右美托咪定对全脑缺血再灌注大鼠血脑屏障通透性的影响

目的 评价右美托咪定对全脑缺血再灌注大鼠血脑屏障通透性的影响.方法 成年雄性SD大鼠36只,体重250 ～ 300 g,采用随机数字表法,将其分为3组(n=12):假手术组(S组)、全脑缺血再灌注组(I/R组)和右美托咪定组(D组).采用夹闭双侧颈总动脉联合低血压法建立大鼠全脑缺血再灌注损伤模型.D组于再灌注即刻经颈总静脉注射右美托咪定3 μg/kg负荷剂量,后以3μg·kg-1·h-1的速率静脉输注至再灌注2h.再灌注24h时,处死大鼠,取脑组织,观察海马CAI区病理学结果,测定细胞凋亡水平、脑含水量、脑组织伊文氏蓝(EB)含量和水通道蛋白4(AQP4)的表达.结果 与S组比较,I/R组和D组细胞凋亡增加,脑含水量和脑组织EB含量升高,AQP4表达上调(P＜ 0.05或0.01);与I/R组比较,D组细胞凋亡减少,脑含水量和脑组织EB含量降低,AQP4表达下调(P＜ 0.05或0.01),病理学损伤减轻.结论 右美托咪定可降低血脑屏障通透性,减轻大鼠全脑缺血再灌注损伤,其机制可能与下调AQP4的表达有关.     

全凭静脉麻醉下罗库溴铵及顺式阿曲库铵起效和恢复时间的变异率的对比研究

目的 比较罗库溴铵及顺式阿曲库铵成年患者和老年患者起效和恢复时间上的变异率.方法 80例全凭静脉麻醉下择期手术的成年患者和老年患者,随机分为罗库溴铵成年组和老年组各20例,顺式阿曲库铵成年组和老年组各20例.TOF-Watch每12秒钟刺激尺神经并监测拇内收肌收缩力量.记录药物在每个患者的起效时间,作用时间及恢复指数.结果 两个年龄组的罗库溴铵的起效时间显著短于相应年龄组的顺式阿曲库铵,变异率小于相应年龄组的顺式阿曲库铵;与成年组相比,罗库溴铵老年组的作用时间显著延长,恢复指数及变异率显著增加,顺式阿曲库铵老年组的作用时间及其变异率差异无统计学意义(P>0.05).结论 丙泊酚和瑞芬太尼全凭静脉麻醉下,等效剂量的罗库溴铵的起效速度显著快于顺式阿曲库铵,而顺式阿曲库铵无论在老年患者成年患者,其作用时间及恢复指数都是相对恒定的.     

布托啡诺预先给药对大鼠心肌缺血再灌注损伤的影响

Objective To investigate the effects of butorphanol pretreatment on myocardial ischemia-reperfusion (IR) injury in rats. Methods Forty healthy male SD rats weighing 200-250 g were randomly divided into 5 groups (n = 8 each) : sham operation group (group S); IR group; butorphanol pretreatment group (group B); Nor-BNI group (group N) and glibenclamide group (group G) . In group IR, B, N and G, myocardial IR was produced by occlusion of left anterior descending artery (LAD) for 30 min followed by 120 min reperfusion. In group S and IR, normal saline S ml/kg was injected via femoral vein 10 min before ischemia and then continuously infused at a rate of 5 ml· kg -1· h-1 iv. In group B, butorphanol 25 μg/kg was injected via femoral vein 10 min before ischemia and the rest method was the same as that described in group IR. In group N, Nor-BNI 2 mg/kg (a selective κ-opioid receptor antagonist) was injected via femoral vein 20 min before ischemia and the rest method was the same as that described in group B. In group G, glibenclamide 1 mg/kg (a KATP channel blocker) was injected via femoral vein 10 min before ischemia and the rest method was the same as that described in group B. Blood samples were taken from femoral artery at 120 min of reperfusion for determination of the concentrations of serum TNF-α, IL-6 and IL-10 by ELISA. Myocardial infarct area and ischemic area were measured by TTC staining and myocardial infarct size was calculated. Results The concentrations of serum TNF-a, IL-6 and IL-10 were significantly higher in the other four groups than in group S (P < 0.05) . The concentrations of serum TNF-α andIL-6 were significantly decreased while IL-10 increased, and the myocardial infarct size was significantly decreased in group B, N and G as compared with group IR ( P < 0.05) . The concentrations of serum TNF-α and IL-6 were significantly increased while the concentration of IL-10 decreased) and the myocardial infarct size was significantly increased in group N and G as compared with group B ( P < 0.05). Conclusion Butorphanol pretreatment can protect the myocardium against IR injury in rate via activating κ receptor and KATP channel.     

