Management of difficult airways with a laryngeal mask airway under propofol anaesthesia

We report four cases of difficult airway managed with a laryngeal mask airway (LMA) under propofol anaesthesia; this method was chosen to minimize psychological and physical trauma. Case 1 was a boy with dermatomyositis; Case 2, a girl wearing a base ring of a stereotactic frame; Case 3, a boy with Treacher-Collins syndrome; Case 4, a boy with Goldenhar syndrome. They were anaesthesized with propofol and though spontaneous ventilation became shallower, or apnoea occurred, the stimulus of inserting an LMA awakened the patient and caused more active spontaneous ventilation while a patent airway was established by the LMA. All tracheal intubations were performed smoothly and without delay through the LMA, and we believe that psychological and physical trauma was thus minimized.     

Calling the patient's own name facilitates recovery from general anaesthesia: a randomised double‐blind trial

People can hear and pay attention to familiar terms such as their own name better than general terms, referred to as the cocktail party effect. We performed a prospective, randomised, double‐blind trial to investigate whether calling the patient's name compared with a general term facilitated a patient's response and recovery from general anaesthesia. We enrolled women having breast cancer surgery with general anaesthesia using propofol and remifentanil. Patients were randomly allocated into two groups depending on whether the patient's name or a general term was called, followed by the verbal command – ‘open your eyes!’ – during emergence from anaesthesia; this pre‐recorded sentence was played to the patient using headphones. Fifty patients were allocated to the name group and 51 to the control group. Our primary outcome was the time from discontinuation of anaesthesia until eye opening. The mean (SD) time was 337 (154) s in the name group and 404 (170) s in the control group (p = 0.041). The time to i‐gel^® removal was 385 (152) vs. 454 (173) s (p = 0.036), the time until achieving a bispectral index of 60 was 174 (133) vs. 205 (160) s (p = 0.3), and the length of stay in the postanaesthesia care unit was 43.8 (3.4) vs. 47.3 (7.1) min (p = 0.005), respectively. In conclusion, using the patient's name may be an easy and effective method to facilitate recovery from general anaesthesia.     

人端粒酶逆转录酶启动子介导的靶向性肿瘤基因治疗的研究进展

端粒酶与肿瘤发生发展的关系是近年来肿瘤研究领域的热点之一．端粒的磨耗限制大多数体细胞的复制,肿瘤细胞主要通过转录上调端粒酶限制成分催化亚基端粒酶逆转录酶（hTERT）维持端粒长度．由于hTERT启动子区域已被克隆,其特点也已被鉴定,hTERT启动子介导的靶向性肿瘤基因治疗成为研究的热点．我们综述了hTERT启动子介导的靶向性肿瘤基因治疗最新研究进展．     

尿中睾酮与表睾酮的三甲基硅烷化及其比值的GC—MS测定

对睾酮及表睾酮的三甲基硅烷化进行了详细考察,找到了较好的抗氧剂巯基乙醇,确定了较好的衍生化条件,衍生化产物单一。并采用GC—MS法测定了尿中睾酮与表睾酮的比值。实验条件为:以氦为载气,SE—54熔融石英柔性毛细管柱、程序升温进行样品分离,多离子检测(MID),监测m/z432的离子。该法专属、灵敏、快速。睾酮与表睾酮比值在1:1～10:1(睾酮为20ng/μl)与相应峰面积比呈线性关系(r=0.998),最低检测限为1ng,最低检测尿药浓度为8ng/ml。     

三七中人参三醇甙对羊心浦氏纤维动作电位及延迟整流钾电流的影响

三七中人参三醇甙(PTS)2.5μg/ml及5.0μg/ml均能明显延长羊心浦氏纤维动作电位时程(APD)包括APD₃₀,APD₅₀,APD₉₀,对动作电位幅度(APA)无明显影响。双微电极法电压钳实验证明,PTS能明显抑制羊心浦氏纤维延迟整流钾电流(I_x)的峰值,且此种抑制作用呈时间及剂量依赖性。揭示PTS通过阻滞延迟整流钾通道而延长APD。     

人工神经网络用于中药材雷公藤和昆明山海棠的分类识别研究

应用误差反向传播学习算法(BP算法)对中药材雷公藤和昆明山海棠浸出物的红外光谱进行分类识别。网络为3层结构,输入节点为9个,隐层节点为21个,输出节点为1。分类结果与XIM-CA法基本一致。此外,本文还考察了网络参数间的相互关系。     

Pinhole scanning in tumors and tumorous conditions of bone: A new imaging approach to skeletal oncology

Tumors and tumorous conditions of bone are one of the most important and diagnostically challenging diseases, and their primary imaging diagnostic means is radiography. As the clinical situation dictates radiography may be supplemented with conventional X-ray tomography, computed tomography (CT) scan, and magnetic resonance (MR) imaging. Bone scan is another important adjunct whose usefulness and exquisite sensitivity are well established. Recently, the use of pinhole bone scan (PBS) has been extended in the imaging of virtually the entire spectrum of bone diseases, including tumors and tumorous conditions, proving its tremendous value. Thus, the extended application of PBS now permits: (1)Anatomical andchemical profile study of bone tumors; (2) evaluation of involutional changes in benign bone tumors and some tumorous conditions; (3) delineation of individual lesions in polyostotic diseases, such as fibrous dysplasia, enchondromatosis, multiple exostosis, osteopetrosis, and others; (4) detection of occult metastasis and osteoid osteoma nidus; (5) portrayal of intramedullary skip metastasis in osteosarcoma and conventional giant cell tumor; (6) assessment of tumor extent and watershed phenomenon; (7) and clarification of unexplained bone pain and altered serum phosphates. It appears that PBS is an economical, practicable, potent solution to the dilemma of not only the low specificity but also the relatively low sensitivity of the conventional planar scan and even single photon emission computed tomography (SPECT) is the diagnosis of bone tumors and tumorous conditions.Presented at the 27th Annual Musculoskeletal Tumor Meeting of the Japanese Orthopaedic Association     

(IN)-efficacy of salvage radiotherapy for rising PSA or clinically isolated local recurrence after radical prostatectomy

PURPOSE: To determine the efficacy of external beam radiotherapy (RT) as salvage treatment for prostate-specific antigen (PSA) failure or local recurrence after radical prostatectomy. METHODS AND MATERIALS: Between 1991 and 1997, 98 patients underwent salvage RT to the prostatic bed at the Toronto Sunnybrook Regional Cancer Centre for PSA failure or local recurrence after radical prostatectomy. Thirty-six patients were treated for persistently detectable postoperative PSA levels (Group A), 26 for a delayed PSA rise (Group B), and 36 for palpable and/or biopsy-proven local recurrence (Group C). None had clinically apparent distant metastasis at the time of salvage RT. Freedom from PSA failure was defined as the maintenance of PSA 相似文献