Carbon dioxide pneumoperitoneum causes severe peritoneal acidosis,unaltered by heating,humidification, or bicarbonate in a porcine model

Background Carbon dioxide (CO₂) is the most common gas used for insufflation in laparoscopy, but its effects on peritoneal physiology are poorly understood. This study looks at the changes in peritoneal and bowel serosal pH during CO₂ pneumoperitoneum, and whether heating and humidification with or without bicarbonate alters the outcomes.Methods Twenty-one pigs divided into four groups as follows: (1) standard (STD) laparoscopy (n = 5); (2) heated and humidified (HH) laparoscopy (n = 6); (3) heated and humidified with bicarbonate (HHBI) laparoscopy (n = 5); and (4) laparotomy (n = 5). Peritoneal pH, bowel serosal pH, and arterial blood gas (ABG) were obtained at 15-min intervals for 3 h.Results Severe peritoneal acidosis (pH range 6.59–6.74) was observed in all laparoscopy groups, and this was unaltered by heating and humidification or the addition of bicarbonate. Bowel serosal acidosis was observed in all laparoscopy groups with onset of pneumoperitoneum, but it recovered after 45 minutes. No significant changes in peritoneal or bowel serosal pH were observed in the laparotomy group.Conclusion CO₂ pneumoperitoneum resulted in severe peritoneal acidosis that was unaltered by heating and humidification with or without bicarbonate. Alteration in peritoneal pH may conceivably be responsible for providing an environment favorable for tumor-cell implantation during laparoscopy.     

The effect of gas flow on the filtration performance of breathing system filters

When tested according to the European standard, the performance of breathing system filters is determined at a flow of 15 or 30 l.min-1 for filters intended for use with paediatric or adult patients, respectively. However, higher flows of gas may pass through a filter in some circumstances. The penetration of sodium chloride particles through seven different breathing system filters (three pleated hydrophobic and four electrostatic) was measured at five different flows ranging from 15 to 75 l.min-1. Penetration varied from 0.004% to 24.4% for the various filters at the different flows. Penetration increased by between 2 and 40 times for the different filters as the flow increased by a factor of five but this did not markedly alter the rank order of the filters in terms of performance. Testing to the standard provides a useful indication of relative performance at any flow.     

Utility of Prostaglandin in the Identification of Discontinuous Pulmonary Arteries by Echocardiography

We describe two distinct cases in which discontinuous pulmonary arteries were identified by echocardiography and color Doppler imaging. In both cases, perfusion of one or both pulmonary arteries was dependent on a patent ductus arteriosus. Establishment of the source of perfusion and the anatomy of the discontinuous pulmonary arteries were evident only after an infusion of prostaglandin had been initiated, thus demonstrating that its use was a key component in the identification of this disease entity.     

Discontinuous electrophoresis of glycosaminoglycans: A screening method for mucopolysaccharidoses

A modified discontinuous electrophoretic method for the separation of standard and urinary glycosaminoglycans has been reported. The merits of the method are the simple and easy to handle apparatus, non-requirement of elaborate cooling system, sensitivity and high reproducibility of the results and applicability of the method for the preliminary grouping of the MPS patients to reduce the number of enzyme assays to be done.     

常用生物黏附性高分子材料物理性质的比较试验

 目的　考察聚卡波菲等11种常用生物黏附性高分子材料的吸水性、黏附力等与制剂学有关的物理性质,为筛选处方提供可靠的依据。方法　采用离心沉降法以溶胀度为指标测定生物黏附性高分子材料的吸水性能,并且考察了高湿条件下它们的吸湿性;评价了生物黏附性高分子材料在水中分散后的流变学性质;采用简便称重法测定体外条件下不同生物黏附性高分子材料的切向黏附力和垂直方向黏附力。结果　考察的11种生物黏附性高分子材料中,溶胀度、吸湿性、黏度、黏附力均以聚卡波菲最大,同浓度下黏附力排列顺序为聚卡波菲、黄原胶、卡波沫(Carbopol 1342P)、卡波沫(Carbopol 974P)、甲壳素、卡波沫(Carbopol971P)、羟丙基甲基纤维素(Methacel K100M)、羧甲基纤维素钠、羟丙基甲基纤维素 (MethacelK15M)、明胶和阿拉伯胶。结论　吸水性、吸湿性、黏度及黏附力具有一定的相关性,可以用来筛选处方工艺。     

