小儿喉乳头状瘤吸入七氟烷麻醉诱导期间呼吸力学变化

目的 通过热线风速仪观察喉乳头状瘤患儿和普通小儿吸入七氟烷麻醉诱导期呼吸力学的变化,旨在获得预测通气和捕管困难的客观量化指标及对控制通气加深麻醉效果的评估.方法 选择普通患儿(C组)和喉乳头状瘤患儿(L组)各20例,静脉注射氯胺酮1 mg/kg,吸入氧气2 L/min+7%七氟烷实施麻醉诱导.热线风速仪采集四时段呼吸力学数据:静注氯胺酮1 min后(T1),开始吸入7%七氟烷时(T2),吸入7%七氟烷3min后(T3),控制通气2min后(T4).结果 L组T1期呼吸的平均速度[(1.48±0.20)m/s和(1.26±0.18m/s)]、最大速度[(1.72±0.25)m/s和(1.97±0.31)m/s]都高于c组(P<0.05),呼吸频率、吸气时间差异无统计学意义(P>0.05). L组T3、T4期平均吸气速度和最大吸气速度的比值(0.612±0.030和0.613±0.032)小于C组(P<0.05).L组T3期最大吸气速度、呼吸频率下降的幅度[(25±6)%和(19±4)%]少于C组(P<0.05).L组T4期各项指标较T3期无明显变化(P>0.05).结论 喉乳头状瘤患儿吸入七氟烷麻醉诱导期是靠加强呼吸做功来代偿通气不足的,其上气道梗阻情况随麻醉加深更加突出,通过控制通气辅助加深麻醉效果不明显.     

传统式胸外按压(standard cardiopulmonary resuscitation)和主动式胸外按压-减压(active compression-decompression resuscitation)在施行心肺复苏时的比较

于 1993～ 1995年作者对心搏骤停患者使用以下不同的复苏方法并进行比较。以患者是在单日或双日病发的方式随机分为两组 ,组Ⅰ在复苏时接受传统式胸外接压 ,组Ⅱ则接受主动式胸外按压 减压 ,结果如下 :1 接受传统胸外按压 377例 ,接受主动式胸外按压 减压为 373例。2 其中 80 %患者诊断心室停顿 ,而非室颤。3 2 %接受传统式胸外按压的患者没有脑内伤 ,而 6 %接受主动式胸外按压 减压的患者没有脑内伤 (Ｐ =0 0 1)。4 一年后有 2 %接受传统式胸外按压的患者依然生存 ,而接受主动式胸外按压 减压的患者有 5 %依然生存 (Ｐ =0 0 3)。5 …     

连续气流通气期间气道内压及流量对犬气体交换的影响

目的　观察不同气道压及气流量对连续气流通气 ( CFV)犬气体交换的影响。方法　选用健康杂种犬 9只 ,在全麻肌松下 ,以较低气道正压 ( Paw为 3 cm H2 O)三种不同气流量 ( 0 .6L· kg- 1· min- 1 ,0 .8L· kg- 1· m in- 1 ,1.0 L· kg- 1· min- 1 )进行 CFV,并与间歇正压通气 ( IPPV)及气道压为 0 cm H2 O时不同气流量 CFV相比较。每种通气方式维持 3 0分钟后抽取股动脉血 ,肺动脉血即混合静脉血作血气分析 ,并根据标准分流公式计算肺内分流率。结果　 CFV各组均能维持 Pa CO2 在正常范围。气道压为 3 cm H2 O时 ,各流量组均能维持 Pa CO2 在正常生理范围 ,且 Pa CO2 随气体流量加大而降低 ,Pa CO2 及 Q.s/ Q.t均显著低于气道压为 0 cm H2 O时对应值 ( P<0 .0 5 )。结论　 CFV时 ,维持较低气道正压能维持有效肺气体交换 ,通气流量大小与 Pa CO2 有较密切关系     

