B超引导下臂丛神经阻滞麻醉对老年桡骨远端粉碎性骨折患者的麻醉效果分析

摘要 目的：研究B超引导下臂丛神经阻滞麻醉对老年桡骨远端粉碎性骨折患者的麻醉效果。方法：选择2018年12月～2020年6月我院的80例老年桡骨远端粉碎性骨折患者,采用随机数字表法,将患者均分为两组。两组均实施臂丛神经阻滞麻醉,其中对照组使用传统的解剖定位法,观察组使用B超引导法。比较两组的麻醉效果、麻醉用药剂量、阻滞起效时间、麻醉完成时间、镇痛维持时间;不同时间的平均动脉压、心率;且记录两组的脊髓麻痹、气胸、呼吸困难、局麻药物中毒发生率。结果：观察组老年桡骨远端粉碎性骨折病人的麻醉效果优良率（95.00 %）明显高于对照组（77.50 %,P<0.05);观察组的麻醉用药剂量、阻滞起效时间、麻醉完成时间均显著低于对照组,镇痛维持时间长于对照组(P<0.05);两组T2和T3时间点的平均动脉压和心率明显高于T1(P<0.05),且观察组的平均动脉压和心率明显更低(P<0.05);观察组的脊髓麻痹、气胸、呼吸困难、局麻药物中毒发生率明显更低(P<0.05)。结论：B超引导臂丛神经阻滞麻醉能提高老年桡骨远端粉碎性骨折患者的麻醉效果。     

彩色多普勒超声对盆腔瘀血综合征的诊断价值及与临床因素的相关性研究

目的:探讨盆腔瘀血综合征患者彩色多普勒超声的影像学特征及与临床因素的相关性。方法:对112例盆腔瘀血综合征患者行彩色多普勒超声检查,按超声诊断分级Ⅰ级、Ⅱ级、Ⅲ级分为62例、27例、23例,观察彩色多普勒超声的影像学特征,分析静脉内径与病程的相关性,并分析超声诊断分级与临床症状积分、体质量指数(BMI)、妊娠次数、既往工作站立时间的相关性。结果:不同超声诊断分级患者的静脉内径、静脉丛范围和静脉流速差异具有统计学意义(P<0.05)。静脉内径与病程呈正相关(P<0.05),超声诊断分级与临床症状积分、妊娠次数、既往工作站立时间呈显著正相关(P<0.05),与BMI呈负相关(P<0.05)。结论:彩色多普勒超声对盆腔瘀血综合征具有特异性的诊断价值,超声诊断分级、静脉内径与临床因素存在一定的的关联性。     

Metallic Lakes of the oxazines (Gallamin Blue,Gallocyanin and Coelestin Blue) as Nuclear Stain Substitutes for Hematoxylin

Becher's investigations upon the soluble metallic lakes of the oxazines have been re-investigated, extended and results described. Gallamin blue, gallocyanin and coelestin blue in combination with ferric ammonium sulfate gave the best results. The dyes are dissolved in a five per cent aqueous solution of ferric ammonium sulfate. The solution is boiled for 2–3 minutes, cooled, filtered and ready for immediate use. The iron lakes of these dyes stain nuclei excellently giving a deep blue or blue black in 3–5 minutes. No differentiation with acid is required. Coelestin blue gives the most stable solution and is recommended as a routine nuclear stain. The protoplasm remains practically colorless and counter-staining with acid dyes such as ethyl-eosin, orange G, or fuchsin gives pictures which cannot be distinguished from a good hematoxylin stain.

Counter-staining with van Gieson solution is also possible. Benda's modification of the van Gieson solution is recommended. Staining of fat with Sudan, scarlet red, etc., does not interfere with nuclear staining by these dyes.

As applied to the central nervous system these dyes are far superior to hematoxylin. Ganglion and glia cells are as excellently stained as with thionin.

The most widely used fixatives, namely formaldehyde, Mueller-formaldehyde, Zenker's and alcohol, give equally as good results. The nature of the staining process is briefly discussed and a prospectus offered.     

Technical Aspects of the Mouse Aortocaval Fistula

Technical aspects of creating an arteriovenous fistula in the mouse are discussed. Under general anesthesia, an abdominal incision is made, and the aorta and inferior vena cava (IVC) are exposed. The proximal infrarenal aorta and the distal aorta are dissected for clamp placement and needle puncture, respectively. Special attention is paid to avoid dissection between the aorta and the IVC. After clamping the aorta, a 25 G needle is used to puncture both walls of the aorta into the IVC. The surrounding connective tissue is used for hemostatic compression. Successful creation of the AVF will show pulsatile arterial blood flow in the IVC. Further confirmation of successful AVF can be achieved by post-operative Doppler ultrasound.     

彩色多普勒超声测量椎动脉血流量对后循环缺血的诊断价值

目的：探讨彩色多普勒超声技术测量椎动脉血流量对后循环缺血（PCI）的诊断价值。方法：选取2012年1月至2013年1月在本院神经内科住院并接受治疗的PCI患者58例作为观察组,另选取同期住院并确诊为非后循环缺血症的患者50例作为对照组。所有患者均接受颈部血管超声检查,测量椎动脉内径及血流量,观察组患者需行头颅CTA检查,比较两组患者的椎动脉内径、血流量及颈动脉硬化斑块发生率等。结果：观察组患者的椎动脉内径及血流量明显低于对照组,两组比较差异有统计学意义（P〈0．01）;观察组颈动脉硬化斑块的发生率为77．5％（44例）,对照组颈动脉硬化斑块的发生率为42％（21例）,两组比较差异有统计学意义（P〈0．05）。无狭窄、轻度狭窄、重度狭窄及闭塞的椎动脉血流量的变化（此处所指的血流量是指小于200mL/min那部分患者）有明显差异（P〈0．05）。结论：与头颅CTA对比检查,彩色多普勒具有直接、准确、方便及可重复性等优点,可有效的诊断后循环缺血症状。     

Zoo soundscape: Daily variation of low-to-high-frequency sounds

Most studies assessing the impact of noises on zoo animal welfare did not measure sound frequencies outside of the human-hearing range (infrasounds and ultrasounds). Many nonhuman mammals can hear these frequencies, and because loud and variable soundscapes are potentially detrimental for animal welfare, this overlooked aspect of their acoustic environment could have important consequences. This study evaluated the soundscape of an urban zoo in a large frequency range (17.5–90,510 Hz) by measuring its average sound levels (L_eq) and variability (the difference between highest and lowest peaks). Sound data were collected for 24 hr in 25 locations (e.g., indoor, outdoor, near the amusement park). The soundscape was not considered problematic for animal welfare when looking at the average sound levels in most locations (<77-dB sound pressure level [SPL]), except for a few indoor areas and near the water park. Ultrasounds were rare, had low average sound levels, and were less variable in time. Infrasounds were always present and were the loudest and most variable sound frequencies. The soundscape was louder and more variable during the day and when visitors were present, suggesting that human-related activities were the sources of these augmentations. Indoor environments were generally louder than outdoor environments and touristic features; however, the water park was near 85-dB SPL during the day. On the basis of results, we suggest a series of mitigation actions to minimize noise-related stress in captive animals.