双侧股神经阻滞用于双膝关节置换术患者的麻醉效果和对血清炎性因子水平的影响

目的:研究双侧股神经阻滞术用于双膝关节置换术患者麻醉效果和对患者血清炎性因子水平的影响。方法:选择2015年10月～2018年10月在我院进行双膝关节置换术的110例患者,按照其入院顺序经随机数字表法分为两组,每组55例。对照组采用全身麻醉,研究组采用双侧股神经阻滞联合全身麻醉。比较两组的麻醉情况,治疗前后血清炎性因子白介素6(IL-6)、C反应蛋白(CRP)、舒张压(DBP)、收缩压(SBP)、心率(HR)水平的变化。结果:两组麻醉时间比较差异无统计学意义(P0.05);研究组拔管、恢复室停留和苏醒时间均显著短于对照组(P0.05)。两组术后24 h、48 h血清炎性因子IL-6、CRP水平均高于术前,但研究组以上指标均显著低于对照组(P0.05);两组术中DBP、SBP、HR水平均较术前显著降低(P0.05),但研究组DBP、SBP、HR水平均显著高于对照组(P0.05),两组术后DBP、SBP、HR水平比较差异均无统计学意义(P0.05)。结论:与单纯采用全身麻醉相比,双侧股神经阻滞可有效改善双膝关节置换术患者的麻醉效果,并降低其血清炎症因子和稳定其血流动力学。     

急诊昏迷患者的迅速分诊与急救方法探讨

目的:探讨急诊昏迷患者的迅速分诊与急救方法。方法:参照5级急诊预检分诊系统和急诊危重病降阶梯治疗方法,对我院2012年1月至2014年12月120例急诊治疗昏迷患者进行规范化分诊、急救护理,回顾性分析其诊疗效果。结果:120例昏迷患者有90例(75.00%)治愈出院,17例(14.17%)因病情平稳转至相关科室进行治疗,13例(10.83%)病死,急诊治疗总有效率和病死率分别为89.17%和10.83%。结论:分诊和急救处置的规范化对患者治愈和预后有重要影响。     

Solute complexation degree with human serum albumin: biochromatographic approach

A mathematical model was developed for the study of the D,L-dansylamino acid retention mechanism in reversed-phase liquid chromatography using a C18 column as a stationary phase and human serum albumin (HSA) as an eluent modifier. The solute retention factor is dependent on the HSA concentration in the eluent as well as the binding constant of the guest-HSA complex. A determination of the degree of complexation n(c) (the percent of the complexed guest) could be carried out. Different Van 't Hoff plot shapes of the degree of complexation were observed with different eluent pH, confirming a change in the solute complexation mechanism for physiological pH (between 7-7.5). Enthalpy-entropy compensation was also analysed in relation to this mathematical model to confirm the solute complexation behavior with HSA. These results finally confirmed that at physiological pH and temperature (approximately 35 degrees C) values the HSA was in a favorable structural conformation for its binding with a great majority of drugs.     

以中枢神经系统症状为首发表现的干燥综合征1例并文献复习

目的:探讨干燥综合征累及中枢神经病变的临床表现及诊断、鉴别诊断、治疗。方法:报告中国人民解放军第175医院1例累及中枢神经病变的干燥综合征患者的临床资料并复习相关文献,对其临床表现、诊断、容易混淆的鉴别诊断及治疗进行分析。结果:1例累及中枢神经病变的干燥综合征患者经治疗病情好转出院。结论:累及中枢神经病变的干燥综合征,尤其以中枢神经系统症状为首发表现者,极易误诊为多发性硬化,遇可疑病例应及时完善检查,避免因忽视其它系统症状而导致漏诊和误诊,影响患者的预后。     

1260例阴道分泌物检测分析

目的调查海宁地区女性阴道感染情况。方法采用白带常规镜检联合需氧菌阴道炎／细菌性阴道病联合测定技术对1260例阴道分泌物进行检测。结果在1260例就诊患者中,清洁度I～II度526例（41．75％）,清洁度III～IV度734例（58．25％）,检出阴道感染患者912例,单一性感染487例（占患病人数的53．4％）,混合感染患者425例（占患病人数的46．6％）。在487例单一性感染患者中,需氧菌阴道炎（AV）患者123例,细菌性阴道病（BV）患者178例,胞溶性阴道病（CV）患者8例,外阴阴道假丝酵母菌病（VVC）患者146例,滴虫性阴道炎（TV）患者32例;在425例混合感染患者中,AV＋BV患者136例,AV＋VVC患者56例,AV＋TV患者62例,BV＋VVC患者103例,BV＋TV患者48例,AV＋BV＋VVC患者13例,AV＋BV＋TV患者7例。结论阴道混合感染及AV发病率较高,值得临床高度关注。     

