中药点滴灌肠治疗小儿高氮质血症的护理体会

目的 探索提高中药点滴灌肠治疗高氮质血症疗效及护理方法。方法 对住院高氮质血症患儿60例用中药灌肠治疗 ,规范中药的煎制及点滴方法。结果 60例患儿中 ,BUN 6天内全部降至正常 ,Cr 6.5天全降至正常 ,总有效率达 10 0 %。结论 ( 1)合理配制中药方剂 ,点滴灌肠能有效降低高氮质血症。 ( 2 )

五种病人不宜喝鸡汤

高胆固醇血症者多喝鸡汤，会促使血胆固醇进一步升高；高血压患者喝鸡汤，除引起动脉硬化外，还会使血压持续升高，难以降下；肾脏功能较差者如多喝鸡汤，会引起高氮质血症；胃酸过多者喝鸡汤，会刺激胃酸过多分泌，从而加重瘸情，胆囊炎或胆石症经常发作者喝鸡汤后，会刺激胆囊收缩，加重病情。

腹膜透析在小婴儿复杂先天性心脏病术后的临床应用

目前，小婴儿危重复杂先天性心脏病手术越来越多。虽然近10年来术后监护设备和技术的逐步改善，但术后出现急性肾功能不全发生率仍为2．4％～8．0％，并有较高的病死率。我们对30例复杂先天性心脏病术中或术后出现全身水肿、低心排出量综合征、少尿、高血钾或高氮质血症的病婴早期进行腹膜透析（PD）治疗，评价腹膜透析治疗对小婴儿危重复杂先天性心脏病术后的临床疗效。

婴幼儿营养过剩有害无益

婴幼儿食量太少,营养素供给不足,不利于孩子生长发育,但食入过多、过高的营养素,对孩子的健康成长也有害,医学上称之为"营养过剩"。①蛋白质过多。蛋白质进入人体后,其代谢产物氮是经肾脏排出的,而肾脏排氮量有一定限度,尤其是要幼儿,肾功能尚未发育完善,不能将体内过多的氮量排出。若遇孩子发热、呕吐、腹泄时,体內水分不足,小便浓缩,很易引起高氮血症,影响幼儿的智力发育。如果长期过量摄入蛋白质,还全破坏体内营养素的平衡,剩余的蛋白质还会转化为脂肪,引起婴幼儿肥胖症。通常嬰幼儿每日蛋白质的供给量每千克体重不得超过3～4克,同时也应注意水份的补充。

Influence of moxibustion temperatures on blood lipids, endothelin-1, and nitric oxide in hyperlipidemia patients

OBJECTIVE： To observe the influence of moxibustion temperature on blood lipids, endothelin-1（ET-1）, nitric oxide（NO）, and ET-1/NO in hyperlipidemia patients. METHODS： Forty-two primary hyperlipidemia patients were randomly divided into two groups of 21 and treated with moxibustion at different temperatures. Moxibustion was performed with the moxa roll 2.5-3.0 cm from the skin in the treatment group and 4 cm in the control group, 10 min per point, once every other day. Skin temperature was precisely measured with a thermometer during moxibustion. After a 12-week treatment, seven measurements of blood lipids, ET-1, and NO were recorded. RESULTS： Total cholesterol and triglyceride, were lower in the treatment group than in the control group（P0.05）. Serum ET-1 and ET-1/NO was obvi-ously lowered in the treatment group（P0.001）. Moxibustion regulated NO and ET-1/NO in the treatment group much better than in the control group. CONCLUSION： Moxibustion can regulate blood lipids and clear blood vessels. Moxibustion at 45℃has a better effect than moxibustion at 38℃ on regulating blood lipids and protecting vascular endothelial function, indicating that suitable temperature influences the curative effect of moxibustion.

Effects of different transdermal penetration enhancers applied to herbal cake-partitioned moxibustion on liver lipids,HSL and HMG-CoA reductase in hyperlipidemia rabbits

Objective:To observe the effects of laurocapram and borneol as transdermal penetration enhancers applied to herbal cake-partitioned moxibustion on liver lipids,hormone-sensitive lipase(HSL)and hydroxymethylglutaryl CoA(HMG-CoA)reductase in hyperlipidemia rabbits.Methods:Forty New-Zealand rabbits were randomly divided into 5 groups using the random number table method,with 8 rats in each group.Rabbits in the blank group were fed routinely with a normal diet;rabbits in the other groups were fed with high-fat diet for 12 weeks to establish the hyperlipidemia model.Rabbits in the blank and the model groups were not given any intervention.After the model was prepared successfully,rabbits in the non-transdermal penetration enhancer group received herbal cake-partitioned moxibustion without transdermal penetration enhancers;rabbits in the laurocapram group and the borneol group received herbal cake-partitioned moxibustion with laurocapram or borneol respectively.After 4 weeks of treatment,the serum was isolated and enzyme-linked immunosorbent assay(ELISA)was applied for the detection of HSL and HMG-CoA reductase.The liver tissues were isolated,and total cholesterol(TC)and triglycerides(TG)were measured by enzymatic methods.One-step method was applied for high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)detection,and transmission turbidimetry was for apolipoprotein A1(Apo-A1)and apolipoprotein B(Apo-B)detection.Results:The serum concentrations of the drugs in the laurocapram and the borneol groups were significantly higher than those in the non-transdermal penetration enhancer group(both P<0.05);all drug penetrations in the borneol group were significantly higher than those in the laurocapram group(both P<0.05),except for tanshinoneⅡA.Compared with the non-transdermal penetration enhancer group,the HSL was significantly increased while the HMG-CoA reductase was significantly decreased in the laurocapram and the borneol groups(both P<0.05);between groups,the HSL in the borneol group was significantly higher than that in the laurocapram group(P<0.05).Compared with the blank group,the levels of LDL-C,TG,TC and Apo-B in rabbit liver were significantly increased in the model group(P<0.05);compared with the model group,the levels of LDL-C,TG,TC and Apo-B in the non-transdermal penetration enhancer,the laurocapram,and the borneol groups were significantly decreased(all P<0.05);between groups,the TG and TC in the laurocapram group and the LDL-C,TG,TC and Apo-B in the borneol group were significantly lower than those in the non-transdermal penetration enhancer group(all P<0.05),and the TG,LDL-C and Apo-B in the borneol group were significantly lower than those in the laurocapram group(all P<0.05).Compared with the blank group,the HDL-C and Apo-A1 were significantly decreased in the model group(both P<0.05),while compared with the model group,the HDL-C and Apo-A1 were significantly increased in the non-transdermal penetration enhancer,the laurocapram,and the borneol groups(all P<0.05).Between groups,the Apo-A1 in the laurocapram group,the HDL-C and Apo-A1 in the borneol group were significantly higher than those in the non-transdermal penetration enhancer group(all P<0.05).Conclusion:The application of laurocapram and borneol,as transdermal penetration enhancers,in herbal cake-partitioned moxibustion can promote the penetration of the drugs in the herbal cake,increase the levels of HDL-C and Apo-A1,improve the metabolism of HSL and HMG-CoA reductase,and also simultaneously reduce the levels of TC,TG,LDL-C and Apo-B in the liver.The transdermal penetration enhancement effect of borneol is slightly better than or equivalent to that of laurocapram.

