Molecular mechanism of noradrenaline during the stress-induced major depressive disorder

Chronic stress-induced depression is a common hallmark of many psychiatric disorders with high morbidity rate.Stress-induced dysregulation of noradrenergic system has been implicated in the pathogenesis of depression.Lack of monoamine in the brain has been believed to be the main causative factor behind pathophysiology of major depressive disorder（MDD） and several antidepressants functions by increasing the monoamine level at the synapses in the brain.However,it is undetermined whether the noradrenergic receptor stimulation is critical for the therapeutic effect of antidepressant.Contrary to noradrenergic receptor stimulation,it has been suggested that the desensitization of β-adrenoceptor is involved in the therapeutic effect of antidepressant.In addition,enhanced noradrenaline（NA） release is central response to stress and thought to be a risk factor for the development of MDD.Moreover,fast acting antidepressant suppresses the hyperactivation of noradrenergic neurons in locus coeruleus（LC）.However,it is unclear how they alter the firing activity of LC neurons.These inconsistent reports about antidepressant effect of NA-reuptake inhibitors（NRIs） and enhanced release of NA as a stress response complicate our understanding about the pathophysiology of MDD.In this review,we will discuss the role of NA in pathophysiology of stress and the mechanism of therapeutic effect of NA in MDD.We will also discuss the possible contributions of each subtype of noradrenergic receptors on LC neurons,hypothalamic-pituitary-adrenal axis（HPA-axis） and brain derived neurotrophic factor-induced hippocampal neurogenesis during stress and therapeutic effect of NRIs in MDD.

Endoscopic-catheter-directed infusion of diluted(-)-noradrenaline for atypical hemobilia caused by liver abscess:A case report

BACKGROUND Hemobilia occurs when there is a fistula between hepatic blood vessels and biliary radicles,and represents only a minority of upper gastrointestinal hemorrhages.Causes of hemobilia are varied,but liver abscess rarely causes hemobilia and only a few cases have been reported.Here,we present a case of atypical hemobilia caused by liver abscess that was successfully managed by endoscopic hepatobiliary intervention through endoscopic retrograde cholangiopancreatography(ERCP).CASE SUMMARY A 54-year-old man presented to our emergency department with a history of right upper quadrant abdominal colic and repeated fever for 6 d.Abdominal sonography and enhanced computed tomography revealed that there was an abscess in the right anterior lobe of the liver.During hospitalization,the patient developed upper gastrointestinal bleeding.Upper gastrointestinal endoscopy revealed a duodenal ulcer bleeding that was treated with three metal clamps.However,the hemodynamics was still unstable.Hence,upper gastrointestinal endoscopy was performed again and fresh blood was seen flowing from the ampulla of Vater.Selective angiography did not show any abnormality.An endoscopic nasobiliary drainage(ENBD)tube was inserted into the right anterior bile duct through ERCP,and subsequently cold saline containing(-)-noradrenaline was infused into the bile duct lumen through the ENBD tube with no episode of further bleeding.CONCLUSION Hemobilia should be considered in the development of liver abscess,and endoscopy is essential for diagnosis and management of some cases.

Effects of Tetrandine on Cardiac Noradrenaline Release Evoked by Electrical Stimulation

The effects of tetrandine (TD) on endogenous cardiac noradrenaline (NA) release evoked by electrical stimulation were investigated in perfused guinea pig hearts. The overflow of cardiac NA and its intraneuronal metabolite 3 ,4-dihydroxyphenylethyleneglycol (DOPEG) were determined by high pressure liquid chromatography (HPLC). In the presence of TD,the release of NA evoked by either nerve ganglion-stimulation or cardiac field-stimulation was significantly reduced (P<0. 01). The overflow of DOPEG was markedly enhanced (P<0. 01).TD inhibited cardiac endogenous NA release resulting from activation of the sympathetic nerve terminals within the myocardium, and increased the release of DOPEG, indicating that TD could result in a loss of NA from storage vesicles or activate monoamine oxidase in axoplasma, which could be detected by markedly increased DOPEG release. These effects of TD may be associated with its property of calcium antagonist.

