中心动脉压测定及对不同药物反应的临床观察

目的观察不同方法测得的中心动脉压和外周动脉压的差别，比较美托洛尔和培哚普利对中心动脉压的作用。方法通过桡动脉应用导管法测量中心动脉压和外周动脉压（桡动脉血压），同时测量肱动脉无创血压，比较高血压病患者应用关托洛尔和培哚普利后中心动脉压和外周动脉压的差别。结果非高血压病患者中心动脉收缩压和桡动脉收缩压明显高于肱动脉无创收缩压，桡动脉有创收缩压明显高于中心动脉收缩压，中心动脉舒张压明显高于桡动脉舒张压和肱动脉无创舒张压，桡动脉舒张压和肱动脉无创舒张压无统计学意义。结论不同测量方法测得中心动脉压和外周血压值不同，培哚普利比较关托洛尔降低中心动脉收缩压效果更为明显。     

老年人主动脉有创血压测量与肱动脉无创血压测量对比研究

目的 了解老年人主动脉有创血压测量与肱动脉无创血压测量是否不同.方法 选择78例冠状动脉造影的老年患者,经周围动脉将导管送到升主动脉测量有创血压,同时用监护仪测量左侧上肢肱动脉无创血压.结果 无创血压测量的收缩压比有创测量的收缩压值平均低12.28 mm Hg(1 mm Hg=0.133 kPa)(P＜0.01),无创...     

老年与青年高血压病患者脉压和血压变异性比较

目的 比较老年和青年高血压病患者动态血压的差异,为老年高血压病患者的治疗提供依据.方法 我院高血压科就诊的83例2周内未服药的高血压病患者,60岁≤年龄＜80岁患者40例作为老年组,18岁≤年龄≤30岁患者43例作为青年组.2组患者均进行24 h动态血压监测,并比较结果.结果 老年高血压组的动态脉压、动态脉压指数和24h收缩压变异系数明显高于青年高血压组[(61±12) mm Hg(1 mm Hg=0.133 kPa)比(52 ±9)mm Hg,(0.44±0.07)比(0.37±0.06),(11±2)％比(8±2)％,均P＜0.01];24 h平均舒张压和24h平均心率明显低于青年高血压组[(79±10) mm Hg比(88±12)mm Hg,(69±8)次/mint比(74±9)次/min,均P＜0.01].结论 老年高血压病患者主要以动态脉压增大和24h收缩压变异性升高为特点;而青年患者以24h平均舒张压升高为主.因此,临床对老年高血压病患者进行降压治疗时,选择的药物不仅要有效降低平均收缩压水平,还要改善脉压和血压变异性.     

连续无创动脉血压监测在冠心病患者麻醉中的应用

目的探讨连续无创动脉血压监测在冠心病患者麻醉中的应用效果。方法选取2017年3月至2018年3月在本院行择期手术的80例冠心病患者作为本次研究的研究对象,麻醉诱导前行右手桡动脉处连接连续无创实时血压监测系统监测无创动脉血压,局麻下左手桡动脉穿刺动脉导管置入监测有创桡动脉血压,比较两种监测方法的舒张压、舒张压和平均压值。结果有创血压监测法的舒张压、舒张压和平均压值与无创血压监测法比较,P> 0.05。结论在行择期手术的冠心病患者全身麻醉中,采取连续无创动脉血压监测,可达到与有创血压监测法的效果,且该法无创、连续、安全,可用于冠心病手术患者麻醉中的血压监测。     

婴幼儿无创和有创动脉血压对比研究

目的探讨婴幼儿无创血压测量结果的准确可靠性.方法选择术中需要进行有创监测的婴幼儿17例,行腋动脉穿刺连续测量有创血压后,在同侧肢体间断测量肱动脉无创血压,并将无创血压结果与有创血压结果进行对比分析.结果有创血压和无创血压比较存在无显著性差异(P＞0.05).收缩压平均偏差为-0.03846,舒张压为-2.52198;收缩压标准方差为4.673146,舒张压为6.097464.结论在婴幼儿无创血压测量结果可以准确反映病人的血压状况.     