胸外按压-主动减压装置及其在心肺复苏应用的展望

胸外按压-主动减压心肺复苏(ACD-CPR)是90年代提出的一种心肺复苏新模式。它与传统的标准心肺复苏(S-CPR)的重要区别在于,继胸外按压后主动上提ACD装置,依靠其吸盘与胸壁紧贴使胸腔产生一定负压,这有利于静脉血回流,增加心室充盈和心排血量,还有助于通气。经初步实验和临床研究表明,ACD-CPR的效率明显优于S-CPR和其他心肺复苏改良方法。该法简便,适宜于各种条件下的心肺复苏。     

饱和氢盐水对大鼠下肢缺血再灌注及远隔肺组织损伤的保护作用

目的 观察饱和氢盐水对大鼠下肢组织缺血再灌注及远隔肺组织损伤的保护作用.方法 将30只健康SD雄性大鼠随机分为3组:假手术组(S组)、生理盐水组(C组)、氢水治疗组(H组).建立大鼠下肢缺血再灌注损伤模型(阻断腹主动脉4 h,再灌注4 h),在再灌注前10min分别注入饱和氢盐水1 ml/100 g(H组),生理盐水1 ml/100 g(C组).再灌注4 h后比较肺及腓肠肌湿/干重(W/D)比值、观察病理切片的改变,测定血清、肺及腓肠肌组织中丙二醛(MDA)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6含量变化.结果 H组肌(4.04±0.22)、肺(4.47±0.23)组织湿/干重比低于C组肌(4.67±0.27),肺(4.67±0.27)、组织(P＜0.05),MDA、TNF-α及IL-6血浆[分别为(2.08±1.27)μmol/L、(528.22±221.17)、(41.14±13.01)ng/L]及组织[肺组织分别为(3.58±1.62)μmol/L、(1.17±0.15)、(0.79±0.29)ng/L;肌组织分别为(8.91±3.13)μmol/L、(3.13±0.41)、(3.07±1.69)ng/L)含量均低于C组(P＜0.05),腓肠肌及肺病理学损害明显减轻,与S组比较差异无统计学意义(P＞0.05).结论 缺血再灌注前输注饱和氢盐水可有效保护大鼠下肢缺血再灌注及远隔肺组织的损伤.

Abstract：

Objective To explore the protective effects of hydrogen-rich saline against hind limb ischemia reperfusion injury and associated remote lung injury in rats. Methods Thirty Sprague-Dawley rats were randomly divided into three groups: sham group ( group S) ; saline control group (group C) , undergoing intravenous infusion of saline (1 ml/100 g) at 10 min before reperfusion; hydrogen-treated group ( group H) , undergoing intravenous infusion of hydrogen-rich saline (1 ml/100 g) at 10 min before reperfusion. Hind limb ischemia reperfusion model was established by 4 h of the abdominal aorta ligation followed by a 4 h of reperfusion. Rats were killed at the end of reperfusion, and blood samples were collected for determination of serum levels of tumor necrosis factor-α ( TNF-α) , interleukin-6 (IL-6) and malonyldialdehyde ( MDA). Specimens of lung and gastrocnemius muscle were collected for measurement of wet-todry weight (W/D) ratio, light microscopic examination and detection of plasma TNF-α, IL-6 and MDA.Results The pathological changes were milder in group H than in group C. The lung (4. 47 ±0. 23) and gastrocnemius muscle (4. 04 ±0. 22) W/D ratio in group H was significantly lower than in group C (4. 67 ±0.27 vs4. 67 ±0.27, P＜0.05). The serum [(2.08 ± 1. 27) μmol/L, (528. 22 ±221. 17) , (41.14± 13. 01) ng/L, respectively] and homogenate levels [(3. 58 ± 1. 62) μmol/L, ( 1. 17 ±0. 15) , (0. 79±0.29) ng/L in the lung; (8.91 ±3. 13) μmol/L, (3. 13 ±0. 41) ,(3. 07 ± 1. 69) ng/L in the gastrocnemius muscle, respectively] of MDA, IL-6 and TNF-a were also significantly lower in group H than in group C (P ＜0. 05) , but there was no significant difference from group S. Conclusion Infusion of hydrogen-rich saline before reperfsion significantly alleviates the hind limb ischemia reperfusion injury and associated remote lung injury.     

