丙泊酚复合低剂量艾司氯胺酮应用于无痛超声支气管镜检查的效果

目的:评估丙泊酚复合低剂量艾司氯胺酮应用于无痛超声支气管镜(EBUS)检查的效果。方法:纳入2022年4月至8月在郑州大学第一附属医院行无痛EBUS检查的96例患者(年龄18～65岁,BMI 18.5～28.0 kg/m²,ASAⅡ或Ⅲ级),随机分为艾司氯胺酮组和对照组,每组48例。对照组麻醉诱导方案为丙泊酚1.5 mg/kg+阿芬太尼30μg/kg+米库氯铵0.15 mg/kg,艾司氯胺酮组在此基础上加用艾司氯胺酮0.25 mg/kg;术中根据患者反应持续泵注瑞芬太尼0.25～4.00μg/(kg·min)和丙泊酚4～6 mg/(kg·h)。记录苏醒期呛咳程度和发生率,记录麻醉前、麻醉诱导后、超声支气管镜进入声门时、穿刺时和苏醒即刻的平均动脉压和心率,记录检查时间、苏醒时间、拔管时间及不良反应发生情况。结果:艾司氯胺酮组苏醒期呛咳程度及发生率均低于对照组(P<0.05);艾司氯胺酮组平均动脉压和心率波动幅度均小于对照组(P<0.05);艾司氯胺酮组低血压、心动过缓发生率低于对照组(P<0.05);两组检查时间、苏醒时间、拔管时间及不良反应发生率...     

右美托咪定在老年患者无痛胃肠镜检查中的应用

目的 探讨右美托咪定在老年患者无痛胃肠镜检查中的应用效果。方法 选取辽宁省健康产业集团阜新矿总医院2018年9月至2019年4月行无痛胃肠镜联合检查的患者340例作为研究对象,依据随机数字表法分为两组,每组170例。对照组静脉推注丙泊酚1.0 mg/kg+芬太尼0.1μg/kg,胃肠镜检查期间泵注丙泊酚2 mg/(kg·h)维持;观察组在对照组基础上加用右美托咪定15 min泵注量为30μg。比较两组丙泊酚诱导用量、苏醒时间;比较两组给药前(T₀)、诱导前(T₁)、检查开始时(T₂)、检查开始后10 min(T₃)、检查结束后Stward评分达到6分时(T₄)的心率(HR)、平均动脉压(MAP)、血氧饱和度(SO₂);比较两组呃逆、心动过缓、心动过速、术中低血压、呼吸抑制发生率。结果 T₂～T₃时,对照组HR、MAP、SO₂低于T₀时,差异有统计学意义(P<0.0...     

环泊酚用于无痛胃肠镜检查的效果及安全性

目的 观察环泊酚用于无痛胃肠镜检查的效果及安全性。方法 选择丽水市第二人民医院2022年1—6月行无痛胃肠镜检查的患者200例,采用随机数字表法分为环泊酚组(C组)和丙泊酚组(P组),每组各100例,C组予舒芬太尼5μg+环泊酚0.4mg/kg,P组予舒芬太尼5μg+丙泊酚2mg/kg,当改良警觉/镇静评分(modified observer dalert sedation scale,MOAA/S)≤2后开始进行检查,记录麻醉镇静前(T₀)、检查前(T₁)、检查结束时(T₂)、苏醒时(T₃)的平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)及血氧饱和度(oxygen saturation of blood,SPO₂),及镇静起效时间、苏醒时间、麻醉恢复室停留时间、不良反应发生情况。结果 两组患者的镇静成功率均为100%,且镇静起效时间,差异均无统计学意义(P>0.05)。与T₀时比较,两组T     

