全凭静脉麻醉期间右美托咪定对靶控输注丙泊酚用量及血流动力学的影响

目的：探讨右关托咪定（dexmedetomidine,DEX）对行全凭静脉麻醉患者靶控输注（target controlled infusion,TCI）丙泊酚用量及拔管期间血流动力学的影响。方法：选择拟于全麻下行经鼻蝶窦垂体瘤切除术的患者30例（ASA I～II级）,随机分为两组,每组15例。试验组（D组）给予DEX负荷剂量0．5μg·kg-1,注药时间15rain,继以0．3μg·kg-1·h-1持续输注至修补硬膜时;对照纽（N组）在相同时间给予等容量生理盐水。两组麻醉诱导方法相同,术中以脑电双频指数（bispectral index,BIS）为麻醉深度监测指标,根据BIS值调节丙泊酚血浆靶浓度维持麻醉。记录拔管期间收缩压（SBP）、舒张压（DBP）和心率（HR）,并计算心肌氧耗指数（RPP）;记录丙泊酚平均用量、用药前后BIS值、呼吸恢复时间、睁眼时间、拔管时间及术中不良反应。结果：①D组给予负荷剂量后,BIS值由（95±3）降至（77±11）,差异有统计学意义（P〈0．01）。②与N组相比,D组丙泊酚用量减少28％,差异有统计学意义（P〈0．01）。⑧拔管期间SBP、DBP和HR与入室时比较,D组无明显变化,N组HR显著升高（P〈0．05）;D组拔管期间SBP、DBP、HR和RPP明显低于N组（P〈0．05）;④两组患者呼吸恢复时间、睁眼时间及拔管时间差异均无统计学意义;⑤两组不良反应（心动过缓、高血压、低血压）的发生率无显著性差异。结论：术中持续静脉输注DEX可减少TCI丙泊酚用量,能使BIS值进一步降低,产生良好镇静效应;同时可有效减轻拔管期间循环变化,降低RPP,减少心肌耗氧量,提高拔管质量。     

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.     

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.     

意识与麻醉

<正>意识可以定义为"个体觉察自我与环境存在的脑功能状态"也就是说,意识是脑对"存在"的觉察,感知"存在"就是对真实自我和环境的觉察、发生在清醒状态下,对"存在"的觉察是脑的基本功能,也是注意、学习、认知、思维等功能的前提.国际上许多实验室,研究麻醉导致的意识丧失以及麻醉后意识的重启动,来揭示意识的神经基础.最近,Solovey等(J Neurosci,2015,35(30):10866)发现,不同麻醉药物诱导的脑活动模式不同,如果忽略那些具体活动的特征,意识丧失与     

Behavioral and electrophysiological analysis of general anesthesia in 3 background strains of Drosophila melanogaster

General anesthetics achieve behavioral unresponsiveness via a mechanism that is incompletely understood. The study of genetic model systems such as the fruit fly Drosophila melanogaster is crucial to advancing our understanding of how anesthetic drugs render animals unresponsive. Previous studies have shown that wild-type control strains differ significantly in their sensitivity to general anesthetics, which potentially introduces confounding factors for comparing genetic mutations placed on these wild-type backgrounds. Here, we examined a variety of behavioral and electrophysiological endpoints in Drosophila, in both adult and larval animals. We characterized these endpoints in 3 commonly used fly strains: wild-type Canton Special (CS), and 2 commonly used white-eyed strains, isoCJ1 and w¹¹¹⁸. We found that CS and isoCJ1 show remarkably similar sensitivity to isoflurane across a variety of behavioral and electrophysiological endpoints. In contrast, w¹¹¹⁸ is resistant to isoflurane compared to the other 2 strains at both the adult and larval stages. This resistance is however not reflected at the level of neurotransmitter release at the larval neuromuscular junction (NMJ). This suggests that the w¹¹¹⁸ strain harbors another mutation that produces isoflurane resistance, by acting on an arousal pathway that is most likely preserved between larval and adult brains. This mutation probably also affects sleep, as marked differences between isoCJ1 and w¹¹¹⁸ have also recently been found for behavioral responsiveness and sleep intensity measures.     

