早产儿血清炎性因子与生长发育指标的关系及对新生儿呼吸窘迫综合征的预测研究

摘要 目的：分析早产儿血清炎性因子与生长发育指标的关系及对新生儿呼吸窘迫综合征（RDS）的预测效能。方法：选择2018年1月至2020年10月在我院出生的98例早产儿作为研究对象,根据是否并发RDS,分为RDS组（58例）和非RDS组（40例）。检测两组血清白细胞介素-1β（IL-1β）、IL-6、IL-8、肿瘤坏死因子-α（TNF-α）、降钙素原（PCT）水平,记录生长发育指标,通过Pearson相关性分析早产儿血清炎性因子与生长发育指标的关系,使用受试者工作特征曲线（ROC）分析血清炎性因子对新生儿呼吸窘迫综合征的预测效能。结果：RDS组血清IL-1β、IL-6、IL-8、TNF-α、PCT水平均高于非RDS组（P＜0.05）;RDS组胎龄、出生体重均小于非RDS组（P＜0.05）;经Pearson相关性分析,早产儿血清IL-1β、IL-6、IL-8、TNF-α、PCT水平均与胎龄、出生体重呈负相关（P＜0.05）;经多因素Logistic回归分析,IL-1β、IL-6、IL-8、TNF-α、PCT均是早产儿并发新生儿呼吸窘迫综合征的独立危险因素（P＜0.05）;经ROC曲线分析,IL-1β、IL-6、IL-8、TNF-α联合PCT预测早产儿并发新生儿呼吸窘迫综合征的AUC为0.910。结论：早产儿血清IL-1β、IL-6、IL-8、TNF-α均与胎龄及出生体重密切相关,这些炎性因子联合预测RDS发生的效能较好,值得临床予以重视应用。     

血管生成素样蛋白4和Ⅱ型肺泡细胞表面抗原-6与急性呼吸窘迫综合征严重程度的关系及对预后的评估效能研究

摘要 目的：分析血管生成素样蛋白4(ANGPTL4)和Ⅱ型肺泡细胞表面抗原-6(KL-6)与急性呼吸窘迫综合征严重程度的关系及对预后的评估效能。方法：选择我院自2020年1月至2022年12月收治的120例急性呼吸窘迫综合征患者作为研究对象（观察组）,根据氧合指数（PaO₂/FiO₂）分为轻度组、中度组和重度组;另选120例非急性呼吸窘迫综合征患者作为对照组。检测所有患者血清ANGPTL4和KL-6的表达水平,分析血清ANGPTL4和KL-6与APACHE Ⅱ评分、PaO₂/FiO₂的关系,使用受试者工作特征曲线（ROC）下面积（AUC）评价血清ANGPTL4联合KL-6对急性呼吸窘迫综合征预后的评估效能。结果：对比对照组,观察组血清ANGPTL4、KL-6的表达水平均明显升高（P＜0.05）;血清ANGPTL4、KL-6的表达水平在轻度组、中度组和重度组中差异有统计学意义,且急性呼吸窘迫综合征越严重,升高越明显（P＜0.05）;经Pearson相关性分析,急性呼吸窘迫综合征患者血清ANGPTL4、KL-6的表达水平与PaO₂/FiO₂呈负相关,与APACHE Ⅱ评分呈正相关（P＜0.05）;经ROC曲线分析,血清ANGPTL4联合KL-6预测急性呼吸窘迫综合征患者入院28d内死亡的敏感度为90.14%、特异度为65.74%,AUC为0.900。结论：血清ANGPTL4、KL-6表达水平升高与急性呼吸窘迫综合征严重程度增大密切相关,两者联合在患者预后评估中具有一定价值,可作为判断病情及预后的辅助指标。     

