中药熏洗坐浴治疗急性白血病化疗后肛周感染

目的探讨中药熏洗坐浴治疗急性白血病患者化疗后肛周感染的疗效。方法以住院时间为顺序将住院化疗后发生肛周感染的患者分为对照组（19例）和观察组（21例）,对照组实施常规护理及对症治疗,每日晨、晚用1：5000高锰酸钾溶液坐浴20min。观察组在对症治疗基础上每日晨、晚采用中药熏洗坐浴。结果治疗第7天,观察组治疗效果显著优于对照组（P〈0．05）。结论中药熏洗坐浴治疗急性白血病化疗后肛周感染的效果优于1：5000高锰酸钾溶液坐浴。     

中药熏洗坐浴治疗急性白血病化疗后肛周感染

目的 探讨中药熏洗坐浴治疗急性白血病患者化疗后肛周感染的疗效.方法 以住院时间为顺序将住院化疗后发生肛周感染的患者分为对照组(19例)和观察组(21例),对照组实施常规护理及对症治疗,每日晨、晚用1:5 000高锰酸钾溶液坐浴20min.观察组在对症治疗基础上每日晨、晚采用中药熏洗坐浴.结果 治疗第7天,观察组治疗效果显著优于对照组(P<0.05).结论 中药熏洗坐浴治疗急性白血病化疗后肛周感染的效果优于1:5 000高锰酸钾溶液坐浴.     

自制坐浴器联合高渗盐水甲硝唑坐浴防治肛周感染

目的探讨自制恒温坐浴器联合坐浴液预防急性白血病化疗后肛周感染的临床效果。方法将100例急性白血病化疗患者随机分为对照组和观察组各50例;对照组采用高锰酸钾联合坐浴盆方法;观察组采用自制恒温坐浴器联合高渗盐水加甲硝唑溶液治疗。结果观察组治疗20d后肛周状况优于对照组;观察组已感染患者治疗20d后效果显著优于对照组已感染患者(P0.05)。结论自制恒温坐浴器联合甲硝唑高渗盐水治疗急性白血病患者化疗后肛周感染优于传统的高锰酸钾联合坐浴盆治疗。     

自制坐浴器联合高渗盐水甲硝唑坐浴防治肛周感染

目的 探讨自制恒温坐浴器联合坐浴液预防急性白血病化疗后肛周感染的临床效果.方法 将100例急性白血病化疗患者随机分为对照组和观察组各50例;对照组采用高锰酸钾联合坐浴盆方法;观察组采用自制恒温坐浴器联合高渗盐水加甲硝唑溶液治疗.结果 观察组治疗20 d后肛周状况优于对照组;观察组已感染患者治疗20 d后效果显著优于对照组已感染患者（P＜0.05）.结论 自制恒温坐浴器联合甲硝唑高渗盐水治疗急性白血病患者化疗后肛周感染优于传统的高锰酸钾联合坐浴盆治疗.     

肛洗Ⅰ号促进PPH术后伤口愈合61例

目的：研究中药肛洗Ⅰ号与高锰酸钾坐浴在混合痔PPH术后的疗效。方法：116例混合痔患者分为2组,中药治疗组（61例）行PPH术后予以中药肛洗1号方坐浴,对照组（55例）予以常规高锰酸钾坐浴。结果：治疗组疼痛、水肿、出血等症状缓解程度优于对照组,切口愈合天数短于对照组（P＜0.05）。结论：肛洗Ⅰ号坐浴能更有效地改善术后疼痛、水肿、出血等症状,缩短切口愈合时间。     

痔术后荆黄汤熏洗507例疗效观察

目的 评价中药荆黄汤熏洗辅助治疗痔术后的效果。方法 将1045例痔术后患者随机分为荆黄汤熏洗坐浴（治疗）组507例和1／5000高锰酸钾坐浴（对照）组538例，术后每日便后坐浴15～20min。观察坐浴对缓解疼痛、减少水肿、切口感染、治愈时间等方面的疗效。结果 疼痛减轻优良率：治疗组为99．61％，对照组为70、82％；水肿发生率：治疗组为2．96％，对照组为8．18％；切口感染率：治疗组为0、18％，对照组为1．11％；术后2周内治愈率：治疗组为98．81％，对照组为77、51％。经统计学分析，均P〈0．05。结论 痔术后用中药荆黄汤熏洗坐浴，对减轻肛门疼痛，减少水肿，预防感染，促进伤口愈合等均明显优于高锰酸钾坐浴。     

痔瘘熏洗散用于痔术后消肿促愈疗效观察

为观察自制痔瘘熏洗散熏洗坐浴对痔术后肛缘水肿和创面愈合时间的影响,将200例痔术后患者随机分为两组治疗,治疗组100例术后每日便后采用痔瘘熏洗散熏洗坐浴;对照组100例术后每日便后采用1：5000PP液熏洗坐浴。观察记录两组患者术后肛缘水肿发生率和创面愈合时间,并进行统计学对比。结果显示,治疗组术后肛缘水肿发生率明显低于对照组（17％vs28％,P〈0．05）,创面愈合时间较对照组明显缩短[（13．8±3．8）dVS（16．5±4．5）d,P〈0．053。结果表明,痔瘘熏洗散用于痔术后熏洗坐浴能够有效降低肛周水肿的发生率,并能促进创面愈合。     

呋喃西林纱布条治疗肛门直肠瘘术后的疗效观察

目的：观察０．２％无菌呋喃西林纱布条治疗肛门直肠瘘术后的临床疗效。方法：通过对１０４例患者根据不同手术方法分成两组，对照组４０例每日换药用洗必泰痔疮栓１只塞肛，外涂马应龙麝香痔疮膏，纱布包扎。治疗组６４例，每日换药时加用０．２％无菌呋喃西林纱布条湿敷创口部位，其它处理同对照组。疗效判断：治愈后进行天数统计分析。结果：不同手术方法，低位肛瘘（按全国统一的分类标准）术后治疗组和对照组的治愈天数平均分别     

硝英方熏洗坐浴用于混合痔术后的疗效观察

目的:观察硝英方熏洗坐浴用于混合痔术后的治疗效果.方法:将80例混合痔术后患者随机分为观察组和对照组,每组各40例.观察组术后采用硝英方熏洗坐浴治疗,对照组术后采用高锰酸钾溶液熏洗坐浴治疗.观察记录2组术后疗效、肛缘水肿、肛门疼痛及肛门坠胀等情况.结果:治疗14 d后,观察组总有效率为90.0％,高于对照组的62.5％...     

中药熏洗坐浴治疗痔术后并发肛门湿疹的疗效探讨

为探讨中药熏洗坐浴治疗痔术后并发肛门湿疹的疗效,将70例痔术后并发肛门湿疹的患者随机分为对照组和治疗组,各35例,对照组用1：5000高锰酸钾溶液熏洗坐浴,治疗组用中药液熏洗坐浴,观察两组治疗肛门湿疹的疗效,以及痔手术创口愈合时间、术后肛门疼痛和肛缘水肿消退时间。结果显示,治疗组治疗肛门湿疹的总有效率（91．4％）明显高于对照组（77．1％）,P〈O．05;痔手术创口愈合时间、术后肛门疼痛、肛缘水肿消退时间均明显短于对照组,P〈O．05。结果表明,中药熏洗坐浴治疗痔术后并发的肛门湿疹具有很好的疗效,而且能有效减轻痔术后患者的疼痛、水肿,促进创口愈合。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

Systemic analgesia adapted to the children's condition

A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.