麻醉诱导时血压下降对术后恶心呕吐的影响

目的观察麻醉诱导时血压下降与术后恶心呕吐的关系。方法选择ASAⅠ-Ⅱ级的经腹胆囊切除术患者40例,按麻醉诱导时血压比基础值下降的程度分为2组,每组20例。A组SBP比基础血压下降>30%;B组SBP比基础血压下降<30%。术后随访病人48小时,记录病人恶心呕吐的发生情况。结果麻醉诱导时血压下降对术后恶心呕吐有明显影响。结论麻醉期间维持血流动力学稳定能降低PONV的发生。     

亚麻醉剂量丙泊酚对术后恶心呕吐的作用研究

目的:观察丙泊酚对术后恶心呕吐的的影响.方法:选择ASAI-Ⅱ级蛛网膜下腔和硬膜外联合穿刺麻醉下行妇科全子宫切除手术患者80例,随机分为4组,每组20例.C组为空白对照组,P组为安慰剂对照组,A组为恩丹西酮组,B组为丙泊酚组.结果:A组和B组的恶心和呕吐的发生率明显的低于C组(P＜0.05).P组和C组恶心呕吐的发生率无显著性差异.A组和B组术后恶心呕吐的发生率无显著性差异.结论:丙泊酚可降低椎管内麻醉患者术后恶心呕吐的发生率.     

手术后恶心呕吐的机制及其防治

在过去的几十年里,随着各种手术技术的不断提高和完善,已使外科手术的死亡率大幅降低,这使医生的注意力逐渐转向手术后的并发症和患者的满意程度上,如手术后恶心呕吐。恶心呕吐是术后严重的并发症之一,尽管术后恶心呕吐(Postoperativenausea and vomiting,PONV)是非致命性的并发症,但是PONV可导致严重的后果,并且增加了医疗费用,极大的影响了患者的满意程度。PONV高发率一直困扰着临床医生和患者。所以,探讨其发生及其风险因素是十分必要的。但是,术后恶心呕吐的病理生理学机制还不是十分清楚,本文总结了目前关于术后恶心呕吐发生机制的一些观点以及术后恶心呕吐的风险因素。虽然以往大量的文献报道了如何预防和治疗术后恶心呕吐,但迄今为止,5-HT3受体拮抗剂仍然是临床上使用的最主要的止吐药。目前,一些新药物,如NK-1受体拮抗剂、更加长效的5-HT3受体拮抗剂以及对于PONV高风险的病人实行的多模式管理和新技术的应用,正变得越来越突出。本文综述了现今手术后恶心呕吐的防治方法的最新进展。     

经皮穴位电刺激联合雷莫司琼对全麻术后恶心呕吐的影响

目的:评价经皮穴位电刺激联合盐酸雷莫司琼对全麻术后恶心呕吐(PONV)的影响。方法:选择择期拟行全麻腹腔镜手术患者90例,随机分为三组。Ⅰ组手术结束前15 min静脉给予盐酸雷莫司琼0.3 mg,Ⅱ组麻醉诱导前30 min给予经皮电刺激30 min,Ⅲ组重复上述两组操作。分别于入室(T0)、术毕(T1)、术后24 h(T2)采集外周静脉血样,测定胃泌素(GAS)浓度并记录术后24小时内PONV的发生情况。结果:与T0时比较,Ⅱ组、Ⅲ组T2时GAS浓度下降,Ⅰ组T2时GAS浓度升高(P0.05);与I组比较,T2时Ⅱ组、Ⅲ组GAS浓度降低(P0.05);与Ⅰ组、Ⅱ组比较,Ⅲ组术后PONV的发生率及发生的严重程度均下降(P0.05)。Ⅰ组、Ⅱ组间PONV发生率及发生的严重程度无明显差异(P0.05)。结论:经皮穴位电刺激可以降低全麻患者术后PONV的发生率,与盐酸雷莫司琼效果相近,二者联用止吐效果更佳,其机制可能与降低GAS浓度有关。     