血清炎症因子联合T淋巴细胞亚群在急性呼吸窘迫综合征中的应用价值分析

摘要 目的：分析血清炎症因子联合T淋巴细胞亚群在急性呼吸窘迫综合征中的应用价值。方法：选择我院2021年7月至2022年12月收治的70例急性呼吸窘迫综合征患者作为研究对象,分为轻度组、中度组和重度组。检测所有入选者的血清炎症因子、T淋巴细胞亚群,分析急性呼吸窘迫综合征患者血清炎症因子、T淋巴细胞亚群与氧合指数（OI）、肺部超声B线数目的关系;观察急性呼吸窘迫综合征患者28 d后预后情况,分为死亡组与存活组,使用ROC曲线分析血清炎症因子联合T淋巴细胞亚群对急性呼吸窘迫综合征患者死亡的预测效能。结果：血清IL-6、IFN-γ表达水平、外周血Th17细胞比例、Th17/Treg比值在轻度组、中度组和重度组中差异显著,两两比较,差异显著（P＜0.05）;经Pearson相关性分析,急性呼吸窘迫综合征患者血清IL-6、IFN-γ表达水平、外周血Th17细胞比例、Th17/Treg比值均与OI呈负相关,与B线数目呈正相关（P＜0.05）;死亡组血清IL-6、IFN-γ表达水平、外周血Th17细胞比例均高于存活组,Th17/Treg比值大于存活组,差异显著（P＜0.05）;经ROC曲线分析,IL-6、IFN-γ联合Th17/Treg比值预测急性呼吸窘迫综合征患者死亡的AUC为0.935。结论：血清炎症因子、T淋巴细胞亚群与急性呼吸窘迫综合征病情严重程度有关,其中IL-6、IFN-γ联合Th17/Treg比值预测预后不良的效能较好,值得临床予以重视应用。     

子宫颈机能不全孕妇血清松弛素、弹性蛋白表达意义及对妊娠结局的评估价值研究

摘要 目的：分析子宫颈机能不全孕妇血清松弛素、弹性蛋白表达意义及对妊娠结局的评估价值。方法：选择我院于2020年5月至2022年5月接诊的120例子宫颈机能不全孕妇作为观察组，另选同期的120例正常妊娠孕妇作为对照组。分析血清松弛素、弹性蛋白表达水平，及其与子宫颈机能不全孕妇宫口扩张宽度、宫颈长度的关系，观察血清松弛素、弹性蛋白在早产者与非早产者间的差异性，使用受试者工作特征曲线(ROC)下面积(AUC)评价血清松弛素联合弹性蛋白对早产及围产儿死亡的预测效能。结果：观察组血清松弛素水平较对照组高，弹性蛋白水平较对照组低（P＜0.05）；经Pearson相关性分析，子宫颈机能不全孕妇宫口扩张宽度与血清松弛素水平呈正相关，与弹性蛋白水平呈负相关（P＜0.05）；宫颈长度与血清松弛素水平呈负相关，与弹性蛋白水平呈正相关（P＜0.05）；在120例子宫颈机能不全孕妇中，早产42例、非早产78例；早产组血清松弛素水平高于非早产组，弹性蛋白水平低于非早产组（P＜0.05）；经ROC曲线分析，血清松弛素联合弹性蛋白预测子宫颈机能不全孕妇发生早产的AUC为0.910，预测围产儿死亡的AUC为0.943。结论：血清松弛素水平升高和弹性蛋白水平降低均与子宫颈机能不全有关，两者联合预测早产及围产儿死亡的效能较好，值得进一步研究应用。     

血清铁蛋白（SF）及sod水平与2型糖尿病患者小纤维神经病变关系的研究

摘要 目的：探血清铁蛋白（SF）及超氧化物歧化酶（sod）水平与2型糖尿病患者小纤维神经病变的关系。方法：选择2017年6月至2019年12月我院接诊的120例2型糖尿病患者,根据病变发生情况分为病变组67例,未发生病变53例作为对照组,分析血清铁蛋白（SF）及sod在其中的表达及其预测小纤维神经病变的价值。结果：病变组铁蛋白（SF）水平显著高于对照组,sod水平显著低于对照组,差异显著（P＜0.05）;ROC结果显示,铁蛋白（SF）预测2型糖尿病患者小纤维神经病变的AUC为0.924,95%CI为0.892~0.957,截断值为223.407 ng/mL ;sod预测2型糖尿病患者小纤维神经病变的AUC为0.96,95%CI为0.944~0.987,截断值为126.862 U/mL;联合预测2型糖尿病患者小纤维神经病变的AUC为0.993,95%CI为0.986~1.000,单独检测分别和联合检测曲线下面积比较均具有显著差异,联合检测的特异度、准确度分别为94.26%、95.16%。结论：在2型糖尿病小纤维神经病变患者中血清铁蛋白（SF）及sod的表达异常,对于疾病的进展有诊断意义,临床应给与关注。     

