不同浓度罗哌卡因腰硬联合麻醉用于人工髋关节置换手术对患者麻醉效果和术后运动功能的影响

摘要 目的：探讨不同浓度罗哌卡因腰硬联合麻醉用于人工髋关节置换手术对患者麻醉效果和术后运动功能的影响。方法：2017年2月至2019年12月选择在本院进行人工髋关节置换手术的患者84例,根据随机数字表法把患者分为观察组与对照组各42例。两组都给予腰硬联合麻醉,对照组采用常规浓度0.5 %罗哌卡因麻醉观察组采用低浓度0.375 %罗哌卡因麻醉,记录患者麻醉效果和术后运动功能变化情况。结果：观察组的麻醉持续时间、运动恢复时间和感觉运动时间都显著短于对照组(P<0.05)。观察组麻醉后10 min、30 min、60 min的Bromage评分都低于对照组(P<0.05)。观察组术后7 d的低血压、恶心呕吐、头晕头痛、尿潴留等不良反应发生率为7.1 %,显著低于对照组的19.0 %(P<0.05)。两组所有患者在术后2 h、术后4 h、术后24 h的呼吸、心率均在正常范围内波动,组间与组内对比都无统计学意义(P>0.05)。结论：低浓度罗哌卡因腰硬联合麻醉用于人工髋关节置换手术能改善患者的麻醉效果和运动功能,提高麻醉效果,并不影响患者的生命体征,且能减少术后不良反应的发生。     

利多卡因经气管内给药和静脉给药对全麻苏醒期患者镇静镇痛效果、血流动力学和呛咳反应的影响

摘要 目的：探讨利多卡因经气管内给药和静脉给药对全麻苏醒期患者镇静镇痛效果、血流动力学和呛咳反应的影响。方法：选取2018年3月~2019年8月于我院在气管内全麻下完成泌尿外科、腹部外科并预计于术后可以迅速拔除气管导管的患者63例,上述患者根据随机数字表法分为A组（n=31）和B组（n=32）,A组患者给予利多卡因静脉给药,B组患者给予利多卡因经气管内给药,比较两组患者苏醒时间、拔管时间、镇静镇痛效果、血流动力学及呛咳反应。结果：两组苏醒时间、拔管时间组间比较差异无统计学意义（P>0.05）。两组插管时、拔管时、拔管后10 min心率（HR）、收缩压（SBP）、舒张压（DBP）均呈先升高后降低趋势,且B组插管时、拔管时、拔管后10 min的HR、SBP、DBP均低于A组（P<0.05）。两组拔管时、拔管后10 min组内及组间镇静-躁动评分(SAS)比较差异无统计学意义（P>0.05）;两组拔管后10 min疼痛视觉模拟量表(VAS)评分高于拔管时,但B组低于A组（P<0.05）。B组患者插管时、拔管时呛咳反应发生率均低于A组（P<0.05）。结论：与静脉给药相比,全麻苏醒期患者给予利多卡因经气管内给药,镇静镇痛效果确切,可减轻血流波动,降低插管时、拔管时呛咳反应发生率。     

可视软性喉镜与光棒在颈椎损伤手术患者全身麻醉气管插管中的应用效果比较

目的:比较可视软性喉镜与光棒用于颈椎损伤手术患者全身麻醉气管插管的有效性与安全性。方法:选择2017年1月至2019年2月本院60例高位颈椎骨折需行气管插管全身麻醉的患者,随机分为可视软性喉镜组(U组)和光棒组(G组)各30例。术前所有患者颈托固定,U组使用UE可视软性喉镜行气管插管,G组使用光棒行气管插管,确认气管插管成功后接呼吸机机械通气。比较两组气管插管时间、一次性插管成功率、拔管后口咽部并发症、插管前后的皮层体感诱发电位(CSEP)及运动诱发电位(MMEP)的变化。记录两组患者麻醉前、麻醉诱导后、气管插管后即刻、气管插管后1 min、气管插管后3 min的平均动脉压(MAP)和心率(HR)。结果:U组气管插管时间较G组插管时间长(P0.05);U组和G组气管插管一次性成功率分别为95%和100%;插管后即刻G组患者MAP升高较U明显(P0.05);与U组比较,G组插管后即刻及插管后1 min、3 min的HR升高较明显(P0.05);U组患者口咽部并发症较G组少;两组患者插管后SSEP及MMEP与插管前相比无阳性改变。结论:可视软性喉镜较光棒需要更长的气管插管时间,两者的气管插管一次性成功率均较高,但可视软性喉镜插管期间循环波动较小、术后口咽部并发症较轻,值得临床推广应用。     

Restoration of Midwestern U.S. Savannas: One Size Does Not Fit All

Lowland savannas are a rare variant of Midwestern United States savanna occurring on alluvial soils, for which reference information is sparse. To evaluate the appropriateness of using upland savanna as a surrogate source of reference information for lowland savanna, we studied a pre‐Euro‐American lowland savanna using original U.S. Public Land Survey data and other historical records. Historical vegetation was reconstructed and compared among upland savannas, lowland savannas, and lowland forests; we also evaluated potential disturbance dynamics maintaining these systems. We found that all three communities were dominated by members of the genus Quercus but also had extensive representation by many other tree species, especially notable for savannas in this region. There were no clear size–density relationships for species in the genus Quercus, indicating that these historical savannas were not characterized exclusively by large, scattered oak trees but rather by trees of many oak species and nonoak species in a wide range of size classes. Both upland and lowland savannas also contained a substantial shrub component. We found no evidence that lowland savannas were maintained by flooding, although the uneven‐aged canopy structure suggested that periodic disturbance occurred. Restoration of lowland savanna in this region should include provisions for maintaining nonoak species and shrubs, with disturbance timed to maintain an uneven‐aged canopy structure. Although the appropriateness of historical data in the face of climate change may be questionable, in this region, a warmer climate may actually help promote the “oak parkland” that was present from 8,000 BP up to Euro‐American settlement.     

