川芎嗪对脑外伤患者血栓素、前列腺环素及颅内压的影响

28例重度脑外伤患者分为川药嗪治疗组和一般治疗对照组,两组病人均于用药前和用药后3小时测定血浆和脑室内脑脊液(VCSF)中血栓素代谢产物(TXB_2)前列腺环素代谢产物6—酮—PGF_(la)(6KP)和颅内压。结果表明:两组治疗前血浆、VCSF中TXB_2及T/K均明显高于正常献血员对照组,川芎嗪能降低脑外伤患者血浆、VCSF中TXB_2及T/K值,对颅内压则无明显影响。提示川芎嗪能抑制脑外伤对血小板的激活、纠正循环血中TXA_2—PGI_2平衡失调,从而改善脑微循环。     

肠溶阿斯匹林剂量和血阿斯匹林及水杨酸盐浓度与药效关系探讨

本文探讨了ＡＳＡ剂量与药效的关系及血ＡＳＡ、ＳＡ药物浓度监测的临床意义，结果表明：（１）ＡＳＡ剂量与６－ｋｅｔｏ－ＰＧＦ_（１α）抑制率呈正相关（Ｐ＜０．０１），而与ＴＸＢ_２及ＰＡｇＲ抑制率无相关性（Ｐ＞０．１）；（２）本文采用ＨＰＬＣ内标法同时测定血ＡＳＡ和ＳＡ浓度，结果准确，方法简便；（３）当口服小剂量ＡＳＡ防治ＣＩ时，监测血ＡＳＡ和ＳＡ以调整ＡＳＡ用药剂量的临床价值并非十分重要。     

Comparison of the sphygmooscillographic method with the direct and auscultatory methods of measuring blood pressure

Objective. The objective of this study was to compare blood pressure (BP) measured by the sphygmooscillographic method with that measured by the direct and auscultatory methods.Methods. In 15 adult patients undergoing cardiac surgery, blood pressure was measured by the sphygmooscillographic and direct methods simultaneously on the same upper extremity. In another group of 86 children and 11 adults, blood pressure was measured by the sphygmooscillographic and auscultatory methods simultaneously, with one cuff. For the sphygmooscillographic measurement, we used sphygmomanometer-S, which measures blood pressure on the basis of the amplitude height (oscillometric) and the morphology (sphygmographic) of pulse waves recorded by a transducer placed in the cuff.Results. The systolic and diastolic blood pressure measured by the sphygmooscillographic method were both 2 mm Hg higher than those from the direct method; the mean blood pressure was 0.6 mm Hg higher. These differences were not significant. Compared with the auscultatory method, sphygmooscillographic systolic values were higher by 7 mm Hg, while diastolic values were lower by 9 mm Hg. These differences were significant.Conclusions. Blood pressure measurements obtained by the sphygmooscillographic method correlate well with the direct method for measuring blood pressure in children and adults; but, they do not correlate well with the auscultatory method.     

Physiological Effects of Mental Stress and Orthostasis in Young Insulin-Dependent Diabetic Patients

ABSTRACT. The effects of procedures which stimulate sympathetic activity, viz. mental stress induced by a colour-word conflict test (CWT) for 20 min, and orthostasis (ORT) for 8 min were studied in 8 young (16-20 yr) insulin-dependent diabetes mellitus (IDDM) patients and 9 age and sex-matched healthy controls. The IDDM patients showed no signs of neuropathy or retinopathy and their mean HbA_1c value was 8.4 ±0.6% (normal value < 5.0 %). Blood pressure and heart rate increased significantly during CWT and ORT in both groups. The changes in systolic blood pressure and heart rate were comparable in both groups during CWT; the IDDM group showed a higher ( p < 0.05) heart rate after 8 min of orthostasis, however. CWT and ORT elicited equivalent increases in noradrenaline in venous plasma in both groups ( p < 0.05), but the IDDM patients had 50% lower values ( p < 0.01) at rest, during CWT and at rest after CWT than controls. CWT and ORT evoked equivalent plasma adrenaline increases in both groups. The lipolysis marker, plasma glycerol, was about 40 % lower ( p < 0.05) in the IDDM group before and after CWT. Yet, mental stress evoked equivalent increases in glycerol levels ( p < 0.01) in both groups. These findings indicate that sympathetic activity in the young diabetic patients without signs of neuropathy may be blunted.     

