舒芬太尼固体脂质纳米粒的制备

目的 分析影响舒芬太尼脂质纳米粒制备的主要因素.方法 利用改良的乳化蒸发-低温固化技术,制备舒芬太尼固体脂质纳米粒混悬液,以单因素分析法筛选处方和工艺,并对该制剂表征进行考察.结果 制备的SUFSLN混悬液呈外观均一、稳定的半透明胶体状分散体系,略带淡蓝色乳光.平均粒径为(115.4±1.6)nm,Zeta电位为(-27.3±1.4)mv、包封率为(80.21±2.44)％.结论 改良的乳化蒸发-低温固化技术,可以用于制备舒芬太尼固体脂质纳米粒混悬液.     

不同浓度七氟醚对人肺腺癌A549细胞Survivin蛋白表达的影响

目的 评价不同浓度七氟醚对人肺腺癌A549细胞Survivin蛋白表达的影响.方法 人肺腺癌A549细胞接种于培养板培养24 h,采用随机数字表法,将人肺腺癌A549细胞随机分为4组:对照组(C组)、1.7%七氟醚组(S1组)、3.4%七氟醚组(S2组)和5.1%七氟醚组(S3组),每组18孔.S1-3组人肺腺癌A549细胞分别经1.7%、3.4%、5.1%七氟醚孵育2、4、6 h,C组通入95%O2-5%CO2混合气体2 L/min,每个时点随机取6孔,继续培养48 h,采用MTT法检测细胞增殖情况,流式细胞仪检测细胞凋亡情况,Western blot法检测经七氟醚孵育4 h的人肺腺癌A549细胞Survivin蛋白表达水平.结果 C组、S1～3组入肺腺癌A549细胞增殖抑制率和凋亡率依次升高,Survivin蛋白表达依次下调(P<0.05).结论 七氟醚可通过下调Survivin蛋白表达抑制人肺腺癌A549细胞增殖和促进凋亡,其效应呈浓度依赖性.

Abstract：

Objective To investigate the effects of different concentrations of sevoflurane on Survivin expression in human adenocarcinoma cell line A549. Methods A549 cells were obtained from Shanghai Cell Biology Medical Research Institute, Chinese Academy of Sciences and inoculated in 96 well culture plate. After being cultured for 24 h, the cells were randomly divided into 4 groups: Ⅰ , Ⅱ , Ⅲ and Ⅳ groups exposed to 95 % O2 -5 %CO2,1.7%, 3.4% and 5.1% sevoflurane respectively. A549 cells were exposed to sevoflurane for 2, 4 and 6 h respectively and then cultured for another 48 h in Ⅱ , Ⅲ and Ⅳ groups. Proliferation of A549 cells were measured by methyl thiazolyl tetrazolium (MTT) assay, and apoptosis was detected with flow cytometer at 48 h after 2, 4 and 6 h sevoflurane exposure. The expression of Survivin in A549 cells was determined by Western blot analysis at 48h after 4 h sevoflurane exposure. Results The rate of proliferation inhibition and percentage of apoptotic cells were significantly higher while the expression of Survivin was significantly lower in a concentration-dependent manner in Ⅱ , Ⅲ and Ⅳ groups as compared with group Ⅰ . Conclusion Sevoflurane can inhibit proliferation and induce apoptosis of A549 cells by inhibition of Survivin expression.     

不同浓度七氟醚对人肺腺癌A549细胞Survivin蛋白表达的影响

Objective To investigate the effects of different concentrations of sevoflurane on Survivin expression in human adenocarcinoma cell line A549. Methods A549 cells were obtained from Shanghai Cell Biology Medical Research Institute, Chinese Academy of Sciences and inoculated in 96 well culture plate. After being cultured for 24 h, the cells were randomly divided into 4 groups: Ⅰ , Ⅱ , Ⅲ and Ⅳ groups exposed to 95 % O2 -5 %CO2,1.7%, 3.4% and 5.1% sevoflurane respectively. A549 cells were exposed to sevoflurane for 2, 4 and 6 h respectively and then cultured for another 48 h in Ⅱ , Ⅲ and Ⅳ groups. Proliferation of A549 cells were measured by methyl thiazolyl tetrazolium (MTT) assay, and apoptosis was detected with flow cytometer at 48 h after 2, 4 and 6 h sevoflurane exposure. The expression of Survivin in A549 cells was determined by Western blot analysis at 48h after 4 h sevoflurane exposure. Results The rate of proliferation inhibition and percentage of apoptotic cells were significantly higher while the expression of Survivin was significantly lower in a concentration-dependent manner in Ⅱ , Ⅲ and Ⅳ groups as compared with group Ⅰ . Conclusion Sevoflurane can inhibit proliferation and induce apoptosis of A549 cells by inhibition of Survivin expression.     

