乌拉地尔防止气管插管引起的心血管反应的临床观察

目的　观察乌拉地尔用于防止气管插管心血管反应的效果。方法　 4 0例全麻择期病人 ,随机分为 2组 (n =2 0 ) ,麻醉诱导用 2 .5 %硫喷妥钠 5～ 8mg/kg ,琥珀胆碱 2mg/kg ,进行快速气管内插管。对照组不用乌拉地尔 ,实验组诱导前静注乌拉地尔 0 .6mg/kg。分别记录诱导前 ,用乌拉地尔后 1、3、5min ,用硫贲妥钠、琥珀胆碱后 1min及插管时 ,插管后 2、5min时的HR、SBP、MAP及RPP值。结果　对照组插管时 ,插管后 2min的HR、SBP、MAP及RPP值明显升高 (P <0 .0 5 )。乌拉地尔组插管时 ,插管后 2min的HR及RPP值明显升高 ,SBP和MAP恢复到诱导前水平。两组之间比较乌拉地尔组HR、SBP、MAP及RPP值升高相对较低 ,组间比较有显著性差异 (P <0 .0 5 )。结论　诱导前使用乌拉地尔可以减轻气管插管心血管反应。     

乌拉地尔、利多卡因预防气管插管时心血管反应的临床观察

为观察气管插管前静脉注射乌拉地尔、利多卡因时对心管反应的临床效果,选择ASAⅠ~Ⅱ级气管插管全身麻醉患者40例,随机分为两组,A组观查组和B组对照组。A组先静注乌拉地尔0.25mg/kg和利多卡因1mg/kg,3min后麻醉诱导。B组先静注生理盐水2mL,3min后麻醉诱导。A组患者心率(HR)和血压(BP)在插管后1min较术前变化不大,而B组较术前变化比较明显,差异有统计学意义(P<0.05),插管后3min均逐渐趋于平稳。认为气管插管前静注乌拉地尔、利多卡因可明显减轻气管插管的刺激而产生的心血管反应。     

乌拉地尔复合利多卡因对老年原发性高血压患者气管插管时血流动力学的影响

目的观察乌拉地尔复合利多卡因对老年原发性高血压患者气管插管时血流动力学的影响。方法选择择期全麻手术患者120例,年龄58～75岁。随机分为A、B、C三组,每组40例,分别于诱导前3 min静注3 ml生理盐水、0.4 mg/kg乌拉地尔、0.4 mg/kg乌拉地尔＋1 mg/kg利多卡因。分别记录三组麻醉诱导前（T0）、诱导后（T1）、气管插管时（T2）、1 min（T3）、3 min（T4）、5 min（T5）的HR、SBP、DBP。结果与T0时比较,T1时三组SBP、DBP明显下降,HR明显减慢（P〈0.01）,T2、T3、T4时,A组SBP、DBP明显升高,HR明显增快（P〈0.01）;B组SBP、DBP稍有升高（P〉0.05）,HR明显增快（P〈0.01）;C组SBP、DBP稍有升高,HR稍加快（P〉0.05）。结论乌拉地尔复合利多卡因应用于老年原发性高血压患者的气管插管诱导,能更好地抑制插管应激产生的心血管反应,用于老年原发性高血压患者是安全可靠的。     

乌拉地尔与芬太尼预防气管插管时心血管反应的研究

目的：观察乌拉地尔、芬太尼两种药物对插管时心血管反应的效果。方法：选择择期手术患者40例随机分为两组：两组诱导时均用芬太尼3μg/kg，Ⅰ组于麻醉诱导前5min用乌拉地尔0.5mg/kg，分别于麻醉诱导前、后气管插管后0、5、10min记录两组血压、心率。结果：Ⅰ组气管插管血流动力学稳定，而Ⅱ组则反应较明显（P＜0.01）。结论：乌拉地尔可有效预防气管插管时的心血管反应。     

乌拉地尔预防气管插管时心血管反应的观察

为观察乌拉地尔预防气管插管时心血管的反应,将56例(ASA Ⅰ～Ⅱ)全麻择期手术患者分为A(n=28),B(n=28)两组。麻醉用安定0.2mg.kg~(-1),氟芬合剂1/2～1/4剂,2.5%硫喷妥钠4～7mg.kg~(1),琥珀胆碱1.5～2mg.kg~(-1)后B组直接气管插管;A组静注硫喷妥钠后即静注乌拉地尔0.5mg.kg~(-1),再静注琥珀胆碱后插管。结果:A组插管后心血管反应较稳定。收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)和心率—收缩压乘积(RPP)明显升高,但升高的幅度较小(P<0.05);B组插管后上述参数显著升高(P<0.01),而且比A组高得多,组间比较有显著差异(P<0.05)。结果提示乌拉地尔能有效地预防气管插管引起的心血管反应。     

