芬太尼与丙泊酚联合用于无痛人工流产的临床分析

目的观察芬太尼与丙泊酚联合用于无痛人工流产的临床效果。方法随机抽取2015年3月~2016年3月在我院自愿行无痛人工流产术患者110例,按随机数字表法分为观察组和对照组,每组55例。观察组给予芬太尼与丙泊酚联合麻醉,对照组单纯用丙泊酚麻醉,观察比较两组患者的麻醉效果,麻醉起效时间、作用持续时间,丙泊酚用量及不良反应发生情况。结果观察组的麻醉总有效率为100.0%,对照组为85.5%,两组比较差异有统计学意义(P0.05);观察组患者的麻醉起效时间、作用持续时间、丙泊酚用量均优于对照组,差异均有统计学意义(均P0.05);观察组不良反应发生率为5.5%,明显低于对照组的20.0%,差异有统计学意义(P0.05)。结论芬太尼与丙泊酚联合用于无痛人工流产手术,能获得较单纯用丙泊酚麻醉更为显著的临床效果,且不良反应少,值得临床推广。     

芬太尼与丙泊酚联合应用于无痛流产的临床观察

传统的人工流产手术方法使许多妇女都经历过难以忍受的疼痛．甚至有一些妇女为此恐惧性生活,担心怀孕再次经历手术的痛苦。我院自2007年1月～2009年12月在麻醉医师的配合下,采用芬太尼、丙泊酚复合静脉麻醉下行人工流产术150例,取得较好的疗效,现报告如下。     

帕瑞昔布钠超前镇痛应用于无痛人工流产术的临床实验研究

目的:探讨帕瑞昔布钠用于无痛人工流产术的临床效果及其安全性.方法:120例人工流产术患者随机分为帕瑞昔布钠组和芬太尼组,对比分析两组丙泊酚的用量、唤醒时间、术中生命体征、麻醉效果、不良反应的发生情况和术后VAS评分.结果:帕瑞昔布钠组丙泊酚用量及苏醒时间均短于芬太尼组,术中血流动力学变化较芬太尼组稳定,且不良反应的发生率和VAS评分也显著低于芬太尼组(P＜0.05).结论:帕瑞昔布钠可显著减少无痛人流术中丙泊酚的总用量,麻醉效果良好,且无明显不良反应,是一种可用于无痛人工流产术的安全、有效的药物.     

盐酸戊乙奎醚与丙泊酚联合用于无痛人工流产术的临床研究

目的:评价盐酸戊乙奎醚联合丙泊酚减轻人工流产术后疼痛的效果.方法:ASAⅠ-H级人工流产术患者100例,随机分为观察组和对照组.处理组先缓慢静脉注射盐酸戊乙奎醚注射剂1mg,30min后静脉注射丙泊酚2.5mg/kg;;对照组单独静脉注射丙泊酚2.5mg/kg.两组丙泊酚静注速率均为5mg/s.结果:处理组苏醒即刻苏醒后15min和30min宫缩痛的VAS评分分别为(3.13±0.15)、(2.02±0.11)和(0.87±0.09)分,明显低于对照组的(4.47± 0.35)、(3.54± 0.14)及(2.01±0.12)(P＜0.01).结论:盐酸戊乙奎醚联合丙泊酚镇痛能减轻人工流产术后的疼痛.     