Monitoring depth of anesthesia using combination of EEG measure and hemodynamic variables

Monitoring depth of anesthesia (DOA) via vital signs is a major ongoing challenge for anesthetists. A number of electroencephalogram (EEG)-based monitors such as the Bispectral (BIS) index have been proposed. However, anesthesia is related to central and autonomic nervous system functions whereas the EEG signal originates only from the central nervous system. This paper proposes an automated DOA detection system which consists of three steps. Initially, we introduce multiscale modified permutation entropy index which is robust in the characterization of the burst suppression pattern and combine multiscale information. This index quantifies the amount of complexity in EEG data and is computationally efficient, conceptually simple and artifact resistant. Then, autonomic nervous system activity is quantified with heart rate and mean arterial pressure which are easily acquired using routine monitoring machine. Finally, the extracted features are used as input to a linear discriminate analyzer (LDA). The method is validated with data obtained from 25 patients during the cardiac surgery requiring cardiopulmonary bypass. The experimental results indicate that an overall accuracy of 89.4 % can be obtained using combination of EEG measure and hemodynamic variables, together with LDA to classify the vital sign into awake, light, surgical and deep anesthetised states. The results demonstrate that the proposed method can estimate DOA more effectively than the commercial BIS index with a stronger artifact-resistance.     

老年患者全身麻醉术后认知功能障碍的影响因素分析

目的：探讨分析老年非心脏手术患者全身麻醉术后认知功能障碍(POCD)的影响因素。方法：选择我院80 例老年行非心脏手 术患者,所有患者均给予全身麻醉手术,于术前及术后1、3 d 分别使用简易智能状态检查法（MMSE）评估患者认知功能,同时记 录行不同手术种类患者POCD 发生率并分析其年龄、麻醉时间、术中出血量、并发症情况及受教育程度等指标与POCD发生的相 关性。结果：80 例患者POCD发生率为30.0%,且不同种类手术中的发生率比较差异无统计学意义（P＞0.05）;POCD 组术后1d MMSE 评分为较术前分明显下降,比较差异具有统计学意义（P＜0.05);POCD组术后3 d及非POCD 组术后1、3 d MMSE 评分与 术前比较差异无统计学意义（P＞0.05）;Logistic 回归分析显示,患者年龄、文化程度、麻醉持续时间≥ 3 h、术中出血量≥ 350 mL及 合并高血压与POCD的发生具有显著相关性（P＜0.05）。结论：行全麻手术患者术后POCD 发病率较高,且患者高龄、文化程度 低、高血压合并症及麻醉持续时间长等是引起POCD发生的重要影响因素。     

硬膜外复合全麻对老年高血压患者腹部手术后并发症的影响

目的：探讨硬膜外复合全麻对老年高血压患者腹部手术后并发生的影响。方法：收集2013 年6 月-2015 年6 月在两家医院 接受腹部手术的老年高血压患者100 例,根据麻醉方法不同分为研究组和对照组。研究组患者给予硬膜外复合麻醉,对照组给予 全凭静脉麻醉。观察并比较两组患者的麻醉时间、药物用量以及术后并发症的发生率。结果：两组麻醉时间比较,差异无统计学意 义（P>0.05）;研究组麻醉药物用量低于对照组,差异具有统计学意义（P<0.05）;两组患者手术时间比较,差异无统计学意义（P>0. 05）;研究组患者术后苏醒时间、拔管时间以及住院时间均短于对照组,差异具有统计学意义（P<0.05）;研究组术后并发症的发生 率低于对照组,差异具有统计学意义（P<0.05）。结论：硬膜外复合全麻用于老年高血压患者腹部手术能够减少麻醉药物用量,降低 术后并发症的发生率,安全性较高。     

以提高教学质量为目标开展“普通植物病理学”课程考试改革

为进一步提高教学质量,培养高素质人才,高校应加大课程考试改革的力度。本文针对“普通植物病理学”课程考试中存在的主要问题,结合课程教学的特点,坚持理论联系实际,积极探索了贯穿于课程教学全过程,能够促进学生提高能力和素质的多元化的综合考核模式。     

FTA卡和普通定性滤纸提取DNA方法研究

用FTA采样卡和普通定性滤纸采集藏绵羊血样,采用NaOH法提取血液基因组DNA,利用设计的一对引物对DRB1基因第三外显子进行扩增,通过PCR产物琼脂糖凝胶检测,对普通定性滤纸与FTA采样卡的两种提取DNA的方法进行比较,结果认为采用普通定性滤纸-NaOH法提取血液基因组DNA,NaOH的最佳洗涤浓度是25 mmol/L,采用FTA-NaOH法提取血液基因组DNA,NaOH的最佳洗涤浓度是20 mmol/L,但普通定性滤纸法提取血液基因组DNA平均成本远低于FTA采样卡,普通定性滤纸法提取血液基因组DNA具有快速、便捷、经济及高效的特点.