Protective Effects of Volatile Agents against Methacholine-induced Bronchoconstriction in Rats

Background: The protective properties of common volatile agents against generalized lung constriction have previously been addressed only via estimations of parameters that combine airway and tissue mechanics. Their effectiveness in preventing airway constriction have not been compared systematically. Therefore, the authors investigated the abilities of halothane, isoflurane, sevoflurane, and desflurane to provide protection against airway constriction induced by methacholine.

Methods: Low-frequency pulmonary impedance data were collected in open-chest rats under baseline conditions and during three consecutive intravenous infusions of methacholine (32 [mu]g [middle dot] kg-1 [middle dot] min-1) while the animals were anesthetized with intravenous pentobarbital (control group). Methacholine challenges were performed in four other groups of rats, first during intravenous anesthesia and then repeated during the inhalation of halothane, isoflurane, sevoflurane, or desflurane at concentrations of 1 and 2 minimum alveolar concentration (MAC). Airway resistance and inertance, parenchymal damping, and elastance were estimated from the impedance data by model fitting.

Results: The methacholine-induced increases in airway resistance during intravenous pentobarbital anesthesia (204 +/- 53%) were markedly and significantly (P < 0.005) reduced by 1-MAC doses of halothane (80 +/- 48%), isoflurane (112 +/- 59%), sevoflurane (68 +/- 34%), and desflurane (96 +/- 34%), with no significant difference between the gases applied. Increasing the concentration to 2 MAC did not lead to any significant further protection against the increase in airway resistance.     

015 口服西米替丁(cimetidine)对膀胱疼痛症(PBD)症状的有效缓解

[英]/R.Thilagarajah…∥BJU International.-2001;87.-207～212 　　PBD的临床表现包括耻骨上疼痛、尿频、尿痛和夜尿增多等一系列不适症状、同时尿液感染检查险性.     

Ophthalmic Regional Anesthesia: Medial Canthus Episcleral (Sub-Tenon) Anesthesia Is More Efficient than Peribulbar Anesthesia: A Double-blind Randomized Study

Background: Regional anesthesia and especially peribulbar anesthesia commonly is used for cataract surgery. Failure rates and need for reinjection remains high, however, with peribulbar anesthesia. Single-injection high-volume medial canthus episcleral (sub-Tenon's) anesthesia has proven to be an efficient and safe alternative to peribulbar anesthesia.

Methods: The authors, in a blind study, compared the effectiveness of both techniques in 66 patients randomly assigned to episcleral anesthesia or single-injection peribulbar anesthesia. Motor blockade (akinesia) was used as the main index of anesthesia effectiveness. It was assessed using an 18-point scale (0-3 for each of the four directions of the gaze, lid opening, and lid closing, the total being from 0 = normal mobility to 18 = no movement at all). This score was compared between the groups 1, 5, 10, and 15 min after injection and at the end of the surgical procedures. Time to onset of the blockade also was compared between the two groups, as was the incidence of incomplete blockade with a need for supplemental injection and the satisfaction of the surgeon, patient, and anesthesiologist.

Results: Episcleral anesthesia provided a quicker onset of anesthesia, a better akinesia score, and a lower rate of incomplete blockade necessitating reinjection (0 vs. 39%;P < 0.0001) than peribulbar anesthesia. Even after supplemental injection, peribulbar anesthesia had a lower akinesia score than did episcleral anesthesia. Peribulbar anesthesia began to wear off during surgery, whereas episcleral anesthesia did not.     

全国胃肠道造影及新进展学习班通知

上海市第六人民医院和上海市卫生局联合举办的胃肠道造影学习班已连续举办１０届，深受各级医院放射工作者的好评，今年９－１０月份将继续举办第十一届学习班。学习班属卫生部批准的全国继续教育项目（学分１４分，批准号：２００１－０９－０１－０３４），学习班由著名放射学家尚克中、陈九如、陈克敏、沈谋绩等授课。重点介绍：胃肠道双对比原理、胃肠道造影新进展、胃肠道ＣＴ、胃肠道病变的支架治疗、吞咽功能检查、小肠造影方法、内镜超声、消化道血管性病变的ＤＳＡ检查，等等。欲参加者请于近期来函或来电报名，届时将向报名者寄发…     

