两种靶控方法输注异丙酚和瑞芬太尼的安全性和有效性比较

目的 比较靶控血浆浓度和效应室浓度输注异丙酚和瑞芬太尼的安全性及有效性。方法 选择44例腹腔镜胆囊切除的病人,年龄18～65岁,ASA Ⅰ～Ⅱ级,随机分为靶控血浆浓度组(P组)和效应室浓度组(E组)。设定异丙酚和瑞芬太尼的靶浓度分别为4 μg/ml和2 ng/ml。观察给药后意识消失时间、血液动力学变化以及听觉诱发电位指数(AAIs)的变化。术中调整两药靶浓度保持AAIS低于20。记录术毕停药后自主呼吸恢复和睁眼时间和AAIs的恢复。结果 E组意识消失的时间[(0.45±0.10)min]明显短于P组;此时两药的用量也明显高于P组。两组均能引起明显的低血压,但降低程度相似,且均未见严重的心血管副作用。AAIs在意识消失时P组为41±22;E组49±16:但插管时均在20以下。术中血液动力学保持较低水平(P<0.01)。两组的插管评分、麻醉质量评分相似。术后自主呼吸恢复时间和睁眼时间两组均无统计学差异。Aldrate评分及手术结束时疼痛评分差异均无显著性。结论靶控血浆和效应室浓度输注均可达到满意的麻醉效果,但靶控效应室诱导时间更短,且无明显心血管副作用。     

Fire in the operating theatre. Evacuation pre–planning may save lives

An operating theatre fire and the steps taken to deal with it are described; the difficulties encountered in evacuating anaesthetised patients are highlighted. Measures which might be taken to prevent recurrence of these problems, and recommendations on the institution of fire drills for the safety of patients and staff are given.     

Correction of webbed-neck deformity in Turner's syndrome

Summary A case of Turner's syndrome with the typical marked webbing of the neck is presented. A posterior approach is preferred for correction of this webbed neck deformity. A butterfly shaped portion of excess skin is excised and the margins of the defect mobilised as four flaps. The flaps are sutured with a very short midline vertical component, resulting in an almost X-shaped scar. The first procedure resulted in only a partial correction of the deformity and an excess of hypertrophic scar tissue. This was treated with a repeat of the procedure but the midline wounds was repaired with mulitple small Z-plasties. The final appearance of the neck was satisfactory in the lateral profile, but there was still some excess tissue posteriorly.     

普通高校学报目标定位及发展思路探讨

针对我国高校学报发展面临的一些问题，从办刊目标定位和发展思路两个方面进行了初步的分析和探讨。高校学报必须明确办刊的目标定位，从树立创新意识和加强质量控制两个方面实现学报的优势发展。     

盐酸维拉帕米自乳化缓释片的研制及释药行为的探讨

目的：探索固体自乳化释放药系统，研制自乳化缓释片，考察体外释药行为。方法：以盐酸维拉帕米（Verpamil Hydrochloride,VH)为模型药物，以吐温80（Tween80），豆磷脂（sbpc)为乳化剂，以羟丙甲纤维素（HPMC），卡波普（carbopol)为骨架材料，制备自乳化缓释片。结果：以含吐温80和豆磷脂10％，羟丙甲纤维素和卡波普30％的处方乳化效果好，体外释药符合要求。结论：通过调节乳化剂和骨架材料的比例，可以获得理想的自乳化固体缓释制剂。     

社区卫生服务信息系统功能建模研究

理顺功能关系、理清业务流程是构建社区卫生服务信息系统的前提和基础,功能建模是理顺功能关系的一个重要手段。在研究现有的各种功能分析方法的基础上,本文以IDEF0模型方法为基础,提出了社区卫生服务信息系统功能建模方法。通过建立功能、数据和约束之间的内在联系,为系统的功能设计和数据分析提供了基础。     

Polynomial matrix solution of H2 optimal control problem for state‐space systems

A polynomial matrix solution to the H₂ output feedback optimal control problems is obtained for systems represented in state‐equation form. The proof does not invoke the separation principle but is obtained in the z‐domain. The cost function includes weighted states, which allows the so‐called standard system model problem to be solved. This encompasses the class of inferential control problems. The results also enable the two‐degree‐of‐freedom optimal control solution properties to be explored. Copyright © 2002 John Wiley & Sons, Ltd.     

Changes in the content of Met-enkephalin in different brain structures during the development of immune response

Changes in the content of the opiate peptide Met-enkephalin at the early stages of immune response are studied in different structures of rats brain 20 min and 24 h after immunization with sheep erythrocytes. Translated fromByulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 123, No. 2, pp. 170–172, February, 1997     

扩大经额硬膜外入路切除巨大侵袭性垂体瘤

目的:探讨采用扩大的经额硬膜外入路切除巨大侵袭性垂体瘤的临床应用.方法:1997年6月至2002年3月采用该入路显微外科切除巨大侵袭性垂体瘤10例,肿瘤主要累及于鞍上、蝶筛窦及上斜坡区.结果:本组10例中,肿瘤全切6例,次全切除3例,大部分切除1例.术后发生颅神经麻痹4例,其中动眼神经障碍3例,外展神经障碍1例.全组无手术死亡.术后影像学随访6～24个月,全切除肿瘤病例未见肿瘤复发,次全切除者无明显增大.结论:该入路可充分显露鞍区肿瘤,术野开阔,对脑组织损伤小,适用于已侵犯蝶筛窦区及上斜坡的侵袭性垂体瘤.     

显微神经外科技术及翼点入路在鞍区肿瘤手术的应用

目的：总结98例鞍区肿瘤患者经翼点入路显微手术治疗及翼点入路应用体会。方法：按照翼点入路各项操作步骤行鞍区肿瘤切除98例，介绍了操作方法并讨论显微神经外科技术在鞍区肿瘤手术中的应用，及不同部位肿瘤作相应手术操作调整的方法。结果：鞍区肿瘤应用翼点入路进行显微手术操作可良好显露鞍区及肿瘤各显微解剖结构以及手术操作平台，使其肿瘤全切率及患者预后得到明显提高。结论：显微神经外科技术及翼点入路手术操作的掌握和熟练程度的提高是显微神经外科技术的关键及获得良好手术效果的基础。