超声引导下QLB复合气管插管全麻对于老年患者TEP腹股沟疝无张力修补术影响因素分析

摘要 目的：探讨与分析超声引导下腰方肌阻滞(quadratus lumborum block,QLB)复合气管插管全麻对于老年患者腹腔镜下全腹膜外（totally extraperitoneal prosthetic,TEP）腹股沟疝无张力修补术的影响,以促进该方法的临床使用。方法：2014年9月到2020年6月选择在本院诊治的腹股沟疝老年患者180例,根据随机数字表法分为QLB组与对照组各90例。所有患者都给予腹腔镜下全腹膜外腹股沟疝无张力修补术,对照组给予气管插管全麻,QLB组在对照组麻醉的基础上给予超声引导下QLB,记录两组镇痛与麻醉效果。结果：两组的术中出血量、手术时间等对比差异无统计学意义(P>0.05),QLB组的术后住院时间、术后胃肠功能恢复时间、术后下床活动时间显著短于对照组(P<0.05)。与术后12 h对比,两组术后24 h与36 h的疼痛VAS评分均降低(P<0.05),且QLB组术后12 h、24 h与36 h的疼痛VAS评分都显著低于对照组(P<0.05)。QLB组术后7 d的血肿、呼吸抑制、脏器损伤、腹股沟区包块等并发症发生率为8.9 %,显著低于对照组的21.1 %(P<0.05)。QLB组的瑞芬太尼用量、术后48 h内有效按压自控静脉镇痛泵次数、自控静脉镇痛泵累计用量都显著少于对照组(P<0.05)。结论：超声引导下QLB复合气管插管全麻在老年患者腹腔镜下全腹膜外腹股沟疝无张力修补术中的应用能提高镇痛与麻醉效果,减少术后并发症的发生,有利于促进患者康复。     

神经精神性狼疮患者血清可溶性fractalkine、乳酸脱氢酶水平与疾病活动程度的关系及其影响因素分析

摘要 目的：探讨神经精神性狼疮（NPSLE）患者血清可溶性fractalkine（sFKN）、乳酸脱氢酶（LDH）水平与疾病活动程度的关系,分析NPSLE发病的危险因素。方法：选取2016年1月-2020年12月我院收治的106例系统性红斑狼疮患者,其中44例患者出现神经精神症状（NPSLE组）,62例患者未出现神经精神症状（非NPSLE组）。检测血清sFKN、LDH水平,采用SLE疾病活动程度（SLEDAI）评分评估疾病活动程度,根据 SLEDAI评分将NPSLE组患者分为轻度组（17例）、中度组（15例）、重度组（12例）。Spearman秩相关分析血清sFKN、LDH水平与SLEDAI评分之间相关性,多因素Logistic回归分析NPSLE发病的影响因素。结果：NPSLE组血清sFKN、LDH水平、SLEDAI评分均高于非NPSLE组（P＜0.05）。重度组血清sFKN、LDH水平高于中度组和轻度组（P＜0.05）,中度组血清sFKN、LDH水平高于轻度组（P＜0.05）。血清sFKN、LDH水平与SLEDAI评分均呈正相关（rs=0.868、0.732,P＜0.05）。多因素Logistic回归分析结果显示发病年龄较小、病程较短、未接受正规糖皮质激素治疗、高sFKN、高LDH是NPSLE发病的危险因素（P＜0.05）。结论：NPSLE患者血清sFKN、LDH水平均增高,高水平sFKN、LDH与NPSLE发生和疾病活动程度增加有关,临床监测血清sFKN、LDH水平有助于早期识别NPSLE。     

Early molecular events in the interaction of enveloped viruses with cells

The fluorescence depolarization of 1,6-diphenyl-hexatriene was used to study the dynamic properties of the hydrophobic regions of the lipid envelopes of ortho- and paramyxoviruses as well as of the Rous sarcoma virus and of the membrane lipids of susceptible and nonsusceptible cells.The systems investigated where active and inactive influenza viruses, and NDV virus acting on chick embryo fibroblasts and Rous sarcoma virus acting on susceptible (C/E) and nonsusceptible (C/B) chicken-cell.Polarization degrees and mean rotational correlation times of DPH embedded in viral lipids were significantly higher than those of DPH in the cell membranes, due to a higher rigidity of the virus envelopes. When suspensions of labelled viruses and unlabelled cells or unlabelled viruses and labelled cells were mixed, a characteristic change of the fluorescence polarization degrees with time was observed. This behaviour was ascribed to a label transfer from virus to cell membranes or vice versa.While the rate constants of label transfer from virus to cells and cells to virus were about the same for the penetrating viruses the rate constants of label release from inactive virus to cells were much larger than for the migration in the opposite direction.     

Coupling of K+-gating and permeation with Ca2+ block in the Ca2+-Activated K+ channel inChara australis

Summary The patch-clamp technique is used here to investigate the kinetics of Ca²⁺ block in single high-conductance Ca²⁺-activated K⁺ channels. These channels are detected in the membrane surounding cytoplasmic drops fromChara australis, a membrane which originates from the tonoplast of the parent cell. The amplitudes and durations of single channel events are measured over a wide range of membrane potential (–300 to 200 mV). Ca²⁺ on either side of the channel reduces its K⁺ conductance and alters its ion-gating characteristics in a voltage-dependent manner. This Ca²⁺-induced attenuation of conductance is analyzed using the theory of diffusion-limited ion flow through pores. Interaction of external Ca²⁺ with the channel's ion-gating mechanism is examined in terms of a kinetic model for ion-gating that includes two voltage-dependent gating mechanisms. The kinetics of channel block by external Ca²⁺ indicates that (i) external Ca²⁺ binds at two sites, a superficial site and a deep site, located at 8 and 40% along the trans-pore potential difference, (ii) the external vestibule cannot be occupied by more than one Ca²⁺ or K⁺, and (iii) the kinetics of Ca²⁺ binding at the deep site is coupled with that of a voltage-dependent gate on the external side of the channel. Kinetics of channel block by internal Ca²⁺ indicates that more than one Ca²⁺ is involved.     

Positive Periodic Solution for a Neutral Delay Model in Population

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