薄荷醇对戊巴比妥中枢抑制作用的影响

研究薄荷醇经胃肠道给药对成巴比妥中枢抑制作用的影响，结果发现，薄荷醇对戊巴比妥的中枢抑制作用具有一定的量效关系，含４．５％的薄荷醇溶液可明显使小鼠的入睡时间缩恒，并使急性死亡率增加，而含１．５％和０．５％的薄荷醇溶液对成巴比妥的中枢抑制作用无明显影响。     

短效催眠药唑吡坦和三唑仑对人体前庭功能的影响

目的 :探讨两种短效催眠药唑吡坦和三唑仑对人体前庭功能的影响 ,为在应急条件下对飞行员服用该药提供试验依据。方法 :8名受试者 ,采用三阶段交叉双盲给药设计方法 ,分别交叉服用三唑仑 (0 .2 5mg)、唑吡坦 (10mg)、安慰剂 ,每次间隔 1周 ,在服药前 1h及服药后1、2、3、4、6、8、10h分别进行一组前庭功能测试 ,包括视动性眼震 (OKN)、前庭眼动反射 (VOR)、前庭眼动反射固视抑制 (VOR -Fix)、视前庭眼动反射 (VVOR)。结果 :与安慰剂组比较 ,服用唑吡坦和三唑仑后均能显著降低VOR、OKN、SPT增益 ,在服药 2h后降到最低〔VOR :(0 .5 1± 0 .0 4 ) ,(0 .5 2± 0 .0 5 )vs (0 .6 7± 0 .13) ;OKN :(0 .32± 0 .0 2 ) ,(0 .6 2± 0 .0 6 )vs (0 .82± 0 .0 7) ;SPT :(0 .71± 0 .14 ) ,(0 .6 6± 0 .0 6 )vs (0 .93± 0 .0 3)〕。其中唑吡坦对OKN增益的降低要强于三唑仑 ,但这种影响持续时间不长 ,在服药 6h后即消失。两种短效催眠药对VVOR增益、SPT相位及VOR -Fix均无明显影响。结论 :唑吡坦及三唑仑对人体前庭功能具有一定的影响 ,但这种影响持续时间较短 ,对人体的空间定向及平衡能力无残留后遗效应     

Bright light treatment for night-time insomnia and daytime sleepiness in elderly people: comparison with a short-acting hypnotic

Night-time bright light (BL) treatment and triazolam (0.125 mg/day) were given to three healthy elderly people in a cross-over design. They kept a daytime sleepiness test and a sleep log, and their wrist-activity was monitored simultaneously. Subjectively, BL increased daytime sleepiness and naps, and decreased night-time sleep. Triazolam decreased daytime sleepiness and naps, and increased night-time sleep. Actigraphic night-time sleep and naps on the first day were similar to these results. However, on the fourth day night-time insomnia induced by BL had recovered, and naps were shorter than the baseline. Triazolam increased actigraphic naps as the days passed.     

Changes in rapidly extracted auditory evoked potentials during tracheal intubation

BACKGROUND: One of the problems encountered in assessment of the hypnotic level during anesthesia is the extraction of a consistent and reliable measure online and close to real time. Hemodynamic parameters such as heart rate and blood pressure are not, at least with the traditional single parameter versus time presentation, adequate for ensuring an optimal level of anesthesia, especially when using neuromuscular blocking agents (NMBA). In the literature, it has been demonstrated that auditory evoked potentials (AEP) are able to provide two aspects relevant to determining level of anesthesia: firstly, they have identifiable anatomical significance and, secondly, their characteristics reflect the way the brain perceives a stimulus. METHODS: The aim of this study was to evaluate the AEP index based on a system identification model, the autoregressive model with exogenous input (ARX-model), and to compare it to the classical method, the moving time average (MTA). The ARX enables the extraction within 15-25 sweeps, depending on the signal-to-noise ratio (SNR), whereas MTA typically needs 250-500 sweeps. The hypothesis of the present study was that since the ARX-model extracts the AEP faster than the MTA-model, the former should be able to detect changes during the brief, intense stimulus of endotracheal intubation. Twelve female patients scheduled for gynecological surgery were included in the study. Anesthesia was initiated with thiopentone and maintained with isoflurane and alfentanil. The AEP was mapped into an index (AEP-index) normalized to 100 when the individual was awake and decreasing to an average of 25 during thiopentone induced anaesthesia. The results were compared to those obtained by MTA-extracted AEP. RESULTS: During tracheal intubation 9 patients showed an increase in the ARX-extracted AEP-index larger than 15, and 6 of these patients showed an increase larger than 25 (mean increase=33, SD=18). The MTA-extracted AEP-index showed only one patient with an increase larger than 15. The ARX-extracted AEP changed significantly faster than the MTA-extracted AEP. CONCLUSION: The ARX-extracted AEP-index increases during tracheal intubation. There is a significant difference between the ARX-extracted AEP and the traditional MTA-extracted AEP, in terms of response time. In order to trace short-lasting changes in the hypnotic level by AEP, the AEP should be extracted by a method with a fast response such as the ARX-model.     

