Normothermic cardiopulmonary bypass: effect on the incidence of persistent postoperative neurological dysfunction following coronary artery bypass graft surgery

We retrospectively reviewed the records of 250 consecutive patients undergoing coronary artery bypass graft surgery (CABG) from January 1994 through January 1996 to determine the incidence of persistent postoperative neurological dysfunction after CABG and to compare normothermic and moderate hypothermic cardiopulmonary bypass (CPB). Normothermic CPB was used in 128 patients (36°–37°C) and hypothermic CPB (27°–28°C) in 122 patients. Postoperative neurological dysfunction included focal motor deficits, delayed recovery of consciousness (>24h) after surgery, and seizures within 1 week postoperatively. Persistent neurological dysfunction was diagnosed if complete resolution had not occurred within 10 days of surgery. The incidence of persistent postoperative neurological dysfunction was 4.1% in the hypothermic CPB group and 2.3% in the normothermic CPB group. There were no statistically significant differences between the two groups (P=NS). These results suggest that normothermic CPB did not increase the incidence of persistent postoperative neurological dysfunction compared to hypothermic CPB.     

不同针刺手法调节体温效应机制研究概况

目的:介绍近年不同的针刺手法对体表温度调节效应的研究,并探讨其产生体温效应的机制。方法:从临床研究、实验研究等方面进行综述。结论:针刺穴位的作用及其疗效,随着手法引起的温度变化而不同,针刺补法引起体温升高,而泻法则引起体温下降。体表温度是由血液循环状态、交感神经兴奋程度和组织新陈代谢状态等多方面决定的,不同的针刺手法引起的皮肤温度变化与影响上述3个环节状态有关。     

Preparation and evaluation of temperature sensitive liposomes containing adriamycin and cytarabine

Temperature sensitive liposomes (TSL) containing adriamycin (ADM) and cytarabine (Ara-C) were prepared. ADM and Ara-C were selected as model compounds of amphiphilic and hydrophilic drug, respectively. Encapsulation efficiency of ADM entrapped into TSL was about twice greater than that of Ara-C. It might be due to different polarity of the drugs. Lipid compositions of TSL had no effect on the encapsulation efficiency of drugs. Thermal behavior of TSL using a differential scanning calorimetry (DSC) was also investigated. Phase transition temperature (T_c) of TSL was dependent on the lipid compositions of TSL.ADM broadened thermogram of TSL but Ara-C did not. However, T_c of TSL was not changed by any drug. Release rate of drugs was highly dependent on temperature. The release profile of ADM was similar to that of Ara-C. The maximum release rate of drugs from TSL was occurred at the near T_c and observed at 39–41°C for DPPC (Dipalmitoylphosphatidylcholine) only, 52–54°C for DSPC (Distearoylphosphatidylcholine) only, 41–43°C for DPPC and DSPC (3∶1), and 43–45°C for DPPC and DSPC (1∶1), respectively. Effect of human serum albumin (HSA) on the release rate of ADM was investigated. HSA had no significant effect on the release of ADM below T_c. However, ADM release from TSL was increased at the near and above T_c. The HSA-induced leakage of drug may result from the interaction of liposomal constituents with HSA structure at the near T_c. From the fact that the release profiles of ADM from freshly prepared TSL and stored TSL for 1 week at 4°C was not changed, the TSL was considered to be stable for at least 1 week at 4°C. Based on these findings, TSL may be useful to deliver drugs to preheated target sites due to its thermal behaviors.     

不同湿热环境下颅脑火器伤死亡因素分析

目的　研究高温高湿环境下颅脑火器伤后生命体征变化特点及死亡因素。　方法　杂种猫 3 2只随机分为 4组 ,火器伤后分别放入A (2 5℃、相对湿度 50 % )、B (3 5℃、相对湿度85% )、C(3 8℃、相对湿度 90 % )、D(40℃、相对湿度 95% )四种环境中。每隔 10min记录一次血压、脉搏、呼吸频率及体温 ,到 6h时结束实验。　结果　常温枪伤组实验过程中生命体征稳定 ,随着温度及湿度的增加 ,各组动物相同时相点的体温、呼吸及心率均明显不同 (P <0 .0 5)。A组、B组动物在伤后 6h内均无死亡。C组 1.5h开始死亡 ,至 5h动物全部死亡 ,平均生存时间为 3 .4h。D组 0 .5h开始死亡 ,至 2 .5h动物全部死亡 ,平均生存时间为 2 .0h。　结论　高温高湿环境对颅脑火器伤时的生命体征变化和死亡率影响显著     

热疗与放疗并用治疗体表恶性肿瘤的初步探讨

本文对12例体表恶性肿瘤病人采用放射治疗与微波加热治疗并用的方法取得了较好的效果,总有效率100%。     

Culturable and nonculturable bacterial symbionts in the toxic benthic dinoflagellate Ostreopsis lenticularis.

