瑞芬太尼复合全麻用于老年开胸患者手术的临床观察

目的探讨瑞分太尼用于老年患者开胸手术的安全性与可控性。方法本组用于老年麻醉46例,随机分为瑞芬太尼组和芬太尼组,分别瑞芬太尼组和芬太尼诱导,观察诱导前、诱导后、插管后、手术中、拔管时平均动脉压、心率变化及停止麻药后清醒时间、拔管后有无呼吸抑制、恶心呕吐、烦躁不安等不良反应。结果瑞芬太尼在循环稳定地方大于芬太尼,在苏醒时间、呼吸抑制、烦躁的发生等方面,瑞芬太尼明显优于芬太尼。结论瑞芬太尼用于老年人麻醉循环平稳,术后苏醒更快,瑞芬太尼的临床应用为老年病人开胸手术提供了可靠的保障。     

瑞芬太尼控制性降压用于脊柱手术的临床研究

目的与硝酸甘油对比研究瑞芬太尼控制性降压用于脊柱手术的安全有效性。方法选择全麻下行脊柱锥体骨折经后路切开复位内固定植骨融合术患者30例,随机分为瑞芬太尼组(R组)和硝酸甘油组(N组),每组15例。静脉复合全身麻醉,手术进入骨质操作后行控制性降压,降压目标为MAP60～65mmHg。R组以瑞芬太尼2μg/kg静注,0.1～0.5μg.kg-1.min-1微量泵维持。N组以硝酸甘油2μg/kg静注,0.5～3μg.kg-1.min-1微量泵维持。降压60min后停止降压。记录MAP、HR、CVP;术中失血量、手术时间、手术结束至拔除气管导管时间。结果两组病人的性别、年龄、体重、手术时间、拔管时间差异无显著意义,术中出血量R组显著少于N组(P<0.01)。实施控制性降压后两组病人的MAP均达到预定目标,MAP下降均显著低于降压前(P<0.01)。R组停止降压10min后、N组停止降压30min后MAP恢复至降压前。降压期间R组的HR显著低于降压前(P<0.05,P<0.01),停止降压10min恢复至降压前。N组降压15min后至停止降压30minHR显著高于降压前(P<0.05,P<0.01)。降压开始15min内R组的CVP与降压前相比差异无显著意义;N组的CVP显著低于降压前(P<0.05,P<0.01)。结论脊柱手术中瑞芬太尼控制性降压安全、有效、易于调控。与硝酸甘油相比,瑞芬太尼降压更平稳,对CVP影响小,不影响病人术毕清醒拔管,是全麻手术行控制性降压较好的选择药物。     

舒芬太尼和芬太尼在颅内肿瘤切除术麻醉中的应用分析

目的 探讨舒芬太尼和芬太尼在颅内肿瘤切除术麻醉中的应用效果。方法 选择我院开颅颅内肿瘤切除术患者50例。随机分为观察组和对照组。术前用药均应用长托宁。静脉注射咪达唑仑、丙泊酚。观察组静注舒芬太尼0.4μg/kg,对照组静脉注射芬太尼4μg/kg,意识消失,2组患者均给予维库溴铵0.1mg/kg。面罩辅助通气3min,行插管机械通气。麻醉诱导5min后,采用微量泵2组分别持续输注舒芬太尼和芬太尼。术中持续给予丙泊酚,七氟烷吸入浓度为1～2MAC,维库溴铵麻醉诱导后每隔60min追加2mg。观察组和对照组在手术结束前30min停止舒芬太尼和芬太尼用药。结果 观察组在头架固定时、切皮时、切口硬脑膜时、关闭硬脑膜时心率分别与对照组同时间点比较,差异有统计学意义(P<0.05);观察组在切皮时、切开硬脑膜时、关闭硬脑膜和拔管后即刻平均动脉压分别与对照组同时间点比较,差异有统计学意义(P<0.05)。结论 舒芬太尼应用于颅内肿瘤开颅麻醉时血流动力学稳定,麻醉苏醒平稳,术后不良反应少,效果显著。     