应用机架旋转时间为330ms的64层螺旋CT检查行无创性冠状动脉血管造影在搭桥术后患者中的诊断准确性

背景:多层螺旋CT(MDCT)血管造影检查可检出冠状动脉搭桥(CABG)血管的闭塞和狭窄。然而,尚未对其用于CABG以及自体冠状动脉评估进行充分检验。方法和结果:共50例患者的138支CABG血管(34支为乳房动脉搭桥,3支为桡动脉搭桥,101支为静脉搭桥)被纳入研究,在术后9～252个月(平均106个月)期间应     

卡铂超敏反应:一项6h12步35疗程的脱敏方案对妇科恶性肿瘤患者的有效性及肥大细胞/IgE介导过敏反应的机制

超敏反应发生率在接受多疗程卡铂治疗的患者中有所增加。本研究旨在评价一项12步脱敏方案的有效性并描述卡铂超敏反应的免疫机制。本文分析了10例多次证实为对卡铂发生超敏反应且有必要继续使用卡铂的患者。对这些接受卡铂治疗的患者在用药前30min实施一项6h12步的脱敏治疗方案。对5例患者进行了皮试。10例患者顺利地完成了35个针对卡铂的脱敏疗程,其中31个疗程无反应。4例患者分别在第1个脱敏疗程(n=3)和第3个脱敏疗程(n=1)时出现症状,但重复注射均可耐受,无进一步的反应发生。对2例出现真皮外症状患者的后续脱敏疗程方案进行了调整,而对另…     

有髓视网膜神经纤维相关性弱视的视力预后

目的:研究有髓神经纤维相关性弱视和屈光参差相关性弱视的视力预后。设计:回顾性无对照病例研究。方法:12例患有有髓神经纤维相关性弱视及屈光参差相关性弱视的儿童,用遮盖疗法和经睫状肌麻痹验光后行戴镜矫正治疗。在每1次就诊时均测量视力,依据最终视力将患者分为三组,并对三组的初诊年龄、等量球镜度数、屈光参差度数、髓鞘面积、终末年龄和随访时间进行统计学分析。结果:例患儿的等量球镜平均屈光不12正度数为-8.16(极差-1.50～-13.00)。治疗开始时的平均年龄为4.2岁(极差2.1～8.6岁),平均随访2.6年(极差0.5～5.1年)。在遮盖疗法后,4例…     

对Rho激酶的抑制可通过改变细胞骨架及结缔组织生长因子的表达,调节小肠平滑肌细胞的辐射诱发纤维化显型

背景:迟发性放射性小肠炎与细胞外基质的积累和小肠肌层结缔组织生长因子(CTGF)的增高表达具有相关性。目的:本研究通过基因图谱分析确定辐射持续诱发纤维化的分子途径,且假定Rho途径的改变可能与辐射诱发纤维化信号和CTGF的持续表达相关。患者和方法:通过cDN A阵列分析放射性小肠炎患者及对照者的回肠活检样本,并建立小肠平滑肌细胞的原代培养。通过实时逆转录PCR、W estern印迹法和电泳迁移率变动分析,应用Y-27632研究p160Rho激酶的药理学抑制作用。结果:迟发性放射性小肠炎的分子图谱分析表明Rho蛋白遗传密码的表达有所改变。为…     

肿瘤芽生强度及其在浸润性结肠癌中的预后意义

目的:本研究旨在定量评估结肠癌的肿瘤芽生强度,并分析其与肿瘤恶性程度之间的关系。方法:研究了174例高度分化或中度分化结肠肿瘤患者,对其手术切除标本浸润面的肿瘤芽生强度进行评估。对比各种临床病理学参数中肿瘤芽生强度的差异,分析与肿瘤芽生强度水平相对应的肿瘤复发与患者的生存状况。结果:155例(89%)患者存在肿瘤芽生,总的芽生强度为6.6±5.6。存在淋巴或血管浸润的肿瘤芽生强度明显高于无淋巴或血管浸润者(9.1±6.6vs4.8±3.9,9.8±6.1vs5.4±4.9;P<0.0001)。随着肿瘤T和N分期增高,肿瘤芽生强度明显增加(P=0.0013,P<0.0001)。C…