静脉输注高氧液体对全麻术后低氧血症的预防作用

目的:研究静脉输注高氧液体在预防全麻术后低氧血症中的作用,探索静脉液体给氧新途径.方法:选择正颌外科择期全麻手术患者60例,随机分为对照组(静脉输注普通平衡盐液)和预防组(输注高氧平衡盐液),每组均在全麻术后拔出气管导管5 min后输入液体,在输入前,输入后15、30、45、60 min监测动脉血气,同时观察患者血氧饱和度(SaO2)、心率(HR)、血压(BP)等指标变化以及有无不良反应.结果:对照组患者输注液体后不同时间,氧分压(PaO2)、SaO2均较输注前显著降低(P＜0.05);而预防组患者输注液体后,PaO2、SaO2逐渐增加,至60 min时与输注前相比有统计学差异(P＜0.05).预防组患者输注液体后,PaO2始终高于对照组并有统计学意义(P＜0.05),SaO2在输注后45、60 min显著高于对照组(P＜0.05).pH、二氧化碳分压(PaCO2)、HR、BP在输注前后及两组之间比较均无显著性差异.两组均无寒战、气栓、过敏等不良反应.结论:高氧液对全麻术后低氧血症有显著的预防作用,液体给氧为人体提供了一种全新的氧供途径.     

静脉输注高氧液治疗家兔单肺通气期间低氧血症

目的 探索高氧液对兔单肺通气期间低氧血症的治疗作用. 方法 家兔30只,随机分为对照组(C组)和高氧液组(H组)各15只. 单肺通气(OLV) 30 min后,对照组静脉输入9 g/L生理盐水100 mL,高氧液组输入高氧液100 mL. 输注完毕后,记录OLV前及OLV后30 min(治疗前)及静脉输液后10 min(治疗后) pH,PaO2,PaCO2, PvO2,SaO2及SvO2等指标. 结果与OLV前相比,两组单肺通气30 min后,SaO2 [(91.0±3.5)%, (91.0±2.9)%], PaO2[(10.7±1.2) kPa, (10.9±1.2)kPa], PvO2[(8.3±1.4) kPa, (8.3±1.5)kPa], SvO2[(57.0±2.3)%, (57.0±3.8)%]均明显下降,而PaCO2[(5.9±0.6) kPa, (5.6±0.6)kPa]显著升高(P<0.01);对照组在输液后10 min各指标仍呈下降趋势,高氧液组在治疗后SaO2(95.0±3.2)%, PaO2(11.9±1.5)kPa, PvO2(9.2±1.4)kPa, SvO2(63.0±3.1)%明显升高,与对照组相应各指标[(89.0±2.7)%, (10.3±1.1)kPa, (8.1±1.2)kPa, (55.0±3.1)%]相比有显著性差异(P<0.05). 结论 静脉输注高氧液对OLV期间低氧血症有明显的治疗作用.     

高氧液对急性呼吸窘迫综合征大鼠的治疗作用

目的 研究静脉滴注高氧液(HO)对油酸型急性呼吸窘迫综合征(ARDS)大鼠的治疗作用并探讨其作用机制.方法 以林格液为基液制备HO,将大鼠随机分为油酸组(A组),高氧液组(B组)和对照组(C组),每组各10只.A组和B组用油酸建立ARDS模型,C组注入等量生理盐水.B组于注射油酸30 min后经静脉给予HO.A组和C组给予等量林格液.各组分别在ARDS模型制备前(0 min)、注射油酸后30,60,120 min采血进行血气分析,120 min后处死动物取肺组织,测定各观察指标.结果 高氧液组经HO治疗后PaO2迅速提升,肺水肿减轻,MDA降低,SOD活力增加,镜下见肺组织损伤减轻.结论 氧化性肺损伤参与油酸性ARDS发病,高氧液对油酸型ARDS大鼠低氧血症有一定的治疗作用.     

