七氟烷吸入麻醉对老年腹腔镜手术患者血流动力学和术后认知功能的影响

近年来研究发现吸入麻醉药应用后会对患者,特别是老年患者产生术后认知功能障碍,从而影响患者的康复[1].七氟烷是一种血气分配系数低、麻醉诱导迅速、苏醒快、对血流动力学影响较小的吸入麻醉药,近年来在临床上应用日趋广泛[2].本研究观察七氟烷和异氟烷吸入麻醉对老年患者血流动力学和术后认知功能的影响,现报告如下.     

AMPA对吸入麻醉药催眠、镇痛作用的影响

目的探讨AMPA(α-amino-3-hydroxy-5-methyl-4-isox-azolepropionic acid,AMPA)对吸入麻醉药恩氟烷、异氟烷、七氟烷催眠、镇痛作用的影响。方法建立小鼠腹腔注射吸入麻醉药催眠、镇痛模型,在催眠和热板法实验中分别观察侧脑室(intracerebroventricular,icv)或鞘内(intrathecal,it)注射不同剂量的AMPA对小鼠睡眠时间(sleep time,ST)和热板法痛阈值(pain threshold in hot-plate test,HPPT)的影响。结果催眠实验中,AMPA50、75、100ng组的ST与aCSF组相比,差异无统计学意义(P>0.05)。镇痛实验中,aCSF及AMPA0.25、0.5、1.0ng it对正常对照组小鼠的HPPT均无影响(P>0.05)。AMPA0.25、0.5、1.0ng it剂量依赖性地降低吸入麻醉药镇痛小鼠的HPPT(P<0.05或P<0.01)。结论脑内的AMPA受体与吸入麻醉药恩氟烷、异氟烷、七氟烷催眠作用的关系不大,脊髓的AMPA受体参与了吸入麻醉药恩氟烷、异氟烷、七氟烷的镇痛作用。     

麻醉废气对手术室医护人员焦虑情绪的影响

<正>麻醉药是能使整个机体或机体局部暂时、可逆性失去知觉及痛觉的药物。根据其作用范围可分为全身麻醉药及局部麻醉药,全身麻醉药根据给药方式不同,又可分为吸入麻醉药和静脉麻醉药~([1])。常见吸入性麻醉剂有:氧化亚氮、氟烷、七氟烷、异氟烷、地氟烷、恩氟烷等,麻醉药的患者暴露与职业暴露(手术室人员麻醉师、医师、护士等常暴露于此麻醉废气工作环境中)可对人体健康造成一定的     

士的宁敏感的甘氨酸受体对吸入麻醉药催眠和镇痛作用的影响

目的探讨士的宁(strychnine,Stry)敏感的甘氨酸受体(strychnine-sensitive glycine receptor,GlyR)与吸入麻醉药异氟烷、恩氟烷、七氟烷和乙醚催眠、镇痛作用的关系。方法建立小鼠腹腔注射吸入麻醉药催眠、镇痛模型,在催醒和热板实验中分别观察侧脑室(intracerebroventricular,icv)或鞘内(intrathecal,it)注射不同剂量士的宁对小鼠睡眠时间(sleeping time,ST)和热板疼痛指数(pain index in hot-platetest,HPPI)的影响。结果催醒实验中,士的宁1、2、4μg icv对上述4种吸入麻醉药的ST均无影响(P>0.05);热板实验中,士的宁0.1、0.2、0.4μg it能够剂量依赖性地减少吸入麻醉药恩氟烷、七氟烷和乙醚镇痛小鼠的HPPI(P<0.05,P<0.01);士的宁0.1μg it对异氟烷镇痛小鼠的HPPI没有影响(P>0.05),0.2、0.4μg it可减少异氟烷镇痛小鼠的HPPI(P<0.05,P<0.01)。结论士的宁敏感的甘氨酸受体是吸入麻醉药异氟烷、恩氟烷、七氟烷和乙醚镇痛作用的重要靶位,但与其催眠作用关系不大。     

七氟烷吸入麻醉用于小儿日间手术的观察和护理

目的总结568例七氟烷吸入麻醉在小儿日间手术中的观察和护理。方法面罩吸入8%七氟烷麻醉诱导,术中2%~3%七氟烷吸入维持。辅以骶管阻滞、臂丛神经阻滞或局部浸润麻醉。结果 568例患儿麻醉诱导和苏醒恢复迅速,循环呼吸影响小,并发症少,无1例发生严重麻醉并发症。结论七氟烷是小儿日间手术麻醉较理想的吸入麻醉药。     

咪达唑仑对异氟烷小鼠的镇痛、催眠作用的影响

<正>异氟烷(Isoflurane,Iso)是临床常用吸入麻醉药。有研究发现[1],GHB受体、神经元烟碱受体与吸入麻醉药的催眠作用有关,而NMDA、GlyR及AMPA与其镇痛作用有关,但是GABA受体与吸入麻醉药的镇痛作用的关系还不明确[2]。咪达唑仑(Midazolam,Mid)是一种含咪唑环的苯二氮     

