Effect of diltiazem and lidocaine on arterial pressure or heart rate and the quality of extubation in patients undergoing uvulopalatopharyngoplasty

Objective：To evaluate the effect of diltiazem and lidocaine on arterial pressure or heart rate and the quality of extubation in patients undergoing uvulopalatopharyngoplasty. Methods： Sixty patients were randomly divided into 4 groups： In the control group patients were given saline; in the lidocaine group patients were given 1.0 mg/kg lidocaine ; in the diltiazem group patients were given 0. 2 mg/kg diltiazem; and in the lidocaine plus diltiazem group patients were given 1.0 mg/kg lidocaine and 0. 2 mg/kg diltiazem. These drugs were given 2 rain before tracheal extuhation. Values for SBP, DBP, and HR were recorded, on arriving at the operating room, immediately at the end of the surgery, at the time of injection of the study drugs, at tracheal extubation, at 1 min and 5 min after extubation. The quality of extubation according to the Sebel＇s grading scale were compared among the 4 groups. Results：During extubation in the control group HR, SBP and DBP increased significantly when compared to baseline levels. Both lidocaine （1.0 mg/kg） and diltiazem （0. 2 mg/kg） successfully alleviated these increases. The suppressive effect of diltiazem was greater than that of lidocaine. The combinative use of the two drugs minimized the increases. The administration of lidocaine significantly suppressed bucking or coughing compared with the other groups. Conclusions： The pressor responses and tachycardia occurring in patients with uvulopalatopharyngoplasty during emergence from anesthesia and tracheal extubation, can be easily blocked by a bolus dose of 1.0 mg/kg lidocaine, 0. 2 mg/kg diltiazem or the comhinative use of the two drugs. And the concurrent use of lidocaine and diltiazem alleviated the hemodynamic changes more obviously.     

Acute and Sub-chronic Toxicity of Tetrandrine in Intravenously Exposed Female BALB/c Mice

Objective: To evaluate the acute and sub-chronic toxicity of intravenously administered tetrandrine(TET) in female BALB/c mice. Methods: The median lethal dose(LD_(50)) of intravenously administered TET was calculated in mice using Dixon's up-and-down method. In the acute toxicity study, mice were intravenously administered with TET at a single dose of 20, 100, 180, 260 and 340 mg/kg, respectively and were evaluated at 14 days after administration. In the sub-acute toxicity study, mice were intravenously administered various doses of TET(30, 90 and 150 mg/kg) each day for 14 consecutive days. Clinical symptoms, mortality, body weight, serum biochemistry, organ weight and histopathology were examined at the end of the experiment, as well as after a 1-week recovery period. Result: LD_(50) was found to be 444.67±35.76 mg/kg. In the acute toxicity study, no statistically significant differences in body weight, blood biochemistry, or organ histology were observed between the administration and control groups when mice were intravenously administered with single dose at 20, 100, 180, 260 and 340 mg/kg of TET(P0.05). In the sub-acute toxicity study, no significant changes in body weight, biochemistry and organ histology were observed with up to 90 mg/kg of TET compared with the control group(P0.05), however, in the 150 mg/kg administered group, TET induced transient toxicity to liver, lungs and kidneys, but withdrawal of TET can lead to reversal of the pathological conditions. Conclusions: The overall findings of this study indicate that TET is relatively non-toxic from a single dose of 20, 100, 180, 260 or 340 mg/kg, and that up to 90 mg/kg daily for 14 consecutive days can be considered a safe application dose.     

Beneficial Effects of Nicorandil on Lidocaine Intoxicity

It was demonstrated that nicorandil 50 and 100 mg/kg intravenously orintraperitoneally could prevent the intoxication of lidocaine and decrease itsmortality rate,furthermore nicorandil 50mg/kg,if combined with 5 mg/kgdiazepam,had a synergetic prophylactic effect against lidocaine toxicity,and thistoxicity could be effectively antagonized by 100 mg/kg of nicorandil in mice.Itwas found that the tolerant dose of lidocaine was elevated by nicorandil 100mg/kg intraperitoneally in rats.     

