碳酸利多卡因硬膜外阻滞在急诊单胎剖宫产的应用

目的：观察碳酸利多卡因在急诊单胎剖宫产的麻醉效果。方法：选择ＡＳＡⅠ－Ⅱ级急诊剖宫产病人４０例。随机分为两组，每组２０例，Ａ组（碳酸组）用１７３％碳酸利多卡因，Ｂ组（盐酸组）用２％盐酸利多卡因行硬膜外阻滞。对比麻醉起效时间，阻滞平面及ＭＡＰＰＳｐＯ２的改变。结果：与盐酸组相比，碳酸利多卡因组麻醉起效时间短，感觉神经阻滞节段数多，ＭＡＰＰＳｐＯ２的改变无统计学差异。结论：碳酸利多卡因用于急诊单胎剖宫产病人。

静脉输注利多卡因在无痛结肠镜检查中的临床应用

目的观察静脉输注利多卡因在无痛结肠镜检查中的临床效果,探讨其有效性和安全性。方法选择在该院接受无痛结肠镜检查的患者90例,采用随机数字表法分为3组:舒芬太尼复合丙泊酚组(S组)、利多卡因复合丙泊酚组(L组)和单纯丙泊酚组(P组),每组30例。采用双盲法分别给予每组患者相应药物,持续监测并记录给药前(T_(0))、睫毛反射消失时(T_(1))、过脾曲时(T_(2))、过肝曲时(T_(3))以及镜检完成时(T_(4))的心率(HR)、平均动脉压(MAP)和脉搏血氧饱和度(SpO_(2)),观察3组患者术中丙泊酚预给量、追加量、总用量、不良事件发生情况和术后恢复情况等。结果与T0时点相比,3组患者T_(1)~T_(4)时点MAP、HR均明显降低(P<0.05),与T_(1)时点相比,P组T_(2)~T_(4)时点MAP、HR明显升高(P<0.05),3组SpO_(2)差异无统计学意义(P>0.05);S组和L组丙泊酚预给量、追加量和总用量均明显少于P组(P<0.05);L组苏醒时间明显短于S组和P组(P<0.05);术后腹部疼痛视觉模拟评分(VAS)和虚弱VAS评分L组明显优于S组或P组(P<0.05);L组注射痛、恶心呕吐、低氧血症发生率明显优于S组或P组(P<0.05),3组患者术中高血压、低血压、心动过缓发生率差异无统计学意义(P>0.05)。结论静脉输注利多卡因应用于无痛结肠镜检查中,可有效降低丙泊酚用量、稳定血流动力学、减少不良反应发生,加快术后恢复。

肌间沟和腋路联合阻滞在上肢手术的临床应用

目的:比较臂丛神经两点阻滞和单点阻滞用于上肢手术的阻滞效果和不良反应。方法:90例手术患者,ASAⅠ-Ⅱ级,手术时间1-5h,按随机双盲法抽取手术中的1/3病例分为三组,每组30例。A组:同侧肌间沟20ml(0.375%罗哌卡因+1%利多卡因)联合腋路15ml(0.375罗哌卡因+1%利多卡因)阻滞;B组:肌间沟阻滞组;C组:腋路阻滞组,均单次注射35ml。比较三组间阻滞效果,阻滞时间和不良反应。结果:两点阻滞法对尺桡侧神经阻滞较完善(p<0.05),阻滞时间明显延长(p<0.05),能较好地满足手术要求,不良反应发生率不增加(p>0.05)。结论:等浓度等剂量的药物浓度行臂丛神经两点阻滞效果优于单点阻滞法,不增加不良反应率,较适合用于上肢手术。

The Effect of pH on the Permeation of Lidocaine Hydrochloride Across Excised Rat Skin

The effect of pH on the permeation of Lidocaine hydrochloride (LH) across excised rat skin was studied, the steady state flux (JSS) at different pH being determined using improved Valia-Chien diffusion cells. JSS increased substantially when pH was close to the pKa of LH. The profile of JSS versus pH showed an 慡?shaped curve. JSS of Lidocaine free base (LFB) was fourteen times that of LH. The pH of vehicle influences the permeation of LH significantly and should be considered as an important factor when a formulation is developed.