不同剂量纳布啡复合丙泊酚在门诊无痛胃肠镜检查中的应用效果

目的 比较门诊无痛胃肠镜检查中不同剂量纳布啡复合丙泊酚的临床作用效果，并探讨纳布啡用于无痛胃肠镜检查中的适宜剂量。方法 以2019―2021年信阳市第二人民医院收治的90例门诊无痛胃肠镜检查患者作为研究对象，按照纳布啡复合丙泊酚使用剂量将患者分为3组，分别为A组(0.05 mg·kg^-1纳布啡复合丙泊酚麻醉)、B组(0.10 mg·kg^-1纳布啡复合丙泊酚麻醉)、C组(0.15 mg·kg^-1纳布啡复合丙泊酚麻醉),每组30例。对比3组患者麻醉术前5 min(T₀)、睫毛反射完全消失时(T₁)、无痛胃肠镜检查开始时(T₂)及检查结束时(T₃)的生命体征相关指标[心率(HR)、血氧饱和度(SpO₂)、平均动脉压(MAP)]、胃肠镜检查相关指标(丙泊酚使用量、麻醉诱导时间、无痛胃肠镜检查时间),比较3组不同剂量纳布啡复合丙泊酚麻醉后不良反应发生情况。结果 3组患者在不同时点HR、SpO₂、MAP...     

盐酸纳布啡、艾司氯胺酮与盐酸氢吗啡酮联合丙泊酚在宫腔镜手术患者麻醉中的效果

目的 比较盐酸纳布啡、艾司氯胺酮与盐酸氢吗啡酮分别联合丙泊酚在宫腔镜手术患者麻醉中的效果。方法 将118例宫腔镜手术患者随机分为A组38例、B组41例、C组39例。A组患者采用盐酸纳布啡0.15 mg/kg+丙泊酚进行麻醉,B组患者采用艾司氯胺酮0.5 mg/kg+丙泊酚进行麻醉,C组患者采用盐酸氢吗啡酮0.02 mg/kg+丙泊酚进行麻醉。比较3组患者麻醉诱导前(T₁)、睫毛反射消失时(T₂)、扩张宫颈时(T₃)、手术3 min (T₄)、手术5 min(T₅)、手术结束时(T₆)、呼之能睁眼时(T₇)、清醒时(T₈)的心率、平均动脉压(MAP)、呼吸频率、经皮动脉血氧饱和度(SpO₂),以及睁眼时间、苏醒期宫缩痛视觉模拟量表(VAS)评分、丙泊酚诱导量及总用量、术中及苏醒期不良反应发生情况等。结果 3组患者的心率、MAP值、呼吸频率的差异有统计学意义(P<0.05),3组患者的心率...     

苯磺酸瑞马唑仑在肥胖患者无痛胃镜检查中的临床效果

目的：观察苯磺酸瑞马唑仑在肥胖患者无痛胃镜检查中的临床效果。方法：选取2021年5月-2022年5月于中国人民解放军联勤保障部队第九〇〇医院行无痛胃镜检查的肥胖患者,共80例。随机分为两组：丙泊酚组(P组)和苯磺酸瑞马唑仑组(R组),各40例。患者检查前均静脉给予舒芬太尼0.1μg/kg,3 min后P组给予丙泊酚2 mg/kg静脉麻醉,R组给予苯磺酸瑞马唑仑0.25 mg/kg静脉麻醉。记录两组麻醉诱导前(T₀)、胃镜到达咽喉部时(T₁)、胃镜到达咽喉部后3 min(T₂)、胃镜检查结束时(T₃)的平均动脉压(MAP)、心率(HR)和脉搏血氧饱和度(SpO₂);记录两组起效时间、苏醒时间、离室时间及不良事件的发生情况。结果：两组T₀的MAP、HR、SpO₂比较,差异均无统计学意义(P>0.05);T₁、T₂、T₃,R组MAP、HR均高于P组;T₁     

BIS监测下固定小剂量瑞马唑仑复合丙泊酚在无痛胃肠镜检查中的临床应用

目的 观察脑电双频指数(BIS)监测下固定小剂量瑞马唑仑复合丙泊酚在无痛胃肠镜检查中的应用效果。方法 选择2021年12月至2022年6月拟行无痛胃肠镜检查的患者120例,男66例,女54例,年龄18～70岁,体重指数18～30 kg/m²,美国麻醉医师协会(ASA)分级Ⅰ～Ⅱ级。采用随机数字表法将患者分为3组：丙泊酚组(P组)、丙泊酚+瑞马唑仑组(P+R组)、瑞马唑仑组(R组),每组40例。3组均静脉注射瑞芬太尼0.2μg/kg, P组静脉注射丙泊酚1～2 mg/kg; P+R组静脉注射瑞马唑仑7 mg复合丙泊酚0.5 mg/kg; R组静脉注射瑞马唑仑0.2 mg/kg。镇静深度采用BIS监测,胃肠镜检查中根据BIS值变化,R组追加瑞马唑仑2.5 mg, P组及P+R组追加丙泊酚0.5 mg/kg,维持BIS值40～60。两次药物追加间隔时间至少1 min,追加次数不超过6次。记录药物用量、镇静诱导时间、检查时间、苏醒时间和离院时间;记录注射痛、呛咳、体动、呃逆、心动过缓、低血压、呼吸抑制、术后恶心、呕吐等不良反应;记录患者满意度。结果 与R组相比,P组及P+...     