The Effects of organic Ligands on the Survival of Daphnia in Zn Solution

Bioassays involving zinc alone and in combinations with two organic ligands, namely histidine and EDTA were conducted on Daphnia longisphna over a period of 96 h. The percentage of mortality was recorded and the Median Lethal Concentration (LC_(50)) at 96 h estmated. The 96 h LC_(50) of D. longispina in zinc solution was 91 μg/1 whereas no values of LC_(50) were revealed when D. longispina were exposed to histidine or EDTA alone although the organic ligands seemed to exert harmful effects (e.g. The mortality at 96 h was 18% at a concentration of 10×10~(-5) M histidine and 16% at a concentration of 6×10~(-6) M EDTA). However, addition of histidine and EDTA effectively reduced the toxicity of zinc to the test animals. The detoxification effect was the most obvious at the concentration of 100 μg/1 Zn added with 5×10~(-5) M histidine and 3×10~(-6) M EDTA where 7-fold and 5-fold reduction in terms of mortality were noted.     

Effect of combined spinal-epidural anesthesia for caesarean section on maternal and neonatal rennin-angiotensin-aldosterone system

Objective To assess the effect of combined spinal-epidural anesthesia (CSEA) for caesarean section on maternal and neonatal rennin-angiotensin-aldosterone system (RAAS). Methods Sixty ASA I primiparae aged 22-29 yr, weighing 46 - 83 kg, scheduled for elective caesarean section were randomized into epidural anesthesia group (EA, n = 30) and combined spinal-epidural anesthesia group ( CSEA, n = 30). All patients were premedicated with intramuscular atropine 0. 5 mg and phenolbarbital 100 mg. In CSEA group a 26 G/16 GChina Medical Abstracts (Surgery) single use spinal/epidural needle (B- D) was used. Spinal and/or epidural anesthesia was performed at L2-3 interspace and a catheter was threaded into the epidural space cephalad for 3 - 5 cm in both groups. In EA group a loading dose of 12 - 16 ml 2 % lidocaine was given and an additional 6-8 ml 2% lidocaine was injected when anesthesia became indadequate during the operation. In CSEA group 2.0-2.5 ml hyperbaric 0.5% bupivacaine (10 - 12.5 mg) was given intra     

Cartilage changes of femoral head osteonecrosis in stage Ⅱ and Ⅲ as detected by dGEMRIC

Objective To detect the cartilage changes of hip joint with osteonecrosis of femoral head (ONFH) in stages Ⅱ and Ⅲ and provide evidence for understanding cartilage changes of femoral head of osteonecrosis before collapse. Methods The cartilage changes of ONFH were determined by delayed gadolinium enhanced magnetic resonance imaging of cartilage (dGEMRIC). According to ARCO classification of ONFH, the samples were divided into three groups: Group A, 11 hips, stageⅡ; Group B,13 hips, stage Ⅲ; Group C, 10 hips, normal. All participates underwent the tests by dGEMRIC. And the data of T1Gd were collected and analyzed. Results The values of T1Gd were 420 ±60 (Group A) ,361 ±54(Group B) and 538 ±26 (Group C) respectively. There was a significant difference among three groups.The values of T1Gd in the ONFH patients were lower than their healthy counterparts. The values of T1Gd of Group B was 14% lower than those of Group A. And the difference was significant statistically. Conclusion Cartilage of the femoral head undergoes abnormal metabolic changes before collapse. There is a loss of GAG in the cartilage and it aggravates with the worsening of ONFH.     

Cartilage changes of femoral head osteonecrosis in stage Ⅱ and Ⅲ as detected by dGEMRIC

Objective To detect the cartilage changes of hip joint with osteonecrosis of femoral head (ONFH) in stages Ⅱ and Ⅲ and provide evidence for understanding cartilage changes of femoral head of osteonecrosis before collapse. Methods The cartilage changes of ONFH were determined by delayed gadolinium enhanced magnetic resonance imaging of cartilage (dGEMRIC). According to ARCO classification of ONFH, the samples were divided into three groups: Group A, 11 hips, stageⅡ; Group B,13 hips, stage Ⅲ; Group C, 10 hips, normal. All participates underwent the tests by dGEMRIC. And the data of T1Gd were collected and analyzed. Results The values of T1Gd were 420 ±60 (Group A) ,361 ±54(Group B) and 538 ±26 (Group C) respectively. There was a significant difference among three groups.The values of T1Gd in the ONFH patients were lower than their healthy counterparts. The values of T1Gd of Group B was 14% lower than those of Group A. And the difference was significant statistically. Conclusion Cartilage of the femoral head undergoes abnormal metabolic changes before collapse. There is a loss of GAG in the cartilage and it aggravates with the worsening of ONFH.     

