薏仁降浊汤对急性痛风性关节炎大鼠关节组织内炎症因子影响

目的:分析薏仁降浊汤结合秋水仙碱和非布司他对急性痛风性关节炎大鼠关节组织内炎症因子影响。方法:选取由本院实验动物中心提供的SPF级Wistar雄性大鼠30只,制备急性痛风性关节炎模型,随机数字表法分成三组,对照组(10只)、西药组(10只)及联合组(10只),其中西药组大鼠每天灌胃1mg/kg非布司他、0.2mg/kg秋水仙碱,联合组大鼠在西药组基础上加用4.8g/kg薏仁降浊汤,对照组大鼠则每天灌胃等剂量生理盐水,连续灌胃7天。观察给药1、7天时大鼠急性炎症状况,全自动生化分析仪检测血清中性粒细胞、淋巴细胞及白细胞含量,ELISA法检测坏关节组织内TNF-α、IL-1β、NO含量及血清内NO、尿酸含量。结果:给药7天后西药组和联合组大鼠炎症指数、足趾肿胀度均低于对照组,差异有统计学意义(P0.05),且联合组效果更优,和西药组对比差异有统计学意义(P0.05);给药7天后联合组大鼠血清中性粒细胞、白细胞、尿酸及淋巴细胞含量较对照组、西药组显著降低,NO含量较对照组、西药组显著升高,差异均有统计学意义(P0.05);给药7天后联合组大鼠踝关节组织内NO、IL-1β及TNF-α含量较对照组、西药组显著降低,差异均有统计学意义(P0.05)。结论:薏仁降浊汤结合秋水仙碱和非布司他可显著降低急性痛风性大鼠关节组织内炎症因子含量。     

急性脑卒中急诊治疗现状及进展

急性脑卒中是内科急危症之一,发病率、致残率高,预后差,治疗是否及时、合理,直接影响到患者的预后.对于急性期缺血性脑卒中最为有效、最有前途的是溶栓抗凝治疗,溶栓治疗越早,临床效果越好.……     

不同剂量异丙酚用于人工流产术的临床观察

人工流产是妇科的常见手术。为了消除人工流产时病人的紧张、恐惧、疼痛感,异丙酚被广泛用于人工流产术。但不同剂量异丙酚的麻醉效果有待进一步研究,故我们对单次静脉注射不同剂量异丙酚用于人工流产进行了探讨。     

自制复合液治疗偏头痛148例疗效分析

偏头痛在临床上是一种常见病,传统的中、西药治疗虽能取得一定疗效,但显效慢,服药时间长,且复发率高.我们对148例有典型血管神经性偏头痛症状者,采用2种复合液治疗,观察其疗效、疗程,旨在探讨有效的治疗方法.     

眼脉冲幅度增加提示动脉反流

目的:报道1例因双眼脉冲幅度(OPA)增加发现动脉反流的病例,而后者正是引起OPA增加的原因。设计:病例报道。方法:偶然发现双眼OPA增高,由此发现脉压增高和动脉反流。患者接受动脉瓣膜手术,待动脉脉压恢复正常后评价OPA。结果:动脉脉压高时的双眼OPA为9mmHg,动脉脉压恢复正常后的双眼OPA为3mmHg。结论:动脉脉压增高可以导致OPA增高。眼脉冲幅度增加提示动脉反流@McKee H.D.R.$Hull and East Yorkshire Eye Hospital, Fountain Street, Hull, Uni ted Kingdom @Saldaa M. @Ahad M.A. @张少娟…     

Nuclear Factor κB and Anesthetic Preconditioning during Myocardial Ischemia-Reperfusion

Background: Volatile anesthetic preconditioning (APC) protects against myocardial ischemia-reperfusion (IR) injury, but the precise mechanisms underlying this phenomenon remain undefined. To investigate the molecular mechanism of APC in myocardial protection, the activation of nuclear factor (NF) [kappa]B and its regulated inflammatory mediators expression were examined in the current study.

Methods: Hearts from male rats were isolated, Langendorff perfused, and randomly assigned to one of three groups: (1) the control group: hearts were continuously perfused for 130 min; (2) the IR group: 30 min of equilibration, 15 min of baseline, 25 min of ischemia, 60 min of reperfusion; and (3) the APC + IR group: 30 min of equilibration, 10 min of sevoflurane exposure and a 5-min washout, 25 min of global ischemia, 60 min of reperfusion. Tissue samples were acquired at the end of reperfusion. NF-[kappa]B activity was determined by electrophoretic mobility shift assay. The NF-[kappa]B inhibitor, I[kappa]B-[alpha], was determined by Western blot analysis. Myocardial inflammatory mediators, including tumor necrosis factor [alpha], interleukin 1, intercellular adhesion molecule 1, and inducible nitric oxide synthase, were also assessed by Western blot analysis.