Symmetric faces are a sign of successful cognitive aging

It has been proposed that a common cause underlies individual differences in bodily and cognitive decline in old age. No good marker for this common cause has been identified to date. Here, fluctuating asymmetry (FA), an indicator of developmental stability that relates to intelligence differences in young adults, was measured from facial photographs of 216 surviving members of the Lothian Birth Cohort 1921 at age 83 and related to their intelligence at ages 11, 79 and 83 years. FA at age 83 was unrelated to intelligence at ages 11 and 79 and to cognitive change between 11 and 79 years. It was, however, associated with intelligence and information processing efficiency at age 83 and with cognitive change between 79 and 83 years. Significant results were limited to men, a result predicted by sex differences in life history tradeoffs and life expectancy. Results were stronger when directional asymmetries were corrected in facial FA measures. Thus, FA is a candidate marker for the common cause of differential senescence.     

小型猪胰腺十二指肠移植术中的麻醉管理

目的探讨提高小型猪胰腺十二指肠移植术麻醉管理的相关问题.方法供体和受体小型猪各20只,采用氯胺酮加咪唑安定进行基础麻醉,氯胺酮加依托咪酯维持麻醉;行平均颈内动脉压、中心静脉压及血气的监测.结果小型猪胰腺移植术中麻醉良好,受体的平均动脉压在吻合血管开放后有明显下降,与开放前有明显差异(P＜0.05).中心静脉压和血气指标无明显变化.结论在小型猪胰腺移植麻醉手术中,充分补充血容量、加强循环系统的监测和管理,尤其是吻合血管开放后循环系统的管理对受体和移植胰腺的存活至关重要.     

Reversal of Ketamine/Xylazine combination anesthesia by Atipamezole in olive baboons (Papio anubis)

Background  The potential of Atipamezole (ATI) to reverse Ketamine/Xylazine (KET/XYL) anesthesia in the Olive baboon ( Papio anubis ) was studied.
Methods  Anesthesia was induced with 10 mg/kg KET and 0.5 mg/kg XYL intramuscularly. Mean arousal time (MAT), heart rate (HR), systolic arterial blood pressure (SAP), rectal temperature, respiratory rate (RR), and hemoglobin oxygen saturation (SpO₂) were monitored. Baboons were treated with: KET/XYL only, KET/XYL followed by 100 μg/kg ATI or by 200 μg/kg ATI administered 25 minutes after KET/XYL.
Results  Atipamezole rapidly reversed depressed HR and SAP (10 ± 5.2 minutes), RR (5 ± 2 minutes) and SpO₂ (3 ± 6 minutes) and significantly decreased MAT (13 ± 2.2 minutes) vs. KET/XYL alone (35 ± 5 minutes). Emesis was absent and salivation was observed after administration of 200 μg/kg ATI only.
Conclusions  Atipamezole at 100 μg/kg is sufficient for rapid and smooth reversal of KET/XYL anesthesia in the Olive baboon with minimal side effects.     

Changes in the binding of copper in the plasma of molybdenum supplemented rats

After incubating plasma of Mo-supplemented rats (Mo-plasma) with ⁶⁴Cu only part of it could be removed by dialysis against EDTA or histidine or by treatment with dithiocarbamate; this nondialyzable Cu was shown to be bound to albumin. The maximal amount of ⁶⁴Cu bound this way equaled the Mo-induced increase in total plasma Cu. After addition of stable Cu dialysis of Mo-plasma against a histidine solution showed that no extra Cu became tightly bound, suggesting that the ⁶⁴Cu binding was due to an exchange between added ⁶⁴Cu and stable Cu already present. Incubating Mo-plasma with Hg compounds prevented ⁶⁴Cu binding and released stable Cu, indicating that Cu in Mo-plasma was sulfhydryl bound. Part of the Mo in Mo-plasma was freely dialyzable. The remaining part was shown to be SH bound as well. The estimated atomic ratio of SH-bound Cu and Mo was unity. Molybdenum increased the number of SH groups in plasma, and for each Cu atom at least one SH group was calculated to be present.     

基于矩阵广义逆和奇异值分解的运动水果模糊图像恢复

针对利用机器视觉对进行水果分级时,由于水果运动所造成的模糊问题,提出了基于矩阵广义逆和奇异值分解的恢复方法,实验表明恢复的图像比较清晰,并且在保证实时的条件下可将水果大小检测的相对误差从4．17%减小为0．671%,相比于传统的恢复方法而言,提高了速度,消除了误差积累,为后续的边缘检测、形状分析、缺陷分类等打下了基础．