布托啡诺预先给药对大鼠心肌缺血再灌注损伤的影响

Objective To investigate the effects of butorphanol pretreatment on myocardial ischemia-reperfusion (IR) injury in rats. Methods Forty healthy male SD rats weighing 200-250 g were randomly divided into 5 groups (n = 8 each) : sham operation group (group S); IR group; butorphanol pretreatment group (group B); Nor-BNI group (group N) and glibenclamide group (group G) . In group IR, B, N and G, myocardial IR was produced by occlusion of left anterior descending artery (LAD) for 30 min followed by 120 min reperfusion. In group S and IR, normal saline S ml/kg was injected via femoral vein 10 min before ischemia and then continuously infused at a rate of 5 ml· kg -1· h-1 iv. In group B, butorphanol 25 μg/kg was injected via femoral vein 10 min before ischemia and the rest method was the same as that described in group IR. In group N, Nor-BNI 2 mg/kg (a selective κ-opioid receptor antagonist) was injected via femoral vein 20 min before ischemia and the rest method was the same as that described in group B. In group G, glibenclamide 1 mg/kg (a KATP channel blocker) was injected via femoral vein 10 min before ischemia and the rest method was the same as that described in group B. Blood samples were taken from femoral artery at 120 min of reperfusion for determination of the concentrations of serum TNF-α, IL-6 and IL-10 by ELISA. Myocardial infarct area and ischemic area were measured by TTC staining and myocardial infarct size was calculated. Results The concentrations of serum TNF-a, IL-6 and IL-10 were significantly higher in the other four groups than in group S (P < 0.05) . The concentrations of serum TNF-α andIL-6 were significantly decreased while IL-10 increased, and the myocardial infarct size was significantly decreased in group B, N and G as compared with group IR ( P < 0.05) . The concentrations of serum TNF-α and IL-6 were significantly increased while the concentration of IL-10 decreased) and the myocardial infarct size was significantly increased in group N and G as compared with group B ( P < 0.05). Conclusion Butorphanol pretreatment can protect the myocardium against IR injury in rate via activating κ receptor and KATP channel.     

PBL教学法在麻醉临床见习气管插管中的应用

目的 探讨可视化技术辅助以问题为导向教学法（PBL）在麻醉临床见习气管插管中的应用效果。方法将本院临床见习的2016—2017级临床医学系本科学生按教学进程分为A组、B组、C组三组,A组学生采用传统教学法,B组学生采用以问题为导向的病例教学法,C组采用可视化技术辅助以问题为导向的病例教学法,记录三组的气管插管成功率、术后并发症发生率,比较各组理论考试成绩并采用问卷调查评价教学效果。结果与A组、B组比较,C组学生在总体教学效果、插管技术的掌握、基础和临床结合紧密度、学习主动性、学习有效性、综合分析能力、系统理解知识、团队协作、展现个性方面的评价优良率明显更高（P <0.05）,在创新能力方面,C组学生评价的优良率虽然高于A组和B组,但组间差异无统计学意义（P> 0.05）。C组学生插管成功率高于A组及B组,组间比较差异有统计学意义（P<0.05）。A组患者气管插管术后并发症发生率为18.2%,主要表现为吞咽困难和声音嘶哑。B组术后并发症发生率是15.2%,主要表现为喉咙疼痛和声音嘶哑。C组仅有2例患者出现声音嘶哑,发生率为5.9%。C组患者术后并发症发生率虽低于A组及B...     

聚明胶肽用于急性等容血液稀释对犬血流动力学及氧代谢的影响

为了研究聚明胶肽作为血浆代用品用于急性等容血液稀释对犬血流动力学、氧代谢和血液流变学的影响 ,为聚明胶肽的临床应用提供实验依据 ,选择 14例健康杂种犬 ,全身麻醉后接多功能呼吸机 ,股动脉、股静脉置管。经股动脉放血 ,同时以相同速率经股静脉输入同量聚明胶肽注射液。经左颈外静脉置入 5 FSwan-Ganz漂浮导管 ,监测心电图及各血流动力学指标。在血液稀释前、血液稀释即刻、稀释后 60 min、12 0 min抽取股动脉、股静脉和肺动脉血检测血液流变学指标 ,并进行血气分析。结果显示 ,实验动物在血液稀释后 HR、MAP、MPAP、PCWP、CVP均无明显变化 ,CO和 CI值在血液稀释后上升明显 ,TVRI和 PVRI在稀释后下降 ;红细胞压积、全血粘度、红细胞聚集指数均有所下降 (P<0 .0 5 ) ;动脉血 p H值、动脉氧分压 (Pa O2 )、动脉血氧饱和度 (Sa O2 )均无显著变化 (P>0 .0 5 )。     

