乙二胺羟丙基壳聚糖固定化天门冬酰胺酶的研究

研制了新型壳聚糖胺基衍生物-乙二胺羟丙基壳聚糖（EDA-HPCS）,并将其用于固定天门冬酰胺酶,分别考察了甲醛活化载体和戊二醛活化载体对固定化酶活力的影响,结果表明,在适当的固定化条件下,甲醛活化EDA-HPCS的固定化酶活力约为30U/g载体,而戊二醛活化EDA-HPCS固定化酶活力约为16U/g载体。     

婴儿期心内直视术45例分析

随着心脏手术技巧和体外循环技术的不断提高 ,婴儿期心脏手术日益增多。笔者于 1997年 1月～ 2 0 0 0年 12月共进行了 45例婴儿心内直视手术 ,效果满意。1　临床资料1.1　一般资料　本组男性 34例 ,女性 11例 ,年龄 7.1± 3.2月 (2 4天～ 12月 ) ,体重 6 .8± 2 .3kg(3.5～ 8.5 kg)。病种 :继发孔房间隔缺损 (ASD)并动脉导管未闭 (PDA) 1例 ;室间隔缺损 (VSD) 33例 ,其中合并 ASD2例 ,PDA4例 ;法洛三联症 2例 ;法洛四联症 (TOF) 5例 ,其中合并肺动脉瓣闭锁(PA) 2例、PDA 4例 ;先天性二尖瓣关闭不全 1例 ;部分型心内膜垫缺损 (ECD…     

缺血预处理结合心麻痹液保护未成熟兔心肌的效果

目的 探讨缺血预处理（IPC）结合心麻痹液对未成熟兔心肌的保护作用。方法 采用体外左心作功模型,比较缺血5min再灌注5min的缺血预处处理加ST.ThomasⅡ液（IPC组）和仅ST,ThomasⅡ液（对照组）对幼兔（3-4周）心脏缺血再灌注后心脏功能,冠脉微循环、能量代谢及超微结构的影响。结果 IPC组心脏收缩功能、冠脉流量及阻力恢复更佳,冠脉流出液中的一氧化氮含量较高而内皮素较低,能量物质含量高,心肌细胞超微结构的影响。结果 IPC组心脏收缩功能、冠脉流量及阻力恢复更佳,冠脉流出液中后 氧化氮含量较高而内皮素较低,能量物质含量高。心肌细胞超微结构损害轻,结论 缺血预处理结合心麻痹液对未成熟兔心肌提供更佳的保护。     

Liposomal Bupivacaine Versus Bupivacaine/Epinephrine Intercostal Nerve Block as Part of an Enhanced Recovery After Thoracic Surgery (ERATS) Care Pathway for Robotic Thoracic Surgery

ObjectivesTo examine how postoperative pain control after robotic thoracoscopic surgery varies with liposomal bupivacaine (LipoB) versus 0.5% bupivacaine/1:200,000 epinephrine (Bupi/Epi) intercostal nerve blocks within the context of an enhanced recovery after thoracic surgery (ERATS) protocol.DesignA retrospective analysis of a prospectively maintained database of patients undergoing robotic thoracoscopic procedures between September 1, 2018 and October 31, 2019 was conducted.SettingUniversity of Miami, single-institutional.ParticipantsPatients.InterventionsTwo hundred fifty-two patients had either LipoB intercostal nerve blocks (n = 129) or Bupi/Epi intercostal nerve blocks (n = 123) when undergoing robotic thoracic surgery.Measurements and Main ResultsComparative analysis of patient-reported pain levels, in-hospital and post-discharge opioid requirements, 90-day operative complications, length of hospital stay, and hospital costs was performed. Data were stratified to either anatomic lung resection or pulmonary wedge resection/mediastinal-pleural procedures. Bupi/Epi patients reported significantly more acute postoperative pain than LipoB patients, which correlated with higher in-hospital and post-discharge opioid requirements. There were no differences in postoperative complications, length of hospital stay, or hospital costs between the two groups.ConclusionsAs part of an ERATS protocol, infiltration of intercostal spaces and surgical wounds with LipoB for robotic thoracoscopic procedures afforded better postoperative subjective pain control and decreased opioid requirements without an increase in hospital costs as compared with use of Bupi/Epi.     

