咪唑安定诱导对心脏瓣膜置换手术病人血流动力学的影响

１７例风湿性心脏病瓣膜置换术手同人，静注咪唑安定０．５ｍｇ／ｋｇ诱导，并以Ｓｗａｍ－Ｇａｎｚ导管测定血流动力学变化。ＭＡＰ、ＨＲ、ＣＩ、ＭＰＡＰ、ＰＣＷＰ、ＬＶＳＷＩ及ＲＶＳＷＩ均在诱导后明显下降，而ＲＡＰ、ＳＩ、ＳＶＲＩ及ＰＶＲＩ无明显变化，气管插ＭＡＰ、ＳＶＲＩ、ＰＶＲＩ增高。     

一氧化氮合酶抑制剂对大鼠异氟醚MAC的影响

目的 研究神经元型一氧化氮合酶（ｎＮＯＳ）抑制剂７－硝基吲唑（７－ＮＩ）对大鼠异氟醚ＭＡＣ的影响。方法 ３０只雄性ＳＤ大鼠,。随机分为６组（每组５只）。大鼠置闭麻醉系统中,按标准夹尾法测定异醚ＭＡＣ。每只鼠测定基础ＭＡＣ后,随机经腹腔注射３ｍｌ花生油,或２０、６０、８０、１２０或２５０ｍｇ．ｋｇ＾－１ＮＩ（溶于３ｍｌ花生油）,３０分钟后ＭＡＣ值。结果 ２０～２５ｍｇ．ｋｇ＾－１７－ＮＩ显著降低异氟     

环孢素及山莨菪碱对肝细胞游离钙的影响

分离ＳＤ大鼠肝细胞，负载荧光钙指示剂Ｆｕｒａ－２／ＡＭ后以无钙Ｈａｎｋｓ液悬浮，分别以入以下试剂：１．二甲亚砜。２．环孢素（ＣｓＡ）１ｍｇ／Ｌ。３．ＧｓＡ１０ｍｇ／Ｌ。４．ＣｓＡ１０ｍｇ／Ｌ，山莨菪碱１０ｍｇ／Ｌ。５．ＣｓＡ１０ｍｇ／Ｌ，山莨菪碱４０ｍｇ／Ｌ。测定肝细胞内游离钙发现ＣｓＡ可增加肝细胞内游离钙，为剂量依赖性，山莨菪可部分拮抗ＣｓＡ引起的升钙作用。     

硬膜外小剂量吗啡四种配方术后止痛的比较研究

２００例ＡＳＡⅠ－Ⅱ级，年龄１８－４４岁，４５－６８ｋｇ的子宫或卵巢全部或部分切除的患者，以单盲法分为四组，每组４０例，分别于术后自硬膜外腔注入（１）吗啡２．５ｍｇ；（２）吗啡２．５ｍｇ＋保分子右旋糖酐６ｍｌ；（３）吗啡２．５ｍｇ＋纳洛酮０４ｍｇ；（４）吗啡２ｍｇ＋５％Ｎａ Ｃｌ６ｍｌ，比较了注药前及注药后１、３、６、９、１２ｈ的ＣＯ２通气反应、止痛效应及副作用。     

Leflunomide免疫抑制作用的实验研究

为了寻找一种抗排斥、疗效好且毒性低的免疫抑制药物，应用Ｌｅｆｌｕｎｏｍｉｄｅ（ＬＦＭ，雷抑素）对大鼠移植模型进行研究，实验分为对照组、ＬＦＭ组、ＣｓＡ组和ＬＦＭ＋ＣｓＡ组。结果显示ＬＦＭ２．５ｍｇ．ｋｇ－１．ｄ－１和ＣｓＡ２．５ｍｇ．ｋｇ－１．ｄ－１术后灌服７天，大鼠移植器官存活时间分别为１８．２±１．５和１３．５±１．３天，较对照组７．２±１．２天明显延长，ＬＦＭ和ＣｓＡ联合用药，移植物存活时间２６．８±５．７天，较单纯用药效果更好。证明ＬＦＭ具有显著的抗排斥作用，与ＣｓＡ合用有协同作用；ＬＦＭ在移植后４天给药，仍可逆转淋巴细胞在移植物内的浸润，能较快地逆转移植物的排斥反应。     