地塞米松预防乳癌患者术后恶心呕吐的有效性和安全性的临床研究

目的：分析地塞米松对接受乳癌根治术的患者术后恶心呕吐、血糖、皮质醇、出血和感染的影响,明确其临床使用的有效性和安全性。方法：将160 例择期全麻下行单侧乳癌改良根治术的女性患者随机分为实验组（地塞米松组,n=80）和对照组（生理盐水组,n=80）。检测两组患者术后第1 天和第3 天血糖和血清皮质醇水平,记录术后1～3天恶心呕吐次数和抗呕吐药物的使用量,比较两组术后1 周内出血和感染的发生情况。结果：实验组患者术后第1 天的恶心发生率显著低于对照组,术后1～2 天的呕吐发生率均显著低于对照组,术后第1 天血清皮质醇较对照组显著降低（P〈0.05）。两组患者术后血糖水平比较无统计学差异（P〉0.05）。术后1 周内,两组患者出血和感染的发生情况比较均无显著性差异（P〉0.05）。结论：地塞米松可有效地预防乳癌改良根治术患者术后恶心呕吐,短暂抑制术后内源性皮质醇水平,不增加患者术后高血糖、出血和感染的风险。     

托烷司琼与帕洛诺司琼用于小儿骨科术后镇痛预防恶心呕吐的效果研究

摘要 目的：比较托烷司琼与帕洛诺司琼用于小儿骨科术后镇痛时预防恶心呕吐的效果。方法：纳入2019年3月到2021年3月在我院进行骨科手术的儿童60例,根据术后镇痛泵中使用止吐药物的不同分为托烷司琼组和帕洛诺司琼组,每组30例,比较两组患儿术前、术后的心率（HR）、平均动脉压（MAP）,在术后48小时内,观察两组患儿恶心呕吐、头晕头痛、皮肤瘙痒以及呼吸抑制等术后并发症。视觉模拟评分法（VAS）评估患儿术后疼痛,Ramsay量表评估患儿术后镇静效果。结果：托烷司琼和帕洛诺司琼组患儿在术前和术后HR和MAP比较均无显著差异（P>0.05）;托烷司琼组和帕洛诺司琼组患儿术后VAS评分、Ramsay评分均随时间延长而降低,且同一时间点两组患儿VAS评分无显著差异（P>0.05）;帕洛诺司琼组术后PONV发生率（20.00 %）高于托烷司琼组（3.33 %）（P<0.05）。帕洛诺司琼组和托烷司琼组患儿出现头晕头痛、皮肤瘙痒以及呼吸抑制例数分别为3/2例、1/0例和1/0例。两组间术后并发症发生率比较无差异（P>0.05）。结论：托烷司琼与帕洛诺司琼对骨科手术后儿童血流动力学、疼痛和镇静效果并无差异,但在预防术后恶心呕吐方面托烷司琼效果优于帕洛诺司琼。     

格拉司琼联合隔药灸治疗肝癌介入术后恶心呕吐临床观察

目的:观察格拉司琼联合隔药灸治疗肝癌介入术后恶心呕吐临床疗效。方法:将符合纳入标准的肝癌介入术后恶心呕吐患者72例,分为治疗组与对照组,每组36例,对照组给予注射用盐酸格拉司琼静脉滴注治疗,治疗组在对照组的基础上给予隔药灸治疗。观察两组患者恶心、呕吐症状、胃液引流量及胃管留置时间,统计临床疗效。结果:治疗后治疗组在恶心、呕吐症状评分、胃液引流量、胃管留置时间方面明显均低于对照组(均P0.05)。治疗组、对照组临床疗效总有效率分别为91.67%、72.22%,比较有统计学意义(P0.05)。结论:格拉司琼联合隔药灸可以明显改善肝癌介入术后恶心呕吐症状,缩短胃管留置时间,临床疗效显著。     