艾司洛尔和乌拉地尔联合用药预防气管插管心血管反应的观察

目的观察艾司洛尔和乌拉地尔联合用药预防气管插管心血管反应的临床效果.方法ASAⅠ-Ⅱ级拟在经口气管插管全麻下手术病人48例,随机分为四组(A、B、C、D组,n=12).于麻醉诱导2min前静注:A组,艾司洛尔2mg/Kg;B组,乌拉地尔0.5mg/Kg;C组,艾司洛尔1mg/Kg 乌拉地尔0.25mg/Kg;D组,生理盐水1mL.用芬太尼和丙泊酚麻醉诱导,直接喉镜下气管插管.吸入异氟醚维持麻醉.监测SBP、DBP、HR和ECG.于术前、用药后2min、插管后1、3、5、7min记录上述指标,计算心率-收缩压乘积(RPP).结果插管后1min四组SBP、DBP、HR和RPP值均明显升高(p＜0.05),与D组比较,A组、B组、C组SBP、DBP、HR和RPP值低于D组(p＜0.05),与C组比较,A组SBP和DBP高于C组(p＜0.05),B组HR高于C组(p＜0.05),A组和B组RPP值高于C组(p＜0.05);插管后3min、5min、7min四组SBP、DBP、HR和RPP值逐步下降至术前水平,其中A组HR下降最快,B组SBP和DBP下降最快,C组RPP值下降最快.结论联合应用艾司洛尔和乌拉地尔更能有效控制气管插管的心血管反应,特别是RPP值的升高,于心肌缺血病人或许有益.     

乌拉地尔在食管癌根治术气管插管中的应用

目的：观察乌拉地尔用于防止气管插管心血管反应的效果。方法：选择100例食管癌患者，ASAⅠ-Ⅱ级，随机分为两组（n=50）：实验组诱导前静注乌拉地尔0．6mg／kg，对照组不用乌拉地尔。分别记录各时点的数值：诱导前、用乌拉地尔后3min、插管时、插管后2min、5min时的HR、SBP、MAP值。结果：对照组插管时、插管后2min测得的HR、SBP、MAP值明显升高（P〈0．05）。乌拉地尔组插管时，插管后2min的HR、SBP、MAP值无明显升高，较为平稳（P〉0．05）。两组之间比较实验组HR、SBP、MAP值升高相对较低，组间比较有显著性差异（P〈0．05）。结论：诱导前使用乌拉地尔可以减轻气管插管心血管反应。     

乌拉地尔预防气管插管所致心血管反应的效果观察

[背景]观察乌拉地尔预防气管插管所致心血管反应的效果.[病例报告]选择需行全身麻醉的手术病人60例,随机分为对照组和观察组,每组各为30例.麻醉诱导期给对照组及观察组患者依次静脉注射咪唑安定0.1 mg/kg、芬太尼2.0μg/kg、依托咪酯0.4 mg/kg及万可松0.14 mg/kg.在气管内插管前30 s给观察组患者静脉推注乌拉地尔0.6 mg/kg,观察并记录麻醉诱导前、插管时、插管后10 min时两组患者血压及心率的变化.结果见插管时对照组患者血压明显高于诱导前,而观察组患者则明显低于诱导前.[讨论]麻醉诱导期气管插管前预防性静脉推注给予乌拉地尔可有效地抑制气管插管所引发的心血管反应,可避免因气管插管所致的麻醉意外发生.     

两种降压药联合在高血压患者全麻诱导气管插管时的血流动力学变化

目的 观察艾司洛尔和乌拉地尔联合用药对高血压患者气管插管时心血管反应的预防控制作用.方法 180例(ASAⅡ～Ⅲ)择期全麻下行腹腔镜胆囊切除术的高血压患者,随机分为A组(艾司洛尔组)、B组(乌拉地尔组)和C组(联合用药组),每组60例.3组均以咪达唑仑、舒芬太尼、阿曲库铵静脉诱导行气管内插管,观察各组诱导前、插管前及插管后1、3、5 min的SBP、DBP、HR变化.结果 插管前3组SBP、DBP、HR均较诱导前下降(P均＜0.05).插管后1min和3 min3组SBP、DBP、HR均较插管前升高(P均＜0.05),且以C组为最低:C组的SBP、DBP、HR均低于B组(P均＜0.05),SBP均低于A组(P均＜0.05).插管后5 min,3组3项指标均降至诱导前水平.结论 麻醉诱导前静脉注射艾司洛尔和乌拉地尔能更有效地控制高血压患者气管插管引起的心血管反应.     

乌拉地尔用于预防全麻气管插管时应激反应的临床观察

目的 :探讨乌拉地尔 (商品名为压宁定 )预防全麻气管插管时应激反应的效果。方法 :30例择期全麻病人随机分成 3组 ,每组 10例。插管前分别静注乌拉地尔 0mg/kg (A组 )、 0 4mg/kg (B组 )、 0 6mg/kg (C组 )。 3组均以芬太尼、硫喷妥钠、琥珀胆碱静注诱导后行气管内插管。测定诱导前、插管前、插管后 1、 3、 5、 10min的SBP、DBP、HR ,并计算出RPP。结果 :不同药组在插管后 1、 3、 5minSBP、HR、RPP均明显高于用药组 (P <0 0 5或 0 0 1)。用药组间相比 ,0 6mg/kg组在插管后 1、 3minSBP、HR、RPP升高幅度较低 ,持续时间较短 ,但两组间差异不明显 (P>0 0 5 )。 3组DBP在插管后 1min升高明显 (P <0 0 5 ) ,但组间比较差异不明显 (P >0 0 5 )。结论 :气管插管前预注乌拉地尔能有效预防插管引起的应激反应 ,且以 0 6mg/kg效果更好     

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.