异丙酚复合瑞芬太尼支持喉镜TCI麻醉的临床研究

目的:观察异丙酚复合瑞芬太尼TCI麻醉用于声带息肉摘除术的麻醉效果.方法:ASAⅠ～Ⅱ级择期声带息肉摘除术患者40例,随机分为2组,A组为TCI麻醉组,以异丙酚复合瑞芬太尼TCI维持,B组为静吸复合麻醉组,以七氟醚吸入维持.2组均采用同一方法诱导,行气管插管.观察记录麻醉诱导前(T1)、插管即刻(T2)、置入支撑喉镜时(T3)、置入喉镜后3 min(T4)、取出喉镜时(T5),各时间点的收缩压、舒张压、心率、BIS值的变化,记录自主呼吸恢复时间、拔管时间、完全清醒时间.结果:A组置入支撑喉镜时、置入喉镜后3 min收缩压、舒张压、心率变化无统计学意义,而B组的收缩压、舒张压、心率变化较大;A组自主呼吸恢复时间、拔管、完全清醒时间明显短于B组(P＜0.05).A组术后恶心、呕吐、躁动例数明显少于B组(P＜0.05).结论:异丙酚复合瑞芬太尼TCI麻醉可以有效抑制置入支撑喉镜时引起的血流动力学变化,苏醒迅速,副作用少,在声带息肉手术维持中明显优于七氟醚.     

清醒猫摄食过程中的胃电活动

本文报告慢性清醒猫正常摄食过程中胃电的变化,以及脑室注射心得安和动物麻醉对胃电的影响。结果显示,空腹饥饿状态下,猫胃电图上出现具有特征性的高振幅的“饥饿波”;摄食时胃电慢波抑制,可见较小快波;进食后半小时左右,胃电开始出现每分钟4—5次的振幅逐渐增大的正弦形慢波,多数慢波负载有快波。脑室注射心得安,可使饱猫胃电慢波抑制期出现饥饿波。动物在饥饿时麻醉,胃电慢波幅度显著降低,饥饿波完全不出现,苏醒后逐渐恢复。     

鼻咽喷射通气在无痛胃镜检查应用的安全性分析

目的:分析鼻咽喷射通气在无痛胃镜检查的应用安全性.方法:将94例自愿选择无痛胃镜检查的患者按简单随机抽样分为3组,A组鼻导管给氧;B组患者不给氧,SPO2降低至90％时面罩给氧;C组患者行鼻咽高频喷射通气.比较3组患者麻醉前后SPO2、呼吸频率以及麻醉相关不良反应.结果:A组患者麻醉后2分钟与麻醉前比较SPO2降低,之后逐步回升至麻醉前水平;其中有6例病人SPO2降低至90％需面罩给氧.B组患者从2分钟开始SPO2下降,直到8分钟开始回升,10分钟后仍未达到麻醉前水平;其中17例患者SPO2下降至90％需要面罩给氧.C组患者SPO2平稳,麻醉前与麻醉后相比未发生明显降低.麻醉后所有患者的呼吸频率均有所下降,8分钟开始呼吸频率逐渐恢复至麻醉前水平.三组患者均为发生麻醉相关不良反应.结论:无痛胃镜应提前给氧以避免危险发生,鼻导管通气有一定的缺点.鼻咽高频喷射通气更加安全、有效,值得临床推广.     

两种用于小型猪胰肾联合移植实验麻醉方法的比较

目的比较静脉复合吸入全麻和静脉全麻两种方法用于小型猪胰肾联合移植实验中的麻醉效果,探讨简单、安全、易行的麻醉方法。方法A、B两组健康贵州小香猪,每组6只,基础麻醉后气管插管,A组：持续吸入异氟醚维持麻醉,根据手术要求间断注入万可松和芬太尼;B组：持续注入氯胺酮,间断静脉注射万可松和芬太尼维持麻醉。观察麻醉持续时间,镇痛和肌松药量,术后拔管和完全清醒时间,监测麻醉过程中血压、心率、脉搏氧的变化。结果A组术中麻醉效果好,血压、心率和脉搏氧稳定,与B组有显著差异（P〈0.05）;B组麻醉效果较差,肌松用药量明显增多,术后完全清醒时间长于A组（P〈0.05）。结论气管插管后静吸复合的麻醉方法是用于贵州小型猪实验安全、合适的麻醉方法。     