静脉输氧治疗急性肺损伤的疗效观察

目的　探讨静脉输氧对急性肺损伤的疗效 ,评价其纠正急性肺损伤 /低氧血症的价值。方法　急性肺损伤患者 2 3例 ,高浓度面罩吸氧 2 h后仍然存在缺氧者即予静脉滴注高氧液 ,于静脉输氧 3 0 min、60 min进行动脉血气分析 ,与治疗前比较 ;对低氧血症未能纠正、进展为 ARDS者及时给予机械通气同时继续静脉输氧。结果　 1 6例患者静脉输氧 3 0 min、60 min后动脉血氧分压明显升高 ( P <0 .0 0 0 1 ) ,氧合指数改善 ( P <0 .0 0 0 1 ) ;对 7例进展为 ARDS的患者及时给予机械通气同时继续静脉输氧 ,其中 5例低氧血症纠正并最终撤机。结论　静脉输氧可以改善急性肺损伤患者的缺氧 ,不会导致二氧化碳潴留加重 ,疗效较好。     

高氧液辅助治疗术中老年患者低氧血症的临床观察

目的:观察高氧液辅助治疗术中老年患者低氧血症的效果。方法:采用历史对照研究,对硬膜外麻醉的老年患者,术中38例发生低氧血症患者采用高氧液辅助治疗,同时选择40例采用传统单纯鼻塞给氧的老年术中低氧血症患者作为对照组,比较两组患者术中治疗前、治疗30 min及手术后各时段生命体征及PaO2、SpO2变化,并记录术后并发症。结果:研究组治疗后PaO2、SpO2较治疗前明显升高,而对照组无明显变化,研究组与治疗前、对照组比较,差异有统计学意义(P<0.05)。两组HR、SBP比较无明显变化(P>0.05)。研究组术后低氧血症发生率为2.63%,对照组术后低氧血症发生率为22.5%;研究组发生率明显低于对照组,组间比较差异有统计学意义(P<0.05)。结论:高氧液给氧技术作为氧疗的有效辅助手段,适用于硬膜外麻醉术中低氧血症老年患者的救治,可有效改善症状,降低术后并发症。     

高氧液对单肺通气低氧血症和肺内分流的影响

目的探讨双腔支气管内麻醉时,输入高氧液对单肺通气时低氧血症和肺内分流(Qs/Qt)的影响。方法选择食管中段癌根治手术20例,随机分为两组,N组(对照组)10例单肺通气时输入平衡液;O组(高氧液组)10例单肺通气时输入高氧平衡液。分别于麻醉前、双肺通气(DLV)30min、单肺通气(OLV)30min抽取动脉血和混合静脉血做血气分析,并计算Qs/Qt等。结果OLV时O组动脉血氧饱和度(SaO2)显著高于N组(P<0.01),O组动脉血氧含量(CaO2)显著高于N组(P<0.05)。OLV时,Qs/Qt较DLV时显著增加(N组P<0.01;O组P<0.05),但两组间比较差异无显著性。结论静脉输注高氧液可以明显升高SaO2和CaO2,高氧液对Qs/Qt的影响不明显。单肺通气时输注高氧液可能对低氧血症有利。     

静舒氧预防老年腹部手术硬膜外阻滞后低氧血症

目的探讨静舒氧对老年患者硬膜外阻滞用于腹部手术早期低氧血症的防治效果。方法40例腹部手术的老年患者,均采用硬膜外阻滞方法,随机分为对照组(I组)20例,静舒氧组(II组)20例。I组呈无吸氧状态,静脉输入林格氏液,II组在静脉穿刺成功后采用静舒氧[(静舒氧∶林格氏液(ml)=1∶1]进行输液给氧。两组患者均连续监测脉搏血氧饱和度(SPO2)、血压(Bp)、心率(HR)。分别记录麻醉毕(T0)、麻醉后5min(T1)、麻醉后10min(T2)、麻醉后20min(T3)、麻醉后30min(T4)SPO2、Bp、HR的变化,并对两组结果进行比较。结果I组SPO2明显低于II组(P<0.01),两组生命体征比较无显著性差异(P>0.05)。结论静舒氧预防老年患者腹部手术硬膜外阻滞后的低氧血症有较大的临床意义,值得推广。     

