不同全麻药物对体外循环患者氧化应激反应影响的比较

目的:观察不同麻醉方式对体外循环冠状动脉搭桥术（CABG）患者围术期氧化应激反应的影响。方法:择期拟行体外循环下CABG术患者45例,随机分为3组(每组15例):丙泊酚组（P组）、依托咪酯组（E组）和七氟烷组（S组）。分别于麻醉前、手术切皮时、体外循环开始前、手术结束时、术后6 、24 、48 、72　h（T_0～7）记录患者心率（HR）和平均动脉压（MAP）,并于T₀、T_4～7时取血测定过氧化物歧化酶（SOD）、过氧化氢酶（CAT）和谷胱甘肽过氧化物酶（GSH-Px）含量。结果:3组患者在T₅和T₆时点SOD、CAT和GSH-Px活性均低于术前（P<0.05）。S组在T₇ 时点SOD和GSH-Px活性依然低于术前（P<0.05）。E组和S组的SOD、CAT和GSH-Px活性在术后均不同程度低于P组（P<0.05）。与E组相比,S组SOD、 CAT和GSH-Px活性在术后有不同程度升高（P<0.05）。结论:与七氟烷和依托咪酯相比较,丙泊酚能更好地对抗体外循CABG术围术期的氧化应激反应。     

综合康复训练结合醒脑开窍针法对偏瘫早期患者运动功能和日常生活能力的影响

目的:探讨应用综合康复训练结合醒脑开窍针法对偏瘫早期患者运动功能和日常生活能力的影响。方法:选取50例2017年5月-2018年8月在本院治疗的偏瘫患者,随机分成两组,每组25例。对照组给予常规内科治疗和醒脑开窍针法治疗,治疗组除以上治疗外,还需给与综合康复训练,治疗2周后,比较两组患者实验数据。结果:经不同治疗方法治疗后,治疗组疗效优于治疗前,同时也优于对照组。比较具有统计学意义。结论:应用综合运动康复训练结合醒脑开窍针法治疗急性脑卒中偏瘫,可提高患者运动功能和日常生活能力,值得推广应用。     

试剂盒法制备细胞块的效果及其技术要点

目的:探讨应用细胞块制备试剂盒制备细胞块效果以及制块过程中的技术要点。方法:应用细胞块制备试剂盒法制备细胞块,常规包埋制片后进行HE染色及免疫组化染色,观察其效果。结果:细胞块制备试剂盒制成的细胞块不散,可对微量标本进行处理,具备组织学优点;满足标本连续切片,并可永久保存标本;能满足免疫组化检测需要。结论:细胞块制备试剂盒法操作简单,技术难点不多,质量容易控制,便于基层医院推广。     

敬告作者

本刊所引用的参考文献书写要求如下：如文献的作者不多于3人,应全部列出;如为4人以上,只列出前3人,后加"等"（中文）、"他"（日文）、"etal"（西文）。其格式如下：［期刊］序号作者．文题．刊名,年份,卷：起页～迄页． 　　［书籍］序号作者．书名．版次．出版地：出版社,年份．起页～止页．或：序号章节作者．文题．见［In］：主编姓名,主编．书名．版次．出版地：出版社,年份．起页～止页． 　　本刊编辑部     

Treatment of chronic bacterial prostatitis with amikacin through anal submucosal injection

Aim: To assess the efficacy and safety of anal submucosal injection (ASI) of amikacin in chronic bacterial prostatitis (CBP). Methods: Fifty male outpatients with CBP were randomly divided into two groups. Thirty cases of ASI group were given amikacin 400 mg daily by ASI for ten times and the other twenty cases of intramuscular injection (IM) group were given the same drug dally by IM. All patients were evaluated with NIH-Chronic prostatitis symptom index (NIH-CPSI), the bacteria culture of the expressed prostate secretion (EPS), proctoscopic examination, rectal biopsy and the clinical manifestation were checked at pretreatment and on day 7 and 90 after cessation of therapy. Results: The cure rate, apparent effective rate and effective rate of ASI group and IM group were 33.3% vs 5% (P<0.05), 43.3% vs 10% (P<0.05) and 16.7% vs 20% (P>0.05), respectively. The score of NIH-CPSI in both of ASI group and IM group decreased significantly 7 days after cessation of therapy, both ASI and IM of amikacin could re     

无C臂透视微创DHS治疗股骨粗隆间骨析

目的探讨在无C臂透视下，应用动力髋螺钉（DHs）内固定治疗股骨粗隆间骨折的方法和疗效。方法对38例股骨粗隆间骨折在无C臂透视条件下采用有限切开DHS内固定治疗。结果全部患者达到手术预期目标。结论在无C臂条件下，充分利用放射科经皮打人导针，有限切开DHS内固定，具有微创、安全、简便、术后功能恢复快等优点，是基层医院治疗股骨粗隆间骨折的一种较理想的手术方法。     

Ketamine Inhibits Presynaptic and Postsynaptic Nicotinic Excitation of Identified Cardiac Parasympathetic Neurons in Nucleus Ambiguus

Background: Ketamine increases both blood pressure and heart rate, effects commonly thought of as sympathoexcitatory. The authors investigated possible central nervous system actions of ketamine to inhibit cardiac parasympathetic neurons in the brainstem by inhibiting multiple nicotinic excitatory mechanisms.

