喉罩通气下七氟醚全凭吸入麻醉在小儿先天性心脏病介入手术的临床麻醉效果

目的:探讨喉罩通气下七氟醚全凭吸入麻醉在小儿先天性心脏病介入手术的临床麻醉效果。方法:选取2017年4月～2019年5月期间我院收治的行先天性心脏病介入手术患儿98例,根据随机数字表法将其分为对照组(n=49)和研究组(n=49)。对照组给予氯胺酮诱导,全凭丙泊酚维持,面罩吸氧;研究组给予全凭七氟醚诱导、维持,喉罩通气。比较两组患儿麻醉前(T0)、切皮前(T1)、切皮后1 min(T2)、切皮后30 min(T3)、术后(T4)的血流动力学指标[平均动脉压(MAP)、心率(HR)]及应激反应指标[血糖、皮质醇],记录两组患儿手术时间、麻醉诱导时间、术后苏醒时间等围术期指标情况。记录两组围术期不良反应发生情况。结果:研究组手术时间、麻醉诱导时间、术后苏醒时间均短于对照组(P0.05)。两组T0时间点血糖、MAP、皮质醇、HR比较差异无统计学意义(P0.05);对照组T1～T4时间点MAP、血糖、皮质醇、HR均较T0升高(P0.05);研究组T1～T4时间点血糖、MAP、皮质醇、HR与T0时间点比较无差异(P0.05);研究组T1～T4时间点血糖、MAP、皮质醇、HR低于对照组(P0.05)。两组不良反应发生率比较无差异(P0.05)。结论:小儿先天性心脏病介入手术中应用喉罩通气下七氟醚全凭吸入麻醉,诱导迅速且安全、术后苏醒快、手术时间短,可有效维持血流动力学稳定,减少应激反应。     

A simple method for using silicone elastomer masks for quantitative analysis of cell migration without cellular damage or substrate disruption

Cell migration is fundamental to many biological processes, including development, normal tissue remodeling, wound healing, and many pathologies. However, cell migration is a complex process, and understanding its regulation in health and disease requires the ability to manipulate and measure this process quantitatively under controlled conditions. This report describes a simple in vitro assay for quantitative analysis of cell migration in two-dimensional cultures that is an inexpensive alternative to the classic “scratch” assay. The method described utilizes flexible silicone masks fabricated in the lab according to the research demands of the specific experiment to create a cell-free area for cells to invade, followed by quantitative analysis based on widely available microscopic imaging tools. This experimental approach has the important advantage of visualizing cell migration in the absence of the cellular damage and disruption of the substrate that occurs when the “wound” is created in the scratch assay. This approach allows the researcher to study the intrinsic migratory characteristics of cells in the absence of potentially confounding contributions from cellular responses to injury and disruption of cell–substrate interactions. This assay has been used with vascular smooth muscle cells, fibroblasts, and epithelial cell types, but should be applicable to the study of practically any type of cultured cell. Furthermore, this method can be easily adapted for use with fluorescence microscopy, molecular biological, or pharmacological manipulations to explore the molecular mechanisms of cell migration, live cell imaging, fluorescence microscopy, and correlative immunolabeling.     

A feature selection method for classification within functional genomics experiments based on the proportional overlapping score

Background

Microarray technology, as well as other functional genomics experiments, allow simultaneous measurements of thousands of genes within each sample. Both the prediction accuracy and interpretability of a classifier could be enhanced by performing the classification based only on selected discriminative genes. We propose a statistical method for selecting genes based on overlapping analysis of expression data across classes. This method results in a novel measure, called proportional overlapping score (POS), of a feature’s relevance to a classification task.

Results

We apply POS, along‐with four widely used gene selection methods, to several benchmark gene expression datasets. The experimental results of classification error rates computed using the Random Forest, k Nearest Neighbor and Support Vector Machine classifiers show that POS achieves a better performance.

Conclusions

A novel gene selection method, POS, is proposed. POS analyzes the expressions overlap across classes taking into account the proportions of overlapping samples. It robustly defines a mask for each gene that allows it to minimize the effect of expression outliers. The constructed masks along‐with a novel gene score are exploited to produce the selected subset of genes.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2105-15-274) contains supplementary material, which is available to authorized users.     

中药面膜联合红蓝光治疗寻常痤疮疗效观察

目的：观察中药面膜联合红蓝光治疗仪治疗寻常痤疮临床疗效及安全性。方法：66例寻常痤疮患者按就诊先后顺序随机分为3组：对照组、面膜组、联合组,治疗4周后进行疗效评估,治疗结束后4周随访复发情况。结果：联合组及面膜组疗效高于对照组（P〈0.05）。结论：中药面膜联合红蓝光治疗仪治疗寻常痤疮疗效好,不良反应少,优于单用疗法,痤疮后期维持治疗同样值得重视。     

一种新型豆渣面膜

介绍了一种新型豆渣面膜,并对其制备工艺、使用方法进行了研究;再对产品进行了测试、功能性讨论。结果表明,该面膜膏产品均符合中华人民共和国轻工行业标准QB/T2872-2007要求,并具有良好的稳定性、配伍性;该面膜具有生产工艺简单、成本低廉、安全环保,使用功效显著、性能温和、无刺激、无副作用的特点,是一种来源广泛的、实用的、多效的美容护肤品。     

Helical Tomotherapy of the breast: Can thermoplastic immobilization improve the reproducibility of the treatment setup and the accuracy of the delivered dose?

