Effects of naloxone on pethidine-induced neonatal depression. Part I--Intravenous naloxone.

Infants whose mothers had had pethidine during labour were given either naloxone 40 microgram or isotonic saline administered intravenously double-blind within one minute of birth. Peak alveolar carbon dioxide tension, carbon dioxide excretion, alveolar ventilation, feeding behaviour, and habituation to a specific sound stimulus were measured regularly up to 48 hours after birth. Alveolar carbon dioxide tension was significantly lower and alveolar ventilation significantly higher half an hour after birth in the naloxone-treated group than in the saline-treated group, but these differences between the groups were not significant at any other time, and there were no significant differences in sucking frequency or pressure, milk consumption, or habituation to the auditory stimulus.     

Uracil metabolism in golden hamster after irradiation.

The catabolism of uracil and the total balance of excreted radioactivity were studied in golden hamsters after a peroral application of 14C-uracil. Twenty-four hours after administration most of the radioactivity taken up appeared in expired carbon dioxide. The percent proportion of radioactivity in carbon dioxide was independent of the amount of uracil administered. On the other hand, the percentage of radioactivity excreted in urine depended on the amount of uracil taken up, high doses of the compound causing up to eight-fold increase in urine-excreted radioactivity. Most of the exogenously-administered uracil was catabolized within the first 5 hours. Irradiation had no substantial effect on the dynamics of uracil catabolism. Analysis of urine revealed that most urine-excreted radioactivity is in the form of uracil. On peroral application of high doses of uracil to irradiated hamsters, their urine was found to contain barbituric acid which originated from uracil.     

Serum levels of parathormone, calcium, magnesium and phosphorus in the perinatal period

Two groups of newborns on different diets were studied: group A was given artificial milk, while group B was breast fed. Blood samples from the cord artery and vein were taken at birth and further blood samples after 1, 6, 12, 24, 48, 72, 96 and 168 hours. No baby underwent more than three blood samples. Calcium (Ca), magnesium (Mg), phosphorus (P) and parathormone (PTH) were measured in all samples. There was a rapid increase in PTH levels in all subjects in the first hours after birth. At 48th the babies in group A had significantly higher serum levels of P than the group B subjects, and their serum Ca and Mg levels were significantly lower. At 72th PTH serum levels were significantly higher in group A, while Ca and Mg levels were significantly higher in group B. In conclusion, the subjects demonstrated a normal secretion of PTH at birth, and the type of diet notably influenced the homeostasis of calcium in the perinatal period.     

Plasma relaxin immunoactivity in the pig at parturition and during nuzzling and suckling.

One sow bled at 30--60-min intervals for 48 h at 5 and 4 days before parturition had mean +/- s.e.m. relaxin levels of 5.0 +/- 0.48 ng/ml and 5.5 +/- 0.44 ng/ml for each 24-h period respectively. This sow and another were bled at frequent intervals during parturition; both showed considerable fluctuations in their relaxin levels but no consistent peaks in relation to each birth. Mean levels during parturition were 10.7 +/- 0.46 ng/ml and 13.4 +/- 0.81 ng/ml respectively, both significantly higher than the levels at 4 and 5 days before birth. Relaxin levels in two lactating sows rose acutely during nursing, showing a 3-fold rise in one animal and an 8-fold rise in the other. Results from a third sow during an extended period of nuzzling and sucking by the piglets showed multiple peaks of relaxin immunoactivity associated with each nuzzling/sucking stimulus.     

Variability of breast sucking, associated milk transfer and the duration of lactational amenorrhoea.

Quantitative relationships between physical parameters of sucking, milk transfer and the duration of amenorrhoea were examined in normal mother-baby pairs under exclusive breastfeeding. Sucking pressures were recorded twice on the second and once on the fifth month after birth, during complete breastfeeding episodes, by means of a catheter attached to the nipple and connected to a pressure transducer, the signals of which were analysed by computer. Babies were weighed before and after each sucking episode to estimate milk transfer. In the first nursing episode after noon, 2-month-old babies sucked from 140 to > 800 times during 4-15 min from the first breast, obtaining from 20 to > 100 g milk. The physical parameters of sucking and milk transfer exhibited high inter-individual but low intra-individual variabilities. There were significant differences in the physical parameters of sucking and milk transfer efficiency between first and second breast and between the second and fifth months after birth. Milk transfer efficiency was inversely correlated with time occupied by non-sucking pauses > or = 1.5 s, and was directly correlated with mean intersuck intervals in the first breast and with duration of the sucking episode, number of sucks, mean pressure and area under the pressure curve in the second breast. There was no correlation between the physical parameters of sucking and duration of lactational amenorrhoea (n = 62). However, significantly more mothers had amenorrhoea lasting > 180 days among those whose babies spent a longer proportion of the nursing episode in non-sucking pauses > or = 1.5 s. This finding indicates that sensory stimulation of the nipple produced during a nursing episode by stimuli other than sucking itself may have an important role in sustaining lactational amenorrhoea. It is concluded that nursing episodes have a complex structure that allows the development of a breastfeeding phenotype in each mother-baby pair, exhibiting important inter-individual variability. The present analysis does not support the contention that this source of variability accounts for the variability in the duration of lactational amenorrhoea.     

