足三里注射新斯的明对急性重症脑梗死患者自主排便功能影响的疗效观察

目的:评估足三里注射新斯的明对急性重症脑梗死患者自主排便功能影响。方法:回顾性分析2018年9月~2019年8月我院血管外科监护室收治的急性重症脑梗死患者63例,对照组30例患者予开塞露、灌肠人工辅助排便措施,治疗组33例患者予足三里注射新斯的明,观察2组患者治疗前后患者肠鸣音,治疗后24 h内自主排便次数、便血、大便失禁、瞳孔缩小等指标,评估疗效。结果:治疗组治疗前患者肠鸣音(0.6±0.9)次/min,治疗后患者肠鸣音(4.3±3.2)次/min,差异有统计学意义(P<0.05);对照组治疗后24 h内自主排便次数(0.3±0.8)次,治疗组治疗后24 h内自主排便次数(2.6±3.0)次,差异有统计学意义(P<0.05);对照组治疗后肠鸣音增加(1.2±1.5)次,治疗组治疗后肠鸣音增加(3.7±3.1)次,差异有统计学意义(P<0.05);所有患者无瞳孔缩小表现。结论:足三里注射新斯的明可促进急性重症脑梗死患者胃肠道蠕动,恢复自主排便功能,且不影响病情观察。     

新斯的明足三里穴位注射治疗麻醉止痛后腹胀168例

2000年5月至2002年5月，我们采用新斯的明足三里穴位注射治疗麻醉止痛后腹胀168例，效果显著。     

穴位注射治疗腹部术后肠胀气152例效果观察

2004年1～12月，我院应用甲基硫酸新斯的明注射液于足三里、三阴交穴位注射，治疗腹部术后肠胀气患者152例。效果满意．现报告如下。     

新斯的明联合大黄灌肠对重症急性胰腺炎腹内高压患者的作用

目的探讨新斯的明联合大黄灌肠治疗SAP患者腹内高压(IAH)的疗效。方法回顾性分析2018年1月至2022年6月间河北北方学院附属第一医院重症监护室(ICU)收治的89例行持续性肾脏替代疗法(CRRT)的SAP患者临床资料。根据治疗方式分为对照组(44例)和研究组(45例), 对照组患者给予大黄灌肠+芒硝盐外敷, 2次/d, 持续7 d;研究组患者在对照组治疗的基础上, 加用肌肉注射新斯的明0.5 mg, 2次/d, 持续7 d。监测腹内压, 记录两组患者急性生理和慢性健康评估(APACHE)Ⅱ、改善肾脏整体预后分级(KDIGO)和肺损伤(LIS)评分及治疗前后血清白细胞、CRP、降钙素原(PCT)、IL-6、IL-8和肿瘤坏死因子(TNF)-ɑ水平。主要研究终点为24 h腹内压变化量, 次要终点包括治疗后1～7 d粪便增加量、新出现腹腔间隔室综合征(ACS)、新出现器官功能障碍、血管并发症、ICU住院时间、总住院时间、存活率及治疗结束6个月后的治疗干预和并发症的发生。结果研究组和对照组腹内压均于治疗后9 h开始下降, 与治疗前相比, 两组治疗7 d后腹内压下降显著, 且研究组7 d内...     

穴位注射新斯的明治疗粘连性肠梗阻的疗效分析

目的 探讨穴位注射新斯的明治疗粘连性肠梗阻的方法及疗效.方法 将90例粘连性肠梗阻患者随机分为三组:(1)单纯保守治疗组30例,单纯采用西医常规非手术疗法,包括如禁食、抗感染、补液、持续胃肠减压等;(2)手术治疗组30例,入院后即行手术治疗;(3)穴位注射新斯的明治疗组,在常规治疗基础上穴位注射新斯的明.结果 (1)穴位注射新斯的明治疗组治愈15例,总有效率为80%,复发率16.7%;(2)单纯保守治疗组治愈12例,总有效率为80%,复发率33.3%;(3)手术治疗组治愈19例,总有效率为93.3%,复发率30%.穴位注射新斯的明治疗组较单纯保守治疗组及手术治疗组平均肛门排气时间、肠蠕动恢复时间、排便时间较单纯组及手术组明显缩短,差异有统计学意义(P<0.01).结论 穴位注射新斯的明治疗粘连性肠梗阻缩短了疗程,多数患者避免了再次手术的痛苦,也大大节省了治疗的费用,是治疗粘连性肠梗阻比较理想的一种治疗方法,临床可以推广应用.     

