化合物A

二氧化碳吸收剂接触七氟醚{CH2F-O-CH(CF3)2,可降解成不饱和的乙稀醚类[CH2-F-O-(CF2)(CF2)],称之为化合物A(compound A),现已证实化合物A对大鼠有肾毒性,当临界量达150 ppm/h至314 ppm/h时即可发生肾脏损害,(约相当于七氟醚75 ppm 2 h),如超过此阈值则肾坏死的严重程度直接与化合物A的ppm-hr呈正相关。虽然用大鼠作实验证实化合物A的肾毒性作用,但人体的临床实践对肾脏的毒性     

A cetabular fractures

AMEDLINE searchwas conducted to identify studies published between January 1999 and November 2003 on OR IF and THA for tream ent of ace tabu lar fractu res. The search strategy identified 37 articles on OR1F and 56 articles on THA. From those identified, …     

A primary study on TRISS in A Chinese hospital

ＩＤｅｐａｒｔｍｅｎｔｏｆＴｈｏｒａｃｉｃ＆ＣａｒｄｉｏｖａｓｃｕｌａｒＳｕｒｇｅｒｙ，ＦｉｒｓｔＵｎｉｖｅｒｓｉｔｙＨｏｓｐｉｔａｌ，ＷｅｓｔＣｈｉｎａＵｎｉｖｅｒｓｉｔｙｏｆＭｅｄｉｃａｌＳｃｉｅｎｃｅｓ，Ｃｈｅｎｇｄｕ，Ｓｉｃｈｕａｎ６１００４...     

省钱粉妆A计划

钻石级的彩妆方案,让你严格遵循自己的理财计划,不会浪费一分钱哦!     

环孢素A减量联合骁悉治疗急性环孢素A肾中毒

目的：探讨环孢素A（CsA）对移植肾的早期毒性与其血清浓度的相关性及对急性CaA肾中毒的诊断与治疗。方法：回顾性地对12例肾移植术后发生CsA毒性反应患者的CsA服用量和全血CsA浓度进行分析，拟诊CsA肾毒性反应后联合应用骁悉（MMF）并减少CsA用量，观察肾功能恢复情况，结果：12例发生CsA肾中毒患者的CsA服用剂量均超过8mg/(kg.d)，其中8例（70％）血清CsA谷值浓度超过400μg/L(HPLC法），经过减少CsA用量并联合应用MMF，12例发生CsA肾中毒患者的肾功能都有不同程度的改善，结论：长时间服用CsA剂量过大是引起CsA肾毒性反应的主要原因，减少CsA用量是有效减少CsA对移植肾毒性的有效方法，改硫唑嘌呤为MMF可有效防止因CsA的低剂量而致的排斥反应。     

维生素A与骨质疏松症

评价骨质疏松症与维生素A之间的关系.北欧居民骨质疏松性骨折发病率很高,相关研究发ⅱ现可能与当地地处高纬度,日光照射时间短造成皮肤1,25(OH)VitD3合成不足有关;另一项相关性研究发现北欧居民骨质疏松性骨折的发病与他们饮食摄入维生素A的量很高也有关.维生素A是普遍运用的维生素.研究显示维生素A过量和缺乏都会刺激和抑制骨的形成,这种影响可能会导致骨量丢失和骨折.人的一生中骨骼不断生长,在骨代谢的过程中有多种维生素参与,其中包括维生素A的参与.为了探讨维生素A与骨质疏松的关系,笔者通过检索相关文献并进行综述.大量研究显示:①维生素A摄入量少于1500μgRE/d而大于500ugRE/d时,对骨密度没有影响;②饮食摄人β-胡萝卜素与骨折风险没有关系;③短期给予大量维生素A在男性不会对骨代谢产生影响;④给予卵巢切除的大鼠大量维生素A,其骨质量明显减少.每天摄入500-1500 μgRE维生素A时不会对骨密度及骨折风险产生影响,但是否对骨代谢产生决定性的影响还需要更进一步的研究来评价.     

A Clinical Pathway for Total Shoulder Arthroplasty—A Pilot Study

Background

Appropriate pain management after total shoulder arthroplasty (TSA) facilitates rehabilitation and may improve clinical outcomes.

Questions/purposes

This prospective, observational study evaluated a multimodal analgesia clinical pathway for TSA.

Methods

Ten TSA patients received an interscalene nerve block (25 cm³ 0.375% ropivacaine) with intraoperative general anesthesia. Postoperative analgesia included regularly scheduled non-opioid analgesics (meloxicam, acetaminophen, and pregabalin) and opioids on demand (oral oxycodone and intravenous patient-controlled hydromorphone). Patients were evaluated twice daily to assess pain, anterior deltoid strength, handgrip strength, and sensory function.

Results

The nerve block lasted an average of 18 h. Patients had minimal pain after surgery; 0 (median score on a 0–10 scale) in the Post-Anesthesia Care Unit (PACU) but increased on postoperative day (POD) 1 to 2.3 (0.0, 3.8; median (25%, 75%)) at rest and 3.8 (2.1, 6.1) with movement. Half of the patients activated the patient-controlled analgesia four or fewer times in the first 24 h after surgery. Operative anterior deltoid strength was 0 in the PACU but returned to 68% by POD 1. Operative hand strength was 0 (median) in the PACU, but the third quartile (75%) had normalized strength 49% of preoperative value.

Conclusions

Patients did well with this multimodal analgesic protocol. Pain scores were low, half of the patients used little or no intravenous opiate, and some patients had good handgrip strength. Future research can focus on increasing duration of analgesia from the nerve block, minimizing motor block, lowering pain scores, and avoiding intravenous opioids.     

Bee Stings—A Remedy for Postherpetic Neuralgia? A Case Report

OBJECTIVE: This case report describes the effects of bee stings on painful postherpetic neuralgia in a 51-year-old man. CASE REPORT: The patient was stung by 3 bees in the distribution in which he had been experiencing postherpetic neuralgia. One day after the bee stings, the patient's painful postherpetic neuralgia was completely relieved, and the relief lasted for 1 and a half months. Subsequently, the patient's pain returned, but at significantly less intensity and frequency than what he had experienced prior to the bee stings. CONCLUSIONS: Bee venom and bee sting therapy have been shown to have both antinociceptive and anti-inflammatory properties, which may explain why the bee stings relieved the patient's postherpetic neuralgia. Bee sting or bee venom therapy should be further investigated as a potential treatment modality for postherpetic neuralgia.     

CYP3A基因多态性与环孢素A个体化用药的研究进展

近年来,环孢素A(CsA)不仅用于器官移植后排斥反应的预防,还用于自身免疫性疾病的治疗.CsA在不同个体间的药代动力学差异较大,肾毒性是限制其临床应用的主要原因.研究者以往多从患者的病理、生理及制剂本身等方面对CsA进行包括药代动力学在内的药理学研究,但仍有一些问题难以解决.