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1.
徐国亭 《中原医刊》2007,34(3):46-47
目的 观察异丙酚、氯胺酮联合靶控输注(TCI)在儿童静脉全身麻醉中应用的安全性、可行性。方法 择期ASAⅠ-Ⅱ级小儿手术患者240例,随机分为两组,每组120例。两组患儿均在入室后以4-6mg/kg氯胺酮肌注诱导。观察组:异丙酚以1-2mg/(kg·h)、氯胺酮以2—4mg/(kg·h)速度联合TCI维持麻醉,依麻醉深浅调整TCI速度:对照组:异丙酚、氯胺酮依麻醉深浅分别单次静脉注射维持麻醉。观察麻醉效果满意率、SBP、HR、RR、SpO2、术后清醒时间、麻醉药总量、不良反应发生情况,并作对比分析。结果 观察组麻醉效果满意率98.5%,术中循环、呼吸稳定,无不良反应,术毕清醒时间(14±3)min,麻药总量;异丙酚(1.2±0.8)mg/kg,氯胺酮(2.6±2、1)mg/kg。对照组麻醉效果满意率84.6%,循环、呼吸不平稳,有呕吐、屏气、躁动、嗜睡等不良反应,术毕清醒时间(69±38)min,麻药总量:异丙酚(2.8±1.4)mg/kg,氯胺酮(6.4±2.7)mg/kg。两组对比差异有统计学意义(P〈0.05)。结论 异丙酚氯胺酮联合TCI维持儿童静脉全身麻醉,循环、呼吸稳定,具有安全、可控性强、术后清醒快、用药总量及不良反应少、操作简捷等优点,可在儿童静脉全身麻醉中推广应用。  相似文献   

2.
丙氨酰谷氨酰胺对脓毒症大鼠肺损伤的保护作用   总被引:1,自引:0,他引:1  
目的:探讨丙氨酰谷氨酰胺对脓毒症大鼠急性肺损伤的保护作用及其机制。方法:静脉注射内毒素(LPS)3mL(6mg/kg)复制大鼠脓毒症急性肺损伤模型,40只健康Wistar大鼠,分为4组,即对照组(静脉注射等量生理盐水28mL/kg)、内毒素组[先后静脉注射生理盐水25mL/kg和内毒素3mL/kg(6mg/kg)]、丙氨酰谷氨酰胺治疗组[先后静脉注射4.5%力太(丙氨酰谷氨酰胺注射液)25mL/kg和内毒素3mL/kg(6mg/kg)]、谷氨酰胺治疗组[先后静脉注射3%谷氨酰胺25mL/kg和内毒素3mL/kg(6mg/kg)]。在静脉注射前(T0),注射后6h(T1),各抽血1mL。注射6h后,处死大鼠,用EusA法测定各时点血清TNF-α,IL-1β,IL-8的浓度,测定肺组织湿/干重比、支气管肺泡灌洗液的总蛋白浓度,光学显微镜下观察肺组织病理改变,原位TUNEL技术进行肺组织细胞凋亡检测分析。结果:与LPs组比较,丙氨酰谷氨酰胺治疗组、谷氨酰胺治疗组的肺组织湿/干重比、支气管肺泡灌洗液的总蛋白浓度,血清TNF-α,IL-1β,IL-8浓度明显降低(P<0.05);丙氨酰谷氨酰胺治疗组、谷氨酰胺治疗组的肺组织损伤程度明显减轻而且凋亡指数也较LPS组显著降低(P<0.05)。结论:静脉给予丙氨酰谷氨酰胺对脓毒症大鼠急性肺损伤有保护作用。  相似文献   

3.
目的:比较微量注射泵输注胰岛素与小剂量持续静脉滴注胰岛素在糖尿病酮症酸中毒(DKA)治疗中的疗效差异。方法:将我科住院DKA病人随机分成微量注射泵输注胰岛素治疗N(MIP组)16例和常规小剂量胰岛素静脉滴注组(对照组)15例,观察两组病人血糖、尿酮变化及低血糖的发生率。结果:两组患者的血糖经治疗后均有明显下降,达目标血糖值所需时间:对照组(4.4±2.1)h,与MIP组(5.6±3.2)h比较,P〉0.05。尿酮转阴时间(27.2±11.1)h,亦较对照组(42.2±9.2)h明显缩短,P〈0.01;MIP组低血糖发生率(0.9-0.3)次/人,较对照组(2.1±0.4)次/人明显减少,P〈0.01。结论:微量注射泵输注胰岛素治疗DKA较常规小剂量静脉滴注胰岛素法更安全有效。  相似文献   