INSURE技术与LISA技术对极早产儿呼吸窘迫综合征患者的疗效

摘要 目的：对比插管-肺表面活性物质给药-拔管（INSURE）技术与微创肺表面活性物质给药（LISA）技术对极早产儿呼吸窘迫综合征患者的疗效。方法：选取2018年1月至2020年4月我院收治的108例极早产儿呼吸窘迫综合征患者作为研究对象,随机将其分为两组,对照组54例,给予INSURE技术治疗,研究组54例,给予LISA技术治疗。观察两组患儿治疗前后的血浆β-内啡肽（β-EP）、智力发展指数（MDI）、精神运动发育指数（PDI)水平,对比两组治疗过程中的指标、并发症、神经运动评价（纠正胎龄6月龄和12月龄的Gesell婴幼儿发育检查量表检测发育商DQ）及死亡率。结果：（1）两组患儿治疗后β-EP水平均下降,MDI、PD水均提高,研究组?茁-EP水平明显低于对照组,MDI、PD水平高于对照组（P＜0.05）。（2）研究组患者反复呼吸暂停发生率明显优于对照组（P＜0.05）;两组对比,心动过缓、血氧饱和度（SpO2）降低、72 h内机械通气、再次使用肺泡表面活性物质（PS）等指标对比无差异（P>0.05）;（3）两组患儿住院期间气胸、视网膜病变、脑室内出血（Ⅲ°或以上）、支气管肺发育不良等不良并发症和死亡率对比无差异（P>0.05）。（4）两组患儿在纠正胎龄6月龄和12月龄的5个能区评分和总发育商（DQ）比较无差异（P>0.05）。结论：LISA技术可减轻呼吸窘迫综合征极早产儿的神经发育损伤,亦能减少住院期间相关早产儿并发症,且对婴儿远期神经心理发育无不良影响,具有很好的临床价值,值得临床推广和应用。     

血清miR-34b-5p、miR-155表达与早产儿急性呼吸窘迫综合征炎症因子和预后的关系分析

摘要 目的：探讨血清微小核糖核酸（miR）-34b-5p、miR-155表达与早产儿急性呼吸窘迫综合征（ARDS）炎症因子和预后的关系。方法：选择2019年2月至2021年3月我院收治的92例ARDS早产儿,根据ARDS病情严重程度将其分为轻度组（31例）、中度组（43例）和重度组（18例）,追踪患儿临床结局,根据院内死亡情况将其分为存活组（51例）和死亡组（41例）。检测所有患儿的血清miR-34b-5p、miR-155表达水平以及白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）水平,比较各组间上述指标差异,分析ARDS早产儿血清miR-34b-5p、miR-155表达与炎症因子的相关性以及miR-34b-5p、miR-155预测ARDS早产儿预后的价值。结果：重度组miR-155表达水平及IL-1β、TNF-α、IL-6水平均高于中度组和轻度组,且中度组高于轻度组（P＜0.05）,重度组miR-34b-5p表达水平低于中度组和轻度组,且中度组低于轻度组（P＜0.05）。死亡组miR-155表达水平及IL-1β、TNF-α、IL-6水平高于存活组（P＜0.05）,死亡组miR-34b-5p表达水平低于存活组（P＜0.05）。ARDS早产儿miR-155表达水平与IL-1β、TNF-α、IL-6水平均呈正相关,而miR-34b-5p表达水平与IL-1β、TNF-α、IL-6水平均呈负相关（P＜0.05）。联合miR-34b-5p、miR-155预测ARDS早产儿死亡的曲线下面积（AUC）为0.853,高于两指标单独预测的0.688、0.649。结论：ARDS早产儿血清miR-34b-5p、miR-155表达水平与患儿血清炎症因子水平以及预后有关,可作为ARDS早产儿病情评估以及预后预测的潜在指标。     

