硬膜外腔注入吗啡镇痛剂量的探讨

目的：探讨了吗啡用于硬膜外腔镇痛的最佳剂量。方法：择期腹部手术病人150例，随机分为三组，每组50例。A组硬膜外腔注入吗啡5μg/kg；B组硬膜外腔注入吗啡10μg/kg；C组硬膜外腔注入吗啡15μg/kg。观察三组病人的镇痛效果、镇痛持续时间及副作用的发生率。结果：三组病人术后镇痛效果均满意。术后镇痛持续时间：A组最短，B、C二组相似；A与B、C二组相比有差异（P＜0.01)。副作用：A、B二组相似（P＞0.05)；C组副作用明显大于A、B二组（P＜0.01)。结论：10μg/kg吗啡运用于术后镇痛，效果满意，副作用少，为最佳剂量。     

剖宫产术后自控镇痛两种用药方法比较

目的寻求一种副作用小,疗效确切的剖宫产术后硬膜腔微电脑控制泵(PCEA)的用药方法。方法选取有剖宫产指征的产妇114例按入院顺序分为A、B两组。A组57例为剖宫产术后硬膜外导管连接PCEA装置,给予持续注入0.01%吗啡。B组57例剖宫产术后连接PCEA装置,持续注入0.01%吗啡 0.125%布比卡因,观察其副作用、镇痛效果及阴道流血量。结果B组副作用比A组明显减少且镇痛效果好,其疗效与A组有显著差异。结论PCEA持续注入小剂量吗啡加布比卡因可减少吗啡用量,副反应少。     

不同给药方式的吗啡-氯胺酮用于老年人上腹部手术PCEA的观察

目的吗啡的硬膜外术后镇痛(PCEA)作用,早已得到公认,临床上也已广泛应用。为提高其镇痛质量,本资料旨在探讨老年人上腹部手术PCEA的安全有效,而且副作用少的用药方法。方法选择40例65岁以上的上腹部手术病人,ASAⅠ~Ⅱ级,麻醉方法均采用全麻复合硬膜外,术后施行PCEA。首先硬膜外腔注入2%利多卡因5ml,待出现麻醉平面后,静注咪唑安定3mg、芬太尼0·1mg、异丙酚15ml、阿曲库铵50mg进行麻醉诱导插管。术中麻醉维持采用间断静注咪唑安定、阿曲库铵,间断硬膜外腔注入0·75%布比卡因,持续静脉泵注异丙酚(15~25ml/h)。将病人随机分组,即A组(n=…     

硬膜外腔注入吗啡复合镇痛液对术后止痛效果观察

目的：对硬膜外腔注入吗啡复合镇痛液术后止痛效果及副作用进行观察;方法：随机将200例行腹部或下肢手术病人分为单纯吗啡组（B组）和吗啡复合镇痛液组（A组）,各100例,手术结束前15分钟,在硬膜外腔B组注入吗啡1．5mg加生理盐水至8ml,A组注入吗啡1．5mg ,氟哌利多2．5mg ,布比卡因15mg,东莨蓉碱0．3mg,加生理盐水至8ml,72小时内观察镇痛时间,镇痛程度,副作用（尿潴留,呼吸抑制,皮肤瘙, 恶心呕吐）,结果：A组的镇痛时间比B组长,A组的副作用比B组少,两组的镇痛程度无差异,结论：吗啡复合镇痛液是较为理想的术后止痛药,只要密切观察病人,具有较好的推广价值。     

镇痛泵用于术后镇痛的临床疗效观察

目的观察硬膜外腔单次注入2mg吗啡和止痛泵48h持续泵入10mg吗啡在术后镇痛中的应用,分析其镇痛效果及不良反应的发生情况。方法选择择期手术患者260例,随机分为A,B两组,A组于手术结束前硬膜外腔单次注入吗啡2mg（生理盐水稀释至10m1）后拔管,B组于手术结束前硬膜外导管接镇痛泵,其药物配方为吗啡10mg,氟派啶5mg,0．75％耐乐品150mg,加生理盐水至60ml,随访3d,记录镇痛效果,血流动力学变化及不良反应。结果A组患者镇痛时间10-20h。副作用包括呕吐42例;恶心严重35例,轻微38例。B组的镇痛时间48—96h。副作用包括呕吐0例;恶心严重0例,轻微35例,两组比较,B组镇痛效果明显优于A组,副作用B组明显少于A组。结论应用镇痛泵（PCEA）硬膜外持续给药镇痛效果明显优于一次性硬外膜给药。     

