Bisulfite-containing propofol: is it a cost-effective alternative to Diprivan for induction of anesthesia?

Propofol (Diprivan(TM); AstraZeneca, Wilmington, DE) is a commonly used drug for the induction of general anesthesia in the ambulatory setting. With the availability of a new bisulfite-containing generic formulation of propofol, questions have arisen regarding its cost effectiveness and safety compared with Diprivan(TM). Two hundred healthy outpatients were randomly assigned, according to a double-blinded protocol, to receive either Diprivan(TM) or bisulfite-containing propofol 1.5 mg/kg IV as part of a standardized induction sequence. Maintenance of anesthesia consisted of either desflurane (4%-8% end-tidal) or sevoflurane (1%-2% end-tidal) in combination with a remifentanil infusion (0.125 microg x kg(-1) x min(-1) IV). Patient assessments included pain on injection, induction time, hemodynamic and bispectral electroencephalographic changes during induction, emergence time, and incidence of postoperative nausea and vomiting. The two propofol groups were comparable demographically, and the induction times and bispectral index values during the induction were also similar. However, the bisulfite-containing formulation was associated with less severe pain on injection (5% vs 11%), with fewer patients recalling pain on injection after surgery (38% vs. 51%, P<0.05). None of the patients manifested allergic-type reactions after the induction of anesthesia. The acquisition cost (average wholesale price in US dollars) of a 20-mL ampoule of Diprivan(TM) was $15 compared with $13 for the bisulfite-containing propofol formulation. Therefore, we concluded that the bisulfite-containing formulation of propofol is a cost-effective alternative to Diprivan(TM) for the induction of outpatient anesthesia. Implications: Bisulfite-containing propofol and Diprivan(TM) (AstraZeneca, Wilmington, DE) were similar with respect to their induction characteristics; however, the generic formulation was associated with a smaller incidence of injection pain. Assuming that the drug costs are similar, these data suggest that the bisulfite-containing formulation of propofol is a cost-effective alternative to Diprivan(TM).     

The effects of ropivacaine on sodium currents in dorsal horn neurons of neonatal rats

We used a whole cell patch clamp technique to study the effects of ropivacaine on rat dorsal horn neurons. Under voltage clamp, ropivacaine (10-400 microM) produced a dose-dependent inhibition of sodium current. From a holding potential (V(h)) of -80 mV, sodium currents evoked by test pulses to 0 mV were inhibited by ropivacaine with a mean drug concentration required to produce 50% current inhibition (IC(50)) value of 117.3 microM, which was more than the value of the bupivacaine (IC(50) 53.7 microM). The inhibition effect of ropivacaine was also voltage-dependent. Current evoked from a V(h) of -60 mV was inhibited by ropivacaine with a mean IC(50) value of 74.3 microM, which was less than that obtained at the V(h) of -80 mV. The inhibition effect of ropivacaine on sodium current was use dependent. Repeated activation by a train of depolarizing pulses (5 Hz, 20 ms) increased the inhibitory effects of ropivacaine. The ratio amplitudes of the 20th to the first pulse were 91.2% and 71.1%, respectively, in the absence and presence of ropivacaine (50 microM). Ropivacaine also produced a significant hyperpolarizing shift of 11 mV in the steady-state inactivation curve of sodium current. The inhibition of ropivacaine on the sodium channel may contribute to the mechanism of action of local anesthetics during epidural and spinal anesthesia.     

天津口岸出入境人员梅毒血清学检测结果分析

目的 通过对梅毒检测结果的分析，掌握出入境人员的梅毒感染情况，有针对性的进行梅毒的防治。方法 对24503名经天津口岸出入境的各类人员进行梅毒血清学检测，并对检测结果进行统计分析。结果 24503名出入境人员中共检出梅毒阳性39例，阳性率为1．59％o，分析发现各年份检出梅毒阳性率呈逐年递增的趋势，不同职业人群中船员的梅毒阳性率为2．01‰，远远高于其他人群的0．88‰。结论 出入境船员作为一个特殊人群，是梅毒感染的高危人群，需加强卫生保健意识，减少感染梅毒的机会，进一步说明梅毒血清学检测在国境口岸传染病监测中的重要性。     

补骨方治疗膝骨性关节炎的疗效观察

目的　探讨应用补骨方治疗膝骨关节炎的疗效。方法　临床应用补骨方和芬必得治疗老年性膝骨性关节炎 6 0例 4周 ,并比较随访疗效。结果　治疗后两组患者症状平均分值、日常活动功能障碍平均分值和总评分平均分值较治疗后显著升高 ,膝关节临床症状明显减轻 ,关节功能显著改善 ,比较具有显著性差别 (P <0 0 1)。经统计学处理 ,两组膝关节日常生活活动评分治疗前后。两组临床资料没有显著差异 (P >0 0 5 ) ,具可比性。结论　补骨方能明显改善膝骨关节炎患者的临床症状和关节功能。     

