目的探究硬脊膜穿破硬膜外阻滞对无痛分娩罗哌卡因用量及应激反应和妊娠结局的影响。方法选取2021年5月至12月徐州医科大学附属徐州妇幼保健院204名进行无痛分娩的孕妇为研究对象,采用随机数字表法分为硬脊膜穿破组(硬脊膜穿破硬膜外阻...目的探究硬脊膜穿破硬膜外阻滞对无痛分娩罗哌卡因用量及应激反应和妊娠结局的影响。方法选取2021年5月至12月徐州医科大学附属徐州妇幼保健院204名进行无痛分娩的孕妇为研究对象,采用随机数字表法分为硬脊膜穿破组(硬脊膜穿破硬膜外阻滞)和对照组(常规硬膜外阻滞),每组102名。比较两组镇痛前和镇痛30 min的血糖、血清皮质醇和去甲肾上腺素水平;比较两组镇痛前、镇痛30 min、镇痛60 min、娩出时的视觉模拟评分法(VAS)评分;比较两组镇痛起效时间,罗哌卡因消耗量,首次患者自控镇痛(PCA)时间;记录两组孕妇不良反应发生情况;比较两组新生儿出生后1、5 min Apgar评分及不良反应发生情况。结果镇痛30min,两组血糖、皮质醇、去甲肾上腺素水平高于镇痛前,差异有统计学意义(P<0.05);硬脊膜穿破组血糖、皮质醇、去甲肾上腺素水平低于对照组,差异有统计学意义(P<0.05)。两组组内不同时间点比较,差异有统计学意义(P<0.05);镇痛30 min、镇痛60 min、娩出时,硬脊膜穿破组VAS评分低于对照组,差异有统计学意义(P<0.05)。硬脊膜穿破组罗帕卡因用量低于对照组,镇痛起效时间短于对照组,首次PCA时间长于对照组,差异有统计学意义(P<0.05)。两组孕妇不良反应发生率比较,差异无统计学意义(P>0.05)。两组新生儿1、5 min Apgar评分比较,差异无统计学意义(P>0.05)。两组新生儿均未出现呼吸抑制与神经损伤等不良结局。结论硬脊膜穿破硬膜外阻滞起效快,降低孕妇应激反应,且可以减少罗哌卡因用量,对产妇和新生儿结局无不良影响。展开更多
Carotenoids are a class of isoprenoids widely distributed in plants,algae,fungi and bacteria.Carotenoids are essential components for human diet,providing health promoting and nutritional benefits.Fruits are the major...Carotenoids are a class of isoprenoids widely distributed in plants,algae,fungi and bacteria.Carotenoids are essential components for human diet,providing health promoting and nutritional benefits.Fruits are the major source of carotenoids for human consumption.Carotenoid biosynthesis and regulation in fruits are of great importance for development and maintenance of nutritional quality.In recent years,significant progress has been made in understanding the biosynthesis and regulation of carotenoids in tomato and other widely consumed fruits.Carotenoid accumulation in fruits is highly regulated by developmental programs,environmental factors,and metabolic signals at multiple levels.In this review,we highlight recent insights into transcriptional(transcription factor,alternative RNA splicing,epigenetic modification,miRNA),post-transcriptional and hormone regulation of carotenoid biosynthesis in plants,especially in fruits.展开更多
文摘目的探究硬脊膜穿破硬膜外阻滞对无痛分娩罗哌卡因用量及应激反应和妊娠结局的影响。方法选取2021年5月至12月徐州医科大学附属徐州妇幼保健院204名进行无痛分娩的孕妇为研究对象,采用随机数字表法分为硬脊膜穿破组(硬脊膜穿破硬膜外阻滞)和对照组(常规硬膜外阻滞),每组102名。比较两组镇痛前和镇痛30 min的血糖、血清皮质醇和去甲肾上腺素水平;比较两组镇痛前、镇痛30 min、镇痛60 min、娩出时的视觉模拟评分法(VAS)评分;比较两组镇痛起效时间,罗哌卡因消耗量,首次患者自控镇痛(PCA)时间;记录两组孕妇不良反应发生情况;比较两组新生儿出生后1、5 min Apgar评分及不良反应发生情况。结果镇痛30min,两组血糖、皮质醇、去甲肾上腺素水平高于镇痛前,差异有统计学意义(P<0.05);硬脊膜穿破组血糖、皮质醇、去甲肾上腺素水平低于对照组,差异有统计学意义(P<0.05)。两组组内不同时间点比较,差异有统计学意义(P<0.05);镇痛30 min、镇痛60 min、娩出时,硬脊膜穿破组VAS评分低于对照组,差异有统计学意义(P<0.05)。硬脊膜穿破组罗帕卡因用量低于对照组,镇痛起效时间短于对照组,首次PCA时间长于对照组,差异有统计学意义(P<0.05)。两组孕妇不良反应发生率比较,差异无统计学意义(P>0.05)。两组新生儿1、5 min Apgar评分比较,差异无统计学意义(P>0.05)。两组新生儿均未出现呼吸抑制与神经损伤等不良结局。结论硬脊膜穿破硬膜外阻滞起效快,降低孕妇应激反应,且可以减少罗哌卡因用量,对产妇和新生儿结局无不良影响。
基金supported by the National Natural Science Foundation of China(Grant Nos.31772041,31322044 and 31501545)Science and Technology Planning Project of Guangdong Province (Grant No.2015B090901058)+1 种基金Science and Technology Planning Project of Guangzhou (Grant No.201604020048)Talent Program of Guangdong Province(No.2014TX01N049)
文摘Carotenoids are a class of isoprenoids widely distributed in plants,algae,fungi and bacteria.Carotenoids are essential components for human diet,providing health promoting and nutritional benefits.Fruits are the major source of carotenoids for human consumption.Carotenoid biosynthesis and regulation in fruits are of great importance for development and maintenance of nutritional quality.In recent years,significant progress has been made in understanding the biosynthesis and regulation of carotenoids in tomato and other widely consumed fruits.Carotenoid accumulation in fruits is highly regulated by developmental programs,environmental factors,and metabolic signals at multiple levels.In this review,we highlight recent insights into transcriptional(transcription factor,alternative RNA splicing,epigenetic modification,miRNA),post-transcriptional and hormone regulation of carotenoid biosynthesis in plants,especially in fruits.