Effect of thoracic epidural etidocaine 1.5% on somatosensory evoked potentials, cortisol and glucose during cholecystectomy

The effect of thoracic (T7-8) epidural etidocaine 1.5%, 9 ml, and continuous per- and postoperative epidural infusion of etidocaine 1.5%, 4 ml/h, on early (less than 500 ms) somatosensory evoked potentials (SEPs), and cortisol and glucose in plasma during cholecystectomy, was examined in ten patients. Spread of analgesia (pin-prick) was T3 (T1-T3) to L2 (T11-L3) 35 min after injection of etidocaine, and T3 (T2-T4) to T12 (T8-L4) 3 h after surgical incision (median (range)). Before operation, epidural etidocaine had no significant effects on peak-to-peak amplitude of SEPs to electrical stimulation at the L1, T10 or T6 dermatomal level (P greater than 0.09). SEPs were abolished in only two patients at T6, and no patient had SEPs abolished at T10 or L1. The plasma concentrations of cortisol and glucose were significantly increased 20 min after surgical incision and remained increased throughout the study. No correlation was found between the block-induced decrease in the peak-to-peak amplitude at T6 or T10 and increase in plasma cortisol, except for a negative correlation at T10 and the initial increase in cortisol (Rs = 0.72, P = 0.03). In conclusion, thoracic epidural administration of 9 ml of etidocaine 1.5% does not provide total afferent somatic blockade assessed by SEP and the stress response to cholecystectomy.     

Cognitive processes involved in the appraisal of stress

Four experiments were organized around a central question: What is the form of relationship between estimated stress level on the one hand and situation strain, personal resources and social support, on the other? The first experiment examined the form of the relationship between estimated level of stress, situation strain and personal resources. The participants were students. They integrated situation strain and personal resources information in a non‐additive way. In particular, the effect of personal resources on the estimated level of stress varied as a function of the level of situation strain considered. When the situation strain was low, the stress level related with this circumstance largely depended on the personal resources of the individual. When the situation strain was high, the stress level related with this circumstance was much less dependent on the personal resources of the individual. The second experiment replicated these results among first‐aid workers, fire‐fighters and persons that had recently been injured. The third and fourth experiments replicated these results in various conditions differing as regards the level of social support. Copyright © 2002 John Wiley & Sons, Ltd.     

N-乙酰半胱氨酸对慢性阻塞性肺疾病患者血淋巴细胞DNA损伤的影响

目的　探讨N -乙酰半胱氨酸 (NAC)治疗不同病期慢性阻塞性肺疾病 (COPD)的疗效。方法　 49例稳定期、急性发作期COPD患者 ,随机分为观察组 (2 5例 )和对照组 (2 4例 ) ,观察组除给予常规治疗外 ,加用NAC(每次 2 0 0mg ,3/d ,连用 2个月 ) ;对照组仅给予常规治疗。治疗前后观察所有患者外周血淋巴细胞DNA损伤程度。结果　治疗前后比较 ,观察组稳定期、急性发作期DNA损伤明显降低 ,差异有显著性 (P <0 .0 5)。对照组稳定期DNA损伤程度亦有一定程度的改善 ,但差异无显著性 (P >0 .0 5) ,急性发作期DNA损伤程度降低 ,差异有显著性 (P <0 .0 5)。结论　COPD患者体内存在氧化 -抗氧化失衡 ,抗氧化治疗可降低COPD患者外周血淋巴细胞DNA损伤程度 ,急性发作期出现氧化应激。     

Modified Kalish osteotomy: A simple approach to minimizing proximal dorsal stress risers

Proximal dorsal stress risers are a potential complication to the Kalish osteotomy. The authors describe a modification to this osteotomy that is simple and effective. Since performing the wing-clip modification, there have been no observed stress risers.     