The toxic benthic dinoflagellate Ostreopsis lenticularis hosts a variety of symbiont bacterial flora. Laboratory cultured Ostreopsis clones require the presence of symbiotic Pseudomonas/Alteromonas bacterial strains for growth and toxicity development. Three culturable bacterial strains associated with Ostreopsis were identified as Pseudomonas/Alteromonas strain 1, Pseudomonas/Alteromonas strain 2 and Acinetobacter. Denaturing gradient gel electrophoresis (DGGE) analyses of extracted Ostreopsis associated bacterial DNAs indicated that there were three culturable and four non-culturable associated bacterial strains. The results presented here are the first report of the presence of unculturable bacterial symbionts in a toxic benthic dinoflagellate. Ostreopsis lost toxicity when exposed to elevated temperatures in the field and laboratory culture and subsequently recovered toxicity at reduced temperatures. Ostreopsis associated culturable Pseudomonas/Alteromonas bacterial strains were significantly reduced in dinoflagellate cultures exposed to elevated temperatures. The decreased toxicity of O. lenticularis exposed to elevated temperatures and their subsequent recovery of toxicity in periods of reduced thermal stress may have resulted from the effects of elevated temperature on the spectrum of culturable and unculturable bacterial species interacting with their Ostreopsis host.     

He—Ne激光治疗声带小结的机理研究

我院应用He－Ne激光治疗551例声带小结，取得较好疗效。为研究作用机理，我们进行了免疫功能测定、测温试验、He－Ne激光照射前后的间接喉镜检查、显微结构研究、抑菌试验和过氧化脂质测定。结果提示He－Ne激光照射治疗声带小结的机理为照射后喉部温度升高、血管扩张、血循环加快，从而增强局部营养，促进喉部粘膜生长、消除组织水肿，加速炎性渗出物和毒素的排泄。而He－Ne激光本身没有杀菌和抑菌作用。     

Maintenance of body temperature in elderly patients who have joint replacement surgery A comparison between the heat and moisture exchanger and heated humidifier

The effect of a heat and moisture exchanger on intra-operative aural canal (core) and mean skin temperatures was investigated in elderly patients who had elective total hip arthroplasty under general anaesthesia with artificial ventilation of the lungs. Group 1 (n = 20) did not receive any form of artificial humidification while in group 2 (n = 20) a heat and moisture exchanger was inserted in the breathing system and in group 3 (n = 20) the inspired gases were humidified and warmed at 40 degrees C by means of a heated humidifier. Time of surgery, intravenous fluid administration and operating theatre temperature were standardised. Mean (SD) aural canal (core) temperature decreased significantly in groups 1 and 2 (p less than 0.001), while there was a fall of 0.3 degrees C (0.6) in group 3, which was not significant. Mean skin temperature decreased during anaesthesia and surgery in both groups 1 and 2 (p less than 0.05), while it increased in group 3. There was a significantly greater loss of body heat in groups 1 and 2 compared with group 3 intra-operatively (p less than 0.001). We conclude tha a heat and moisture exchanger did not prevent the decrease in intra-operative body temperature in elderly patients.     

Lithium and 5-HT1A receptor sensitivity: a neuroendocrine study in healthy volunteers

The effect of lithium administration (800 mg daily for 7 days) on the neuroendocrine and temperature responses to the 5-HT_1A receptor agonist, gepirone, was studied in eight healthy male volunteers. Gepirone (20 mg orally) significantly increased plasma levels of prolactin, growth hormone, corticotropin and cortisol, and lowered oral temperature. None of these responses was significantly altered by lithium treatment. The results suggest that the ability of short-term lithium treatment to increase 5-HT-mediated neuroendocrine responses in humans is unlikely to be related to changes in the sensitivity of pre- or post-synaptic 5-HT_1A receptors.     

Regional differentiation of sympathetic activity during hypothalamic heating and cooling in anesthetized rabbits

Summary In anesthetized rabbits immobilized with succinyl choline, the discharges of sympathetic efferents supplying cutaneous and visceral regions were simultaneously recorded. The effects of thermal stimulation of the hypothalamic region were tested on the basis of the integrated discharges. During hypothalamic heating cutaneous sympathetic activity decreased, corresponding to increased ear blood flow, while visceral sympathetic activity increased. During hypothalamic cooling there was, on the average, no significant change of regional sympathetic activity. However, in single experimental periods an increase of cutaneous and a decrease of visceral sympathetic activity was found.The observed responses of regional sympathetic activity were compared with findings about regional cutaneous and intestinal blood flow under the same thermal stimulus and further with corresponding former investigations on regional blood flow and regional sympathetic activity during spinal thermal stimulation. It is suggested by this comparison that regional differentiation of sympathetic activity represents a specific thermoregulatory response of the vasomotor system mediated by the hypothalamic thermoregulatory center.