相同MAC浓度的安氟醚和异氟醚对脑电图功率谱的影响

２４例 ２０～５０岁、ＡＳＡⅠ级、行择期外科手术的患者，随机分成两组：安氟醚组和异氟醚组。不用术前药，麻醉诱导以静脉硫喷妥钠５ｍｇ／ｋｇ、阿曲库胺０．６～０．７ｍｇ／ｋｇ。单纯吸入安氟醚或异氟醚维持全麻。气管插管后控制呼吸，维持呼气末二氧化碳分压（ＰＥＴＣＯ２）４．２７。４．９３ｈｐａ。以ＴＯＦ监测肌松，间断给予阿曲库胺 １０～１５ｍｇ，维持Ｔ４／Ｔ１＜２５％。采用 ＦＰ１－Ａ１、ＦＰ２－Ａ２双导联监护脑电，验证呼气末麻醉药浓度在 ０． ５、０．８、１． ０、１． ３和 １．５ ＭＡＣ时的脑电功率谱、９５％边缘频率（ＳＥＦ）和中心频率（ＭＰＦ）改变。结果发现，随ＭＡＣ增加脑电功率谱表现出波增加，α和β波减少，而ＳＥＦ、ＭＰＦ值随ＭＡＣ增加而减少的改变呈负性线性关系，ｒ＝－０．９５。提示脑电功率谱、ＳＥＦ和ＭＰＦ在评价全麻深度上有一定意义。     

诱发性一氧化氮合酶抑制药对感染性休克鼠肝,肺组织学改变？…

目的 研究诱导性一氧化氮合酶（ｉＮＯＳ）抑制药氨基胍（ＡＧ）和非选择性ＮＯＳ抑制药Ｌ－Ｎ硝基精氨甲酯（Ｌ－ＮＡＭＥ）对感染性休克鼠肝肺组织学改变的影响。方法 小鼠腹腔内注射（ｉ．ｐ．）内毒素（ＬＰＳ,２０ｍｇ·ｋｇ＾－１）后４小时随机分为ＬＰＳ组（ｎ＝６０）,ＬＰＳ＋Ｌ－ＮＡＭＥ组（３０ｍｇ·ｋｇ＾－１ｉ．ｐ．,ｎ＝６０）。和ＬＰＳ＋ＡＧ组（２０ｍｇ·ｋｇ＾－１ｉ．ｐ．ｎ＝６０）。５小时后取受试鼠     

曲马多—可乐定复合液硬膜外镇痛的临床研究

将１０５例ＡＳＡⅠ－Ⅱ级胸部择期手术患者随机分为七组，每组１５例。用盲法将Ⅰ至Ⅲ分别注入单纯曲马多０．５ｍｇ／ｋｇ，０．８ｍｇ／ｋｇ及１．２ｍｇ／ｋｇ，Ⅳ组注入可乐定１５０μｇ，Ⅴ至Ⅶ组分别注入曲马多０．５ｍｇ／ｋｇ，０．８ｍｇ／ｋｇ及１．２ｍｇ／ｋｇ各加可乐定１５０μｇ。注药后测定起效和维持时间，评价镇痛效果，监测血流动力学（０至１２０分钟）和呼吸频率等指标。结果显示：七组病例一般统计学资料差…     

溶脲脲原体感染动物模型的建立──在泌尿生殖系中的分布

将１００只雄性ＳＤ大鼠分为３组。Ａ组４５只；Ｂ组２２只；Ｃ组３３只。Ａ组每只动物经膀胱注入血清８型溶脲脲原体（ｕｒｅａｐｌａｓｍａｕｒｅａｌｙｔｉｃｕｍ，ＵＵ）菌株（１９６０），浓度为１０５ＣＣＵ／ｍｌ。Ｂ组处理方法同Ａ组，在接种３个月后给予美满霉素（２０～１００ｍｇ／ｋｇ体重），连续１４天。Ｃ组为对照组，每只动物膀胱注入等量溶脲脲原体液体培养基。结果表明，在Ａ组动物的膀胱（８７．５％）、睾丸（６２．５％）、附睾（５５．０％）、精囊（６５．０％）和前列腺（５７．５％）中均检出溶脲脲原体。Ｂ组溶脲脲原体检出率显著低于Ａ组。Ｃ组上述器官溶脲脲原体培养均为阴性。     

