舒芬太尼用于全凭静脉麻醉40例研究

目的：探讨舒芬太尼全凭静脉复合麻醉时对听觉诱发电位指数、血流动力学和术后复苏的影响.方法：40例美国标准协会（ASA）Ⅰ～Ⅱ级病人择期行胆囊切除手术,随机分为Ⅰ组（舒芬太尼组）和Ⅱ组（芬太尼组）,记录两组病人麻醉期间各时间点的听觉诱发电位指数（AEPI）值、收缩压、舒张压、心率和SpO2.结果：Ⅱ组插管后1 min、2 min的收缩压较Ⅰ组升高,而插管后1 min的心率较Ⅰ组降低（P＜0.05）;Ⅰ组插管后1 min、2 min和3 min时的AEPI值低于Ⅱ组（P＜0.05）;Ⅰ组拔管后至定向力恢复的时间较Ⅱ组长（P＜0.05）;Ⅰ组丙泊酚的用量较Ⅱ组少（P＜0.05）.结论：等效剂量的舒芬太尼较芬太尼的全凭静脉复合麻醉可以使病人达到更为合适的麻醉深度,并能使血流动力学更加稳定,同时可减少丙泊酚用量.     

全胃切除消化道重建术中空肠储袋的临床研究进展

全胃切除术是常见的胃癌根治术之一。尽管消化道重建的方式繁多，但何种最好尚无定论。经检索近年来有关全胃切除后的消化道重建临床研究报道，主要介绍不同空肠肠袋、Roux-en-Y重建术式的优劣。结果表明，空肠肠袋、Roux—en—Y重建术式并不显著增加手术病死率和并发症发生率，能够改善术后早期食物摄入和体重增加。多数报道认为有利于提高术后生活质量。肠袋重建并未增加手术的风险，而且在早期能改善食物摄入，增加体重，有利于患者术后恢复，一定程度上提高患者生活质量。而患者术后长期效果，由于其影响因素涉及范围广，如地区差异和经济条件等，故要得出一精确结论还有待于进一步的探索。现就非十二指肠径路的主要方式及效果作一简述。     

Heat and moisture exchangers as a treatment option in the post-operative rehabilitation of laryngectomized patients

A multi-institutional, prospective clinical study was undertaken to investigate whether the use of a heat and moisture exchanger (HME) in the period following total laryngectomy could prevent the development or reduce the severity of respiratory symptoms. Fifty-nine patients from three hospitals were provided with HMEs, either immediately post-surgery or, in the case of post-surgical radiotherapy, upon completion of the radiotherapy. For the total sample (n= 59) statistically significant improvements over time (between 3 and 6 months) could be found in forced expectoration (P < 0.05), in the perceived voice quality (P < 0.001), social anxiety (P < 0.001), social interactions (P < 0.001) and in feelings of anxiety and depression (P < 0.05). Repeated measures analysis of variance indicated statistically significant group differences over time in forced expectoration and stoma cleaning (P < 0.05). No statistically significant differences over time were noted between the regular and non(regular) HME user groups in voice quality or in various aspects of daily living.     

白芍总甙促干扰素诱生及抗病毒作用的研究

研究白芍总甙的促干扰素诱生及抗病毒作用,结果表明;白芍总甙10 mg·L~(-1)在试管内无直接诱生干扰素(JFN)作用.可促进鸡新城疫互I系弱毒冻干疫苗诱生αIFN,其最适浓度为10 mg·L~(-1)可促进ConA诱生γIFN.当ConA为亚适剂量时,最适浓度为l～10 mg·L~(-1)当ConA为最适剂量时,其最适浓度为0.1 ～1mg·L~(-1),皆可提高IFN效价l～2倍。具有直接抗病毒作用,白芍总甙250 mg·L~(-1)能使水泡性口炎病毒效价下降2.22个对数值。     

Hypersexual Desire in Males: An Operational Definition and Clinical Implications for Males with Paraphilias and Paraphilia-Related Disorders

