植入式输液港的临床应用

目的探讨植入式输液港的护理方法和体会。方法对我科11例患者进行植入输液港,对植入方法、护理技术、常见问题进行研究、总结。结果植入式输液港解决了患者频繁输液的痛苦,减轻了护士的工作量。结论植入式输液港提高了护理安全性,应广泛推广并规范这一新技术。     

小剂量快速注射丙泊酚在胃镜检查中的安全有效性分析

目的：观察小剂量快速注射丙泊酚在无痛胃镜检查中的安全性及有效性,观察该方法对患者识记能力的影响。方法：选择60例行无痛胃镜检查的患者,随机分成A组和B组。所有患者均给予1μg／kg芬太尼。给予芬太尼后1分钟后,A组患者按照5mg／sec的速度给予2mg／kg丙泊酚;B组患者按照20mg／sec的速度给予1mg／kg丙泊酚。患者睫毛反射消失后进行胃镜检查。记录患者基础时及麻醉过程中不同时点的收缩压、舒张压、心率以及脉搏血氧饱和度,记录患者失去意识时间、胃镜检查时间、患者苏醒时间,记录检查过程中有无呛咳、体动,记录患者有无术中知晓,记录患者检查后一周内的有无识记能力的减退。结果：两组患者基本情况无统计学差异;60例患者无一例出现术中知晓;两组患者在麻醉过程中不同时点的循环情况及脉搏血氧饱和度之间没有统计学差异;检查过程中呛咳、体动的发生率组间比较无统计学差异;失去意识时间和苏醒时间组间比较P≤0．05,具有统计学差异;检查后一周内,识记能力减退发生率组间比较具有统计学差异。结论：快速注射小剂量丙泊酚可以保证患者安全、满足无痛胃镜检查的需要,同时可以降低丙泊酚的用量,减少药物蓄积,减少丙泊酚所致的识记功能减退。     

Chronomodulated chemotherapy: clinical value and possibilities for dissemination in the United States

Modern medicine has been relatively slow to apply chronotherapeutic principles to standard oncologic practice. Despite the impressive body of evidence supporting the use of chronochemotherapy, with only a rare exception most oncology clinics in the United States lack the expertise and capability to implement it. At the same time, American medicine has increasingly come to recognize the importance of toxicity mitigation, cytoprotection, and quality of life for patients undergoing cancer treatment. However, toxicity mitigation strategies such as chronomodulated infusional chemotherapy and novel cytoprotective agents are not widely embraced by U.S. physicians. This article explores some reasons why this situation exists, including the influence of non-medical biases that may affect management decisions on the application of chemotherapy. The author conducted a survey of U.S. companies representing the three private insurance payers available (HMO, PPO, Indemnity) as well as representatives of Medicare and Medicaid. Responses to the survey confirmed that U.S. insurers do not at present officially reimburse for chronotherapy; however, changes will come about through educational efforts aimed at increasing awareness among insurers as to the clinical benefits and cost-effectiveness of this mode of treatment. At this juncture, the outlook for cancer chronotherapy as a first-line approach to the treatment of metastatic cancer in the United States remains uncertain. Under the current method of insurance reimbursement, the advancement of chronotherapy in the United States is threatened despite evidence that such treatment is both therapeutically sound and cost-effective.     

Trypanosoma cruzi: effect of benznidazole therapy combined with the iron chelator desferrioxamine in infected mice

Iron chelators have been employed in various studies aimed at evaluating the relationship between the iron status of the host and the development of infection. In the present study, the effects of benznidazole (BZ) therapy in combination with the iron chelator desferrioxamine (DFO) on the development of infection in mice inoculated with Trypanosoma cruzi Y strain have been investigated. Infected mice treated with DFO presented lower levels of parasitemia compared with infected untreated animals. Therapy with BZ for 21 days, with or without DFO, led to decreased parasitemia and reduced mortality, but BZ in combination with DFO treatment for 35 days (BZ/DFO-35) gave 0% mortality. All infected groups presented lower levels of iron in the liver, but serum iron concentrations were greater in DFO-35 and BZ/DFO-35, whereas hemoglobin levels were higher in BZ/DFO-35 and lower in DFO-35 compared with other treated groups. The percentage cure, determined from negative hemoculture and PCR results in animals that had survived for 60 days post-infection, was 18% for BZ and BZ/DFO-35, 42% for BZ combined with DFO for 21 days, and 67% for DFO-35. The results demonstrate that modification in iron stores increases BZ efficacy.     