静脉注射不同剂量异丙酚对血流动力学及通气功能的影响

应用阻抗法和分气流监测法观察静脉注射不同剂量异丙酚（Ｐｒｏｐｏｆｏｌ，ＰＲＯ）后患者血流动力学（ＭＡＰ、ＮＲ、ＳＬＣＩ、ＩＦＩ、ＶＥＴ、ＥＶＩ、ＳＶＲＩ、ＩＣ、ＰＦＩ、ＬＳＷＩ）与通气功能（ＶＴ、ＲＲ、ＶＥ、ＦＥＶ１％、ＥＴＣＯ２、ＳＰＯ２、 Ｉ－ＥｔＯ２）的变化。 ４０例（ＡＳＡⅠ～ Ⅱ）随机分成四组，ＰＲＯ剂量分别为 １．０ｍｇ／ｋｇ、１．５ｍｇ／ｋｇ、２．０ｍｇ／ｋｇ、２．５ｍｇ／ｋｇ。结果：（１）１～４组呼吸暂停发生率为０％、２０％、３０％、８０％，苏醒时间分别为３ ０±１．５、７．４±２．３、９．１±３．６、９．６±４．２分钟：（２）静脉注射不同剂量ＰＲＯ启ＳＡＰ、ＤＡＰ、ＭＡＰ、ＳＩ下降，ＨＲ、ＣＩ、ＳＶＲＩ无明显变化，心肌收缩性（ＩＣ、ＰＦＩ、ＥＶＩ）明显减弱，ＳＶＲＩ减少；（３）ＰＲＯ对呼吸有抑制作用，以ＶＴ和ＶＥ影响最大，与剂量呈正相关；对面罩吸氧患者ＳｐＯ２、ＲＲ、ＥＴＣＯ２无明显改变，Ｉ－ＥｔＯ２减少；舌后坠者托起下颌对ＶＴ、ＶＥ的恢复颇为有效。     

不同内侧界右半结肠癌D3淋巴结清扫前瞻性对比研究

目的 对比分析不同内侧界右半结肠癌D3淋巴结清扫的临床效果。方法 选取2018年1月至2020年12月于池州市人民医院行腹腔镜右半结肠癌D3淋巴结清扫的56例右半结肠癌患者为研究对象,采用随机数字表法分为两组,各28例,分别以肠系膜上动脉左侧(SMA组)和肠系膜上静脉左侧(SMV组)为内侧界进行腹腔镜右半结肠癌D3淋巴结清扫。比较两组围手术期相关指标、术后并发症及术后生存情况。结果 SMA组淋巴结清扫总数和阳性淋巴结数目较SMV组显著增多(P<0.05),两组手术时间、术中出血量及术后引流量、排气时间、住院时间、术后总并发症发生率比较,差异均无统计学意义。术后随访35(18～54)个月,SMA组累积无病生存率(82.1%vs71.4%)及累积总生存率(89.3%vs 78.6%)略高于SMV组,但差异无统计学意义(χ²=0.995、1.402,P=0.319、0.236)。结论 以SMV左侧与SMA左侧为内侧界的腹腔镜右半结肠癌D3淋巴结清扫均是安全可行的,在保证肿瘤根治性切除的基础上,以SMA左侧为内侧界清扫淋巴结更彻底,提高了肿瘤根治程度且未显著增加手术...     