Effect of herbal cake-partitioned moxibustion on Leptin/JAK#STAT3 in lipid-lowering pathway of hyperlipidemia rabbits

Objective:To observe the lipid-lowering effect of different transdermal absorption enhancers applied to the herbal cake-partitioned moxibustion in hyperlipidemia model rabbits,and to explore the possible mechanism.Methods:Forty New-Zea I a nd rabbits were ran domly divided into 5 groups using the ran dom nu mber table method,with 8 rats in each group.Rabbits in the blank group were fed routinely with normal diet;rabbits in the other groups were fed with high-fat diet for 12 weeks to establish the hyperlipidemia model.Rabbits in the blank and the model groups were not treated.After the model was prepared,rabbits in the non-transdermal absorption enhancer group received herbal cake-partitioned moxibustion without transdermal absorption enhancer;rabbits in the laurocapram group and the borneol group received herbal cake-partitioned moxibustion with laurocapram or borneol respectively.After 4 weeks of treatment,serum was collected for enzyme-linked immunosorbent assay(ELISA),and the liver tissues were isolated for imm uno histochemistry,qua ntitative polymerase chain reactio n(qPCR)and Western-blotting(WB)detecti on.Results:Serum ELISA results showed that leptin was significantly decreased in the model group compared with the blank group(P<0.05);compared with the model group,lepti n was significa ntly in creased in the non-tran sdermal absorpti on enhanee。the laurocapram and the borneol groups(all P<0.05);compared with the non-transdermal absorption enhancer group,leptin was significantly increased in the laurocapram group and the borneol group(both P<0.05);there was no significant differenee in leptin between the laurocapram and the borneol groups(P>0.05).The qPCR results of rabbit liver tissues showed that the mRNA expressions of leptin,Janus kinase 2(JAK2)and signal transducer and activator of transcription 3(STOT3)in the model group were significantly lower than those in the blank group(all P<0.05);compared with the model group,the mRNA expressions of leptin,leptin receptor(LR),JAK2 and S1AT3 in the non-transdermal absorptio n enhan cer,the laurocapram and the born eol groups were significantly in creased(all P<0.05);compared with the non-transdermal absorption enhancer group,the mRNA expressions of leptin,LR,JAK2 and S77VT3 in the laurocapram and the bor neol groups were sign ificantly in creased(all P<0.05);compared with the laurocapram group,the mRNA expressi ons of lepti n,LR,JAK2 and SW3 in the bor neol group were significa ntly in creased(P<0.05).The trend of immun ohistochemistry and WB detecti on results was basically con siste nt with the qPCR assay results.The immuno histochemistry and WB detection results of phosphorylated JAK2(phospho-JAK2)and phosphorylated S7AT3(phospho-STAT3)were basically consistent with those of JAK2 and S7AT3.Conclusion:The molecular expression of Leptin/JAK"S7AT3 pathway in the hyperlipidemia model rabbits was decreased.The molecular expression of Leptin/JAK0STCT3 pathway was significantly increased after the herbal cake-partitioned moxibustion.The application of laurocapram and borneol,as transdermal absorption enhancers,in the herbal cake-partitioned moxibustion could more obviously up-regulate the factors of the Leptin/JAK^SIAT3 lipid-regulating pathway than the herbal cake-partitioned moxibustion alone.

不同肾功能状态对小鼠生育能力的影响

实验分别对单肾切除及实验性高氮质血症条件下动物的生殖能力进行了观察。结果显示单肾切除组动物的受孕率、每胎怀仔数及睾丸组织学情况与对照组相比均无明显差异。而实验性高氮质血症可使动物生殖能力严重受损,受孕率及每胎怀仔数明显降低(P<0.001),睾丸曲细精管生精停止,间质细胞活性下降。但各组间睾丸重量相比较未显示出明显的差异。实验结果证明,单纯单肾切除不会对动物的生殖能力造成影响。而高氮质血症可使动物的生殖能力受到损害。