长期饮酒对异丙酚使患者意识消失的半数有效效应室靶浓度的影响

目的 拟通过探讨长期饮酒对异丙酚使患者意识消失的半数有效效应室靶浓度(EC50)的影响,评价长期饮酒对异丙酚镇静效力的影响.方法 择期拟行外科手术的男性患者50例,年龄25～60岁,体重50～80kg,ASA分级Ⅰ或Ⅱ级,根据是否有长期饮酒史分为2组(n=25),对照组:日饮酒量＜25 g;长期饮酒组:日饮酒量超过45 g持续2年或2年以上.采用序贯法确定异丙酚使患者意识消失的EC50其95%可信区间,长期饮酒组和对照组异丙酚初始效应室靶浓度分别为2.0和1.5μg/ml,各相邻靶浓度之比为1.05.以睫毛反射消失及对言语指令无反应作为判断意识消失的标准.结果 长期饮酒组和对照组异丙酚使患者意识消失时的EC50及其95%可信区间分别为3.92(3.56～4.63)g/ml和2.73(2.26～3.31)μg/ml,长期饮酒组EC50高于对照组(P＜0.05).结论 长期饮酒可增加异丙酚使患者意识消失时的EC50,降低其镇静效力.

Abstract：

Objective To evaluate the effect of chronic alcohol intake on the sedative potency of propofol through investigating the effect of chronic alcohol intake on the half-effective target effect-site concentration ( EC50 )of propofol required for loss of consciousness in patients. Methods Fifty male ASA Ⅰ or Ⅱ patients, aged 25-60 yr, weighing 50-80 kg, scheduled for elective surgery, were divided into 2 groups according to the history of chronic alcoholic intake ( n = 25 each): control group (alcoholic intake per day ＜ 25 g) and chronic alcoholic group (alcoholic intake per day＞45 g, lasting for 2 yr or more). The EC50 and 95% confidence interval (CI)were determined by up-and-down sequential method. The initial target effect-site concentration was 2 μg/nl in chronic alcoholic group and 1.5μg/ml in control group, and the ratio between the two successive concentrations was 1.05. Loss of consciousness was defined as loss of response to verbal command and eyelash stimulation. Results The EC50 of propofol that produced loss of consciousness was 3.92 (95 % CI 3.56-4.63 ) μg/ml in chronic alcoholic group and 2.73 (95%CI 2.26-3.31)μg/ml in control group. The EC50 of propofol was significantly higher in chronic alcoholic group than in control group ( P ＜ 0.05). Conclusion Chronic alcohol intake can increase the EC50 of propofol required to induce loss of consciousness and reduce sedative potency in patients.     

基于免疫磁珠法的自动化粪便脱落细胞提取仪的研制与应用

Objective To design a device based on immunobead method which enables extraction of exfoliated colonocytes from human feces to become an automatic concentrating process. Methods The automatic device for extraction of exfoliated colonocytes from human feces was designed based on the composition and physiochemical features of the feces as well as the distribution of exfoliated colonocytes, so as to integrate its functions in sample collection, pretreatment, exfoliated colonocyte-immunobead binding,and exfoliated colonocyte- immunobead complex washing. The immunobeads were prepared by coating magnetic beads with monoclonal antibody of epethelial cell adhesion molecule (EpCAM) Ber-EP4 and used to concentrate colorectal cancer cells from cell culture. The binding of colorectal cells to immunobeads was observed under microscopy. Cancer tissues of 10 colorectal cancer patients (or tissues around cancer) were collected. The automatic device for extraction of exfoliated colonocytes from human feces was used to get exfoliated cells from stool specimens of the patients. QRT-PCR was used to detect gene expression of c-myc、cox-2、CD44v6 in tissues and cells collected. Rate of gene positive expression of different original specimens was compared. Results The automatic device for extraction of colonocytes from human feces was designed and manufactured. Extracting exfoliated coloncytes from feces sample was successfully completed by the automatic device and self-prepared immunobeads with coating special monoclonal antibody. The recovery rate of cells was 27%. Rate of c-myc, cox-2 and CD44v6 gene positive expression in cancer tissues or tissues around cancer was 20%, 10% and 20% respectively, and 100% in exfoliated cells from stool specimens. The difference of positive rate among specimens was significant (all P＜0.01). Exfoliated cells from stool specimens collected by the automatic device for extraction of exfoliated colonocytes from human feces were cancer cells. Conclusions As one of the latest-developed approaches, immunobead-based concentration of exfoliated colonocytes appears practical. An automatic device thereby developed may be used for early detection of colorectal cancers.     