非营养吸吮和金双歧预防早产儿喂养不耐受115例分析

目的评价比较非营养吸吮和金双歧对促进早产儿胃肠功能成熟度,预防早产儿喂养不耐受的效果。方法回顾分析我院2004年6月至2008年3月收治的符合标准的115例早产儿,根据喂养干预措施分成非营养吸吮（NNS）组（38例）、金双歧组（42例）和对照组（35例）,组间胎龄、出生体重及Apgar评分均衡。NNS组常规干预外,生后6～12h开始NNS,在每次喂养前给予吸吮无孔橡皮奶头10min,7—8次／24h。金双歧组常规干预外,生后6—12h开始口服金双歧,每次0．5g,每Et3次。对照组常规干预。临床观察喂养不耐受发生情况,生后10d评价结果。结果各组喂养不耐受的发生率比较,NNS组明显低于对照组,差异有显著性（χ^2=6．510,P〈0．05）;金双歧组也明显低于对照组,差异有显著性（χ^2=5．840,P〈0．05）;NNS组比金双歧组发生率略低,但差异元显著性（χ^2=0．066,P〉0．05）。结论早期NNS或早期使用金双歧都可以明显降低喂养不耐受的发生,均可作为预防喂养不耐受的有效措施,两者效果相当。对于吸吮极差的极低或超低体重儿,早期NNS并不具有可操作性或不能达到足够的操作时间,而使用金双歧灌喂更具有操作性。     

Negative arterial-mixed expired PC02 gradient during acute and chronic hypercapnia.

In resting conscious dogs physiological dead space was calculated using the Bohr equation and measurements of arterial and mixed expired carbon dioxide tension. Whenever dogs inhaled carbon dioxide mixtures (5-10%) that had normal or low oxygen concentrations, the calculated dead space became negative. This paradox was based on the fact that the mixed expired carbon dioxide tension in resting hypercapnic dogs. Under these circumstances carbon dioxide was produced from the lung as measured by gas analyses and blood analyses. By the lung as measured by gas analyses and blood analyses. By reasoning this implies that "alveolar" carbon dioxide tension was higher than pulmonary venous carbon dioxide tension. The negative carbon dioxide gradient persisted at 14 days of chronic hypercapnia and reverted to normal within 10 min of breathing air after chronic hypercapnia. These findings suggest that the exchange of carbon dioxide in the lung cannot be explained solely on the basis of passive diffusion.     

Energy metabolism of beating rat heart cell cultures: II. - Glucose metabolism

Glycogen metabolism, lactate excretion and carbon dioxide production from uniformly labelled glucose were studied on beating rat heart cell cultures in relation to medium replenishment. Only a small fraction of labelled glucose was incorporated into glycogen and then released at a high rate, while exogenous glucose was still continuously taken up by the cells. When glucose in the medium was nearly depleted, glycogen degradation slowed down. The rate of carbon flow through phosphopentose shunt showed a 600 p. cent increase several hours before DNA synthesis. Up to 24 hours after medium renewal, the cells excreted high amounts of lactate; then lactate was reutilized, probably through transaminating processes. Up to 10 hours after medium renewal, labelled carbon dioxide production from exogenous labelled glucose decreased strongly and then increases. Only one of these variations (pentose phosphate shunt) could be attributed to the release of topoinhibition by serum. The other three also occured in the absence of serum and probably resulted from the variation in substrate avaibility induced by medium replenishment.     

Postnatal alveolar development of the rabbit.