原发性气管血管球瘤一例

患者　女 ,46岁。活动后胸闷气促 ,反复发作喘息 8年 ,持续性呼吸困难 ,阵发性加重 15天 ,偶伴咯血或痰中带血。门诊以哮喘收入院。查体 :端坐位 ,唇紫绀 ,呼吸 34次 /分 ,心率12 5次 /分 ,双肺呼吸音粗 ,胸骨旁可闻及少许哮鸣音 ,吸气三凹征明显。血常规示 :白细胞 2 0 .4× 10 9/ L ,中性粒细胞 0 .88。痰黏稠 ,无血丝 ,未见脱落细胞 ,痰培养可见白色念珠菌和草绿色链球菌。血气分析示 :氧分压 (PO2 ) 4 0 mm Hg(1k Pa=7.5 mm Hg) ,氧饱和度 0 .70 ,标准细胞外碱 14mmol/ L,剩余碱 13.9mm ol/ L。支气管扩张试验示 :重度阻塞性通气障…     

抗肝肠钙粘连蛋白单克隆抗体对肝癌细胞生物学行为的影响

目的 观察抗肝肠钙粘连蛋白(CDH17)单克隆抗体Lic5对肝癌细胞生物学行为的影响.方法 Western blot和实时定量聚合酶链反应(PCR)检测细胞株MHCC97H、MHCC97L、PLC/PRF/5及MIHA中CDH17的表达.噻唑蓝(MTT)比色法、细胞划痕法、Transwell法及平板克隆法检测Lic5对肝癌细胞生物学行为的影响.结果 CDH17仅在细胞株MHCC97H、MHCC97L中表达,Lic5可结合肝癌细胞表面的CDH17,并抑制CDH17表达.Lic5 50mg/L组、100mg/L组、小鼠IgG组4 d细胞增殖抑制率在MHCC97H为26.1%、43.6%、6.4%,MHCC97L为26.0%、40.7%、7.7%;Lic5100mg/L组、小鼠IgG组、磷酸盐缓冲液(PBS)组48h细胞迁移抑制率在MHCC97H为36.7%、8.4%、5.6%,MHCC97L为42.3%、10.2%、7.4%(P＜0.05);穿膜细胞数在MHCC97H为(39.20±9.56)、(106.50±7.56)、(96.60±13.02)个,MHCC97L为(26.00±8.61)、(86.00±10.26)、(90.40±12.04)(P＜0.05);克隆形成数在MHCC97H为(59.30±11.68)、(141.70±19.40)、(150.30±14.64),MHCC97L为(57.20±10.21)、(132.50±9.07)、(121.70±11.93)(P＜0.01).Lic5对PLC/PRF/5及MIHA细胞的生物学行为无明显影响.结论 单克隆抗体Lic5能够下调肝癌细胞CDH17表达,抑制肝癌细胞的增殖、迁移、侵袭和克隆形成能力.

