【摘要】 目的 探討乳突根治術后耳內窺鏡換藥與常規換藥相比是否具有優勢。 方法 2003年3月-2008年10月對89例共89只耳行開放式乳突根治術患者按隨機數字表法隨機分為試驗組及對照組，試驗組45例45只耳采用耳內窺鏡換藥，對照組44例44只耳常規換藥；分別觀察試驗組和對照組的干耳人數及干耳的時間，計算干耳率及干耳的平均時間。 結果 試驗組45只耳中42只干耳，干耳率93.3％；對照組44只耳中40只干耳，干耳率90.9％。兩組比較差異無統計學意義（Pgt;0.05）。試驗組42例干耳患者平均干耳時間為術后（50.8±13.4） d，對照組40例干耳患者平均干耳時間為術后（60.7±12.2） d；兩組比較，差異有統計學意義（Plt;0.001）。 結論 中耳乳突根治術后耳內窺鏡下換藥與常規換藥相比不能顯著提高干耳率，但能有效縮短干耳時間。【Abstract】 Objective To evaluate the application of otoendoscope in dressing change after mastoidectomy. Method Between March 2003 and October 2008, 89 patients (89 ears) underwent mastoidectomy in Department of Otolaryngology Head and Neck Surgery, West China Hospital of Sichuan University and in Department of Otolaryngology, Nuclear Industry 416 Hospital of Chengdu. The patients were randomly divided into two groups by simple randomization (trial group and control group). Forty-five patients in the trial group underwent the dressing change under otoendoscope, while 44 patients in the control group under the routine method. The ear drying rate and the ear drying time in the two groups were observed. Results The ear drying rate was 93.3% (42 dry ears)in the trial group, and was 90.9% (40 dry ears) in the control group; the difference between the two groups was not significant (Pgt;0.01). The ear drying time was (50.8±13.4) days in the trial group and was (60.7±12.2) days in the control groups; the difference between the two groups was significant (Plt;0.001). Conclusion Dressing change under the otoendoscope after mastoidectomy may not improve the ear drying rate but can shorten the ear drying time.
目的:討論胃鏡檢查中更加舒適的一種鎮靜鎮痛方法。方法:芬太尼-異丙酚為Ⅰ組,咪唑安定-異丙酚組為Ⅱ組。觀察記錄各組術中的反應、胃鏡操作時間、麻醉藥物起效時間、蘇醒時間和清醒時間,檢查前中后BP、HR和SpO2的變化,及術后問卷調查。結果:Ⅰ組藥物的起效快,受檢者蘇醒及清醒時間短,術中不適反應少,與Ⅱ組比較有統計學意義(Plt;0.01)。結論:鎮靜無痛苦胃鏡檢查中芬太尼-異丙酚聯合用藥更舒適。
目的 觀察不同濃度腎上腺素與利多卡因混合液頭皮浸潤注射對開顱術患者血流動力學的影響。方法 選取2010年5月－10月80例顱內腫瘤患者，隨機分成4組，行1%利多卡因溶液混合不同濃度的腎上腺素16 mL頭皮浸潤注射。腎上腺素濃度：A組2.5 μg/mL、B組5.0 μg/mL、C組7.5 μg/mL、D組10.0 μg/mL。記錄注射前（T0）、注射后5 min內（T1-10）心率（HR）、平均動脈壓（MAP）、收縮壓（SBP）、舒張壓（DBP），根據各時段的MAP最低值和最高值，計算MAP的降低率和升高率，計數各組MAP下降10%以內、10%～20%和20%以上的例數。 結果 C組的MAP下降例數最多且MAP下降率最高，與其他組間比較差異有統計學意義（P＜0.05）。組內比較，C組MAP、SBP在1.5、2.0、2.5 min時、DBP在2 min時和D組MAP和DBP在1.5、2.0 min時下降差異有統計學意義（P＜0.05）。4組血壓下降的同時伴HR增快，但HR組間差異無統計學意義（P＞0.05）。 結論 低濃度的腎上腺素與10%利多卡因混合液用于開顱術患者頭皮浸潤注射時可導致血壓下降。
目的 研究利多卡因對海馬的神經毒性是否會對大鼠空間學習記憶能力產生影響，并探討大鼠空間學習能力的變化與海馬CA3區錐體細胞數目的相關性。 方法 將成年Wistar雄性大鼠隨機分為基礎值組（n=7）和利多卡因驚厥組（n=40）。基礎值組大鼠靜脈給予生理鹽水后使用Y迷宮測定大鼠的空間學習能力。利多卡因驚厥組大鼠尾靜脈持續輸注利多卡因造成驚厥，待大鼠恢復正常運動以后放入鼠籠重新飼養。并于驚厥后第1、3、5、7天從中隨機抓取大鼠測試其空間學習能力以及組織學改變。根據對應天數將利多卡因驚厥組的40只大鼠隨機細分為Day-1、Day-3、Day-5、Day-7亞組，每亞組10只。所有大鼠在測定空間學習能力之后立即處死，取出大腦并做石蠟包埋，冠狀面切片后進行組織學檢測，顯微鏡下評估海馬CA3區錐體細胞狀態。 結果 ① 基礎值組和Day-1、Day-3、Day-5、Day-7亞組大鼠的Y迷宮穿梭次數分別為（25.2 ± 3.7）、（27.1 ± 8.1）、（36.9 ± 9.9）、（38.7 ± 10.6）、（40.6 ± 16.3）次，除Day-1亞組與基礎值組比較差異無統計學意義（P＞0.05）外，其余各亞組與基礎值組差異均有統計學意義（P＜0.05）；② 與基礎值組單位面積（10.3 ± 4.5）個（異常錐體）細胞比較，利多卡因驚厥組大鼠海馬CA3區異常錐體細胞數增加，Day-1、Day-3、Day-5、Day-7亞組計數值分別為13.0 ± 7.2、15.6 ± 5.0、19.6 ± 8.1、18.1 ± 5.1，且與大鼠Y迷宮穿梭次數呈正相關（r=0.711，P＜0.05）。 結論 利多卡因引起的驚厥使成年大鼠海馬依賴性空間學習能力下降，利多卡因的神經毒性引起的海馬異常錐體細胞增多可能是造成這一現象的一種原因。
