Effect of hyperbaric oxygen on microvascular anastomosis healing and patency in the rat

Recent evidence has shown that changes in blood viscosity and marked increases in both platelet count and fibrinogen concentration occur after exposure to hyperbaric oxygen (HBO). The purpose of the present study was to address whether repeated HBO therapy would increase either hematocrit or platelet count, and to determine if these changes would influence the patency of the microvascular anastomosis, as well as anastomotic healing. Eighty femoral arteries from 40 rats were divided into four groups (n = 10), and arterial anastomoses were performed on normal arteries in the first two groups, and on crushed arteries in the second two groups. One of the normal artery groups and one of the crushed artery groups received repeated HBO treatments for 5 days. Anastomotic patency rates, platelet count, hematocrit, and breaking strength were recorded. Among the results of this study were that: (1) there was no difference in patency rate following HBO treatment in both the normal and crushed artery groups; (2) platelet count was significantly higher following HBO treatment in the groups with the undamaged arteries; (3) breaking strength was significantly increased following HBO treatment in the groups with the crushed arteries. The authors concluded that HBO therapy may be useful in improving the healing of microvascular anastomoses in vessels that have undergone crush injury. Although HBO treatment results in an increased platelet count, this does not influence anastomotic patency.     

双歧杆菌对实验性大肠癌的预防及诱导细胞凋亡的作用

目的　探讨青春型双歧杆菌对实验性大肠癌的预防作用及其防瘤机制。方法　以裸鼠大肠癌移植瘤为动物模型,预先用双歧杆菌注射于裸鼠腹腔,观察移植瘤的生长速度,同时利用透射电镜、原位末端标记技术及免疫组化技术观察大肠癌裸鼠移植瘤的超微结构、凋亡细胞密度以及ｂｃｌ２、ｂａｘ 蛋白表达率及其阳性细胞密度。结果　双歧杆菌预防组大肠癌移植瘤的生长速度显著慢于对照组; 此外双歧杆菌预防组移植瘤组织中可见多量处于不同凋亡时期的瘤细胞,其凋亡细胞密度、ｂａｘ 蛋白表达率以及阳性细胞密度均显著高于肿瘤对照组,而ｂｃｌ２ 蛋白的表达情况则相反。结论　青春型双歧杆菌能显著预防大肠癌的发生与发展,并能诱导其细胞凋亡。     

芬太尼用于开胸术后硬膜外患者自控镇痛的研究

目的：研究不同配伍的芬太尼用于开胸术后PCEA的镇痛效果。方法：75例（ASAⅠ～Ⅱ级）择期剖胸患者随机分为三组,各25例,F组单用芬太尼;FB组用芬太尼＋布比卡因;FBM组用芬太尼＋布比卡因＋吗啡。观察用药总量,D／D比值,VAS评分,整体满意度,并发症。结果：用药总量F组显著大于FB及FBM组（P＜0．05）;D／D比值＜2、VAS＜3、整体满意度为优的病例数FB组及FBM组显著多于F组（P＜0．05）;恶心、皮肤瘙痒患者以FBM组最多（P＜0．05,P＜0．005）。结论：开胸术后患者使用IPCEA时以小剂量芬太尼合用低浓度布比卡因的给药模式为宜。     

Three novel bicyclic taxane diterpenoids with verticillene skeleton from the needles of Chinese yew, Taxus chinensis var. mairei.

Three novel bicyclic taxane diterpenoids with the verticillene skeleton were isolated from the needles of Chinese yew, Taxus chinensis var. mairei. Their structures were established as (3E,7E)-2 alpha, 10 beta, 13 alpha, 20-tetraacetoxy-5 alpha-hydroxy-3,8-secotaxa-3,7,11-trien-9-one (1), (3E,7E)-2 alpha, 5 alpha, 10 beta, 13 alpha-tetraacetoxy-20-hydroxy-3,8-secotaxa-3,7,11-trien-9-one (2), and (3E,7E)-10 beta, 13 alpha-diacetoxy-2 alpha, 5 alpha, 20-trihydroxy-3,8-secotaxa-3,7,11-trien-9-one (3) on the basis of 1D, 2D NMR and HR-MS spectroscopic analysis. Verticillene skeleton was considered as the biogenetic intermediate of taxane diterpenoids, isolation of bicyclic taxane diterpenoids with verticillene skeleton from this plant provides direct proof for this hypothesis.     

Three new taxane diterpenoids from seeds of the Chinese yew, Taxus yunnanensis and T. chinensis var. mairei

Three new taxane diterpenoids were isolated from the seeds of the Chinese yew, Taxus yunnanensis Cheng et L. K. Fu and T. chinensis var. mairei Cheng et L. K. Fu. The structures were established as 1beta,10beta-dihydroxy-9alpha,13alpha-diacetoxy-5alpha-(3'-dimethylamino-3'-phenyl)-propionyloxytaxa-4(20),11-diene, 5alpha-hydroxy-9alpha,100,13alpha-triacetoxy-11(15-->1)abeotaxa-4(20),11-di-ene, and 5alpha,13alpha-dihydroxy-9alpha,10beta-diacetoxy-11 (15-->1 )abeo-taxa-4(20),11-diene on the basis of 1D, 2D NMR, and mass spectral analysis.     

Ingenane diterpenes from Euphorbia petiolata

From the whole plants of Euphorbia petiolata, four new ingenane-type diterpenoids, 3,20-O-diacetylingenol 5-O-(2' E,4' Z)-tetradecadienoate (1), 5,20-O-diacetylingenol 3- O-(2' E,4' Z)-tetradecadienoate (2), ingenol 3-O-(2' E,4' Z)-tetradecadienoate (3), and 5,20-O-isopropylidenylingenol 3-O-(2' E,4' Z)-tetradecadienoate (4) were isolated. Their structures were elucidated by spectroscopic methods and chemical transformations.     

枢椎椎弓骨折

本文报告14例枢椎椎弓骨折，仅1例有脊髓损伤症状，且于短期内恢复。该骨折以非手术疗法为主，本组14例疗效满意。由于枢难解剖结构较特殊，故其损伤机制及治疗方法亦有其特殊性，作者对此进行了讨论。     

非体外循环下小儿腔肺吻合术疗效分析

为总结体外循环与非体外循环的两组病例行双向腔肺吻合(M．Glenn)术后的转归，以客观评价小儿施行非体外循环腔肺吻合术的可行性，将2000年5月--2002年11月行单纯M．Glenn术的32例患儿(年龄0．33--ll岁，体重6—32kg)分为两组，A组(n＝16)为体外循环组，B组(n＝16)为非体外循环组。所有病例监测术后1、6、12、24、48h氧合指数(OI)；测定人ICU即刻(T1)、呼吸机撤离前、后(T2和T3)3个时间点的中心静脉压(CVP)、跨肺压(TPG)、跨脑压(TCP)；记录两组病例手术时间(OT)、术后并发症、术后12h用血球量、呼吸机使用时间(VT)、ICU滞留时间(IT)以及住院费用。结果显示，B组术后OI均高于A组，尤其在术后lh和6h，OI分别为A组的1．4倍和1．3倍，差异有非常显著性(P＜0．01)。尽管撤机前B组CVP为A组的1．3倍(P＜0．05)，TCP明显低于A组，但撤机后两组差异无显著性。两组VT、IT差异虽无显著性(P＞0．05)，但B组术后12h用血球量、并发症明显降低，住院开支亦较A组节省了约30％(P＜0．05)。提示非体外循环技术应用于小儿双向腔肺吻合术是可行且有利的。