不同浓度右美托咪啶对小儿麻醉后血清肌钙蛋白I、C反应蛋白以及补体水平的影响

目的:探讨不同浓度右美托咪啶对小儿麻醉后血清肌钙蛋白I、C反应蛋白(CRP)及补体水平的影响。方法:选取我院收治的拟行手术的患儿60例,根据应用右美托咪定的浓度随机分为A、B、C三组,每组各20例。A、B组患儿予右美托咪啶0.5、0.25μg/kg的负荷剂量静脉推注给药10分钟,然后以0.2-0.7μg/kg/h的速度持续静脉微量泵入维持患者镇静状态,C组直接以右美托咪啶0.2-0.7μg/kg/h的速度持续泵入维持镇静状态。比较三组患儿麻醉术后的苏醒情况,麻醉前后不同时点血清肌钙蛋白I、C反应蛋白及补体水平的变化。结果:治疗前,三组患儿的各项指标比较均无统计学差异(P0.05);治疗后,与A、C两组比较,B组患者自主呼吸恢复时间、气管导管拔管时间、解除监护时间显著缩短(P0.05),术后24、72 h血清CRP水平更低,术后1、6、24 h血清肌钙蛋白I水平较低(P0.05),术后1、24、72 h血清补体水平较高(P0.05)。结论:0.25μg/kg浓度的右美托咪啶对于对小儿麻醉后血清肌钙蛋白I、C反应蛋白及补体水平的影响明显,且有助于患儿术后的苏醒。     

丙泊酚联合七氟烷复合麻醉对小儿麻醉苏醒期躁动评分的影响

目的:探讨丙泊酚联合七氟烷对小儿麻醉苏醒期躁动的临床效果。方法:选择2013年8月-2015年8月在我院接受手术治疗的患儿53例,根据麻醉方法不同,将研究对象分为丙泊酚组(17例)、七氟烷组(19组)和联合组(17例),分别给予丙泊酚,七氟烷以及丙泊酚联合七氟烷进行麻醉并维持。观察并比较各组患儿的手术时间、麻醉时间、清醒时间、躁动发生率以及苏醒期躁动评分。结果:三组患儿的手术时间和麻醉苏醒时间比较,差异均无统计学意义(P0.05);联合组患儿躁动发生率及躁动评分均低于七氟烷组和丙泊酚组,差异具有统计学意义(P0.05);三组患儿恶心、呕吐等不良反应的发生率比较,差异无统计学意义(P0.05)。结论:丙泊酚联合七氟烷可显著改善小儿麻醉苏醒期躁动情况,临床效果显著。     

右美托咪啶对苏醒期小儿血清肌钙蛋白I、C 反应蛋白及补体的影响

目的:探究不同浓度右美托咪啶对小儿麻醉后肌钙蛋白I、C反应蛋白以及补体变化的影响。方法:收集我院下腹股沟斜疝、急性阑尾炎以及肠套叠手术患儿75例,根据治疗方法不同分为三组,每组25例,其中A组实施0.5μg/kg负荷剂量右美托咪啶治疗,B组实施0.25μg/kg负荷剂量右美托咪啶治疗,C组实施右美托咪啶0.2~0.7μg/kg/h持续泵入。对比三组患者苏醒情况、血清肌钙蛋白I、C反应蛋白、补体水平、镇定及躁动评分。结果:手术后,B组自主呼吸恢复时间、气管导管拔管时间、解除监护时间明显缩短,且与其他两组比较,差异有统计学意义(P0.05);与A、C两组相比,B组手术后C反应蛋白及血清肌钙蛋白I水平较低,而C3及C4水平较高,差异具有统计学意义(P0.05);B组镇静、躁动评分明显降低,差异有统计学意义(P0.05)。结论:0.25μg/kg负荷剂量右美托咪啶能够有效减轻患儿术后炎性反应,缓解麻醉后神经损伤,有助于脏器功能的恢复。     

