戊巴比妥钠用于雄性裸鼠皮下-肝原位移植人肝细胞癌模型麻醉的方法

目的:研究戊巴比妥钠在裸鼠皮下-肝间接原位移植人肝细胞肝癌模型建立中的合适剂量.方法:共30例接种肝癌细胞株的皮下瘤雄性裸鼠取瘤后,对共150只雄性裸鼠行皮下-肝包膜下瘤体原位移植,观察供受体麻醉过程、药物剂量和效果.结果:供体手术戊巴比妥钠麻醉的剂量以80 mg/kg合适,受体手术戊巴比妥钠麻醉剂量以70 mg/kg合适.结论:在裸鼠皮下-肝脏原位肝癌模型建立的手术中,戊巴比妥钠是一种理想的麻醉药品.     

氯胺酮用于大鼠麻醉的效果观察

目的：不同剂量氯胺酮麻醉大鼠后，进行麻醉效果评价及生理指标观察。方法：3组不同剂量氯胺酮（100、120、150mg／kg）分别腹腔注射大鼠，进行大鼠左肾切除术。记录麻醉起效时间、麻醉维持时间；无创心电监护仪监测大鼠心率（HR）、呼吸（RR）、氧饱和度（SO2）、体温（T）；进行镇痛评价、呼吸道评价、肌肉松弛度评价。结果：3组剂量中，以氯胺酮120mg／kg体重腹腔注射大鼠，麻醉持续时闯45±9．59min，HR、RR波动小，镇痛效果、肌肉松弛度较好；以氯胺酮100mg／kg体重腹腔注射大鼠，麻醉效果较差，麻醉时间在27．0±3．033min，HR、RR、S02指标波动大；以氯胺酮150mg／kg注射大鼠，麻醉效果虽好，但呼吸受抑制，体温较另外两组低。结论：以氯胺酮120mg／kg体重腹腔注射大鼠，麻醉效果评价较其他两组好，可满足于45min左右的大鼠实验。     

小儿眼外伤手术的麻醉探讨

我院近年收治小儿开放性眼外伤30例,现将手术麻醉总结如下。1　临床资料　　开放性眼外伤手术患者30例,ASAI～级,男22例,女8例,4～12岁,体重12～31kg,术前禁食6h,术前肌注阿托品0.01mg/kg,采用氯胺酮静脉麻醉,对不合作者肌注氯胺酮4～5mg/kg,入睡后开放静脉,采用鼻导管吸氧,手术开始前静脉缓注0.2mg/kg安定,氯胺酮1～2mg/kg,保留自主呼吸,术中静滴0.1%氯胺酮50～100μg/kg以维持麻醉。术中监测SpO2、血压、心率及呼吸。2　结　果　　SpO2麻醉前后无明显变化,均在98%以上。血压、心率麻醉后较麻醉前增加。术中心率有变化,但无明显规律。…     

丙泊酚、氯胺酮麻醉在支撑喉镜手术中的应用比较

目的 :通过比较丙泊酚、氯胺酮两种药物在支撑喉镜手术中的应用 ,寻求安全有效的麻醉方法。方法 :ASAⅠ～Ⅱ级喉外科手术病人 80例 ,无心血管和内分泌疾病 ,随机分为两组 ,每组 40例。术前均肌注苯巴比妥钠 0 2 g、阿托品 0 5mg。以咪唑安定 0 1mg/kg、芬太尼 0 0 0 1mg/kg、琥珀胆碱 1 5mg/kg及Ⅰ组给予丙泊酚 2mg/kg、Ⅱ组给予氯胺酮 2mg/kg诱导麻醉 ,在术者插入支撑喉镜以后 ,用KP Ⅲ (B)型开放式喷射呼吸机进行高频喷射通气。Ⅰ组以 12mg/kg·h速度连续静脉输注丙泊酚维持麻醉 ,Ⅱ组以 10～ 15min后追加首剂 1/ 2剂量氯胺酮并以此递减的方式维持麻醉 ,两组均复合琥珀胆碱 0 0 3～ 0 0 1mg/kg·min静滴维持肌松。结果 :氯胺酮相较丙泊酚麻醉、诱导和围术期对心血管系统干扰极大 ,麻醉不够平稳 ;停药后病人完全清醒时间氯胺酮麻醉比丙泊酚麻醉显著延长 ,且氯胺酮麻醉苏醒期多出现精神症状。结论 :支撑喉镜手术应用丙泊酚麻醉优于氯胺酮麻醉。     

Orexin-A对氯胺酮麻醉老年大鼠苏醒的影响

目的 观察Orexin-A对老年大鼠氯胺酮麻醉后苏醒及认知功能的影响.方法 将55只老年大鼠随机分为空白对照组10只,模型对照组、Orexin-A低剂量组、Orexin-A高剂量组各15只.以100 mg/kg氯胺酮腹腔注射建立麻醉模型.麻醉10min后,治疗组侧脑室注入Orexin-A 1、4 nmol/10μl.对照组注入等量人工脑脊液.观察各组大鼠麻醉后翻正反射持续时间;侧脑室给药前后脑电图δ波相对比的变化;Morris水迷宫检测学习记忆功能.结果 氯胺酮麻醉可使老年大鼠学习记忆能力明显下降,Orexin-A能明显缩短麻醉后大鼠翻正反射持续时间,减少δ波的相对比例,并能改善麻醉后老年大鼠的学习记忆能力,以较大剂量效果显著(P<0.05).结论 Orexin-A对氯胺酮麻醉后老年大鼠具有促醒作用,且能明显改善麻醉后大鼠认知功能.     