Isolation and Characterization of Rat Trophoblast Cells

ABSTRACT: Previous immunohistochemical studies of the rat placenta using specific alloantisera and/or monoclonal antibodies showed that the basal zone trophoblasts stained for Pa and A^a class I major histocompatibility complex (MHC) antigens and for the human SP1-related antigen. In an effort to isolate the basal zone trophoblast cells from the rat placenta, we used these markers to assess the degree of purification of the cells separated by density gradient centrifugation using either Ficoll-Hypaque or Percoll as the gradient medium. The cells were put either on the top or at the bottom of discontinuous density gradients in the range of 1.005-1.10 or/ml. The cell separation profiles for the two media were different. With Percoll, most of the trophoblast cells (80–95%) were collected at the density gradients 1.04/1.06 and 1.06/1.08, whereas with Ficoll-Hypaque, these gradients separated only a small fraction (4–23%) of the trophoblast cells, and most of them pelleted at the bottom of the tube. The trophoblast cells separated by Ficoll-Hypaque, however, showed fewer contaminant cells than those separated by the Percoll gradients.     

微量注射泵湿化对人工气道效果的观察

目的观察微量注射泵与传统湿化方法的效果，使之临床应用。方法选择150例机械通气患者，随机分为两组，统一表格记录，进行连续观察，将获得资料进行统计分析。结果微量注射泵组无发生刺激性咳嗽及痰阻、痰痂形成1例、气道粘膜损伤出血2例、肺部感染5例：传统组刺激性咳嗽67例、气道粘膜损伤出血10例、痰痂形成21例、痰阻16例、肺部感染26例。结论微量注射泵湿化是一种简单、安全、稳定、有效的方法，减少流程、提高效率。     

0．45％氯化钠溶液与灭菌注射用水在机械通气患者气道湿化中的对照研究

目的观察两种不同湿化液在建立人工气道机械通气患者气道湿化中的作用。方法将我院2009年1-4月心脏外科接受心脏手术治疗后行机械通气的患者40例,利用随机数字表随机分为A组和B组各20例,A组给予0．45％氯化钠溶液100ml加沐舒坦15mg气道湿化液,B组给予灭菌注射用水100ml加沐舒坦15mg作为气道湿化液,观察2组患者吸出痰液的量、颜色、黏稠度、患者的体温、肺部的听诊以及x线胸片情况。结果机械通气后4、8、16、24h及l～2、3～5、6．7d2组患者痰液的量、颜色、黏稠度、患者的体温以及x线胸片情况比较无显著差异,2组患者机械通气后4、16、24h,1-2、3-5、6-7d患者的肺部听诊隋况无显著差异,机械通气后8h的肺部的听诊情况B组优于A组。结论没有足够的依据认为0．45％氯化钠溶液100ml加沐舒坦15mg和灭菌注射用水100ml加沐舒坦15mg作为气道湿化液在机械通气患者气道湿化中的作用效果不同。     

微泵持续湿化气道对气管切开患者的影响

目的比较气管内持续微泵推注湿化法与气管内间断滴药湿化法对患者的影响。方法采用随机分组法,观察组25例气管切开患者应用持续微泵推注湿化法湿化气道;对照组24例用气管内间断滴药湿化法湿化气道,2组进行回顾性对照研究。结果观察组患者的血氧饱和度较对照组明显增加,痰痂形成、刺激性咳嗽、气道出血、肺部感染较对照组明显降低,两者比较,差异明显。结论持续性气管内滴药法的效果优于传统的间断气管内滴药法,且可明显节省气道湿化的护理工作量。     

持续加氧气道湿化在胸外科应用的效果观察

目的:探讨间断滴注气道湿化法与持续加氧微泵气道湿化法对胸外科患者治疗效果及并发症预防的不同效果。方法:将48例未使用呼吸机或已停机的气管切开患者随机分为两组,观察两组患者生命体征、痰液性状以及并发症的情况。结果:持续加氧微泵气道湿化法的湿化效果、对生命体征的影响以及并发症等方面明显优于间断滴注气道湿化法(P<0.05)。结论:持续加氧微泵气道湿化可改善患者的舒适度、减少并发症,缩短带管时间等优点。