Objective To observe the changes of serum potassium level and the factors that affected it when preoperative intravenous administration of gelofusine was given rapidly at high dose. Methods Thirty patients scheduled for upper abdominal operation were selected for the study and they were randomizely divided into test group (gelofusion group) and control group with 15 cases in each group. The first blood and urine sample was taken after epidural puncture and the potassium value was used as basic values. Then an intravenous administration of gelofusion at a dose of 10ml/kg was given in gelofusion group within 30min and then the second sample was obtained. Another intravenous administration of gelofusion at a dose of 10 ml/kg was given within 1 hour and the third sample was taken, while the fourth and fifth samples were taken 30 and 90 minutes after the third samples taken respectively. All the blood samples were tested for serum level of electrolytes (Na+,K+,Cl-,Ca2+,Mg2+), pH, Osm, Hct. The value of electrolytes (Na+,K+,Cl-,Ca2+,Mg2+) of urine samples were determined too. The intracellular levels of K+ and Mg2+ of erythrocyte were tested. The gelofusion were replaced by saline solution in control group and the other procedures were the same.Results The serum level of potassium was decreased progressively after rapid intravenous administration of gelofusine at high dose. Conclusion The serum level of potassium will decrease significantly after rapid intravenous administration of gelofusion at high dose during operation.
ObjectiveTo study the influence of hemin on blood pressure of intermittent hypoxic rats and investigate the mechanism of hypertension caused by intermittent hypoxia.MethodsTwenty-four male SD rats were randomly divided into a hemin group, an intermittent hypoxia group (IH group) and a normal group. Thirty minutes after intraperitoneal injection of hemin, the rats in the hemin group were exposed to intermittent normobaric hypoxic environment (8 h/d). The rats in the IH group were intraperitoneal injected with normal sodium and then exposed to the same environment (8 h/d). The rats in the normal group were intraperitoneal injected with normal sodium and placed in the glass box. The three groups were bred in the same condition. Thirty-five days later, the mean carotid artery pressure (mCAP) of the rats was measured and their plasma carbon monoxide (CO) level was measured by Chalmer’s method. Reverse transcription polymerase chain reaction was performed to detect the levels of heme oxygenase-1 (HO-1) mRNA expression in lung, liver, spleen, kidney and other organs. The expression of HO-1 protein in the organs was detected by immunohistochemistry.ResultsThe mCAP in the IH group was significantly higher than the hemin group and the normal group (P<0.05), and was higher in the hemin group than the normal group (P<0.05). The concentration of plasma CO in the hemin group was higher than the IH group and the normal group (P<0.05). There was no significant difference in plasma CO between the IH group and the normal group (P>0.05). The expression of HO-1 mRNA of lung, liver, spleen and kidney in the hemin group and the IH group was higher than the normal group (P<0.05), and was higher in the hemin group than the IH group (P<0.05). The relationship between mCAP and HO-1 mRNA showed a curvilinear trend. The quadratic curve fitting equation was Y=39.715+446.640X-334.353X2.ConclusionsIntermittent hypoxia can cause hypertension in rats. The HO-1 expression is increased in hypoxic rats, but the plasma CO does not increase significantly. As an inducer of HO-1, hemin can increase the expression of HO-1 and CO in hypoxic rats, then lower their blood pressure to some extent.