4.
盐酸多西环素对内毒素诱导大鼠急性肺损伤的保护作用   总被引:1,自引:0,他引:1  
张琦  张丙芳  牛雯  李勇  王晓明  李志超 《医学争鸣》2009,(17):1560-1563
目的:研究盐酸多西环素对内毒素诱导大鼠急性肺损伤(ALI)的保护作用.方法:将72只雄性SD大鼠随机分为对照组,损伤组(ALI组),脂多糖治疗组(LPS组),每组24只.每组按造模后不同观察时间点又分为1,2,4,8h4个亚组(n=6).于0h时给予对照组气管内滴注生理盐水(NS)0.3mL,10min后股静脉注射NS1mL.ALI组气管内滴注LPS0.2mg/kg(溶于0.3mL NS),10min后股静脉注射NS 1mL.LPS组气管内滴注LPS0.2mg/kg,10min后股静脉注射盐酸多西环素20mg/kg(溶于1 mL NS).各组于1,2,4,8h4个时间点心脏抽血检测动脉血氧分压(PaO2);取肺组织进行肺湿/干质量(W/D)比值测定,并采用HE染色观察肺组织形态学变化;免疫组织化学法检测肺组织中基质金属蛋白酶-2(MMP-2),基质金属蛋白酶-9(MMP-9)表达.结果:给予气管内滴注LPS后1~8h大鼠动脉血PaO2 ALI组,LPS组显著降低,4h时达最低点,各时间点动脉血PaO2 LPS组均显著高于AU组(P〈0.05,P〈0.01).W/D比值1~8h时AU组,LPS组均显著增加,2组相比较LPS组较AU组降低(P〈0.05,P〈0.01).病理形态学观察可见LPS组肺水肿、出血、炎性细胞浸润程度程度较AU组减轻.免疫组化结果显示ALI组肺组织MMP-2,MMP-9在气管内滴入LPS后1h后迅速升高,4h时达峰值,LPS组MMP-2,MMP-9表达在相同时间均较Au组显著降低(P〈0.05,P〈0.01).而对照组肺组织MMP-2,MMP-9在不同时间点无明显变化.结论:盐酸多西环素可抑制内毒素性大鼠AU肺组织MMP-2,MMP-9表达,改善呼吸氧合功能,减轻肺损伤.  相似文献   

5.
 【目的】观察改变肾组织醛固酮及其受体水平对自发性高血压大鼠肾脏纤维化的影响。【方法】8周龄的雄性自发性高血压大鼠(SHR)24只及同源正常京都大鼠(WKY)8只,SHR分为贝那普利干预组[30ing/(kg·d)]、大剂量安体舒通干预组[100mg/(kg·d)]和高血压模型对照组,同时设同源的正常对照组,干预时间为8周,检测收缩压、尿蛋白、血白蛋白、尿素氮、肌酐、肾组织醛固酮受体、TGF-β1的mRNA和蛋白表达。【结果】贝那普利能下调组织醛固酮【(15.8±2.6)vs(22.2±0.6)pg/mg]及其受体水平【(15±4)vs(13±5)PU]并减轻肾脏纤维化[(17.0±1.8)vs(20.0±2.3)PU],均为P〈0.05;大剂量安体舒通能上调组织醛固酮[(24.3±4.6)vs(22.2±0.6)pg/mg]及其受体水平[(16±6)vs(13±5)PU]并加重肾脏纤维化[(22.6±3.0)vs(20.0±2.3)PU],均为P〈0.05。【结论】肾组织醛固酮及其受体水平的改变可能影响高血压肾脏纤维化的过程。  相似文献   

6.
异丙酚对内毒素致大鼠急性肺损伤的保护作用及机制   总被引:1,自引:0,他引:1  
目的探讨异丙酚对内毒素致大鼠急性肺损伤(ALI)的保护作用及机制。方法Wistar大鼠随机分成3组,每组20只。对照组(C组):股静脉输注生理盐水5mL在1.5h内输注完毕;内毒素(LPS)对照组(L组):经股静脉输注生理盐水3mL/h,然后再输注LPS8mg/kg(溶于2mL生理盐水中),30min内输注完毕;异丙酚处理组(LT组):异丙酚20mg/kg溶于3mL生理盐水中,经股静脉1h内输注,然后输注LPS(方法如上)。6h时取大鼠肺组织标本,HE染色后观察肺组织形态学的变化;检测肺组织湿/干重(W/D)比、肺水含量、血管壁通透性(EB渗出)、肺通透指数(LPI)等指标反映肺损伤程度;检测丙二醛(MDA)、NO、诱导型NO合成酶(iNOS)、超氧化物歧化酶(SOD)及髓过氧化物酶(MPO)的活性来反映氧自由基的代谢;Kaplan—Meier曲线分析4、6、8、10、12h生存率。结果L组W/D比、EB渗出、LPI、MDA、NO、iNOS、MPO显著高于C组、LT组(P〈0.01),而SOD较LT组明显下降(P〈0.01):结论异丙酚增强SOD活性,抑制iNOS、MPO活性,减少了内毒素致ALI后肺部的炎性反应及氧化应激反应,从而减轻了肺损伤程度。  相似文献   