Disciplined sleep for healthy living: Role of noradrenaline

Sleep is essential for maintaining normal physiological processes. It has been broadly divided into rapid eye movement sleep(REMS) and non-REMS(NREMS); one spends the least amount of time in REMS. Sleep(both NREMS and REMS) disturbance is associated with most altered states, disorders and pathological conditions. It is affected by factors within the body as well as the environment, which ultimately modulate lifestyle.Noradrenaline(NA) is one of the key molecules whose level increases upon sleep-loss, REMS-loss in particular and it induces several REMS-loss associated effects and symptoms. The locus coeruleus(LC)-NAergic neurons are primarily responsible for providing NA throughout the brain. As those neurons project to and receive inputs from across the brain, they are modulated by lifestyle changes, which include changes within the body as well as in the environment. We have reviewed the literature showing how various inputs from outside and within the body integrate at the LC neuronal level to modulate sleep(NREMS and REMS) and vice versa. We propose that these changes modulate NA levels in the brain, which in turn is responsible for acute as well as chronic psychosomatic disorders and pathological conditions.

Release of myocardial noradrenaline during acute hibernation in the isolated rat heart

Objective： To explore the release of myocardial noradrenaline during acute hibernation. Methods： The hearts were gained from rats and set up as modified Langendorf preparations beating isometrically. They were perfused with modified Krebs-Henseleit buffer under controlled pressure. Mechanical measurements and coronary effluent were recorded simultaneously at 30min intervals for 150min. Lactate dehydrogenase in coronary effluent was assayed at the beginning, 60min and 120min low-flow ischemia. Noradrenaline in coronary effluent was determined at the beginning of low-flow and 120min of low-flow ischemia and also in control, during hibernation and after 30min reperfusion during stimulation, myocardial noradrenaline response on tyramine was investigated in absence or presence of desipramine after 30min reperfusion. Results： In the control, there was nosignificant chant in noradrenaline overflow during 120min perfusion; In the acute myocardial hibernation group, there was also nosignificant difference in noradrenaline overflow between the beginning and 120min low-flow ischemia. The electrical field stimulation-induced overflow of noradrenaline during hibernation myocardium was significantly less than preischemia or after reperfusion, but there was nosignificant difference between preischemia and reperfusion group. Tyramine induced significant noradrenaline release in absence of desipramine after 30min reperfusion, but this increase in noradrenaline release had nosignificant in the presence of desipramine. These studies indicated that there was not significant spontaneous noadrenaline overflow during acute myocardial hibernation in isolated rat hearts, the stimulation-induced noradrenaline overflow decreased during hibernation and restored to the level of preischemia after reperfusion, myocardial noradrenaline response to tyramine remained after 30min reperfusion. Conclusion： Myocardial noradrenaline overflow may not contribute to the development of acute myocardial hibernation and the function of sympathetic nerve may also maintain in hibernation as myocardium does during acute myocardial hibernation, reperfusion of myocardium may contribute to restoring the function of sympathetic nerve.

Quantitative Determination of Adrenaline Hydrochloride Injection and Noradrenaline Bitartrate Injection by a New HPLC Method via Substitute for Reference Substance

An HPLC method for quantitative determination of adrenaline hydrochloride injection and noradrenaline bitartrate injection was established and validated with a substitute for the reference substance.Phenylephrine hydrochloride was selected as the substitute for the reference substance of adrenaline and noradrenaline bitartrate.The correction factor of phenylephrine hydrochloride with respect to the reference substance of adrenaline and noradrenaline bitartrate was determined under defined conditions.Adrenaline hydrochloride injection and noradrenaline bitartrate injection were quantified by assaying phenylephrine hydrochloride and a correct factor.The results indicate that the HPLC method with the substitute for reference substance was reliable and feasible for quantitative determination of drugs.

