异丙酚与微量氯胺酮联合用于人工流产术

５０例人工流产患者随机分为两组。Ｉ组：静注异丙酚１ｍｇ／ｋｇ和氯胺酮０．２ｍｇ／ｋｇ：Ⅱ组：单次静注异丙酚２ｍｇ－２．５ｍｇ／ｋｇ,术中必要时可追加异丙酚２０－３０ｍｇ以维持适当的麻醉深度。术中观察两组血压、心率、氧饱和度（ＳｐＯ２）记录麻醉时间、苏醒时间及异丙酚的总量。结果表明：微量氯胺酮能增强异丙酚的麻醉作用,而并未加重其对循环、呼吸的抑制作用,且麻醉苏醒时间和质量不受影响。结论：单用异丙酚或与氯胺酮联合用于人工流产术均为安全、有效、可行的麻醉方式,但后者在使用中更具优势。     

异丙酚、咪唑安定在全麻诱导中的联合应用

比较异丙酚、咪唑安定或两药联合应用在全麻诱导中的效应。方法３６例无心血管疾病、年龄＜６０岁（２０～５７岁）的择期全麻手术病人，随机分为４组。Ⅰ组采用异丙酚２．０ｍｇ／ｋｇ，Ⅱ组采用异丙酚２．５ｍｇ／ｋｇ，Ⅲ组采用咪唑安定０．３ｍｇ／ｋｇ，Ⅳ组采用异丙酚１．５ｍｇ／ｋｇ合并咪唑安定０．１ｍｇ／ｋｇ，辅以芬太尼、维库溴胺诱导插管。观察各组的起效时间及诱导、插管后的循环变化。结果单独采用异丙酚或咪唑安定诱导后，血压下降明显，且异丙酚２．０ｍｇ／ｋｇ不足于抑制插管应激反应，另咪唑安定起效慢；异丙酚合并咪唑安定组诱导起效快，与异丙酚组相比无差异，诱导后循环变化小，能有效抑制插管应激反应。结论异丙酚１．５ｍｇ／ｋｇ合并小剂量咪唑安定（０．１ｍｇ／ｋｇ）用于麻醉诱导，诱导迅速、循环稳定、效果确切，是一种较为合理的麻醉诱导方法。     

异丙酚,咪唑安定在全麻诱导中的联合应用

目的 比较异丙酚，咪唑安定或两药联合应用在全麻诱导的中的效应。方法 ３６例无心血管疾病，年龄〈６０岁（２０～５７岁）的择期全麻手术病人，随机分为４组，Ｉ组采用异丙酚２．０ｍｇ／ｋｇ，Ⅱ组采用异丙酚２．５ｍｇ／ｋｇ，Ⅲ组采用咪唑安定０．３ｍｇ／ｋｇ，Ⅳ期采用异丙酚１．５ｍｇ／ｋｇ合并咪唑安定０．１ｍｇ／ｋｇ，辅以芬太尼，维库溴胺诱导插管。观察各组的起效时间及诱导，插管后的循环变化，结果 单独采用异丙     

异丙酚伍用不同药物用于人工流产术麻醉的观察

目的 观察异丙酚分别伍用芬太尼、氯胺酮、咪唑安定用于人工流产术麻醉时的临床效果及对呼吸、循环的影响。方法 80例人工流产孕妇，分为单纯异丙酚组(I组)、复合芬太尼组(Ⅱ组)、复合氯胺酮组(Ⅲ组)、复合咪唑安定组(Ⅳ组)，Ⅱ、Ⅲ、Ⅳ组于异丙酚静注前分别给予芬太尼0．8μg/kg、氯胺酮0．3mg／kg、咪唑安定0.04mg／kg，观察异丙酚用量、麻醉效果、对呼吸循环的影响。结果 Ⅰ组、Ⅳ组用药2min后血压、心率明显下降(P＜0．01)，Ⅱ、Ⅲ、Ⅳ组异丙酚用量比I组明显减少(P＜0．01)，Ⅱ、Ⅲ、Ⅳ组麻醉效果优于I组，Ⅳ组苏醒时间延长(P＜0．05)。结论 芬太尼、氯胺酮、咪唑安定均可提高异丙酚的麻醉效能，减少异丙酚用于人工流产术麻醉时的用量。氯胺酮可对抗异丙酚的降血压作用，咪唑安定可使异丙酚静脉麻醉的苏醒期延长。     

异丙酚辅助硬膜外麻醉的临床观察

腹盆腔手术２００例行硬膜外阻滞，局部药为２％利多卡因１０ｍｌ＋０．３％地卡因１０ｍｌ＋１：２０万Ｕ肾上腺素，麻醉平面出现后，随机分组，异丙酚组１００例，术前５ｍｉｎ静滴异丙酚稀释（５％ＧＳ４份＋异丙酚１份），负荷量为１０ｍｇ／ｋｇ，维持量２￣４ｍｇ／ｋｇ。氟芬合剂组１００例，术前５ｍｉｎ静注氟芬合剂２￣３ｍｌ作为对照组。结果两组均能满足手术要求，术中Ｐ、Ｒ、ＭＢＰ、ＳＰＯ２、ＥＴＣＯ２等指标两组无     