小儿硬膜外术后镇痛单次用药的可行性

目的评价硬膜外吗啡复合氟哌利多单次注入对小儿术后镇痛的效果及安全性。方法选择择期腹部或下肢手术的患儿60例，随机分为A、B、C3组，术毕A组硬膜外注入吗啡0.04-0.05mg／kg加入0．9％氯化钠10ml，B组硬膜外给予吗啡0．04-0．05mg／kg和氟哌利多0．03mg／kg加入0．9％氯化钠10ml，c组硬膜外给予吗啡负荷量20μg／kg后，以维持量2μg·kg^-1·h^-1持续注入，观察镇痛效果及副作用，术中监测血压、心率、呼吸频率及脉搏氧饱和度。结果3组间镇痛评分无统计学差异，但B组复合氟哌利多不良反应明显减少。结论硬膜外吗啡0.04＋0.05mg／kg复合氟哌利多0．03mg／k加入0．9％氯化钠10ml单次注入是小儿术后简单、实用而又安全有效的镇痛方法之一。     

食管癌术后病人自控镇痛临床观察

目的：观察食管癌手术采用硬膜外阻滞经静吸复合全麻与术后病人自控硬膜外镇痛（PCEA）不同药物配比的止痛效果。方法：50例40～75岁ASAⅠ-Ⅱ级开胸手术的食管病人，随机分为2组。A组：（n=25）用药：0．75％布比卡因20ml、吗啡10mg、氟哌利多10mg加生理盐水至100ml。B组：（n=25）用药：0．75％布比卡因20ml、芬太尼0．4mg、氟哌利多10mg加生理盐水至100nd。对比术后止痛效果并分别于手术当天、术后t、2天随访。结果：A组病人按键次数少，用药量少；B组病人按键次数多，用药量多。结论：A组病人镇痛效果好，皮肤瘙痒、恶心呕吐发生率高；B组病人病人镇痛效果稍差但是副作用发生率低。     

新斯的明联合氟哌利多对减少吗啡术后镇痛不良反应的观察

目的 探讨吗啡联合氟哌利多和新斯的明用于术后硬膜外腔镇痛时减少镇痛不良反应的影响.方法 选择ASA Ⅰ～Ⅱ级手术患者150例,随机分为三组,A组:吗啡2mg 氟哌利多2.5mg;B组吗啡2mg 新斯的明0.5mg;C组吗啡2mg 氟哌利多2.5mg 新斯的明0.5mg.分别在手术结束时注入硬膜外腔,观察用药后的镇痛效不,镇痛时间及并发症.结果 C组与A,B组相比,术后镇病时间明显延长,并发症显著减少(P<0.01).结论 吗啡复合氟哌刺多和新斯的明应用于术后硬膜外镇痛,既保留了吗啡的良好镇病作用,又能明显减少不良反应.     

臂丛神经阻滞加用地塞米松和小剂量吗啡用于术后镇痛的效果观察

目的 观察臂丛神经阻滞的局麻药液中加入地塞米松和小剂量吗啡用于术后镇痛的效果和副作用。方法 80例患者随机分为A、B、C、D四组。全部用肌间沟法臂丛神经阻滞，A组（n=20)注入0.5%布比卡因、2%利多卡因等量混合液25ml；B组（n=20)注入A组用药加地塞米松10mg(2ml)；C组（n=20)注入A组用药加吗啡2mg(0.2ml)；D组（n=20)注入A组用药加地塞米松10mg(2ml)、吗啡2mg(0.2ml)。结果 B、C、D组与A组相比起效时间显著缩短、镇痛时间显著延长，差异非常显著（P＜0.01)；而D组和B、C组相比镇痛时间又明显延长，差异非常显著（P＜0.01)；C组中有1例（5％）因发生恶心呕吐，其余多组无并发症发生。结论 臂丛神经阻滞的局麻药液中加入地塞米松和小剂量吗啡用于术后镇痛，镇痛时间长，效果可靠，副作用少，操作方便，经济实用。     

持续硬膜外输注用于腹部手术后镇痛的效果

目的　观察持续硬膜外输注吗啡、布比卡因、氟哌啶醇混合液用于腹部手术后镇痛的效果及副作用。方法　 1 0 0例腹部手术患者随机分为持续硬膜外镇痛组 (CCEA组 )和对照组 (M组 )。CCEA组术后保留硬膜外导管连接镇痛泵按 2ml/h持续输注低浓度吗啡、布比卡因、氟哌啶醇混合液镇痛 ,M组术毕单次给予吗啡 2mg 生理盐水 5ml后 ,拔出硬膜外导管。比较两组术后 4 8h内镇痛效果及副作用。结果　CCEA组在不同时间内镇痛差异无显著性 (P >0 0 5 ) ;M组差异有显著性。在 6～ 4 8h内CCEA组镇痛效果明显优于M组 ;CCEA组恶心呕吐明显少于M组。结论　术后持续硬膜外输注吗啡、布比卡因、氟哌啶醇混合液是腹部手术后可靠的镇痛方法 ,副作用少。     

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.     

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<正>As culture is the soul of a nation,the three books,"History of Chinese Philosophy,""History of Chinese Culture"and"History of Chinese Science and Technology"have demonstrated the superiority of our great Chinese culture,and its significant impact in the field of international culture.Both core value and practical value of the Chinese culture are very clear,reflected in the views of universe,nature,life,health,disease,and therapy and related considerations,concepts,and technical methods.