神经生长因子对脊髓损伤后脊髓组织一氧化氮生成的影响

目的 :探讨神经生长因子 ( NGF)对脊髓损伤保护作用的机制 ,为临床应用提供理论依据。方法 :采用 Allen法以 2 5 g/cm3力致伤大鼠 T8脊髓 ,插蛛网膜下隙导管于术后即刻、2、4、8、12、2 4 h各注入神经生长因子 ( NGF)溶液 ,并与生理盐水组和正常对照组作对照。采用免疫组化法 ( ABC法 )和原位杂交法检测神经元型固有型一氧化氮合成酶 ( nc NOS)在脊髓中的表达。结果 :大鼠伤后脊髓前角运动神经元出现 nc NOS蛋白和 nc NOS m RNA异常表达 ,NGF组与生理盐水组相比较 ,nc NOS蛋白和nc NOS m RNA异常表达明显减少 ( P<0 .0 1或 P<0 .0 5 )。结论 :NGF能通过抑制脊髓损伤 nc NOS的异常表达 ,抑制一氧化氮( NO)过多释放所致的神经毒性作用 ,从而保护了损伤的神经组织。     

胰岛素泵治疗继发性失效2型糖尿病临床研究

目的 比较磺脲类药物失效（ｓｕｌｆｏｎｙｌｕｒｅａ ｆａｉｌｕｒｅ,ＳＦ）的 ２型糖尿病患者胰岛素泵连续皮下输注治疗（ｃｏｎｔｉｎｕ－ｏｕｓ　ｓｕｂｃｕｔａｎｅｏｕｓ　ｉｎｓｕｌｉｎ　ｉｎｆｕｓｉｏｎ,ＣＳⅡ）组和多次注射胰岛素组（ｍｕｌｔｉｐｌｅ ｓｕｂｃｕｔａｎｅｏｕｓ　ｉｎｓｕｌｉｎ　ｉｎｊｅｃｔｉｏｎ,ＭＳⅡ）血糖控制的疗效和安全性。方法 采用对照研究方法探讨ＣＳⅡ和ＭＳⅡ两种治疗方法在控制血糖、胰岛素剂量、低血糖的发生率的差异。结果 ＧＤⅡ组治疗达到理想血糖控制的疗效和所需的时间明显短于ＭＳⅡ组（Ｐ＜０．０１）;ＧＳⅡ组治疗达到理想血糖控制所需的胰岛素量明显少于ＭＳⅡ组（Ｐ＜０。０１）;ＣＳⅡ组低血糖发生率低于ＭＳⅡ组。结论ＣＳⅡ治疗能缩短达到理想血糖控制的时间,有效地降低餐后２小时血糖;减少了胰岛素用量;减少了低血糖的发生。囚此,ＣＳⅡ疗法对ＳＦ的２型糖尿病患者理想血搪控制比ＭＳⅡ疗法更快、更有效,且使用胰岛素剂量更小,更安全。     

化工过程在线模拟和优化的软件框架

首先讨论了在线优化和企业自动化水平的关系,接着描述了过程模型的开发和实现范例,并归纳了一个在线优化软件系统的功能需求,进而描述了一个面向程的模拟优化系统的主要组成部分,最后讨论了在线优化应用的结构以及和控制策略的关系。     

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.