抗精神病药物引起骨质疏松症的机制及研究进展

骨质疏松症是抗精神病药物的常见不良反应,其症状是以低骨密度为特征,导致骨脆性增加、畸形和骨折的全身性进行性骨骼疾病.以利培酮为代表的抗精神病药物使用会导致高泌乳素血症,高水平催乳素能够通过刺激骨吸收、降低性激素水平影响骨代谢.然而高乳素血症学说存在一定的局限性.现通过探讨人骨代谢指标的变化、动物体内骨量变化和对成骨细胞...     

Effects of the addition of low-dose ketamine to propofol-fentanyl anaesthesia during diagnostic gynaecological laparoscopy

Objectives

Diagnostic gynaecological laparoscopy (DGL) is a brief procedure, generally performed on an outpatient basis. Propofol-fentanyl is often used for anaesthesia in minor outpatient procedures because of its rapid onset, short duration of action and smooth patient awakening. However, propofol has various cardiovascular effects such as reduced arterial pressure, cardiac output and cardiac index. Ketamine is an intravenous anaesthetic and short-acting analgesic that could alleviate the haemodynamic effects of propofol due to its sympathomimetic activity. The aim of this placebo-controlled trial was to evaluate the effects of the addition of low-dose ketamine to propofol-fentanyl anaesthesia in DGL.

Study design

In this double-blind randomized trial, 60 healthy women undergoing gynaecological laparoscopy to investigate infertility were studied. Following injection of midazolam and fentanyl in all patients, the study group (n = 30) received ketamine 0.5 mg/kg and propofol 1–2.5 mg/kg, and the placebo group (n = 30) received saline 0.9% and propofol 1–2.5 mg/kg. Propofol was subsequently infused for the maintenance of anaesthesia.

Results

Patients in the study group had a significantly lower incidence of pain than patients in the placebo group during propofol injection (13% vs 87%, respectively; p < 0.0001). After induction of anaesthesia, 16 (53%) patients in the placebo group and three (10%) patients in the study group had a decreased heart rate (p < 0.001). The decrease in mean arterial pressure was greater in the placebo group compared with the study group (37% vs 7%, respectively; p < 0.001). During the procedure, the total mean ± standard deviation dose of propofol was 420 ± 65 mg in the placebo group and 330 ± 35 mg in the study group (p < 0.001). Pain scores for the first 3 h after the operation were significantly lower in the study group (p < 0.001).

Conclusion

Use of low-dose ketamine with propofol-fentanyl anaesthesia in patients undergoing DGL was associated with less pain during propofol injection, lower incidence of haemodynamic changes, lower total dose of propofol and improved postoperative analgesia.     

影响高原部队官兵生殖健康知识水平的因素分析

基层部队官兵对性生理知识和艾滋病传播及防治知识了解不多,有的甚至还存在一定的认识误区。本研究对高原部队官兵性生理及艾滋病知识进行了问卷调查,旨在了解高原部队官兵生殖健康知识水平,并探讨其可能的影响因素,以提供更有针对性、目的性的生殖健康保健服务,提高高原部队官兵对性生理知识和艾滋病防治知识的认知水平和生殖健康水平。     

胫骨高位截骨术治疗膝内侧间室骨关节炎的疗效分析

目的 探讨内侧开放式胫骨高位截骨术治疗膝关节内侧骨关节炎的临床疗效.方法 选取2016年1月至2019年2月于暨南大学附属第一医院骨关节科诊断为膝内侧骨关节炎并行内侧开放式胫骨高位截骨术的患者56例(64膝).纳入标准:膝关节内侧间室骨关节炎;合并胫骨侧内翻畸形.排除标准:炎症性、感染性关节炎;多间室的关节退变;膝关节...     

Study on mechanism of release oxygen by photo-excited hemoglobin in low-level laser therapy

According to the calculated results on the charge distribution of oxygenated heme and deoxygenated heme, and based on the theory of electron excitations in photo-acceptor molecules and the absorption spectra of hemoglobin, it is found that low-level laser within the waveband of about 800–1060 nm can promote the release of oxygen from oxyhemoglobin and improve the oxygen supply of capillaries to surrounding tissues. Furthermore, the reasons have been explained that why the low-level laser at a wavelength of 830 nm is better in the treatment on burn injury and stimulation of hair growth. We also explained why the near-infrared laser of 1064 nm is applied to the forehead to improve cerebral oxygenation in healthy humans. Finally, according to comparison of atomic charge distribution in heme before and after bound to small molecule of carbon monoxide or nitric oxide, it could be inferred that the low-level laser with an appropriate wavelength can promote the carbon monoxide hemoglobin and nitric oxide hemoglobin to dissociate the carbon monoxide molecules and the nitric oxide molecules. This may be used for adjuvant therapy of carbon monoxide poisoning or nitric oxide poisoning.     

hsp70, hsp32, and grp78 are increased in thermally injured skin with and without antithrombin(human) concentrate infusion

An acquired deficiency of antithrombin (AT), an anti-inflammatory protein, develops in patients with thermal injuries. Skin thermotolerance is regulated by heat shock protein (hsp) genes. hsp70, hsp32, hsp27, and glucose-regulated protein78 (grp78) were studied in burned and unburned human skin to determine whether correction of the AT deficiency modulated the intensity of expression of these proteins. Fifty-four human skin samples were prepared by Western blot analysis: 11 unburned and 22 burned control skin samples and 7 unburned and 14 burned skin samples from patients treated with AT(Human), or AT(H). The intensity of hsp32 expression in burned AT(H)-treated skin (P < .001) and in burned control skin (P < .01) was significantly increased compared with unburned control skin. The intensity of expression of hsp70 was statistically significant in burned AT(H)-treated skin compared with unburned control skin (P < .02), as was that of grp78 (P < .01). Thermally injured skin with or without AT(H) treatment had an increased expression of hsp70, hsp32, and grp78 compared with unburned control skin.     

Hymenolepis diminuta a rare zoonotic infection report of a case

Hymenolepis diminuta a rare zoonotic tapeworm infection is reported in a young child coming from pure vegetarian family.     

Glycemic index,glycemic load,and risk of type 2 diabetes

The possibility that high, long-term intake of carbohydrates that are rapidly absorbed as glucose may increase the risk of type 2 diabetes has been a long-standing controversy. Two main mechanisms have been hypothesized, one mediated by increases in insulin resistance and the other by pancreatic exhaustion as a result of the increased demand for insulin. During the past decade, several lines of evidence have collectively provided strong support for a relation between such diets and diabetes incidence. In animals and in short-term human studies, a high intake of carbohydrates with a high glycemic index (a relative measure of the incremental glucose response per gram of carbohydrate) produced greater insulin resistance than did the intake of low-glycemic-index carbohydrates. In large prospective epidemiologic studies, both the glycemic index and the glycemic load (the glycemic index multiplied by the amount of carbohydrate) of the overall diet have been associated with a greater risk of type 2 diabetes in both men and women. Conversely, a higher intake of cereal fiber has been consistently associated with lower diabetes risk. In diabetic patients, evidence from medium-term studies suggests that replacing high-glycemic-index carbohydrates with a low-glycemic-index forms will improve glycemic control and, among persons treated with insulin, will reduce hypoglycemic episodes. These dietary changes, which can be made by replacing products made with white flour and potatoes with whole-grain, minimally refined cereal products, have also been associated with a lower risk of cardiovascular disease and can be an appropriate component of recommendations for an overall healthy diet.