对比剂注射方式对下肢动脉血管成像质量的影响

目的:探讨对比剂不同注射方式对下肢动脉血管成像(CTA)质量的影响。方法:选择2013年6月到2015年10月在我院怀疑下肢动脉栓塞或狭窄而行CTA检查的患者80例,按随机数字表法分为A、B两组,各40例。A组患者先以5 mL/s的速率注射100 mL优维显,后以5 mL/s的速率注射50 mL生理盐水。B组患者先以5 mL/s的速率注射50 mL优维显,后以2.5 mL/s的速率注射50 mL优维显,最后以5 mL/s的速率注射50 mL生理盐水。比较两组患者的下肢动脉CTA图像质量。结果:B组患者不同横断面CT值相比于A组较平稳(P0.05)。B组患者小腿动脉和足部动脉的边缘分级、血管分支等级评价及显示的节段数均明显高于A组(P0.05)。结论:对比剂以不同速率相结合的注射方式能够使下肢动脉血管中对比剂浓度维持在平稳且较高的水平,可以提高下肢动脉CTA图像质量,值得在临床上推广应用。     

单腔静脉留置针在冠脉CTA检查应用中的安全性评价

目的:评价单腔静脉留置针在冠状CTA检查中的安全性应用.方法:对2006年1月至2009年12月我院行冠脉CTA检查4600例病人全部采用美国Becton?Dickinson(B-D公司)18-20#单腔静脉留置针注射对比剂,注射速率5-6ml/sec,对比剂浓度350mg/ml.结果:99.8%病例顺利完成冠脉CTA检查,图像质量优良;有0.2%的患者因穿刺技术、血管本身条件差或等待中保护不当造成不同程度渗漏,未完成检查.结论:冠脉CTA检查需高流速、高浓度注入对比剂,其静脉留置针的安全性明显高于传统强化头皮针;同时便于对比荆毒副反应抢救用药.     

不同剂量64排CT增强扫描结合三维重建在胃癌应用中的图像质量研究

目的:研究不同剂量64排CT增强扫描结合三维重建在胃癌应用中的图像质量。方法:90例胃癌行胃部64层螺旋CT三期增强扫描患者后根据管电压设置分成A、B、C三组:A组120KV、B组100KV、C组80KV。通过轴位图像结合三维重建(VR、MPR和MIP等)分析不同剂量下螺旋CT扫描结合三维重建图像诊断质量。结果:A、B两组的图像清晰度的差异无统计学意义(P0.05),A、B组剂量加权指数降低率的差异具有统计学意义,A、C两组间图像清晰度及剂量加权指数降低率的差异具有统计学意义(P0.05),B、C组两项差异具有统计学意义。结论:适当调整MSCT的剂量,可以获得与常规MSCT剂量完全相同的图像而且可以降低辐射。     

静脉与硬膜外注射地塞米松对吗啡硬膜外术后镇痛的影响

目的:比较两种不同途径注射地塞米松磷酸钠对吗啡硬膜外术后镇痛的影响。方法:选择200例(ASAⅠ-Ⅱ)在腰硬联合麻醉下行腹式子宫切除术的患者,随机分为A、B、C、D四组(n=50),各组均给以硬膜外注射2.5 mg吗啡作为术后镇痛治疗的同时,A组静脉注射安慰剂(生理盐水),B组静脉注射地塞米松磷酸钠10 mg,C组静脉注射地塞米松磷酸钠5 mg,D组硬膜外注射地塞米松磷酸钠5 mg及静脉注射安慰剂(生理盐水),以上均以5 mL作为注射容积。观察和比较术后24 h内各组恶心和呕吐(PONV)、皮肤瘙痒、补救镇痛、呼吸抑制的发生率、排气时间和补救镇痛时间。结果:B、C、D三组的PONV总发生率显著低于A组(P0.0083),而B、C、D三组之间比较无显著差异(P0.0083);A、B、C、D四组间恶心的发生率无显著差异(P0.05),而D组呕吐的发生率明显低于A组(P0.0083);B组皮肤瘙痒的发生率明显低于A组(P0.0083);四组患者的VAS评分比较无显著差异,均达到满意的镇痛效果(P0.05)。四组患者补救镇痛的发生率、补救镇痛药量和排气时间比较无明显差异(P0.05),而C、D组的补救镇痛时间明显比A组延长(P0.0083),四组患者均未出现呼吸抑制。结论:地塞米松磷酸钠可降低吗啡硬膜外术后恶心和呕吐的发生率,延长补救镇痛时间;硬膜外注射地塞米松磷酸钠对降低呕吐的发生率更有效;静脉注射地塞米松磷酸钠10 mg可降低瘙痒的发生率,且无明显的不良反应。     