小儿上肢骨折手术的快通道麻醉

目的:观察喉罩下丙泊酚复合雷米芬太尼加神经刺激器引导下臂丛阻滞的快通道麻醉在小儿上肢骨折术中的应用效果,并与传统的麻醉方法咪唑安定加氯胺酮作比较.方法:选择ASA Ⅰ级小儿上肢骨折手术40例.随机分为2组:试验组(喉罩下丙泊酚复合雷米芬太尼加神经刺激器引导下臂丛阻滞)20例和对照组(咪唑安定+氯胺酮)20例.试验组惠儿静脉注射丙泊酚和雷米芬太尼后置入喉罩,连接麻醉机控制通气,麻醉维持采用丙泊酚和雷米芬太尼持续输注.1%利多卡因8□/□在神经刺激器引导下臂丛阻滞,手术结束停麻醉药.对照组静脉给予咪唑安定和氯胺酮,术中微量泵入咪唑安定加氯胺酮,术中根据需要调整输注速度,手术结束前5min停药.记录两组患儿的镇静镇痛效果、术中SPO2、手术时间、苏醒时间.结果:两组惠儿术中镇静镇痛效果均能满足手术需要,差异无统计学意义;两组患儿术中SPO2差异有统计学意义,试验组对气道的控制优于对照组;两组患儿手术时间差异无统计学意义,苏醒时间差异有统计学意义,对照组显著长于试验组.结论:喉罩下丙泊酚复合雷米芬太尼加神经刺激器引导下臂丛阻滞是小儿上肢骨折手术一种很好的快通道麻醉技术.     

右美托咪定联合丙泊酚用于老年患者无痛肠镜的临床观察

目的:探讨右美托咪定联合丙泊酚用于老年患者无痛纤维结肠镜检查术的麻醉效果及安全性。方法:选择ASA 1-II级择期行无痛肠镜检查术的86例患者随机分为两组,即右美托咪定联合丙泊酚(实验组)和丙泊酚和芬太尼组(对照组),每组各43例。实验组先于10 min内缓解静脉输入右美托咪定0.5μg/kg,对照组同样时间内静脉输入1μg/kg芬太尼。两组均静脉给予丙泊酚1.5 mg/kg,必要时追加丙泊酚。观察两组患者注药前(T0)、注药镜检前(T1)、过脾曲时(T2)、过肝曲时(T3)、退镜时(T4)的心率(HR)、收缩压(SBP)、血氧饱和度(Sp O2)的变化,镇痛效果(VAS评分)、丙泊酚用量、苏醒时间及麻醉后不良反应发生情况。结果:实验组丙泊酚用量和苏醒时间明显短于对照组(P0.05),但两组VAS评分无统计学差异。实验组在T1-T4时间的HR和SBP显著低于对照组(P0.05),实验组Sp O2在T2-T3时间显著高于对照组(P0.05)。观察组低血压、呼吸抑制、不良体动均显著低于对照组(P0.05)。两组嗜睡、头晕、恶心呕吐发生率无统计学差异。结论:右美托咪定联合丙泊酚用于老年患者无痛肠镜检查麻醉效果确切,相对丙泊酚联合芬太尼,可以减少丙泊酚用量,不良反应少,值得临床推广。     

浅全麻下拔除气管导管在临床中的应用

目的:探讨丙泊酚与瑞芬太尼持续泵注浅全麻状态下拔除气管导管在临床中的应用效果。方法:选择ASAI-II级择期行开腹胆囊切除手术全麻患者200例,随机分为对照组和试验组,各100例。对照组术毕符合拔管条件时拔除气管导管,试验组手术结束时持续泵注丙泊酚瑞芬太尼维持病人于浅麻醉状态,待患者自主呼吸恢复,潮气量达6～8ml/kg,呼吸频率大于12次/min,脱氧10minSpO2在95%以上,PetCO2在正常范围,停止输注丙泊酚和瑞芬太尼,拔除气管导管。记录两组患者手术结束时、拔管时、拔管后1min、3min、5min各时点的平均动脉压(MAP)、心率(HR)及术后患者恢复情况。结果:组内比较,与T1时刻比较,试验组T2、T3、T4时刻的MAP、HR差异无统计学意义;对照组T2、T3、T4时刻的MAP、HR高于T1时刻(P<0.05)。组间比较,T1时刻两组比较差异无统计学意义,T2、T3、T4时刻的MAP、HR对照组高于试验组(P<0.05)。试验组不良记忆的发生例数少于对照组(P<0.05)。两组患者SpO2<96%的发生例数、自主呼吸恢复时间、拔管时间比较差异无统计学意义。结论:丙泊酚与瑞芬太尼持续泵注浅全麻状态下拔除气管导管,患者血流动力学平稳,无不良记忆。     