Comparison between the Effects of Intraperitoneal Injection of LDL and Intravenous Injection of LDL on Arterial Endothelial Cells Apoptosis

To observe the effect of oxidized low density lipoprotein (OxLDL) on arterial endothelialcells apoptosis in vivo, we established a model in which Sprague-Dawley rats were given intraperi-toneal and intravenous injection of unmodified LDL (8 mg/kg every day) via the tail vein. Sevendays after the injection, the aortic endothelial cells specimens were prepared by an en face preparationof rat aorta. The apoptotic cells were identified and counted by in situ nick and labelling (TUNEL)method and light microscopy. The numbers of the apoptotic cells were 12.52±4.71/field in the in-traperitoneal injection control group, 11.41±2.94/field in the intravenous injection control group,22.98±8.01/field in the intraperitoneal injection LDL group and 103.8±11.5/field in the intra-venous injection LDL group, respectively. The difference was significant between injection LDLgroup and control (P<0.01), and the difference was also significant between two LDL injectiongroups (P<0.01). These findings suggest that injectio     

Effects of mixture of lidocaine and ropivacaine at different concentrations on the central nervous system and cardiovascular toxicity in rats

Background Lidocaine and ropivacaine are often combined in clinical practice to obtain a rapid onset and a prolonged duration of action. However, the systemic toxicity of their mixture at different concentrations is unclear. This study aimed to compare the systemic toxicity of the mixture of ropivacaine and lidocaine at different concentrations when administered intravenously in rats. Methods Forty-eJght male WJstar rats were randomly divided into 4 groups （n=12 each）： 0.5% ropJvacaine （group Ⅰ）; 1.0% ropivacaine and 1.0% lidocaine mixture （group Ⅱ）; 1.0% ropivacaine and 2.0% lidocaine mixture （group Ⅲ）; and 1.0% lidocaine （group Ⅳ）. Local anesthetics were infused at a constant rate until cardiac arrest. Electrocardiogram, electroencephalogram and arterial blood pressure were continuously monitored. The onset of toxic manifestations （seizure, dysrhythmia, and cardiac arrest） was recorded, and then the doses of local anesthetics were calculated. Arterial blood samples were drawn for the determination of local anesthetics concentrations by high-performance liquid chromatography. Results The onset of dysrhythmia was later significantly in group IV than in group Ⅰ, group Ⅱ, and group Ⅲ （P 〈0.01）, but there was no significant difference in these groups （P 〉0.05）. The onset of seizure, cardiac arrest in group Ⅰ （（9.2±1.0） min, （37.0±3.0） min） was similar to that in group Ⅱ（（9.1±0.9） min, （35.0±4.0） min） （P 〉0.05）, but both were later in group Ⅲ （（7.5±0.7） min, （28.0±3.0） min） （P 〈0.05）. The onset of each toxic manifestation was significantly later in group Ⅳ than in group Ⅰ （P 〈0.01）. The plasma concentrations of the lidocaine-alone group at the onset of dysrhythmia （DYS）, cardiac arrest （CA） （（41.2±6.8） min, （59.0±9.0） min） were higher than those of the ropivacaine alone group （（20.5±3.8） min, （38.0±8.0） min） （P 〈0.05）. The plasma concentrations of ropivacaine inducing toxic manifestation were not significantly different among groups Ⅰ, Ⅱ, and Ⅲ（P 〉0.05）. Conclusions The systemic toxicity of the mixture of 1.0% ropivacaine and 2.0% lidocaine is the greatest while that of 1.0% lidocaine is the least. However, the systemic toxicity of the mixture of 1.0% ropivacaine and 1.0% lidocaine is similar to that of 0.5% ropivacaine alone.     

