导尿时机对男性患者全麻苏醒期的影响

目的观察不同导尿时机对男性患者全麻苏醒期的影响。方法选择120例全麻下手术的男性患者,随机分为麻醉诱导后导尿组（观察组）和麻醉前导尿组（对照组）,比较两组患者全麻苏醒期躁动的发生情况、血压及心率的变化。结果观察组全麻苏醒期躁动的发生率明显高于对照组（P〈0.01）,且易引起血压升高、心率加快（P〈0.01）。结论麻醉诱导后留置导尿增加男性患者全麻苏醒期的躁动及血压、心率的升高。留置导尿宜在麻醉前进行。     

丁卡因胶浆导尿对降低全麻苏醒期病人躁动的观察分析

目的:探讨在为全麻手术病人行无痛导尿时,丁卡因胶浆的局部应用对降低病人苏醒期躁动的效果。方法:选择200例全麻手术男性病人,随机分为两组。常规组:101例于全麻诱导后行无痛导尿术。对照组:99例在全麻前清醒状态下用丁卡因胶浆作尿道表面麻醉行导尿术。观察比较两组患者的无痛效果及在全麻苏醒期躁动的差异。结果:常规组与对照组比较,置尿管过程均顺利,血压、心率、一次性置管成功率无明显差异(P>0.05),而麻醉苏醒期躁动的发生率两组问有显著性差异。结论:全麻前导尿、丁卡因胶浆的应用,可降低病人苏醒期躁动的发生率。     

丁卡因胶浆导尿对降低全麻苏醒期病人躁动的观察分析

目的：探讨在为全麻手术病人行无痛导尿时，丁卡因胶浆的局部应用对降低病人苏醒期躁动的效果。方法：选择200例全麻手术男性病人。随机分为两组。常规组：101例于全麻诱导后行无痛导尿术。对照组：99例在全麻前清醒状态下用丁卡因胶浆作尿道表面麻醉行导尿术。观察比较两组患者的无痛效果及在全麻苏醒期躁动的差异。结果：常规组与对照组比较，置尿管过程均顺利，血压、心率、一次性置管成功率无明显差异（P〉0．05），而麻醉苏醒期躁动的发生率两组间有显著性差异。结论：全麻前导尿、丁卡因胶浆的应用，可降低病人苏醒期躁动的发生率。     

无痛导尿管预防全身麻醉苏醒期患者导尿管源性躁动

目的 观察新型一次性无痛导尿管对全身麻醉(全麻)苏醒期患者导尿管源性躁动的防治效果.方法 200例全麻下行普通外科手术患者随机分为2组,观察组(n=100)在全麻诱导后用新型一次性无痛导尿管行导尿术,对照组(n=100)则用普通气囊导尿管行导尿术,比较2组患者在全麻苏醒期因导尿管所致躁动的发生率、躁动程度及导管脱出率.结果 观察组与对照组比较,后者导尿管源性躁动发生率、躁动程度明显高于前者(P＜0.01).结论 全麻诱导后置导尿管可显著增加麻醉苏醒期躁动的发生率和躁动程度,新型一次性无痛导尿管能有效预防苏醒期导尿管源性躁动.     

盐酸利多卡因凝胶导尿降低全麻苏醒期患者躁动的临床应用

目的 讨论在为全麻男性患者行无痛导尿时盐酸利多卡因凝胶局部应用对降低患者苏醒期躁动的效果.方法 选择100例男性患者在全麻下施行手术,随机分为两组,常规组51例于全麻诱导后行无痛导尿术,对照组49例在全麻前清醒状态下用盐酸利多卡因凝胶作尿道表面麻醉下行导尿术.观察比较两组患者的无痛效果及全麻苏醒期躁动的差异.结果 常规组与对照组比较,置尿管过程均顺利,血压、心率、一次性置尿管成功率无明显差异(P>0.05).而麻醉苏醒期躁动的发生率两组之间有明显差异.结论 全麻前用盐酸利多卡因凝胶导尿可明显降低病人苏醒期躁动的发生.     

