低浓度左旋布比卡因用于颈丛阻滞的临床观察

左旋布比卡因是消旋布比卡因的纯S-（-）异构体，为新型长效局麻药，其心脏、中枢神经系统毒性显著低于布比卡因…。目前已有左旋布比卡因硬膜外，臂丛及术后镇痛的临床研究，但国内尚无颈丛阻滞临床对比研究报告，本研究旨在通过布比卡因的对比，观察左旋布比卡因的颈丛阻滞效果。     

罗哌卡因对腰硬联合麻醉下子宫全切术患者运动神经阻滞的影响分析

目的讨论罗哌卡因对腰硬联合麻醉下子宫全切术患者运动神经阻滞的影响。方法选择本院近1年接诊收治的110例腰硬联合麻醉下子宫全切术患者作为研究对象,随机将其分为罗哌卡因组和左旋布比卡因组,每组各55例。分析两种药物对患者运动神经阻滞的影响。结果罗哌卡因组患者运动神经阻滞时间及Bromege评分明显优于左旋布比卡因组,差异具有统计学意义(P0.05);各个时间点两组患者MAP、HR变化趋势比较,差异无统计学意义(P0.05);两组患者感觉神经阻滞时间比较,差异无统计学意义(P0.05);罗哌卡因组患者并发症发生率为3.6%,明显低于左旋布比卡因组的13.4%,差异具有统计学意义(P0.05)。结论罗哌卡因应用于腰硬联合麻醉子宫全切术中手术安全性高,降低对患者运动神经阻滞的影响,提高了临床疗效。     

左旋布比卡因配伍芬太尼在产科术后硬膜外镇痛的临床应用

目的评价左旋布比卡因配伍芬太尼用于产科术后硬膜外镇痛的临床效果。方法选择择期产科手术患者60例，ASAⅠ-Ⅱ级，随机分为两组：左旋布比卡因配伍芬太尼组（A组，n=30例）与布比卡因配伍芬太尼组（B组，n=30例）。采用腰麻联合硬膜外麻醉。关腹时，经硬膜外导管注入0．125％左旋布比卡因（A组）或0．125％布比卡因（B组）5ml，再用2ml／h微量止痛泵持续硬膜外输入镇痛药。A组术后硬膜外维持用药为0．125％左旋布比卡因100ml配伍芬太尼0．5mg，B组术后硬膜外用药为0．125％布比卡因100ml配伍芬太尼0．5mg，两组术后镇痛时间均为48h。记录术后6h、12h、24h和36h的镇痛、镇静、运动阻滞、心率、血压和不良反应。结果两组病人镇痛效果（VAS评分）、镇静程度（Ramesay评分）和运动阻滞情况（MBS评分）无统计学差异（P〉0．05）。在镇痛期间两组病人均能安静合作。镇痛期间两组病人心率、血压组间比较无统计学差异（P〉0．05）。镇痛期间不良反应比较无统计学差异。结论0．125％的左旋布比卡因配伍0．0005％的芬太尼行持续硬膜外镇痛，效果确切，循环影响小，副作用少，适用于产科手术病人的术后镇痛。     

左旋布比卡因骶管阻滞复合异丙酚静注在小儿下腹部手术中的应用

目的探讨左旋布比卡因骶管阻滞复合异丙酚静注在小儿下腹部手术中应用的效果。方法选择择期斜疝修补术或睾丸固定术的患儿50例,随机分成两组。观察组(A组)和对照组(B组)。A组用0.25%左旋布比卡因0.7ml/kg骶管阻滞复合异丙酚2～4mg/kg.h静脉麻醉。B组以0.1%氯胺酮复合异丙酚2～4mg/kg.h静脉麻醉。记录两组患儿在麻醉前、术中探查时、MAP、HR、的变化,术后并发症恶心呕吐、呼吸抑制、苏醒后烦躁哭闹的发生率和术毕苏醒时间。结果B组在术中探查时的MAP、HR明显高于A组(P<0.05),差异有显著性,且恶心呕吐、呼吸抑制、苏醒后烦躁哭闹的发生率明显高于A组(P<0.01)术毕苏醒时间明显比A组延长(P<0.05),差异有显著性。结论左旋布比卡因骶管阻滞复合异丙酚麻醉用于小儿下腹部手术是一种镇痛完善、血流动力学稳定、苏醒快、术后并发症少的安全有效的麻醉方法。     