Protective effects of lidocaine injected into the hepatoduodenal ligament on warm ischemia-reperfusion injury to the rat liver

Background Ischemia-reperfusion (IR) injury to the liver is still a critical and daunting problem in the field of hepatobiliary surgery. Ischemic preconditioning (IP) of the liver serves as an effective approach against IR injury. This study was to develop a novel procedure that could mimic IP, but might be more feasible than IP during surgery. Methods Eighty-two SD rats were randomly divided into 5 groups. L group （n=21）: 0.4% lidocaine (10 mg/kg) was injected into the hepatoduodenal ligament 10 minutes before a 40-minute hepatic IR. IP group （n=16）: a 5-minute ischemia was followed by a 10-minute reperfusion prior to a 40-minute hepatic IR. ILR group （n=15）: after a 40-minute ischemia of the liver, 0.4% lidocaine (10 mg/kg) was injected into the hepatoduodenal ligament 10 minutes prior to a 40-minute reperfusion of the liver. IR group （n=15）: the liver of the rat was subjected to a 40-minute IR. Control group （n=15）: 0.9% sodium chloride was injected into the hepatoduodenal ligament without other treatments. The levels of plasma alanine transaminase (ALT) and aspartate transaminase (AST) were determined for each group after treatment. Results The mean concentrations of ALT and AST were (379.80±141.69) U/L and (606.05±220.26) U/L for the L group, (334.64±141.94) U/L and (625.68±267.06) U/L for the IP group, (523.36±170.35) U/L and (765.47±238.45) U/L for the ILP group, (524.29±163.59) U/L and (764.63±246.79) U/L for the IR group, and (150.90±27.05) U/L and (298.15±47.68) U/L for the control group (standard error of the mean). Conclusion A significant decrease in ALT and AST levels was observed in the L and IP groups when compared to the ILR and IR groups (P&lt;0.05), but no significant difference in ALT and AST levels was observed in the L group when compared to the IP group (P&gt;0.05). These results suggest that pretreatment with lidocaine injected into the hepatoduodenal ligament prior to IR provides effective protection against subsequent IR injury to the liver. The novel approach of blocking innervation with lidocaine mimics hepatic IP, but is more convenient than IP at the time of liver surgery.     

经络腧穴理论的形成与发展

从<脉书·十一脉><黄帝内经>等文献人手,梳理了血气、经络、腧穴理论的形成与发展,简要介绍了四肢部的基本腧穴、躯体部要穴,以及腧穴配伍的基本要义.     

神经病学与神经解剖学优化整合的评价与分析

目的评价神经病学与神经解剖学优化整合教学法的教学效果,寻找存在的问题及解决对策,为今后的神经病学教学改革提供参考。方法采用问卷调查、访谈的方式,分析神经病学教改后的教学效果、对学生学习态度的影响、教学中存在的不足。结果教改班的教学效果、对学生学习态度的改善优于非教改班(P<0.01)。结论神经病学与神经解剖学优化整合的教学改革效果显著,达到了预期的目的。     

载脂蛋白的结构和功能与病毒病的预防和治疗

载脂蛋白（apo）是脂蛋白的重要组成成分,其主要功能是调节酶活性,介导细胞受体与脂蛋白结合,保持脂蛋白结构的稳定性。目前已发现数十种载脂蛋白,其结构的显著特点是分子中具有多个双性alpha螺旋及Beta-折叠结构。载脂蛋白的这种双性alpha螺旋结构是其结合及转运脂质的结构基础。在HIV外壳结构中的一种糖蛋白（gP）也具有这种alpha螺旋结构。近年研究表明,载脂蛋白和由载脂蛋白组成的脂质体还具有抗肝炎病毒、抗HIV病毒、抗单纯疱疹和中和细菌内毒素的功能。以脂蛋白和载脂蛋白为主要成分构成的脂质体已成为运载抗病毒和抗肿瘤药物受体的靶向性载体。     