飞行员配穿两种囊式抗荷服在不同环境温度和代谢水平时的热应激

目的　探讨飞行员配穿囊式抗荷服在不同环境温度、不同代谢水平条件下的热应激 ,为评价囊式抗荷服的热负荷和制定相应的保障措施提供理论依据。方法　 6名受试者分别配穿KH - 3抗荷服及配套装备和KH - 7抗荷服及配套装备 (以下分别简称为“KH - 3”和“KH -7”) ,以不同代谢水平暴露于 2 0℃、2 5℃和 35℃环境。每次试验 70min。测量了受试者配穿KH- 3和KH - 7时的卫生学参数、皮肤温度、直肠温度、心率等 ,并以综合热应激指数 (CIHS)评定了热应激防护等级。结果　KH - 3和KH - 7的各项卫生学参数 (clo值、im、im/IJ)均无显著差别。KH - 3对照Ⅲ组和KH - 7对照Ⅳ组 (2 5℃ ,1178～ 132 5kJ·h- 115min ,36 8kJ·h- 15 5min)的CIHS均未超过生理安全限的 6 0 % (分别为 3.5 4和 3.4 6 ,属轻度热应激 ) ;KH - 3高代谢组和KH- 7高代谢组 (2 0℃ ,84 6～ 10 30kJ·h- 170min)的CIHS在生理安全限的 6 0 %～ 95 %之间 (分别为4 .2 4和 4 .6 0 ,属中度热应激 ) ;KH - 3高温组和KH - 7高温组 (35℃ ,1178～ 132 5kJ·h- 115min ,36 8kJ·h- 15 5min)的CIHS却超过生理安全限的 95 % (分别为 7.31和 7.87,属重度热应激 )。结论　受试者配穿KH - 3与KH - 7时的各项卫生学参数、热应激等均无显著差别 ,但配穿后者比     

无张力阴道吊带术治疗女性压力性尿失禁(附20例报告)

目的 评价无张力阴道吊带术(tension-free vaginal tape，TVT)治疗女性压力性尿失禁的疗效。方法 总结采用TVT术治疗女性压力性尿失禁20例的临床资料。结果 平均手术时间26.5min。拔除尿管后，19例病人控尿满意，1例仍有轻微尿失禁。术后平均随访12(3-24)个月，20例病人均无尿失禁。合并症有1例膀胱穿孔，1例术后轻度排尿不畅，2例尿频尿急。结论 TVT术操作简便快捷，创伤小，合并症少，术后康复快，是一种治疗女性压力性尿失禁的理想方法。     

Vascular endothelium and inflammatory process, in patients with combined Type 2 diabetes mellitus and coronary atherosclerosis: the effects of vitamin C.

AIMS: Type 2 diabetes mellitus (DM) and coronary artery disease (CAD) are both associated with endothelial dysfunction and elevated oxidative and inflammatory state. We examined the effect of vitamin C on endothelial function and levels of soluble vascular cell adhesion molecule (sVCAM-1), interleukin-6 (IL-6) and tumour necrosis factor (TNF-alpha), in DM patients with or without CAD and in non-diabetic subjects. METHODS: Thirty-seven patients with DM + CAD, 17 patients with DM without CAD and 21 non-diabetic subjects were divided into groups receiving vitamin C 2 g/day or no anti-oxidant for 4 weeks. Forearm blood flow was determined using venous occlusion gauge-strain plethysmography. Forearm vasodilatory response to reactive hyperemia was considered as index of endothelium-dependent dilation. RESULTS: Baseline levels of IL-6 and TNF-alpha were significantly higher in patients with DM + CAD compared with patients with DM (P < 0.01) or non-diabetic subjects (P < 0.01). IL-6 and TNF-alpha levels were also higher in DM compared with non-diabetic subjects (P < 0.05). sVCAM-1 levels were lower in non-diabetic controls compared with DM + CAD (P < 0.05) or DM (P < 0.05). Reactive hyperaemia was higher in non-diabetic controls compared with DM + CAD (P < 0.001) or DM (P < 0.001). Vitamin C significantly increased reactive hyperaemia only in the DM + CAD group, while it had no effect on serum levels of sVCAM-1, TNF-alpha and IL-6 in any of the groups. CONCLUSIONS: Type 2 diabetes mellitus is associated with impaired endothelial function and increased levels of TNF-alpha, IL-6 and sVCAM-1, especially in patients with DM and CAD. Vitamin C significantly increased forearm vasodilatory response to reactive hyperaemia only in patients with combined DM and CAD.     