记忆合金加压钉抑制山羊半侧脊柱生长的实验研究

目的观察记忆合金加压钉置入山羊胸椎侧方对山羊脊柱生长的影响。方法16只2～3个月雌性山羊,分为单钉组、双钉组和对照组。单钉组6只,经第8肋开胸术显露胸椎,将5枚记忆合金加压钉分别跨越椎间隙置入山羊T6～11椎体右侧中央,每个椎间隙置入1枚;双钉组6只,实施相同开胸手术,每个椎间隙置入2枚加压钉;对照组4只,进行右侧开胸手术不置入加压钉。每隔1个月拍摄X线片,观察脊柱生长情况。结果X线观察发现,术后2个月时形成侧凸,单钉组山羊加压节段Cobb角12．83°±12．17°;双钉组Cobb角12．00°±3．22°。术后4个月时,单钉组侧凸变为6．00°±4．94°,双钉组侧凸增加到25．17°±3．71°。对照组在术后4个月中,未见脊柱形成侧凸畸形。单钉组1只山羊在术后2个月形成15°的后凸畸形,术后4个月时未变化。双钉组1只山羊在术后后凸畸形逐渐增大,4个月时T6～9节段形成10°的Cobb角。结论记忆合金加压钉对半侧椎体进行加压,能够有效抑制半侧脊椎骨骺的生长,调节脊柱生长方向,同时,加压力的大小与脊柱生长抑制成正相关。     

Repeated vas occlusion and non-invasive reversal with styrene maleic anhydride for male contraception in langur monkeys

The feasibility of a spacing method for contraception, using Styrene Maleic Anhydride (SMA) as a vas occlusive agent, has been assessed in male langur monkeys. The vas deferens of 6 animals were occluded with 60 mg SMA in 120 microL DMSO. After 150 days, the occlusion was reversed by a technique which involved palpation, percutaneous electrical stimulation, forced vibratory movement, suprapubic percussion and per-rectal digital massage of the vas segments. The vas deferens were then re-occluded with SMA and reversed by the non-invasive method after three consecutive azoospermic samples. The second vas occlusion resulted in uniform azoospermia after the third ejaculation and reversal caused the reappearance of spermatozoa in the semen to severe oligozoospermic levels in the first two ejaculations and rising to normospermia in the subsequent ejaculations. Ultrastructure of the spermatozoa by SEM and TEM and sperm function tests revealed that the spermatozoa had recovered normal morphology. Vas morphology also regained a normal pseudostratified columnar epithelium containing basal and principal cells. The results suggest that the SMA-based spacing technique for male contraception could be extrapolated to the human by use of no-scalpel injection and non-invasive reversal.     

依托咪酯对大鼠肠缺血-再灌注致视网膜损伤的保护作用

目的 探讨依托咪酯是否可对大鼠肠缺血-再灌注引起的视网膜损伤产生保护作用.方法 Wistar大鼠24只分为三组:假手术组(S组)、缺血-再灌注组(Ⅰ组)、依托咪酯组(E组).S组仅分离肠系膜上动脉(SMA),不夹闭;Ⅰ组夹闭SMA 1 h,再灌注2 h,下腔静脉持续输注生理盐水10ml·kg<'-1>·h<'-1>;E组则输注依托咪酯0.2 mg·kg<'-1>·h<'-1>.静脉采血2 ml,测定血清肌酐(Cr)水平.剥离视网膜,测定其组织匀浆中超氧化物歧化酶(SOD)活性及丙二醛(MDA)含量.病理切片观察小肠和视网膜病理变化.结果 与S组比较,Ⅰ组SOD活性显著降低,MDA含量和Cr水平显著升高(P<0.05);与Ⅰ组比较,E组SOD活性的增高和MDA含量与Cr水平降低(P<0.05).病理观察:与S组比较,Ⅰ组肠上皮下间隙扩张,黏膜上皮层与固有层中度分离,中性粒细胞增多,部分绒毛顶端破损.视网膜内层明显水肿,神经节细胞分散,排列不规则;外核层分解、破坏.E组小肠组织结构轻度改变,部分绒毛顶端破损.视网膜内层水肿明显减轻,末梢小血管开放,细胞排列较规则.结论 依托咪酯对大鼠小肠缺血-再灌注所致的视网膜损伤具有保护作用.     