无痛人工流产临床分析

随着人们生活水平的提高,健康舒适意识的观点增强,如何在施术时提高镇痛技术,减免孕妇的痛苦显得极为必要。

Antitumor efficacy of lidamycin on hepatoma and active moiety of its molecule

AIM: To study the in vitro and in vivo antitumor effect of lidamycin (LDM) on hepatoma and the active moiety of its molecule.METHODS: MTT assay was used to determine the growth inhibition of human hepatoma BEL-7402 cells, SMMC-7721cells and mouse hepatoma H22 cells. The in vivo therapeutic effects of lidamycin and mitomycin C were determined by transplantable hepatoma 22 (H22) in mice and human hepatoma BEL-7402 xenografts in athymic mice.RESULTS: In terms of IC50values, the cytotoxicity of LDM was 10 000-fold more potent than that of mitomycin C (MMC)and adriamycin (ADM) in human hepatoma BEL-7402 cells and SMMC-7721 cells. LDM molecule consists of two moieties,an aproprotein (LDP) and an enediyne chromophore (LDC). In terms of IC50 values, the potency of LDC was similar to LDM. However, LDP was 105-fold less potent than LDM and LDC to hepatoma cells. For mouse hepatoma H22 cells, the IC50value of LDM was 0.025 nmol/L. Given by single intravenous injection at doses of 0.1, 0.05 and 0.025 mg/kg, LDM markedly suppressed the growth of hepatoma 22 in mice by 84.7%, 71.6% and 61.8%,respectively. The therapeutic indexes (TI) of LDM and MMC were 15 and 2.5, respectively. By 2 iv. Injections in two experiments, the growth inhibition rates by LDM at doses of 0.1, 0.05, 0.025, 0.00625 and 0.0125 mg/kg were 88.8-89.5%, 81.1-82.5%, 71.2-74.9%, 52.3-59.575%,and 33.3-48.3%, respectively. In comparison, MMC at doses of 5, 2.5, and 1.25 mg/kg inhibited tumor growth by 69.7-73.6%, 54.0-56.5%, and 31.5-52.2%,respectively. Moreover, in human hepatoma BEL-7402 xenografts, the growth inhibition rates by LDM at doses of 0.05 mg/kg ×2 and 0.025 mg/kg ×2 were 68.7%and 27.2%, respectively. However, MMC at the dose of 1.25 mg/kg ×2 showed an inhibition rate of 34.5%. The inhibition rate of tumor growth by LDM was higher than that by MMC at the tolerated dose.CONCLUSION: Both LDM and its chromophore LDC display extremely potent cytotoxicity to hepatoma cells. LDM shows a remarkable therapeutic efficacy against murine and human hepatomas in vivo.

Comparison of 1.5% lidocaine and 0.5% ropivacaine epidural anesthesia combined with propofol general anesthesia guided by bispectral index

Objective： To compare the effects of epidural anesthesia with 1.5% lidocaine and 0.5% ropivacaine on propofol requirements, the time to loss of consciousness （LOC）, effect-site propofol concentrations, and the hemodynamic variables during induction of general anesthesia guided by bispectral index （BIS） were studied. Methods： Forty-five patients were divided into three groups to receive epidurally administered saline （Group S）, 1.5% （w/w） lidocaine （Group L）, or 0,5% （w/w） ropivacaine （Group R） Propofol infusion was started to produce blood concentration of 4 lag/ml. Once the BIS value reached 40-50, endotracheal intubation was facilitated by 0.1 mg/kg vecuronium. Measurements included the time to LOC, effect-site propofol concentrations, total propofol dose, mean arterial blood pressure （MABP）, and heart rate （HR） at different study time points. Results： During induction of anesthesia, both Groups L and R were similar for the time to LOC, effect-site propofol concentrations, total propofol dose, MABP, HR, and BIS. The total doses of propofol administered until 1 min post-intubation were significantly less in patients of Groups R and L compared with Group S. MABP and HR were significantly lower following propofol induction compared with baseline values in the three groups, or MABP was significantly increased following intubation as compared with that prior to intubation in Group S but not in Groups R and L while HR was significantly increased following intubation in the three groups. Conclusion： Epidural anesthesia with 1.5% lidocaine and 0.5% ropivacaine has similar effects on the time to LOC, effect-site propofol concentrations, total propofol dose, and the hemodynamic variables during induction of general anesthesia.