盐酸丁卡因胶浆导尿降低全麻苏醒期患者躁动的临床应用

目的讨论应用盐酸丁卡因胶浆为全麻男性患者行无痛导尿对降低患者苏醒期躁动的效果。方法选择180例男性患者在全麻下施行手术,随机分为两组,常规组91例于全麻诱导后行无痛导尿术,对照组89例在全麻前清醒状态下用盐酸丁卡因胶浆作尿道表面麻醉下行导尿术。观察比较两组患者的无痛效果及全麻苏醒期躁动的差异。结果常规组与对照组比较,置尿管过程均顺利,血压、心率、一次性置尿管成功率无明显差异(P>0.05)。而麻醉苏醒期躁动的发生率两组之间有明显差异。结论全麻前用盐酸丁卡因胶浆导尿可明显降低病人苏醒期躁动的发生。     

全身麻醉术前应用复方利多卡因乳膏行无痛导尿术的临床观察

[目的]探讨全身麻醉（下简称＂全麻＂）前应用复方利多卡因乳膏行无痛导尿术的效果。[方法]将240例进行全麻手术的男性患者,随机分为2组,对照组120例在全麻诱导后行无痛导尿术,观察组120例在全麻前清醒状态下采用复方利多卡因乳膏做尿道表面麻醉行无痛导尿术。观察并比较两组患者导尿前、中、后的心率、血压变化以及一次性置管导尿术成功率,并记录麻醉苏醒期患者的躁动情况。[结果]两组患者置管过程均基本顺利,血压、心率无明显差异,但观察组苏醒期躁动发生率及程度优于对照组。[结论]全麻前应用复方利多卡因乳膏行无痛导尿术安全、有效,值得临床推广。     

全麻诱导后留置导尿管对成年男性患者麻醉苏醒期血流动力学及不良反应的影响

目的：观察全麻诱导后留置导尿管对成年男性患者麻醉苏醒期血流动力学及躁动等不良反应的影响。方法：90例择期全麻下行胃癌根治术男性患者分为两组,对照组（n=45）在清醒状态下行导尿术,实验组（n=45）在全麻诱导后行导尿术,观察两组患者麻醉苏醒期血压（BP）及心率（HR）的变化,以及苏醒期躁动程度和导管脱出率。结果：实验组患者气管导管拔除即刻、拔除后5min、10min及15min时的SBP、DBP及HR均高于对照组（P〈0.05）,实验组患者躁动程度和导管脱出率也均高于对照组（P〈0．01或P〈0．05）。结论：成年男性患者全麻诱导后密置导尿管可导致患者苏醒期血流动力学指标急剧升高、以及躁动程度和导管脱出率的明显增加,导尿管留置宜在全麻诱导前实施。     

全麻前后留置导尿管对男性手术患者术后苏醒期躁动的影响

目的:观察不同时期导尿对男性手术患者全麻术后苏醒期的影响,减轻患者全麻苏醒期CRBD(留置导尿相关膀胱不适)症状,确保围手术期护理安全,提高患者手术耐受性,减少麻醉苏醒期烦躁及并发症,真正意义上体现手术室优质护理服务.方法:将该院2013年1月至2016年12月200例全麻手术留置导尿的男性患者(无精神病史,无前列腺增生,未使用镇痛泵)随机分为实验组(全麻诱导前留置导尿管)和对照组(全麻诱导后留置导尿)各100例,采用全麻诱导前10分钟和全麻诱导后两种留置导尿方法,术毕麻醉苏醒期对两组患者进行尿道刺激反应和躁动情况进行对比.结果:通过临床实践,数据统计分析,针对男性手术患者,采用全麻诱导前实施留置导尿,有效降低患者术后复苏期躁动发生率和因躁动引起的非计划性拔管,切口出血等潜在并发症.结论:选择全麻诱导前实施留置导尿,在充分的心理护理及健康教育后,患者对导尿管插入的不适感明显减轻,苏醒期躁动发生率低,在手术护理实践中有指导意义.     

全麻诱导后置导尿管增加中老年患者麻醉苏醒期躁动

目的观察术前置导尿管对中老年患者在全麻苏醒期躁动情况的影响，探寻适宜的术前置导尿管时机，提高医疗质量。方法100例胸外科全麻下行食管癌切除手术的中老年患者分为2组，对照组（n=50）在清醒状态下行导尿术，实验组（n=50）在全麻诱导后行导尿术，比较2组患者在全麻苏醒期的躁动程度和导管脱出率。结果实验组与对照组比较，前者躁动程度和导管脱出率均明显高于后者（P〈0．01）。结论中老年患者在全麻诱导后置导尿管可导致麻醉苏醒期躁动程度的明显增加和术后并发症发生率的提高，术前置导尿管术宜在全麻诱导前实施。     

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…     

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.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…