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羟考酮超前镇痛方案有效性与安全性的系统评价与Meta分析
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作者 乐婷 杨勇 +2 位作者 肖娈 商媛媛 李平 《中国急救复苏与灾害医学杂志》 2024年第6期801-806,共6页
目的通过系统综述和Meta分析评价羟考酮超前镇痛方案对手术患者的有效性与安全性。方法计算机检索英文数据库(PubMed,Medline,Web of Science,Embase,Cochrane图书馆)及中文数据库[中国学术期刊全文数据库(CNKI)、中国生物医学文献数据... 目的通过系统综述和Meta分析评价羟考酮超前镇痛方案对手术患者的有效性与安全性。方法计算机检索英文数据库(PubMed,Medline,Web of Science,Embase,Cochrane图书馆)及中文数据库[中国学术期刊全文数据库(CNKI)、中国生物医学文献数据光盘数据库(CBM disc)及维普数据库(VIP)]纳入涉及羟考酮超前镇痛相关的各类型研究。文献检索时间为数据库建立至2023年6月30日。评价指标包括:术后患者疼痛视觉评分(VIS),术后并发症发生率。用RevMan 5.4和SPSS 23.0软件进行统计学分析。结果检出文献13810篇,根据纳入标准最终入选15篇文献进行系统评价,10项RCT研究进入Meta分析;共入选病例890例。与对照组(生理盐水或安慰剂)患者相比,羟考酮超前镇痛组患者术后8 h/12 h疼痛VIS评分(IV=-1.00,95%CI:-1.21~-0.78,P<0.001)、术后4 h/6 h疼痛VIS评分(IV=-1.06,95%CI:-1.50~-0.62,P<0.001)、术后24 h疼痛VIS评分(IV=-0.53,95%CI:-0.86~-0.20,P=0.002)存在显著差异,羟考酮超前镇痛组患者疼痛评分更低;两组患者术后不良反应发生率(OR=0.34,95%CI:0.17~0.7,P=0.003)存在显著差异,羟考酮超前镇痛组患者术后不良反应发生率更低,差异均有统计学意义(P<0.05)。结论羟考酮超前镇痛方案可以广泛应用于外科手术的麻醉实践中,其有效性和安全性得到验证。具有术后患者疼痛更轻,不良反应发生更少的优势。 展开更多
关键词 羟考酮 超前镇痛 系统评价 META分析
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羟考酮超前镇痛对VATS患者术后疼痛及免疫功能的影响
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作者 乐婷 杨勇 +1 位作者 肖娈 商媛媛 《河北医科大学学报》 CAS 2023年第10期1216-1221,共6页
目的探讨羟考酮超前镇痛对电视辅助胸腔镜手术(video-assisted thoracic surgery,VATS)患者术后疼痛及免疫功能的影响。方法选取美国麻醉师协会分级Ⅰ~Ⅱ级拟在全身麻醉下接受VATS的患者80例,随机分为试验组和对照组,每组40例。试验组... 目的探讨羟考酮超前镇痛对电视辅助胸腔镜手术(video-assisted thoracic surgery,VATS)患者术后疼痛及免疫功能的影响。方法选取美国麻醉师协会分级Ⅰ~Ⅱ级拟在全身麻醉下接受VATS的患者80例,随机分为试验组和对照组,每组40例。试验组给予羟考酮0.1 mg/kg静脉注射,对照组给予生理盐水0.1 mg/kg静脉注射。比较2组疼痛视觉模拟评分(visual analogue score,VAS)、镇痛相关不良事件发生率,术后肺部炎症发生率,术后觉醒时间,住院时间血清CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)比值、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、C反应蛋白(C-reactive protein,CRP),c-Fos mRNA水平。结果随时间延长,2组内脏痛和切口痛VAS评分均呈逐渐升高趋势,试验组内脏痛和切口痛VAS评分小于对照组,组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.05)。试验组术后恶心、醒时躁动、肺部炎症发生率小于对照组,差异有统计学意义(P<0.05)。2组CD4^(+)水平均呈逐渐降低趋势,试验组降低幅度小于对照组,组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.05)。2组CD8^(+)水平变化不明显,试验组CD8^(+)水平低于对照组,组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.05)。2组CD4^(+)/CD8^(+)比值均呈逐渐升高趋势,试验组CD4^(+)/CD8^(+)比值大于对照组,组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.05)。2组TNF-α、CRP水平均呈逐渐升高趋势,试验组TNF-α、CRP水平低于对照组,组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.05)。术后15~30 min,2组血清c-Fos mRNA水平显著高于术前,试验组血清c-Fos mRNA水平显著低于对照组,差异有统计学意义(P<0.05)。结论羟考酮超前镇痛方案可调节VATS患者术后疼痛应激反应蛋白水平,减少炎症反应,同时还可降低炎症反应造成患者术后免疫抑制的能力,有利于术后恢复。 展开更多
关键词 胸腔镜检查 羟考酮 镇痛
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羟考酮超前镇痛方案对胸腔镜手术患者的临床效果及对围手术期炎性因子的影响 被引量:2
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作者 商媛媛 乐婷 +2 位作者 肖娈 杨勇 李平 《中国急救复苏与灾害医学杂志》 2023年第9期1199-1202,共4页
目的探究羟考酮对胸腔镜手术患者超前镇痛(PA)的效果及对炎性反应的影响。方法纳入2021年6月—2022年1月在华北石油管理局总医院接受胸腔镜手术的患者100例,随机分为超前镇痛组50例和对照组50例。术后两组患者均给予帕瑞昔布钠40 mg静... 目的探究羟考酮对胸腔镜手术患者超前镇痛(PA)的效果及对炎性反应的影响。方法纳入2021年6月—2022年1月在华北石油管理局总医院接受胸腔镜手术的患者100例,随机分为超前镇痛组50例和对照组50例。术后两组患者均给予帕瑞昔布钠40 mg静脉注射,然后超前镇痛组给予羟考酮0.1 mg/kg静脉注射,对照组给予舒芬太尼0.1μg/kg静脉注射。观察两组患者手术结束时(T1)及手术结束后1 h(T2)、6 h(T3)和24 h(T4)的血清IL-6和IL-10水平,静态疼痛评分(NRS)、Ramsay镇静评分、镇痛相关不良反应、肺部炎症事件和术后住院时间,并比较两组患者上述指标的差异。结果术后T3和T4超前镇痛组的IL-6水平显著低于对照组,IL-10水平显著高于对照组(P<0.05);在各观察时间点,超前镇痛组内脏痛的NRS均显著低于对照组,Ramsay镇静评分比较无统计学意义(P>0.05),拔管后6 h、24 h和48 h切口痛的NRS均显著低于对照组(P<0.05);在术后恶心呕吐及肺部炎症发生率上,超前镇痛组显著低于对照组(P<0.05)。结论在胸腔镜手术患者中超前镇痛应用羟考酮可调节炎症细胞因子水平,降低炎性反应,减少术后并发症。 展开更多
关键词 羟考酮 超前镇痛 胸腔镜手术
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Three-Year Consecutive Field Application of Erythromycin Fermentation Residue Following Hydrothermal Treatment:Cumulative Effect on Soil Antibiotic Resistance Genes 被引量:3
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作者 Ziming Han Haodi Feng +7 位作者 xiao luan Yunpeng Shen Liren Ren Liujie Deng D.G.Joakim Larsson Michael Gillings Yu Zhang Min Yang 《Engineering》 SCIE EI CAS 2022年第8期78-88,共11页
