维持性血液透析患者透析充分性相关因素分析

目的:探究维持性血液透析患者透析充分性的相关因素,为临床提供指导。方法:以2015年6月～2017年5月某院125例维持性血液透析患者作为观察对象,对125例维持性血液透析患者的临床资料进行回顾性分析,结合透析充分性结果将其分为透析充分性好组(75例)、透析充分性差组(50例),研究维持性血液透析患者透析充分性的相关因素。结果:透析充分性好组和透析充分性差组患者之间的年龄、每周透析次数、付款方式、营养状况结果存在显著差异,P0.05;对透析充分性好的相关因素进行Logistic回归分析可知,年龄、每周透析次数、付款方式、营养状况的结果均具有统计学意义,P0.05。结论:影响维持性血液透析患者透析充分性好的相关因素较多,例如年龄、每周透析次数、付款方式、营养状况等。     

不同透析模式对老年维持性血液透析患者低血压的疗效观察

目的：探讨不同血液透析方式对老年尿毒症血液透析患者透析相关低血压的预防。方法：选择我院透析室规律血液透析的老年血透患者80例,以随机抽样法分为普通透析组和可调钠透析组、可调钠联合超滤曲线、低温可调钠联合超滤曲线等4组,观察治疗过程中患者的血压情况、透析前后血钠水平、透析间期体质量增加及口渴感。结果：可调钠透析组、可调钠联合超滤曲线组及低温可调钠联合超滤曲线组患者低血压发生率较普通透析组均显著降低（P〈0.01）。结论：可调钠透析、低温可调钠及其联合超滤曲线等模式能改善老年患者血液透析相关低血压的发生,并可改善预后。     

老年尿毒症患者进行血液透析的临床护理对策探析

目的：探讨老年尿毒症患者行血液透析的临床护理对策。方法行血液透析治疗的尿毒症患者128例,对所有患者均加强临床护理,观察并分析其疗效。结果本组128例患者中,118例（92.2%）仍进行维持性透析的治疗,且透析充分,病情稳定,营养状况良好,无严重并发症发生。结论加强对行血液透析治疗的老年尿毒症患者透析前、透析过程中以及透析后的护理,对降低并发症发生,提高透析效果具有重要作用。     

长期血液透析患者的舒适护理介绍

肾脏相关慢性疾病具有治疗周期长、难彻底治愈等特点,需要长期维持性血液透析[1]。透析是尿毒症患者维持治疗的重要措施,患者稳定、良好的身心状态,对于保证透析质量和降低透析意外发生率具有重要意义[2]。为了给患者提供更好的服务,我们对长期血液透析患者采用舒适护理模式,取得较好效果。现将舒适护理方法介绍如下:     

透析用水和透析液中细菌内毒素考察

目的:拟订和建立血液透析用水和透析液细菌内毒素的质量控制标准和方法。方法:结合各国药典对透析用水和透析液的生物学限值标准,依据2005年版《中国药典》相关方法建立微生物细菌培养及动态比浊法,对样本进行监测和评估。结果:拟定标准为微生物和内毒素的制成水、透析液(没有滤过)、超滤透析液分别为<100、<200、<1cfu.mL-1及<0.25、<1.0、<0.10EU.mL-1,据此标准所检查样本结果合格。结论:所建立方法可行,能确保血液透析的医疗使用安全。     

关于某区血液透析患者心律失常发生原因的调查与防治

目的探讨维持性血液透析患者在透析期间发生心律失常的原因及防治办法,透析中心律失常的发生与患者的年龄、营养状况,贫血程度及超滤脱水量等有着直接的关系。方法收集30例维持性血透患者,分析在血液透析中心律失常发生情况及其原因。结果在30例患者每周透析2～3次,1年约共血液透析约3600例次,出现心律失常420次,发生率12%左右。结论积极纠正诱发透析相关心律失常的危险因素,是完全可以避免或减少透析相关心律失常的发生。     

低温配合可调钠曲线超滤预防血液透析相关低血压

低血压是血液透析中常见的并发症之一,发生率约20%～40%[1],其不仅直接影响透析效果,而且严重影响患者心脑血管功能的稳定性,因此,预防透析相关性低血压,降低其发生率具有重要的临床意义。本文就低温可调钠曲线超滤透析方式的联合应用,对透析相关低血压的预防作用进行了临床观察。     

腹膜透析联合血液透析一例临床分析

目的 探讨腹膜透析联合血液透析的临床意义.方法 对北京市朝阳区小红门社区卫生服务中心血液透析中心的一例腹膜透析联合血液透析的患者进行总结,并结合文献进行分析.结果 该患者经过腹膜透析联合血液透析及营养支持,患者症状明显比之前好转.结论 腹膜透析和血液透析各有优势和不足,根据患者的具体情况采用合适的透析方法是十分重要的,...     

血液透析相关低血压观察及护理

目的 探讨血液透析相关低血压发生的原因及护理措施.方法 2009年10月至2011年10月我院门诊和住院部共接诊血液透析患者34例,行血液透析3326次.所有患者在行血液透析前均进行健康宣教,透析过程中一旦发生低血压则及时采取相关处理措施.结果 共发生血液透析相关性低血压227次,占透析总数的6.83%.其中201例次(88.5%)经有效处理后血压恢复正常,可继续完成血液透析;26例次(11.5%)经治疗无效,停止血液透析后血压逐渐恢复正常.结论 血压透析相关低血压发生率较高,提前预防和及时处理是纠正低血压的关键措施.     

血液透析用水的总有机碳测定研究

目的 研究测定血液透析用水的TOC测定方法,考察血液透析用水的质量.方法 参照中国药典2010年版制药用水中TOC测定法,测定25家医院透析用水的TOC含量.结果 22家医院的血液透析用水的TOC值小于0.02mg/1,2家医院TOC值在0.02～0.04mg/1之间,1家医院TOC值为0.10mg1.结论 本方法简便...     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.