速眠新与盐酸氯胺酮对猕猴麻醉效果的初步观察

目的　比较速眠新与盐酸氯胺酮和速眠新复合麻醉对猕猴的麻醉效果。方法　成年健康猕猴 10只 ,动物分成单纯麻醉组 (速眠新组 ,5只 )和复合麻醉组 (速眠新和盐酸氯胺酮组 ,5只 ) ,均采用肌内注射麻醉。结果　速眠新麻醉维持时间仅 0～ 1h ,麻醉效果低于复合麻醉效果。速眠新有较好的镇静、镇痛和肌肉松弛作用 ,复合麻醉使速眠新效果更佳 ,麻醉时间更长、更稳定 (1～ 2h) ,复苏期较快。结论　速眠新和盐酸氯胺酮复合麻醉适合动物实验时间较长的手术 ,是一种较理想的实验动物麻醉方法     

单纯速眠新麻醉在动物实验中的应用

对56只动物实验手术犬采用单纯速眠新麻醉,现将有关麻醉情况报告如下。1　材料与方法11　药物速眠新(二甲苯胺噻唑、乙二胺四乙酸、盐酸二氢埃托啡和氟哌定醇组成复方制剂)[1],由解放军农牧大学军事兽医研究所提供。12　方法健康杂种犬56只,雌雄兼用,体重8～27ｋｇ。手术式分别为盲肠部分切除术、小肠吻合术、清创术、气管切开术和胸腔闭式引流术。犬入室前麻醉用速眠新01ｍｌ/ｋｇ,肌肉注射。待犬卧倒入睡后,开始脱毛备皮,放置手术台上,固定后实施手术。2　结　果注药后入睡时间最短5分钟,最长28分钟,平均18分钟。诱导期呕吐5例(均未禁食)…     

引入地西泮对速眠新复合氯胺酮麻醉效果的改进观察

目的：改进速眠新单纯与复合麻醉方法的不足,观察引入地西泮对速眠新复合盐酸氯胺酮麻醉效果的影响。方法成年实验家兔80只,雌雄各半,随机分为A、B、C三组,A组肌肉注射速眠新（0．3 mL／kg）,B组肌肉注射速眠新复合盐酸氯胺酮混合液（0．3 mL／kg）,C组肌肉注射速眠新复合盐酸氯胺酮混合液（0．3 mL／kg）,并静注地西泮注射液（1．5 mL／kg）,对比三组的麻醉效果、麻醉显效时间、初次麻醉维持时间、总麻醉药用量及总手术时间。结果 C组麻醉显效时间明显短于A、B组（ P＜0．01）;初次麻醉维持时间C组长于A、B组（ P＜0．01）;总麻醉药用量C组明显少于A、B组（P＜0．01）;C组总的手术时间少于A、B两组（P＜0．01）;C组的麻醉效果优于A、B组（ P＜0．01）。结论采用速眠新、盐酸氯胺酮联合地西泮复合麻醉明显提高了麻醉效果,是适于家兔敏感手术部位及手术时间较长的动物实验的理想麻醉方法。     

氯胺酮与速眠新、硫喷妥钠对犬麻醉效果的观察

目的比较氯胺酮与速眠新、硫喷妥钠复合麻醉对犬的麻醉效果。方法成年健康犬180只。动物分成单纯麻醉组（氯胺酮组，60只）和复合麻醉组（氯胺酮与速眠新组，60只；氯胺酮与硫喷妥钠组，60只），采用肌肉注射和静脉注射麻醉。结果氯胺酮麻醉维持时间为0．5～1h，用量较大，麻醉效果低于复合麻醉效果，复合麻醉能相互弥补本身不足，增强麻醉效果，提高肌肉松驰力，麻醉深浅容易控制，对呼吸，循环系统无明显的抑制，麻醉时间更长，更稳定（1～4h），用量小，苏醒快。结论氯胺酮与速眠新、硫喷妥钠复合麻醉适合动物实验时间较长的手术，是一种较理想的实验犬麻醉剂。     