Previous studies of alveolarization have used rats or lambs; however, neither closely reflects human alveolar development. We characterized alveolar development in rabbits (n = 3-7 /group) at 28 days gestation (dg) to 9 mo to determine whether they followed the human pattern more closely. The right lung was made up of 30% alveolar and 50% duct space at 28 dg to 3 days and of 50 and 30%, respectively, at 14 days to 9 mo. Tissue fraction and alveolar wall thickness decreased by 40% 28 dg to birth. At birth, approximately 4.5% of the number of alveoli seen at 9 mo were present, with alveolar number increasing progressively well into adulthood. The rate of alveolar formation was high around birth, decreasing progressively with age. Alveolar volume increased more than twofold (28 dg to birth) and continued to increase postnatally to 16 wk. Surface fraction decreased by 17% (28 dg to 3 days), after which it remained uniform. Our findings suggest that the timing of onset of alveolarization in humans and rabbits is similar and that rabbits may be used to model postnatal influences on alveolar development.     

Reduction in mortality after myocardial infarction with long-term beta-adrenoceptor blockade. Multicentre international study: supplementary report.

In a controlled multicentre trial carried out to assess the value of long-term practolol treatment after myocardial infarction the provisional results showed a significant reduction in mortality, though some of the data were lacking. These have now been included and the results updated. The final figures for all deaths were 78 in the placebo group of 1533 patients and 48 in the practolol group of 1520 patients. The reduction in mortality (38%) was significant at the 1% level. The figures for non-fatal reinfarction (97 in the placebo group, and 75 in the practolol group) were not significantly different. Patients with pre-entry anterior infarction, and especially those with a diastolic blood pressure equal to or below the mean (78 mm Hg) at entry to the trial, were at high risk but benefited particularly well from beta-adrenoceptor blockade. After pre-entry inferior infarction the percentage reduction in deaths occurring within two hours after symptoms of a new event was similar to that after anterior infarction, but the incidence of death more than two hours after the event was greater in the practolol-treated group. Thus the difference between groups in total deaths after pretrial inferior infarction was marginal. Until the results of further trials are reported long-term beta-adrenoceptor blockade (possibly up to two years) is recommended after uncomplicated anterior myocardial infarction.     

基于加速康复外科理念的前交叉韧带重建术中麻醉方式的选择

摘要 目的：基于加速康复外科理念,比较分析收肌管阻滞和股神经阻滞两组麻醉方式术后早期反应,探讨其在ACL重建术中的应用。方法：选取符合手术条件的88名ACL损伤的患者,随机分为收肌管阻滞组和股神经阻滞组,手术均在全麻下由同一组医生实施,采用自体腘绳肌重建ACL。比较术后早期2h,4 h,8 h,24 h和48 h患者静息和主动活动时VAS评分;患者首次主动直腿抬高时间;首次自主下地时间;48 h内追加盐酸哌替啶的的人次数;以及不良反应的例数。分析比较两组麻醉方式在术后早期的不同。结果：收肌管阻滞组患者在术后首次直腿抬高的时间和首次自主下地时间两方面与股神经阻滞组相比较,差异有统计学意义（P＜0.05）;两组患者在术后2 h,4 h,8 h,24 h和48 h静息和主动活动时疼痛程度以及48 h内追加盐酸哌替啶的人次数和不良反应的例数之间差异无统计学意义（P＞0.05）。结论：收肌管阻滞能够满足ACL重建术后的早期康复需要,在术后早期对股四头肌的影响较小,有助于患者早期康复,是一种安全、有效的麻醉方式。     

The importance of glucose in the oxidative metabolism of the testis of the conscious ram and the role of the pentose cycle

1. [U-(14)C]Glucose was infused into one or both testicular arteries of ten conscious rams and the specific activity of the glucose taken up by the testis was compared with the specific activity of the carbon dioxide produced by the testis. 2. Equilibration had occurred after infusion for 3hr. when a mean of 68% of the carbon dioxide was being derived by the testis from blood glucose and 86% of the glucose taken up by the testis was being oxidized to carbon dioxide. After 5hr. infusion, these values were 71% and 83% respectively. 3. In four other conscious rams, [1-(14)C]glucose was infused into one testicular artery and [6-(14)C] glucose into the other and the ;specific yields' of carbon dioxide calculated for the two forms of glucose. 4. From these values, it was calculated that a mean of 9.3% of the glucose taken up by the testis was metabolized via the pentose cycle.     

Comparative Effect of Pethidine,Trichloroethylene, and Entonox on Fetal and Neonatal Acid-Base and Po2

The second stage of labour is associated with relative fetal hypoxia and progressive metabolic acidosis. Maternal analgesia can increase the danger, especially for the high-risk fetus.In 152 patients the effect on the fetus of pethidine alone, pethidine + trichloroethylene, or pethidine + Entonox was assessed by fetal scalp blood sampling. Fetal pH, Pco₂, and Po₂ were measured and base excess was calculated. Capillary samples were also taken 45 to 60 minutes after birth in 88 of the babies to estimate the rate of neonatal recovery.Entonox proved safer than trichloroethylene, and babies treated with it maintained their Po₂ before birth, had better Apgar scores at birth, and one hour later were significantly less acidotic and much better oxygenated.     

