氯胺酮两种注射方式对小鼠的麻醉效果观察

目的探讨氯胺酮腹腔及肌肉注射对小鼠的麻醉效果观察。方法将30只BALB/c小鼠随机分为两组,按100mg/kg体重给予盐酸氯胺酮分别行腹腔及肌肉注射麻醉。结果给予腹腔及肌肉注射麻醉组小鼠分别在(3.60±0.74)min,(3.47±0.87)min进入麻醉状态,无显著性差异(P>0.05),维持时间分别为(22. 13±4.73)min,(30.60±6.19)min,有统计学差异(P<0.05);两组小鼠进入麻醉状态前后呼吸、体温均无显著性差异(P>0.05)。结论氯胺酮用于小鼠麻醉是一种安全有效的麻醉剂,选择合适剂量的氯胺酮行腹腔及肌肉注射均能为小鼠实验应用提供良好的麻醉效果。     

氯胺酮与氟哌啶复合麻醉用于兔膝骨性关节炎模型

目的探索氯胺酮、氟哌啶应用于兔麻醉后对呼吸系统的影响并进行麻醉效果评价。方法32只健康新西兰兔随机分为两组,氯胺酮、氟哌啶组(KD组);氯胺酮组(K组)。KD组以(100 mg氯胺酮 5 mg氟哌啶)/kg体重肌内注射;K组以100 mg氯胺酮/kg体重肌内注射,均进行兔膝骨性关节炎模型的建立。于麻醉后15 min时抽取耳中央动脉血做血气分析,评价麻醉效果、记录持续时间、死亡率。结果KD组麻醉前与麻醉后15 min时比较:酸碱度(pH)、碱剩余(BE(B))差异有显著性(P<0.01);标准碳酸氢盐(SB)、细胞外液缓冲碱(Beecf)、氧饱和度(SO2)差异有显著性(P<0.05)。K组麻醉前与麻醉后15 min时比较:pH、二氧化碳分压(PaCO2)差异有显著性(P<0.01);SB、Beecf、BE(B)差异有显著性(P<0.05)。KD组与K组在麻醉后15 min时比较:实际碳酸氢盐(HCO3ˉ)、总二氧化碳(TCO2)差异有显著性(P<0.01);Beecf BE(B)总血红蛋白(THBc)差异有显著性(P<0.05)。KD组的麻醉效果为优75%、良25%、差0%,死亡率0%,麻醉有效时间(45±5)min。K组的麻醉效果为优0%、良31%、差69%,死亡率0%,麻醉有效时间(20±5)min。结论用氯胺酮、氟哌啶联合应用于兔麻醉效果优于单纯氯胺酮麻醉。     

氯胺酮与甲苯噻嗪用于大鼠脊髓损伤模型的麻醉效果

目的分析氯胺酮与甲苯噻嗪用于大鼠脊髓损伤模型麻醉的效果。方法 Sprague-Dawley雄性大鼠60只,分别用盐酸氯胺酮100 mg/kg(Ⅰ组)、盐酸甲苯噻嗪25 mg/kg(Ⅱ组)、盐酸氯胺酮100 mg/kg复合盐酸甲苯噻嗪25 mg/kg(Ⅲ组)腹腔注射麻醉后,建立脊髓损伤动物模型,无创心电监护仪监测心率、呼吸、血氧饱和度及体温变化,记录麻醉起效时间、麻醉持续时间、呼吸道分泌物情况、镇痛效果及肌肉松弛程度。结果Ⅲ组的麻醉起效时间为(2.2±0.5)min,显著短于Ⅰ组的(14.3±2.3)min和Ⅱ组的(18.2±3.0)min(P值均<0.05)。Ⅲ组的麻醉持续时间为(139.0±12.6)min,显著长于Ⅰ组的(41.6±6.2)min和Ⅱ组的(63.9±8.2)min(P值均<0.01)。Ⅲ组在麻醉过程中各时间点的心率、呼吸、血氧饱和度和体温均保持平稳。结论盐酸氯胺酮100 mg/kg复合盐酸甲苯噻嗪25 mg/kg腹腔注射用于大鼠脊髓损伤动物模型建立的麻醉,较单纯使用盐酸氯胺酮或盐酸甲苯噻嗪效果更好。     