血清D-二聚体测定对急性肠系膜上动脉栓塞的诊断价值

目的 评估测定血清D-二聚体（D-dimer）含量在诊断急性肠系膜上动脉（superior mesenteric artery,SMA）栓塞中的价值。方法将我院1998年6月-2006年6月入院诊断或出院诊断为急性肠系膜血管缺血性疾病的63例分为SMA栓塞（11例）和其它急腹症（52例）两组。使用ROC曲线法评价D-二聚体对SMA栓塞的诊断价值,明确D-二聚体的诊断临界点,绘制ROC曲线。结果ROC曲线下面积为0．939,并有统计学意义。通过ROC曲线确定诊断临界点为0．73mg／L,并具有较高的灵敏度和特异度。结论血清D-二聚体测定可用于急腹症中SMA栓塞的临床排除诊断。当血清D-二聚体高于0．73mg／L时,应高度怀疑为SMA栓塞。     

Pancreas head carcinoma: frequency of invasion to soft tissue adherent to the superior mesenteric artery

Despite radical extension of surgical procedures, the cure rate of pancreatic head carcinoma patients still remains low. A cause of this concerns unsuccessful locoregional control, which may originate from a positive surgical margin near the superior mesenteric artery (SMA). However, no studies have examined invasion of pancreatic carcinoma around the SMA. En bloc resection of the head of the pancreas and the superior mesenteric vessels was performed on 6 patients who had pancreatic head carcinoma invading the superior mesenteric vein. The specimens were cut perpendicular to the SMA and consecutive serial sections were made. The slices were stained with hematoxylin and eosin or immunohistochemistry for cytokeratin 19 to easily detect carcinoma tissue under a microscope. Nodal metastasis around the SMAs was found in all of the cases. There were no characteristics of the arrangement of the metastatic nodes along the SMA. Lymphatic emboli were often observed close to the metastatic nodes. Neural invasions were detected around the tumors in every case and were continuously connected with the extrapancreatic nerve plexus. The nerve plexus covering the SMA were involved in 4 cases. Involvement was observed mainly behind the SMA, reaching as far as the left side of the SMA in 3 cases. The invasion extended further upwards along the right side of SMA for the celiac nerve plexus. The lymphatics and the nerve plexus in the area around the SMA were frequently involved by pancreatic head carcinoma. This involvement would have been left behind unless the SMA was resected.     

腹腔镜SMA与SMV左侧为界D3根治术治疗右半肠癌的临床价值比较

目的比较腹腔镜肠系膜上动脉(SMA)与肠系膜上静脉(SMV)左侧为界D3根治术治疗右半肠癌的临床价值。方法回顾性分析2017年8月至2019年11月接受手术治疗的83例右半肠癌患者病例资料,将SMA左侧作为术中淋巴结清扫内侧界线的40例患者纳入SMA组,将SMV左侧作为术中淋巴结清扫内侧界线的43例患者纳入SMV组。采用SPSS 25.0软件包处理数据,手术相关指标、淋巴清除情况等计量资料以(x±s)描述,行独立t检验;并发症等计数资料行χ^2检验,P<0.05为差异有统计学意义。结果SMA组术中出血量、术后肛门排气时间、住院时间与SMV组相比,差异无统计学意义(P>0.05);SMA组手术时间、术后引流量、术后引流放置时间、平均阳性淋巴结数量、平均淋巴结清扫总数均比SMV组长/多,差异有统计学意义(P<0.05);SMA组术后并发症总发生率比SMV组高(42.5%vs.20.9%),差异有统计学意义(P<0.05)。结论相较于以SMV左侧为界,腹腔镜SMA左侧为界右半肠癌D3根治术可对病灶进行更加彻底的清扫,但术后并发症较多,临床选择需谨慎。     

Interhemispheric integration: I. Symmetry and convergence of the corticocortical connections of the left and the right principal sulcus (PS) and the left and the right supplementary motor area (SMA) in the rhesus monkey.