Beagle犬异氟醚注射液MAC测定及其对循环的影响

目的测定Beagle犬异氟醚注射液(8%,容积比)最低肺泡有效浓度(MAC静脉),观察其诱导对循环的影响,并与异氟醚吸入最低肺泡有效浓度(MAC吸入)进行比较。方法将Beagle犬12只随机分为异氟醚注射液静脉组(静脉组)和异氟醚吸入组(吸入组)。采用上下法和夹尾刺激测定两组的MAC。监测并记录诱导前及诱导期间的MAP、HR和SpO2变化。结果MAC静脉(1.08±0.16)%明显小于MAC吸入(1.35±0.10)%(P<0.05)。静脉组诱导开始至插管所需时间短于吸入组(P<0.01),且静脉组异氟醚平均诱导用量明显少于吸入组(P<0.01);静脉组停药至拔管时间和停药至站立时间均短于吸入组(P<0.01)。吸入组插管后即刻的MAP和HR均高于插管前(P<0.05),而静脉组插管后即刻的MAP和HR与插管前相比差异无统计学意义。结论MAC静脉明显小于MAC吸入。与吸入异氟醚相比,异氟醚注射液静脉诱导速度快、用药量少、苏醒快、气管插管反应轻。     

全身麻醉药诱发睡眠紊乱的研究进展

全身麻醉药可干扰机体的昼夜节律,诱发术后睡眠紊乱,但其具体的机制尚未完全阐明。研究表明,全身麻醉药可通过激活γ-氨基丁酸（γ-aminobutyric acid, GABA）能受体、抑制NMDA受体引起昼夜节律紊乱。文章简要阐明全身麻醉药诱发睡眠紊乱的机制,重点阐释时钟基因（circadian locomotor ou...     

烟酰胺单核苷酸对睡眠剥夺幼鼠神经发生减退的影响

目的评价烟酰胺单核苷酸对睡眠剥夺幼鼠神经发生减退的影响。方法清洁级健康雄性SD大鼠78只, 7日龄, 体重10～15 g, 采用随机数字表法分为3组(n=26):对照组(Con组)、睡眠剥夺组(SD组)和睡眠剥夺+烟酰胺单核苷酸组(SD+NMN组)。采用毛刷轻柔刺激法制备幼鼠睡眠剥夺模型, 每天睡眠剥夺10 h, 连续14 d。SD+NMN组腹腔注射烟酰胺单核苷酸500 mg/kg, 连续14 d。Con组和SD组腹腔注射等容量蒸馏水。于睡眠剥夺结束后即刻腹腔注射5-溴脱氧尿苷(BrdU)100 mg/kg标记新生细胞, 睡眠剥夺完成后24 h时分别采用免疫荧光和免疫组化法计数海马DG区干细胞多能性转录因子(SOX2)和双肾上腺皮质激素(DCX)阳性细胞, 采用正电子发射型计算机断层显像观察海马18F-氟代脱氧葡萄糖的代谢水平。睡眠剥夺完成后4周采用免疫荧光法计数海马神经元核抗原(NeuN)/BrdU和神经胶质酸性蛋白(GFAP)/BrdU阳性细胞, 采用新物体识别试验测试认知功能。结果与Con组比较, SD组大鼠SOX2和DCX阳性细胞数减少, 海马葡萄糖标准摄取值降低, NeuN/...     

大麻素2型受体在七氟烷后处理减轻大鼠肠缺血再灌注损伤中的作用

目的评价大麻素2型受体(CB2R)在七氟烷后处理减轻大鼠肠缺血再灌注损伤中的作用。方法清洁级健康雄性SD大鼠24只, 8～10周龄, 体重220～270 g, 采用随机数字表法分为4组(n=6):假手术组(Sham组)、肠缺血再灌注组(I/R组)、肠缺血再灌注+七氟烷后处理组(Sevo组)和肠缺血再灌注+七氟烷后处理+CB2R拮抗剂AM630组(AM组)。采用夹闭肠系膜上动脉45 min, 再灌注2 h的方法制备大鼠肠缺血再灌注损伤模型。Sevo组再灌注即刻吸入2%七氟烷, 持续30 min, AM组缺血前1 h腹腔注射CB2R拮抗剂AM630 3 mg/kg, 其余操作同Sevo组。于再灌注2 h时, 麻醉后处死大鼠取小肠组织, 光镜下观察肠组织病理学结果并行Chui评分, 确定湿重/干重(W/D)比值, 采用硫代巴比妥酸比色分析法检测MDA含量, 采用髓过氧化物酶法测定MPO活性, 采用Western blot法检测cleaved caspase-3的表达。结果与Sham组比较, I/R组小肠组织Chui评分、W/D比值、MDA含量和MPO活性升高, cleaved caspase...