臂丛神经阻滞加用地塞米松和小剂量吗啡用于术后镇痛的效果观察

目的 观察臂丛神经阻滞的局麻药液中加入地塞米松和小剂量吗啡用于术后镇痛的效果和副作用。方法 80例患者随机分为A、B、C、D四组。全部用肌间沟法臂丛神经阻滞，A组（n=20)注入0.5%布比卡因、2%利多卡因等量混合液25ml；B组（n=20)注入A组用药加地塞米松10mg(2ml)；C组（n=20)注入A组用药加吗啡2mg(0.2ml)；D组（n=20)注入A组用药加地塞米松10mg(2ml)、吗啡2mg(0.2ml)。结果 B、C、D组与A组相比起效时间显著缩短、镇痛时间显著延长，差异非常显著（P＜0.01)；而D组和B、C组相比镇痛时间又明显延长，差异非常显著（P＜0.01)；C组中有1例（5％）因发生恶心呕吐，其余多组无并发症发生。结论 臂丛神经阻滞的局麻药液中加入地塞米松和小剂量吗啡用于术后镇痛，镇痛时间长，效果可靠，副作用少，操作方便，经济实用。     

Discrimination of idiopathic pain syndromes from neurogenic pain syndromes and healthy volunteers by means of clinical rating,personality traits,monoamine metabolites in CSF,serum cortisol,platelet MAO and urinary melatonin

Summary The aim of the present study was to investigate the discriminative power of a series of variables (including determination of depressive symptomatology by means of a visual analogue scale, determination of personality traits by means of the Karolinska Scales of Personality, determination of monoamine metabolites in CSF, platelet MAO activities, serum cortisol before and after dexamethasone suppression and urinary melatonin) in differentiating (a) chronic pain patients from healthy subjects, and (b) patients with idiopathic pain syndromes from patients with neurogenic pain syndromes. Separately each of the measures gave a significant but often low contribution to the discrimination, while a combination of several measures gave a complete discrimination both between healthy subjects and patients with chronic pain syndromes and between patients with idiopathic and neurogenic pain syndromes, respectively.Supported in part by grants from the Swedish Medical Research Council (grants no. 3371, 4145 and 5740) and by a grant from Stiftelsen Söderström-Königska Sjukhemmet     

Glucocorticoids potentiate kainic acid-induced seizures and wet dog shakes

Glucocorticoid effects on kainic acid-induced motor seizures and wet dog shakes in rats were investigated by adrenalectomy and dexamethasone treatment. One-day adrenalectomy attenuated kainic acid-induced wet dog shakes and seizure activity. These effects were restored by dexamethasone. Administration of dexamethasone to non-adrenalectomized rats potentiated kainic acid-induced wet dog shakes and severity of seizure activity. These results suggest that glucocorticoids may play an important role in modulating the severity of kainic acid-induced seizures and wet dog shakes.     

Interleukin-1 inhibits keratan sulfate production by rabbit chondrocytes: Possible role of prostaglandin E2

We investigated the importance of prostaglandin E2 (PGE2) release in interleukin-1 (IL-1)-induced inhibition of aggrecan synthesis by chondrocytes. Keratan sulfate (KS) production was measured in parallel with PGE2 release in chondrocytes. IL-1 inhibited KS production and stimulated PGE2 release. In the presence of PGE2, there was a dosedependent decrease in baseline KS production. Indomethacin and dexamethasone partially blocked the IL-1-induced PGE2 release while KS production recovered. Our results suggest that IL-1 inhibits KS production, in part, by stimulating the release of PGE2.     

地塞米松对扩张皮瓣血运障碍的救治

目的寻求扩张皮肤Ⅱ期手术形成皮瓣时出现血运障碍及防止坏死的有效治疗方法。方法皮瓣出现血运障碍时，立即静脉给予地塞米松0．4mg／kg，然后逐渐减量，术后6d停药。10d时观察判断皮瓣成活情况。结果35例出现血运障碍的皮瓣，经救治完全成活33例，大部分成活2例。成活后皮瓣色泽、弹性均好。结论及时用地塞米松是防止扩张皮瓣出现血运障碍及坏死的良好方法。     

地塞米松预防术后硬膜外吗啡镇痛的部分并发症

目的：观察静脉注射地塞米松（Dex)对减少手术后与硬膜外吗啡镇痛有关的部分并发症的发生率的作用。方法：随机双盲选择48例在硬膜外麻醉下行妇科肿瘤手术病人进行观察。所有病人在手术后均接受硬膜外吗啡镇痛。Dex组病人（n=24)在手术毕静注Dex8mg，对照组病人（n=24)则给予等量生理盐水。结果：在手术后24h内，Dex组病人手术后总的恶性呕吐发生率为16．7％，明显低于对照组病人的50％（P＜0．01）。两组病人手术后皮肤瘙痒的发生率无明显差异，镇痛效果也无明显差异。结论：预防性静脉注射Dex可减少术后硬膜外吗啡镇痛引起的恶心呕吐的发生率。     

地塞米松缓释微粒在增生性玻璃体视网膜病变的应用

目的：观察含地塞米松（DEX）的缓释微粒治疗增生性玻璃体视网膜病变（PVR）的临床疗效。方法：9例（9只眼）视网膜脱离伴PVR患者进行常规玻璃体视网膜手术，并在玻璃体腔内植入1粒DEX微粒（含地塞米松1mg），观察术后反应及视力、PVR发展、DEX的位置及形状变化等。结果：术后炎症反应轻，7只眼视网膜复位，3只眼后极部视网膜前有增生；2只眼视网膜局限性脱离，最终3只眼玻璃腔内硅油填充。随访视力有8只眼较术前提高（P=0.015）。DEX未见对视网膜有不良影响，仅在随着处有少量色素吸附，4-6月后吸收。结论：DEX抑制PVR术后炎症反应及较远期作用是安全、有效的；对手术未完全清除的视网膜前增生有一定的抑制作用。     

地塞米松对缺血再灌注鼠视网膜电图的影响

目的观察地塞米松对大鼠视网膜缺血再灌注损伤 (retinalischemiareperfusion ,RIR)视网膜电图 (ERG)的影响。方法应用前房灌注液体升高眼内压的方法 ,建立RIR模型 ,并随机分为防治组和对照组 ,防治组大鼠地塞米松用药从缺血前 6天开始 ,剂量为 1mg/kg ,溶于 1ml生理盐水中腹腔注射 ,给药持续 8天 ,对照组用同体积的生理盐水代替。两组缺血 60分钟后分别再灌注 3 0分钟、2 4小时、72小时 ,进行视网膜电图。结果防治组ERG标化b波振幅显著高于对照组 (P <0 .0 1 )。结论地塞米松对RIR有一定防治作用