The relationship between the termination zones of projections from paired homotopic areas in the frontal lobe was examined in the cerebral cortex of the macaque monkey. Injections of WGA-HRP and tritiated amino acids were made in topographically matched regions of the principal sulcus (PS) or the supplementary motor area (SMA) in each hemisphere, such that the projections from the same area on each side were differentially labeled in the same animal. Adjacent sections through the cortical regions that received bilateral inputs from these areas were processed for the respective tracers, permitting the relationship between the converging projections to be defined. Comparison of the cortical connections of the left and right PS or of the left and right SMA yielded two major findings. First, only minor differences in the topographic distribution and strength of connections of homotopic areas were observed, providing little evidence of asymmetry in the connections of either the PS or the SMA in the macaque. Second, with the exception of interdigitation observed in a portion of the dorsal bank of the PS, the cortical projections from both the left and the right PS and SMA converged (overlapped) in common columnar territories. These termination patterns allow for a remarkable degree of interhemispheric integration.     

Gangliosides on intestinal microcirculation and animal survival during reperfusion

This study investigated the effect of gangliosides (Gang) on small bowel microcirculation and animal survival after normothermic intestinal ischemia-reperfusion injury. Five adult male EPM-1 Wistar rats in each of three groups received FK506 (0.2 mg/kg), Gang (3 mg/kg), or vehicle (at same volume) either 24 or 12 hours prior to the experiment. The animals were anesthetized intramuscularly with ketamine (60 mg/kg) and xylazine (10 mg/kg) and hydrated with 80 mL/kg of prewarmed saline solution delivered subcutaneously before the ischemic insult and 40 mL/kg at 1 hour after reperfusion. Under anesthesia, they underwent a laparotomy with clamping of the superior mesenteric artery (SMA) at its origin for 75 minutes. Microcirculation was evaluated with a laser Doppler flowmeter, 5 minutes before ischemia (baseline) and reperfusion (ischemia), and 20, 40, and 60 minutes after reperfusion. Animal survival was observed up to 24 hours. Small bowel flow measured before ischemia was considered to be the baseline level (100%). After SMA occlusion a significant reduction in microcirculatory tissue perfusion to about 8% was observed in all groups. At 20, 40, and 60 minutes of reperfusion treatment with Gang (77%, 81%, and 100%) or FK506 (70%, 85%, and 98%) promoted better recovery of the intestinal microcirculation when compared to the control group (45%, 72%, and 75%). Concerning animal survival there was no difference between groups (just one animal from each group, Gang and FK506, survived up to 24 hours). Based on our data we conclude that Gang and FK506 improve intestinal microcirculation in ischemia-reperfusion injury but do not change animal survival after severe ischemia.     

Do Surface-Modifying Additive Circuits Reduce the Rate of Cerebral Microemboli During Cardiopulmonary Bypass?

The objective of this study was to determine if surface-modifying additive (SMA) cardiopulmonary bypass (CPB) circuits are associated with a lower rate of cerebral microemboli during CPB compared with standard circuits. In a 2 x 2 factorial design, patients undergoing coronary artery bypass graft surgery were randomized to SMA or standard CPB circuits (with and without methyl-prednisolone). Transcranial Doppler was used to detect high-intensity transient signals (HITS) in both middle cerebral arteries. HITS were counted from onset to end of CPB. Intervals of interest were as follows: period 1, from CPB onset to aortic cross-clamping; period 2, from aortic cross-clamping to immediately before de-clamping; period 3, from aortic declamping to before aortic side-clamping; period 4, from the application of the aortic side clamp to immediately before the release of the side clamp; period 5, from aortic side clamp release to the end of CPB. There were 14 patients in each circuit group. No significant differences were found on the partial and total counts of HITS (medians [25th, 75th percentile]) between patients exposed to standard (total count: 228 HITS [174, 2801) and SMA circuits (total count: 156 HITS [104, 356]; p = .427). The median of the sum of HITS per patient associated with perfusionist interventions was not different between both circuit groups (standard: 17 HITS [7, 80]; SMA: 43 HITS [13, 168]; p = .085). This study, with a sample size of 28 patients, indicates that it is unlikely to find any difference in the count of HITS during CPB that is greater than 117 HITS between the two CPB circuits. Moreover, our findings emphasize the relevance of minimizing additional sources of cerebral microembolization during CPB that are not directly related to the biocompatible nature of the SMA CPB circuit.