Dietary Fat Dose Dependently Increases Spontaneous Caloric Intake in Rat

Objective: To characterize the dose‐response relationship between dietary fat to carbohydrate ratio and spontaneous caloric intake. Research Methods and Procedures: Male Long‐Evans rats consumed milk‐based liquid diets that differed in fat content (17% to 60% of kilocalories) but had equivalent protein content and energy density. In Experiment 1, rats consumed one of the diets (n = 9/diet group) as the sole source of nutrition for 16 days. In Experiment 2, diets were offered as an option to nutritionally complete chow for 4 days followed by a 3‐day chow‐only washout in a randomized within‐subjects design (n = 30). In Experiment 3, nine rats received isocaloric intragastric infusions of diet overnight, with chow available ad libitum. At least two no‐infusion days separated the different diet infusions, which were given in random order. Food intake was measured daily Results: Dietary fat dose dependently increased total daily kilocalories in each of the three paradigms. Discussion: These data imply that the postingestive effects of carbohydrate and fat differentially engage the physiological substrates that regulate daily caloric intake. These findings reiterate the importance of investigating macronutrient‐specific controls of feeding, rather than prematurely concluding that dietary attributes that covary with fat content (e.g., caloric density and palatability) drive the overeating associated with a high‐fat diet.     

Towards high-throughput metabolomics using ultrahigh-field Fourier transform ion cyclotron resonance mass spectrometry

With unmatched mass resolution, mass accuracy, and exceptional detection sensitivity, Fourier Transform Ion Cyclotron Resonance Mass Spectrometry (FTICR-MS) has the potential to be a powerful new technique for high-throughput metabolomic analysis. In this study, we examine the properties of an ultrahigh-field 12-Tesla (12T) FTICR-MS for the identification and absolute quantitation of human plasma metabolites, and for the untargeted metabolic fingerprinting of inbred-strain mouse serum by direct infusion (DI). Using internal mass calibration (mass error ≤1 ppm), we determined the rational elemental compositions (incorporating unlimited C, H, N and O, and a maximum of two S, three P, two Na, and one K per formula) of approximately 250 out of 570 metabolite features detected in a 3-min infusion analysis of aqueous extract of human plasma, and were able to identify more than 100 metabolites. Using isotopically-labeled internal standards, we were able to obtain excellent calibration curves for the absolute quantitation of choline with sub-pmol sensitivity, using 500 times less sample than previous LC/MS analyses. Under optimized serum dilution conditions, chemical compounds spiked into mouse serum as metabolite mimics showed a linear response over a 600-fold concentration range. DI/FTICR-MS analysis of serum from 26 mice from 2 inbred strains, with and without acute trichloroethylene (TCE) treatment, gave a relative standard deviation (RSD) of 4.5%. Finally, we extended this method to the metabolomic fingerprinting of serum samples from 49 mice from 5 inbred strains involved in an acute alcohol toxicity study, using both positive and negative electrospray ionization (ESI). Using these samples, we demonstrated the utility of this method for high-throughput metabolomics, with more than 400 metabolites profiled in only 24 h. Our experiments demonstrate that DI/FTICR-MS is well-suited for high-throughput metabolomic analysis. Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Modeling a simplified regulatory system of blood glucose at molecular levels