模拟50米氮氧饱和潜水5昼夜过程中高、低二氧化碳对人体脑电图的影响

本文报道人体暴露于50米氮氧饱和条件下高、低 CO_2对脑电图的影响。1.在50米氮氧暴露时静息脑电图上的α波频率下降,振幅降低,指数减少,而慢波指数明显增多。有的受测者在暴露期,脑电图上可表现为以慢波占优势,主要为θ波,也有少量δ波,此时给予光刺激可使慢波暂时消失,α波暂时恢复。高压下在脑电图发生明显变化时,某些受测者可出现一些神经症状,如头痛、头昏、噁心、呕吐等。随着在高压下暴露时间的延长,症状消失。减至常压后脑电图能很快恢复到加压前的水平。2.在常压下过度通气造成体内低二氧化碳,可引起脑电图上慢波的增加;而在高压下,当静息脑电图以慢波占优势时,过度通气所致的低二氧化碳可引起慢波成分的减少。在常压下重复呼吸造成体内高二氧化碳时,脑电图出现变化;而在高压下高二氧化碳可以引起脑电图更为明显变化。     

生态恢复对马尾松叶片化学计量及氮磷转移的影响

为了解生态恢复对侵蚀红壤恢复的马尾松林叶片碳氮磷化学计量及氮磷养分转移的影响,在福建省长汀县河田镇典型侵蚀红壤区选取恢复13、30、33a的马尾松林为研究对象,并以未治理侵蚀地(CK1)和次生林(CK2)分别作为恢复前和恢复后的对照,通过测定马尾松叶片的碳、氮、磷含量,计算其计量比,内稳性指数和氮磷转移率,分析了侵蚀红壤生长的马尾松养分限制与养分转移的关系。结果表明:在侵蚀红壤恢复过程中,马尾松1年龄叶片C、N、P含量及1年龄叶片C∶N、C∶P、N∶P变化较小,这与马尾松较高的内稳性有关(N和P内稳性指数分别为7.57和3.89)。所有实验地马尾松1年龄叶片N∶P处于11.0—13.4之间,表明马尾松的生长受N、P共同限制,其中马尾松叶片N转移率显著低于P转移率,这与生态恢复过程中马尾松养分利用效率、生长需求以及土壤养分供应状况有关。1年龄叶片C∶N、C∶P分别与马尾松N、P转移率成负相关关系,当马尾松叶片C∶N、C∶P较低时,表明N、P利用效率较低,叶片衰老时更多的N和P被转移利用;反之,则N、P利用效率较高,转移率低。同时,C∶N、C∶P分别与树高、胸径成显著负相关关系,即马尾松生长对N、P的需求同样会影响化学计量比的变化,从而影响养分转移。虽然侵蚀地生态恢复过程中土壤N、P含量增加,但仍较贫瘠,不足以满足马尾松的生长,马尾松养分转移率较高,因此,为了提高侵蚀地恢复的马尾松林的生产力,建议下一步恢复措施中适当施加N肥和P肥。该研究将侵蚀红壤不同生态恢复年限的马尾松叶片C、N、P化学计量及养分转移结合,有助于全面、系统地揭示生态恢复过程马尾松林的养分循环,对指导侵蚀红壤恢复和提高马尾松生产力具有重要意义。     

