脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

腹腔镜下经皮腹膜外疝囊高位结扎术治疗学龄前儿童腹股沟斜疝的临床效果分析

目的探讨腹腔镜下经皮腹膜外疝囊高位结扎术治疗学龄前儿童腹股沟斜疝的临床效果。方法回顾性分析笔者所在医院2014年1~12月期间收治的53例学龄前儿童腹股沟斜疝患者的临床资料。结果本组53例患儿均顺利度过手术,无中转手术病例。手术时间11~14 min、(11.35±2.11)min;术中出血5~10 m L、(7.00±3.15)m L;住院时间2~3 d,中位数为2.6 d。术中发现对侧隐匿疝8例,以同法处理,均获成功。术后2例患儿发生阴囊肿胀,其余无积血、积液、腹痛等并发症发生。术后53例患儿均获访,随访时间3~6个月,中位数为4.5个月。随访期间无复发病例,1例单侧腹股沟斜疝患儿对侧发生新发疝。结论腹腔镜下经皮腹膜外疝囊高位结扎术治疗学龄前儿童腹股沟斜疝是可行的,其手术操作简便、住院时间短、术后并发症少,值得临床推广。     

抑制小胶质细胞激活对骨癌痛小鼠疼痛维持的影响

目的研究鞘内注射小胶质细胞特异性抑制剂米诺环素(minocycline,MC)抑制脊髓小胶质细胞的激活对骨癌痛维持的影响。方法采用小鼠跟骨癌痛模型,♂C3H/He小鼠42只,随机分为3组(n=14),sarcoma+PBS(phosphatebuffered saline)组和sarcoma+MC组行小鼠跟骨癌痛模型制作,跟骨内注射肿瘤细胞;sham+PBS组行假手术,跟骨内注射PBS。造模后11天(post-implantation day11,PID11),每组随机取10只小鼠,sham+PBS组和sarcoma+PBS组单次鞘内注射MC溶媒(PBS 5μl),sarcoma+MC组单次鞘内注射MC(1 nmol,5μl)。各组分别在鞘内注射前、注射后0.5、1、2、4、8、24 h测定机械性痛觉超敏、冷痛觉过敏。各组剩余4只小鼠在PID12鞘内注射后1 h行非伤害性触摸右侧足底90min,分析脊髓背角c-fos蛋白的表达。结果骨癌痛导致小鼠机械性痛阈和冷痛阈降低,脊髓背角c-fos蛋白的表达上调;单次鞘内注射MC能暂时提高小鼠疼痛阈值,并抑制脊髓背角c-fos蛋白的表达。结论小胶质细胞的激活对骨癌痛的维持具有重要作用。     

右美托咪定联合右旋氯胺酮静脉患者自控镇痛对癌痛患者抑郁情绪的影响

目的 观察右美托咪定联合右旋氯胺酮静脉患者自控镇痛(PCA)对癌痛患者抑郁情绪的影响.方法 60例实施镇痛的癌痛患者随机分为两组,每组30例.C组静脉PCA吗啡剂量为口服剂量的1/3,DK组加用右美托咪定0.1μg· kg-1·h-1联合右旋氯胺酮60 μg· kg-1· h-1静脉PCA.记录用药前(T0)和PCA 6 h(T1)、12 h(T2)、24 h(T3)和48 h(T4)时的数字评价量表(NRS)镇痛评分、Ramsay镇静评分、状态-特质焦虑问卷评分及贝克抑郁量表第二版(BDI-Ⅱ)评分.观察48 h内的镇痛、镇静效果和抑郁等不良反应发生情况.结果 与T0比较,两组T1～T4时的NRS镇痛评分、BDI-Ⅱ评分和状态焦虑评分降低,Ramsay镇静评分、患者生活质量和满意度评分升高(P＜0.05).与C组比较,DK组T1～T4时的NRS镇痛评分、BDI-Ⅱ评分和状态焦虑评分降低,患者生活质量和满意度评分升高(P＜0.05).与C组相比,DK组患者抑郁发生率降低,镇痛有效率升高,恶心和呕吐发生率降低(P＜0.05).结论 右美托咪定联合右旋氯胺酮静脉PCA能显著增强癌痛患者的镇痛效果,改善癌痛患者的焦虑、抑郁情绪,提高患者生活质量.     

超声引导下收肌管阻滞联合膝关节囊后间隙阻滞在全膝关节置换中的应用

目的 观察超声引导下收肌管阻滞(ACB)联合膝关节囊后间隙(IPACK)阻滞在全膝关节置换(TKA)术中的应用效果.方法 将60例初次单侧TKA手术患者按随机数字表法分为A组(采用ACB+IPACK阻滞镇痛,30例)和B组(采用股神经阻滞镇痛,30例).记录术后不同时间点静息和活动状态下疼痛数字分级法(NRS)评分、股...     

宁夏南部山区回族胎儿心脏观测——动脉导管与卵圆孔的研究

本文对宁夏南部山区70例回族胎尸动脉导管和卵圆孔进行了研究,计算了月份与生长的相关系数,各项数据与其它地区对照,其结果相近似。表明宁夏南部山区胎儿的生长发育是正常的。     

肉毒毒素A对慢性坐骨神经结扎大鼠机械痛敏和热痛敏的影响

目的探讨肉毒毒素A(botulinum toxin type A,BoNT-A)后处理对神经病理性疼痛大鼠疼痛行为学的影响。方法建立SD大鼠右侧慢性坐骨神经结扎模型(chronic con-striction injury of sciatic nerve,CCI)。CCI术后d3始,CCI同侧肢体足底注射BoNT-A7.5、15、30U·kg-1或等容积生理盐水,或对侧肢体足底注射BoNT-A15或30U·kg-1。分别于术前、术后1、3、5、7、14d,测定大鼠的机械缩足反射阈值(MWT)和热缩足潜伏期(TWL)。结果CCI手术同侧足底皮下注射BoNT-A可以增加大鼠的MWT和TWL,对侧应用BoNT-A对MWT和TWL无影响。结论BoNT-A可以通过局部作用减轻CCI手术同侧肢体的机械痛敏和热痛敏。     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

支气管封堵器隔离左肺盲探插管方法的应用

正随着外科技术水平的提高,较多复杂的胸科手术如食管手术、肺叶手术和纵隔手术等也比较常见,需要单肺隔离技术才能顺利的完成。应用支气管封堵器解决了部分双腔支气管导管不能解决的单肺通气问题,如儿科的单肺通气技术和双腔支气管导管困难插管的病人,应用支气管封堵器如果术后需要机