Respiratory activity during germination of seeds of Cicer arietinum L. II. Effect of some metabolic inhibitors and mitochondrial activities

Changes in respiration rate during the early period of germination of Cicer arietinum L. seeds were studied. Three phases were distinguished. During phases I and II the RQ was higher than unity. Sodium fluoride showed no effect on gaseous exchange during phase I while in phases II and III a progressive increase in the inhibition of the respiratory activity was obtained. Iodoacetate inhibited oxygen uptake and carbon dioxide evolution from the beginning of germination. The activities of mitochondrial enzymes increased during the germination period, especially after the first 24 hours. The respiratory control and ADP/O ratio of the isolated mitochondria increased gradually during germination, reaching maximum values at 48 hours, lower, however than the expected theoretical ones.     

Negative extrathoracic pressure in treatment of respiratory failure in infants and young children.

OBJECTIVE--To assess the efficacy of a newly developed system for applying continuous or intermittent negative (subatmospheric) extrathoracic pressure in respiratory failure. DESIGN--Uncontrolled clinical trials in infants deteriorating or failing to improve despite standard medical treatment. SETTING--Paediatric and neonatal intensive care units and paediatric wards. PATIENTS--88 Infants and young children aged 1 day to 2 years with respiratory failure due to bronchopulmonary dysplasia, the neonatal respiratory distress syndrome, bronchiolitis, myopathy, the congenital hypoventilation syndrome, pneumonitis, and postoperative phrenic nerve palsy. At the start of treatment 59 were receiving greater than or equal to 50% inspired oxygen and 40 positive airway pressure ventilation. INTERVENTION--Treatment was provided within purpose built Perspex chambers of appropriate size. The chamber incorporated safe and effective latex neck seals; facilities for access, monitoring, and observation; and a heater to control the ambient air temperature. MAIN OUTCOME MEASURES--Inspired oxygen concentration and carbon dioxide pressure before application of negative extrathoracic pressure and two and 48 hours afterwards; duration of treatment; and final outcome (discharge home or death). RESULTS--While arterial oxygen saturation was maintained at constant values 75 infants showed reductions in inspired oxygen concentrations (range 4-50%, median 15%) two hours after starting treatment and 74 showed reductions at 48 hours (2-79%, median 20%). Of 59 infants who had carbon dioxide pressure measured before and after starting negative extrathoracic pressure, 21 showed a reduction (range 0.6-8.9 kPa, median 2.0), 30 no change (+/- 0.5 kPa), and eight a rise (range 0.6-5.1 kPa, median 2.1). In 28 patients extubation was facilitated, 54 patients were discharged home, where six continued treatment, and 34 died. Treatments lasted for between two and 236 days (median 13 days). CONCLUSION--Negative pressure respiratory support is a non-invasive yet effective treatment for respiratory failure. It may avoid the need for intubation, reduce the pathophysiological consequences of positive airway pressure ventilation, and aid extubation.     

Root excision decreases nutrient absorption and gas fluxes

The roots of barley plants (Hordeum vulgare L. cv Steptoe) were monitored before and after excision for net uptake of carbon dioxide, oxygen, ammonium, potassium, nitrate, and chloride and for their content of sucrose, glucose, fructose, and malic acid. All fluxes began to attenuate within 2 hours after excision. Net potassium uptake returned to control levels 6 hours after excision, but carbon dioxide, oxygen, ammonium, and nitrate fluxes continued to diminish for the remainder of the observation period. The addition of 0.1 molar glucose or 0.1 molar sucrose to excision medium had no significant effect on these changes in ion and gas fluxes. Net chloride uptake was negligible for all treatments. Sugar and malic acid content of the root declined after excision. Sucrose and glucose levels remained depressed for the entire observation period, whereas fructose and malic acid returned to control levels after 9 hours. These results indicate that excision has profound, adverse effects on root respiration and the absorption of mineral nitrogen.     