Abstract：

Objective To investigate the effect of monoclonal antibody against liver-intestine cadherin (CDH17) on the cell proliferation, migration, invasion and colony formation of hepatocellular carcinoma cell lines. Methods Hepatocellular carcinoma cell lines MHCC97H, MHCC97L, PLC/PRF/5 and MIHA were examined for CDH17 expression by Western blotting and quantitative real-time polymerase chain reaction (PGR). The combination capacity between bepatocellular carcinoma cell lines and monoclonal antibody Lic5 was detected by the way of immunofluorescence staining. The cell lines were treated with Lic5, PBS and mouse IgG respectively. Methyl thiazol tetrazolium (MTT) assay, wound healing assay, Transwell invasion assay and colony formation assay were used to study the changes in cell proliferation, migration, invasion and colony formation of hepatocellular carcinoma cell lines. Results High expression level of CDH17 was detected in MHCC97H and MHCC97L cell lines. CDH17 protein level was down-regulated but there was no significant effect on CDH17 mRNA after treatment with Lie5 in MHCC97H and MHCC97L. Cellular growth rate of MHCC97H in Lic5 (50 mg/L), Lic5 ( 100 mg/L) and mouse IgG groups was decreased by 26. 1%, 43.6% and 6. 4%, and by 26. 0%, 40. 7% and 7. 7% in MHCC97L on the 4th day respectively (P ＜0. 05 ). The inhibition rate of cell migration at 48 h was 36. 7%, 8. 4% and 5.6% in Lic5 ( 100 mg/L), mouse IgG and PBS groups in MHCC97H, and 42. 3%, 10. 2% and 7. 4% in MHCC97L respectively ( P ＜ 0. 05 ). The number of invasion cells was ( 39. 20 t 9. 56),(106.50±7.56) and (96.60±13.02) in MHCC97H, and (26.00±8.61), (86.00±10.26) and (90.40±12.04) in MHCC97L in Lic5 (50 mg/L), Lic5 (100 mg/L) and mouse IgG groups, respectively (P ＜ 0. 05 ). The number of colony formation was ( 59. 30 ± 11.68 ), ( 141.70 ± 19. 40 ) and (150.30 ±14.64) in MHCC97H, and (57.20 ± 10.21), (132.50 ±9.07) and (121.70 ±11.93) in MHCC97L in Lie5 (50 mg/L), Lic5 (100 mg/L) and mouse IgG groups, respectively (P＜ 0. 01 ).There was no significant difference between Lic5 treatment groups and controls in PLC/PRF/5 and MIHA cell lines. Conclusion The anti-CDH17 monoclonal antibody Lic5 can down-regulate CDH17 expression and inhibit the cell proliferation, migration, invasion and colony formation in hepatocellular carcinoma cell lines.     

单节段椎弓根螺钉固定联合上方棘突间Coflex置入的生物力学评价

目的:对腰椎单节段椎弓根螺钉固定联合上节段使用棘突间Coflex置入手术(Topping-off手术)进行生物力学评价。方法:采用6具男性L3~S1节段的人脊柱标本,建立L4/5椎弓根螺钉坚强固定(后路腰椎体间融合术,PLIF)模型及L4/5椎弓根螺钉固定联合L3/4棘突间Coflex置入(Topping-off手术)的模型。每具标本均进行完整、坚强固定和联合固定3种状态的生物力学测试。分别比较完整标本(A组)、L4/5坚强固定(B组)、联合固定(C组)中L3/4和L5/S1节段活动度及椎间盘内压差异。结果:B组L3/4节段平均活动度较A组显著增加(P0.05)(分别比A组前屈增大0.54°,后伸增大0.34°,侧弯增大0.30°,旋转增大0.19°);B组L5/S1活动度亦比A组增加,但无统计学意义(P0.05)。C组L3/4节段的活动度与B组相比,后伸方向显著减小(P0.05)(比B组减小0.32°),而前屈、侧弯、旋转减小不明显(P0.05);与A组相比,后伸及旋转无显著增大(P0.05),前屈及侧屈有显著增大(P0.05)(分别比A组前屈增大0.38°,侧屈增大0.28°)。C组L5/S1活动度与B组相比,除前屈方向外均有增大趋势,但无统计学意义(P0.05);与A组比较,均有增大,但无统计学意义(P0.05)。与A组相比,B组L3/4椎间盘内压显著增加(P0.05)(分别比A组前屈增大0.78k Pa,后伸增大0.88k Pa,侧弯增大1.84k Pa,旋转增大1.45k Pa);L5/S1椎间盘内压也显著增加(P0.05)(分别比A组前屈增大1.21k Pa,后伸增大0.94k Pa,侧弯增大0.70k Pa,旋转增大0.81k Pa)。与B组相比,C组L3/4椎间盘内压减小(分别比B组前屈减小0.29k Pa,后伸减小1.39k Pa,侧弯减小0.13k Pa,旋转减小0.10k Pa),但仅后伸减小有统计学意义(P0.05);C组L5/S1椎间盘内压分别比B组前屈减小0.39k Pa,后伸减小0.10k Pa,侧弯增大0.15k Pa,旋转增加0.18k Pa,但无统计学意义(P0.05)。与A组相比,C组L3/4椎间盘内压增大,其中前屈、侧屈及旋转显著增大(P0.05)(分别比A组前屈增大1.53k Pa,侧屈增大1.71k Pa,旋转增大1.35k Pa);C组L5/S1椎间盘内压也显著增大(P0.05)(分别比A组前屈增大0.82k Pa,后伸增大0.84k Pa,侧屈增大0.85k Pa,旋转增大0.99k Pa)。结论 :生物力学测试发现,Topping-off手术中Coflex对单节段坚强固定上方相邻节段有保护作用;但使下方相邻节段的应力增加,可能对远期退变产生不良影响。     

