电动气压止血带在儿童骨科四肢手术中的安全应用

目的 探讨电动气压止血带应用于儿童骨科手术中的安全效果.方法 选取2009年3月-2010年5月年本院收治的需经手术治疗的四肢骨折患儿86例,随机分成试验组和对照组,每组43例.试验组在手术过程中采用电动气压止血带行术中止血,对照组采用传统止血带行术中止血,两组患者分别从止血带休克发生率,上下肢放松止血带前、后血压、心率变化情况进行比较.结果 试验组止血带休克发生率为2.33%（1/43）,对照组为9.30%（4/43）,两组比较差异有统计学意义（P＜0.05）.两组上、下肢放松止血带前后血压、心率比较,差异有统计学意义（P＜0.05）.放松止血带后3、5min两组血压、心率间比较,差异均有统计学意义（P＜0.05）.结论 电动气压止血带应用于儿童骨科四肢手术,能够明显降低止血带休克发生率,减少术中出血量,具有较好的临床推广价值.     

数控气压止血带在骨科四肢手术中的应用效果观察

目的观察数控气压止血带在骨科四肢手术中的应用效果。方法将胫腓骨骨折择期手术及内固定取出患者67例随机分为观察组34例和对照组33例。观察组在手术时使用数控气压止血带,对照组在手术时使用普通气压止血带。观察2组患者术中的手术野暴露情况及术后的不良反应。结果 2组患者在手术野暴露方面差异无统计学意义(P>0.05)。观察组术后不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论数控气压止血带的使用不但减少了手术中的出血量,使手术野暴露清晰,还降低了术后的不良反应。     

自动气压止血带不同保护垫与充气时间对病人皮肤的影响

目的探讨使用气压止血带的有效方法.方法下肢骨折行切开复位内固定手术病人246例,随机分为2组,每组123例,采用棉纸作止血带保护垫者为实验组,采用手术巾或绷带作保护垫者为对照组,比较2组病人在使用止血带后皮肤受损的差异性.然后根据止血带使用时间再将实验组和对照组按随机表法分为A组(55±5)分钟,B组(70±5)分钟,C组(85±5)分钟3组,每组41例,比较实验组和对照组各组间的皮肤反应.结果经统计学x 2检验,比较出对照组与实验组的皮肤反应有差异(P＜0.01).但实验组在使用止血带的不同时间段内皮肤出现压痕、红肿、小水泡等皮肤反应很少,且组间比较无差异,(P＞0.05),而对照组随着止血带使用时间的延长皮肤反应越严重,组间比较有差异(P＜0.01),结论止血带使用过程中出现皮肤反应的轻重与使用止血带保护垫的正确与否有关.所以,优质有效的护理能减轻病人的不适,降低手术并发症的发生.     

护理干预对术中使用电子气压止血带患者不良反应的影响

目的:观察护理干预措施对手术室术中使用电子气压止血带患者不良反应的影响.方法:将骨科四肢手术术中使用电子气压止血带的180例患者随机分成对照组(90例)与观察组(90例).对照组按骨科四肢手术常规护理,观察组在常规护理基础上进行认知、心理和行为护理干预.比较2组病人出现不良反应的情况.结果:观察组患者术中及术后的不良反应明显低于对照组.结论:护理干预措施有效地预防术中使用电子气压止血带患者的不良反应.     

活动衬垫型和固定衬垫型膝关节假体在置换后1年时膝关节活动度和临床效果的对比研究

目的比较活动衬垫型和固定衬垫型膝关节假体在置换后1年时膝关节活动度和临床效果。方法将80例膝关节骨关节炎且患膝既往无手术史的患者按照奇偶数字法随机地均分为A、B组,各为40例。A组采用活动衬垫型膝关节假体,B组采用固定衬垫型膝关节假体。比较两组术后HSS评分结果以及置换术后膝关节相关活动度的角度。结果①A、B两组术后6周、术后3个月、术后6个月及术后1年HSS评分结果相比,差异均无统计学意义(P>0.05);②A、B两组置换术后患膝屈曲挛缩、最大屈曲度、股骨角、胫骨角、胫骨平台后倾角及置换术后髌骨高度比较,均无统计学差异(P>0.05)、结论活动衬垫型和固定衬垫型膝关节假体治疗置换后1年时膝关节骨关节炎均具有较好的临床疗效,因此二者均可行。     

膝关节置换手术中全程及半程应用止血带对术中出血及术后康复的影响

目的 探讨膝关节置换手术中全程及半程应用止血带对术中出血及术后康复的影响.方法 选取2013年1月至2015年5月我院收治的膝关节骨性关节炎68例为研究对象,均择期行膝关节置换术,采用随机数表法分为观察组和对照组各34例,观察组术中半程应用止血带止血,对照组术中全程应用止血带,比较两组手术时间、住院时间、术中出血量、红细胞计数(RBC)、C反应蛋白(CRP)等围术期指标,并应用膝关节HSS评分表评价膝关节功能优良率,同时记录术后并发症发生率.结果 观察组手术时间、住院时间及术中出血量高于对照组(P＜0.05),观察组治疗后RBC低于对照组(P＜0.05);两组术后出血量、CRP水平比较无统计学差异(P＞0.05).观察组膝关节功能优良率与对照组比较无统计学差异(91.2％ vs.94.1％;x2=0.07,P＞0.05).两组并发症发生率比较无统计学差异(8.8％vs.5.9％;x2=0.216,P＞0.05).结论 膝关节置换手术中半程应用止血带可能会延长手术时间、住院时间,增加术中出血,但不会增加术后出血,对术后康复无明显影响.     