舒芬太尼复合异丙酚用于无痛结肠镜的临床研究

目的 观察舒芬太尼复合异丙酚用于纤维结肠镜检的镇静镇痛效果及副作用,探讨其用于无痛结肠镜检的安全性和可行性.方法 120例ASAⅠ-Ⅱ级拟行结肠镜检的病人,随机分为两组,每组60例Ⅰ组(舒芬太尼 异丙酚组),静脉注射舒芬太尼0.15μg/kg后,再注射异丙酚1.5～2.0mg/kg;Ⅱ组(异丙酚组),静脉注射异丙酚2.0～2.5mg/kg.两组均待患者入睡,对呼唤反应迟钝后,即开始进行纤维结肠镜检查和治疗.术中根据病人的反应酌情追加异丙酚10～20mg.记录用药前1min、用药后2min及手术结束时的HR、BP,SpO2,异丙酚用量,术中镇静评分(OAA/S评分法)、术中肢体反应,手术时间及苏醒时间.结果 Ⅱ组病人在用药后2min HR、MAP、SpO2均出现一定程度的下降,组内、组间比较差异有显著性(P＜0.05);Ⅰ组的异丙酚用量为(61.5±10.4)mg,Ⅱ组用量为(126.8±15.1)mg,组间比较有显著性差异(P＜0.01);Ⅰ组苏醒时间为(2.46±0.30)min,Ⅱ组为(3.78±0.58)min,组间比较也有显著性差异(P＜0.01).结论 舒芬太尼复合异丙酚用于纤维结肠镜检的镇静镇痛效果好,副作用少,是一种安全、有效的结肠镜检镇痛方法.     

舒芬太尼对老年患者围手术期血流动力学和血糖的影响

目的观察舒芬太尼对老年患者围手术期血流动力学和血糖的影响。方法老年全麻患者62例,随机均分2组,舒芬太尼组(S组)用舒芬太尼0.4μg/kg诱导;芬太尼组(F组)用芬太尼3μg/kg诱导。比较2组麻醉诱导各时段的血糖和血流动力学各指标的差异。结果与麻醉诱导前比较,2组在插管前SBP、DBP、HR均明显下降(P<0.05),且F组DBP、HR显著低于S组(P<0.05)。麻醉插管后直至术毕2h,2组患者血糖较麻醉前升高,但舒芬太尼组的血糖显著低于芬太尼组的患者。结论舒芬太尼对老年患者全麻诱导中的血糖和血流动力学指标的影响作用小于芬太尼。     

探讨神经外科手术中的2种麻醉方法的临床效果

目的探讨2种方法在神经外科手术中的麻醉效果,选择最佳麻醉组合。方法选择2008年5月至2010年6月我院68例神经外科择期手术病人,ASAⅠ级和Ⅱ级,随机分为2组:丙泊酚-芬太尼组(A组),丙泊酚-瑞芬太尼组(B组)。分别对其镇痛效果进行评估。结果 2种麻醉方法镇痛效果、不良反应发生率比较差异无统计学意义(P>0.05)。结论神经外科的手术,采用丙泊酚-瑞芬太尼进行静脉麻醉,起效时间快、作用时间短、快速苏醒,是理想的麻醉方法 。     

耳鼻喉科丙泊酚复合瑞芬太尼和安氟醚复合芬太尼全凭静脉麻醉效果比较

目的与麻醉同仁共同探讨2种复合药物的麻醉效果。方法将2组药物进行临床分析对比。结果丙泊酚复合瑞芬太尼麻醉较安氟醚复合芬太尼麻醉血液动力学更加平稳,麻醉恢复较快。结论丙泊酚复合瑞芬太尼麻醉更适用于耳鼻喉科手术患者。     

瑞芬太尼在手术麻醉中的应用及效果初步研究

目的:研究瑞芬太尼在手术麻醉中的应用及麻醉效果.方法:随机选择2014年1月至2016年7月我院收治的120例手术治疗患者作为研究对象,根据随机数字法,将120例患者分成两组,其中60例患者手术前行芬太尼麻醉设为对照组,另外60例患者手术前行瑞芬太尼麻醉,比较两组麻醉效果.结果:观察组麻醉优良率100%,对照组麻醉优良率88.3%,观察组麻醉优良明显比对照组高,两组对比具有显著差异(P<0.05);观察组拔管时间、认知恢复时间均比对照组短,两组对比具有显著差异(P<0.05).结论:瑞芬太尼应用于手术麻醉中效果理想,可以保证患者的手术麻醉效果,而且能保证患者血压、心率等指标保持在平衡状态,缩短患者拔管时间和认知恢复时间,值得借鉴推广.     