三种不同麻醉方式对产妇血流动力学及新生儿的影响

目的;探讨硬膜外麻醉、蛛网膜下腔-硬膜外麻、气管插管全麻三种不同麻醉方式对剖宫产产妇血流动力学及胎儿的影响。方法:纳入行择期剖宫产产妇152例,采用随机表法将其分为硬膜外组(48例)、腰硬联合麻醉组(52例)、气管内插管全麻组(52例)。观察麻醉前正常状态时(T1)、麻醉成功后5 min(T2)、胎儿娩出时(T3)三个时间点产妇SBP、DBP、HR、SV、CO、SVR及胎儿相关指标,包括出生后1 min、5 min Apgar评分、脐动脉血pH、PCO_2、PO_2。结果:硬膜外麻、腰麻-硬膜外联合麻醉、全麻三组间麻醉起效时间有明显统计学差异(P0.05),气管内插管全麻组起效时间最快。三组间在T1时间点SBP、DBP、HR、SV、CO、SVR差异无统计学意义(P0.05)。在T2时间点,硬膜外麻、联合麻醉、全麻三组SBP、DBP、HR、SVR水平均较T1时间点明显降低,差异有统计学意义(P0.05)。T2时间点,全麻组SBP、DBP、HR、SVR水平高于硬膜外、联合麻醉组(P0.05)。T3时间点三组SBP、DBP、HR、SV、CO水平均较T2时间相比差异有统计学意义(P0.05)。T3时间点,全麻组SBP、DBP、SVR高于其他两组,心率低于其他两组,差异有统计学意义(P0.05)。三组间新生儿出生后1 min Apagr、5 min Apgar评分、脐动脉血学pH、PCO_2无统计学差异(P0.05)。三组间脐动脉血PO_2有明显统计学差异(P0.05),气管内插管全麻组脐动脉血PO_2最高。结论:三种麻醉均可以用于剖宫产术,全麻剖宫产术对产妇血流动力学影响最小,起效快,但对胎儿脐动脉血氧浓度有一定的影响。     

高丽参注射液对硬膜外麻醉老年病人血流动力学的影响

硬膜外麻醉为老年手术病人常用的麻醉方法,然而,该方法常导致病人术中血压下降,影响手术的进行。既往常规使用乳酸林格氏液静脉滴注,仍未能获得满意的效果。我院研制的高丽参注射液用于多种休克病人,具有明显的“回阳救逆”的效果,升压效果持续稳定。应用于40例硬膜外麻醉的老年手术病人,亦获得较好的升压、稳压效果,现报告如下。     

吸氧对椎管内麻醉下剖宫产术后疼痛的影响

目的:评价麻醉前和术中持续吸氧对椎管内麻醉下剖宫产术后疼痛的效果。方法:选择ASAI-II级择期行剖宫产手术的初产妇100例,将其随机分为面罩吸氧组和空气吸入组(对照组)。吸氧组于术前30 min及术中通过面罩全程给氧,吸入氧浓度为60%,空气组则不给予特殊处理。检测和比较两组产妇不同时点的心率、血压及SpO2的变化,手术时间,视觉模拟评分(VAS),新生儿Apgar评分,胎儿氧饱和度,新生儿脐动静脉血气,产妇血气以及术后24 h内恶心呕吐的发生率。结果:两组产妇各时间点心率、血压、SpO2、手术时间及新生儿Apgar评分、胎儿氧饱和度比较均无显著性差异(P0.05)。吸氧组术后6 h、12 h、24 h的VAS评分分别为(4.07±0.10)、(2.13±0.12)和(0.42±0.08),均明显低于对照组的(6.10±0.11)、(4.02±0.13)及(1.10±0.22)(P0.05)。吸氧组新生儿脐动静脉血气、产妇血气氧分压均显著高于对照组(P0.05),术后24h内恶心呕吐的发生率显著低于对照组(P0.05)。结论:麻醉前和术中持续吸氧能显著减轻椎管内麻醉下剖宫产术后疼痛,同时有效降低术后恶心呕吐的发生率。     