小剂量左旋布比卡因腰麻在老年患者下肢手术中的可行性报告

目的 评价老年患者骨科下肢手术小剂量左旋布比卡因应用的可行性.方法 择期骨科下肢手术的老年患者60例,临床观察随机分为腰麻(I组)和连续硬膜外阻滞组(II组)两组均选L2-3间隙行椎管内麻醉,I组蛛网膜下腔穿刺成功后,注入0.5%左旋布比卡因等比重液1.5ml～2ml,II组行硬膜外穿刺置管注入2%利多卡因试验量3ml,然后追加0.5%左旋布比卡因液6-10ml,术中根据阻滞平面追加上述局麻药,观察两组在麻醉前(T0)和给予首剂量后5min(T1)15min(T2)30min(T3)1h(T4)术毕(T5)相关指标,比较两组感觉阻滞平面,改良的Bromage评分,观察下肢运动恢复情况,术中及术后24h心动过缓、低血压、恶心、呕吐、头痛、神经系统,并发症的发生率,结果Ⅰ组较Ⅱ组感觉运动阻滞完善,血流动力学平稳,并发症少,用于老年骨科下肢手术病人是可行的.     

左旋氨氯地平的临床疗效与生物学特性

目的 通过观察手性药物左旋氨氯地平在治疗轻、中度高血压的临床疗效,分析手性药物的生物学特性.方法 入选62例轻、中度高血压患者,随机分为左旋氨氯地平治疗组30例,氨氯地平治疗组32例,观察8周后两组血压变化及不良反应情况.结果 左旋氨氯地平治疗轻、中度高血压的总有效率为86.7％,氨氯地平的总有效率为87.5％,无显著性差异,但不良反应方面,左旋氨氯地平低于氨氯地平.结论 手性药左旋氨氯地平是高效、安全的抗高血压药.氨氯地平的有效活性成分是其左旋异构体.     

甲磺酸罗哌卡因复合盐酸利多卡因用于肌间沟阻滞的临床观察

目的 观察比较甲磺酸罗哌卡因复合盐酸利多卡因与盐酸布比卡因复合盐酸利多卡因用于肌间沟臂丛神经阻滞施行上肢手术的临床效果.方法 52例拟行上肢手术的手术患者随机分为两组.L组:0.596％甲磺酸罗哌卡因10m1+1％盐酸利多卡因10m126例.B组0.375％盐酸布比卡因10ml+1％盐酸利多卡因10m126例,肌间沟阻滞后观察临床效果.结果 罗哌卡因组与盐酸布比卡因组在阻滞效果、维持时间、起效时间,不良反应上两组无明显统计学意义.结论 甲磺酸罗哌卡因与盐酸布比卡因肌间沟神经阻滞麻醉均可产生良好的感觉和运动阻滞,两种药物药效学相似.     

碳酸利多卡因联合罗哌卡因用于颈丛阻滞效果观察

目的比较0.8%碳酸利多卡因+0.375%罗哌卡因和0.375%罗哌卡因在颈丛阻滞中的效果.方法 40例行甲状腺手术的患者,随机分成对照组使用0.375%哌卡因,试验组使用0.8%碳酸利多卡因+0.375%罗哌卡因.药物有效性的观察指标包括:感觉阻滞起效时间、完善时间、麻醉荆量20ml安全性厦不良反应.结果试验组麻醉起效时间明显短于对照组(p＜0.05),麻醉质量、不良反应差率异均无统计学意义(p＞0.05).结论用0.8%酸利多卡因+0.375%罗哌卡因用于颈丛阻滞可获得良好的麻醉效果,安全可靠,比单纯用0.375%罗哌卡因起效快.     