改良微创肺泡表面活性物质技术对极早早产儿呼吸窘迫综合征患儿Th1/Th2细胞因子含量及心肌损伤指标的影响

摘要 目的：观察应用改良微创肺泡表面活性物质技术对极早早产儿呼吸窘迫综合征患儿Th1/Th2细胞因子含量及心肌损伤指标的影响。方法：以自2018年1月-2020年3月于本院院收治的104例极早早产儿呼吸窘迫综合征患儿为研究对象,按随机数字表法分为研究组（52例,给予改良微创肺泡表面活性物质技术治疗）和对照组（52例,给予气管插管-肺表面活性物质-拔管（INSURE）技术）。观察两组患儿治疗前、治疗7 d后的Th1/Th2细胞因子含量及心肌损伤指标,统计治疗后不良反应及并发症的发生率。结果：（1）干预前,两组患儿干扰素-γ（IFN-γ）、白介素-4（IL-4）及IFN-γ/IL-4含量比较,差异不显著（P＞0.05）;治疗后,两组IFN-γ及IFN-γ/IL-4含量均较治疗前降低,而IL-4含量明显上升;其中研究组IFN-γ及IFN-γ/IL-4含量均低于对照组,IL-4含量高于对照组,差异显著（P<0.05）。（2）干预前,两组患儿肌酸激酶同工酶（CK-MB）、肌酐蛋白（cTnI）及乳酸脱氢酶（LDH）含量比较,差异不显著（P＞0.05）;治疗后,两组CK-MB、cTnI及LDH含量均较治疗前降低,其中研究组CK-MB、cTnI及LDH含量均明显低于对照组（P<0.05）。（3）在治疗过程中,两组不良反应中心动过缓、经皮血氧饱和度（SpO2）下降、72 h内机械通气率及再次使用肺泡表面活性物质率比较,差异不显著（P＞0.05）。（4）在治疗过程中,两组并发症中早产儿视网膜病、坏死性小肠结肠炎、支气管肺发育不良、气胸、脑室内出血及死亡率比较,差异不显著（P＞0.05）。结论：应用改良微创肺泡表面活性物质技术可有效调节极早早产儿呼吸窘迫综合征患儿免疫功能,保护心肌细胞,且安全性高,值得临床推广使用。     