舒芬太尼及瑞芬太尼在剖宫产术后的镇痛临床药效分析

目的:分析舒芬太尼与瑞芬太尼在剖宫产术中用于静脉镇痛的临床药效比较。方法:选取花溪区人民医院2015年4月~2016年11月的118例行剖宫产产妇,随机分为舒芬太尼组(S组)及瑞芬太尼组(F组),观察并记录2组临床治疗效果、疼痛视觉模拟评分(VAS)、镇静评分、舒适评分(BCS)、按压次数、血流动力学变化及不良反应。结果:2组产妇心率、血压值均明显低于诱导前(P0.05);S组心率及血压值明显低于F组,差异具有统计学意义(P0.05);S组VAS评分低于F组,同时S组的BCS、镇静评分均明显高于F组,S组按压次数始终少于F组,S组不良反应发生率为10.17%;F组为2.04%。结论:舒芬太尼在产妇剖宫产术后静脉镇痛中能发挥最佳的镇痛效果,安全性相对较高,在临床应用中值得推广。     

丙泊酚靶控输注对老年患者的血压影响

目的观察丙泊酚靶控输注复合瑞芬太尼诱导对老年高血压患者血压的影响。方法选择32例老年高血压与47例老年非高血压外科住院拟行全麻手术患者,均以丙泊酚靶控输注复合瑞芬太尼诱导。记录诱导前、诱导结束、气管插管5min、10min的血压等指标,并做统计学分析。结果两组入选者诱导期间各时间段,心率情况比较未见统计学差异(P>0.05);高血压组诱导期收缩压/舒张压水平明显高于相应时间段的非高血压组(P<0.05),且高血压组诱导期间收缩压波动明显,与诱导前比较明显下降(P<0.05)。诱导期间高血压组脉压差明显高于非高血压组(P<0.05)。结论老年高血压患者在丙泊酚靶控输注复合瑞芬太尼诱导期间血压较其非高血压组波动更加显著,但是其波动性仍在可接受范围内,该方法用于老年高血压患者全麻手术诱导安全、有效。     

Ischemic and Ozone Oxidative Preconditioning in the Protection Against Hepatic Ischemic-Reperfusion Injury

It has been demonstrated that ozone, probably through a mechanism of oxidative preconditioning (OP), protected the liver against the damage mediated by reactive oxygen species. Taking into account that iscehmic preconditioning (IschP) is also a protective mechanism, a comparative study between both preconditioning settings was performed in order to study the effectiveness of both protective procedures. Rats were randomly divided into 4 groups: 1- control, sham operated (anesthesia and laparotomy plus surgical manipulation); 2- I/R (ischemia for 90?min followed by 90?min reperfusion); 3- Ischp+I/R, as group 2 but submitted to a previous ischemic preconditioning (ischemia 10?min and reperfusion 10?min); 4- OzoneOP+I/R, as group 2 but submitted to a pervious oxidative preconditioning with 15 sessions, daily, of ozone by rectal administration (dose of 1?mg/kg). The comparison between both preconditionings showed no biochemical differences for the parameters evaluated. Nevertheless, the histological study demonstrated that the protective effect produced by the OzoneOP is superior to that achieved with the IschP.     

高龄患者麻醉诱导和复苏时间研究比较

目的探讨高龄全麻手术患者不同的麻醉诱导方法与复苏时间的关系。方法选择2008年10月至2010年5月,于我院住院需全麻手术的高龄患者78例,随机分为3组,丙泊酚诱导组、七氟醚诱导组和异丙酚诱导组,每组26例,观察患者从术毕到自主呼吸恢复时间、咽喉反射恢复时间、睁眼时间、对语言有反应时间和定向力恢复时间,并进行统计学处理。结果七氟醚组高龄患者的术后呼吸、喉咙反射、睁眼、语言反应、定向力和完全苏醒时间最短。与异丙酚以及丙泊酚比较,苏醒时间均具有显著性差异,P<0.05。结论七氟醚麻醉诱导效果优于丙泊酚和异丙酚,其复苏时间短,可以用于高龄手术患者的全麻手术。     

