硬膜外注入异氟醚－氧化亚氮气体增强利多卡因麻醉作用

我们对５０例子宫、卵巢手术病人，使用利多卡因做硬膜外麻醉，其中２５例向硬膜外腔内注入异氟醚－氧化亚氮气体。２组对比发现，实验组麻醉平面明显高于对照组，在同样手术时间内实验组所使用的利多卡因量明显少于对照组。表明异氟醚－氧化亚氮气体有增强利多卡因的硬膜外麻醉作用，同时未发现注入吸入麻醉药产生副作用。     

ZMW型环氧乙烷灭菌箱对骨移植材料灭菌效果的初步观察

目的 :观察ZMW型环氧乙烷灭菌箱对异体骨材料灭菌效果 ,旨在寻找一种安全、经济的灭菌方法。方法 :清洁条件下取骨 ,制成 0 .5cm× 0 .5cm× 2cm湿润骨材料和干燥骨材料 ,抽取样本 ,用ZMW型环氧乙烷灭菌箱 (15 0L)在不同温度及时间下消毒 ,以环氧乙烷指示胶带是否变色作为灭菌指标 ,样本在消毒前后分别作细菌培养。结果 :不同消毒条件下 ,每批样本均有细菌生长 ,干燥骨材料有菌率高于湿润的骨材料。结论 :ZMW型环氧乙烷灭菌箱不能使异体骨移植材料完全达到灭菌的要求 ,环氧乙烷指示胶带不能作为骨移植材料的灭菌指标 ,干燥可能使细菌的抗环氧乙烷能力增加 ,从而间接的影响了环氧乙烷的消毒效果。     

Increased carbon monoxide levels in the nasal airways of subjects with a history of seasonal allergic rhinitis and in patients with upper respiratory tract infection

BACKGROUND: Carbon monoxide (CO) has emerged as an endogenously produced gaseous mediator known to be involved in bronchial smooth muscle regulation. Increased amounts of CO have been found in exhaled air during asthma and lower airway inflammation. Recently CO has been shown to be produced in the nasal airways, but there are no reports of altered CO levels in nasal airways during inflammation. OBJECTIVE: This study was designed to investigate if CO levels increase in the human nasal airways during inflammatory conditions, such as allergy and upper airway respiratory tract infection (URTI). METHODS: CO was sampled separately from the upper and lower airways of 13 healthy control subjects, six patients with a history of allergic rhinitis and six patients with URTI. RESULTS: Nasal CO levels were increased in subjects with allergic rhinitis, compared to healthy controls (2.07 +/- 0.15 ppm, n = 6 and 1.62 +/- 0.08 ppm, n = 13, respectively, P < 0.01). CO levels were also increased in patients with URTI, compared to the same controls (1.92 +/- 0.09 ppm, n = 6, P < 0.05). Normal levels of CO were found in air from the lower airways among subjects with allergic rhinitis, whereas corresponding levels in the URTI patients were increased. CONCLUSION: The present data demonstrates that upper airway CO levels increase in parallel with different inflammatory stimuli, such as allergy and infection, suggesting a role for CO as marker or mediator of nasal inflammation.     

3,6-(二甲氨基)-二苯骈碘杂六环葡萄糖酸盐对AGEP引起的大鼠主动脉平滑肌细胞增殖及牛主动脉内皮细胞内皮素和一氧化氮改变的影响

目的 :观察 3 ,6 (二甲氨基 ) 二苯骈碘杂六环葡萄糖酸盐对AGEP引起的大鼠主动脉平滑肌细胞增殖及牛主动脉内皮细胞内皮素和一氧化氮改变的影响。方法 :采用牛血清白蛋白 (BSA)与不同浓度葡萄糖 (0 ,2 0 ,5 0 ,80mmol·L-1)体外孵育制备糖基化终产物 (AGEP) ,应用 [3 H] TdR掺入法和MTT比色法观察I-93对重度糖化的AGEP诱导的大鼠主动脉平滑肌细胞 (ASMC)增殖的影响 ;应用放射免疫技术及Greiss法观察I -93对AGEP引起的牛主动脉内皮细胞 (BAEC)释放内皮素 1(ET 1)和一氧化氮 (NO)的影响。结果 :I-93 10 -7～ 10 -5mol·L-1能明显抑制AGEP引起的ASMC增殖 ,其 [3 H] TdR掺入量和MTT比色法的最大抑制率分别为79 .4%和 44 .2 %。随AGEP糖浓度的增加 (2 0～ 80mmol·L-1) ,BAEC培养液中ET 1含量亦逐渐上升 [(4 93± 63 )～ (779± 10 5 )ng·L-1] ,I -93 10 -7～ 10 -5mol·L-1能明显抑制重度糖化的AGEP促进ET 1释放的作用 ;I -93对AGEP灭活NO的作用有剂量依赖性抑制效应。结论 :I -93有抑制ASMC增殖的作用 ;对AGEP诱导的BAEC释放ET 1和NO间平衡失调有调节作用 ,在防治阻塞性血管疾病方面I -93具有潜在的应用价值     