先天性巨结肠根治术76例麻醉体会

<正> 临床资料 本组76例,男57例,女19例;年龄最小40d,最大7岁;手术时间最短105min,最长250min;输血量最少100ml,最多400ml。麻醉方法Ⅰ是用羟丁酸钠(80mg/kg)稀释成10％缓慢静脉推注,10min后,在充分表面麻醉下行气管插管,以氯胺酮和羟丁酸钠或潘侃洛宁维持。氯胺酮首次剂量按5～8mg/kg肌肉注射,每隔30min追加1次,剂量为首次剂量的1/2～2/3,潘侃洛宁(0.08mg/kg)在肌松不满意时静脉推注。本组有64例,其中有两例术中出现     

异丙酚-氯胺酮混合液用于小儿门诊手术的麻醉

目的:观察静注异丙酚-氯胺酮混合液用于小儿门诊手术麻醉的安全性。方法:将60例择期门诊手术的患儿随机分成2组,每组30例。处理组在30 s内分别静注氯胺酮1～1.5 mg/kg和异丙酚1～1.2 mg/kg诱导后,继以微量泵将两者混合液按异丙酚4 mg/(kg.h)和氯胺酮2 mg/(kg.h)的起始速率连续静脉输注维持。对照组在30 s内静注氯胺酮2 mg/kg诱导后,并用微量泵以2～4 mg/(kg.h)的速率连续输注维持,观察并记录麻醉期间的生命体征、麻醉恢复时间及用药后可能出现的副作用。结果:处理组的SBP、DBP和HR变化较对照组更为平稳(P<0.05)。处理组的麻醉恢复时间较对照组明显缩短(P<0.05)。结论:静注异丙酚-氯胺酮混合液能有效地用于小儿门诊手术的麻醉。     

婴幼儿先天性马蹄内翻足手术100例麻醉分析

通过对我院100例3岁以下婴幼儿马蹄内翻足矫正术分析,认为吗啡0.15～0.20 mg/kg,阿托品0.01～0.02 mg/kg为术前药,肌注硫喷妥钠20 mg/kg为基础麻醉,以0.25％利多卡因局部麻醉,必要时追加氯胺酮2～5 mg/kg肌注,不失为婴幼儿手术选用的既安全又简便易行的麻醉方法。     

氯胺酮复合力月西静脉麻醉用于小儿疝气修补术

目的 观察氯胺酮复合力月西静脉麻醉在小儿疝气修补术中的麻醉效果及对循环.呼吸的影响.方法 40例挥期手术患儿,年龄4～5岁,ASA I～II级.体重(11～17)kg,术前常规肌注阿托品0.02mg/kg,非那根1mg/kg,杜冷丁1mg/kg,入睡后进手术室肌注氯胺酮(4～5)mg/kg,常规面罩吸氧.多功能监护仅监测心率、氧饱和度、呼吸,随后经莫非氏滴管滴入力月西(0.1～0.2)mg/kg,等待手术消毒铺巾完毕静注氯胺酮(1～2)mg/kg开始手术,并观察麻醉效果及循环变化.结果 氯胺酮做为小儿静脉全麻药在我们农村基层医院运用广泛,氮胺酮与力月西伍用可增加麻醉镇痛镇静作用,呼吸循环影响小,能充分发挥镇静松弛遗忘作用,避免单独使用氯胺酮产生的副作用.结论 氯胺酮与力月西二者复合静脉全麻可提高麻醉效果和延长麻醉作用时间,并可减少并发症的发生.     

Orexin-A对氯胺酮麻醉老年大鼠学习记忆及基底前脑ChAT表达的影响

目的 观察orexin-A对氯胺酮麻醉老年大鼠学习记忆及基底前脑ChAT表达的影响,并探讨其可能机制.方法 将40只老年大鼠,随机分为空白对照组、模型对照组、orexin-A低剂量组、orexin-A高剂量组,各10只.以100mg/kg氯胺酮腹腔注射建立实验模型.麻醉10min后,治疗组侧脑室注入orexin-A 1、4nmol/10μL.对照组注入等量人工脑脊液.以Morris水迷宫行为学及免疫组化方法,观察麻醉后大鼠学习记忆功能和基底前脑胆碱乙酰基转移酶(ChAT)的表达变化.结果 (1)氯胺酮麻醉后老年大鼠Morris水迷宫成绩明显下降,orexin-A可提高水迷宫各观察指标成绩,以4nmol剂量效果显著(P<0.05,P<0.01).(2)氯胺酮麻醉后,基底前脑ChAT表达降低,4nmol orexin-A能部分逆转其变化(P<0.05).结论 一定剂量orexin-A可明显改善氯胺酮麻醉后老年大鼠学习记忆功能.此效应可能与其逆转麻醉后大鼠基底前脑ChAT的低表达密切相关.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.