非淋菌性尿道炎合并盆腔感染药物治疗效果对比研究

目的探讨临床上对非淋菌性尿道(宫颈)炎合并盆腔感染有效的治疗方法。方法将妇产科及性病科门诊确诊的非淋菌性尿道(宫颈)炎合并盆腔感染201例病人随机分为2组,治疗组采用头孢曲松纳加阿奇霉素治疗,对照组采用头孢曲松纳加口服美满霉素治疗。结果治疗组治愈率为80.95%,总有效率为97.14%;对照组治愈率为58.33%,总有效率为69.79%。两者的,临床治愈率及有效率有显著性的差异(P<0.005)。结论头孢曲松纳加阿奇霉素静脉给药治疗非淋菌性尿道(宫颈)炎合并盆腔感染取得良好的治疗效果,较头孢曲松纳加美满霉素效果有显著性提高。     

Firebird冠脉涂膜支架系统生物学安全性评价研究

依据国家标准GB/T16175-1996,选择10项试验对Firebird冠脉涂膜支架系统进行生物学安全性评价[1],结果表明该支架系统的血液相容性良好,无全身毒性和细胞毒性,无热源性、致敏性、刺激性,也无遗传毒性,组织相容性尚可,是一种生物相容性优良的Firebird冠脉涂膜支架系统.     

鼻腔鼻窦鳞状细胞癌中细胞质凋亡抑制蛋白2和半胱氨酸蛋白水解酶4的表达

OBJECTIVE: To examine the expression of apoptosis-related genes c-IAP2 and caspase-4 in sinonasal squamous carcinoma. To investigate the role and mechanism of the two apoptosis-related genes in nasal cavity and sinus squamons carcinoma. METHODS: Forty-one pathologically confirmed specimens of nasal cavity and sinus squamons carcinoma were subjected for immunohistochemical staining to analyze the expression of c-IAP2 and caspase-4, in addition 10 normal nasal mucosa were used as control. RESULTS: The positive rate of c-IAP2 in sinonasal squamons carcinoma was 87.8%, among which 14 cases were strongly stained(+ + +), 15 cases were stained(+ +), 7 cases were stained (+), only 5 cases were negative. In 10 normal control tissues, no case was stained(+ + +), 2 cases were stained (+ +), 3 cases were stained(+), the other 5 cases were negative. Higher level expression of c-IAP2 protein was detected more often in squamons carcinoma specimens than that in normal nasal mucosa. There was statistically significant difference between the two groups for the staining(P < 0.05). The expression of c-IAP2 was not correlated with clinical staging (P > 0.05), but there were positive correlation with clinical prognosis (P < 0.01) and pathological classification (P < 0.01); The positive rate of caspase-4 in nasal cavity and sinus squamons carcinoma was 58.5%, among which 4 cases were strongly stained (+ + +), 7 cases were stained (+ +), 13 case was stained(+), 17 cases were negative. The expression of caspase-4 protein was more deletion in squamons carcinoma specimens than that in control group, there was statistically significant difference between the two groups for the staining (P < 0.05). The expression of caspase-4 protein was negatively correlated with clinical prognosis (P < 0.01) and pathological classification ( P < 0.01), not correlated with clinical staging(P > 0.05). The expression of c-IAP2 was negativelly correlated with the experssion of caspase-4. CONCLUSIONS: The results indicates that in sinonasal squamous carcinoma, c-IAP2 is activated, while caspase-4 is restrained, the signal transduction pathway of apoptosis is arrested, leading to surviving of tumor cells, this maybe directly associated with the development of sinonasal squamons carcinoma, and with the failure of tumor trentment.     

上颌窦息肉及囊肿处理方法的探讨

目的 :探讨鼻内镜下上颌窦内息肉、囊肿手术切除方法。方法 :将上颌窦内有息肉和囊肿的 96例患者随机分为两组 :治疗组 5 0例 ,对照组 4 6例。治疗组应用Rudolf 4 .5mm上颌窦开窗器 ,经下鼻道钻孔 ,套管内窥及息肉和囊肿 ,电动吸引切割器切除。对照组经扩大的自然开口 ,用上颌窦息肉钳清除窦口可见到的息肉和囊肿。结果 :术后随访 6个月 ,治疗组治愈 4 1例 ,好转 8例 ,无效 1例 ,总有效率为 98.0 0 % ,治愈率为 82 .0 0 % ;对照组治愈 2 8例 ,好转 11例 ,无效 7例 ,总有效率为 84 .78% ,治愈率为 6 0 .87% ,两组比较 ,差异均有统计学意义 (P <0 .0 1和P <0 .0 5 )。结论 :鼻内镜下经下鼻道钻孔上颌窦息肉、囊肿电动吸引切割术是一种简单、疗效肯定的手术方法 ,可以提高慢性鼻窦炎的治愈率。     

使用多媒体辅助医学影像设备教学

电路工作程序分析是<医学影像设备学>学习中的重点,同时也是一个难点,如何搞好该环节的教学是我们思考最多的一个问题,经过不断的尝试,我们引入了多媒体辅助教学,取得了一定的教学效果.