Methods: The authors used a novel in vitro approach to study the effect of ketamine on identified cardiac parasympathetic preganglionic neurons in rat brainstem slices. The cardiac parasympathetic neurons in the nucleus ambiguus were retrogradely prelabeled with the fluorescent tracer by placing rhodamine into the pericardial sac. Dye-labeled neurons were visually identified for patch clamp recording. The effects of ketamine were tested on nicotine-evoked ligand-gated currents and spontaneous glutamatergic miniature synaptic currents (mini) in cardiac parasympathetic preganglionic neurons.

Results: Ketamine (10 [mu]m) inhibited (1) the nicotine (1 [mu]m)-evoked presynaptic facilitation of glutamate release (mini frequency, 18 +/- 7% of control; n = 9), and (2) the direct postsynaptic ligand-gated current (27 +/- 8% of control; n = 9), but ketamine did not alter the amplitude of postsynaptic miniature non-N-methyl-d-aspartate currents. [alpha] Bungarotoxin, an antagonist of [alpha]7 containing nicotinic presynaptic receptors, blocked ketamine actions on mini frequency (n = 10) but not mini amplitude.     

Oxygen Reverses Deficits of Cognitive Function and Memory and Increased Heart Rate Induced by Acute Severe Isovolemic Anemia

Background: Erythrocytes are transfused to improve oxygen delivery and prevent or treat inadequate oxygenation of tissues. Acute isovolemic anemia subtly slows human data processing and degrades memory, increases heart rate, and decreases self-assessed energy level. Erythrocyte transfusion is efficacious in reversing these effects of acute anemia. We tested the hypothesis that increasing arterial oxygen pressure (Pao2) to 350 mmHg or greater would supply sufficient oxygen to be equivalent to augmenting hemoglobin concentration by 2-3 g/dl and thus reverse the effects of acute anemia.

Methods: Thirty-one healthy volunteers, aged 28 +/- 4 yr (mean +/- SD), were tested with verbal memory and standard, computerized neuropsychologic tests before and twice after acute isovolemic reduction of their hemoglobin concentration to 5.7 +/- 0.3 g/dl. Two sets of tests were performed in randomized order at the lower hemoglobin concentration: with the volunteer breathing room air or oxygen. The subject and those administering the tests and recording the results were unaware which gas was administered. As an additional control for duration of the experiment, 10 of these volunteers also completed the same tests on a separate day, without alteration of hemoglobin concentration, at times of the day similar to those on the experimental day. Heart rate, mean arterial blood pressure, and self-assessed sense of energy were recorded at the time of each test.

Results: Reaction time for digit-symbol substitution test increased, delayed memory was degraded, mean arterial pressure and energy level decreased, and heart rate increased at a hemoglobin concentration of 5.7 g/dl (all P < 0.05). Increasing Pao2 to 406 +/- 47 mmHg reversed the digit-symbol substitution test result and the delayed memory changes to values not different from those at the baseline hemoglobin concentration of 12.7 +/- 1.0 g/dl, and decreased heart rate (P < 0.05). However, mean arterial pressure and energy level changes were not altered with increased Pao2 during acute anemia.     

Differences in Systemic Opioid Use Do Not Explain Increased Fever Incidence in Parturients Receiving Epidural Analgesia

Background: It has been hypothesized that an increased incidence of fever in patients receiving epidural analgesia might result not from epidural per se, but rather from the antipyretic effect of opioids preferentially administered to women in the no-epidural group. If this were the case, then one would expect the incidence of fever in parturients who did not receive systemic opioids to be independent of whether they received epidural analgesia.

Methods: Using a cohort study design, the authors evaluated the records of 1,233 nulliparous patients whose labor analgesia was managed with (1) no medication (N = 170); (2) 10 mg intravenous systemic nalbuphine plus 10 mg intramuscular every 3 to 4 h as required (N = 327); (3) epidural analgesia with continuous infusion of 0.125% bupivacaine with 2 [mu]g/ml fentanyl (N = 278); or (4) patients who received both systemic nalbuphine and epidural analgesia (N = 458). Fever was diagnosed if the maximum temperature during labor exceeded 100.4[degrees]F (38[degrees]C).

Results: The incidence of fever did not differ according to nalbuphine administration for women not receiving epidural analgesia (1% no nalbuphine, 0.3% with nalbuphine, P = 0.27) or for women receiving epidural analgesia (17% no nalbuphine, 17% with nalbuphine, P = 1.0). However, the incidence of fever differed significantly between patients who received no analgesia as compared to those who received epidural analgesia alone (1%vs. 17%, P = 10-6). Controlling for confounding did not alter these associations.