连续无创血压监测系统在老年患者全麻诱导期的应用

目的 评价TL-300 Tensymeter系统(TL-300)所测的连续无创血压(CNAP)在老年患者全麻诱导期的有效性及安全性.方法 择期全身麻醉手术的老年患者30例,ASAⅠ～Ⅲ 级.麻醉诱导前无菌操作下将动脉导管置入非优势手的桡动脉内行有创血压(IAP)监测,另一侧手臂连接TL-300系统行CNAP监测,稳定5 min后,于稳定后(T0)、诱导前(T1)、插管前(T2)、插管即刻(T3)、插管后1 min(T4)、插管后3 min(T5)、插管后5 min(T6)同时记录IAP和CNAP监测的收缩压、舒张压和平均压.结果 CNAP与IAP所测收缩压、舒张压和平均压偏倚分别为(-1.3±8.3)、(-1.6±4.4)、(-0.9±3.9)mmHg,在其相应的一致性界限范围内所占比值分别为95.2％、91.4％、91.9％.两种血压监测方法的收缩压、舒张压和平均压的相关系数分别为0.813、0.935和0.896,均P<0.001.结论 与IAP监测相比,CNAP监测在老年患者全麻诱导期可提供连续、无创、准确的血压监测.     

婴幼儿体外循环术后有创与无创血压监测的对比性研究

目的：探讨婴幼儿体外循环心脏术后有创血压与无创血压监测值的差异。方法采用自身对照的方法对心脏外科60例先心病婴幼儿进行24 h有创血压和无创血压的监测比较，每位患儿选择前臂桡动脉穿刺行有创动脉血压连续监测，比较心脏术后回ICU0、6、12、18、24h两种测压法的临床效果，并对相关数据进行统计学分析。结果30例血压正常者有创血压与无创血压24 h内无差异性，P＞0．05；30例低血压者有创血压与无创血压监测值在术后12 h内有差异性，P＜0．05；术后13～24 h无差异性，P＞0．05。结论有创血压监测能连续更准确提供患儿瞬间血压变化值，为疾病观察提供可靠依据。婴幼儿体外循环术后早期低血压者12 h内，有创血压更能准确反映病情，12 h后有创血压与无创血压基本一致，无创测压可以替代有创测压，避免有创测压带来的危害和并发症。     

高血压患者动态血压参数与左室肥厚关系探讨

目的探讨高血压患者动态血压参数与左室肥厚的关系。方法采用无创动态血压仪对102例高血压病患者进行24 h动态血压监测及心脏超声检查,根据左室质量指数（LVMI）分2组：左室肥厚组（n=30）与非左室肥厚组（n=72）。结果（1）左室肥厚组与非左室肥厚组的临床指标比较无统计学意义;（2）左室肥厚组与非左室肥厚组的动态血压参数比较,24 h、白昼、夜间收缩压及脉压以及夜间舒张压有统计学意义（P〈0.05）：24 h平均收缩压分别为（146.2±13.5）mm Hg、（125.7±9.2）mm Hg;24 h脉压分别为（59.7±12.7）mm Hg、（46.8±7.1）mm Hg;白天平均收缩压分别为（149.3±10.9）mm Hg、（128.2±10.64）mm Hg,白天脉压分别为（60.2±12.4）mm Hg、（48.1±8.0）;夜间平均收缩压分别为（141.7±16.9）mm Hg、（118.8±9.7）mm Hg;夜间脉压分别为（57.8±14.1）mm Hg、（43.7±6.7）mm Hg;夜间平均舒张压分别为（84.0±10.7）mm Hg、（75.1±7.6）mm Hg。左室肥厚组与非左室肥厚组其动态血压呈非杓型节律为66.7%比30.6%,其差异有非常显著性（P〈0.01）。结论高血压病动态血压参数异常者左室肥厚发生率高,对靶器官损害有预测价值。     

小儿低血压状态时振荡法无创血压测量准确性研究

目的探讨小儿低血压状态下无创血压测量的准确性.方法选择术中需要静吸复合全麻并气管插管的婴幼儿24例,术中采用异氟醚降低患儿血压至大于基础值的30%,对比迈瑞公司的振荡法无创血压模块(采用迈瑞PM-9000监护仪)和听诊法对患儿血压监测的测量值.结果振荡法无创血压模块和听诊法比较差异无显著性(P＞0.05).收缩压平均偏差为-0.11,舒张压为4.57;收缩压标准方差为5.11,舒张压为5.98.结论低血压情况下振荡法无创血压测量方法是准确,可靠的.     