PurposeTo evaluate the impact of thermoplastic mask immobilization in the setup reproducibility and delivered dose for Helical Tomotherapy (HT) of the breast/chest wall.Methods16 patients treated with Accuray Hi-Art HT for breast-cancer were considered. Patients were positioned supine with arms extended above the head using Civco Wing Board (WB) system. In 50% of patients an Orfit thermoplastic mask was added in order to improve immobilization.Before each treatment fraction a megavoltage CT (MVCT) scan was taken and registered to the planning CT by experienced medical staff. The impact of thermoplastic mask was investigated analysing MVCT shift-roll data and MVCT dose distribution using Planned Adaptive software.ResultsIn the analysed cases, the addition of thermoplastic mask had minor impact on the lateral, longitudinal and roll data distribution. Variance of vertical shifts was significantly reduced in the WB + Orfit group. Van Herk's margins were not affected by addition of thermoplastic immobilization.In both groups, target coverage (V95) and maximum dose (D1) were almost identical to planned values. D1 of organs at risk were not significantly different in the two groups.ConclusionsAnalysis of shift-roll data shows no improvement in the group of patients immobilized with the addition of thermoplastic mask. Van Herk's margin is quite large (7–10 mm) in both groups evidencing the need to perform daily setup correction. The adapted dose distribution complies well with the planned one, showing that if MVCT is used before each treatment fraction, a 3 mm margin (setup component) for CTVs expansion could be adequate.     

关于复合呼吸机械负荷生理、心理效应的观察与分析

以12名男性成年为被试者,观察了外加死腔(V_(ADS))与吸气阻力(RI)对呼吸型式、通气功能以及呼吸不适感觉的联合影响。结果表明:(1)V_(ADS)及R_I对吸气相面罩腔(口腔)压力(P_I)及外呼吸功率(W_I)具有协同的增强作用;复合呼吸机械负荷的强度越大,此种协同作用也越加明显。(2)无论V_(ADS)及R_I的比例关系如何,反应呼吸不适感觉强度的类别量值(S)与P_I(或W_I)之间,总是符合共同的线性关系,故可以P_I(或W_I)作为复合呼吸机械负荷的综合强度指标。(3)在所观察范围内,V_(ADS)并不影响对阻力性机械负荷的呼吸调节功能。以上结果对制订呼吸防护装备生理标准有一定意义。     

轻,中度体力负荷条件下外加吸气阻力的感觉阈限

以10名健康男青年为被试者,分别于静坐及轻、中度(200、600Kg.m.min~(-1))体力活动条件下观察了外加吸气阻力负荷所引起的面罩腔压力(P)及外呼吸功(w)变化;并采用辨别阈梯级(JND)与多级估量量表(MES)相结合的方法测出了不同体力负荷条件下的呼吸阻力感觉阈限。结果表明:(1)面罩腔压力与外呼吸功分别与呼吸感觉量值呈高度相关关系(P<0.01)但又以压力指标相关程度更为密切,故选用面罩腔压力波动幅度()作为反映呼吸感觉程度的客观生理指标较外吸气功率更为适宜。(2)体力负荷与外加吸气阻力对面罩腔压力、外呼吸功及感觉量值均具有协同的增强效应。(3)随体力负荷的增强,呼吸阻力感觉的阈限值也相应升高。在轻度体力负荷下能引起轻、中度呼吸阻力感觉的面罩腔压力波动幅度阈限值分别为(60、100mmH_2O);在中度体力负荷下,则分别为80、130mmH_2O。述结果对制订航空供氧装备附加呼吸阻力生理学标准具有实际意义。     

双管喉罩在小儿眼科手术中应用的临床研究

目的：研究双管喉罩（PLMA）在小儿眼科麻醉中应用的可行性和安全性。方法：择期小儿眼科手术患者180例,随机均分为（P组）双管喉罩组、（L组）普通喉罩组、（T组）气管插管组。记录麻醉诱导前（T0）,置入喉罩（导管）后（T1）,手术开始1分钟后（T2）,手术刺激最强（T3）,拔出喉罩（导管）前（T4）,出手术室前（T5）,的心率（HR）,平均动脉压（MAP）,脑电双频指数（BIS）值。记录手术时间、拔管时间、麻醉药用量（丙泊酚用量）、苏醒时间及拔管后不良反应（呛咳、低氧血症、喉痉挛、声音嘶哑、咽喉痛）。结果：P组、L组喉罩一次性置入成功率高于T组气管导管一次性插入成功率。P组和L组丙泊酚用量明显低于T组（P〈0.05）。与T组比较P组、L组在T1、T2、T3、T4时HR较慢,MAP较低,BIS值较高（P〈0.05）,T组血流动力学波动明显大于P组、L组。P组和L组苏醒时间明显短于T组（P〈0.05）。结论：在小儿眼科手术麻醉中,PLMA放置成功率高,血流动力学平稳,术中通气情况良好,发生反流、误吸、分泌物增多等并发症少,苏醒迅速,是一种安全有效的麻醉方法。