舒芬太尼联合地塞米松对肺癌患者气管拔管时血流动力学的影响

目的：观察联合应用舒芬太尼和地塞米松对肺癌患者双腔支气管拔管时血流动力学的影响。方法：选择在全麻下行肺癌根治术的患者60例,ASA分级Ⅰ-Ⅱ级,随机分为三组,舒芬太尼组（s组）、舒芬太尼联合地塞米松组（SD组）和生理盐水组（N组）,每组20例。SD组于麻醉诱导前静脉推注10 mg地塞米松,手术结束前30 min静脉推注0.15μg/kg舒芬太尼;S组、N组分别于手术结束前30 min静脉推注0.15μg/kg舒芬太尼和2 mL生理盐水;记录麻醉诱导前（T0）、拔管即刻（T1）、拔管后3 min（T2）及拔管后5 min（T3）时的心率（HR）,平均动脉压（MAP）,并计算心率与收缩压的乘积（RPP）;术毕后麻醉恢复时间：自主呼吸恢复时间、睁眼时间、拔管时间。结果：与麻醉诱导前（T0）相比,S组、SD组在手术拔管期各时间点的MAP,HR,RPP变化幅度明显低于N组（P〈0.05）;SD组较S组血流动力学更加平稳（P〈0.05）。S组、SD组虽然自主呼吸恢复时间和睁眼时间与N组比较有所延长,但拔管时间并无显著性差（P〉0.05）,且S组、SD组比较无统计学差异（P〉0.05）。结论：应用舒芬太尼联合地塞米松可以使双腔支气管导管拔管时的血流动力学更加平稳。     

清醒猫与乌拉坦麻醉猫的心电图比较

本文对清醒站位、乌拉坦麻醉站位和仰卧位的猫心电图参数做了统计比较。乌拉坦麻醉可使猫心电图各波和间期时间延长,心率减慢。对各波振幅和出现率亦有不同程度影响,以11导联 Q 波变化较明显。麻醉后的不同体位对各导联图型影响不很明显。     

应用无创通气治疗56例COPD患者呼吸衰竭的临床分析

目的探讨无创通气在慢性阻塞性肺疾病（COPD）呼吸衰竭的应用价值。方法将急性加重期COPD患者56例分为无创通气组26例和有创通气组30例,观察患者上机前、上机后30min、上机后2天的血气变化,机械通气天数,住院天数。费用及并发感染等指标。结果有创通气组上机30min后PaO2升高、PaCO2下降、pH的恢复幅度明显快于无创通气组（P〈0．01）.但2天后两组PaO2、PaCO2、pH差异无显著性（P〉0．05）。无创通气组机械通气天数、住院天数、费用以及院内感染的发病率明显低于有创通气组（P〈0．01）。无创通气组明显嗜睡者12例．占27．3％,其中10例经无创通气治疗后清醒,无需有创通气。结论无创通气治疗急性加重期COPD患者呼吸衰竭是一种方便有效的方法。     

全麻及全麻复合硬膜外麻醉对胃癌手术患者凝血功能的影响对比

目的:探讨全麻及全麻复合硬膜外麻醉对胃癌手术患者凝血功能的影响。方法:选择2013年1月~2015年12月我院收治的60例胃癌根治术患者,随机均分为全麻组(A组)及全麻复合硬膜外麻醉组(B组)。对比两组患者的术后恢复情况、T0(术前)、T1(术毕)、T2(术后24 h)、T3(术后72 h)的血浆纤维蛋白原(FIB)、凝血酶时间(TT)、血浆凝血酶原时间(PT)、部分活化凝血酶时间(APTT)、血小板计数(PLT)及血栓素B2(TXB2)值。结果:B组的清醒时间、自主呼吸恢复时间、拔管时间及异丙酚维持麻醉用量明显低于A组(P分别为0.044、0.036、0.042);与T0相比,B组PT、APTT在T2、T3时明显延长(P0.05),A组及B组的FIB在T2、T3时明显升高(P0.05),而B组明显低于A组(P0.05);与T0相比,两组PLT在T2、T3点时明显降低(P0.05),且A组明显低于B组(P0.05);两组TXB2在T2、T3点时明显升高(P0.05),且A组明显高于B组(P0.05)。结论:全麻复合硬膜外麻醉效果确切,可以减少对患者凝血系统的影响,预防术后血栓性疾病的发生,值得临床推广应用。     

去甲肾上腺素,甘氨酸,γ—氨基丁酸和L—谷氨酸对节段性与下行性...