多沙唑嗪对兔膀胱出口部分梗阻致膀胱顺应性减低的影响

目的 探讨多沙唑嗪对兔膀胱出口部分梗阻后膀胱顺应性改变的影响.方法 成年雄性新西兰兔40只随机分为4组,每组10只,A组为假手术对照组,B组为膀胱出口部分梗阻组,C组为膀胱出口部分梗阻后口服多沙唑嗪组,D组为假手术后给予多沙唑嗪组.各组于14周行尿动力学检测,检测完成后处死并留取膀胱标本,行膀胱称重.结果 4组膀胱标本质量分别为(3.2±0.9)、(14.1±2.3)、(5.0±2.0)、(2.9±0.5)g;B、C组均高于A、D组,B组高于C组,差异均有统计学意义(P＜0.01);A、D组间比较差异无统计学意义(P＞0.05).4组逼尿肌漏尿点压分别为(10.2±2.5)、(18.8±6.1)、(13.5±4.7)、(11.6±3.6)cm H2O(1 cm H2O=0.098 kPa),B组高于A、D组,差异有统计学意义(P＜0.01),且高于C组,差异有统计学意义(P＜0.05);A、C、D组间差异无统计学意义(P＞0.05).膀胱顺应性分别为(2.86±0.56)、(1.22±0.39)、(4.25±2.19)、(2.90±0.53)ml/cm H2O,B组与A、D组相比明显下降,差异有统计学意义(P＜0.01);C组高于A、D组,差异有统计学意义(P＜0.05);A、D组间差异无统计学意义(P＞0.05).结论膀胱出口部分梗阻后早期应用多沙唑嗪治疗能够延迟梗阻对膀胱顺应性的损害,保护膀胱储尿功能.

Abstract：

Objective To explore the effect of doxazosin on rabbit bladder compliance after partial bladder outlet obstruction. Methods A total of 40 male New Zealand white rabbits were randomized into 4 groups, with 10 rabbits in each group. Partial bladder outlet obstruction was established in groups B and C, while groups A and D underwent the same operation but without partial bladder outlet obstruction. On the day after the operation, groups C and D received oral administration of doxazosin. After 14 weeks, urodynamic examinations were carried out in all groups, and the bladder was weighted after cystectomy. Results Bladder weight was (3.2±0.9) g in group A, (14.1±2.3) g in group B, (5.0±2.0) in group C,and (2.9±0.5) g in group D. The bladder weight in groups B and C increased significantly compared to groups A and D (P＜0.01), group B increased significantly over group C (P＜0.01), and there was no significant difference between groups A and D (P＞0.05).The detrusor leak point pressure was (10.2±2.5) cm H2O in group A, (18.8±6.1) cm H2O in group B, (13.5±4.7) cm H2O in group C,and (11.6±3.6) cm H2O in group D. The detrusor leak point pressure in group B was significantly higher than group A, group D (P＜0.01) and group C (P＜0.05). There was no significant difference between group A, group C and group D (P＞0.05). The bladder compliance was (2.86±0.56) ml/cm H2O in group A, (1.22±0.39) ml/cm H2O in group B, (4.25±2.19) ml/cm H2O in group C,and (2.90±0.53) ml/cm H2O in group D. The bladder compliance was significantly decreased in group B compared to groups A and D (P＜0.01). Bladder compliance in group C was significantly higher than in groups A and D (P＜0.05), and there was no significant difference between group A and group D (P＞0.05). Conclusion Early use of doxazosin can delay the occurrence of lower bladder compliance after partial bladder outlet obstruction, thus protecting the storage function of bladder.     