丙泊酚复合速眠新Ⅱ在高强度聚焦超声辐照活体羊肝的麻醉效果

目的:探讨丙泊酚复合速眠新Ⅱ注射液麻醉用于高强度聚焦超声(High intensity focusing ultrasound,HIFU)无创定位辐照活体羊肝术的麻醉,观察其有效性和安全性.方法:南江黄羊30只,雌雄不拘,体重15～25kg,随机分为丙泊酚复合速眠新Ⅱ组(A组,n=15)和速眠新Ⅱ组(C组,n=15).A组予以臀部肌肉注射速眠新Ⅱ0.05ml/kg,静脉注射丙泊酚2mg/kg丙泊酚进行麻醉诱导,术中泵注丙泊酚50～150μg/(kg·min)维持.C组仅臀部肌肉注射速眠新0.1ml/kg,术中间断静脉推注速眠新维持麻醉至术毕.观察各组气管插管反应及围术期血流动力学变化情况,比较麻醉恢复时间及并发症情况.结果:与C组相比,A组气管插管时的呛咳反应较小(P<0.01).麻醉后2min、插管后2min两组MAP变化不明显,差异无统计学意义(P0.05),而心率A组较C组下降更为明显,差异有统计学意义(P<0.05).HIFU治疗后5min、30min时A组MAP及HR与C组相比更稳定,差异有统计学意义(P<0.05).两组术毕自主呼吸恢复、拔管时间A组少于C组,差异有统计学意义(P<0.01).结论:丙泊酚复合速眠新Ⅱ用于HIFU辐照活体羊肝麻醉效果比单用速眠新Ⅱ更满意,术后苏醒快,可靠性高.     

腰麻-硬膜外联合麻醉在妇科腹腔镜手术中的应用

目的　比较腰麻 -硬膜外联合麻醉与静吸复合全麻用于妇科腹腔镜手术对BP、HR、SpO2 、PETCO2 的影响。方法　 4 0例妇科腹腔镜手术患者随机分成腰麻 -硬膜外联合麻醉组 (CSEA组 ) 2 0例 ,静吸复合全麻 (GA组 )2 0例。监测患者麻醉前 10分钟 ,气腹前 ,气腹后 10分钟、30分钟、术毕放气后 10分钟的BP、HR、SpO2 、PETCO2 ,记录各组数据。结果　①气腹后CSEA组和GA组较气腹前HR都明显增快 (p <0 .0 1) ,MAP明显升高 (P <0 .0 5 ) ;②CSEA组患者PETCO2 于气腹后明显上升 (p <0 .0 5 ) ,GA组无明显差异 ;③GA组麻醉后SpO2 较CSEA组高 (p <0 .0 1)。④CSEA组BP、HR、SpO2 、PETCO2 均在正常范围。结论　腰麻 -硬膜外联合麻醉用于妇科腹腔镜手术安全可靠 ,较静吸复合全麻简便、经济 ,是较理想的麻醉方法。     

速眠新Ⅱ联用安定在Beagle犬牙周手术中麻醉效果安全性的初步观察

目的:观察速眠新Ⅱ与安定复合麻醉对牙周手术实验中Beagle犬的麻醉效果以资参考.方法:成年健康雄性Beagle犬,按速眠新Ⅱ0.05、0.1、0.15ml/kg辅以安定0.3ml的剂量,臀部肌内注射(联合用药组),追加剂量为首次用量的1/2.单纯速眠新Ⅱ按0.05、0.1、0.15 ml/kg的剂量为对照,追加次数视情况而定.比较各组Beagle犬麻醉诱导期、初次麻醉维持时间及麻醉后不良反应的差别.结果:联合用药组各剂量诱导期分别为(11.00±1.41)min、(9.00±0.82)min、(12.75±0.50)min,初次麻醉维持时间分别为(29.75±6.65)min、(46.00 ±5.29)min、(45.25 ±6.02)min,术中追加1次可再延长麻醉维持时间分别为(38.75±3.50)min、(45.25±4.03)min、(37.25±2.75)min.单纯速眠新Ⅱ的麻醉诱导期分别为(15.75±2.50)min、(14.25±2.99)min、(14.50 ±2.08)min,初次麻醉维持时间分别为(20.75±5.19)min、(20.5±3.42)min、(22.25±5.19)min,术中麻药追加次数不定,实验犬死亡数为2只.联合用药组与单纯速眠新Ⅱ各组间诱导期经t检验.速眠新Ⅱ0.1 ml/kg辅以安定0.3 ml的剂量(P<0.05),联合用药组与单纯速眠新Ⅱ的初次麻醉维持时间经t检验(P<0.05).结论:速眠新Ⅱ0.1 ml/kg辅以安定0.3ml的剂量复合麻醉时协同效果比单用速眠新Ⅱ更满意,术后苏醒快,可靠性高,不良反应少,利于较长的Beagle犬牙周手术实验.     