In this paper, we propose a new mathematical control system for a simplified regulatory system of blood glucose by taking into account the dynamics of glucose and glycogen in liver and the dynamics of insulin and glucagon receptors at the molecular level. Numerical simulations show that the proposed feedback control system agrees approximately with published experimental data. Sensitivity analysis predicts that feedback control gains of insulin receptors and glucagon receptors are robust. Using the model, we develop a new formula to compute the insulin sensitivity. The formula shows that the insulin sensitivity depends on various parameters that determine the insulin influence on insulin-dependent glucose utilization and reflect the efficiency of binding of insulin to its receptors. Using Lyapunov indirect method, we prove that the new control system is input-output stable. The stability result provides theoretical evidence for the phenomenon that the blood glucose fluctuates within a narrow range in response to the exogenous glucose input from food. We also show that the regulatory system is controllable and observable. These structural system properties could explain why the glucose level can be regulated.     

Functional study of rat 5-HT2A receptors using antisense oligonucleotides

We studied the effects in rats of a 6-day intracerebroventricular (i.c.v) infusion of four different end-capped phosphorothioate-modified antisense oligonucleotides (AOs), specifically targeting different regions of the 5-hydroxytryptamine2A (5-HT2A) receptor mRNA, on central 5-HT2A receptor expression and 5-HT2A receptor-mediated behaviours. Only one of the AOs (sequence 4), directed against the 5'-untranslated region (from + 557 to + 577), specifically affected central 5-HT2A receptor expression and receptor-mediated behaviour. This AO (sequence 4) reduced binding of the 5-HT2A agonist 1-(2,5-dimethoxy-4-[125I]iodophenyl)-2-aminopropane ([125I]DOI) up to 25% in cortical areas, as measured by quantitative autoradiography. Cortical binding of the antagonist [3H]ketanserin was not affected. As the specific AO treatment presumably affects the synthesis of new receptor, we hypothesize that this newly synthesized receptor represents the major part of the functionally active, G protein coupled receptor. A 5-day infusion of AO (sequence 4) resulted in profound inhibition of the head-twitch response (HTR) to 1-(2,5-dimethoxy-4-methylphenyl)-2-aminopropane (DOM). In contrast, treatment with vehicle, sense oligonucleotides (SOs) and other AOs (sequences 1, 2 and 3) caused an increased DOM-induced HTR as well as a spontaneous HTR. The latter was abolished by treatment with the 5-HT2 receptor antagonist, ritanserin. Systematic investigation of the surgical and infusion procedures revealed that the enhanced HTR already appeared following drilling of the skull. This wounding can probably damage the blood-brain barrier and cause a stress-induced increase in serotonergic transmission. AO (sequence 4) treatment also abolished the spontaneous HTR. AO (sequence 4) treatment allowed the identification of specific central 5-HT2A receptor-mediated behaviours in the complex serotonergic syndrome induced by tryptamine in rats. Only bilateral convulsions and body tremors were significantly inhibited. The backward locomotion, hunched back and Straub tail were not affected, nor was cyanosis, an index of vasoconstriction induced by peripheral 5-HT2A receptor activation. Labelling of central 5-HT2C receptors by [3H]mesulergine, and 5-HT2C receptor-mediated anxiety were not attenuated by AO or SO treatment. Rats treated with AO (sequence 4) showed increased locomotor activity and a strong reactivity towards touching. We hypothesize that the down-regulation of functional 5-HT2A receptors may shift the balance between various 5-HT receptor subtypes. Our analysis of the behavioural consequences of AO treatment and the use of different AOs and SOs has shown that specific receptor-mediated behaviour can be identified.     