母婴同室新生儿皮肤菌群分析

目的了解母婴同室新生儿皮肤菌群及皮肤感染致病菌情况,为医院感染管理提供依据。方法选取我院母婴同室区2017年3月至7月出生的新生儿,对新生儿出生5min内、出生24h后第1次沐浴前、出生48h后第2次沐浴前、出生72h后第3次沐浴前及皮肤感染部位使用琼脂直接接触培养(RODCA)法采样并将采样平皿送入检验科微生物室进行培养观察。结果本研究共纳入157例新生儿,其中23例新生儿发生皮肤感染。随着出生时间的增加,检出的细菌菌落数显著增加,差异有统计学意义(P0.05)。新生儿出生5min内无细菌生长,出生5min之后主要检出表皮葡萄球菌(320株)、微球菌(118株)和枯草芽胞杆菌(96株)。阴道分娩新生儿皮肤感染发生率低于剖宫产新生儿(P0.05),其感染部位致病微生物为表皮葡萄球菌(18株)。结论我院母婴同室区无外来致病菌,不会造成医院感染的暴发。新生儿出生后72h内是皮肤感染的高危时间段,医院感染管理者应高度重视。     

凝血及纤溶系统在腹腔镜子宫全切手术后的变化

目的:比较分析妇科腹腔镜子宫全切术与开腹子宫全切术对凝血及纤溶系统功能的影响。方法:选择75例接受子宫全切除术的患者,随机分为腹腔镜组38例和开腹组37例,分别于术前24h、术后24h及术后48h采用凝固法检测血浆凝血酶原时间(PT),活化部分凝血活酶时间(APTT),凝血酶时间(TT),纤维蛋白原(FIB)水平,采用酶联免疫吸附双抗体夹心法(ELISA)测定血浆D-二聚体(D-D)的含量。自动血细胞技术分析仪测定血小板(PLT)。结果:①腹腔镜组与开腹组术前24h及术后48h血浆PT、APTT、TT、FIB、PLT、D-D水平相比差异无统计学意义(P>0.05)。②两组病人术后24h血浆PT、APTT均缩短,组间相比差异无统计学意义(P>0.05),但与术前24h相比差异有统计学意义(P<0.05)。③TT及PLT在术前24h及术后24h水平相比差异无统计学意义(P>0.05)。④FIB、D-D两组术后24h均升高,与术前相比差异有统计学意义(P<0.05),组间比较差异无统计学意义(P>0.05)。结论:腹腔镜子宫全切除术特殊的二氧化碳气腹的建立,头低臀高的膀胱截石位,气管插管的全麻协同作用,使患者的血流动力学发生改变,血流速度减慢,同开腹手术一样,均可使患者术后血液呈现不同程度高凝状态,从而均可增加术后下肢静脉血栓形成的危险。因此,对有高危因素的患者应加强围手术期的管理,防止血栓性疾病的发生。     

Why is grouper larval rearing difficult?: an approach from the development of the feeding apparatus in early stage larvae of the grouper,Epinephelus coioides

The osteological development of elements forming the oral cavity was examined in early stage larvae of the grouper,Epinephelus coioides, from hatching to 242.5 hours after hatching. By the time of initial mouth opening, at 54 hours after hatching, the fundamental elements, composed of the trabecula, some components of the lower branchial and hyoid arches, the quadrate and symplectic-hyomandibular cartilages, maxilla and Meckel's cartilage, had appeared. No further elements were observed until 165 hours after initial mouth opening, except some components in the lower branchial arch and head region. The appearance of new elements and initial ossification of existing cartilage occurred thereafter, but all elements related to feeding either had not appeared or had not started ossifying until 188.5 hours after initial mouth opening. Based on the morphology and developmental modes of these elements, the feeding mode of grouper larvae was considered to be “sucking/grasping.” However, the appearance and ossification of elements occurred slowly, with no transitional phase from sucking to grasping modes of feeding being observed during the study; such delayed development of the feeding-related bony elements was considered to be a cause of the difficulty in rearing early stage grouper larvae.     

Local regulation of pulmonary blood flow and ventilation-perfusion ratios in the coatimundi.

Small catheters (ca. 3 mm diam at tip) were wedged in subsegmental bronchi in anesthetized coatimundi (Nasua nasua) during spontaneous breathing. Mixed expired gases of a group of lobules were sampled continuously without contamination from neighboring units, and local tidal volume, frequency, carbon dioxide production, and oxygen consumption were measured, as well as mixed venous PO2 and PCO2. Local ventilation-perfusion ratio, alveolar PO2, PCO2, and blood flow were calculated. There was a 22% reduction (range 15-38) in local perfusion (as percent of flow at PAO2 100 mmHg) per 10 mmHg fall in local alveolar oxygen tension over the PAO2 range 150-36 mmHg. Local hypercapnia had little effect on local flow. Local tidal volume (ca. 1% of total tidal volume) was unaffected by changes in alveolar gas tensions. The contribution of vasoconstriction or vasodilatation, as a negative feedback system, to the stability of local PAO2 was greatest close to the physiologic range (65-85 mmHg) falloderate efficiency.