罗哌卡因与布比卡因在剖宫产手术中的应用

本文观察罗哌卡因用于腰麻的安全性与有效性及其相应的反应。 一、资料与方法 病例选择ASA Ⅰ-Ⅱ级40例剖宫术病人,年龄20～35岁,体重55～80kg,随机分为罗哌卡因(ROP)组与布比卡因(BUP)组。每组20例。 1.药物配方:0.75％罗哌卡因2ml与0.75％布比卡因2ml分别加5入10％葡萄糖1ml,分别为3ml。病人入手术室后     

左旋布比卡因椎管内麻醉在老年全髋关节置换术中的应用价值分析

目的探讨分析左旋布比卡因用于椎管内麻醉在老年全髋关节置换术中的应用价值。方法选取2016年1月至2016年12月在我院行全髋关节置换术的90例老年患者作为研究对象,按随机数字表法将其分为对照组和观察组,每组各45例。对照组给予全身麻醉,观察组给予椎管内麻醉。观察比较两组老年患者麻醉室停留时间、手术时间、手术后麻醉室留观时间、28d内术后心动过速、心脑血管意外、肺栓塞、手术部位感染、尿道感染、病死率、并发症联合发生率、术中低血压、深静脉血栓、输血率等具体情况。结果 (1)观察组手术时间、术后麻醉室留观时间均低于对照组(P0.05);(2)观察组28d内并发症联合发生率、术中低血压、深静脉血栓、输血率均明显低于对照组(P0.05)。结论左旋布比卡因椎管内麻醉应用于行全髋关节置换术的老年患者中具有良好的临床疗效,可有效减少手术时间,降低手术并发症发生率,值得临床推广应用。     

脑干表面纤维束的观察

目的：调查脑干表面纤维束的外形特点,补充脑干的解剖学资料。方法：在解剖显微镜下对脑干进行解剖观察。结果：5种未见报道的纤维束的出现率如下：大脑脚底表面纤维整体向腹内侧下旋,左侧24．0％,右侧28.0％,双侧28．0％;大脑脚底表面部分纤维成弓形向下凸,仅左侧2．7％;脑桥表面部分脑桥小脑纤维向外下绕三叉神经根下方行入桥臂,左侧10.7％,右侧6．7％,双侧5．3％;脑桥表面部分脑桥小脑纤维向外上绕三叉神经根上方行入桥臂,左侧1．3％,右侧2．7％;移位的锥体束纤维跨过或覆盖橄榄表面,左侧9．3％,右侧21．3％,双侧9．3％。还有国内未见报道的脚底丘索内侧束、横脚束、桥带、脑桥斜束和前外侧弓状纤维等。结论：本文丰富了国人脑干表面纤维束的类型,为人类学和医学研究提供了脑干表面纤维束的解剖学资料。     

Interpersonal emotion regulation as a mechanism of social support in depression

Although social support is widely considered to be protective against depression, the mechanisms through which it acts on depressive psychopathology are not well known. This integrative review argues that emotion regulation serves as such a mechanism. First, the literature on the effects of social support on depression is reviewed, with an emphasis on open empirical questions regarding mechanisms linking support and depression. Then, the literature on emotion regulation is reviewed, highlighting its importance as a mechanism in the psychopathology of depression. Finally, potential interpersonal influences on depressive emotion regulation and dysregulation are suggested, drawing from theory and research on psychotherapy and on close relationships. The review suggests that emotion regulation is responsive to interpersonal influences, and that this responsiveness may account for the effects of social support on depression. Implications of an interpersonal perspective for basic and clinical research on depression, close relationships, and emotion regulation are discussed.     

Injecting drugs of abuse and immunity: implications for HIV vaccine testing and efficacy

The recreational use of legal and illegal drugs has significant effects on immune responses and can potentially modulate susceptibility to infection by a number of pathogens. A number of agents including cannabinoids (marijuana), cocaine opiates, amphetamines, nicotine and alcohol were demonstrated to have potentially adverse effects on the susceptibility to infections, mediated most likely, by adverse effects on immunity. As such, these drugs of abuse could have significant and potentially adverse effects on the vaccination efficacy of a number of vaccines currently on the market and on potential experimental vaccines currently in the pipeline. This review will present an overview on how drugs of abuse potentially impacts immune responses and vaccination efficacy. The emphasis of this review will be the effects of opiate abuse, as exemplified by injecting/intravenous drug users (IDU), on HIV/AIDS and its potential impact on vaccine efficacy trials against this devastating infection/syndrome.     

