阿曲库铵预注剂量的探讨

研究４组不同预注剂量的阿曲库铵对神经肌肉接头的阻滞效应。结果表明，随着阿曲库铵预注量逐渐增加，对肌颤搐抑制程度也逐渐增加，气管插管所需时间也逐渐缩短；当剂量增至０．０９ｍｇ／ｋｇ以上时，加大剂量并不相应地抑制肌颤搐，也不能缩短插管时间，而且对神经肌肉传导有一定影响，引起不良反应。因此推荐：预注０．０９ｍｇ／ｋｇ阿曲库铵３～５ｍｉｎ后再注入０．５１ｍｇ／ｋｇ的插管剂量为最佳选择。     

罗库溴铵、阿曲库铵和琥珀酰胆碱三药肌松作用的对照研究

全麻下组Ⅰ以罗库溴铵０ ．６ ｍｇ／ｋｇ 静注,组Ⅱ以阿曲库铵０ ．５ ｍｇ／ｋｇ 静注,组Ⅲ以琥珀酰胆碱１ ．５ ｍｇ／ｋｇ 静注。结果：气管插管条件,以琥珀酰胆碱组肌松作用最好,而罗库溴铵和阿曲库铵肌松作用相似;罗库溴铵组肌松起效时间、临床恢复时间和无反应时间分别为８６ ．２５ ±２７ ．１３ｓ 、２９ ．９０ ±６ ．２５ ｍｉｎ 和２０ ．８４ ±７ ．９５ ｍｉｎ ,介于其它两药之间。说明,罗库溴铵可为临床提供较好的气管插管条件,且无琥珀酰胆碱的诸多副作用。     

罗库溴铵在气管插管及肌松维持中的作用

目的观察静脉注射罗库溴铵时的气管插管条件、维持肌松过程和恢复过程,及其对循环的影响。方法将３２例择期手术病人,随机分为两组：Ⅰ组、Ⅱ组病人分别于静脉注射罗库溴铵后６０和９０秒钟进行气管插管。完成插管后将病人再分为两组（Ⅲ、Ⅳ组）,Ⅲ组间断静脉注射罗库溴铵维持肌松,Ⅳ组连续滴注罗库溴铵维持肌松。结果静脉注射罗库溴铵０．６ｍｇ／ｋｇ（２×ＥＤ９５）后６０秒钟和９０秒钟时的气管插管条件均为优良,神经肌肉阻滞程度分别是Ｔ１为（２３±２２）％,Ｔ４／Ｔ１为（２７±２８）％（６０秒钟）和Ｔ１为（６±１０）％,Ｔ４／Ｔ为（１７±１９）％（９０秒钟）,起效时间为２．３分钟。静脉注射罗库溴铵后心率、血压平稳。结论静注罗库溴铵（０．６ｍｇ／ｋｇ）后６０～９０秒钟均可为气管插管提供满意的肌松,术中间断静注或连续滴注均可维持满意的手术肌松,恢复过程无明显差别     

地氟醚对维库溴铵肌松作用的影响

目的　研究新型吸入麻醉药地氟醚对维库溴铵肌松作用的影响。方法　４０ 例ＡＳＡⅠ－ Ⅱ级择期腹部手术病人,随机分为两组,各２０ 例,两组均采用表面麻醉下静注芬太尼,异丙酚诱导插管。对照组以异丙酚持续静注维持麻醉,１５ｍｉｎ 后,静脉注射维库溴铵０．０５ｍｇ／ｋｇ ,地氟醚组在吸入６ ％ 地氟醚１５ 分钟后,静脉注射维库溴铵０ ．０５ｍｇ／ｋｇ,使用ＭＨＪ－ ２ 肌松监测仪监测ＴＯＦ情况。结果　对照组和地氟醚组起效时间分别为４．７２ ±１ ．３７ 和３ ．８２ ±１．０９ｍｉｎ,地氟醚组明显缩短,两组Ｔ１ 显现时间为１０ ．０８ ±２．４７ 和１７．３７ ±３ ．７８ｍｉｎ;Ｔ１２５％ 恢复时间为１９．８８ ±５ ．９１ 和２９ ．７８±５ ．７３ｍｉｎ;Ｔ１ 恢复９０％ 时间为３０ ．２５ ±５．２７ 和４９ ．４８±１２．６０ｍｉｎ 地氟醚组明显延长,两组恢复指数分别为１３ ．６７ ±３ ．５３ 和２２ ．８６ ±３ ．５８ｍｉｎ ,地氟醚组延长。结论　吸入１ＭＡＣ地氟醚能明显缩短维库溴铵起效时间,延长维库溴铵的临床作用和恢复时间。     

阿曲库铵预注剂量的探讨

研究４组不同预注剂量的阿曲库铵对神经肌肉接头的阻滞效应。结果表明，随着阿曲库铵预注量逐渐增加，对肌颤搞抑制程度也逐渐增加，气管插管所需时间也逐渐综合短；当剂量增至０．０９ｍｇ／ｋｇ以上时，加大剂量并不相应地抑制肌颤搞，也不能缩短插管时间，至神经肌肉传导有一定影响，引起不良反应。     