Effects of serotonin and noradrenaline on neuronal activities of the solitary tract nucleus and its alteration after ketanserin

Effects of serotonin(5-HT)and noradrenaline(NA)on neuronal activities of the sol-itary tract nucleus(NTS)were investigated in rat medullary slice preparations.After perfusingthe slice with 5-HT,the spontaneous discharge was significantly increased in 25(of 43,58.1%)NTS neurons,reduced in 13(30.2%)and not changed in 5(11.7%).After perfusingthe slice with NA,the spontaneous discharge was significantly reduced or even completelyceased in 27(62.8%)neurons,increased in 13(30.2%)and not changed in 3(7%).Therewere 38(88.4%)neurons responding to both 5-HT and NA.From the 38 neurons,21 wereselected for studying the effect of ketanserin.It was found that ketanserin potentiated the ef-fect of NA on spontaneous discharge in 10(47.6%)neurons and attenuated it in 4(19.0%)neurons.These results suggest that there is an interaction between 5-HT receptorand α-adrenoceptor at the NTS level.This interaction may be helpful in explaining themechanism of the central antihypertensive action of ketanserin.

Management of Arterial Hypotension Induced by Spinal Anesthesia during Cesarean Section at the Parakou University Hospital in Benin in 2020: Ephedrine versus Noradrenaline

Background: Spinal anesthesia (SA) is a preferred anesthetic technique for childbirth through caesarean section. It causes a sympathetic block responsible for low blood pressure which can be prevented or treated with vasopressors. Aim: This research aims to compare the effect of Noradrenaline with that of Ephedrine in the management of arterial hypotension caused by SA during Caesarean act. Study method: It was a cross-sectional study with two comparative settings which took place at the Teaching hospital of Parakou from April 15th to August 15th 2020. It included all parturients who underwent a caesarian act and received spinal anesthesia. To prevent hypotension two groups were formed. The first group parturient received Noradrenaline (10 γ) as prophylactic and the second group received Ephedrine (10 mg) before anesthesia. The main evaluation criteria were the time before the hypotension occurs and, the secondary endpoint was the number of hypotension episode. The two groups were compared using the usual statistical tests. The study received the approval of the Local Ethical committee of University of Parakou. Results: Two hundred and four parturients were compiled with 102 in each group. The mean age was 28.37 ± 6.15 years with extremes of 16 and 45 years. The main indications for Caesarean section were respectively iterative Caesarean section (46.57%) for scheduled Caesarean section and acute fetal distress (15.69%) for emergency Caesarean section. The incidence of hypotension was 38.24%. The mean delay of occurrence of hypotension was significantly longer in adrenaline group (19.90 min) than ephedrine group (12.53 min) with P = 0.001. According to the secondary endpoint the number of episodes of hypotension, number of tachycardia, and the total doses of each vasopressor were significantly lower in adrenaline group than in the ephedrine group. Conclusion: The use of Noradrenaline according to the established protocol demonstrated its efficiency compared with Ephedrine in the management of hypotension after spinal anesthesia.

Noradrenaline as a putative neurotransmitter mediating hypotension-induced Fos-like immunoreactivity inthe supraoptic nucleus of the rat

Hemorrhage or hypotension induces extensive Foslike immunoreactivity in the magnocellular neurosecretory cells in the supraoptic nucleus of the hypothalamus in rat, especially in the vasopressin neurons. The present study was to explore the neurotransmitter mediating this effect. Microinfusion of the alpha-adrenergic blocker into the supraoptic nucleus reduced the hypotension-induced Fos, whereas beta-antagonist did not affect it significantly. Alpha1- and alpha2-antagonist, prazosin and yohimbine,both reduced the Fos-positive cell counts. However, the effective dosage of yohimbine was much larger. Alpha1-agonist, methoxamine, induced abundant Fos-like immnnoreactivity in the vasopressin cells in this nucleus,while beta-and alpha2-agonist did not elicit such effect.Administration of the noradrenergic re-uptake inhibitor,desipramine, to this nucleus to locally accumulate the spontaneously released noradrenaline from the nerve terminals also induced Fos expression, mostly in the vasopressin cells.