早产儿急性呼吸窘迫综合征血清1,25-(OH)2D3、PGRN、SIRT1、CTRP3水平与炎症反应和预后的关系研究

摘要 目的：探讨不同病情严重程度早产儿急性呼吸窘迫综合征（ARDS）血清1,25-二羟维生素D₃（1,25-(OH) ₂D₃）、颗粒体蛋白前体（PGRN）、沉默信息调节因子2相关酶1（SIRT1）、C1q/肿瘤坏死因子相关蛋白3（CTRP3）的变化，分析其与炎症反应和预后的关系。方法：选择2018年10月至2019年12月安徽省妇幼保健院收治的ARDS早产儿100例作为ARDS组，另选取同期在我院出生的健康新生儿60例作为对照组。根据《"新生儿急性呼吸窘迫综合征"蒙特勒标准（2017年版）》的病情判定标准将ARDS早产儿分为轻度组（n=40）、中度组（n=32）、重度组（n=28），比较不同病情严重程度ARDS早产儿血清1,25-(OH) ₂D₃、PGRN、SIRT1、CTRP3、炎症反应指标肿瘤坏死子因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-1β（IL-1β）水平变化，采用Pearson法分析ARDS早产儿血清1,25-(OH) ₂D₃、PGRN、SIRT1、CTRP3与炎症反应指标的相关性。另根据ARDS组患儿预后情况分为预后良好组（n=65）和预后不良组（n=35），采用单因素和多因素Logistic回归分析影响ARDS早产儿预后不良的危险因素。结果：ARDS组血清1,25-(OH) ₂D₃、SIRT1、CTRP3、PGRN水平明显低于对照组（P<0.05），ARDS组血清TNF-α、IL-6、IL-1β水平明显高于对照组（P<0.05）。不同病情严重程度ARDS早产儿血清1,25-(OH) ₂D₃、PGRN、SIRT1、CTRP3、炎症反应指标比较差异有统计学意义（P<0.05）。ARDS早产儿血清1,25-(OH) ₂D₃、PGRN、SIRT1、CTRP3水平与TNF-α、IL-6、IL-1β水平呈负相关（P<0.05）。多因素Logistic回归分析结果显示，低出生体重、肺表面活性物质（PS）使用次数≥3次、出现低白蛋白血症是影响ARDS早产儿预后不良的危险因素（P<0.05），血清1,25-(OH)2D3（较高）、PGRN（较高）、SIRT1（较高）、CTRP3（较高）是ARDS早产儿预后不良的保护因素（P<0.05）。结论：血清1,25-(OH) ₂D₃、PGRN、SIRT1、CTRP3可能参与ARDS早产儿的炎症反应过程，与ARDS早产儿的病情进展及预后密切相关，检测血清1,25-(OH) ₂D₃、PGRN、SIRT1、CTRP3有助于评估ARDS早产儿的预后。     

血清HBP、uNAG及Lp-PLA2在糖尿病酮症酸中毒患者中的表达及与病情程度的相关性分析

摘要 目的：探讨血清肝素结合蛋白（HBP）、N-乙酰-β-D-氨基葡萄糖苷酶（uNAG）及脂蛋白相关磷脂酶A2（Lp-PLA2）在糖尿病酮症酸中毒患者中的表达及与病情程度的相关性。方法：选择2018年3月至2020年3月于我院进行治疗的78例糖尿病酮症酸中毒患者进行研究,设为病例组,并选择我院同期治疗的单纯糖尿病患者70例作为对照组,分析血清HBP、uNAG及Lp-PLA2水平变化情况及与病情程度的相关性及其预测价值。结果：病例组血清HBP、uNAG及Lp-PLA2水平显著高于对照组,差异显著（P＜0.05）;轻度组血清HBP、uNAG及Lp-PLA2显著低于中度组、重度组患者,中度组HBP、uNAG及Lp-PLA2显著低于重度组患者,差异显著（P＜0.05）;相关性分析结果中显示,血清HBP、uNAG及Lp-PLA2均和病情程度之间呈正相关（P＜0.05）;ROC结果显示,血清HBP预测糖尿病酮症酸中毒的AUC为0.804,灵敏度为82.56%,特异度为86.32%,截断值为59.92 ng/mL;uNAG预测糖尿病酮症酸中毒的AUC为0.886,灵敏度为83.48%,特异度为87.95%,截断值为12.53 IU/L;血清Lp-PLA2预测糖尿病酮症酸中毒的AUC为0.977,灵敏度为88.69%,特异度为89.97%,截断值为194.96 ng/L,（P＜0.05）。结论：血清HBP、uNAG及Lp-PLA2在糖尿病酮症酸中毒患者中表达异常,与病情程度之间关系密切,对于病情控制具有重要临床意义。     

Anthropology and genetics of the caucasus peoples and the problem of the origin of the caucasoids

The electrophoretical polymorphisms of some blood proteins were studied in the Talysh population of Pirasora situated in South-East Azerbaidjan. We calculated the gene frequencies of these polymorphisms and determined the genetic distances between the Talyshes and some Iranian populations of North, Central and South Iran, Afghans, and three populations of Azerbaijan. The Talyshes are very close to Iranians of Shiraz, whereas they are distant from the Azerbaijanians. Anthropological investigations showed that the Caucasoids and Mongoloids lived in the Aragvi Basin since the Eneolithic period. This was stated by Alexeev (1974), who emphasized the mixture of the Caucasus populations from ancient times on. We calculated the genetic distances between the Caucasus populations and numerous populations of other geographic regions, considering 28 alleles of 12 loci of blood group, serum protein and red cell enzyme polymorphisms and constructed the dendrogram of these populations. The position of the Caucasus populations in the dendrogram corresponds on principle to the earlier anthropological observations. The clustering of the Caucasoid populations corresponds completely with anthropological and historical data, and supports our earlier hypothesis (Nazarova 1999) concerning the differentiation of Caucasoids, Northern Mongoloids and Amerinds from the populations, which inhabitated Asia in palaeolithic times.     