Results: Nuclear factor [kappa]B-DNA binding activity was significantly increased at the end of reperfusion in rat myocardium, and cytosolic I[kappa]B-[alpha] was decreased. Supershift assay revealed the involvement of NF-[kappa]B p65 and p50 subunits. APC with sevoflurane attenuated NF-[kappa]B activation and reduced the expression of tumor necrosis factor [alpha], interleukin 1, intercellular adhesion molecule 1, and inducible nitric oxide synthase. APC also reduced infarct size and creatine kinase release and improved myocardial left ventricular developed pressure during IR.     

Morphine Enhances Pharmacological Preconditioning by Isoflurane: Role of Mitochondrial KATP Channels and Opioid Receptors

Background: Adenosine triphosphate-regulated potassium channels mediate protection against myocardial infarction produced by volatile anesthetics and opioids. We tested the hypothesis that morphine enhances the protective effect of isoflurane by activating mitochondrial adenosine triphosphate-regulated potassium channels and opioid receptors.

Methods: Barbiturate-anesthetized rats (n = 131) were instrumented for measurement of hemodynamics and subjected to a 30 min coronary artery occlusion followed by 2 h of reperfusion. Myocardial infarct size was determined using triphenyltetrazolium staining. Rats were randomly assigned to receive 0.9% saline, isoflurane (0.5 and 1.0 minimum alveolar concentration [MAC]), morphine (0.1 and 0.3 mg/kg), or morphine (0.3 mg/kg) plus isoflurane (1.0 MAC). Isoflurane was administered for 30 min and discontinued 15 min before coronary occlusion. In eight additional groups of experiments, rats received 5-hydroxydecanoic acid (5-HD; 10 mg/kg) or naloxone (6 mg/kg) in the presence or absence of isoflurane, morphine, and morphine plus isoflurane.

Results: Isoflurane (1.0 MAC) and morphine (0.3 mg/kg) reduced infarct size (41 +/- 3%; n = 13 and 38 +/- 2% of the area at risk; n = 10, respectively) as compared to control experiments (59 +/- 2%; n = 10). Morphine plus isoflurane further decreased infarct size to 26 +/- 3% (n = 11). 5-HD and naloxone alone did not affect infarct size, but abolished cardioprotection produced by isoflurane, morphine, and morphine plus isoflurane.     

劳拉西泮引起多尿1例报道

患者XX，女，58岁，因心烦、失眠、焦虑、坐卧不安，情绪低落1年余来门诊求治，查体未见异常。辅助检查血、尿常规、肝功、肾功、血糖、心电图均未见异常，诊断“抑郁症”。口服盐酸帕罗西汀每日20mg及劳拉西泮每日1～2mg，患者情绪明显改善，睡眠较好，服用帕罗西汀6个月后病情稳定而停药，因几次欲停劳拉西泮出现明显戒断症状（心烦、失眠、坐卧不安、心动过速，出虚汗）而停不掉。于服用9个月左右出现多尿，每日尿量约3000～3500毫升左右，每日小便10余次，患者无多饮、多食症状，体重明显下降.     

Eliminating Intensive Postoperative Care in Same-day Surgery Patients Using Short-acting Anesthetics

Background: A multidisciplinary effort was undertaken to determine whether patients could safely bypass the postanesthesia care unit (PACU) after same-day surgery by moving to an earlier time point evaluation of recovery criteria.

Methods: A prospective, outcomes research study with a baseline month, an intervention month, and a follow-up month was designed. Five surgical centers (three community-based hospitals and two freestanding ambulatory surgical centers) were utilized. Two thousand five hundred eight patients were involved in the baseline period, and 2,354 were involved in the follow-up period. Outcome measures included PACU bypass rates and adverse events. Intervention consisted of a multidisciplinary educational program and routine feedback reports.

Results: The overall PACU bypass rate (58%) was significantly different from baseline (15.9%, P < 0.001), for patients to whom a general anesthetic was administered (0.4-31.8%, P < 0.001), and for those given other anesthetic techniques (monitored anesthesia care, regional or local anesthetics; 29.1-84.2%, P < 0.001). During the follow-up period, the average (SD) recovery duration for patients who bypassed the PACU was significantly shorter compared to that for patients who did not bypass, 84.6 (61.5) versus 175.1 (98.8) min, P < 0.001, with no change in patient outcome. Patients receiving only short-acting anesthetics were 78% more likely (P < 0.002) to bypass the PACU after adjusting for various surgical procedures.