感染性休克液体复苏完成时限对病情转归的影响

目的 探究感染性休克液体复苏完成时限对患者病情转归的影响。方法 选取2020年7月—2023年7月收治的感染性休克156例,根据液体复苏完成时限分为<1 h组68例、1~2 h组57例、≥2 h组31例。比较3组液体复苏前后急性生理和慢性健康状况评分(APACHEⅡ)、序贯器官衰竭评分(SOFA)、血流动力学指标[中心静脉压(CVP)、心指数、外周血管阻力指数(SVRI)、每搏量指数(SVI)]、血乳酸、pH值、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、血管外肺水指数(ELWI)、肺血管通透性指数(PVPI)、血肌酐、液体复苏量,以及去甲肾上腺素应用剂量、重症监护病房(ICU)住院时间、机械通气时间、28 d生存率。结果 <1 h组、1~2 h组复苏后APACHEⅡ、SOFA评分低于≥2 h组(P<0.05);≤1 h组、1~2 h组复苏后APACHEⅡ、SOFA评分无明显差异(P>0.05);<1 h组、1~2 h组复苏后CVP、心指数、SVI高于≥2 h组,SVRI低于≥2 h组(P<0.05);<1 h组、1~2 h组复苏后CVP、心指数、SVRI、SVI比较无明显差异(P>0.05)。<1 h组、1~2 h组复苏后血乳酸低于≥2 h组(P<0.05);<1 h组、1~2 h组复苏后血乳酸比较无明显差异(P>0.05);3组复苏后血pH值、PaO_(2)、PaCO_(2)比较无明显差异(P>0.05)。<1 h组复苏后ELWI、PVPI、血肌酐高于复苏前,并高于1~2 h组、≥2 h组(P<0.05);3组1 h液体复苏量比较无明显差异(P>0.05),<1 h组、1~2 h组、≥2 h组3 h液体复苏量呈依次降低趋势(P<0.05)。≥2 h组去甲肾上腺素剂量高于<1 h组、1~2 h组(P<0.05);<1 h组ICU住院时间、机械通气时间长于1~2 h组、≥2 h组(P<0.05)。1~2 h组、≥2 h组28 d生存率高于<1 h组(P<0.05,P<0.01)。结论 感染性休克患者初始液体复苏应在1~2 h内完成,能有效改善器官功能障碍和病情,维持血流动力学水平,加快恢复进程,促进病情良好转归。

围术期目标导向液体治疗在妇科腔镜手术患者围术期的应用效果

目的:探讨围术期目标导向液体治疗(GDFT)在妇科腔镜手术患者围术期的应用效果。方法:选取2022年1月至2022年10月蚌埠市第三人民医院收治的行妇科腔镜手术患者80例作为研究对象,按照随机数字表法随机分为观察组和对照组,每组40例。观察组围术期基于心排量监测技术予以患者GDFT,对照组围术期常规补液。比较2组术中胶体、晶体的输入量、总输液量以及尿量、去甲肾上腺素(NE)使用量和低血压发生数,匹兹堡睡眠质量指数(PSQI)评估量表评价2组睡眠质量。结果:观察组晶体输入量、胶体输入量、总输液量、NE使用量、低血压发生率低于对照组,(P<0.05);尿量多于对照组(P<0.05)。观察组术后第1天PSQI评分高于对照组(P<0.05)。结论:围术期予以妇科腔镜手术患者GDFT可以获得较常规补液更满意的容量状态,对改善患者术后早期睡眠质量也可能具有积极作用。

Simultaneous Determination of Epinephrine, Noradrenaline and Dopamine in Human Serum Samples by High Performance Liquid Chromatography with Chemiluminescence Detection

A simple, rapid and accurate high performance liquid chromatographic （HPLC） technique coupled with chemiluminescence （CL） detection was developed for the simultaneous determination of epinephrine （E）, noradrenaline （NA） and dopamine （DA）. It was based on the analyte enhancement effect on the CL reaction between luminol and potassium ferricyanide. The effects of various parameters, such as potassium ferricyanide concentration, luminol concentration, pH value and component of the mobile phase on chromatographic behaviors of the analytes （E, NA and DA） were investigated. The separation was carded out on C18 column using the mobile phase of 0.01 mol/L potassium hydrogen phthalate solution and methanol （92 ： 8, V/V）. Under the optimum condi- tions, E, NA and DA showed good linear relationships in the range of 1 × 10^-8 -5 × 10^-6, 5.0× 10^-9 -1.0× 10^-6 and 5.0×10^-9-1.0× 10^-6 g]mL respectively. The detection limits for E, NA and DA were 4.0×10^-9, 1.0× 10^-9 and 8.0 × 10^-10 g/mL. The proposed method has been applied successfully to the analysis of E, NA and DA in human serum samples.