曲马多丙泊酚复合罗哌卡因臂丛阻滞在小儿上肢手术中的应用

目的突破小儿上肢手术传统上常采用氯胺酮静脉麻醉[1],探讨曲马多丙泊酚复合罗哌卡因臂丛阻滞在小儿上肢手术中的临床效果分析。方法对28例小儿上肢手术中采用曲马多丙泊酚复合罗哌卡因臂丛阻滞麻醉,术中对一系列经常性指标进行观测。结果术后各例均表现正常,无一例患儿出现情绪焦躁,深度睡眠等情况。结论臂丛神经阻滞麻醉复合曲马多丙泊酚复合罗哌卡因用于婴幼儿上肢手术具有镇静、镇痛效果好,呼吸、循环平稳,全麻苏醒迅速,麻醉并发症少等优点,是一种安全性高、可行性强的婴幼儿上肢手术的麻醉方法。     

液相色谱-串联质谱测定植物性食品中啶虫脒、甲霜灵和哒螨灵残留量

建立了植物性食品中啶虫脒、甲霜灵和哒螨灵残留量的液相色谱-串联质谱(ESI源)检测方法。试样经乙腈提取,用V(乙腈)∶V(甲苯)=3∶1的溶液淋洗的固相萃取柱净化后,用LC-MS-MS测定。采用工作曲线法进行校正基质效应引来的定量的误差。3种农药的方法线性范围:0.2~20.0μg/kg,线性关系良好(r≥0.995)。在2.0~10.0μg/kg的添加水平范围内的平均回收率均大于80.0%,相对标准偏差为均低于15%,3种农药的最低检出限0.2μg/kg,定量限为1.0μg/kg。     

Lycopene Enhances Antioxidant Enzyme Activities and Immunity Function in N-Methyl-N'-nitro-N-nitrosoguanidine-Induced Gastric Cancer Rats

To investigate anticancer effect of lycopene, we examined the effects of lycopene on the oxidative injury and immunity activities of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)-induced gastric cancer rats. The animals were divided into five groups. Group I served as the normal control and was given corn oil orally for 20 weeks. Group II were induced with MNNG 200 mg/kg body weight by oral gavage at days 0 and 14, and saturated NaCl (1 mL per rats) was given once every three days for four weeks until the end of the experimental period. Group III, IV and V were posttreated with lycopene (50, 100 and 150 mg/kg body weight, dissolved in corn oil) from the sixth week of MNNG (as in group II) induction up to the end of the experimental period. In the presence of MNNG, MDA and immunity levels were significantly increased, whereas enzymatic (SOD, CAT, and GPx) antioxidant activities were decreased in the treated rats compared with normal control rats. Administration of lycopene to gastric carcinoma-induced rats largely up-regulated the redox status and immunity activities to decrease the risk of cancer compared to group II. We conclude that up-regulation of antioxidants and immunity by lycopene treatment might be responsible for the anticancer effect in gastric carcinoma.     

Argon Attenuates Multiorgan Failure in Relation with HMGB1 Inhibition

Argon inhalation attenuates multiorgan failure (MOF) after experimental ischemic injury. We hypothesized that this protection could involve decreased High Mobility Group Box 1 (HMGB1) systemic release. We investigated this issue in an animal model of MOF induced by aortic cross-clamping. Anesthetized rabbits were submitted to supra-coeliac aortic cross-clamping for 30 min, followed by 300 min of reperfusion. They were randomly divided into three groups (n = 7/group). The Control group inhaled nitrogen (70%) and oxygen (30%). The Argon group was exposed to a mixture of argon (70%) and oxygen (30%). The last group inhaled nitrogen/oxygen (70/30%) with an administration of the HMGB1 inhibitor glycyrrhizin (4 mg/kg i.v.) 5 min before aortic unclamping. At the end of follow-up, cardiac output was significantly higher in Argon and Glycyrrhizin vs. Control (60 ± 4 and 49 ± 4 vs. 33 ± 8 mL/kg/min, respectively). Metabolic acidosis was attenuated in Argon and Glycyrrhizin vs. Control, along with reduced amount of norepinephrine to reverse arterial hypotension. This was associated with reduced interleukin-6 and HMGB1 plasma concentration in Argon and Glycyrrhizin vs. Control. End-organ damages were also attenuated in the liver and kidney in Argon and Glycyrrhizin vs. Control, respectively. Argon inhalation reduced HMGB1 blood level after experimental aortic cross-clamping and provided similar benefits to direct HMGB1 inhibition.     