Cytogenetic studies in couples experiencing repeated pregnancy losses

A computerized database generated from the literature on cytogeneticstudies in couples experiencing repeated pregnancy losses hasbeen set up at the University of Quebec at Chicoutimi. At thepresent time, it contains data on 22 199 couples (44 398 individuals).The statistical analyses showed a relationship between the distributionof the chromosome abnormalities and the number of abortions.An uneven distribution of the chromosomal structural rearrangementsaccording to the sex of the carrier was found (P < 0.05).Overall, 4.7% of the couples ascertained for two or more spontaneousabortions included one carrier. It also appeared that only translations(both reciprocal and Robertsonian) and inversions were associatedwith a higher risk of pregnancy wastage. Therefore, geneticcounselling should be offered to these couples and investigationsperformed on their extended families.     

Diagnosis of metastatic lesions to the stomach by salvage cytology

Summary Secondary neoplasms of the stomach are rare and are often clinical and diagnostic problems. Three patients with bleeding volcano-like ulcers were diagnosed by combined endoscopic salvage cytology and surgical biopsy as having metastatic submucosal lesions from hematologic spread. The combination of endoscopic appearance, clinical findings, and tissue and cytologic examination can lead to the correct diagnosis. The results from these cases support the utility of this cytologic technique in combination with biopsy in this clinical setting.     

转化生长因子-α在血液透析过程中的水平变化及其临床意义

目的：探讨血清及尿液中转 化生长因子α（ Ｔ Ｇ Ｆα）含量变化对血液 透析（ Ｈ Ｄ） 的影响。方法：采用放 射免疫分析法,对 ４９ 例维持性 Ｈ Ｄ 患者血清 及 １２ 小时 尿液进行 Ｔ Ｇ Ｆα的 水平检测, 以 ３０ 例健康 人作为对 照。结果：与对照组比较, Ｈ Ｄ 前 Ｔ Ｇ Ｆα水平明显降低（ Ｐ＜ ０．０１））。与 Ｈ Ｄ 前比较, Ｈ Ｄ 后 Ｔ Ｇ Ｆα水平增高十 分显著（ Ｐ＜ ０．０５）;１２ 小时尿液中 Ｔ Ｇ Ｆα水平明显高于对照组,有显著性差异（ Ｐ＜ ０．０５）;使用铜仿膜与聚砜膜透析器患者血清 Ｔ Ｇ Ｆα水平明显高于醋酸纤维膜与血仿膜组。结论： Ｔ Ｇ Ｆα水平明显改变参与了 Ｈ Ｄ 患者 的发病机理及病理生理过程;使用铜仿膜和聚砜膜透析器可使 Ｈ Ｄ 患者 Ｔ Ｇ Ｆα含量增高。     

A comparison of T4 and T7 dermatomal levels of analgesia for caesarean section using the lumbar epidural technique

We compared analgesia to the T₄ dermatomal level with analgesia to the T₇ level with and without prophylactic intramuscular administration of ephedrine 25 mg to determine the adequacy and side effects of such analgesia for caesarean section. Unmedicated patients were prehydrated (727 ± 303 ml of saline solution) and kept in a left lateral tilt position. Sufficient three per cent chloroprocaine was given to obtain analgesia to the T₇ (T₆-T₈) dermatomal level (455 ± 128 mg) or to the T₄ (T₃-T₅) dermatomal level (758 ± 168 mg). Patients who received analgesia to the higher level required less narcotic than those who received analgesia to the lower level (21 per cent versus 48 per cent) (p < 0.05). The incidence of hypotension in patients with analgesia at the T₄ level was 21 per cent for those receiving ephedrine and 64 per cent for those who did not receive ephedrine (p < 0.05). Intramuscular administration of ephedrine 25 mg was not associated with increased plasma levels of norepinephrine, epinephrine or dopamine. There was no difference in Apgar score, behavioural test scores, neonatal acid-base status or oxygenation in children of mothers in the different groups. We conclude that a T₄ dermatomal level of analgesia, combined with intramuscular administration of ephedrine 25 mg, provides more maternal comfort than a T₇ level of analgesia does, with or without ephedrine, and is without significant maternal or foetal side effects.     

豆蔻挥发油β-环糊精包含工艺研究

目的：研究豆蔻挥发油β环糊精包合的最佳工艺。方法：正交试验法，考察挥发油利用率指标。结果：优选出包合工艺为：豆蔻挥发油：β环糊精1：8，包合温度50℃，包合时间2h，挥发油利用率为79．7％。结论：此工艺适合大生产。