云南省应对澜湄流域毒品犯罪问题研究

毒源地"金三角"地理位置处于"澜沧江—湄公河"流域的中心地带,受全球化国际毒潮泛滥的影响,澜湄流域毒情形势严峻复杂,传统毒品与合成毒品的种、制、贩活动与消费供应均呈现出不减反增的态势,并且跨境有组织的毒品犯罪活动频发高发,破坏了"澜湄六国"的安全稳定和国际形象.云南作为澜湄流域禁毒执法安全合作的关键枢纽,不仅要应对流域...     

乳腺导管造影对乳头溢液疾病的诊断价值

目的探讨乳腺导管造影对乳头溢液的病因诊断价值。方法回顾分析我院2009—2012乳头溢液患者术后病理明确的40例乳腺导管造影检查的影像资料。结果乳腺导管扩张症伴囊性增生症6例,导管内乳头状瘤13例,导管内癌5例,单纯导管扩张9例,纤维囊性乳腺病及乳腺增生7例。结论乳腺导管造影对乳头溢液疾病的诊断及鉴别诊断具有重要价值,为临床医生提供可靠的诊断治疗依据,为外科医生确定手术切除范围具有指导意义。     

微量清蛋白尿在非糖尿病的冠心病患者中的临床意义

目的探讨微量清蛋白尿(MA)与非糖尿病冠心病(CHD)之间的关系及临床意义。方法选择性冠状动脉造影患者140例,入院后48h内通过放射免疫法测定尿清蛋白分泌率(UAER),根据选择性冠状动脉造影结果,分为CHD组96例和对照组44例(冠脉造影未见异常)。结果 MA阳性率在CHD组明显高于对照组,分别为60.42%、13.64%(χ2=33.715,P<0.001)。结论 MA阳性可能与CHD密切相关,而且可能与冠状动脉病变严重程度正相关。     

浅谈“寒温和,则六腑化谷”

《黄帝内经》是中医学的奠基之作,对于《内经》的学习非常重要,本文从外界气候、饮食水谷、疾病状态三个方面来理解“寒温和,则六腑化谷”,说明多种因素都可导致脾胃运化功能的失司,脾胃疾病的治疗要从多个方面考虑.     

昂丹司琼不同时间和不同剂量给药预防妇科腹腔镜手术术后恶心呕吐的疗效分析

目的探讨给于妇科腹腔镜手术患者不同时间和不同剂量的昂丹司琼对术后恶心呕吐的预防作用。方法152例妇科腹腔镜手术患者随机分为A、B、C三个给药组和空白对照组,给药组各组给于昂丹司琼时间及剂量分别为麻醉诱导前给予8mg、结束时8mg、麻醉诱导前4mg。结果与对照组比较,A组、B组、C组的术后恶心发生率明显较低,差异具有统计学意义（P〈0．05）,A组与B组、A组与C组比较术后恶心呕吐发生率差异无著性（P〉0．05）。结论对于妇科腹腔镜手术患者不同时间和不同剂量给予昂丹司琼均能有效预防恶心呕吐的发生,麻醉诱导前与结束时给药、药量8mg与4mg给药差异较小。     

垂体特异性转录因子Pou1f1靶基因在不同证候H22荷瘤小鼠的表达特征

目的分析垂体重要功能基因及其垂体特异性转录因子(Pou1f1)靶基因在不同证候荷瘤小鼠的表达差异。方法将H22肝癌腹水细胞接种于190只昆明种小鼠腋下,并设置对照组,采用小鼠标准化四诊信息采集与辨证技术筛选典型的邪毒壅盛证、气虚证、阳气虚证、气阴阳虚证小鼠,并抽提小鼠垂体、下丘脑、肾上腺等组织RNA,采用基因芯片技术检测不同组织基因表达谱,本文重点分析不同证候垂体基因芯片数据。结果与对照组比较,垂体重要功能基因阿片促黑素皮质素原(Pomc)、生长激素(Gh)和催乳素(Prl)在早期的邪毒壅盛证和气虚证中表达下调约10%,而Pomc、Gh、Prl和促甲状腺激素β亚基(Tshb)在中晚期的阳气虚证和气阴阳虚证中表达上调30%以上。Pou1f1在垂体组织中表达最高,呈现组织特异性表达特征;垂体特异性转录因子Pou1f1和Neurod1仅在邪毒壅盛证上调,Tbx19和Egr1在不同证候中均呈现上调特征,Nr4a1、Nr4a2、Pitx1、Gata2、Nr4a3、Foxl2等基因在不同证候中均呈现下调特征。Pou1f1相关靶基因Crem、Tcf4、Rnf41、Lrpprc,Mrps18b、Eif3a、Lars,Arf4、Cep57、Vcpip1,Ptpn6、Myd88、F3,Lrrfip2、Dixdc1与Pou1f1基因表达模式类似,即在邪毒壅盛证上调。结论肿瘤状态下的不同证候小鼠,其垂体重要功能基因表达失常,垂体特异性转录因子Pou1f1及其靶基因在邪毒壅盛证具有类似的表达模式。