Noradrenaline (NE), glucine (GLY), gamma-aminobutyric acid (GABA) and L-glutamic acid (L-GLU) were locally applied to the dorsal surface of lumbar spinal cord on anesthetized and immobilized rats and their effects on segmental (SP) and descending (DP) spinal field potentials were examined. Both waves N and P of SP and DP were reduced markedly in amplitudes following local application of NE. A significant decrease in amplitude of wave N and a remarkable increase in wave P in both SP and DP were shown during the application of GLY, GABA and L-GLU. The results suggest that these neurotransmitters may be involved in the generation of waves N and P, particularly affecting the activities of interneurons in the spinal dorsal horn.     

The evoked cortical activity of the cerebral hemispheres in man during the active and passive perception of facial expression]

Twenty-two right-handed subjects were asked either to identify sad, neutral, or laughing faces presented on a computer monitor or to view passively the same pictures without classification. Visual evoked potentials were recorded from F3/4, C3/4, P3/4, O1/2, and T5/6 derivations. In comparison with the passive viewing, the emotion recognition was characterized by the higher level of cortical activity reflected in the higher N1, N2, N3 amplitudes and shortened latencies of N1, P2, and N2 waves. In contrast, the latencies of the later P3 and N3 waves were longer. During emotion recognition, the dynamical brain mapping technique revealed symmetrical activation of the frontocentral areas and only the right-side activation during the passive perception. Factor analysis demonstrated a complication of N2 structure in the task of face emotion recognition. A principal component corresponding to the descending part of the N2 wave was revealed, which probably reflected the stage of image classification.     

视力与视觉诱发电位的相关分析

对104例病人的图形翻转VEP的瞬态波形各参数,以及9例正常或近视学生的稳态曲线功率谱与视力之间的关系进行了多元相关统计分析,旨在探讨VEP的哪些参数可客观地评估视力.结果表明,瞬态VEP的波形参数中以13’格诱发的N_1P_1、P_1N_2的峰峰值及P_(100)潜伏期与视力的相关系数最大,故认为,分析视力时以平均P_(100)波的波幅值和P_(100)波潜伏期作指标较为灵敏;而稳态、VEP能谱曲线则显示,视力与平均相叶能谱或刺激频率点的能谱相关性较大,与二次谐波的相关性则小.     

Dorsal root potentials evoked by stimulation of cutaneous afferents in the spinal cat (study of the N3 wave)

The comparative study, when stimulation is increased, of the amplitude changes shown by the negative waves of dorsal root potentials, indicates that the N1 and N2 waves are evoked by A alpha cutaneous afferent, whereas N3 wave is due to A alpha, A beta and perhaps A delta cutaneous afferents. On the other hand, a possible inhibitory action of N1, N2 negative complex on N3 wave is postulated.     

兔孤束核腹外侧区微量注射谷氨酸钠及甘氨酸对弓状核诱发电位的影响

实验在６６只麻醉、制动,断双侧颈迷走神经和人工通气的家兔上进行。通过微量注射神经元胞体兴奋剂谷氨酸钠和神经元胞体抑制剂甘氨酸,改变孤束核腹外侧区神经元兴奋活动,探讨对下丘脑弓状核诱发电位的影响及其可能的机制和意义。实验结果如下：（１）孤束核腹外侧区微量注射谷氨酸钠,可使膈神经放电显著增加和使弓状核诱发电位Ｐ２及Ｎ２波幅显著降低;而微量注射甘氨酸则使膈神经放电显著减少和使弓状核诱发电位Ｐ２及Ｎ２波幅显著增大。（２）静脉注射纳洛酮对谷氨酸钠引起的膈神经放电兴奋效应无明显影响,但能翻转谷氨酸钠对弓状核诱发电位Ｐ２及Ｎ２波幅的抑制效应。提示：孤束核腹外侧区呼吸神经元的兴奋活动可扩散至弓状核,并对弓状核诱发电位产生影响,此影响可能是由内源性阿片系统参与而实现的。     

Changes in visual evoked potentials observed in humans involved in cleanup work after the Chernobyl’ catastrophe

We studied the parameters of visual evoked potentials (VEP) recorded in humans involved in the cleanup work after the Chernobyl’ catastrophe and in persons of the control group. The VEP evoked by presentation of a reversing chessboard pattern were significantly modified in the group of cleanup workers: in many subjects their shape was drastically changed, the mean latent periods for P100 and N145 waves increased, and their amplitudes significantly dropped. The amplitude of the P200 component somewhat increased in the group of cleanup workers. Possible reasons for the observed changes in the evoked electrical activity and the mechanisms underlying the changes in the visual analyzer of the persons subjected to long-term irradiation are discussed.     