Late chronotypes are associated with neoadjuvant chemotherapy-induced nausea and vomiting in women with breast cancer

Neoadjuvant chemotherapy, that is, the administration of chemotherapy before surgery, has been commonly used for locally advanced breast cancer to improve the surgical outcomes and increase the opportunity for breast-conserving therapy. Women with breast cancer often receive an anthracycline-based regimen as the neoadjuvant chemotherapy, which is associated with a high risk of emesis. Despite the development of novel antiemetics, chemotherapy-induced nausea and vomiting (CINV) has been commonly reported as a major adverse effect, affecting the quality of life of the patients. However, the factors predicting CINV in women with breast cancer undergoing neoadjuvant chemotherapy remain unclear. In this single-institution, prospective, observational study conducted at an outpatient cancer centre in the Republic of Korea from November 2013 to March 2016, we analysed women with breast cancer who planned to be treated with neoadjuvant chemotherapy before surgery. Candidate factors associated with CINV were assessed before neoadjuvant chemotherapy using the Munich Chronotype Questionnaire, Pittsburgh Sleep Quality Index and Hospital Anxiety and Depression Scale. CINV was assessed after chemotherapy by using the Multinational Association of Supportive Care in Cancer Antiemesis Tool. Of a total of 143 participants, 7 patients were lost to follow-up and 2 patients were excluded due to changes in their treatment plan; thus, 134 patients were finally included in the analyses. Overall, 48.5% of the participants experienced CINV, with delayed CINV prevalence (42.5%) being more common than acute (39.6%). In the univariate analyses, overall CINV was significantly associated with late chronotypes (odds ratio [OR], 3.49; 95% confidence interval [CI], 1.37–8.87; p = 0.009), a history of nausea/vomiting (OR, 2.19; 95% CI, 1.10–4.37; p = 0.026) and anxiety (OR, 2.25; 95% CI, 1.05–4.81; p = 0.036). In the multivariate analyses, late chronotypes (OR, 3.53; 95% CI, 1.27–9.79; p = 0.015) and a history of nausea/vomiting (OR, 2.83; 95% CI, 1.31–6.13; p = 0.008) remained significantly associated with CINV. In conclusion, in women with breast cancer undergoing neoadjuvant chemotherapy before surgery, late chronotypes were found to have an increased risk of CINV; these data suggest that clinicians need to assess and consider the chronotype in the management of CINV.     

The effects of carbon dioxide anesthesia and anoxia on rapid cold-hardening and chill coma recovery in Drosophila melanogaster

Carbon dioxide gas is used as an insect anesthetic in many laboratories, despite recent studies which have shown that CO(2) can alter behavior and fitness. We examine the effects of CO(2) and anoxia (N(2)) on cold tolerance, measuring the rapid cold-hardening (RCH) response and chill coma recovery in Drosophila melanogaster. Short exposures to CO(2) or N(2) do not significantly affect RCH, but 60 min of exposure negates RCH. Exposure to CO(2) anesthesia increases chill coma recovery time, but this effect disappears if the flies are given 90 min recovery in air before chill coma induction. Flies treated with N(2) show a similar pattern, but require significantly longer chill coma recovery times even after 90 min of recovery from anoxia. Our results suggest that CO(2) anesthesia is an acceptable way to manipulate flies before cold tolerance experiments (when using RCH or chill coma recovery as a measure), provided exposure duration is minimized and recovery is permitted before chill coma induction. However, we recommend that exposure to N(2) not be used as a method of anesthesia for chill coma studies.     