盐酸氯胺酮和戊巴比妥钠对树[鼠句]的麻醉效果

目的观察盐酸氯胺酮和戊巴比妥钠对树[鼠句]产生的麻醉效果,以及麻醉产生的副作用,建立安全、可靠的实验树购麻醉技术方法。方法选用成年树[鼠句]共110只,60只腹腔注射盐酸氯胺酮溶液（40mg／kg）;50只腹腔注射戊巴比妥钠（剂量50mg／kg）,观察麻醉效果。结果盐酸氯胺酮对树[鼠句]麻醉诱导期为2．78±1．28min,麻醉期为10．12±2．13min,麻醉期间有大量唾液分泌：戊巴比妥钠对树[鼠句]的诱导期为4．84±2．15min,麻醉期为51．95±12．94min,麻醉持续时间长,动物平静,体温下降极显著。结论一定剂量的盐酸氯胺酮和戊巴比妥钠均能对树购产生麻醉效果,并安全可靠;盐酸氯胺酮显效快、麻醉维持时间短,戊巴比妥钠则麻醉维持时间长,动物非常安定。     

不同催醒药对氯胺酮麻醉小鼠的催醒效果

目的 观察临床常用催醒药对氯胺酮麻醉小鼠的催醒效果,为临床合理用药提供依据.方法 昆明种小鼠随机分成5组(n=10):生理盐水组(NS组)、纳洛酮组、氟马西尼组、氨茶碱组、盐酸多沙普仑组.腹腔注射氯胺酮待翻正反射消失后1 min,各组再分别给予腹腔注射纳洛酮(2 mg/kg)、氟马西尼(0.5 mg/kg)、氨茶碱(15.5 mg/kg)、盐酸多沙普仑(100 mg/kg)和生理盐水(10 ml/kg),观察翻正反射消失持续时间(恢复时间).结果 纳洛酮组恢复时间短于NS组(P<0.05),其他各组的恢复时间与NS组相似(P>0.05).结论 纳洛酮可以缩短氯胺酮麻醉持续时间,常用剂量的氟马西尼、氨茶碱、盐酸多沙普仑则不能明显影响氯胺酮的麻醉持续时间,氯胺酮的麻醉作用可能与阿片受体有关.     

氯胺酮2种注射方式对小鼠的麻醉效果观察

目的探讨氯胺酮腹腔及肌肉注射对小鼠的麻醉效果。方法将30只BALB/c小鼠随机分成2组,按100mg/kg体重给予盐酸氯胺酮分别行腹腔及肌肉注射麻醉。结果给予腹腔及肌肉注射麻醉组小鼠分别在（3.60±0.74）min、（3.47±0.87）min进入麻醉状态无显著性差异（P〉00.5）,维持时间分别为（22.13±4.73）min、（30.60±6.19）min（P〈00.5）有统计学差异;2组小鼠进入麻醉状态前后呼吸、体温均无显著性差异（P〉0.05）。结论胺酮用于小鼠麻醉是一种安全有效的麻醉剂,选择合适剂量的氯胺酮行腹腔及肌肉注射均能为小鼠实验应用提供良好麻醉效果。     

氯胺酮麻醉前不同时间肌内注射阿托品对小儿呼吸道的影响

目的探讨氯胺酮麻醉前不同时间肌内注射阿托品对小儿呼吸道的影响。方法将2012年1月至2013年6月在廊坊市第四人民医院住院的100例患儿按随机数字表法分为两组:A组(50例)于氯胺酮麻醉前30~60 min肌内注射阿托品(0.02 mg/kg),B组(50例)阿托品(0.02 mg/kg)与氯胺酮同时间肌内注射。两组患儿均于氯胺酮肌内注射2~4 min后入室准备手术,术中观察记录两组患儿呼吸道和肺部的听诊变化及脉搏血氧饱和度(Sp O2)变化。结果 A组Ⅰ级(即呼吸道未受影响)44例,Ⅱ级以上(即呼吸道受到不同程度影响)6例,阳性率为12%(6/50);B组Ⅰ级33例,Ⅱ级以上17例,阳性率为34%(17∕50)。两组患儿呼吸道受影响程度的比较,差异有统计学意义(P<0.01)。结论小儿氯胺酮麻醉前30 min肌内注射阿托品,能有效降低氯胺酮对患儿呼吸道的影响,提高术中患儿的安全系数。     