艾司洛尔联合去甲肾上腺素对脓毒症休克患者心功能及预后的影响

目的:探讨艾司洛尔联合去甲肾上腺素对脓毒症休克患者心功能及预后的影响。方法:回顾性分析2020年12月至2023年1月该院收治的74例脓毒症休克患者的临床资料,根据治疗方案不同将其分为对照组与研究组各37例。两组均予以常规抗感染、抗炎、液体复苏等治疗,在此基础上对照组采用重酒石酸去甲肾上腺素注射液治疗,研究组在对照组基础上加用盐酸艾司洛尔注射液治疗。比较两组治疗前后血流动力学指标[心率、平均动脉压(MAP)]水平、病情危重度[急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)、序贯器官衰竭评估量表(SOFA)]评分、心功能指标[每搏指数(SVI)、心脏指数(CI)]水平、心肌损伤标志物[高敏肌钙蛋白T(hs-cTnT)、N末端B型脑钠肽前体(NT-proBNP)]水平、血清炎性因子[高迁移率族蛋白B1(HMGB1)、白细胞介素-6(IL-6)]水平、血乳酸水平、不良反应发生率及28 d生存率。结果:治疗后研究组心率,APACHEⅡ、SOFA评分,血清hs-cTnT、NT-proBNP、HMGB1、IL-6、血乳酸水平均低于对照组,SVI、CI水平均高于对照组,差异有统计学意义(P<0.05);治疗6 h后,两组MAP水平均高于治疗前,但组间比较差异无统计学意义(P>0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05);研究组28 d生存率为78.39%(29/37),对照组28 d生存率为67.57%(25/37),差异无统计学意义(P>0.05)。结论:艾司洛尔联合去甲肾上腺素治疗脓毒症休克患者可促进心率恢复正常,且不影响血压水平,并减轻心肌损伤,提高心功能,降低血清炎性因子和血乳酸水平,从而加快病情缓解,效果优于单用去甲肾上腺素。

艾司洛尔联合去甲肾上腺素与液体复苏治疗脓毒性休克患者的效果

目的:观察艾司洛尔联合去甲肾上腺素与液体复苏治疗脓毒性休克患者的效果。方法:回顾性分析2020—2022年该院收治的88例脓毒性休克患者的临床资料,按照治疗方式不同将其分为研究组和对照组各44例。对照组采用去甲肾上腺素联合液体复苏治疗,研究组在对照组基础上联合艾司洛尔治疗,比较两组治疗前后血流动力学指标[平均动脉压(MAP)、心率]水平、组织氧合指标[中心静脉压(CVP)、氧合指数(PaO_(2)/FiO_(2))、血乳酸]水平、临床疗效和不良反应发生率。结果:治疗后,两组MAP水平均高于治疗前,且研究组高于对照组,两组心率水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组CVP、PaO_(2)/FiO_(2)水平均高于治疗前,且研究组高于对照组,两组血乳酸水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组治疗总有效率为95.45%(42/44),高于对照组的79.55%(35/44),差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:艾司洛尔联合去甲肾上腺素与液体复苏治疗脓毒性休克患者可提高治疗总有效率,改善血流动力学指标和组织氧合指标水平,其效果优于去甲肾上腺素联合液体复苏治疗。