The longitudinal history and temporal stability of total sexual outlet (TSO) in a group of outpatient males with paraphilias (PA) and paraphilia-related disorders (PRD) was assessed. Based on extant normative data from contemporary population-based surveys of sexual behavior, it was hypothesized that a persistent TSO of 7 or more orgasms/week for a minimum duration of 6 months be considered as the lower boundary for hypersexual desire in males. In almost all statistical analyses, the PA (n = 65) and PRD (n = 35) groups were not statistically different. The mean current TSO (PA, 7.4 ± 5.7; PRD, 8.0 ± 4.2) as well as the current average time consumed in all unconventional sexual behaviors (1–2 hr/day) were not statistically different. Unconventional sexual behaviors (i.e., related to PAs or PRDs) leading to orgasm constituted 77% of current TSO. In the combined group (n = 100), 72% (n = 72) reported a hypersexual TSO of 7 or greater. Age of onset of hypersexual TSO in the PAs (19.2 ± 6.8 years; range 10–43) and the PRDs (21.0 ± 8.6; range 10–46) and the duration of hypersexual TSO (PA, 11.1 ± 11.2 years; PRD, 10.5 ± 9.1) were not significantly different. Fifty-seven males (57%) reported a TSO of 7 or more for a minimum duration of 5 years. Clinical implications of reconceptualizing PAs and PRD as sexual desire disorders are discussed.     

2－托品酮全合成方法改进

以环庚三烯为原料，经氰化、环加成、水解和重排降解，全合成２－托品酮，总收率４０％。本法步骤短、操作简便、收率高。     

Collection of blood mononuclear cells by leukapheresis for transplantation in a yucatan miniature swine model

A large animal model is needed to evaluate new apheresis technologies. These technologies include novel methods of harvesting the blood mononuclear cell population which contains the hematopoietic stem cells needed to restore hematopoiesis in recipients of hematopoietically lethal therapy and the use of cytokines to provide a safe and predictable method of manipulating these circulating hematopoietic stem cells. We describe the methods used to collect mononuclear cells by leukapheresis from Yucatan miniature swine. These animals are of sufficient size to tolerate the procedures and have many physiologic and hematologic similarities to man. They are of good temperament and are easily trained. Long-term venous access was obtained using single lumen silicone rubber catheters placed in the inferior vena cava. The animals were apheresed while fully awake using a Haemonetics Model V50 machine and a modified lymphocyte collection protocol. The procedure was highly efficient for the collection of mononuclear cells and a 10 pass procedure yielded a product which contained 19.7 × 10⁹ mononuclear cells, 10.7 × 10⁹ granulocytes, and 17 ml of erythrocytes in a volume of approximately 100 ml. This product can be cryopreserved and used for subsequent transplantation. The content of four apheresis procedures provides hematopoietic reconstitution of lethally irradiated swine on a time scale equivalent to transplantation of optimal numbers of bone marrow cells. © 1992 Wiley-Liss, Inc.     

萃取—钼蓝比色法测定杞菊地黄口服液总磷脂含量

本文采用folch试剂萃取,以钼蓝比色法对14枇杞菊地黄口服液中总磷脂成分进行了含量测定。分析结果表明,回收率的变异系数为2.18%,该法简便准确,专一性强,为杞菊地黄口服液的内在质量控制提供了分析方法。     

白芍总苷治疗口腔扁平苔藓的疗效评价研究

目的：观察羟氯喹及羟氯喹与白芍总苷两者合并治疗口腔扁平苔藓（OLP）的疗效,并且同时比较两种定性疗效评价方法,对OLP的损害程度和治疗效果进行评价。方法：随机选取两组初诊患者,分别采用羟氯喹及羟氯喹与白芍总苷治疗三个月,使用绝对数值标准和相对变化标准分别计算。结果：白芍总苷和羟氯喹联合用药,对OLP糜烂型和充血型损害有效。单用羟氯喹治疗OLP糜烂型和充血型损害无效。对于OLP斑纹型损害,两组均有效。白芍总苷和羟氯喹联合用药治疗OLP,可以减少羟氯喹的不良反应。采用＂绝对数值标准＂的定性评价方法与采用＂相对变化标准＂的定性评价方法相比,具有记录简便、评价准确的优点。结论：白芍总苷辅助治疗口腔扁平苔藓有效;绝对数值标准高效准确。