不同浓度七氟烷吸入麻醉对非体外循环冠脉搭桥手术患者苏醒质量、心肾功能和认知功能的影响

摘要 目的：探讨不同浓度七氟烷吸入麻醉对非体外循环冠脉搭桥手术（OPCABG）患者苏醒质量、心肾功能和认知功能的影响。方法：选取我院2018年5月~2021年3月期间收治的行OPCABG患者93例,采用随机数字表法将受试对象随机分为A组（舒芬太尼、丙泊酚,31例）、B组（舒芬太尼、丙泊酚、0.5 MAC七氟烷,31例）和C组（舒芬太尼、丙泊酚、1.0 MAC七氟烷,31例）。观察三组患者血流动力学[心率（HR）和平均动脉压（MAP）]、苏醒质量、心肾功能[心肌肌钙蛋白I（cTnI）、肌酸激酶（CK-MB）/肌酐（Scr）、尿素氮（BUN）]和认知功能[简易精神状态测量量表（MMSE）、蒙特利尔认知功能评估量表（MoCA）评分]的变化,记录三组不良反应发生情况。结果：三组术后即刻（T1）~术后24h（T3）时间点HR升高后下降,MAP下降后升高（P<0.05）;B组T1、术后6 h（T2）时间点HR低于A组、C组,MAP高于A组、C组（P<0.05）;A组与C组T1、T2时间HR、MAP组间对比无显著性差异（P>0.05）。三组苏醒期躁动发生率组间对比无统计学差异（P>0.05）;B组术后苏醒时间短于A组、C组（P<0.05）;A组与C组术后苏醒时间组间对比无显著性差异（P>0.05）。三组的cTnI、CK-MB、Scr、BUN水平相较于麻醉开始前（T0）时间点均升高（P>0.05）;B组T3时间点cTnI、CK-MB、Scr、BUN水平低于A组、C组（P<0.05）。B组术后第3 d MMSE、MoCA评分高于A组、C组（P<0.05）。三组不良反应发生率对比无差异（P>0.05）。结论：OPCABG患者在舒芬太尼、丙泊酚麻醉的基础上结合七氟烷吸入麻醉,可更好的稳定血流动力学,减轻对机体心肾功能和认知功能的影响,提高苏醒质量,且以0.5 MAC浓度的七氟烷综合效果最佳。     

丙泊酚联合瑞芬太尼靶控输注在小儿短小手术中的效果分析

目的:探讨不同浓度丙泊酚联合瑞芬太尼靶控输注喉罩麻醉在小儿短小手术中的临床效果。方法:127例采用小儿短小手术治疗的患儿按丙泊酚给药目标浓度分为A组(2 ng/mL)、B组(3 ng/mL)和C组(4 ng/mL),分别与瑞芬太尼2 ng/mL联合应用靶控输注,行喉罩置入,失败则逐次增加瑞芬太尼剂量0.5 ng/mL直至成功置入。将各组成功率最高时浓度下的患儿分为A1、B1和C1,比较三个亚组不良反应发生情况、以及各时段HR、BIS值和MAP。结果:A组、B组和C组患儿中分别在3 ng/mL、2.5 ng/mL和2 ng/mL时置入成功率最高,满意/可接受比也最高,与其它浓度比较差异有统计学意义(P0.05)。B1组满意/可接受比值高于A1组和C1组,差异有统计学意义(x2=5.189,x2=7.031,P0.05)。不良反应发生率A1组最高,其次是C1组,与B1组比较差异均有统计学意义(P0.05)。组内行方差分析发现,A1组和C1组有较大波动,差异有统计学意义(P0.05),而B1组总体平稳,差异无统计学意义(P0.05)。结论:2.5 ng/mL瑞芬太尼与3 ng/mL丙泊酚靶控输注时喉罩麻醉在小儿短小手术中的应用效果最好,各临床指标较为平稳,不良反应发生率低。     

不同麻醉方案在小儿烧伤中的应用分析

目的:探讨不同麻醉方案对儿童烧伤患者的效果及意义。方法:将60例烧伤患儿随机均分为AB两组。A组患儿采用七氟醚与瑞芬太尼联合麻醉的方案进行,B组患儿采用丙泊酚与瑞芬太尼联合的方案进行麻醉。观察并比较两种不同麻醉方案对患儿的作用及对手术效果的影响。结果:A组T4时的SpO2明显高于B组,具有统计学意义(P0.00001);A组患儿的自主呼吸恢复时间、拔管时间和苏醒时间均明显高于B组,差异具有统计学意义(P0.01);两组的麻醉时间、呕吐、体动、支气管痉挛例数和患儿苏醒期躁动评分相似,无统计学意义(P0.05)。结论:相较丙泊酚联合瑞芬太尼麻醉方案,七氟醚联合瑞芬太尼麻醉方案用于小儿烧伤手术麻醉可明显缩短患儿自主呼吸的恢复时间、拔管时间和苏醒时间。     