石膏棉纸和纱布用作气压止血带衬垫材料的对比观察

气压止血带在四肢手术中使用已非常普遍,应用止血带可最大限度地制止创面出血,使手术野干净无血,便于辨认各种组织,有利于手术操作,而缩短手术时间,并可减少或免除输血[1].原来使用的气压止血带使用压力高,现在我院采用美国ZIMMER公司的A.T.S750自动气压止血带,其袖带材料的改善和宽度增加,具有使用压力低、设定时间长、止血更彻底的优点[2].     

气压止血带在院前急救中的应用

院前急救中四肢创伤的患者所占外伤患者比例较大,常规止血采用橡胶止血带法、加压包扎止血等方法.气压止血带一般用于四肢手术中控制出血量,确保切口无渗血,缩短手术时间.2011年我急救中心车载设备中增加了JXX-001型手动气压止血带,用于院前四肢外伤止血,报告如下.     

气压止血带恰当放气时机可保证双下肢手术患者血压及心率的平稳

目的观察气压止血带不同放气时机对双下肢同时手术患者血压及心率的影响。方法我院骨科行双下肢同时手术患者60例,按入手术室序号分为A、B、C三组,各20例。三组患者均采用个性化压力充气、纯棉螺纹弹性衬垫、间隙放气法等。一侧肢体气压止血带放气后A组间隔10分钟再放另一侧,B组间隔15分钟,C组间隔20分钟。比较三组一侧肢体放气前后即刻和另一侧放气前后有创血压和心率的变化。结果一侧肢体止血带放气后即刻三组均血压下降,心率增快;另一侧放气后,A组血压继续下降,心率进一步增快;B组波动幅度没有A组明显;C组血压下降,心率增快,但基本能维持在安全范围。结论在骨科双下肢同时手术时,气压止血带恰当放气时机可保证患者手术过程中生命体征的平稳。     

158例经皮肾镜超声气压弹道碎石术治疗上尿路结石临床分析

目的探讨经皮肾镜超声气压弹道碎石术治疗上尿路结石方法及效果。方法随机抽取本院收治的210例上尿路结石患者随机分为2组,实验组158例,行经皮肾镜超声气压弹道碎石术;对照组52例,单纯行开放性手术。随访1~2月,比较两组患者的临床疗效以及术后并发症发生率。结果两组间相比,治疗后实验组患者的临床疗效以及术后并发症发生率均优于对照组,差异有统计学意义(P<0.05)。结论早期应用经皮肾镜超声气压弹道碎石术治疗上尿路结石,可以显著提高疗效,减少患者并发症。     

添加四针状氧化锌晶须抗菌剂对义齿软衬材料机械性能的影响

目的:研究添加四针状氧化锌晶须(T-Znow)抗菌剂对义齿软村材料机械性能的影响.方法:将T-ZnOw抗菌剂按0%(对照组)、1%、2%、3%分别加入到Silagum软衬材料和上海自凝软衬垫中,按国家相关标准检测其粘结强度、拉伸强度、拉伸伸长率、邵氏硬度的变化.结果:当T-Znow抗菌剂添加质量分数为2%时,软衬材料机...     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.     

Biochemical and molecular characterisation of cubozoan protein toxins

Class Cubozoa includes several species of box jellyfish that are harmful to humans. The venoms of box jellyfish are stored and discharged by nematocysts and contain a variety of bioactive proteins that are cytolytic, cytotoxic, inflammatory or lethal. Although cubozoan venoms generally share similar biological activities, the diverse range and severity of effects caused by different species indicate that their venoms vary in protein composition, activity and potency. To date, few individual venom proteins have been thoroughly characterised, however, accumulating evidence suggests that cubozoan jellyfish produce at least one group of homologous bioactive proteins that are labile, basic, haemolytic and similar in molecular mass (42-46 kDa). The novel box jellyfish toxins are also potentially lethal and the cause of cutaneous pain, inflammation and necrosis, similar to that observed in envenomed humans. Secondary structure analysis and remote protein homology predictions suggest that the box jellyfish toxins may act as α-pore-forming toxins. However, more research is required to elucidate their structures and investigate their mechanism(s) of action. The biological, biochemical and molecular characteristics of cubozoan venoms and their bioactive protein components are reviewed, with particular focus on cubozoan cytolysins and the newly emerging family of box jellyfish toxins.     

Dose tolerability of chronically inhaled voriconazole solution in rodents

Invasive pulmonary aspergillosis (IPA) is a fungal disease of the lung associated with high mortality rates in immunosuppressed patients despite treatment. Targeted drug delivery of aqueous voriconazole solutions has been shown in previous studies to produce high tissue and plasma drug concentrations as well as improved survival in a murine model of IPA. In the present study, rats were exposed to 20 min nebulizations of normal saline (control group) or aerosolized aqueous solutions of voriconazole at 15.625 mg (low dose group) or 31.25 mg (high dose group). Peak voriconazole concentrations in rat lung tissue and plasma after 3 days of twice daily dosing in the high dose group were 0.85 ± 0.63 μg/g wet lung weight and 0.58 ± 0.30 μg/mL, with low dose group lung and plasma concentrations of 0.38 ± 0.01 μg/g wet lung weight and 0.09 ± 0.06 μg/mL, respectively. Trough plasma concentrations were low but demonstrated some drug accumulation over 21 days of inhaled voriconazole administered twice daily. Following multiple inhaled doses, statistically significant but clinically irrelevant abnormalities in laboratory values were observed. Histopathology also revealed an increase in the number of alveolar macrophages but without inflammation or ulceration of the airway, interstitial changes, or edema. Inhaled voriconazole was well tolerated in a rat model of drug inhalation.