去甲肾上腺素辅助椎管内麻醉对剖宫产术产妇围手术期心功能的影响研究

目的:观察去甲肾上腺素(NE)辅助椎管内麻醉对改善剖宫产术产妇围手术期心功能指标的效果。方法:选取2021年2月—2022年2月南阳医学高等专科学校附属中医院行剖宫产术的110例产妇作为研究对象。采用抽签法将患者分为观察组和对照组,每组各55例。两组患者均实施椎管内麻醉,观察组在此基础上采用NE辅助椎管内麻醉,比较两组产妇围手术期心功能变化情况、不良事件发生情况及新生儿娩出情况。结果:观察组产妇麻醉10min后(T1)、麻醉30min后(T2)、术毕时(T3)、苏醒后(T4)时平均动脉压(MAP)和心率(HR)低于对照组,心输出量(CO)高于对照组,差异有统计学意义(t=3.062、3.527、3.821、3.657、2.571、3.115、3.251、3.162、2.427、2.402、2.459、2.615,P<0.05);观察组产妇苏醒时间以及新生儿娩出后1min、5min、10min时的Apgar评分与对照组近似,差异无统计学意义(t=1.138、0.202、0.223、0.152,P>0.05);观察组的不良事件发生率(5.45%)低于对照组(16.36%),差异有统计学意义(χ^(2)=6.126,P<0.05)。结论:采用NE辅助剖宫产产妇的椎管内麻醉可显著改善其围手术期心功能,NE不会对产妇苏醒情况及新生儿娩出情况产生明显影响,但会显著降低术后低血压、寒战等不良事件发生风险,改善产妇预后。

间羟胺、去甲肾上腺素治疗脓毒性休克的疗效及对肾功能的影响

目的探讨间羟胺、去甲肾上腺素治疗脓毒性休克的疗效并分析对肾功能的影响。方法选取2019年1月—2022年4月吴中人民医院收治的72例脓毒性休克患者为研究对象,按照治疗方案分为对照组和观察组,各36例。对照组以去甲肾上腺素治疗,观察组以间羟胺治疗。对比两组患者生理指标、血清学指标、肾功能指标。结果治疗后,两组患者HR均下降,MAP上升,差异无统计学意义(P>0.05);治疗后,两组患者PCT、CRP、LA均下降,差异无统计学意义(P>0.05);治疗后,观察组每小时尿量、CCr升至(65.12±15.52)mL/h、(52.16±6.82)mL/min,高于对照组的(41.37±15.91)mL/h、(39.46±6.50)mL/min,BUN、SCr降至(12.31±3.16)、(97.16±12.56)μmol/L,低于对照组的(17.62±3.42)、(131.26±14.20)μmol/L,差异有统计学意义(P<0.05)。结论间羟胺、去甲肾上腺素在治疗脓毒性休克时均能改善患者心率、血压,促进血清炎性反应缓解,但间羟胺在预防肾功能损伤方面更具优势。

去甲肾上腺素治疗重症感染性休克患者的效果及其对血流动力学的影响分析

目的探究去甲肾上腺素治疗重症感染性休克患者的效果及其对血流动力学的影响。方法选取2019年6月至2020年10月本院收治的68例重症感染性休克患者作为研究对象,根据治疗方案不同分为对照组与观察组,各34例。对照组给予多巴酚丁胺治疗,观察组在对照组基础上给予去甲肾上腺素治疗,比较两组治疗前后血流动力学指标[心率(HR)、心排出指数(CI)、平均动脉压(MAP)]、肾功能指标[肌酐清除率(Ccr)、血乳酸(LAC)、尿量]及临床疗效。结果治疗后,两组HR均慢于治疗前,CI、MAP均高于治疗前,且观察组HR慢于对照组,CI、MAP均高于对照组,差异有统计学意义(P<0.05);治疗后,两组LAC水平均低于治疗前,Ccr均高于治疗前,尿量均多于治疗前,且观察组LAC水平低于对照组,Ccr高于对照组,尿量多于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率为94.12%,高于对照组的76.47%,差异有统计学意义(P<0.05)。结论去甲肾上腺素治疗重症感染性休克疗效确切,有利于稳定患者血流动力学,促进肾脏灌注改善。