Pathophysiology of idiopathic dystonia: findings from genetic animal models

Dystonia is a common movement disorder which is thought to represent a disease of the basal ganglia. However, the pathogenesis of the idiopathic dystonias, i.e. the neuroanatomic and neurochemical basis, is still a mystery. Research in dystonia is complicated by the existence of various phenotypic and genotypic subtypes of idiopathic dystonia, probably related to heterogeneous dysfunctions.In neurological diseases in which no obvious neuronal degeneration can be found, such as in idiopathic dystonia, the identification of a primary defect is difficult, because of the large number of chemically distinct, but functionally interrelated, neurotransmitter systems in the brain.The variable response to pharmacological agents in patients with idiopathic dystonia supports the notion that the underlying biochemical dysfunctions vary in the subtypes of idiopathic dystonia. Hence, in basic research it is important to clearly define the involved type of dystonia.Animal models of dystonias were described as limited. However, over the last years, there has been considerable progress in the evaluation of animal models for different types of dystonia.Apart from animal models of symptomatic dystonia, genetic animal models with inherited dystonia which occurs in the absence of pathomorphological alterations in brain and spinal cord are described.This review will focus mainly on genetic animal models of different idiopathic dystonias and pathophysiological findings. In particular, in the case of the mutant dystonic (dt) rat, a model of generalized dystonia, and in the case of the genetically dystonic hamster (dt^sz), a model of paroxysmal dystonic choreoathetosis has been used, as these show great promise in contributing to the identification of underlying mechanisms in idiopathic dystonias, although even a proper animal model will probably never be equivalent to a human disease.Several pathophysiological findings from animal models are in line with clinical observations in dystonic patients, indicating abnormalities not only in the basal ganglia and thalamic nuclei, but also in the cerebellum and brainstem. Through clinical studies and neurochemical data several similarities were found in the genetic animal models, although the current data indicates different defects in dystonic animals which is consistent with the notion that dystonia is a heterogenous disorder.Different supraspinal dysfunctions appear to lead to manifestation of dystonic movements and postures. In addition to increasing our understanding of the pathophysiology of idiopathic dystonia, animal models may help to improve therapeutic strategies for this movement disorder.     

不同麻醉方法对28例胃癌手术患者红细胞醛糖还原酶及血浆一氧化氮的影响

目的:观察不同麻醉方法对胃癌手术患者红细胞醛糖还原酶(AR)活性及血浆一氧化氮(NO)浓度的影响。方法:28例胃癌手术患者随机分为两组,组1吸入1.5～2.0最小肺泡吸入有效浓度(MAC)的异氟醚,组2为0.5～1.0MAC异氟醚复合硬膜外麻醉。分别于麻醉前30min、手术90min、术后60min、术后1天和术后2天5个时间点抽取静脉血,测定血糖浓度、红细胞AR活性及血浆NO浓度。结果:与麻醉前值相比,组1病人血糖浓度于手术90min、术后60min、术后1天明显升高(P<0.05或P<0.01);术后1天红细胞AR活性明显升高(P<0.05),同时血浆NO浓度显著下降(P<0.05)。组2病人血糖浓度于手术90min、术后60min显著升高(P<0.01);红细胞AR活性及血浆NO浓度,虽有与组1病人相似的变化趋势,但与麻醉前值相比,各时间点无明显变化。术后1天组1病人红细胞AR活性明显高于组2(P<0.05),而血浆NO浓度则相反(P<0.05),两组间血糖无明显差异。结论:胃癌手术病人在应激高血糖状态下,红细胞多元醇途径被激活的同时血浆NO合成受抑制。全麻联合硬膜外阻滞能较好抑制这一改变。     