Fermentation-based antibiotic production results in abundant nutrient-rich fermentation residue with high potential for recycling,but the high antibiotic residual concentration restricts its usefulness(e.g.,in land ap... Fermentation-based antibiotic production results in abundant nutrient-rich fermentation residue with high potential for recycling,but the high antibiotic residual concentration restricts its usefulness(e.g.,in land application as organic fertilizer).In this study,an industrial-scale hydrothermal facility for the treatment of erythromycin fermentation residue(EFR)was investigated,and the potential risk of the long-term soil application of treated EFR promoting environmental antibiotic resistance development was evaluated.The treatment effectively removed bacteria and their DNA,and an erythromycin removal ratio of up to approximately 98%was achieved.The treated EFR was utilized as organic fertilizer for consecutive field applications from 2018 to 2020,with dosages ranging from 3750 to 15000 kg·hm^(-2),resulting in subinhibitory levels of erythromycin(ranging from 0.83-76.00μg·kg^(-1))in soils.Metagenomic shotgun sequencing was then used to characterize the antibiotic resistance genes(ARGs),mobile genetic elements(MGEs),and bacterial community composition of the soils.The soil ARG abundance and diversity did not respond to the treated EFR application in the first year,but gradually changed in the second and third year of application.The highest fold change in relative abundance of macrolide-lincosamide-streptogramin(MLS)and total ARGs were 12.59 and 2.75 times,compared with the control(CK;without application),respectively.The soil MGEs and taxonomic composition showed similar temporal trends to those of the ARGs,and appeared to assist in driving increasing ARG proliferation,as revealed by correlation analysis and structural equation models(SEMs).The relative abundance of particular erm resistance genes(RNA methyltransferase genes)increased significantly in the third year of treated EFR application.The close association of erm with MGEs suggested that horizontal gene transfer played a critical role in the observed erm gene enrichment.Metagenomic binning results demonstrated that the proliferation of mac genecarrying hosts was responsible for the increased abundance of mac genes(efflux pump genes).This study shows that sub-inhibitory levels of erythromycin in soils had a cumulative effect on soil ARGs over time and emphasizes the importance of long-term monitoring for assessing the risk of soil amendment with treated industrial waste. 展开更多
关键词 Pharmaceutical manufacturing RESISTOME Antibiotic Risk assessment REMEDIATION Land application
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Degradation potential and diversity of oil-degrading bacteria isolated from the sediments of the Jiaozhou Bay, China 被引量:1
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作者 Wei Gao Xiangxing Gao +10 位作者 Tiezhu Mi Bin Han Yiran Zhang Xinzi Li xiaofei Yin Chengjun Sun Qian Li Zhisong Cui xiao luan Zhigang Yu Li Zheng 《Acta Oceanologica Sinica》 SCIE CAS CSCD 2019年第6期54-64,共11页
A great deal of oil contaminated the shoreline by the Qingdao oil pipeline explosion in 2013. The four oildegrading consortia were enriched from sediment samples with crude oil as sole carbon and energy sources. The b... A great deal of oil contaminated the shoreline by the Qingdao oil pipeline explosion in 2013. The four oildegrading consortia were enriched from sediment samples with crude oil as sole carbon and energy sources. The biodiversity and community analysis showed that the Luteibacter, Parvibaculum and a genus belonging to Alcanivoracaceae were found predominant bacteria in the four consortia, which belonged to Proteobacteria. Nine strains exhibiting distinct 16S rRNA gene sequences were isolated from the consortia. These strains were identified to eight genera based on 16S rRNA gene sequences. Five of the nine strains degraded more than 30% of the crude oil in two weeks by gravimetric method. From the analysis of GC-MS, most of the isolated strains tended to degrade n-alkanes rather than PAHs. Five strains showed high degrading ability of the total n-alkanes. Only Strain D2 showed great PAHs degrading ability and the degrading rates ranged from 34.9% to 77.5%. The sequencing analysis of the oil-degrading consortia confirmed that the genus of Alcanivorax was one of the dominant bacteria in Consortia A and E and Strain E4 might be one of the dominant bacteria. The strains obtained in this study demonstrated the potential for oil bioremediation in oil-contaminated beach ecosystems. 展开更多