戊巴比妥钠联用速眠新在手术实验犬中的麻醉效果观察

目的观察戊巴比妥钠与速眠新复合麻醉对外科手术实验用杂种犬的麻醉效果。方法成年健康杂种犬303只,雌雄兼用,按5%戊巴比妥钠0.5 mL/kg体重、速眠新0.1 mL/kg体重的标准,同侧臀部不同部位肌肉内同时注射麻醉(联合用药组)。追加剂量为首次用量的1/2。以单纯戊巴比妥钠麻醉(256只)和单纯速眠新麻醉(280只)为对照。结果联合用药组的诱导期为4.0±0.2 min,初次麻醉维持时间为240.0±30.0 min,术中只追加1次,即可再延长麻醉维持时间270.0±30.0 min,实验犬死亡6只(1.98%)。单纯戊巴比妥钠麻醉组和单纯速眠新麻醉组的诱导期分别为13.0±1.2 min和4.8±0.3 min,初次麻醉维持时间分别为125.0±13.1 min和30.0±3.1 min,实验犬死亡数分别为79只(28.21%)和43只(16.80%),术中麻药追加次数均不定。结论戊巴比妥钠与速眠新复合麻醉协同作用好,可扬长避短。此方法适合需要连续处理多个动物的外科实验和实验时间较长的动物外科教学,是一种较理想的实验动物麻醉方法。     

环孢菌素A预处理对大鼠移植心脏缺血再灌注时心肌TNFα、MPO的影响

目的 :探讨移植心脏再灌注时心肌肿瘤坏死因子α(TNFα)表达、髓过氧化物酶 (MPO)水平的变化及环孢菌素A(CsA)预处理对移植心脏再灌注损伤 (I/R)的影响。方法 :将 84只雄性Wistar大鼠随机分为对照组 (C组 )和实验组 (E组 )。 2组均分为 0h、3h、6h、2 4h 4个时间点。其中每组 0h作为缺血再灌注前对照 ,均为 6只。而 2组其他 3个时间点则为供、受体动物各 6只。 2组的 3h、6h、2 4h 3个时间点动物移植心缺血时间约为 5 0min。E组供、受体鼠术前 1h尾静脉注射CsA(10mg/kg)。分别于再灌注 0h、3h、6h、2 4h取移植心测定心肌TNFα、MPO水平及心肌含水量的变化。结果 :①C组移植心再灌注后心肌TNFα明显升高 ,于再灌注 3h最显著 ,且明显高于 0h(P <0 .0 1)。E组再灌注 3h、6h、2 4h心肌TNFα水平均明显低于同期C组 (P均 <0 .0 5 )。②C组再灌注后心肌MPO含量、心肌含水量逐渐升高 ,于 6h最明显 ,与 0h相比 ,P <0 .0 1。E组再灌注 3h、6h、2 4h心肌MPO含量、心肌含水量明显低于同期C组 ,P均 <0 .0 5。结论 :①心脏移植再灌注后心肌TNFα、MPO明显升高 ,且参与了心肌再灌注损伤。②供、受体应用CsA预处理可以抑制TNFα的表达 ,降低MPO水平 ,减轻心肌水肿 ,从而减轻心肌再灌注损伤     

依托咪酯持续输注对犬肾上腺素及去甲肾上腺素的影响

目的对比观察不同剂量依托咪酯持续输注对犬全身麻醉中血浆肾上腺素及去甲肾上腺素的影响。方法健康成年雄性犬36只,随机分为6组(n=6),对照组(C组):1%戊巴比妥钠基础麻醉后不输注任何药物;实验组:E1、E2、E3、E4、E5五组,1%戊巴比妥钠基础麻醉后分别输注依托咪酯乳剂10、15、20、25、30μg/(kg.min)维持麻醉3 h。持续监测生命体征,并用放射免疫法分别于气管插管前(T0)、气管插管后1 h(T1)、2 h(T2)、3 h(T3)检测血浆中肾上腺素及去甲肾上腺素的浓度。结果 E1～E5组随着持续输注依托咪酯剂量及时间的增加各时间点心率、平均动脉压、肾上腺素及去甲肾上腺素的浓度均在正常范围,比较差异无统计学意义(P>0.05)。结论持续输注依托咪酯对犬肾上腺素、去甲肾上腺素及血流动力学无明显影响。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

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.