不同麻醉方法对腹腔镜子宫全切2型糖尿病患者血流动力学、血糖水平及补体C3、C4的影响

摘要 目的：探讨不同麻醉方法对行腹腔镜子宫全切2型糖尿病（T2DM）患者血流动力学、血糖水平及补体C3、C4的影响。方法：前瞻性选择2016年1月至2019年1月期间我院收治的120例拟行腹腔镜子宫全切术的T2DM患者,采用随机数字表法将患者分为两组,A组（60例）采用靶控输注丙泊酚、瑞芬太尼全麻,B组（60例）采用靶控输注丙泊酚、瑞芬太尼复合吸入七氟醚全麻。观察两组围手术期血流动力学、血糖、胰岛素、胰高血糖素、C肽及补体C3、C4水平变化和差异,对比两组麻醉效果。结果：B组苏醒时间、拔管时间短于A 组（P＜0.05）,苏醒后视觉模拟评分法（VAS）评分低于A组（P＜0.05）。B组建立气腹前（T1）、建立气腹后1.5 h（T2）、手术结束时(T3)、苏醒时(T4) 观测点平均动脉压（MAP）高于A组（P＜0.05）。建立气腹前（M1）、建立气腹后1.5 h（M2）、术后第1 d（M3）、术后第3 d（M4）观测点胰岛素、C肽水平低于A组（P＜0.05）。M1-M4观测点血糖高于A组（P＜0.05）,M2-M4观测点胰高血糖素水平高于A组（P＜0.05）。M1-M4观测点补体C3、C4水平高于A组（P＜0.05）。结论：靶控输注丙泊酚、瑞芬太尼复合七氟醚全麻麻醉效果更好,且有助于维持腹腔镜子宫全切T2DM患者血流动力学稳定,改善补体C3、C4水平,而靶控输注丙泊酚、瑞芬太尼全麻可维持血糖水平稳定,临床应根据患者情况选择合适的麻醉方案。     

丙泊酚靶控输注麻醉维持对老年胃癌根治术患者血流动力学 及苏醒质量的影响

目的:探讨丙泊酚靶控输注麻醉维持对老年胃癌根治术患者血流动力学以及术后苏醒质量的影响.方法:ASAI～Ⅱ级行胃癌根治术的60例患者随机分为A组和B组.两组使用靶控输注麻醉诱导,起始血浆靶浓度为1μg·ml-1 1％丙泊酚泵注,A组采用靶控输注丙泊酚维持麻醉,B组采用七氟烷吸入维持麻醉.记录麻醉前(T0)、切皮后5min(T1)、手术开始30 rmin(T2)、手术开始60min(T3)、停药时(T4)、出室时(T5)各时间点的血流动力学指标的变化.记录患者术后睁眼时间、拔管时间、定向力恢复时间.结果:两组血流动力学指标(SBP、DBP、HR)在T1～T3时点迅速下降,与T0比较均有显著性差异(P＜0.05),T4时血流动力学指标(SBP、DBP、HR)开始上升,至T5时基本达到基线水平,与T0比较差异无统计学意义(P＞0.05).血流动力学指标(SBP、DBP、HR)在组间比较差异均无统计学意义(P＞0.05).两组术后睁眼时间比较差异无统计学意义(P＞0.05),A组术后拔管时间、定向力恢复时间均低于B组,相比较有显著性差异(P＜0.05).结论:丙泊酚靶控输注麻醉维持对老年胃癌根治术患者血流动力学影响小,患者术后苏醒质量高,是老年胃癌根治术患者理想的麻醉方法.     