下腹部手术麻醉中不同靶浓度瑞芬太尼与异丙酚的作用研究

目的研究下腹部手术麻醉患者应用不同靶浓度瑞芬太尼和异丙酚的作用效果。方法将我院收治的下腹部手术麻醉患者为研究对象,并按随机分组法分为3组,均固定瑞芬太尼靶浓度,A组为6ng/ml,B组为8ng/ml,C组为10ng/ml,同时改变异丙酚靶浓度,范围为2~4μg/ml,观察比较各组的麻醉效果。结果 T1时刻A组的收缩压(SBR)高于B组,心率(HR)高于C组,差异有统计学意义(P0.05);而T2、T3时刻比较,A组的SBR以及HR均较B、C组高(P0.05)。随时间推移,去甲肾上腺素(NE)各时点比较,T1时刻A组的NE高于C组,而血清皮质醇(COR)低于B、C组;T2、T3时刻A组的NE均显著高于B、C组,但3组COR变化无显著差异性(P0.05)。C组自主呼吸恢复时间、拔除气管导管时间、指令反应时间和离室时间均较长,而其睁眼时间较短(P0.05)。结论将瑞芬太尼靶浓度调节为8ng/ml,可取得较为明显的麻醉镇痛效果。     

腹腔复苏治疗创伤失血性休克大鼠的实验研究

目的:探讨在静脉输液通道无法建立的情况下,单纯腹腔复苏对创伤失血性休克是否有效.方法:40只SD大鼠被随机分为A组(空白对照组)、B组(休克不复苏组,出血+急救期不接受任何治疗)、C组(腹腔复苏组,出血+急救期给予腹腔注射平衡液10ml/100g体重)、D组(静脉输液组,出血+急救期静脉输入平衡液并保持大鼠MAP在60+5mmHg),B、C、D三组大鼠均制备为未控制创伤失血性休克模型,记录各组大鼠的生存时间,比较各组大鼠的生存率,在0、30、90和120 min时相点观察比较各组大鼠临床指标、血气分析指标和血清TNF-α.结果:C组大鼠的存活时间较B组明显延长(P＜0.05);C组大鼠72 h存活率明显高于B组,但低于D组(P＜0.05).C组大鼠的临床复苏指标、血气分析指标均优于B组,但较D组差;C组大鼠血清TNF-α低于B组,高于D组.C组大鼠生存率明显高于B组,低于D组.结论:腹腔复苏治疗创伤失血性休克大鼠是有效的但效果比静脉复苏差.     

帕瑞昔布钠超前应用减轻异丙酚注射痛

目的:比较注射不同剂量帕瑞昔布钠预防异丙酚注射痛的效果.方法:采用随机双肓对照方法,选择我院择期手术病人150例,ASAⅠ～Ⅱ级,随机分为3组,每组50例.麻醉诱导前1 min,均从手背静脉预给药,给药前使该手臂举起15 sec,然后在前臂近端扎止血带放平.A组:静脉注射帕瑞昔布钠40 mg;B组:静脉注射帕瑞昔布钠20 mg;均溶于5 mL生理盐水;C组:静脉注射0.9％生理盐水5mL.推注60 sec后松开止血带,以0.5 ml/sec的速度注射异丙酚.注射期间使用4分法对注射痛评分.结果:与B组和C组比较,A组异丙酚注射痛发生率明显降低(P＜0.001).三组患者异丙酚注射痛的VRS评分在轻度疼痛方面没有差异.但在中至重度疼痛方面A组和B组明显低于C组(P＜0.001).A组的无痛患者明显高于B组,而VRS评分明显低于B组(P＜0.001).结论:静脉注射帕瑞昔布钠40 mg预充盈血管60 sec均能明显降低异丙酚注射痛.静脉注射帕瑞昔布钠20 mg能降低异丙酚注射痛的程度但不能降低异丙酚注射痛的发生率.     