ACE activity during the hypotension produced by standardized aqueous extract of Cecropia glaziovii Sneth: A comparative study to captopril effects in rats

To evaluate the effect of the standardized aqueous extract (AE) of Cecropia glaziovii Sneth on the plasma angiotensin I converting enzyme (ACE-EC 3.4.15.1) activity, rats were treated with a single dose of AE (1 g/kg, p.o.) or repeatedly (0.5 g/kg/bid, p.o.) for 60 days. Captopril (50 mg/kg, p.o.) was used as positive control on the same animals. The effects on the blood pressure were recorded directly from the femoral artery (single dose), or indirectly by the tail cuff method (repeated doses) in conscious rats. The plasma ACE activity was determined spectrofluorimetrically using Hypuril-Hystidine-Leucine as substrate. The arterial blood pressure, heart rate and plasma ACE activity were not significantly modified within 24 h after a single dose administration of AE. Comparatively, blood pressure in captopril treated rats was reduced by 7-16% and heart rate was increased by 10-20% from 30 min to 24 h after drug administration. ACE activity after captopril presented a dual response: an immediate inhibition peaking at 30 min and a slow reversal to 32% up-regulation after 24 h. To correlate the drug effects upon repeated administration of either compound, normotensive rats were separated in three groups: animals with high ACE (48.8+/-2.6 nmol/min/ml), intermediate ACE (39.4+/-1.4 nmol/min/ml) and low ACE (23.5+/-0.6 nmol/min/ml) activity, significantly different among them. Repeated treatment with AE reduced the mean systolic blood pressure (121.7+/-0.5 mm Hg) by 20 mm Hg after 14 days. The hypotension was reversed upon washout 60 days afterwards. Likely, repeated captopril administration decreased blood pressure by 20 mm Hg throughout treatment in all groups. After 30 days treatment with AE (0.5 g/kg/bid, p.o.) the plasma ACE activity was unchanged in any experimental group. After captopril (50 mg/kg/bid, p.o.) administration the plasma ACE activity was inhibited by 50% within 1 h treatment but it was up-regulated by 120% after 12 h in all groups. It is concluded that the hypotension produced by prolonged treatment with AE of C. glaziovii is unrelated to ACE inhibition.     

短日照对休眠诱导期油桃花芽两条电子传递途径的调控

以油桃品种“曙光”为试材,采用呼吸抑制剂法研究了短日照处理下花芽在休眠诱导期两条电子传递途径的发生和运行情况.结果表明:花芽总呼吸速率(Vt)和细胞色素电子传递途径呼吸速率(ρ'Vcyt)均呈双峰曲线变化,短日照可同步诱导两者的一次峰前移、二次峰后延,抑制ρ’Vcyt,但对Vt无显著影响.交替途径容量(Valt)和实际运行活性(ρValt)亦呈双峰曲线,两者基本同步变化,短日照可以显著诱导Valt和ρValt的前期高峰期提前,提高Valt和ρValt,对后期高峰期无明显作用.细胞色素电子传递途径呼吸速率下降和交替途径呼吸速率上升是油桃花芽休眠诱导期的重要特点.从两条电子传递途径的呼吸速率对总呼吸速率的贡献率来看,细胞色素电子传递途径仍是主要电子传递途径,交替途径起辅助与分流作用.     

异丙酚复合布托啡诺辅助腰硬联合麻醉用于妇科腹腔镜手术

目的探讨异丙酚复合布托啡诺辅助腰硬联合麻醉应用于妇科腹腔镜手术的安全性和优越性。方法将50例行妇科腹腔镜手术患者随机分为两组,B组为异丙酚复合布托啡诺辅助腰硬联合麻醉组,F组为异丙酚复合芬太尼辅助腰硬联合麻醉组。术中保证患者睡眠、无体动。观察两组术中有无呼吸抑制、舌后坠及恶心呕吐,记录各时段生命体征及气腹时间、苏醒时间、异丙酚总用量。结果两组患者各时段的MAP、HR、RR、SpO2变化均在正常范围内。B组呼吸抑制、舌后坠、寒战发生率显著低于F组（P〈0.05）,异丙酚总用量显著少于F组（P〈0.05）。结论异丙酚复合布托啡诺辅助腰硬联合麻醉能为妇科短时间腹腔镜手术提供安全满意的麻醉效果。     

Effects of activated charcoal effects on induction and development of microtubers in potato (Solanurn tuberosum L.)