口服镇静催眠药中毒患者药物治疗性分析

目的 比较两种药物联合应用治疗镇静催眠药中毒治疗效果的优劣。方法 根据我院急诊科临床用药情况将2016年1月~2018年12月收治的59例镇静催眠药中毒患者分为纳洛酮、氟马西尼联合治疗组（A组）;醒脑静、氟马西尼联合治疗组（B组）,比较两组患者GCS（格拉斯哥昏迷评分）、苏醒时间、住院时间、不良反应等,分析两种联合用药情况的优劣。结果 两组患者治疗后GCS（格拉斯哥昏迷评分）、苏醒时间、住院时间差异具有统计学意义（P<0.05）,B组治疗效果优于A组。结论 醒脑静、氟马西尼联合治疗镇静催眠药中毒,能明显缩短住院时间,效果优于纳洛酮和氟马西尼。     

右旋佐匹克隆的合成新方法

目的制备右旋佐匹克隆。方法以2,3-吡嗪二酸酐和2-氨基-5-氯吡啶为起始原料,经酯化、环合、不对称还原、成酯和精制反应得到右旋佐匹克隆。结果与结论目标化合物的结构经1H-NMR谱确证。新合成方法操作简便、收率高,适合工业化生产。产品光学纯度大于99.9%,化学纯度大于99.5%。     

国产沉香化学成分及药理作用研究进展

根据国内外有关国产沉香化学成分及药理作用的文献报道,国产沉香的主要化学成分为倍半萜类和色酮类成分,除此之外,还包括芳香族类、脂肪酸类、三萜类等成分。国产沉香具有多种生物活性,其药理作用包括催眠镇静、缓解肠道平滑肌痉挛、止咳平喘、抗心肌缺血、降血糖等。根据当前研究情况,今后应对国产沉香中2-(2-苯乙基)色酮类多聚体成分进行系统研究,探索沉香化学成分与药理药效的关系,以清楚地了解各成分在各种药理作用中的具体作用机制。参考文献46篇。     

Effect of sedative-hypnotics,anesthetics and analgesics on sleep architecture in obstructive sleep apnea

The perioperative care of obstructive sleep apnea (OSA) patients is currently receiving much attention due to an increased risk for complications. It is established that postoperative changes in sleep architecture occur and this may have pathophysiological implications for OSA patients. Upper airway muscle activity decreases during rapid eye movement sleep (REMS). Severe OSA patients exhibit exaggerated chemoreceptor-driven ventilation during non-rapid eye movement sleep (NREMS), which leads to central and obstructive apnea. This article critically reviewed the literature relevant to preoperative screening for OSA, prevalence of OSA in surgical populations and changes in postoperative sleep architecture relevant to OSA patients. In particular, we addressed three questions in regard to the effects of sedative-hypnotics, anesthetics and analgesics on sleep architecture, the underlying mechanisms and the relevance to OSA. Indeed, these classes of drugs alter sleep architecture, which likely significantly contributes to abnormal postoperative sleep architecture, exacerbation of OSA and postoperative complications.     

不同比例五味子宁神口服液镇静催眠作用研究

目的:寻找五味子宁神口服液镇静催眠作用的最佳配伍比例。方法:通过对小鼠自发活动的影响、对戊巴比妥钠的协同作用、对中枢神经递质的影响等3方面药理学研究,探讨五味子宁神口服液不同配伍比例的镇静催眠作用。结果:五味子宁神口服液以原方用药25%五味子比例作用最好。结论:五味子宁神口服液组方配伍是合理的。