丙泊酚对新生鼠神经干细胞增殖及学习记忆的影响

目的 研究丙泊酚对新生鼠神经干细胞增殖及学习记忆的影响.方法 出生后7 d Wistar乳鼠104只随机均分成四组:丙泊酚50 mg/kg组(A组)、丙泊酚100 mg/kg组(B组)、生理盐水10 ml/kg组(C组)、脂肪乳剂10 ml/kg组(D组),各组均为腹腔注射,连续注射7 d,第7天每组取10只腹腔注射300 mg/kg 5-溴脱氧尿苷(Brdu),12 h后灌注切脑片做Brdu免疫组化,6只取海马提蛋白westerblo0t检测脑源性神经营养因子(BDNF),剩下10只饲养2个月后行Morris水迷宫测试.结果 与C组比较,D组对Brdu阳性细胞无影响,A、B组Brdu阳性细胞数明显减少(P＜0.05),其中B组阳性细胞数又明显少于A组(P＜0.05).A、B组BDNF含量减少,但只有B组明显抑制成年后鼠的学习记忆功能.结论 丙泊酚能抑制新生鼠神经干细胞增殖,大剂量丙泊酚可损害鼠成年后学习记忆功能,可能与丙泊酚减少BDNF分泌有关.     

不同剂量舒芬太尼复合靶控输注异丙酚麻醉诱导对患者血液动力学的影响前瞻性、多中心、随机、双盲研究

目的 评价不同剂量舒芬太尼复合靶控输注异丙酚麻醉诱导对患者血液动力学的影响,探讨复合异丙酚时舒芬太尼的适宜麻醉诱导剂量.方法 本试验为前瞻性、多中心、随机、双盲的临床研究.拟行腹部手术患者165例,ASA Ⅰ或Ⅱ级,年龄18～63岁,性别不限,体重42～90 kg,根据舒芬太尼不同麻醉诱导剂量分为4组:舒芬太尼0.4 μg/kg组(S1组,n=44)、0.6 μg/kg组(S2组,n=43)、0.8 μg/kg组(S3组,n=38)、1 μg/kg组(S4组,n=40).麻醉诱导:静脉注射咪达唑仑0.05 mg/kg,靶控输注异丙酚,血浆靶浓度3.0 μg/ml,当BIS<60且异丙酚达设定血浆靶浓度时,各组经30 s分别静脉注射舒芬太尼0.4、0.6、0.8、1 μg/kg,四组均静脉注射罗库溴铵0.9 mg/kg,静脉注射舒芬太尼后3 min(BIS 35～45)行气管插管、机械通气.于麻醉诱导前(T0)、异丙酚血浆靶浓度3.0 μg/ml时(T1)、静脉注射舒芬太尼后1 min(T2)、3 min(T3)、气管插管后即刻(T4)、1 min(T5)、3 min(T6)、5 min(T7)时记录SP、DP、MAP和HR.记录心血管不良事件和气管插管反应的发生情况.结果 四组麻醉诱导期间低血压、高血压和心动过速的发生率比较差异无统计学意义(P>0.05),T4-7时S4组心动过缓发生率较其余各组升高(P<0.05);S1组和S2组气管插管反应发生率较S3组和S4组升高(P<0.05或0.01).结论 舒芬太尼0.8 μg/kg复合靶控输注异丙酚(血浆靶浓度3.0 μg/ml)麻醉诱导时患者血液动力学平稳,是复合异丙酚时舒芬太尼适宜的麻醉诱导剂量.     