A型肉毒杆菌毒素水凝胶去神经支配作用的定量研究

目的：探讨改变剂型后的A型肉毒杆菌毒素（BTXA）的生物活性是否存在,并对其去神经支配作用进行定量分析。方法：SD大鼠36只,随机分成4组。A~D组随机一侧腓肠肌肌内注射BTXA水溶液0.1 ml（5U）、BTX-A水凝胶0.1 ml（12.5U）、0.1 ml（5U）及0.1 ml（2U）,对侧腓肠肌肌内注射0.1 ml相应溶剂。于用药前、用药后5d、2周、3周、1个月、2个月及3个月分别测定双侧腓肠肌复合动作电位（CMAP）,并记录波幅。结果：不同时间段用药侧与对侧腓肠肌CMAP波幅的下降幅度比较有非常显著性差异（P〈0.01）,用药后的用药侧与对侧腓肠肌CMAP波幅的下降幅度均明显高于用药前（P〈0.01）;各组间的用药侧与对侧CMAP波幅的下降幅度比较有非常显著性差异（P〈0.01）,A组及B组的下降幅度明显高于C组及D组（P〈0.01）,A组及B组比较则没有显著性差异,C组的下降幅度高于D组（P〈0.01）。结论：水凝胶剂型的BTXA不仅保存了其去神经支配的生物活性,且表现明显的量效关系和时效关系。     

不同镇静深度静吸复合麻醉对老年腹腔镜腹部手术患者术后认知功能的影响比较

目的:比较不同镇静深度静吸复合麻醉对老年腹腔镜腹部手术患者术后认知功能的影响。方法:选择我院2014年3月-2015年3月90例拟择期行腹部手术的老年患者随机分为A、B、C三组,每组30例,采用不同深度静吸复合麻醉,根据BIS指数调节七氟醚浓度和瑞芬太尼输注速率,其中A组维持BIS值水平51-60,B组维持BIS值水平41-50,C组维持BIS值水平31-40,于术前1d和术后1 d对患者认知功能进行测评。结果:各组麻前1 d A组TMT完成时间和MMSE评分比较差异无显著性(P0.05)。A组术后24 h认知功能下降发生率为30.0%,B组术后24 h认知功能下降发生率为23.33%,C组认知功能下降发生率为16.67%,C组与A组比较差异具有显著性(P0.05)。C组TMT完成时间和MMSE评分差值均低于A组B组,但各组内和组间比较差异无显著性(P0.05)。结论:深度麻醉对老年腹腔镜腹部手术患者早期术后认知功能影响较小。     