7.
 【目的】探讨三磷酸肌醇(IB)和PTEN蛋白变化在三羟异黄酮(genistein)诱导肝癌细胞凋亡中的作用。【方法】以肝癌HepG2细胞培养72h为对照组,实验各组以60Ixmol/L三羟异黄酮作用于HepG2细胞不同时间后,应用同位素试剂盒检测细胞嵋含量,Western blot分析细胞PTEN蛋白表达,流式细胞仪检测细胞凋亡率。【结果】对照组Ib含量为(29.2±0.6)pmol/10^6 cells,PTEN蛋白与内参actin蛋白灰度和面积之积的比值V-PTEN/V-actin为0.12±0.00;细胞凋亡率为(2.6±0.1)%。三羟异黄酮作用于肝癌HepG2细胞12、24、48、72h后珉分别为(12.0±1.4)pmol/10^6cells,(7.5±0.8)pmol/10^4 cells,(5.6±0.5)pmol/10^6cells,(3.3±0.6)pmol/10^6 cells;V-PTEN,V-actin分别为13.13±0.20,19.17±1.09,28.51±2.18,41.12±3.80;细胞凋亡率分别为(2.7±0.2)%。(7.4±0.5)%,(20.5±2.0)%,(30.7±1.6)%。与对照组比,三羟异黄酮作用于肝癌HepG2细12h后各时相珉显著降低(P〈0.01),PTEN蛋白表达显著增高(P〈0.01),24h后各时相细胞凋亡率显著增高(P〈0.01)。【结论】三羟异黄酮能减少瑕生成,上调PTEN基因表达,诱导肝癌细胞凋亡。  相似文献   

8.
目的观察氟比洛芬酯复合芬太尼用于鼻内窥手术后静脉自控镇痛(PCIA)的有效性和不良反应。方珐择期鼻内窥镜手术患者60例,手术结束后随机分为两组:实验组:术毕静脉注射氟比洛芬酯50mg为负荷剂量后接PCA泵,泵内药物为氟比洛芬酯200mg+芬太尼0.5mg+氟哌利多5.0mg+生理盐水至100mL;对照组:术毕静脉注射芬太尼0.1mg为负荷剂量后接PCA泵,泵内药物为芬太尼1.2mg+氟哌利多5.0mg+生理盐水至100mL。两组均采用持续输注2.0mL/h,单项PCA剂量0.5mL,锁定时间15min。记录术后48h内镇痛评分(VAS)、镇静评分(SS)及不良反应。结果两组镇痛效果、镇静评分差异元统计学意义(P〉0.05),实验组恶心、呕吐和头晕等不良反应低于对照组(P〈0.05)。结论氟比洛芬酯复合芬太尼用于鼻内窥镜手术后静脉自控镇痛,可减少芬太尼不良反应,提高镇痛质量。  相似文献   

9.
 【目的】探讨白蛋白对近端肾小管上皮细胞(PTCs)增殖与凋亡的影响。【方法】用不同剂量(0.1,0.5,1,5,10,30mg/mL)去脂牛血清白蛋白(dBSA)超载体外培养的NRK52E,dBSA 0mg/mL作为对照。细胞增殖活性用MTS比色法检测和显微镜观察。细胞凋亡检测:荧光染料DAPI染核,DNA梯带实验,原位末端标记(TUNEL)实验和苔盼蓝染色计数。【结果】高剂量dBSA超载未完全融合NRK52E细胞144h后细胞变得更密集。MTS比色结果发现,高剂量dBSA(5、10、30mg/mL)超载可明显诱导NRK52E细胞增殖,增殖活性分别为(0.700±0.045)A、(1.021±0.029)A和(1.273±0.173)A,较对照细胞(0.441±0.020)A显著升高,P均〈0.05。高剂量dBSA超载的NRK52E细胞,有较多出现核碎裂和核固缩,有较强DNA梯带和原位末端标记信号。苔盼蓝染色计数发现,高剂量dBSA(5、10、30mg/mL)超载NRK52E细胞72h的死亡细胞数[(680000±28618)/mL,(970000±52915)/mL和(1132500±88954)/mL较对照的死亡细胞数[(312500±28395)/mL]显著升高,P均〈0.05;而且死亡细胞数呈剂量依赖性。【结论】白蛋白超载NRK52E细胞既可诱导细胞增殖,又可诱导细胞凋亡。  相似文献   

10.
粗壮女贞叶提取物静脉注射0.098、0.140和0.200g/kg可使麻醉大鼠的血压显著下降,峰值下降37.7%、38.6%和50.2%:灌胃给药(ig)1.36g/kgqd×3d,不影响清醒大鼠的血压。清醒自发性高血压大鼠ig1.08和2.16g/kgqd×5d,血压由24.3±0.5和24.3±0.6降至18.1±0.9和16.6±0.7kPa,降压作用显著(P<0.001,<0.001);对清醒二肾-夹型高血压大鼠,ig粗壮女贞0.5g/kgqd×7d,血压由20.3±3.9降至16.2±3.9kPa,血压下降20%。以上结果提示具有降压作用。昆明小鼠急性毒性试验,ig49g/kg10d内动物生长良好,未出现死亡;腹腔注射5个剂量组(每组10只)按简化机率单位法测得LD502.64±0.21g/kg(P=0.95)。  相似文献   

11.
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.  相似文献   

12.
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.  相似文献   

13.
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.  相似文献   

14.
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.  相似文献   

15.
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.  相似文献   

16.
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.  相似文献   

17.
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.  相似文献   

18.
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.  相似文献   

19.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

20.
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.  相似文献   

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