氯胺酮麻醉对乳鼠脑细胞凋亡的影响

目的探讨临床上常用的麻醉剂氯胺酮对乳鼠脑细胞凋亡的影响。方法新生7日龄SD大鼠15只,随机分成3组:氯胺酮低剂量组、高剂量组分别腹腔注射20 mg/kg、80 mg/kg氯胺酮,对照组给予等量的生理盐水。麻醉后24 h,取脑组织作HE染色,用TUNEL法检测脑细胞的凋亡情况,用免疫组织化学法检测Caspase-3的表达水平。结果与对照组比较,氯胺酮低剂量组的凋亡细胞增多但不明显(P0.05),神经元核固缩和Caspase-3阳性细胞数明显增多(P0.05);氯胺酮高剂量组的凋亡细胞数、神经元核固缩及Caspase-3阳性细胞数显著性增加(P0.05)。神经元核固缩、凋亡细胞和Caspase-3阳性细胞均以皮层区多见。结论 80 mg/kg氯胺酮可引起乳鼠脑细胞凋亡,以皮层区为主,Caspase-3的激活可能是其作用机制之一;20 mg/kg氯胺酮对乳鼠脑细胞凋亡的影响较轻微,其临床等效剂量为3 mg/kg。氯胺酮小儿麻醉用量不宜过多,避免引起脑细胞的凋亡。     

小剂量氯胺酮-丙泊酚复合静脉麻醉用于无痛胃镜检查的临床研究

目的 观察丙泊酚镇静中辅以小剂量氯胺酮是否有利于改善麻醉和镇痛效能并减少丙泊酚和氯胺酮的相关不良反应.方法 无痛胃镜检查患者100例,年龄28～65岁,ASA Ⅰ ～Ⅱ级.随机分为2组:P组,单纯静脉注射丙泊酚;PK组,给予丙泊酚复合小剂量氯胺酮(1％丙泊酚20 m加入氯胺酮50 mg配成约4:1的丙泊酚-氯胺酮混合液)静脉注射.P组单纯静脉推注丙泊酚,以1.5mg/kg开始,每次增加0.5 mg/kg.PK组首次剂量为氯胺酮0.25 mg/kg,此时丙泊酚量按比例约为1 mg/kg,每次增加氯胺酮0.05 mg/kg合并丙泊酚0.2 mg/kg.所有患者注射至睫毛反射消失、胃镜插入时无明显肢体活动等反应时开始内镜检查,此时的静脉药物使用量记录为有效剂量.检查中如有明显体动或吞咽反射则两组患者均追加丙泊酚0.5 mg/kg,记录丙泊酚总用量.术中观察患者血压、心率、脉搏血氧饱和度(SpO2)、呼吸频率,是否有注射痛;记录丙泊酚及氯胺酮有效剂量和丙泊酚总用量;记录有无托下颌、辅助通气,内镜置人时有无体动,意识恢复时间(最后给药至呼之能应的时间),正常行走时间(意识清醒至能正常行走的时间).记录患者术中做梦、清醒后头晕及主观舒适度情况.结果 两组患者的年龄、体重、性别比例差异均无统计学意义,P组患者麻醉诱导后血压、心率较麻醉诱导前降低,但差异无统计学意义.P组注射痛(80％ vs.30％)、术中托下颌(30％vs.4％)及体动发生率(48％ vs.26％)明显高于PK组(P均＜0.05),PK组有5例患者术后述头晕.P组丙泊酚有效剂量[(2.15±0.37) vs.(1.05±0.01)mg/kg,P＜ 0.01]和总用量[(2.38±0.32) vs.(1.15±0.21)mg/kg,P＜0.05]显著高于PK组,两组患者术后恢复情况差异无统计学意义.所有患者均顺利完成内镜检查,患者满意度为100％.结论 在无痛胃镜检查中,单独应用丙泊酚或丙泊酚合用小剂量氯胺酮均可满足操作需要,但丙泊酚1 mg/kg合用氯胺酮0.25 mg/kg是更为安全可靠的方案.     

兔咪唑安定基础麻醉下手术全麻效果的实验观察

【目的】评价动物实验中采用咪唑安定基础麻醉对盐酸氯胺酮和速眠新Ⅱ复合麻醉效果的影响。【方法】成年健康新西兰大白兔96只,分成A组(48只),盐酸氯胺酮和速眠新Ⅱ复合麻醉;B组(48只),咪唑安定基础麻醉下,行盐酸氯胺酮与速眠新Ⅱ复合麻醉。均采用肌内注射麻醉。【结果】麻醉显效时间、首次用药维持时间、第二次维持时间、总维持时间分别为:A组,(7.2±1.5)min,(38.4±4.9)min,(32.7±5.5)min,(70.5±3.8)min;B组,(3.9±1.3)min,(52.3±6.7)min,(43.2±4.1)min,(95.4±2.3)min。两组间有显著性差异(P<0.01)。【结论】咪唑安定基础麻醉盐酸氯胺酮与速眠新Ⅱ复合麻醉可有效增强复合麻醉效果,减少麻醉药物用量,提高麻醉的安全性及可控性。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.