Pharmacodynamic effects of amikacin, ciprofloxacin and imipenem on growing and non-growing Escherichia coli and Pseudomonas aeruginosa

Objective: To compare control-related effective regrowth times (CERTs) and postantibiotic effects (PAEs) of amikacin, ciprofloxacin and imipenem on growing and non-growing Escherichia coli and Pseudomonas aeruginosa .
Methods: CERTs and PAEs of amikacin, ciprofloxacin and imipenem were determined with bioluminescence assay of bacteriai ATP and viable counts.
Results: Negative viable count PAEs of amikacin and imipenem occurred on growing bacteria, but bioluminescence PAEs were positive. CERTs were equal with both methods. Amikacin and ciprofloxacin induced long, concentration-dependent CERTs on growing and non-growing cultures. Amikacin (32 mg/L) prevented regrowth of E. coli and induced a CERT of 6.0 h on P. aeruginosa ; corresponding CERTs on non-growing bacteria were 3.4 h and 3.3 h, respectively. Ciprofloxacin (8 mg/L) prevented regrowth of both strains in growing cultures and induced CERTs of 5.1 h on non-growing E. coli and 13.3 h on P. aeruginosa . Imipenem induced a concentration-dependent CERT on growing bacteria and no CERT on non-growing cultures. Imipenem (16 mg/L) induced a CERT of 5.3 h on growing P. aeruginosa and 3.2 h on E. coli.
Conclusion: Amikacin and ciprofloxacin induced strong pharmacodynamic effects on growing and non-growing E. coli and P. aeruginosa , while imipenem was only effective on growing cultures.     

Development of cerebral sulci and gyri in fetuses of cynomolgus monkeys (Macaca fascicularis)

This study aimed to clarify the development of sulci and gyri on the external surface of the cerebrum of cynomolgus monkeys. Sulcus formation began with the appearance of the lateral fissure on embryonic day (ED) 70, followed by delineations of four cerebral lobes by the emergence of the parietooccipital sulcus, central sulcus, and preoccipital notch on EDs 80–90. The following primary sulci were then visible until ED 120: the superior temporal sulcus on ED 90; the intraparietal sulcus, lunate sulcus, inferior occipital sulcus, and arcuate sulcus on ED 100; and the principle sulcus on ED 110; the occipitotemporal sulcus, anterior middle temporal sulcus, and superior postcentral dimple on ED 120. These sulci demarcated the superior temporal gyrus on ED 90, the precentral gyrus, supramarginal gyrus, and angular gyrus on ED 100, and the inferior and middle temporal gyri, postocentral gyrus, superior parietal lobule, superior, middle and inferior frontal gyri, and inferior occipital gyrus on ED 120. Except for the intermediate and lateral orbitofrontal sulci, the sulci that appeared on ED 130 and thereafter were not related to the gyrus demarcations. Intriguingly, the brain markedly gained weight on EDs 100 and 120, corresponding to the embryonic ages when almost all gyri were visible. The results suggest that a rapid growth of the cerebrum involves convolutions of the gyri by a regular sequence of the sulcus formation in cynomolgus monkeys. This study further provides a standard of reference for normal development in the cerebral cortical morphology of cynomolgus monkeys.     

Letter to the EditorActivin A: A Possible Marker for Liver Transplant Outcome

Abstract

The influence of recombinant human IL-17 on granulocyte-macrophage (CFU-GM) and erythroid (BFU-E and CFU-E) progenitors and the release of IL-1α/β, IL-6 and erythropoietin (EPO) was estimated in the bone marrow cells obtained from normal and sub-lethally irradiated mice. In normal mice IL-17 increased CFU-GM and BFU-E and reduced CFU-E derived colonies numbers and augmented release of IL-6 and EPO. In irradiated mice the effects of IL-17 on hematopoietic progenitors were lineage-dependent, as well as dependent on their stage of differentiation and the time after the irradiation. IL-17 had no major effects on CFU-GM on day 1 and 3, but decreased their number on day 2, while enhanced both BFU-E and CFU-E on day 1 and 2 after irradiation, whereas on day 3 its effect on erythroid progenitors was again as observed in normal mice. After irradiation, IL-17 increased the release of IL-1α, IL-6 and EPO. The observed effects suggested the involvement of IL-17 in the regulation of hematopoiesis and indicated that its effects on both hematopoietic progenitors and cytokine release are dependent on the physiological/ pathological status of the organism.     