热应激对血管内皮细胞增殖的影响及其机制初探

目的　探讨热应激条件下对血管内皮细胞增殖的影响 ,进一步从DNA损伤后P5 3mRNA、P2 1mRNA表达改变角度探讨增殖调控的机理。方法　以建立的血管内皮细胞热应激 (4 3℃ ,2小时 )为实验模型 ,应用流式细胞仪观察热应激后血管内皮细胞株ECV30 4的细胞周期变化 ,单细胞凝胶电泳方法观察热应激对血管内皮细胞DNA的损伤 ,RT PCR检测P5 3mRNA、P2 1mRNA表达改变情况。结果　热应激可使血管内皮细胞DNA产生显著损伤 (P <0 .0 5 ) ,继而P5 3mRNA表达增高 ,并促进P2 1mRNA的上调表达 ,最终使细胞产生G1期阻滞。结论　热应激可损伤血管内皮细胞DNA ,并通过P5 3、P2 1通路抑制细胞增殖     

Social problem solving as a moderating variable between negative life stress and depressive symptoms

The present study sought to investigate the moderating function that social problem-solving effectiveness serves in relation to negative stressful life events and depressive symptomatology. It was also hypothesized that knowledge of problem solving would improve upon the prediction of level of depressive symptoms beyond the assessment of stressful events. Results involving 462 undergraduate students provide support for both predictions. Specifically, findings from a multiple regression analysis indicated that (1) differences in reported depressive mood between subjects under high and low stress levels were minimal for individuals characterized as effective problem-solvers, relative to those persons with problem-solving scores reflective of ineffective problem solving; and (2) assessment of problem-solving scores and their interaction with stress level provided for an additional three times the amount of explained variance in predicting depression scores beyond life stress scores. Additionally, a cross-validation of the regression analysis was conducted and found to result in a minimal amount of shrinkage that could be due to samplespecific characteristics.We would like to extend our appreciation to two anonymous reviewers for their helpful comments on an earlier draft of this article. The study was supported in part by a grant funded by Fairleigh Dickinson University to the first author.     

过氧化氢对不同时相HepG2细胞氧化作用的研究

背景与目的:研究过氧化氢(H2O2)对不同时相HepG2细胞作用的选择性,以进一步探讨H2O2:诱导肿瘤细胞凋亡的机制.材料与方法:以胸腺嘧啶核苷(TdR)阻断法获得不同细胞周期时相的同步化细胞,分别加入800 μmol/L的H2O2作用3 h,并检测各组细胞的丙二醛(MDA)含量、黄嘌呤氧化酶(XOD)和5'核苷酸酶(5'NT)的活性及抗羟自由基(抗·OH)和抗超氧阴离子自由基(抗O2)的活性.结果:经H2O2处理的各组MDA含量和XOD、抗·OH、抗O2活性显著高于对照组,其差异均具有统计学意义(P均＜0.01),5'NT活性低于对照组(P＜0.01).与未同步化组比较,同步化于S期和G2/M期的细胞MDA含量和XOD、5'NT、抗·OH和抗O2活性显著升高,其差异均具有统计学意义(P均＜0.01),而同步化于G1期的细胞MDA含量、XOD、5'NT和抗O2-活性显著降低,差异均具有统计学意义(P均＜0.01).结论:H2O2作用同步化HepG2细胞后,代谢产生自由基的酶活性,脂质过氧化产物含量以及抗氧化水平均表现出细胞周期特异性,这可能是过氧化氢对不同时相HepG2细胞损伤作用不同的原因.