补骨脂抑制人工关节假体周围骨溶解的研究*

摘要目的：探讨中药补骨脂对人工关节置换术后假体周围骨溶解,假体无菌性松动的核因子资B受体活化因子配体- 核因子资B 受体活化因子受体- 骨保护素(RANKL-RANK-OPG)信号通路的作用。方法：取24 只200± 5 g雌性SD大鼠,随机分为A、B、C 组,均注射钛颗粒溶液建立骨溶解模型,术后A 组采用中药补骨脂水溶液腹腔注射,B 组采用外源性OPG 腹腔注射作为阳性对 照,C 组采用生理盐水腹腔注射作为阴性对照。给药4 周后,通过免疫组化及反转录聚合酶链反应(RT-PCR)检测各组动物体内 RANKL/RANK的表达水平变化。结果：用药4 周后,3 组12 只大鼠背部气囊均为厚壁囊腔,骨溶解模型成功建立,免疫组化及 RT-PCR 检测RANKL/RANK 均呈阳性表达。免疫组化RANKL平均光密度(AOD)值A组(0.168± 0.017)、B 组(0.147± 0.009)明显 低于C 组(0.314± 0.011),差异有统计学意义(P＜0.05);A 组、B组之间比较无明显差异。RANK AOD值测定A组(0.172± 0.015)、 B 组(0.193± 0.045)明显低于C 组(0.342± 0.007),差异有统计学意义(P＜0.05);A 组、B 组之间比较无明显差异。RT-PCR 检测 RANKL相对量A 组(0.575± 0.143)、B 组(0.543± 0.174)明显低于C 组(0.951± 0.362),差异有统计学意义(P＜0.05);A 组、B 组之 间比较无明显差异。RANK 相对量A 组(0.433± 0.025)、B组(0.611± 0.209)明显低于C 组(0.871± 0.211),差异有统计学意义(P＜ 0.05);A 组、B 组之间比较无明显差异。结论：中药补骨脂对人工关节置换术后假体周围骨溶解,假体无菌性松动具有抑制作用。     

Thermogenic responses of high-altitude adapted rats on low temperatures and low pressures

The male rats were raised in two groups, one at Mt. Yatsugatake (2,100 m above sea level, the average ambient temperature 12.5 degrees C) for 30 days, and the other at a laboratory of Matsumoto (610 m above sea level, the average temperature 20 degrees C). The steady-state oxygen consumptions (VO2) and the rectal temperatures (TR) were measured under exposure conditions of various temperatures combined with different simulated altitudes. The values of VO2 and TR for a control group at 610 m-20 degrees C were regarded as 100% and the relative changes to the control values were obtained at various temperatures in the respective low-pressure condition. When measured at a simulated altitude of 2,000 m on the 2nd day after the rats raised at Mt. Yatsugatake were translocated to Matsumoto, the values at 0 degrees C and 10 degrees C room temperatures, VO2 and TR, were still significantly increased as compared with those of rats raised at Matsumoto. On the 40th day after the translocation from Mt. Yatsugatake, however, the values turned out to exhibit no significant difference in both groups. These results indicated that the greater thermogenesis of high-altitude adapted rats had been established by combined stimuli of low temperatures and low pressures as compared with those of Matsumoto-level adapted rats, but the responses returned to the control level by deadaptation process at 40 days after the translocation.     

Effects of electromagnetic fields of low frequency and low intensity on rat metabolism

A series of experiments on rats have been performed, to study the effects of long time (50 days) exposure to electromagnetic fields of extremely low frequency (ELF, i.e. less than 100 Hz) and amplitude (non thermal), testing whether the metabolic processes would be affected. The background lies on recent observations on the behaviour of isolated enzymes in vitro exposed to EFL fields. In these experiments, the cyclotron (or Larmor) frequency of the metallic ion has been used to "stimulate" the metalloproteins redox-active site, thus obtaining a clear variation of the enzyme functionality. In this paper we have extended for the first time the check to more complex animal metabolism. The novelty of this approach implies that a large amount of data had to be analyzed since it was not possible, in principle, to select only a few parameters among all the potential effects. Several biochemical parameters have been evaluated by comparing their values during the periods of exposure (field ON) and non exposure (field OFF). The evidence that long term exposure to electromagnetic fields with a well defined frequency may have relevant effects on parameters such as body weight, blood glucose and fatty acid metabolism has been obtained.     

Comparison of plasma clearance of low density lipoprotein with beta-very low density lipoprotein or acetoacetylated low density lipoprotein in cholesterol-fed rabbits

The plasma clearance and tissue distribution of radioiodinated low-density lipoprotein (LDL), beta-very low density lipoprotein (beta-VLDL), and acetoacetylated LDL were studied in cholesterol-fed rabbits. Radioiodinated LDL ([125I]LDL) was cleared more slowly than either [125I]beta-VLDL or acetoacetylated-[125I]LDL and its fractional catabolic rate was one-half that of [125I]beta-VLDL and one-ninth that of acetoacetylated-[125I]LDL. Forty-eight hours after the injection of the labeled lipoproteins, the hepatic uptake was the greatest among the organs evaluated with the uptake of [125I]LDL being one-third that of either [125I]beta-VLDL or acetoacetylated-[125I]LDL. The reduction in the hepatic uptake of LDL due to a down-regulation of the receptors would account for this retarded plasma clearance.     

