【摘要】 目的 探讨乳突根治术后耳内窥镜换药与常规换药相比是否具有优势。 方法 2003年3月-2008年10月对89例共89只耳行开放式乳突根治术患者按随机数字表法随机分为试验组及对照组，试验组45例45只耳采用耳内窥镜换药，对照组44例44只耳常规换药；分别观察试验组和对照组的干耳人数及干耳的时间，计算干耳率及干耳的平均时间。 结果 试验组45只耳中42只干耳，干耳率93.3％；对照组44只耳中40只干耳，干耳率90.9％。两组比较差异无统计学意义（Pgt;0.05）。试验组42例干耳患者平均干耳时间为术后（50.8±13.4） d，对照组40例干耳患者平均干耳时间为术后（60.7±12.2） d；两组比较，差异有统计学意义（Plt;0.001）。 结论 中耳乳突根治术后耳内窥镜下换药与常规换药相比不能显著提高干耳率，但能有效缩短干耳时间。【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.
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.
目的 观察不同浓度肾上腺素与利多卡因混合液头皮浸润注射对开颅术患者血流动力学的影响。方法 选取2010年5月－10月80例颅内肿瘤患者，随机分成4组，行1%利多卡因溶液混合不同浓度的肾上腺素16 mL头皮浸润注射。肾上腺素浓度：A组2.5 μg/mL、B组5.0 μg/mL、C组7.5 μg/mL、D组10.0 μg/mL。记录注射前（T0）、注射后5 min内（T1-10）心率（HR）、平均动脉压（MAP）、收缩压（SBP）、舒张压（DBP），根据各时段的MAP最低值和最高值，计算MAP的降低率和升高率，计数各组MAP下降10%以内、10%～20%和20%以上的例数。 结果 C组的MAP下降例数最多且MAP下降率最高，与其他组间比较差异有统计学意义（P＜0.05）。组内比较，C组MAP、SBP在1.5、2.0、2.5 min时、DBP在2 min时和D组MAP和DBP在1.5、2.0 min时下降差异有统计学意义（P＜0.05）。4组血压下降的同时伴HR增快，但HR组间差异无统计学意义（P＞0.05）。 结论 低浓度的肾上腺素与10%利多卡因混合液用于开颅术患者头皮浸润注射时可导致血压下降。
目的 研究利多卡因对海马的神经毒性是否会对大鼠空间学习记忆能力产生影响，并探讨大鼠空间学习能力的变化与海马CA3区锥体细胞数目的相关性。 方法 将成年Wistar雄性大鼠随机分为基础值组（n=7）和利多卡因惊厥组（n=40）。基础值组大鼠静脉给予生理盐水后使用Y迷宫测定大鼠的空间学习能力。利多卡因惊厥组大鼠尾静脉持续输注利多卡因造成惊厥，待大鼠恢复正常运动以后放入鼠笼重新饲养。并于惊厥后第1、3、5、7天从中随机抓取大鼠测试其空间学习能力以及组织学改变。根据对应天数将利多卡因惊厥组的40只大鼠随机细分为Day-1、Day-3、Day-5、Day-7亚组，每亚组10只。所有大鼠在测定空间学习能力之后立即处死，取出大脑并做石蜡包埋，冠状面切片后进行组织学检测，显微镜下评估海马CA3区锥体细胞状态。 结果 ① 基础值组和Day-1、Day-3、Day-5、Day-7亚组大鼠的Y迷宫穿梭次数分别为（25.2 ± 3.7）、（27.1 ± 8.1）、（36.9 ± 9.9）、（38.7 ± 10.6）、（40.6 ± 16.3）次，除Day-1亚组与基础值组比较差异无统计学意义（P＞0.05）外，其余各亚组与基础值组差异均有统计学意义（P＜0.05）；② 与基础值组单位面积（10.3 ± 4.5）个（异常锥体）细胞比较，利多卡因惊厥组大鼠海马CA3区异常锥体细胞数增加，Day-1、Day-3、Day-5、Day-7亚组计数值分别为13.0 ± 7.2、15.6 ± 5.0、19.6 ± 8.1、18.1 ± 5.1，且与大鼠Y迷宫穿梭次数呈正相关（r=0.711，P＜0.05）。 结论 利多卡因引起的惊厥使成年大鼠海马依赖性空间学习能力下降，利多卡因的神经毒性引起的海马异常锥体细胞增多可能是造成这一现象的一种原因。
目的:讨论胃镜检查中更加舒适的一种镇静镇痛方法。方法:芬太尼-异丙酚为Ⅰ组,咪唑安定-异丙酚组为Ⅱ组。观察记录各组术中的反应、胃镜操作时间、麻醉药物起效时间、苏醒时间和清醒时间,检查前中后BP、HR和SpO2的变化,及术后问卷调查。结果:Ⅰ组药物的起效快,受检者苏醒及清醒时间短,术中不适反应少,与Ⅱ组比较有统计学意义(Plt;0.01)。结论:镇静无痛苦胃镜检查中芬太尼-异丙酚联合用药更舒适。
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.
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.
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.