the glycidyl carbamate functional group is more reactive than a glycidyl ether group. Presented at the 82nd Annual Meeting of the Federation of Societies for Coatings Technology, on October 27–29, 2004, in Chicago, IL.