冠状动脉旁路移植术后患者有创血压与无创血压的对比研究

目的探讨冠状动脉旁路移植术后患者有创血压与无创血压监测的误差及原因。方法对ICU 40例冠状动脉旁路移植术后患者有创血压与无创血压进行比较,每位患者均采用选择左侧或右侧桡动脉穿刺行直接动脉血压连续监测,每15分钟测定1次,所测得的数据进行统计分析。结果有创血压和无创血压在术后18 h内比较差异有统计学意义（P〈0.05）,但在术后18 h后差异无统计学意义（P〉0.05）。结论对冠状动脉旁路移植术后患者早期存在一定误差,在临床抢救和治疗用药时考虑有创与无创血压的差值,有条件的尽可能用有创血压。     

Degraded and undegraded carrageenans and experimental gastric and duodenal ulceration

The prevention of histamine-induced gastric and duodenal ulceration in the guinea-pig has been examined using a series of undegraded and degraded carrageenans. Undegraded carrageenans were active at lower doses than degraded carrageenans. The high viscosity of the undegraded carrageenans in solution prevented their use in larger doses. Degradation of carrageenan without serious loss of sulphate, gives a product which allows the dose to be increased to an extent that its effect more than offsets the slight loss in activity caused by the degradation. No single feature of carrageenan structure can be related to anti-ulcer activity although degradation, and hence reduction of molecular size, generally reduces activity. Sulphate contents over 30% have little apparent effect on activity; κ-carrageenans were not consistently different in anti-ulcer activity from Λ-carrageenans. This contrasts with the antipeptic activity of carrageenans where κ-carrageenans are less active than their Λ-counter-parts. As with antipeptic activity, the degree of anti-ulcer activity is probably determined by a combination of structural features which includes molecular size and polyanionic properties.     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Alcohol and Substance Use and Abuse in Women and Children

No abstract available for this article.     

Excretion and biotransformation of alfentanil and sufentanil in rats and dogs

The excretion and biotransformation of alfentanil (ALF) and sufentanil (SUF), two recent analogues of the synthetic opioid fentanyl, were studied after single iv administration of the tritium-labeled drugs in male rats and dogs. The drugs were almost completely metabolized in the two species, which resulted in a large number of metabolites. The excretion of the metabolites was rapid and exceeded 95% within 4 days, except for that of ALF metabolites in dogs (about 85%). For ALF, excretion of the radioactivity with the urine (73% in rats, about 76% in dogs) exceeded that with the feces. For SUF, excretion of the radioactivity with the urine amounted to 38 and 60% and that with the feces to 62 and 40%, in rats and dogs, respectively. Bile-cannulated rats excreted 68% with the bile within 24 hr after SUF dosing, and about 22% of this biliary radioactivity was subjected to enterohepatic circulation. After an ALF dose, the biliary excretion amounted to 24%, and the enterohepatic circulation was minimal. The main metabolic pathways of the two drugs were the oxidative N-dealkylation at the piperidine nitrogen and at the amide nitrogen, oxidative O-demethylation, aromatic hydroxylation, and the formation of ether glucuronides. N-[4-(Hydroxymethyl)-4-piperidinyl]-N-phenylpropanamide (M6) was the main metabolite of both ALF and SUF in rats. In dogs, the glucuronide of N-(4-hydroxyphenyl)propanamide (M5) was the main metabolite of ALF. After SUF dosing in dogs, N-[4-(methoxymethyl)-4-piperidinyl]-N-phenylpropanamide was more abundant than M5.