脑囊虫病患者脑脊液中一氧化氮及肿瘤坏死因子α水平研究

目的　探讨脑囊虫病患者各期脑脊液中的一氧化氮 (NO)、肿瘤坏死因子α(TNF α)的变化规律及它们在脑囊虫病中的作用机制。方法　检测 4 9例明确诊断并依据MR分期 ,单发脑实质内囊虫的脑囊虫病患者和 2 0名对照者脑脊液中NO、TNF α水平。结果　NO在脑囊虫病的Ⅰ期显著降低而TNF α水平呈显著升高 ,NO、TNF α于Ⅱ期、Ⅲ期 (整个退变死亡期 )均表现为高水平 ,Ⅳ期恢复正常 ,NO和TNF α存在高度正相关关系。结论　在单发脑实质内囊虫病中NO、TNF α可能参与杀虫作用 ,其免疫调节与杀虫机制存在着动态平衡 ,参与感染控制     

大鼠氮能神经与胃电节律失常的关系

目的 :探讨一氧化氮与胃电节律失常的关系 .方法 :2 8只大鼠随机分为 3组 :正常对照组 (12只 )和胃电节律失常模型组 (8只 )喂养 4wk后 ,先记录胃电、再行胃窦肌间神经丛氮能神经染色 ;药物组 (8只 ) :观察注射不同剂量硝普钠 (SNP)、一氧化氮合酶抑制剂左型精氨酸甲酯 (L NAME)后的胃电变化 .结果 :药物组大鼠注射硝普钠或大剂量L NAME后出现了明显的胃电节律失常 ;模型组大鼠胃电节律失常增加 ,异常节律指数 (ARI)和慢波频率变异系数 (coefficientofvariation,CV)分别为 2 1.8%和 2 5 .7% ,明显高于正常对照组大鼠 (ARI和CV分别为 9.5 %和 17.2 % ,P <0 .0 1) ,胃窦肌间神经丛的氮能神经含量也明显多于正常对照组 (2 1.9%vs13.8% ,P <0 .0 1) .结论 :一氧化氮增多或过少均可导致明显的胃电节律失常     

山东农村儿童膳食中人体锌吸收率的测定

目的:测定山东农村儿童代表性膳食中锌(Zn)的人体吸收率。方法:模拟山东农村典型膳食模式,采用富集的天然低丰度稳定性同位素67Zn标记ZnCl2,使用热电离质谱法(TIMS)检测膳食和粪便中总锌含量与67Zn/68Zn比值,计算锌的真吸收率;使用原子吸收分光光度计穴AAS雪测定膳食与粪便的总锌,计算锌的表观吸收率。同时测定影响锌吸收的因子膳食脂肪、蛋白、植酸、纤维素和维生素C(Vc)的含量,计算日平均摄入量,将其结果与我国儿童每日推荐膳食营养素摄入量(RNIs)进行比较。结果:锌的真吸收率为(12.94±3.32)%,锌的表观吸收率为(22.37±1.59)%,两者差异有统计学意义(P<0.05)。锌的平均日摄入量为11.16mg,占RNI的111.6%,高于推荐量。蛋白质和Vc的日摄入量分别为31.2g与13.3mg,占RNIs的56.73%和29.60%,低于推荐量。脂肪、植酸和膳食纤维的日摄入量较高。结论:在蛋白质和Vc的日摄入量较低,脂肪、植酸和膳食纤维的日摄入量较高的条件下,锌的真吸收率较低。     

硫酸锌对肠缺血—再灌注损伤的防治作用

目的：探讨硫酸锌对肠缺血－再灌注（ischemia-reperfusion,I/R)损伤的防治作用及其机制。（2）方法：复制家兔肠I／R损伤模型，观察硫酸锌对超氧化物歧化酶（SOD），黄嘌呤氧化酶（XO）及丙二醛（MDA）含量的影响，实验分为I／R损伤组，硫酸锌＋I／R组和假手术组（Sham)对照组，并进行比较。（3）结果：缺血前3组动物红细胞SOD、红细胞膜及血浆MDA，血浆XO值均无统计学差异，I／R组再灌注后2h与缺血前及Sham组相比，SOD活性显下降，XO活性及MDA含量明显增加（P＜0．01），此外，肠、肺、肝等组织MDA含量亦明显高于Sham组（P＜0．01），静脉给予硫酸锌，可使XO及MDA含量降低，且可防止SOD减少。结论：肠I／R过程中伴有多器官脂质过氧化损伤，硫酸锌通过抗脂质过氧化能减轻或在一定程度上避免再灌注损伤的进一步加剧。