Intracellular trafficking of pigeon beta-very low density lipoprotein and low density lipoprotein at low and high concentrations in pigeon macrophages

Foam cell formation occurs in vitro at lipoprotein concentrations above 50 microgram/ml in pigeon macrophages. Hypothetically, intracellular trafficking of lipoproteins at higher concentrations may differ from uptake of lipoproteins associated with low concentrations, revealing a separate atherogenic endocytic pathway. Macrophage intracellular trafficking of pigeon beta-very low density lipoprotein (beta-VLDL) and low density lipoprotein (LDL) at low concentrations (12 microgram/ml) near the saturation of high affinity binding sites and high lipoprotein concentrations (50-150 microgram/ml) used to induce foam cell formation were examined. Pigeon beta-VLDL and LDL, differentially labeled with colloidal gold, were added simultaneously to contrast trafficking of beta-VLDL, which causes in vitro foam cell formation, with LDL, which does not. The binding of lipoproteins to cell surface structures, distribution of lipoproteins in endocytic organelles, and the extent of colabeling in the endocytic organelles were determined by thin-section transmission electron microscopy.At low concentrations, the intracellular trafficking of pigeon LDL and beta-VLDL was identical. At high concentrations, LDL was removed more rapidly from the plasma membrane and reached lysosomes more quickly than beta-VLDL. No separate endocytic route was present at high concentrations of beta-VLDL; rather, an increased residence on the plasma membrane, association with nonmicrovillar portions of the plasma membrane, and slower trafficking in organelles of coated-pit endocytosis reflected a more atherogenic trafficking pattern.     

Enhancement of virus-induced gene silencing in tomato by low temperature and low humidity

Virus-induced gene silencing (VIGS) is an attractive reverse-genetics tool for studying gene function in plants. We showed that silencing of a phytoene desaturase (PDS) gene is maintained throughout TRV-PDS-inoculated tomato plants as well as in their flowers and fruit and is enhanced by low temperature (15 degrees C) and low humidity (30%). RT-PCR analysis of the PDS gene revealed a dramatic reduction in the level of PDS mRNA in leaves, flowers and fruits. Silencing of PDS results in the accumulation of phytoene, the desaturase substrate. In addition, the content of chlorophyll a, chlorophyll b and total chlorophyll in the leaves of PDS-silenced plants was reduced by more than 90%. We also silenced the LeEIN2 gene by infecting seedlings, and this suppressed fruit ripenning. We conclude that this VIGS approach should facilitate large-scale functional analysis of genes involved in the development and ripening of tomato.     

Characterization of the chicken oocyte receptor for low and very low density lipoproteins

The chicken oocyte receptor for low and very low density lipoproteins has been identified and characterized. Receptor activity present in octyl-beta-D-glucoside extracts of oocyte membranes was measured by a solid phase filtration assay, and the receptor was visualized by ligand blotting. The protein had an apparent Mr of 95,000 in sodium dodecyl sulfate-polyacrylamide gels under nonreducing conditions and exhibited high affinity for apolipoprotein B-containing lipoproteins, but not for high density lipoproteins or lipoproteins in which lysine residues had been reductively methylated. Binding of lipoproteins was sensitive to EDTA, suramin, and treatment with Pronase. In these aspects, the avian oocyte system was analogous to the mammalian low density lipoprotein receptor in somatic cells. Furthermore, a structural relationship between the mammalian and avian receptors was revealed by immunoblotting: polyclonal antibodies directed against the purified bovine low density lipoprotein receptor reacted selectively with the 95-kDa chicken receptor present in crude oocyte membrane extracts.