The aim of this research was to compare hormone-free medium with media with regulator substances (activated charcoal, cytokinins, polyamine biosynthesis inhibitor and chlorocholine chloride) used for microtuber induction and development. Explants of cvs Monalisa, Primura and Spunta were multiplied subculturing nodal segments on plant growth regulator-free Murashige & Skoog (1962) (MS) medium. When the plantlets had 6–8 nodes, single-node stem segments were excised and transferred to eight tuberisation media, each consisting of MS basal components supplemented with sucrose (8% w/v) and various regulator substances. The control was a regulator-free medium including only sucrose. Results were expressed as the number and weight of microtubers per nodal explant.
The cultivars showed wide variations in the mean weight of microtubers, ranging from 44.6 mg (Primura) to 77.5 mg (Spunta), and nearly all plants produced tubers. Medium containing activated charcoal gave the highest rate of tuberisation and the largest microtubers. It thus played a role in optimising conditions for rapid, mass tuberisation of these cultivars, and produced large microtubers for field planting.     

Changes in cotyledon mRNA during floral induction of Pharbitis nil CV. Violet

Floral induction in seedlings of Pharbitis nil Choisy cv. Violet, with one cotyledon removed, was manipulated by applying various photoperiodic treatments to the remaining cotyledon. Populations of polyadenylated RNA from treated cotyledons were examined to identify messages specifically involved in floral induction. The RNA was translated in vitro using a wheat-germ system, and the resulting translation products were analysed by two-dimensional polyacrylamide gel electrophoresis. Substantial qualitative and quantitative differences were found between mRNA from cotyledons of seedlings kept in continuous light (non-induced) and of seedlings given a 16-h dark period (induced). In contrast, inhibition of flowering with a night-break resulted only in one detectable, quantitative difference in mRNA.Abbreviations CL continuous light - kDa kilodalton - NB 16 h darkness+10 min red-light break, 8 h into the dark period - poly(A)⁺ RNA polyadenylated RNA (isolated by binding to a cellulose oligodeoxythymidine affinity column) - SD short day (16 h dark) - SDP short-day plant - SDS sodium dodecyl sulfate     

Cytological effects of urethan on cleavage induction in parthenogenetically activated sea urchin eggs

The effect of urethan on artificial induction of cleavage in eggs of the sea urchin, Hemicentrotus pulcherrimus, was studied. When the eggs were exposed for 20 minutes to seawater containing urethan (final concentration, 0.08 M) after butyric acid-activation and then treated with hypertonic seawater, the cleavage rate was enchanced by about 1.5 times as compared with the nontreated eggs. In the eggs exposed to urethan–seawater for over 70 minutes many clear spots appeared throughout the cytoplasm. Simultaneously, the pigment granules, which had been embedded within the cortex, migrated to the inner cytoplasm and encircled a monastral centrosphere and clear spots. The clear spots were composed of microtubules much like cytasters, and in the central region of them centrioles were not yet found. The eggs in which the pigment granules disappeared from the cortex may be more susceptible to cleavage induction by succeeding hypertonic treatment.     

海岛棉愈伤组织诱导和分化研究

以海岛棉无菌苗的胚根、下胚轴和子叶作外植体,对这３种器官在离体培养中愈伤组织诱导、分化以及影响因素进行了研究。结果表明：下胚轴作外植体效果最好,愈伤组织生长块、质地好,有芽的分化,进而可再生出植株。胚根效果很差,愈伤组织产生很少而且很易褐化死亡。子叶效果不好,愈伤组织少、生长慢无分化。外源激素中２．４－Ｄ与ＫＴ配合使用效果好,愈伤组织可以分化。无菌苗生长状态及培养基中非激素成分对愈伤组织诱导和分化