异丙酚复合芬太尼静脉麻醉镇痛对门诊人工流产术的影响

目的:观察异丙酚复合芬太尼静脉麻醉对于人工流产术时及术后的影响。方法:选择2001年3月——2001年9月在本院计划生育门诊就诊、自愿要求无痛人工流产的妇女120例作为无痛人工流产组(简称:无痛组),同期按常规方法行人工流产的妇女120例作为对照组(简称:对照组),进行配对研究。无痛组用异丙酚1.5mg/kg复合芬太尼2μg/kg诱导,术中用异丙酚维持,人工流产术按常规方法施行。结果:无痛组术中异丙酚用量为2.7±0.7mg/kg,芬太尼2μg/kg,术中无知觉,120例妇女均无疼痛主诉。对照组轻度疼痛82例(68.3％),中度疼痛33例(27.5％),重度疼痛3例(4.2％)。无痛组在麻醉诱导及维持期间均出现呼吸频率下降,通过控制呼吸、面罩吸氧,SaO_2可以保持在99％以上,不需气管插管。两组妇女术前及术后宫腔深度无明显差异(P>0.05)。无痛组术中出血量为32.2±23.2ml,对照组为19.8±15.9ml,无痛组较对照组明显增多,有极显著统计学差异(P<0.01)。结论:异丙酚复合芬太尼静脉麻醉对人工流产术的主要影响是手术的出血量略增多,但不影响子宫收缩及术后恶露持续时间,该麻醉是一种有效镇痛方法,适用于门诊人工流产术。     

浅全麻下拔除气管导管在临床中的应用

目的:探讨丙泊酚与瑞芬太尼持续泵注浅全麻状态下拔除气管导管在临床中的应用效果.方法:选择ASAI-Ⅱ级择期行开腹胆囊切除手术全麻患者200例,随机分为对照组和试验组,各100例.对照组术毕符合拔管条件时拔除气管导管,试验组手术结束时持续泵注丙泊酚瑞芬太尼维持病人于浅麻醉状态,待患者自主呼吸恢复,潮气量达6～8ml/kg,呼吸频率大于12次/min,脱氧10minSpO2在95％以上,PetCO2在正常范围,停止输注丙泊酚和瑞芬太尼,拔除气管导管.记录两组患者手术结束时、拔管时、拔管后1min、3min、5min各时点的平均动脉压(MAP)、心率(HR)及术后患者恢复情况.结果:组内比较,与T1时刻比较,试验组T2、T3、T4时刻的MAP、HR差异无统计学意义;对照组T2、T3、T4时刻的MAP、HR高于T1时刻(P＜0.05).组间比较,T1时刻两组比较差异无统计学意义,T2、T3、T4时刻的MAP、HR对照组高于试验组(P＜0.05).试验组不良记忆的发生例数少于对照组(P＜0.05).两组患者SpO2＜96％的发生例数、自主呼吸恢复时间、拔管时间比较差异无统计学意义.结论:丙泊酚与瑞芬太尼持续泵注浅全麻状态下拔除气管导管,患者血流动力学平稳,无不良记忆.     

丙泊酚复合芬太尼静脉复合全麻在老年主动脉夹层介入手术中的麻醉效果研究

目的:探讨老年主动脉夹层介入手术采用丙泊酚复合芬太尼静脉复合全麻对患者麻醉效果的影响。方法:选取2015年6月到2018年3月四川省攀枝花市中心医院麻醉科接诊的老年胸、腹主动脉夹层行介入手术治疗的患者76例作为研究对象,采用随机数字表法将患者分为观察组(38例)及对照组(38例),观察组采用丙泊酚复合芬太尼静脉复合全麻,对照组采用丙泊酚静脉复合全麻,观察并比较两组患者循环功能指标[血压(DBP、SBP)、心率(HR)、平均动脉压(MAP)]、肺功能指标[呼吸频率(R)、呼气末二氧化碳(P~(ET)CO_2)、血氧饱和度(SpO_2)、气道压力(PAW)]及麻醉效果[脑电双频指数(BIS)值、苏醒时间(术后自主呼吸恢复时间、睁眼时间、定向力恢复时间)、拔管时间的组间差异。结果:观察组术后苏醒时间(自主呼吸恢复时间、睁眼时间、定向力恢复时间)及拔管时间低于对照组(P0.05)。观察组R在T1～T5时间点均低于对照组(P0.05),在T1时间点,观察组P~(ET)CO_2低于对照组,PAW高于对照组(P0.05),观察组SpO_2在T3、T4高于对照组(P0.05);观察组HR、SBP、DBP、MAP在T1～T3时间点均高于对照组(P0.01)。观察组患者的HR、MAP在不同时间点间比较无统计学意义(P0.05)。结论:采用丙泊酚复合芬太尼静脉复合全麻对于老年主动脉夹层介入手术患者,具有降低患者呼吸及循环功能影响的效果,具有更优的麻醉效果。     