剖宫产术后并发假性肠梗阻1例报告

患者29岁,因足月妊娠检查时,发现羊水减少12 h入院,行子宫下段剖宫产术.手术顺利,术中出血300 ml,分娩一足月活婴,无窒息.术后给予抗炎、补液、促宫缩治疗.术后24 h,患者出现腹胀、反酸、恶心等不适,静滴甲氰咪呱,肌注新斯的明,肛塞开塞露、舡管排气等治疗后,症状元好转,术后30 h腹胀、腹痛、恶心明显.查体:全腹胀气明显,无压痛、反跳痛和肌紧张,叩鼓音,移动性浊音(一),肠鸣音减弱.     

耳穴贴压促进胃癌术后胃肠功能恢复的研究

[目的]探讨耳穴贴压促进胃癌术后胃肠功能恢复及预防术后并发症的作用.[方法]选择60例择期行胃癌根治术的患者,随机分为对照组（30例）和观察组（30例）,对照组行禁食、胃肠减压、营养支持等常规治疗,观察组在常规治疗的基础上行耳穴贴压,通过观察两组患者肠鸣音恢复时间、首次肛门排气/排便时间和术后并发症（如恶心呕吐、腹胀）发生率,来评价耳穴贴压促进胃癌术后胃肠功能恢复及预防术后并发症的作用效果.[结果]观察组患者术后肠鸣音恢复时间、首次肛门排气/排便时间明显少于对照组,差异有统计学意义（P＜0.05）;术后早期观察组恶心呕吐、腹胀发生率低于对照组,差异有统计学意义（P＜0.05）.[结论]耳穴贴压可促进胃癌术后胃肠功能恢复,并有效预防术后并发症.     

肝移植患者术中凝血功能的变化及影响因素

目的:探讨不同肝移植术式术中凝血功能变化的规律及相关的影响因素.方法:将2006-06/2007-05我院15例亲体肝移植患者及29例原位肝移植患者,分为肝癌组,肝硬化和急性肝衰组.综合评估患者术前状态,于患者术前及术中(无肝前期、无肝期、再灌注期30 min、再灌注期1 h)检测凝血酶原时间(PT)、活化的部分凝血酶原时间(APTT)、国际标准化比值(INR)、纤维蛋白原(FIB)、血小板计数(PLT)、血红蛋白量(HB)、白蛋白(ALB)及CO_2结合力(TCO_2),观察不同肝移植术式术中各组患者凝血功能及酸碱失衡的变化规律及特点,分析术前和术中可能存在的影响因素及与凝血功能的相关性.结果:肝硬化患者组术前凝血状态介于肝癌组与急性肝衰组之间.术前PLT明显减少,与其他两组相比差异显著(P<0.05).无肝期各项指标进一步恶化.再灌注30 min PT,APTT,INR值达到峰值,FIB水平于无肝期达到最低点(亲体移植:0.68±0.17 g/L vs 0.93±0.37 g/L,0.77±0.19 g/L,0.83±0.27 g/L,0.72±0.31 g/L;原位肝移植:0.65±0.14 g/L vs 0.89±0.10 g/L,0.71±0.26 g/L,0.69±0.16 g/L,0.70±0.23 g/L,P<0.05).肝癌组各指标术前基本正常,术中变化幅度均较前两组小(P<0.05).急性肝衰组患者术前PT、APTT、INR延长最为显著,凝血状态最差(P<0.05),但术中恢复较快.除无肝期外,FIB较其他两组明显减少(P<0.05).应用Pearson相关分析术中出血量与围手术期因素的相关关系,发现MELD评分与术中出血量具有相关性(r=0.619,P<0.05).与原位肝移植相比,亲体肝移植术中凝血功能及代谢紊乱的变化较大,尤以无肝前期及无肝期恶化明显.再灌注后各项凝血指标恢复迅速(P<0.05).结论:应根据具体情况个性化治疗肝移植患者.     