爱肌松与潘侃朗宁肌松作用的临床研究

４０例全麻患者随机分为４组，以观察爱肌松和潘侃朗宁肌松效应。神经肌肉接头功能监测结果表明，０．３ｍｇ／ｋｇ爱肌松的起效时间和维持时间２．４ｍｉｎ和６３ｍｉｎ，，０．１ｍｇ／ｋｇ潘侃朗宁的起效时间和维持时间分别为２．７ｍｉｎ和７０ｍｉｎ。上述剂量可满足气管插管和外科对肌松的需要。肌松剂注入前后未见血压、心率及血钾、血钠明显变化。     

阿曲库铵恢复期应用琥珀胆碱的肌松效应观察

目的观察在阿曲库铵阻滞恢复期应用琥珀胆碱的肌松效应及相互影响。方法23例择期眼科手术病人随机分为两组:在TOF肌松监测下,两组病人于诱导过程均应用琥珀胆碱(Ⅰ组1.5mg/kg,Ⅱ组1mg/kg)以施行气管内插管(TOF=0)。气管插管后T1恢复至75%时,静注阿曲库铵0.5mg/kg以维持肌松;当T1恢复至对照的50%时Ⅰ组静注琥珀胆碱1.5mg/kg,Ⅱ组1mg/kg。监测起效时间、临床肌松维持时间、50%恢复时间、75%恢复时间和肌松类型。结果Ⅰ组在阿曲库铵恢复期应用琥珀胆碱(RS),较诱导期应用琥珀胆碱(IS)起效时间明显延长(IS为0.7±0.3分钟,RS为1.8±0.4分钟);25%恢复时间缩短(IS为10.2±3.0分钟,RS为5.8±1.7分钟);50%恢复时间缩短(IS为12.8±4.0分钟,RS为7.8±2.6分钟)。Ⅱ组阿曲库铵恢复期应用琥珀胆碱,很少能达到满意的临床肌松效应。结论全麻中应用阿曲库铵后当T1恢复至50%时,加用琥珀胆碱并不延长其肌松恢复时间,但两者存在一定的拮抗作用,欲达到满意的肌松效果,琥珀胆碱剂量应增加至1.5mg/kg。     

异丙酚笑气氨氟醚用于腹腔镜胆囊切除术麻醉的临床探讨

对异丙酚、笑气、氨氟醚静吸复合麻醉用于腹腔镜胆囊切除术１４５例进行临床分析。静注芬太尼２～４μｇ／ｋｇ，异丙酚２ｍｇ／ｋｇ，卡肌宁０．５ｍｇ／ｋｇ诱导插管后，吸入４５％～６０％笑气，１％～２％氨氟醚，并间断静注异丙酚和卡肌宁加深麻醉和维持肌松。诱导后血压下降１．８５±０．５１ｋＰａ，插管后恢复到诱导前水平或略高，ＣＯ２人工气腹后５～１０ｍｉｎ血压升高１．４５±０．３９ｋＰａ，ＰＥＴＣＯ２上升０．５４３±０．０５９ｋＰａ，Ｐｐｅａｋ上升０．３９５±０．０５７ｋＰａ，ＴＶ下降１５０±４１．５ｍｌ，牵拉胆囊时无明显低血压及窦缓等胆心综合征，术毕迅速清醒，无严重意外及并发症发生。     

分枝杆菌多糖对小鼠造血功能的影响

观察了分枝杆菌多糖（ＭＰＳ）对环磷酰胺抑制ＢＡＬＢ／ｃ小鼠骨髓作用的影响。结果表明：给予ＣＰＡ使小鼠骨髓ＧＭ－ＣＦＵ抑制约３０％左右。１．０ｍｇ／ｋｇ的ＭＰＳ对ＧＭ－ＣＦＵ有促进作用（第１批实验ＣＰＡ对照组３１６．５±３４．６，实验１组４５４．５±１９．１，Ｐ＜０．０５；第２批实验ＣＰＡ对照组２０８．７±４３．７，实验２组４３７．８±５４．１，Ｐ＜０．０２）；而０．１５ｍｇ／ｋｇＭＰＳ无促进作用。在０．１５和１．０ｍｇ／ｋｇ剂量下，小鼠血清ＧＭ－ＣＳＦ活性水平明显提高；０．１５和１．０ｍｇ／ｋｇＭＰＳ可分别刺激小鼠每０．１ｍＬ血清产生５００Ｕ和８５０ＵＧＭ－ＣＳＦ。分析认为ＭＰＳ与日本的Ｚ－１００活性水平相当，这些作用可能通过激活单核或Ｔ细胞而间接产生。     

μ—硒化卡拉胶与亚硒酸钠在兔的吸收与分布比较

给兔灌胃Ｋａｐｐａ－硒化卡拉胶３８ｍｇ．ｋｇ＾－１和亚酸钠１ｍｇ．ｋｇ＾－１，结果显示μ－ＳｅＣ组血Ｓｅ水平的ＡＵＣ０－７２ｈ为１２．８９±３．１３ｍｇ．Ｌ＾－１．ｈ，显著高于亚硒酸钠组的８．６６±１．２０ｍｇ．Ｌ＾－１．ｈ（Ｐ＜０．０５）；μ－ＳｅＣ和亚硒酸钠组的Ｃｍａｘ分别为０．５５６±０．０８６ｍｇ．Ｌ＾－１和０．４９３±０．０９１Ｓｅｍｇ．Ｌ＾－１（ｐ＞０．０５），Ｔｍａｘ分别为４．６５±     

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…