舒氧康静脉给氧预防术后低氧血症

目的探讨舒氧康静脉给氧对老年病人术后早期低氧血症的防治效果.方法40例行腹部手术的老年患者,随机分为对照组(Ⅰ组)20例和实验组(Ⅱ组)20例.Ⅰ组病人从离开手术室到转送回病房共20分钟不吸氧;Ⅱ组病人离开手术室即开始在平衡盐液中使用舒氧康以6ml/kg,输注速度为0.3ml/(kg@min)进行输液给氧.两组病人均应用脉搏血氧饱和度监测仪连续动态监测SpO2.比较两组的脉搏血氧饱和度(SpO2)、血压(BP)、心率(HR)并进行统计学分析.结果对照组(Ⅰ组)脉搏血氧饱和度(SpO2)明显低于实验组(Ⅱ组)(P＜0.05),两组生命体征比较无显著性差异(P＞0.05).结论在手术后转送病房途中,由于不具备吸氧条件,老年病人容易发生低氧血症,舒氧康可以维持SpO2值,预防转送途中低氧血症的发生.     

高氧液预处理对兔脊髓缺血损伤的保护作用及机制

目的 :探讨高氧液预处理对兔脊髓缺血损伤是否有保护作用及氧自由基是否参与这种保护作用 .方法 :32只成年雄性新西兰兔随机分成 4组 (每组 8只 ) ,即对照组 (C组 )、高氧液预处理组 (H组 )、二甲基硫脲 (DMTU ,自由基清除剂 ) +高氧液预处理组 (D +H组 )及DMTU组 (D组 ) .H组每天静脉给予 1 0mL·kg-1 高氧液 ,2 0min匀速泵完 ,连续 5d ;C组用同样方法给予等容量生理盐水 ;D +H组在每次高氧液预处理前 1h静脉给予 5 0 0mg·kg-1 DMTU ,其他处理同H组 ;D组每天静脉给予 5 0 0mg·kg-1 DMTU ,连续 5d .最后一次预处理结束后 2 4h ,夹闭所有动物腹主动脉肾下段 2 0min ,制作兔脊髓缺血模型 .再灌注后 4 8h ,对所有动物神经功能评分 ,然后处死动物取脊髓 (L5 7) ,制作标本行组织病理学观察 .结果 :H组的神经功能评分和脊髓前角正常神经细胞数明显多于C组、D +H组及D组 (P <0 .0 5 ) ;C组、D +H组及D组的神经功能评分和脊髓前角正常神经细胞数组间无明显差异 (P >0 .0 5 ) ;神经功能评分与其对应脊髓前角正常神经细胞计数之间有显著相关性 (r =0 .80 4 ,P <0 .0 1 ) .结论 :高氧液预处理对兔脊髓缺血再灌注损伤有明显的保护作用 ,氧自由基可能参与这种保护作用     

增氧呼吸器在模拟缺氧条件下对血氧饱和度和心率的影响

目的:探讨在模拟缺氧条件下增氧呼吸器对人体血氧饱和度和心率的影响. 方法:16名受试者在低压舱中(模拟海拔5000 m)进行运动负荷试验,随机分为2组(n=8):A组佩戴使用增氧呼吸器,B组不使用仪器. 分别检测血氧饱和度(SaO2)和心率. 结果:与B组比较,A组SaO2值明显增加(P<0.05),心率的变化则没有显著性差异. 运动负荷结束后3 min及5 min心率恢复速度两组之间的差异有统计学意义(P<0.05). 结论:增氧呼吸器能有效地促进高原习服过程,提高和改善低氧条件下人体的劳动能力.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.