关键词 oil SPILL BIODEGRADATION microbial CONSORTIUM DOMINANT bacteria
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Contrasting vertical distribution between prokaryotes and fungi in different water masses on the Ninety-East Ridge, Southern Indian Ocean
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作者 Shujun LI Zhisong CUI +5 位作者 Mutai BAO xiao luan Fei TENG Shujiang LI Tengfei XU Li ZHENG 《Journal of Oceanology and Limnology》 SCIE CAS CSCD 2022年第2期605-619,共15页
Although the microbial diversity of the Indian Ocean has been extensively investigated,little is known about the community composition of microbes in the Southern Indian Ocean.In the present study,we divided 60 water ... Although the microbial diversity of the Indian Ocean has been extensively investigated,little is known about the community composition of microbes in the Southern Indian Ocean.In the present study,we divided 60 water column samples on the Ninety-East Ridge(NER)into fi ve water masses according to the temperature-salinity curves.We presented,for the fi rst time,a full description of the microbial biodiversity on NER through high-throughput amplicon sequencing approach,including bacteria,archaea,and fungi.We found that bacteria exhibited higher richness and diversity than archaea and fungi across the water masses on NER.More importantly,each water mass on NER featured distinct prokaryotic microbial communities,as indicated by the results of non-metric multidimensional scaling.In contrast,fungi were eurybathic across the water masses.Redundancy analysis results demonstrated that environmental factors might play a pivotal role in the formation and stability of prokaryotic communities in each water mass,especially that of archaea.In addition,indicator species might be used as fi ngerprints to identify corresponding water masses on NER.These results provide new insights into the vertical distribution,structure,and diversity of microorganisms on NER from the perspective of water mass. 展开更多
关键词 Ninety-East Ridge(NER) temperature-salinity curve microbial vertical distribution water mass microbial diversity
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Field-based evidence for the enrichment of intrinsic antibiotic resistome stimulated by plant-derived fertilizer in agricultural soil 被引量:1
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作者 Shihai Liu Ziming Han +5 位作者 Dong Zhu xiao luan Liujie Deng Liping Dong Min Yang Yu Zhang 《Journal of Environmental Sciences》 SCIE EI CAS CSCD 2024年第1期728-740,共13页
Animal manures have been demonstrated to enhance antibiotic resistance in agricultural soils.However,little is known about the effects of plant-derived fertilizer on soil antibiotic resistome.Herein,metagenomic sequen... Animal manures have been demonstrated to enhance antibiotic resistance in agricultural soils.However,little is known about the effects of plant-derived fertilizer on soil antibiotic resistome.Herein,metagenomic sequencing was used to investigate the effects of a plantderived fertilizer processed from sugarcane and beet on soil antibiotic resistance genes(ARGs)in a soybean field along crop growth stages.ARG profiles in the soils amended by plant-derived fertilizer were compared with those in the soils amended by chicken manure.The abundance and diversity of total ARGs in the soils amended by plant-derived fertilizer were significantly(P<0.05)elevated at the sprout stage,to a level comparable to that in the manured soils.Whereas,unlike chicken manure mainly introducing manure-borne ARGs to soil,the plant-derived fertilizer was indicated to mainly enrich multidrug resistance genes in soil by nourishing indigenous