Roux-en-Y胃旁路术改善非肥胖性2型糖尿病患者的糖脂代谢

目的 观察Roux-en-Y胃旁路术对非肥胖性2型糖尿病患者血糖和血脂代谢的影响.方法 共37例非肥胖2型糖尿病患者接受Roux-en-Y胃旁路术,观察其手术前、手术后3个月和6个月的体质量指数、糖化血红蛋白、空腹血糖、胰岛素、C肽、胰岛素抵抗指数、甘油三酯、总胆固醇、高密度脂蛋白和低密度脂蛋白含量的变化,并比较口服葡萄糖后2 h血糖、胰岛素和C肽的变化.结果 本组37例患者无严重围手术期并发症.手术前、手术后3个月和6个月体质量指数变化之间相比差异均无统计学意义(P>0.05);手术前、手术后3个月和6个月空腹血糖[(8.8±0.9)mmol/L、(7.0±2.0)mmol/L、(6.3±0.6)mmol/L,P<0.01]、糖化血红蛋白[(8.2%±1.2%、7.0%±0.8%、6.2%±0.7%,P<0.01]、空腹胰岛素[(10.6±1.2)mU/L、(9.0±0.9)mU/L、(9.0±0.8)mU/L,P<0.05]、空腹C肽[(1.9±0.5)nmol/L、(1.2±0.6)nmol/L、(1.2±0.4)nmol/L,P<0.01]、空腹甘油三酯[(3.3±0.8)mmol/L、(2.7 ±0.9)mmol/L、(2.6±0.7)mmol/L,P<0.05]、空腹总胆固醇[(6.5±1.8)mmol/L、(4.6±0.9)mmol/L、(4.2±1.0)mmol/L,P<0.05]、空腹低密度脂蛋白[(3.6±1.2)mmol/L、(2.8±0.8)mmol/L、(2.7±0.2)mmol/L,P<0.01]、餐后2 h血糖[(18.6±3.0)mmol/L、(12.7±2.3)mmol/L、(11.4±2.0)mmol/L,P<0.01]、胰岛素抵抗指数[(3.2±1.7)、(2.6±1.6)、(2.5±1.3),P<0.05]之间相比差异均有统计学意义.空腹高密度脂蛋白[(1.2±0.1)mmol/L、(1.4±0.4)mmol/L、(1.4±0.2)mmol/L,P<0.01]、餐后2 h胰岛素[(17.2±3,4)mU/L、(26.3±4.7)mU/L、(28.6±4.1)mU/L,P<0.01]、2 h C肽[(4.2±1.0)nmol/L、(6.3±1.5)nmol/L、(6.2±1.4)nmol/L,P<0.01]在手术后均明显升高.结论 Roux-en-Y胃旁路术可改善非肥胖性2型糖尿病患者血糖和血脂代谢,且与体质量指数变化无关.