依托咪脂,异丙酚在人工流产术中的应用比较

５３例人工流产患者随机分成两组，麻醉药一组应用异丙酚２．５ｍｇ／ｋｇ，另一组应用依托咪脂０．３ｍｇ／ｋｇ。结果表明：两组均起效快，效果良好，确定、苏醒恢复快；对呼吸循环系有一定抑制作用，异丙酚无术中、术后不良反应，依托咪脂术中、术后不良反应发生率较高。建议对有经济随能力的患者首选异丙酚。     

氯胺酮复合异丙酚用于小儿麻醉的临床观察

选择小儿肿瘤择期手术４０例，ＡＳＡⅠ￣Ⅱ级，随机分为氯胺酮－异丙酚（Ｐ组）少单用氯胺酮（Ｋ组）两组，两组均肌注氯胺酮５ｍｇ￣１０ｍｇ／ｍｇ做基础麻醉，Ｐ组以氯胺酮１ｍｇ／ｋｇ和异丙酚２ｍｇ￣２．５ｍｇ／ｋｇ静脉维持；Ｋ组单用氯胺酮１．５ｍｇ￣２ｍｇ／ｋｇ静脉维持；观察两组给药后血压、心率、脉搏血氧饱和度的比较。结果：Ｋ组血压（ＢＰ）、心率（ＨＲ）明显上升；Ｐ组血压（ＢＰ）、心率（ＨＲ）均维持在正常     

异丙酚并高频喷射通气用于小儿气管异物取出术

我们采用异丙酚合并高频喷射通气（ＨＦＪＶ）用于小儿气管异物取出术,并与氯胺酮复合全麻进行比较,现报告如下。资料与方法气管异物取出术３０例,年龄１岁～１２岁,其中男１８例,女１２例,体重８ｋｇ～３４ｋｇ。术前均肌注阿托品０．０２ｍｇ／ｋｇ,苯巴比妥钠５ｍｇ／ｋｇ。患者分两组,Ａ组１５例,用安定０．４ｍｇ／ｋｇ,异丙酚（１．５～２）ｍｇ／ｋｇ诱导,间断注射异丙酚０．５ｍｇ／ｋｇ维持;Ｂ组用安定０．４ｍｇ／ｋｇ,氯胺酮（１～２）ｍｇ／ｋｇ诱导,间断静注氯胺酮首量的一半维持。Ａ组患者中３岁以上加用芬太尼…     

利多卡因预防异丙酚静注痛的最佳剂量探讨

为探讨利多卡因预防异丙酚静注痛的最佳剂量，１２０例ＡＳＡＩ～Ⅱ级择期手术患者，随机分为例数相等的四组，Ｉ组：异丙酚，Ⅱ组：异丙酚＋利多卡因０．１ｍｇ／ｋｇ；Ⅲ组：异丙酚＋利多卡因０．３ｍｇ／ｋｇ，Ⅳ组：异丙酚＋利多卡因０．５ｍｇ／ｋｇ。异丙酚的用量均为２．５ｍｇ／ｋｇ，结果：Ⅱ，Ⅲ，Ⅳ组异丙酚静注痛的发生率明显低于Ｉ组（Ｐ〈０．０１～０．０５），而Ⅱ，Ⅲ，Ⅳ组间异丙酚静注痛的发生率无显著性差异（Ｐ     

咪唑安定、安定在儿童氯胺酮麻醉中的不同作用

目的：观察比较安定和咪唑安定对儿童氯胺酮麻醉中的不同影响,寻求氯胺酮与苯二氮Ｚｈｕｏ类药物的理想配伍。方法：儿童静脉全麻６０例,ＡＳＡ为Ⅰ～Ⅱ级,随机分为三组,每组２０例。分别静脉注射氯胺酮２ｍｇ／ｋｇ（Ⅰ组）、安定５ｍｇ／ｋｇ（Ⅱ组）、咪唑安定０．２ｍｇ／ｋｇ（Ⅲ组）为诱导,以氯胺酮２０～５０μｇ／ｋｇ．ｍｉｎ泵注维持。记录各不同时段的ＳＰＯ２、ＨＲ、ＭＡＰ及术后苏醒时间,精神症状及恶心呕吐发生率。结果：（１）Ⅲ组的心血管系统的稳定性较Ⅰ组、Ⅱ组都强。Ⅱ组Ⅲ组无明显的呼吸抑制。（２）Ⅲ组苏醒时间较Ⅰ组、Ⅱ组明显缩短,精神症状及恶心、呕吐发生率较Ⅰ组、Ⅱ组也低。结论：咪发定与氯胺酮复合麻醉用于儿童在保持心血管系统稳定,缩短苏醒时间及降低并发症等方面,更具优越性。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.