bacteria.ARGs with abundances in amended soils significantly(P<0.05)higher than in unamended soils at the sprout stage of soybean were considered as enriched ARGs.Decrease in the abundance of the enriched ARGs was observed in both the amended soils from the sprout to the harvest.Network analysis further identified Proteobacteria and Bacteroidetes as the primary bacterial taxa involved in the temporal variation of the enriched ARGs in the soils amended by plant-derived fertilizer,while in manured soils were Firmicutes and Actinobacteria.As revealed by multivariate statistical analyses,variation of the enriched ARGs in the soils amended by plant-derived fertilizer was majorly attributed to the response of co-occurred bacteria to depleting nutrients,which was different from the failed establishment of manure-borne bacteria in the manured soils.Our study provided field-based evidence that plant-derived fertilizer stimulated the intrinsic antibiotic resistome,and proposed attention to the un-perceived risk since some clinically relevant ARGs originate and evolve from natural resistome. 展开更多
关键词 Organic fertilizer Intrinsic antibiotic resistance Indigenous bacteria Metagenomic sequencing
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Metagenomic insights into microorganisms and antibiotic resistance genes of waste antibiotic fermentation residues along production,storage and treatment processes
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作者 Ziming Han xiao luan +3 位作者 Haodi Feng Yanqin Deng Min Yang Yu Zhang 《Journal of Environmental Sciences》 SCIE EI CAS CSCD 2024年第2期45-55,共11页
Antibiotic fermentation residue(AFR)is nutrient-rich solid waste generated from fermentative antibiotic production process.It is demonstrated that AFR contains high-concentration of remaining antibiotics,and thus may ... Antibiotic fermentation residue(AFR)is nutrient-rich solid waste generated from fermentative antibiotic production process.It is demonstrated that AFR contains high-concentration of remaining antibiotics,and thus may promote antibiotic resistance development in receiving environment or feeding farmed animals.However,the dominate microorganisms and antibiotic resistance genes(ARGs)in AFRs have not been adequately explored,hampering understanding on the potential antibiotic resistance risk development caused by AFRs.Herein,seven kinds of representative AFRs along their production,storage,and treatment processes were collected,and multiple methods including amplicon sequencing,metagenomic sequencing,and bioinformatic approaches were adopted to explore the biological characteristics of AFRs.As expected,antibiotic fermentation producer was found as the predominant species in raw AFRs,which were collected at the outlet of fermentation tanks.However,except for producer species,more environment-derived species persisted in stored AFRs,which were temporarily stored at a semi-open space.Lactobacillus genus,classified as Firmicutes phylum and Bacilli class,became predominant bacterial taxa in stored AFRs,which might attribute to its tolerance to high concentration of antibiotics.Results from metagenomic sequencing together with assembly and binning approaches showed that these newly-colonizing species(e.g.,Lactobacillus genus)tended to carry ARGs conferring resistance to the remaining antibiotic.However,after thermal treatment,remaining antibiotic could be efficiently removed from AFRs,and microorganisms together with DNA could be strongly destroyed.In sum,the main risk from the AFRs was the remaining antibiotic,while environment-derived bacteria which tolerate extreme environment,survived in ARFs with high content antibiotics,and may carry ARGs.Thus,hydrothermal or other harmless treatment technologies are recommended to remove antibiotic content and inactivate bacteria before recycling of AFRs in pharmaceutical industry. 展开更多
关键词 Pharmaceutical manufacturing Antibiotic mycelia residue Antibiotic resistance bacteria Thermal treatment Solid waste
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