血清MUC1粘蛋白IRMA及其初步临床应用

建立有效的ＭＵＣ１粘蛋白免疫放射分析法（ＩＲＭＡ），并初步用于乳腺肿瘤的诊断。利用纯化的ＭＵＣ１及其多抗，建立ＭＵＣ１双抗夹心ＩＲＭＡ法，对５５例健康女性、１１例乳腺良性肿瘤、２７例乳腺癌及２８例乳腺癌术后患者进行血清ＭＵＣ１的测定。结果：血清ＭＵＣ１ＩＲＭＡ的灵敏度为０７４ｋＵ／Ｌ；健康女性、乳腺良性肿瘤、乳腺癌及乳腺癌术后患者血清ＭＵＣ１的平均含量分别为７２３±３６７、１７８０±１０５６、３００４±２３８４和３１８４±２４７９ｋＵ／Ｌ；正常值上限为１３５４ｋＵ／Ｌ，假阳性率为１８２％；乳腺肿瘤患者血清ＭＵＣ１水平较健康女性明显提高；乳腺癌患者血清ＭＵＣ１水平高于乳腺良性肿瘤患者，但两者的阳性率（７７８７％和７２７０％）差异无显著性（χ２＝０１５４，Ｐ＞００５）；乳腺癌与乳腺癌术后患者血清ＭＵＣ１水平差异无显著性（ｔ＝－０２２，Ｐ＞００５）。ＭＵＣ１血清水平与肿瘤恶性程度成正相关，对于乳腺癌的诊断具有重要参考价值。     

An inexpensive, self-assembly pressure algometer

We have developed a simple instrument for pressure algometry. It can be made easily using components found in most anaesthetic rooms. Ten students were able to make the device using written instructions. All the resulting algometers performed within 10% accuracy limits for values up to 4 kgcm⁻².     

Doppler-sonographische durchblutungsmessungen der unteren extremität des menschen

Summary A duplex ultrasound system was used to examine the blood flow of the common femoral artery in ten young patients with fractures of the lower extremities. Two patients had fractures of both legs. In eight patients the blood flow in the injuried leg was comparable with that in the not injured leg. The flow alterations were measured on 3–7 different days over a period of 6–224 days after trauma. All patients showed a significant (to twice or three times that before injury) increase in blood flow in the injured leg a few days after trauma and/or operation, whereas the blood flow in the uninjured leg remained the same or even decreased a little. In the case of undisturbed fracture healing the change in blood flow disappeared within 8–12 weeks, corresponding to fracture consolidation. When fracture healing was delayed and/or further operations on the injured leg were necessary, the blood flow was increased for much longer. The hemodynamics of an injured extremity are compared with those reported elsewhere in the literature. The increased demand for oxygen or energy can explain the changes only in part. Another function of the reflective increase in blood flow could be the temperature increase in the extremity.

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Doppler-sonographische durchblutungsmessungen der unteren extremität des menschenII. Hämodynamik nach trauma und operation

Zusammenfassung Mittels Doppler-sonographischer Durchblutungsmessung wurde die Hämodynamik der verletzten Extremität an 10 jungen Patienten mit Frakturen der unteren Extremität untersucht. Bei 8 Patienten konnte die Durchblutung des verletzten Beins mit der unverletzten Gegenseite verglichen werden. Die Messungen erfolgten an 3–7 verschiedenen Tagen in einem Zeitraum von 6–224 Tagen nach dem Unfall. An allen verletzten Extremitäten steigt die Durchblutung wenige Tage nach dem Unfall und/oder der Operation deutlich um das 2- bis 3fache an, während die Durchblutung des unverletzten Beins niedrig bleibt. Bei einem ungestörten klinischen Verlauf sinkt die Durchblutung in 8–12 Wochen wieder. Heilungsstörungen und weitere Operationen an dem Bein verzögern diese Normalisierung deutlich. Diese Ergebnisse werden mit anderen Untersuchungen der Literatur verglichen. Ursache und Funktion der hämodynamischen Änderungen könnte u. a. in einer reflektorischen Temperaturerhöhung zu sehen sein.

     

控制性降压在临床麻醉中的应用进展

控制性低血压是指在某些手术麻醉期间，用药物等方法降低血压，以达到减少手术野出血，便于手术操作的一种方法，通常采用血管扩张剂，钙通道阻断剂及麻醉来控制血压，现就这一领域的研究进展作一综述。     

Change in urethral pressure during voluntary pelvic floor muscle contraction and vaginal electrical stimulation

The purpose of the study was to compare the effect of voluntary pelvic floor muscle (PFM) contraction and vaginal electrical stimulation on urethral pressure. Twelve women with genuine stress incontinence, mean age 49.4 years (range 33–66) participated in the study. The urethral and bladder pressures were recorded simultaneously through a double-lumen 8 Ch catheter. The patients first performed three voluntary PFM contractions. Then two electrical stimulators, Conmax and Medicon MS 105, 50 Hz, were used in random order. A visual analog scale was used to measure pain and discomfort. Pain was reported to mean 6.8, SEM 0.64 (range 0.7–9.9) and mean 6.1, SEM 0.81 (range 0–9.1) with Conmax and Medicon MS 105, respectively. The mean paired difference in favor of voluntary contraction with Conmax was ?8.0, SD 6.7,P=0.0067, and with Medicon MS 105 it was ?12.2, SD 5.9,P=0.0022. The results demonstrated that voluntary PFM contraction increased urethral pressure significantly more than did vaginal electrical stimulation.