Spinal cord potentials evoked by stimulation of cutaneous afferents in the cat spine (evidence of an N3 wave)]

Negative intermediary cord potentials evoked by low threshold cutaneous afferents were recorded from the surface of the lumbosacral spinal cord. In addition to the N1, N2 waves classically described, it is possible to distinguish a third one names here N3 wave. The characteristics and longitudinal distribution of this wave are different from those of N1 or N2.     

Various forms of potentials recorded from caudate nucleus neurons

Spontaneous and evoked activity of caudate nucleus neurons was recorded extracellularly in acute experiments on cats. Different forms of potentials were found by analysis of the results. The potentials recorded belong to three types: ordinary action potentials; prepotentials or incomplete spikes differing from ordinary action potentials in their lower amplitude and slower decline, and complex discharges in which a spike of somewhat reduced amplitude is followed by a slow positive-negative wave. In the spontaneous activity prepotentials were observed both in complete action potentials and in isolation. The frequency of the complex discharges was 0.5–1 per second. The slow wave of these discharges blocked prepotential and action potential formation. The origin of these forms of potentials in neurons of the caudate nucleus is discussed and they are compared with analogous forms of potentials described for the Purkinje cells of the cerebellum.A. A. Bogomolets Institute of Physiology, Academy of Sciences of the Ukranian SSR, Kiev. Translated from Neirofiziologiya, Vol. 9, No. 2, pp. 149–156, March–April, 1977.     

Personality-related differences in recognition of facial emotional expression and cortical evoked potentials

A correlation between some characteristics of the visual evoked potentials and individual personality traits (by the Kettell scale) was revealed in 40 healthy subjects when they recognized facial expressions of anger and fear. As compared to emotionally stable subjects, emotionally unstable subjects had shorter latencies of evoked potentials and suppressed late negativity in the occipital and temporal areas. In contrast, amplitude of these waves in the frontal areas was increased. In emotionally stable group of subjects differences in the evoked potentials related to emotional expressions were evident throughout the whole signal processing beginning from the early sensory stage (P1 wave). In emotionally unstable group differences in the evoked potentials related to recognized emotional expressions developed later. Sensitivity of the evoked potentials to emotional salience of faces was also more pronounced in the emotionally stable group. The involvement of the frontal cortex, amygdala, and the anterior cingulate cortex in the development of individual features of recognition of facial expressions of anger and fear is discussed.     

The effects of H2O2 on electromechanical activity of the ileum longitudinal muscle

The effects of H2O2 on electrical and mechanical activity of the longitudinal layer from the guinea-pig ileum were studied using sucrose-gap technique and the influence of H2O2 on ionic current was investigated in single smooth muscle cells by the patch-clamp method. In most of the preparations tested, the spontaneous activity observed was composed of slow waves with superimposed action potentials (APs). Both were resistant to tetrodotoxin and atropine. H2O2 (1 mmol/l) evoked sustained 3-5 mV membrane depolarisation, doubled the amplitude of the slow waves and increased their frequency, augmented the APs and reduced their splitting. These changes were accompanied with significant contraction, which had an amplitude comparable to that of the tonic component of 50 mmol/l K+-induced contraction. Calcium-free solution caused membrane depolarisation, reduction of the slow wave amplitude and frequency, disappearance of APs and decreased the mechanical tension of the preparations. Application of H2O2 (1 mmol/l) into the zero-calcium bath solution recovered the APs, which was accompanied by a low amplitude contraction. H2O2 (up to 1 mmol/l) increased the L-type calcium current (I(Ca)) both under conventional whole-cell patch-clamp configuration and under amphotericin-perforated patches by 16 +/- 3%. These data demonstrated that contractile response of the ileum longitudinal smooth muscle preparation evoked by H2O2 was mainly due to the enhanced electrical activity.