七氟烷联合利多卡因对全身麻醉患者心功能影响研究

目的:通过观察七氟烷联合利多卡因对全身麻醉患者心功能影响,探究七氟烷联合利多卡因诱导全身麻醉的临床价值。方法:选取我院外科收治的需行非心脏手术并进行全身麻醉诱导的患者70例,随机分为两组,其中对照组35例,予单纯七氟烷诱导全身麻醉行非心脏手术;实验组35例,予以七氟烷联合利多卡因进行全身麻醉诱导。分别于全身麻醉诱导前(T1)、诱导插管后30分钟(T2)、诱导插管后1小时(T3)3个时间点对患者心功能进行观察和监测,对比观察各个时间点的外周血管阻力(SVR)、每搏输出量(SV)、每分输出量(CO)、峰值速度(Vp K)、心率(HR)、净射血时间百分比(ET%)等指标。结果:1实验组和对照组患者在T1时SVR、SV、CO、Vp K、HR、ET%水平均无明显变化,差异无统计学意义(P0.05);2与T1相比,实验组和对照组患者在T2和T3的SVR、SV、CO、Vp K、HR水平均明显下降,差异有统计学意义(P0.05),ET%升高明显,差异有统计学意义(P0.05);3实验组在T2和T3时SVR、SV、CO、Vp K、HR水平均明显高于对照组,差异有统计学意义(P0.05),ET%较对照组明显下降,差异有统计学意义(P0.05)。结论:单纯七氟烷诱导和七氟烷联合利多卡因诱导全身麻醉对心功能均有影响,但与单纯七氟烷组相比,七氟烷联合利多卡因组对心功能的影响更小,更适合于外科手术的全身麻醉诱导,对临床具有指导意义,值得临床推广。     

七氟醚联合瑞芬太尼维持麻醉对介入治疗颅内动脉瘤患者神经功能、认知功能、炎性因子的影响

摘要 目的：探讨七氟醚联合瑞芬太尼维持麻醉对介入治疗颅内动脉瘤（IA）患者神经功能、认知功能及炎性因子的影响。方法：选入2020年1月~2022年6月在我院接受介入手术治疗的IA患者80例,根据麻醉方式不同分为A组（七氟醚联合瑞芬太尼）和B组（丙泊酚联合瑞芬太尼）,每组40例。评价两组患者的神经功能、认知功能、炎症因子水平等指标,并进行统计比较。结果：A组T1~T3时心率（HR）和平均动脉压（MAP）明显优于B组（P＜0.05）;A组术后24 h和术后7 d美国国立卫生研究院卒中量表（NIHSS）评分明显低于B组（P＜0.05）,易智能精神状态检查量表（MMSE）评分显著高于B组（P＜0.05）;A组术后24 h、术后3 d血清肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）和白细胞介素-6（IL-6）水平均明显低于B组（P＜0.05）;A组术后自主呼吸恢复时间、苏醒时间、拔管时间及拔管后躁动发生率较B组低（P<0.05）;不良反应无差异（P＞0.05）。结论：将七氟醚联合瑞芬太尼维持麻醉应用于介入治疗IA患者,可平稳血流动力学,改善术后神经功能及认知功能,降低炎症反应,提高麻醉苏醒质量。     

A Unique Protease Cleavage Site Predicted in the Spike Protein of the Novel Pneumonia Coronavirus (2019-nCoV) Potentially Related to Viral Transmissibility

正Dear Editor,In December 2019, a novel human coronavirus caused an epidemic of severe pneumonia(Coronavirus Disease 2019,COVID-19) in Wuhan, Hubei, China(Wu et al. 2020; Zhu et al. 2020). So far, this virus has spread to all areas of China and even to other countries. The epidemic has caused 67,102 confirmed infections with 1526 fatal cases     

Curcuminoids as inhibitors of thioredoxin reductase: A receptor based pharmacophore study with distance mapping of the active site

Curcumin is the yellow pigment of turmeric that interacts irreversibly forming an adduct with thioredoxin reductase (TrxR), an enzyme responsible for redox control of cell and defence against oxidative stress. Docking at both the active sites of TrxR was performed to compare the potency of three naturally occurring curcuminoids, namely curcumin, demethoxy curcumin and bis-demethoxy curcumin. Results show that active sites of TrxR occur at the junction of E and F chains. Volume and area of both cavities is predicted. It has been concluded by distance mapping of the most active conformations that Se atom of catalytic residue SeCYS498, is at a distance of 3.56 from C13 of demethoxy curcumin at the E chain active site, whereas C13 carbon atom forms adduct with Se atom of SeCys 498. We report that at least one methoxy group in curcuminoids is necessary for interation with catalytic residues of thioredoxin. Pharmacophore of both active sites of the TrxR receptor for curcumin and demethoxy curcumin molecules has been drawn and proposed for design and synthesis of most probable potent antiproliferative synthetic drugs.     