不同剂量酒石酸布托啡诺复合丙泊酚对老年无痛胃肠镜的效果比较

目的：比较不同剂量酒石酸布托啡诺(诺扬)复合丙泊酚靶控输注(TCI)对老年无痛胃肠镜的效果，为临床应用提供参考。方法：选取2020年7月—2021年7月我院收治的120例无痛胃肠镜老年患者，根据用药方案不同分为三组，各40例，对照组给予丙泊酚靶控输注，0.5mg布托啡诺组给予0.5mg诺扬1min内静脉推注完加丙泊酚靶控输注，1mg布托啡诺组给予1mg诺扬1min内静脉推注完加丙泊酚靶控输注，对比三组不同时间[给药前(T₀)、诱导完成即刻(T₁)、置镜时(T₂)、术毕时(T₃)]血流动力学[平均动脉压(MAP)、心率(HR)]及呼吸变化[脉搏氧饱和度(SpO₂)]、麻醉效果(诱导、检查、苏醒用时及丙泊酚用量)、不良反应及术后镇静Ramsay评分。结果：T₁时三组MAP、HR水平均较T₀时降低(P<0.05),T₁时三组MAP对比：0.5mg布托啡诺组>1mg布托啡诺组>对照组(P<0.05...     

亚麻醉剂量艾司氯胺酮对甲状腺癌根治术后患者苏醒及疼痛的影响

目的 研究亚麻醉剂量艾司氯胺酮对甲状腺癌根治术(Radical resection of thyroid carcinoma, RRTC)后患者苏醒及疼痛的影响。方法 选取2020年8月-2021年3月安庆市立医院麻醉科行RRTC的90例患者为研究对象，采用随机数字表法将患者分为A、B、C组，每组30例，A组术中持续输注生理盐水；B组术中持续输注艾司氯胺酮0.25 mg·kg^-1·h^-1;C组术中持续输注艾司氯胺酮0.5 mg·kg^-1·h^-1。观察各组患者术中各时间点[麻醉诱导前(T₀)、注射药物5 min后(T₁)、气管插管后(T₂)、手术结束(T₃)、术后1 h(T₄)]心率(Heart rate, HR)、平均动脉压(Mean arterial pressure, MAP)、动脉压水平波动情况，统计术中丙泊酚、瑞芬太尼用量；观察各组患者术后不同时间的镇静情况(Ramsay镇静评分)及...     

右美托咪定联合氢吗啡酮在喉罩无肌松全麻宫腔镜手术中的应用

目的：探讨右美托咪定联合氢吗啡酮应用在喉罩无肌松全麻宫腔镜手术中的效果。方法：选择2021年1-12月于江阴市人民医院行喉罩无肌松全麻下宫腔镜手术患者58例,随机分为右美托咪定+氢吗啡酮组(DH组)、舒芬太尼组(SF组),每组29例。DH组麻醉诱导采用右美托咪定0.2μg/kg静注(≥10 min)联合氢吗啡酮0.02 mg/kg、丙泊酚2.5 mg/kg静注,SF组麻醉诱导采用舒芬太尼0.3μg/kg、丙泊酚2.5 mg/kg静注,两组麻醉维持均采用丙泊酚6 mg/kg静脉泵注。记录两组全麻诱导前(T₀)、手术开始前(T₁)、手术开始10 min后(T₂)、手术结束(T₃)的心率(HR)、平均动脉压(MAP)及T₁、T₂、T₃的脑电双频指数(BIS),记录两组手术时间、手术结束至苏醒时间及术中体动发生情况。结果：与SF组相比,DH组在T₁、T₂时HR、MAP均高于SF组,T₁     

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.     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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…     

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.