气相色谱法测定阔草清在大豆籽粒中的残留量

本文研究了用气相色谱法测定大豆籽粒中阔草清的残留量。阔草清用酸性丙酮提取,提取液经正己烷和二氯甲烷净化,残留物用碘甲烷甲基化,形成N－甲基阔草清衍生物,再于气相色谱仪上测定。本实验采用添加法测定回收率,添加水平为5．0－100．0μg/kg,其平均回收率为88．7％－95．3％。本方法最小检出限为5．0μg/kg,具有灵敏度高、回收率高以及操作简便等优点。     

Involvement of Chaperone Sigma1R in the Anxiolytic Effect of Fabomotizole

Sigma-1 receptor (chaperone Sigma1R) is an intracellular protein with chaperone functions, which is expressed in various organs, including the brain. Sigma1R participates in the regulation of physiological mechanisms of anxiety (Su, T. P. et al., 2016) and reactions to emotional stress (Hayashi, T., 2015). In 2006, fabomotizole (ethoxy-2-[2-(morpholino)-ethylthio]benzimidazole dihydrochloride) was registered in Russia as an anxiolytic (Seredenin S. and Voronin M., 2009). The molecular targets of fabomotizole are Sigma1R, NRH: quinone reductase 2 (NQO2), and monoamine oxidase A (MAO-A) (Seredenin S. and Voronin M., 2009). The current study aimed to clarify the dependence of fabomotizole anxiolytic action on its interaction with Sigma1R and perform a docking analysis of fabomotizole interaction with Sigma1R. An elevated plus maze (EPM) test revealed that the anxiolytic-like effect of fabomotizole (2.5 mg/kg i.p.) administered to male BALB/c mice 30 min prior EPM exposition was blocked by Sigma1R antagonists BD-1047 (1.0 mg/kg i.p.) and NE-100 (1.0 mg/kg i.p.) pretreatment. Results of initial in silico study showed that fabomotizole locates in the active center of Sigma1R, reproducing the interactions with the site’s amino acids common for established Sigma1R ligands, with the ΔG_bind value closer to that of agonist (+)-pentazocine in the 6DK1 binding site.     

强化混凝与PAC吸附组合工艺去除百菌清效能研究

采用强化混凝与粉末活性炭吸附组合工艺去除饮用水中的百菌清。结果表明,针对原水中不同浓度百菌清（65．55、212．81、316．89、396．06、543．35μg／L）,调节PAC投量（10、20、30、40、50mg／L）,吸附30min后,再投加10mg／L聚合氯化铝,混凝沉淀出水中百菌清浓度分别为3．34、2．50、2．58、2．60、2．92μg／L,满足《生活饮用水卫生标准》（GB5749—2006）要求。此方法操作方便、经济有效,可作为水厂应急预案。     

合成R134和R134a的新工艺

以一氯二氟甲烷（Ｒ２２）为原料,裂解成含四氟乙烯Ｃ２Ｆ４混合气,以钯为催化剂加氢合成１,１,２,２ 四氟乙烷（Ｒ１３４）,以铬为催化剂经异构化制得１,１,１,２ 四氟乙烷（Ｒ１３４ａ）。自行设计和制作了中试合成装置,加氢的最佳工艺条件是：反应温度为８０℃,Ｖ（Ｃ２Ｆ４）∶Ｖ（Ｈ２）＝１∶２～１∶４,气体流速２．５０～３．５０ｍ／ｍｉｎ,Ｃ２Ｈ４的转化率为８０％左右;异构化的最佳工艺条件是：温度３００℃,异构化后的混合物中Ｒ１３４ａ的体积分数达７２．６％。