Brain-computer interface (BCI) based on functional near-infrared spectroscopy (fNIRS) is a new-type human-computer interaction technique. To explore the separability of fNIRS signals in different motor imageries on the single limb, the study measured the fNIRS signals of 15 subjects (amateur football fans) during three different motor imageries of the right foot (passing, stopping and shooting). And the correlation coefficient of the HbO signal during different motor imageries was extracted as features for the input of a three-classification model based on support vector machines. The results found that the classification accuracy of the three motor imageries of the right foot was 78.89%±6.161%. The classification accuracy of the two-classification of motor imageries of the right foot, that is, passing and stopping, passing and shooting, and stopping and shooting was 85.17%±4.768%, 82.33%±6.011%, and 89.33%±6.713%, respectively. The results demonstrate that the fNIRS of different motor imageries of the single limb is separable, which is expected to add new control commands to fNIRS-BCI and also provide a new option for rehabilitation training and control peripherals for unilateral stroke patients. Besides, the study also confirms that the correlation coefficient can be used as an effective feature to classify different motor imageries.
Objective To observe the inhibitory effects of local co-transfection of tissuetype plasminogen activator(tPA) gene and proliferating cell nuclear antigen antisense oligodeoxynucleotides(PCNA-ASODN) on the intima proliferation and restenosis of autograft artery in rabbits. Methods One hundred and twenty male Zelanian rabbits were randomly divided into four groups(n=30, in each group): control group, PCNA-ASODN group, tPA group and tPA+PCNAASODN group. The left and right external iliac arteries (length 1.0 cm) were transplanted reciprocally. The transplanted arteries were respectively soaked in lipofection, PCNAASODN, pBudCE4.1/tPA and pBudCE4.1/tPA+PCNA-ASODN solution about 15 minutes. The transplanted arteries were sutured with 9-0 sutures soaked in PCNA-ASODN and pBudCE4.1/tPA solution. Each group were divided into five subgroups(n=6, in each subgroup) according to the sacrifice time (3 d, 7 d, 14 d, 28 d and 56 d after operation). On every sacrifice time point, the vascular specimens were harvested. The thrombocyte assembling and thrombus forming lining vessel wall were observed by scanning electron microscope. The pathological morphology of transplanted arteries were observed under microscope(HE). The intimal areas and stenosis ratio(%) of transplanted arteries were calculate and analyzed statistically among groups by computer system. The mRNA expression of tPA gene in transplanted ressel wall was detected with vevere transcriptionPCR(RT-PCR). The number of PCNA positive cells in transplanted vessel wall was counted by SP immunochemisty.Results The mRNA expression of tPA gene in the transplanted vessel wall in tPA and tPA+PCNA-ASODN groups was higher than that of the other two groups(P＜0.01).The number of PCNA positive cells in the transplanted arteries in PCNAASODN, tPA and tPA+PCNAASODN groups were significantly lower than that of control group(P＜0.05，P＜0.01). The intimal areas and degrees of luminal stenosis of PCNAASODN, tPA and tPA+PCNAASODN groups were lower than those of control group(P＜0.05，P＜0.01), and those of tPA＋ PCNA-ASODN group were lower than those of PCNA-ASODN and tPA groups(P＜0.05). Scanning electron microscopy showed that there were a few thrombocytes lining the vessel wall of tPA group and tPA+PCNAASODN group and no thrombus, whereas there were abundant thrombocytes and thrombi lining the vessel wall of the control group. Conclusion Co-transfection of tPA gene and PCNA-ASODN can effectively inhibit the proliferation of VSMC, hyperplasia of intima and restenosis of transplanted artery.
Neuropathic pain has been redefined by NeuPSIG as “pain arising as a direct consequence of a lesion or disease affecting the somatosensory syste”. However, pharmacological management for neuropathic pain is not effective, which is correlated with the uncertainty of pathogenesis. For a long time, neuron had been considered acting a major role in the development of neuropathic pain. In recent years, a majority of studies revealed that glia cell also involved in the occurrence and development of neuropathic pain, and neuron-glia interaction is one of the key mechanism of neuropathic pain, including complex signaling pathways as purinergic signaling. This review focuses on recent advances on the role of purinergic receptors in neuropathic pain.
ObjectiveTo investigate and evaluate the safety and efficacy of Bentall operation in the reoperation of patients with small aortic root or annulus.MethodsBentall procedure was performed in 24 patients with small aortic root or annulus in our hospital from September 2014 to December 2019. There were 18 males and 6 females with a mean age of 31-68 (45.70±15.27) years. All patients had undergone a previous replacement of the aortic valve including 20 patients receiving valve replacement, 2 patients aortic root replacement with a valved conduit and 2 patients bioprothesis replacement.ResultsThere was no early death in hospital and one death during the 30-day postoperative period. Re-thoracotomy due to bleeding was necessary in only 2 patients and no bleeding was related to the proximal anastomosis of the conduit. One patient performed pacemaker implantation for heart block after the procedure. The mean sizes of implanted aortic valve prosthesis were 22.75±1.78 mm. A mean gradient across the aortic valve prostheses in the postoperative echocardiographic examination was 11.17±2.24 mm Hg.ConclusionBentall procedure is safe and allows a larger size of prosthesis implantation in patients with small aortic annulus or root after previous aortic valve or complete root replacement, resulting in good postoperative hemodynamic characteristics and short-term clinical results.