Serology and systematics of the Ebenales and the Theales

The systematic position ofthe Ebenaceae, Sapotaceae, Styracaceae, Ochnaceae, Stachyuraceae, Dipterocarpaceae, Clusiaceae and Hypericaceae has been investigated using serological comparisons of sets of antigenic determinants. The results show that the Sytracaceae and Sapotaceae are undoubtedly more closely associated with the Actinidiaeceae and Theaceae, respectively, than with each other. We found no corresponding determinants betnween antigen systems from the Ebenaceae and systems from any other family whose relations to this family have been proposed. As discovered previously, investigations of antigen systems from the Ochnaceae, Dipterocarpaceae, Stachyuraceae, Clusiaceae and Hypericaceae are against the idea of a natural order “Theales” in which these families, or at least some of them, are combined with the Theaceae and Actinidiaceae. This paper completes our previous investigations which largely support a superorder Ericanae sensu Ehrendorfer and Takhtajan. We propose to include the Actinidiaceae and Theaceae in this superorder, assigning them a central position laong with the Sapotaceae and Sytracaeae on one side and the Primulales and Ericales on the other. Another most interesting finding is that there are corresponding determinants between antigen systems from the members of the Ericanae and representatives of the Polemoniaceae and Loasaceae.     

人类基因组及后基因组研究进展及其应用与开发研究现状

人类对自身基因组的研究,随着人类基因组工作草图的绘制完成和对基因功能研究的深入已加快进入了实质性、关键性的开发利用阶段。本文概述了人类基因组及后基因组的研究进展及依此开展基因治疗及基因（组）药物研制等应用开发研究的现状。     

On the structure and dynamics of the complex of the nucleosome and the linker histone

Several different models of the linker histone (LH)–nucleosome complex have been proposed, but none of them has unambiguously revealed the position and binding sites of the LH on the nucleosome. Using Brownian dynamics-based docking together with normal mode analysis of the nucleosome to account for the flexibility of two flanking 10 bp long linker DNAs (L-DNA), we identified binding modes of the H5-LH globular domain (GH5) to the nucleosome. For a wide range of nucleosomal conformations with the L-DNA ends less than 65 Å apart, one dominant binding mode was identified for GH5 and found to be consistent with fluorescence recovery after photobleaching (FRAP) experiments. GH5 binds asymmetrically with respect to the nucleosomal dyad axis, fitting between the nucleosomal DNA and one of the L-DNAs. For greater distances between L-DNA ends, docking of GH5 to the L-DNA that is more restrained and less open becomes favored. These results suggest a selection mechanism by which GH5 preferentially binds one of the L-DNAs and thereby affects DNA dynamics and accessibility and contributes to formation of a particular chromatin fiber structure. The two binding modes identified would, respectively, favor a tight zigzag chromatin structure or a loose solenoid chromatin fiber.     

Kinematics and dynamics of the temporomandibular joint and of the movements of the mandible