Comparative morphology of the carpel in the Liliaceae: Hewardieae, Petrosavieae, and Tricyrteae

The young pistils in the melanthioid tribes, Hewardieae, Petrosavieae and Tricyrteae, are uniformly tricarpellate and syncarpous. They lack raphide idioblasts. All are multiovulate, with bitegmic ovules. The Petrosavieae are marked by the presence of septal glands and incomplete syncarpy. Tepals and stamens adhere to the ovary in the Hewardieae and the Petrosavieae but not in the Tricyrteae. Two vascular bundles occur in the stamens of the Hewartlieae and Tricyrtis latifolia. Ventral bundles in the upper part of the ovary of the Hewardieae are continuous with compound septal bundles and placental bundles in the lower part. Putative ventral bundles occur in the alternate position in the Tricyrteae and putative placental bundles in the opposite. position in the Petrosavieae. The dichtomously branched stigma in each carpel of the Tricyrteae is supplied by a bifurcated dorsal bundle.     

Enterovirus 71 3C proteolytically processes the histone H3 N-terminal tail during infection

Highlights
1. The N-terminal tail of histone H3 is specifically cleaved during EV71 infection.
2. Viral protease 3C is identified as a protease responsible for proteolytically processing the N-terminal H3 tail.
3. Our finding reveals a new epigenetic regulatory mechanism for Enterovirus 71 in virus-host interactions.     

Detection of EBV and HHV6 in the Brain Tissue of Patients with Rasmussen’s Encephalitis

Rasmussen’s encephalitis (RE) is a rare pediatric neurological disorder, and the exact etiology is not clear. Viral infection may be involved in the pathogenesis of RE, but conflicting results have reported. In this study, we evaluated the expression of both Epstein-Barr virus (EBV) and human herpes virus (HHV) 6 antigens in brain sections from 30 patients with RE and 16 control individuals by immunohistochemistry. In the RE group, EBV and HHV6 antigens were detected in 56.7% (17/30) and 50% (15/30) of individuals, respectively. In contrast, no detectable EBV and HHV6 antigen expression was found in brain tissues of the control group. The co-expression of EBV and HHV6 was detected in 20.0% (6/30) of individuals. In particular, a 4-year-old boy had a typical clinical course, including a medical history of viral encephalitis, intractable epilepsy, and hemispheric atrophy. The co-expression of EBV and HHV6 was detected in neurons and astrocytes in the brain tissue, accompanied by a high frequency of CD8⁺ T cells. Our results suggest that EBV and HHV6 infection and the activation of CD8⁺ T cells are involved in the pathogenesis of RE.     

Perinatal Vertical Transmission of Chikungunya Virus in Ruili,a Town on the Border between China and Myanmar

正Dear Editor,Chikungunya virus (CHIKV), an arbovirus in the family of Togaviridae, genus Alphavirus, is transmitted by the A.aegyptii or A. albopictus mosquito, and causes disease in humans characterized by fever, rash, and arthralgia (Silva and Dermody 2017; Suhrbier 2019). It was first reported in 1953 in Tanzania, and caused only a few outbreaks and sporadic cases in Africa and Asia in last century. However, in the epidemic in 2004, CHIKV acquired mutations that conferred enhanced transmission by the A. albopictus mosquito(Schuffenecker et al. 2006). Since then, it has successively caused outbreaks in Africa, the Indian Ocean, South East Asia, the South America, and Europe (Zeller et al. 2016).     

Development of a Novel Reverse Transcription Loop-Mediated Isothermal Amplification Method for Rapid Detection of SARS-CoV-2

In conclusion, the novel visual RT-LAMP assay is a simple, rapid, and sensitive approach for detection of SARS-CoV-2, and it is ready for application in primary care and community hospitals or health care centers, and even patients' own houses in response to the current SARS-CoV-2 epidemic because the assay does not require sophisticated equipment and skilled personnel. Furthermore, it is also ready to be used in fields for screening samples from wild animals and environments to facilitate the identification of potential intermediate hosts that mediate the cross-species transmission of SARS-CoV-2 from bats to humans.