新生儿游泳对生长发育的影响研究

目的:探讨新生儿游泳的护理以及对生长发育的影响。方法:按照知情同意制度,选取125例实施游泳的新生儿为观察组,随机选取同期未游泳的新生儿为对照组(125例)。观察两组新生儿出生后42d头围、生长和体重的变化,比较两组生后7d、15d和28d的24h摄乳量。结果:42d后游泳组的婴儿头围、生长、体重增长明显,特别是体重增幅较大,两组统计学有明显差异;游泳组摄乳量从第7天开始均高于对照组,出生后28d更是明显增多,有显著统计学意义。结论:游泳有利于新生儿增加摄乳量,促进新生儿体格发育。     

卵巢子宫内膜样癌的CT、MRI诊断与病理分析

目的：探讨卵巢子宫内膜样癌（OEC）的CT、MRI表现及病理基础。方法：回顾性分析经手术病理证实的8例OEC的CT、MRI表现,并与手术和组织病理学结果进行对照分析。结果：8例OEC位于左侧5例,右侧3例。肿瘤最大径4．5～17．5cm,平均9．2cm。全部肿瘤均呈囊实性,6例形态不规则呈分叶状,2例呈圆形或卵圆形。肿瘤边界部分模糊7例,清楚1例。CT平扫：肿瘤实性成分cT值37～46Hu,平均4lHu,囊性成分cT值14～40Hu,平均25Hu;增强后肿瘤实性成分呈中等程度强化,动脉期cT值6l～77HIJ,平均66Hu,实质期cT值65～78HU,平均71HU。MR平扫：T2wI实性成分呈等信号,囊性成分呈低信号,T2wI实性成分呈稍高信号,囊性成分呈高信号,增强后肿瘤实性成分中等程度强化。8例OEC中合并子宫体内膜癌2例,其中l例经MRI检查,表现为子宫体部内膜不规则增厚,T2wI呈等信号,TnwI呈稍高信号,增强后呈中等程度强化,1例合并同侧卵巢巧克力囊肿。结论：CT、MRI能较好地反映OEC的病理特征,清晰显示肿瘤的形态、内部结构及邻近结构侵犯等情况,具有重要的定性价值,并为临床选择合理治疗方案提供依据。     

析议痰瘀同源、互结、同治

目的:探讨痰瘀相关,意在梳理痰瘀知识、并强调痰瘀相关的重要性。方法:通过多角度地分析、刍议"痰瘀同源"、"痰瘀互结"、"痰瘀同治"等痰瘀经典理论的方式论述痰瘀相关。结果:痰与瘀是中医界里重要的元素,痰与瘀互结是许多疾患共同的病机,痰瘀同治是常用治法。结论:痰瘀同源、互结、同治,不但在临床上有着实用的指导意义,又能与时俱进、在探究中创新。     

“医信融创”教育模式的构建与实践探索

从必要性、要求及实质3个角度梳理了“医信融创”教育的内涵,并在此基础上探索“医信融创”教育的模式。“医信融创”需要遵循由“融”到“创”的逻辑主线,通过“融行-融智-融心”的过程最后走向“创新”的目的。最后以山西医科大学的实践案例证明了“医信融创”教育的必然性和可行性。     

瘿病源流简析

以先秦两汉、隋唐、宋金元、明清四个时期,将瘿病的发展总结为理论奠基期、方药汇集期、方药充实期和应用发展期。通过对中国历代医学文献中有关瘿病内容的梳理,追溯有关瘿病理、法、方、药认识的历史,厘清前人对瘿病在不同历史时期的表述特点,以及前人对这一疾病认识的发展脉络,为现今中医药防治瘿病提供理论依据和启示。     

教考分离的实践与探索

通过对学校三个年级学生使用“基础医学课程国家试题库”后的情况分析,认为教考分离是今后考试工作的一个趋势。但目衣使用的试题库在知识点的构成,个别试题质量以及适应性方面有待改进。因此有必要建立适合我校的,反映最新学科进展的试题库,以利于提高教学质量。     

中国脊柱关节炎和强直性脊柱炎的规范监测和研究展望

脊柱关节炎和强直性脊柱炎是风湿病中青壮年致残率较高的常见疾病之一,近年来在定义、分类、诊断和治疗方面不断更新,但是,达标治疗还缺乏有效的策略.围绕近年研究热点,本文结合作者研究团队的我国脊柱关节炎和强直性脊柱炎的研究结果进行论述,以期为今后该类疾病的探索性基础和临床研究方向提供线索.