In order to analyze the complicated movements of the mandible as the open-closing movement and the protrusio are, it is useful to evaluate the basic kinematic principles and reduce them to simple technical constructions. Both the open-closing movement and the protrusio could be reduced to 4-bar links, which were used to simulate the movements with help of a computer. Besides, the polodes and the curves of points in the muscular attachments could be constructed. The 2 entirely different 4-bar links have 3 things in common: The resting system - cranium, the moving system - mandibula, and 1 of the 2 arms connecting these 2 systems - the ligamentum laterale. As this ligament is taut during movements it can be considered a "guiding ligament" representing 1 of the 3 determining components of the mandibular movements. The other of the 2 arms has no anatomical equivalent; this arm, however, is "replaced" by the 2 other determining components of the mandibular movements: the joint and the muscles. The curves, which the Caput mandibulae describes, are practically identical for the open-closing movement and the protrusio despite of the different 4-bar links and these curves exactly correspond to the Discus articularis, taut by the upper part of the M. pterygoideus lateralis. The muscles do not only just move the mandibula, but they are also the component, which can choose between the different mandibular movements. By means of the curves, which points in the muscular attachments describe, the function of the masticatory muscles could be analyzed exactly.     

Biophysics and Structure of the Patch and the Gigaseal

Interpreting channel behavior in patches requires an understanding of patch structure and dynamics, especially in studies of mechanosensitive channels. High resolution optical studies show that patch formation occurs via blebbing that disrupts normal membrane structure and redistributes in situ components including ion channels. There is a 1-2 μm region of the seal below the patch where proteins are excluded and this may consist of extracted lipids that form the gigaseal. Patch domes often have complex geometries with inhomogeneous stresses due to the membrane-glass adhesion energy (E_a), cytoskeletal forces, and possible lipid subdomains. The resting tension in the patch dome ranges from 1-4 mN/m, a significant fraction of the lytic tension of a bilayer (∼10 mN/m). Thus, all patch experiments are conducted under substantial, and uneven, resting tension that may alter the kinetics of many channels. E_a seems dominated by van der Waals attraction overlaid with a normally repulsive Coulombic force. High ionic strength pipette saline increased E_a and, surprisingly, increased cytoskeletal rigidity in cell-attached patches. Low pH pipette saline also increased E_a and reduced the seal selectivity for cations, presumably by neutralizing the membrane surface charge. The seal is a negatively charged, cation selective, space with a resistance of ∼7 gigohm/μm in 100 mM KCl, and the high resistivity of the space may result from the presence of high viscosity glycoproteins. Patches creep up the pipette over time with voltage independent and voltage dependent components. Voltage-independent creep is expected from the capillary attraction of E_a and the flow of fresh lipids from the cell. Voltage-dependent creep seems to arise from electroosmosis in the seal. Neutralization of negative charges on the seal membrane with low pH decreased the creep rate and reversed the direction of creep at positive pipette potentials.     

The efficacy of ropivacaine and bupivacaine in the caesarean section and the effect on the vital signs and the hemodynamics of the lying-in women

ObjectiveTo investigate the efficacy of ropivacaine and bupivacaine in caesarean section and vital signs and the hemodynamics of the lying-in women.MethodsA total of 480 lying-in women who were admitted to this hospital for treatment between December 2017 and June 2018 were enrolled into this study as the subjects, which were divided into the experiment group and the control group, with 240 subjects in each group. In the experiment group, subjects received the local anesthesia by infusion of 1.5 mL ropivacaine (0.75%), while those in the control group also took the local anesthesia by infusion of 1.5 mL bupivacaine (0.75%). Thereafter, we observed the differences in the anesthetic efficiency, vital signs and hemodynamics of the lying-in women between two groups.ResultsThe excellent and good rates of the anesthesia in two groups were 92.1% and 87.9%, showing no obvious difference; in the experiment group, the average arterial pressures and systolic pressures at 5 min and 10 min after combined spinal and epidural analgesia (CSEA) were all elevated when comparing to the control group (all P < 0.05); in the experiment group, the onset time was obviously extended, while duration of sensory and motor block and the duration of motor block were all shorter than those in the control group (all P < 0.05). During anesthesia, the incidence rate of the adverse reactions in the control group was 2.50%, significantly higher than 0.83% in the experiment group (P < 0.05).ConclusionDespite that ropivacaine and bupivacaine are efficient in anesthesia in the CSEA in the caesarean section, ropivacaine is more recommended for little influence on the hemodynamics, shorter duration of sensory block and motor block and low incidence rate of adverse reactions, which are conducive to the recovery and also safe to the patients.