4%琥珀酰明胶溶液术前扩容对胃癌根治术患者血液高黏状态的改善作用

目的 观察4%琥珀酰明胶溶液(4% succinylated gelatin,GEL)术前扩容对胃癌患者围术期血液流变性的影响.方法 择期行胃癌根治术的40例患者,通过计算机产生的随机数分为2组(n=20),另选20例同期在本院行健康查体者作为正常对照.麻醉诱导时于30min内给2组患者分别输注15ml/kg GEL溶液(GEL组)或乳酸钠林格氏(ringer's lactated,RL)溶液(RL 组).分别于麻醉诱导前(T_0)、扩容结束后即刻(T_1)、扩容结束后1h(T_2)和手术结束后1 h(T_3)抽取静脉血,采用全功能自动血液流变仪检测全血黏度、血浆黏度、红细胞聚集指数(EAI)、纤维蛋白原和血细胞压积(Hct).结果 与正常对照组比较,胃癌组的全血低切黏度、全血中切黏度、全血高切黏度、血浆黏度、EAI、纤维蛋白原增加(P<0.05 .与T_0比较,GEL组T_1、T_2和T_3时全血黏度、血浆黏度、EAI、纤维蛋白原、Hct降低(P<0.05).与T_0比较,RL组T_1时全血黏度、血浆黏度、EAI、纤维蛋白原、Hct降低,(P<0.05),T_3时伞血低切黏度、红细胞聚集指数增加(P<0.05).与RL组比较,GEL组T_2和T_3时全血黏度、EAI、纤维蛋白原、Hct降低(P<0.05).结论 胃癌患者血液处于高黏状态,术前采用GEL溶液扩容能明显改善胃癌根治术患者围术期血液流变性、减轻高黏状态.     

围术期目标导向液体治疗

围术期液体管理一直是围术期处理争论最多的问题之一.最近的研究显示围术期目标导向液体治疗有助于减少围术期并发症,如术后恶心呕吐;加快胃肠功能恢复;缩短住院日.现就围术期目标导向液体治疗的实施方案、监测指标和监护仪的选择及对术后转归的影响作一综述.     

肌松监测下罗库溴铵气管插管时机的临床研究

目的 比较肌松监测下静脉注射罗库溴铵0.9mg/kg后60秒和4个成串刺激(train-of-four,TOF)的T1达到最大抑制程度时的气管插管条件,探讨该药理想的气管插管时机.方法 120例行择期腹腔镜胆囊切除术患者,年龄18岁～60岁,ASA Ⅰ-Ⅱ级,随机均分为两组.分别于静脉注射罗库溴铵0.9 mg/kg后60秒(A组)或T1达到最大抑制程度时(B组)行气管插管.观察并记录两组罗库溴铵起效时间(TOF的T1达到最大抑制程度的时间)、气管插管条件(Cooper's评分)、声门暴露程度(Cormack-Lehane分级)、诱导过程中的心率(heart rate,HR)和收缩压(systolic blood pressuref,SBP)变化以及术后24 h咽喉并发症(喉痛、声嘶等不适).结果 静注罗库溴铵0.9 mg/kg后66.0秒±18.1秒(95%可信区间30.2秒一101.8秒)达到T1最大抑制.B组Cooper's评分和Cormack-Lehane分级均优于A组(P相似文献   

不同麻醉方法用于老年患者纤支镜检查的临床研究

目的 探讨不同麻醉方法用于老年患者纤支镜检查的效果与安全性.方法 将40例需行纤支镜检查的老年患者随机分成无痛纤支镜(S)组和常规纤支镜(C)组两组.每组20例患者.S组采用异丙酚、舒芬太尼麻醉,C组采用2%利多卡因雾化喷喉,分别观察两组检查前、检查中及检查后的脉搏血氧饱和度(pulse oxygen saturation,SpO2)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、心率(heart rate,HR)变化及副作用.结果 S组麻醉后患者能在无知觉和无痛苦中接受检查,出现呛咳、憋气、及体动等副作用少,血压(blood pressure,BP)、HR变化与C组相比相对稳定,均低于C组(P<0.05).结论 采用异丙酚复合小剂量舒芬太尼麻醉用于老年患者纤支镜检查可充分减轻患者的痛苦,患者无挣扎,手术操作顺利,循环稳定,并发症少,是一种安全而有效的麻醉方法.