乌司他丁联合去甲肾上腺素治疗重症脓毒症休克的疗效及对血流动力学和免疫功能的影响

目的 观察乌司他丁联合去甲肾上腺素治疗重症脓毒症休克的疗效及对血流动力学和免疫功能的影响。方法 选取2020年1月—2023年2月临沂市中心医院收治的重症脓毒症休克患者74例,按照随机数字表法分为对照组37例和研究组37例。对照组使用去甲肾上腺素,研究组则在对照组治疗基础上联用乌司他丁,2组均持续治疗2周。比较2组抢救结果,治疗前、治疗结束后3 d血流动力学指标[平均动脉压(MAP)、心率(HR)]、组织氧合功能指标[氧输送量(DO_(2))、氧合指数(OI)]、免疫功能指标[免疫球蛋白A(IgA)、免疫球蛋白M(IgM)]、炎性指标[C反应蛋白(CRP)、降钙素原(PCT)、白细胞计数(WBC)]、血管内皮功能指标[内皮素-1(ET-1)、同型半胱氨酸(Hcy)]及不良反应。结果 研究组抢救成功率高于对照组(89.19%vs. 70.27%,χ^(2)=4.097,P=0.043)。治疗结束后3 d, 2组MAP、DO_(2)、OI及血清IgA、IgM水平高于治疗前,HR低于治疗前,且研究组升高/降低幅度大于对照组(P<0.01);2组血清CRP、PCT、ET-1、Hcy水平及WBC低于治疗前,且研究组低于对照组(P<0.05或P<0.01)。研究组不良反应总发生率低于对照组(8.11%vs. 29.73%,χ^(2)=5.638,P=0.018)。结论 乌司他丁联合去甲肾上腺素治疗重症脓毒症休克的效果显著,能够提高患者抢救成功率,促使机体血流动力学和组织氧合功能稳定,改善免疫功能及血管内皮功能,且安全性较高。

不同严重程度多动症儿童的血清NE和DA水平及其影响因素分析

目的 探究不同严重程度多动症儿童的血清去甲肾上腺素(NE)、多巴胺(DA)水平及其影响因素。方法 选取2021年11月~2022年11月期间长沙市第一医院儿科纳入的66例多动症患儿作为观察组,并选择同期健康体检儿童50例为对照组。评估血清NE、DA水平,并采用多因素Logistic回归分析探讨其影响因素,再采用Pearson相关性分析分析血清NE、DA水平及病情的关系。结果 观察组患儿血清NE、DA水平均高于对照组(P <0.05);中度组和重度组患儿血清NE、DA水平均高于轻度组,且随着病情的加重,患儿血清NE、DA水平越高(P <0.05);单因素分析显示,三组血镁比较差异有统计学意义(P <0.05);经多因素Logistic回归分析显示,血镁、血清NE、DA均为多动症病情严重程度的独立危险因素(P <0.05);多动症患儿血清NE、DA水平与病情严重程度呈正相关(P <0.05)。结论 血镁、血清NE、DA均为多动症病情严重程度的独立危险因素,且血清NE、DA水平与病情严重程度呈正相关,血清NE、DA可作为评估多动症患儿病情严重程度的指标。

脑心通胶囊联合米力农注射液治疗慢性心力衰竭患者的效果

目的:观察脑心通胶囊联合米力农注射液治疗慢性心力衰竭(CHF)患者的效果。方法:选取2019年9月至2022年9月该院收治的96例CHF患者进行前瞻性研究,按照随机数字表法将其分为研究组(n=48)和对照组(n=48)。对照组采用米力农注射液治疗,研究组在对照组基础上联合脑心通胶囊治疗。比较两组临床疗效、治疗前后心功能指标[心排出量(CO)、每搏输出量(SV)、左心室射血分数(LVEF)]水平、去甲肾上腺素(NA)水平、血管紧张素Ⅱ(AngⅡ)水平和不良反应发生率。结果:研究组治疗总有效率为93.75%(45/48),高于对照组的77.08%(37/48),差异有统计学意义(P<0.05);治疗后,两组CO、LVEF、SV水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);两组NA、AngⅡ水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:脑心通胶囊联合米力农注射液治疗CHF患者可提高治疗总有效率和心功能指标水平,降低NA和AngⅡ水平,其效果优于单纯米力农注射液治疗。