Temporal information for spatially constrained locomotion

How is locomotion adapted to spatial environmental constraints? The control of this everyday behavior is claimed to be based on information that specifies either spatial or temporal properties of the actor-environment system. Although studies on open-loop locomotor pointing (i.e., the positioning of a foot on a target on the floor while walking) agree on the use of spatial information, studies on closed-loop locomotor pointing propose the use of temporal information. Here, we test the hypothesis of closed-loop locomotor pointing based on temporal information, by dissociating spatial and temporal information in a virtual reality setup (virtual environment connected to a treadmill). The results support this hypothesis and shed some light on the type of temporal information that is used. The performed dissociation between spatial and temporal information, however, does not rule out a control based on a continuous updating of spatial information. Therefore, our conclusion on the use of temporal information was moderated.     

牛精子表面糖复合物的分布及洗涤的影响

用４种辣根过氧化物酶标记的凝集素，对牛精子表面糖复合物的分布进行了定位研究，并观察了固定和洗涤对糖复合物的影响。在直接涂片的精子上，麦芽凝集素，伴刀豆球蛋白Ａ，蓖麻凝集素Ⅰ和大豆凝集素均集中标记无明显影响。但在洗涤后涂片的精子上，有些在顶体区部分或全部脱落一层样结构，从而导致了同一凝集素在不同的精子上表现出了不同的标记。     

Enhanced Cellular Responses of Human Bone Marrow Stromal Cells Cultured on Pretreated Surface with Allogenic Platelet-Rich Plasma

The principal objective of this study was to evaluate the effects of surface pretreatment with platelet-rich plasma (PRP) on the cellular functions of human bone marrow stromal cells (hBMSCs). The surfaces of tissue culture plates (TCPs) were pretreated by adding PRP followed by centrifugation to bring platelets closer to the surface, followed by incubation for 60 min at 37°C. Then, hBMSCs were seeded onto TCP and TCP pretreated with PRP (TCP-PRP), followed by culture in osteogenic medium. Cell attachment, proliferation, and osteogenic differentiation were evaluated. Field emission scanning electron microscope (FE-SEM; JSM-7401F, JEOL Ltd., Japan) observations were conducted. The attachment of hBMSCs was significantly lower on TCP-PRP than on TCP. However, when the cell numbers were normalized with those observed on day 1 of culture, cellular proliferation on 5 days was significantly higher on TCP-PRP. Alkaline phosphatase activity, an index of early phase of osteoblastic differentiation, was significantly higher on TCP-PRP on day 14. Calcium deposition amount, an index of terminal osteoblastic differentiation, was also significantly higher on TCP-PRP on days 14 and 21. The results of von Kossa staining confirmed that, on day 21, the area of mineralized nodules was significantly larger on TCP-PRP. FE-SEM observation demonstrated that activated platelets and fibrin network covered the surface after PRP treatment. An increase in the number of hBMSCs and their cellular products was evident on the FE-SEM observation, and the fibrin network remained on day 21. Our results demonstrate that a PRP-treated surface enhanced early proliferation and late osteogenic differentiation of hBMSCs.     

Effects of the DBA/1Bg Y chromosome on testis weight and aggression

Several behavioral, physiological, and morphological characteristics are influenced by the Y chromosome of mice. The purpose of this study is to determine whether the DBA/1 Y chromosome influences not only aggression, but also testis or other organ weights. At 50 days of age, the DBA/1 Y chromosome has a decremental effect on body weight, no effect on testis weight (uncorrected for body weight), a decremental effect on seminal vesicle weight (uncorrected for body weight), no effect on kidney weight (uncorrected for body weight), and an incremental effect on intermale aggression. In contrast, the CBA Y chromosome has no effect on body weight, a large decremental effect on testis weight, no effect on seminal vesicle weight, no effect on kidney weight, and an incremental effect on intermale aggression. Thus, there is not an invariant relationship for Y-chromosomal effects on body weight, testis weight, seminal vesicle weight, and intermale aggression.The research reported herein was supported by USPHS Grant MH28021.