Oviposition responses of gravid Aedes aegypti Linn. Mosquitoes (Diptera: Culicidae) to natural organic infusions under laboratory condition

The aim of this study was to investigate the effectiveness of different concentrations of three organic infusions as an oviposition attractancy agents of gravid Ae. aegypti mosquito under laboratory condition. Three organic infusions namely, Costus igneus Nak (Insulin plant leaf), Psidium guajava Linn (Guava tree leaf), and Cicer arietinum Linn (Black chickpea) were prepared by fermentation process and bioassays such as choice bioassay and comparison bioassay were performed to assess its oviposition attractiveness. In the choice bioassay, four different concentrations namely, 5%, 10%, 15%, 50% of each infusion was tested with gravid female Ae. aegypti and the oviposition results were compared to the water control. The results showed that the oviposition attractiveness was significantly differed among the different concentrations of three infusions. The highest mean oviposition was observed to be 457.3 ± 22.9 in 15% insulin plant leave infusion and it was 192.6 ± 11.5 in water control (F = 49.64; P = <0.001; OAI = +0.40). The best resulted concentration of the infusions in the choice bioassay was further studied and compared to the positive control (10% hay infusion). The highest mean oviposition was recorded in comparison bioassay was 475.3 ± 10.7 in 15% insulin plant leaf infusion and it was 235.3 ± 9.9 in 10% hay infusion (F = 18.71; P = <0.001; OAI = +0.38). These findings suggest that the insulin plant leaf infusion could be used in ovitraps as an effective organic oviposition attractant in Ae. aegypti mosquito surveillance and control program.     

Post-ruminal or intravenous infusions of carbohydrates or amino acids to dairy cows 1. Early lactation

The objectives of this study were to compare the effects of post-ruminal and intravenous infusions of wheat starch or glucose (CHO) or a mixture of amino acids (AA) on milk protein yield, nitrogen utilisation, plasma metabolites and mammary extraction rate of dairy cows in early lactation. Eight cow, ruminally fistulated, was assigned to two 4 × 4 Latin squares during 14-day periods, where the last 7 days were for infusions. Infusions were: (1) starch in the abomasum (SP), (2) glucose in the blood (GB), (3) AA in the abomasum (AP), and (4) AA in the blood (AB). The experiment started 54 ± 4 days (mean ± s.e.) post partum (milk yield 33.4 ± 1.7 kg). Daily amounts of nutrients infused were 378, 365, 341, and 333 g for SP, GB, AP and AB, respectively. The cows were fed a basal diet consisting of a concentrate mixture and grass silage (55:45 on dry-matter (DM) basis), and DM intake was 17.2 kg/day. Milk production was affected by site of infusion within substrate, whereas infusion substrates within infusion site (CHO or AA) were of minor importance. Compared with SP infusion, GB infusion increased ( P < 0.05) milk protein yield and concentration by 55 g and 1 g/kg. The AB infusion tended to ( P < 0.10) increase milk yield and ECM and increased ( P < 0.05) protein yield and concentration by 1.8 and 2.2 kg, 83 g and 1.1 g/kg compared with AP infusion, respectively. Nitrogen balance data indicated higher losses of metabolic faecal nitrogen (MFN) by abomasal than by intravenous infusions, and an increased ( P < 0.05) catabolism for AP and AB infusions compared with SP and GB infusions. GB infusion did not increase ( P>0.10) plasma glucose or insulin concentrations above that of SP infusion. Compared with the SP infusion, the GB infusion had minor effect on plasma AA. AP infusion increased ( P < 0.05) plasma non-essential AA (NEAA) concentration compared with AB infusion, whereas infusion site of AA had no effect ( P>0.05) on essential AA (EAA) or branched-chain AA (BCAA). Although a higher milk protein synthesis was observed for AB infusion, the mammary extraction rate was not higher ( P>0.05) than for AP infusion. Across infusion site, AP and AB infusions increased plasma concentration of EAA and BCAA, but compared with GB infusion, the mammary extraction rates tended ( P < 0.10) to be lower. It is concluded that abomasal nutrient infusion increases loss of MFN and that the gastrointestinal metabolism influences the nutrients available for milk synthesis. Our conclusion is that when glucose was infused, AA limited a further milk protein synthesis, but when AA was infused, glucose or energy substrate might have been the limiting factor. Our results verify that glucogenic substrates are limiting when cows are in negative energy balance.