Effect of diltiazem and lidocaine on arterial pressure or heart rate and the quality of extubation in patients undergoing uvulopalatopharyngoplasty

Objective：To evaluate the effect of diltiazem and lidocaine on arterial pressure or heart rate and the quality of extubation in patients undergoing uvulopalatopharyngoplasty. Methods： Sixty patients were randomly divided into 4 groups： In the control group patients were given saline; in the lidocaine group patients were given 1.0 mg/kg lidocaine ; in the diltiazem group patients were given 0. 2 mg/kg diltiazem; and in the lidocaine plus diltiazem group patients were given 1.0 mg/kg lidocaine and 0. 2 mg/kg diltiazem. These drugs were given 2 rain before tracheal extuhation. Values for SBP, DBP, and HR were recorded, on arriving at the operating room, immediately at the end of the surgery, at the time of injection of the study drugs, at tracheal extubation, at 1 min and 5 min after extubation. The quality of extubation according to the Sebel＇s grading scale were compared among the 4 groups. Results：During extubation in the control group HR, SBP and DBP increased significantly when compared to baseline levels. Both lidocaine （1.0 mg/kg） and diltiazem （0. 2 mg/kg） successfully alleviated these increases. The suppressive effect of diltiazem was greater than that of lidocaine. The combinative use of the two drugs minimized the increases. The administration of lidocaine significantly suppressed bucking or coughing compared with the other groups. Conclusions： The pressor responses and tachycardia occurring in patients with uvulopalatopharyngoplasty during emergence from anesthesia and tracheal extubation, can be easily blocked by a bolus dose of 1.0 mg/kg lidocaine, 0. 2 mg/kg diltiazem or the comhinative use of the two drugs. And the concurrent use of lidocaine and diltiazem alleviated the hemodynamic changes more obviously.

Effectiveness of Mesotherapy on Temporomandibular Joint Disorders

TMJDs （Temporomandibular joint disorders） are a common pathology but best treatment remains unclear. The goal of this study was to evaluate the effectiveness of mesotherapy on TMJD. We conducted a case review of all TMJD patients treated since 2006 with mesotherapy procedures only and using a cocktail of drugs composing of lidocaine, piroxicam and pentoxifylline. Patients were treated every 15 days until symptomatic relief was achieved and thereafter every two months. Main outcome was complete symptomatic relief, and associated factors were analysed. 27 patients were included. Complete pain relief was achieved in 26. The necessary number of procedures to get pain relief ranged from 1 to 6 （median of 1） and the total number of treatments from 1 to 40 （median of 11）. 19 patients had other painful complains mainly related with anxiety disorders. A weak correlation （r = 0.357; p = 0.05） between anxiety disorders and the required months of treatments was found. Mesotherapy is a valuable option on pain relief in a temporomandibular pain syndrome with none of the systemic effects of oral medication. Anxiety may have a role on the aetiology and therapeutic success highlights the holistic approach of these patients. Future comparative studies are necessary.

Different suppressive effect of lidocaine on persistent Na^+ current and transient Na^+ current in dorsal root ganglion neurons

Objective ：To investigate the different suppressive effect of lidocaine on persistent Na^＋ current and transient Na^＋ current in injured or uninjured dorsal root ganglion neurons. Methods： Totally 23 SD rats were randomly divided into 2 groups： control group （n： 10） and chronically compressed DRG （dorsal root ganglion） group （CCD group, n= 13）. Rats were anesthetized and DRG was isolated. Single DRG neuron was isolated by enzymatic disassociation method. Persistent Na^＋ current （INap） and transient Na^＋ current （INaT） were elicited in voltage clamp mode. Results： The presence of INap was testified in most DRG neurons （38/46 neurons in CCD group and 31/39 neurons in control group, P〉0. 05）. However, the cur- rent density of INap in CCD group （4. 6±0. 6 pA/pF, n=38 neurons） was greater than that in control group （2.5±0.4 pA/pF, n=31 neurons） （P〈0. 05）. The characteristics of INap was observed and found that INap could he blocked by 0.2 μmol/L tetrodotoxin easily. Furthermore, the does-effect relationship of lidocaine on INaP and IN.T were also examined. INaP and IN.T were suppressed by different concentrations of li- docaine, the range for INap was 5-20 μmol/L and for INaT was 0. 05-2 mmol/L. Conclusion： INap and INaT were suppressed by different concentrations of lidocaine. INap was suppressed by very low concentration of lidocaine （5-20 μmol/L）. However, INaT could only be blocked by high concentration of lidocaine （0.05-2 mmol/L）.