新斯的明经足三里注射对胃肠手术患者术后胃肠功能恢复的影响

目的:探讨在胃肠道手术后给予新斯的明足三里穴位注射对其胃肠功能恢复的影响.方法:回顾性分析在2006-05/2014-05武汉科技大学附属汉阳医院收治的行胃肠道手术后的300例患者,有A、B、C、D 4组,D组患者给予常规治疗,其余3组患者均在常规治疗基础上给予下述治疗,A组患者联合给予针刺足三里治疗、B组患者联合给予足三里盐水注射治疗、C组患者给予新斯的明足三里穴位注射治疗,每组75例,然后将3组患者的首次排气时间、首次排便时间、肠鸣音恢复时间、胃液量及胃泌素含量等进行比较.结果:在首次排气时间、首次排便时间、肠鸣音恢复时间上C组患者分别为31.2 h±9.5 h、40.6 h±10.7 h、30.6 h±3.4 h,均低于A组(46.9 h±10.1 h、55.7 h±11.8 h、45.1 h±9.6 h)、B组(45.6 h±9.8 h、56.3 h±10.9 h、44.6 h±9.8 h)及D组(51.3 h±10.5 h、56.6 h±12.1 h、50.6 h±9.2 h)(P0.05);4组患者在治疗前的胃液量和胃泌素上无明显差异(P0.05);在治疗后,C组患者的胃液量为251.6 m L/d±210.7 m L/d,明显低于A组(540.6 m L/d±391.8 m L/d)、B组(99.3 m L/d±45.6 m L/d)及D组(551.6 m L/d±410.5 m L/d)(P0.05),C组患者的胃泌素为119.8 n g/L±58.6 ng/L,明显高于A组(95.1 ng/L±43.3n g/L)、B组(99.3 n g/L±45.6 n g/L)及D组(89.8 ng/L±46.6 ng/L)(P0.05).结论:在胃肠道手术后给予新斯的明足三里穴位注射的治疗方案,能够显著的促进其胃肠功能的恢复,使其早日康复,可以在普外科推广应用.     

肝后腔静脉成形术行原位肝移植103例

目的:探讨肝移植新术式肝后腔静脉成形术在人原位肝移植中的应用价值.方法:应用改良肝移植新术式肝后腔静脉成形术行原位肝移植103例,观察其手术所用时间、无肝期、术中出血量及并发症等.结果:本组无1例发生围手术期死亡.肝后腔静脉成形术手术所用时间及无肝期(6.8±0.8 h,52.6±14.5 min)显著短于同期报告资料经典式肝移植(7.4±0.6 h,86.5±7.1 min)以及改良背驮式肝移植(7.9±0.6 h,78.4±7.94 min).术中出血量(2960±1120 mL)也显著少于改良背驮式(4662±913 mL)和经典式肝移植(4441±1072 mL).肝后腔静脉成形术术后肾功能不全发生率为29.1%(30/103),与经典式肝移植相近,比改良背驮式高,但均能在术后3-4 wk内恢复正常.结论:肝移植新术式肝后腔静脉成形术能简化病肝切除和新肝植入的手术操作,缩短手术时间,减少术中出血,值得临床进一步推广应用.     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Language of CTO interventions – Focus on hardware

The knowledge of variety of chronic total occlusion (CTO) hardware and the ability to use them represents the key to success of any CTO interventions. However, the multiplicity of CTO hardware and their physical character and the terminology used by experts create confusion in the mind of an average interventional cardiologist, particularly a beginner in this field. This knowledge is available but is scattered. We aim to classify and compare the currently used devices based on their properties focusing on how physical character of each device can be utilized in a specific situation, thus clarifying and simplifying the technical discourse.