Abstract：

Objective To evaluate Roux-en-Y gastric bypass operation on carbohydrate and lipid metabolism in type 2 diabetes mellitus patients with BMI range of 24 -29. Methods Thirty seven cases of type 2 diabetes mellitus patients undergoing Roux-en-Y gastric bypass operation were studied. Body mass index (BMI), glycosylated hemoglobin ( GHbAlc), fasting glucose ( FPG), fasting insulin (FIns) and C-peptide( FC-p), HOMA-IR, oral glucose tolerance (OGTT) including 2 hour insulin (2hIns) and C-peptide (2hC-p) , plasma levels of total cholesterol (TC), triglycerides(TG), high density lipoprotein( HDL-c)and low density lipoprotein ( LDL-c) were measured preoperatively and on 3 months, 6 months, later postoperatively. Result There was no statistically significant difference between BMI values measured preoperatively and postoperatively (P>0. 05 ). Serum levels measured in pre-operative and third and sixth post-operative months were: FPG (8. 8 ± 0. 9, 7. 0 ± 2. 0, 6. 3 ± 0. 6, P<0. 01) ( mmol/L) , GHbAlc (8.2±1.2, 7.0±0.8, 6.2±0.7, P<0.01)(%), FIns(10. 6 ±1. 2, 9.0±0.9, 9.0±0.8, P<0.05)(mU/L), FC-p(1.9±0.5, 1.2 ±0.6, 1.2 ±0.4, P<0. 01) (nmol/L), TG(3.3 ±0.8, 2.7 ±0.9,2.6±0.7, P<0.05)(mmol/L), TC(6.5±1.8, 4.6±0.9, 4.2 + 1.0, P<0. 05) (mmol/L)and LDL-c (3. 6 ±1.2, 2. 8 ±0.8, 2. 7 ±0.2, P<0.01) (mmol/L), 2 hour glucose after OGTT(2hPG) (18. 6 ±3.0, 12.7 ±2.3, 11.4±2.0, P<0. 01) (mmol/L), HOMA-IR(3. 2 ± 1. 7, 2.6±1.6, 2. 5 ±1.3, P<0. 05). Postoperative levels of HDL-c (1. 2 ± 0. 1, 1. 4 ± 0. 4, 1. 4 ± 0. 2, P<0. 01) ( mmol/L) , 2hIns (17. 2 ±3.4, 26. 3 ±4.7, 28. 6 ±4.1, P<0. 01) (mU/L)and 2hC-p(4. 2 ± 1. 0, 6. 3 ± 1. 5, 6. 2 ± 1.4,P<0. 01 ) ( nmol/L) were significantly higher than that of the pre-operative values ( P<0. 01 ).Conclusions Roux-en-Y gastric bypass significantly improves the metabolism of carbohydrate and lipid in type 2 diabetes patients with BMI 24-29, and the effects are not associated with weight loss.     

Clinical outcomes in patients with renal artery stenosis treated with stent placement with embolic protection compared with those treated with stent alone

Purpose: To compare the clinical outcomes in patients with chronic renal insufficiency (CRI) and renal artery stenosis (RAS) following renal artery (RA) stent placement with and without embolic protection device (EPD) usage. Materials and Methods: Eighteen patients who had RA stent placement with EPD were matched to control patients (RA stent only). Blood pressure, number of hypertensive medications, and estimated glomerular filtration rate (eGFR) at 3 months before the procedure and after 12 months were determined. An increase of ≥ 20% in eGFR at 12 months from baseline was defined as "improvement," decrease of ≥20% as "deterioration," and an eGFR change between those values as "stabilization" at 12 months. Results: At 12 months, stage 4 patients treated with EPD had significantly higher eGFR than controls (P = .01). There was no statistical difference in blood pressure outcomes between the 2 groups. Conclusions: Patients with stage 4 CRI did significantly better with EPD than those treated without it.     

Intubation with propofol augmented with intravenous lignocaine

Sixty patients of ASA grade 1 and aged 18 to 55 years were admitted to a double-blind study. Anaesthesia was induced with propofol 2.5 mg/kg after intravenous pretreatment with lignocaine 1.5 mg/kg or a similar volume of isotonic saline. The quality of subsequent tracheal intubation was graded and the pressor response to tracheal intubation assessed. There were no significant differences between treatment groups.