六种藓类植物茎的比较解剖学研究

通过对6种藓类植物,即褶叶青藓(Brachythecium salebrosum(Web.et Mohr.)B.S.G.)、湿地匐灯藓(Plagiomnium acutum(Lindb.)Kop.)、侧枝匐灯藓(Plagiomnium maximoviczii(Lindb.)Kop.)、大凤尾藓(Fissidensnobilis Griff.)、大羽藓(Thuidium cymbifolium(Doz.et Molk.)B.S.G.)和大灰藓(Hypnum plumaeforme Wils.)嫩茎和老茎的石蜡切片和显微观察发现,同一藓类植株的嫩茎和老茎,茎结构稳定,不同种藓类植物茎横切面具有不同特征.植物体茎横切面形状、表层细胞的层数、细胞大小和细胞壁厚薄、皮层细胞大小和形状、中轴的有无以及比例等特征可以作为藓类植物的分科分类依据之一.     

Photoregulation of seed germination of wild-type and of an aurea-mutant of tomato

Seed germination of an aurea mutant of tomato ( Lycopersicon esculentum Mill.) is promoted by continuous irradiation with red, far-red or long-wavelength far-red (758 nm) light as well as by cyclic irradiations (5 min red or 5 min far-red/25 min darkness). Far-red light applied immediately after each red does not change the germination behaviour. Seed germination of the isogenic wild-type, cv. UC-105, is promoted by continuous and cyclic red light while it is inhibited by continuous and cyclic far-red light and by continious 758 nm irradiation. Far-red irradiation reverses almost completely the promoting effect of red light. The promoting effect (in the aurea mutant) and the inhibitory effect (in the wild-type) of continuous far-red light do not show photon fluence rate dependency above 20 nmol m⁻² s⁻¹. It is concluded that phytochrome controls tomato seed germination throgh low energy responses in both the wild type and the au mutant. The promoting effect of continuous and cyclic far-red light in the au mutant can be attributed to a greater sensitivity to P_fr.     

真菌类遗传学分析的知识结构教学

本文以认知结构理论为指导,讨论了真菌类遗传分析与高等动植物遗传分析的内在联系,认为利用这种内在联系进行教学可收到好的效果并说明了作者的具体教学过程。 Abstract:In the paper, the relationship between genetic analysis of Fungi and genetic analysis of high animal and plant was discussed.A good results were obtained when we adopted this method in the teaching.     

Cause of Senescence of Nine Sorts of Flowers

The levels of endogenous phytohormones and respiratory rate in nine sorts of flowers such as Cymbidium faberi Rolfe, Nopalxochia ackermannii Kunth and others were investigated both at full bloom and senescence and meanwhile the effect of exogenous phytohormones on prolonging the blossoms and promoting ethylene production were tested. There is a high content of endogenous ethylene in all the long-lived flowere, about 3–16 folds higer than the short-lived ones. There is a high level of ABA at full blooming flowers of short-lived flowers, in which there is no or only some cytokinins in it, but the ratio of CTK (6BA+zeatin)/ABA is smaller(l.7). The endogenous ABA reached a much higher level at senescence in all nine sorts of flowers, so it is reasonable to consider that it is ABA which plays an important role of regulation in controlling flower's senescence. There is a much higher level of GA3 and zeatin in the long-lived flowers which is not demonstrated in the shortlived ones. The respiratory rate is one of the factors controtling the longevity of flowers, but it does not play a decided role. Application of 6BA and zeatin prolongs distinctly orchid’s longevity, however exogenous IAA through the promotive action on ethylene production, evidently extends the longevity of the flowers of the Nopalxochia ackermannii Kunth.     