γ-羟基丁酸受体与恩氟烷、异氟烷镇痛、催眠作用的关系

目的探讨γ-羟基丁酸(gamma-hydroxybutyric acid,GHBA)受体与吸入麻醉药异氟烷和恩氟烷催眠、镇痛作用的关系。方法建立小鼠腹腔和皮下注射吸入麻醉药催眠、镇痛模型。在催醒、热板和扭体实验中分别观察侧脑室(intracerebroventricular,icv)或鞘内(intrathecal,it)注射不同剂量GHBA受体拮抗剂NCS-382对小鼠睡眠时间(sleepingtime,ST)、热板疼痛指数(pain index in hot-plate test,HPPI)和扭体次数(writhing times)的影响。结果催醒实验中,NCS-3821、5、25μg icv均可使异氟烷和恩氟烷催眠小鼠的ST缩短(P<0.01);热板实验中,NCS-3821、5、25μg it对清醒和镇痛小鼠的HPPI没有影响(P>0.05);扭体实验中,皮下注射异氟烷和恩氟烷后引起小鼠的扭体次数减少(P<0.01),但NCS-3821、5、25μg it对清醒小鼠及镇痛小鼠的扭体次数均无明显影响(P>0.05)。结论γ-羟基丁酸受体是吸入麻醉药异氟烷和恩氟烷催眠作用的靶位之一,但与其抗热刺激伤害和抗化学内脏痛作用关系不大。     

七氟烷与地佐辛复合吸入麻醉用于宫腔镜电切术的效果分析

目的对应用七氟烷与地佐辛复合吸入方式对接受宫腔镜电切术治疗的患者实施麻醉的临床效果进行研究。方法选择在我院就诊的接受宫腔镜电切术治疗的患者92例,随机分为对照组和观察组,平均每组46例。采用七氟烷与舒芬太尼复合方式对对照组患者实施麻醉;采用七氟烷与地佐辛复合吸入方式对观察组患者实施麻醉。结果观察组患者麻醉起效时间、术后清醒时间、住院治疗总时间明显短于对照组;宫腔镜电切术麻醉效果明显优于对照组。结论应用七氟烷与地佐辛复合吸入方式对接受宫腔镜电切术治疗的患者实施麻醉的临床效果非常理想。     

七氟烷吸入麻醉对大鼠脑内cAMP含量的影响

七氟烷(sevoflurane)是一种新型吸入麻醉药,已在临床上广泛应用,然而其全麻作用的确切机制目前仍不十分清楚.3′,5′-环腺苷酸(cAMP)是最早发现的第二信使,也是cAMP信号转导系统中的关键环节.在中枢神经系统中,cAMP在某些神经递质引起的膜电位变化中起中介作用,并对某些神经递质起调制作用[1].本研究旨在观察七氟烷麻醉后大鼠不同脑区、不同时期cAMP含量的动态变化,探讨cAMP在七氟烷麻醉中的作用.     

小儿七氟烷麻醉苏醒期躁动的研究进展

七氟烷是临床常用的吸入麻醉药,具有镇静、镇痛作用,对呼吸和血流动力学影响轻微;其起效迅速,无刺激性等优点被国内外广泛地应用于儿科麻醉,但小儿苏醒期躁动的发生率高于成人.该文概括了七氟烷麻醉在小儿苏醒期躁动的原因及可能机制,重点论述了小儿在七氟烷麻醉苏醒期躁动的预防与治疗,以便为临床应用与研究提供参考.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.     

Biochemical and molecular characterisation of cubozoan protein toxins

Class Cubozoa includes several species of box jellyfish that are harmful to humans. The venoms of box jellyfish are stored and discharged by nematocysts and contain a variety of bioactive proteins that are cytolytic, cytotoxic, inflammatory or lethal. Although cubozoan venoms generally share similar biological activities, the diverse range and severity of effects caused by different species indicate that their venoms vary in protein composition, activity and potency. To date, few individual venom proteins have been thoroughly characterised, however, accumulating evidence suggests that cubozoan jellyfish produce at least one group of homologous bioactive proteins that are labile, basic, haemolytic and similar in molecular mass (42-46 kDa). The novel box jellyfish toxins are also potentially lethal and the cause of cutaneous pain, inflammation and necrosis, similar to that observed in envenomed humans. Secondary structure analysis and remote protein homology predictions suggest that the box jellyfish toxins may act as α-pore-forming toxins. However, more research is required to elucidate their structures and investigate their mechanism(s) of action. The biological, biochemical and molecular characteristics of cubozoan venoms and their bioactive protein components are reviewed, with particular focus on cubozoan cytolysins and the newly emerging family of box jellyfish toxins.     

Dose tolerability of chronically inhaled voriconazole solution in rodents

Invasive pulmonary aspergillosis (IPA) is a fungal disease of the lung associated with high mortality rates in immunosuppressed patients despite treatment. Targeted drug delivery of aqueous voriconazole solutions has been shown in previous studies to produce high tissue and plasma drug concentrations as well as improved survival in a murine model of IPA. In the present study, rats were exposed to 20 min nebulizations of normal saline (control group) or aerosolized aqueous solutions of voriconazole at 15.625 mg (low dose group) or 31.25 mg (high dose group). Peak voriconazole concentrations in rat lung tissue and plasma after 3 days of twice daily dosing in the high dose group were 0.85 ± 0.63 μg/g wet lung weight and 0.58 ± 0.30 μg/mL, with low dose group lung and plasma concentrations of 0.38 ± 0.01 μg/g wet lung weight and 0.09 ± 0.06 μg/mL, respectively. Trough plasma concentrations were low but demonstrated some drug accumulation over 21 days of inhaled voriconazole administered twice daily. Following multiple inhaled doses, statistically significant but clinically irrelevant abnormalities in laboratory values were observed. Histopathology also revealed an increase in the number of alveolar macrophages but without inflammation or ulceration of the airway, interstitial changes, or edema. Inhaled voriconazole was well tolerated in a rat model of drug inhalation.