丙泊酚-舒芬太尼TCI全凭静脉麻醉用于非停跳冠脉搭桥手术的可行性和剂量探讨

靶控输注(TCI)已是一种较为成熟的全凭静脉麻醉(TIVA)技术,但针对冠脉搭桥手术(CABG)这一特殊群体的实际应用方面的观察研究尚不多。效应室靶浓度(Ce)的TCI调控更为快速有效,但血浆药物浓度有短时间的超高,对循环的稳定可能不利。目前用吸盘固定局部心肌行非停跳冠脉搭桥手术的     

异丙酚靶控输注镇静时脑电双频指数和非线性参数变化分析

目的分析异丙酚靶控输注(TCI)时意识消失-清醒时的脑电双频指数(BIS)和非线性参数关联维数(D2)、近似熵(ApEn)、复杂度(Cx)的变化。方法ASAⅠ～Ⅱ级择期行下肢手术患者20例,血药浓度(Cp)为目标TCI,0.3～0.5μg/ml浓度梯度上下调整Cp予术中镇静,直至患者意识消失,每个预期浓度维持12min,记录患者意识清醒-消失时的脑电BIS值和非线性参数。结果意识消失-清醒时,BIS值分别为67.3±7.9,80.2±6.2;D2值分别为3.01±0.16,3.45±0.18;ApEn值分别为0.71±0.060.84±0.05;Cx值分别为0.44±0.05,0.55±0.05。在意识消失时的脑电确定性阈值(定义为100%特异度)BIS为51(灵敏度3.8%)D2为2.90(灵敏度30.3%),ApEn为0.69(灵敏度42.3%),Cx为0.41(灵敏度25.5%)。结论BIS、D2、ApEn及Cx均可反映异丙酚镇静时意识消失清醒的变化,提示四个值中ApEn是区分意识清醒-消失的最佳指标。     

智能输液监测系统设计与应用

利用无线网络和监测设备设计基于物联网的智能输液监测系统,对患者输液过程进行实时监测和智能提醒,介绍系统架构、工作模式、功能、应用效果等方面,指出系统的使用有助于提高护理工作效率,减少安全事故,提升医院信息化管理水平。     

Investigation of the Initial Corrosion Destruction of a Metal Matrix around Different Non-Metallic Inclusions on Surfaces of Pipeline Steels

Typical non-metallic inclusions in two industrial low-carbon steels for oil pipelines were investigated as three-dimensional objects on film filters after electrolytic extraction and filtration of metal samples. A method of soft chemical extraction using a 10%AA electrolyte was used to study the initial corrosion process in the steel matrix surrounding various non-metallic inclusions. To determine and compare “corrosive” inclusions and their influence on the initial stages of corrosion of the adjacent layer of the steel matrix, quantitative parameters (such as the diameter of the corrosion crater (D_cr) and pit (D_pit), and the relative dissolution coefficient of the metal matrix (KD) around various inclusions) were determined after chemical extraction. It was found that CaO-Al₂O₃-MgO oxides and TiN inclusions did not cause an initial corrosion of the steel matrix surrounding these inclusions. However, tensile stresses in the steel matrix occurred around CaS inclusions (or complex inclusions containing a CaS phase), which contributed to the initiation of corrosion around these inclusions.     

深低温冻存自体造血干细胞回输副反应的观察及护理

目的探讨深低温冻存自体造血干细胞解冻回输过程中如何确保干细胞回输顺利实现。方法回顾性总结了76例次自体造血干细胞移植患者在干细胞解冻回输过程中出现的副反应的观察及护理措施。结果76例次中64.4%发生不同程度的恶心、呕吐、呼吸困难等副反应,此外3l例次(40.7%)出现了心率减慢,38例次(50%)有血压升高等心血管变化。通过有效护理,76例次干细胞回输均顺利完成。结论有效的心理护理、严格的无菌操作、完善的物品准备、操作中严密的观察与护理,是确保深低温冻存自体造血干细胞顺利回输的关键。     

静脉泵入咪达唑仑清醒镇静技术控制牙科恐惧症的临床效果评价

目的评价静脉泵入咪达唑仑控制牙科恐惧症的临床效果。方法选择31例对牙科治疗极度恐惧但能与医师良好沟通的患者,将其两侧需行根管治疗的2颗患牙分别纳入试验组和对照组,对照组为常规牙科治疗,试验组加用咪达唑仑静脉泵入清醒镇静技术,控制患者治疗过程中的恐惧。评价两组患者的治疗依从性和行为治疗效果,并观察试验组患者生命体征的变化及副作用的发生率。结果试验组、对照组的Houpt行为治疗效果评分和Frankl治疗依从性评分均存在显著性差异（z=- 4.846,P=0.000;z=- 4.907,P=0.000）。试验组患者采用镇静措施后血压、心率均有轻度降低,并有轻度的呼吸抑制,但不影响治疗完成。结论单纯咪达唑仑静脉镇静对于能够良好沟通、主观愿意配合的极度牙科恐惧患者具有较好的疗效。     

恶性胶质瘤同步放射化学治疗继以动脉灌注嘧啶亚硝脲治疗观察

１９８７年１１月至１９９１年２月对５５例手术后恶性胶质瘤（星形细胞瘤Ⅲ级或Ⅳ级）患者分成三组继续治疗：Ａ组（１４例）行同步放射化学治疗，随后每隔３～６个月行患侧动脉灌注嘧啶亚硝脲（ＡＣＮＵ）治疗；Ｂ组（１６例）单纯行同步放射化学治疗；Ｃ组（２５例）单纯放射治疗以作对照。近期效果用ＣＴ扫描比较，同步放射化学治疗的有效率（６３％）高于单纯放射治疗（２８％）Ｐ值＜０．０１。５５例患者均行连续随访，１、２、３年生存率Ａ组（９３％，６２％，５０％）明显高于Ｃ组（５１％，１３％，１３％），Ｐ值＜０．００１。Ｂ组１，２年生存率高于Ｃ组，但无统计学差别。作者认为采用同步放射化学治疗继以动脉灌注ＡＣＮＵ维持治疗对恶性胶质瘤术后患者是一个较佳的选择治疗方案。     

Chronic intracerebroventricular administration of orexin-A to rats increases food intake in daytime, but has no effect on body weight

Orexins are recently identified neuropeptides, and have been shown to increase food intake when administered intracerebroventricularly. We examined the effects of chronic administration of orexin in rats by continuous intracerebroventricular administration by means of an osmotic minipump. Continuous administration of orexin-A (0.5 nmol/h) for 7 days in rats resulted in a significant increase in food intake in the daytime. Daytime food intake increased to 180% of the control value. However, it resulted in a slight decrease nighttime food intake as compared with vehicle-treated rats. The total amount of food intake per day was almost comparable with that of vehicle-administered rats. The gain of body weight and blood glucose, total cholesterol and free fatty acid levels were normal. Chronic orexin-A treatment did not cause obesity in rats. We observed abnormal behavior during the daytime after starting administration of orexin-A; these rats kept awake during the daytime. Our present observation showed that continuous administration of orexin-A could not overcome the regulation of energy homeostasis and body weight. However, orexin-A might be implicated in short-term, immediate regulation of feeding behavior.