Interconnection of parameters of regulation system of lipid peroxidation and of morphophysiological parameters of mouse liver

A complex analysis of seasonal fluctuations of the mean group parameters of the system of regulation of lipid peroxidation has been performed in liver of Balb/c mice. Association of lipid characteristics and morphophysiological parameters is studied in the Balb/c mouse liver. An inter-connection is revealed between the liver index and the amount of lysoforms of phospholipids, the scale and character of the interconnection differing essentially depending on proportion of phos-phatidylcholine in mouse liver phospholipids.     

龙胆科药用植物化学成分的研究现状

龙胆科植物在我国的分布范围很广,且多数为药用植物,其多数种属的药用植物,至今其化学成分尚未被系统研究。综述了目前龙胆科药用植物的化学成分的研究现状及一般提取方法,对近年来发现的环烯醚萜及裂环烯醚萜类化合物进行了总结,为本科药用植物的更深入研究提供了参考。     

Physiological characteristics of various species of strains of carboxydobacteria

Seven strains of aerobic carbon monoxide-oxidizing bacteria (carboxydebacteria) when growing on CO as sole source of carbon and energy had doubling times which ranged from 12–42 h. The activity profiles obtained after discontinuous sucrose density gradient centrifugation indicated that the CO-oxidizing enzymes are soluble and the hydrogenases are membrane-bound in all strains examined. The CO-oxidizing enzymes of Pseudomonas carboxydohydrogena, Pseudomonas carboxydoflava, Comamonas compransoris, and the so far unidentified strains OM2, OM3, and OM4 had a molecular weight of 230,000; that of Achromobacter carboxydus amounted to 170,000. The molecular weights of the CO-oxidizing and H₂-oxidizing enzymes turned out to be identical. The cell sonicates were shown to catalyze the oxidation of both CO and H₂ with methylene blue, thionine, phenazine methosulfate, toluylene blue, dichlorophenolindophenol, cytochrome c or ferricyanide as electron acceptors. Methyl viologen, benzyl viologen, FAD⁺, FMN⁺, and NAD(P)⁺ were not reduced. The spectrum of electron acceptors was identical for all strains tested. Neither free formate, hydrogen nor oxygen gas were involved in the CO-oxidation reaction. Methylene blue was reduced by CO at a 1:1 molar ratio. The results indicate that CO-oxidation by carboxydobacteria is catalyzed by identical or similar enzymes and that the reaction obeys the equation CO+H₂OCO₂+2H⁺+2e^- as previously shown for Pseudomonas carboxydovorans.Dedicated to Otto Kandler remembering almost three decades of enjoyable cooperation     

Modulation of allostery of pyruvate kinase by shifting of an ensemble of microstates

Since the introduction of the concepts of allostery about four decades ago, much advancement has been made in elucidating the structure-function correlation in allostery. However, there are still a number of issues that remain unresolved. In this review we used mammalian pyruvate kinase (PK) as a model system to understand the role of protein dynamics in modulating cooperativity. PK has a triosephosphate isomerase (TIM)(α/β)₈ barrel structural motif. PK is an ideal system to address basic questions regarding regulatory mechanisms about this common (α/β)₈ structural motif. The simplest model accounting for all of the solution thermodynamic and kinetic data on ligand-enzyme interactions involves two conformational states, inactive E^T and active E^R. These conformational states are represented by domain movements. Further studies provide the first evidence for a differential effect of ligand binding on the dynamics of the structural elements, not major secondary structural changes. These data are consistent with our model that allosteric regulation of PK is the consequence of perturbation of the distribution of an ensemble of states in which the inactive E^T and active E^R represent the two extreme end states. Sequence differences and ligands can modulate the distribution of states leading to alterations of functions. The future work includes: defining the network of functionally connected residues; elucidating the chemical principles governing the sequence differences which affect functions; and probing the nature of mutations on the stability of the secondary structural elements, which in turn modulate allostery.