Evaluation of Intensive Urban Land Use Based on an Artificial Neural Network Model:A Case Study of Nanjing City,China

In this paper, the artificial neural network(ANN) model was used to evaluate the degree of intensive urban land use in Nanjing City, China. The construction and application of the ANN model took into account the comprehensive, spatial and complex nature of urban land use. Through a preliminary calculation of the degree of intensive land use of the sample area, representative sample area selection and using the back propagation neural network model to train, the intensive land use level of each evaluation unit is finally determined in the study area. Results show that the method can effectively correct the errors caused by the limitations of the model itself and the determination of the ideal value and weights when the multifactor comprehensive evaluation is used alone. The ANN model can make the evaluation results more objective and practical. The evaluation results show a tendency of decreasing land use intensity from the core urban area to the periphery and the industrial functional area has relatively low land use intensity compared with other functional areas. Based on the evaluation results, some suggestions are put forward, such as transforming the mode of urban spatial expansion, strengthening the integration and potential exploitation of the land in the urban built-up area, and strengthening the control of the construction intensity of protected areas.

Multivariate Analysis of Accidents in Children Under 15 in Algeria （2012-MICS4）

Usually, data on road traffic accidents in Algeria are not available to researchers. Fortunately, MICS4mthe Multiple Indicator Cluster Survey conducted by UNICEF during 2012-2013 has introduced a module on accidents among children less than 15 years. In Algeria, the MICS4 survey targeted a sample of 28,000 households distributed over the national territory. These are the main results of polynomial logistic regression： Children in the richest quintile （B = .562, p 〈 .05）, are much less exposed than children in the poorest quintile. The odd ratio is 1.75. Compared to children aged 12 to 14, the younger children of 0-2 years （B = -1.059, p 〈 .05）, are three times less exposed （odd ratio = .347） to road traffic accidents; and children of 9-11 years （B = .520, p 〈 .05）, are most exposed with an odd ratio of 1.68. For territorial planning areas, with the South being taken as a reference category, the risk of traffic accidents for a child is the lowest in the West Highlanders （B = -1.257, p 〈 .05）, followed by the North Center （B = -1.163, p 〈 .05）, the East Highlands （B = -1.053, p 〈 .05）, the Northwest （B = -1.034, p 〈 .05）, and the Northeast （B = -.805, p 〈 .05）. Odd ratio values are respectively .29, .313, .349, .356, and .447.

Several factors including ITPA polymorphism influence ribavirin-induced anemia in chronic hepatitis C

AIM： To construct formulae for predicting the likelihood of ribavirin-induced anemia in pegylated interferon plus ribavirin for chronic hepatitis C. METHODS： Five hundred and sixty-one Japanese patients with hepatitis C virus genotype lb who had received combination treatment were enrolled and as- signed randomly to the derivation and confirmatory groups. Single nucleotide polymorphisms at or nearby ITPA were genotyped by real-time detection poly- merase chain reaction. Factors influencing significant anemia （hemoglobin concentration 〈 10.0 g/dL at week 4 of treatment） and significant hemoglobin decline （declining concentrations 〉 3.0 g/dL at week 4） were analyzed using multiple regression analyses. Prediction formulae were constructed by significantly independent factors. RESULTS： Multivariate analysis for the derivation group identified four independent factors associated with significant hemoglobin decline： hemoglobin decline at week 2 [P = 3.29× 10^4, odds ratio （OR） = 7.54 （g/dL）], estimated glomerular filtration rate [P = 2.16× 10^4, OR = 0.962 （ml/min/1.73 m2）], rs1127354 （P = 5.75 × 10^4, OR = 10.94） and baseline hemoglobin [P = 7.86 × 10^4, OR = 1.50 （g/alL）]. Using the model constructed by these factors, positive and negative predictive values and predictive accuracy were 79.8%, 88.8% and 86.2%, respectively. For the confirmatory group, they were 83.3%, 91.0% and 88.3%. These factors were closely correlated with significant anemia. However, the model could not be constructed, because no patients with rs1127354 minor genotype CA/AA had significant anemia. CONCLUSION： Reliable formulae for predicting the likelihood of ribavirin-induced anemia were constructed. Such modeling may be useful in developing individual tailoring and optimization of ribavirin dosage.

Genetic Structure of Tetraploid Italian and Westerwolds Ryegrasses （Lolium spp,） as Revealed by Enzyme and ISSR Polymorphism

The genetic variation of Italian ryegrass （Lolium multiflorum Lain.） and westerwolds ryegrass （L. westerwoldicum Breakw.） was investigated in eight tetraploid cultivars originated from Poland. The 337 individual seedlings, cultivated in uniform greenhouse conditions, were tested with horizontal gel electrophoresis according to five enzyme systems： diaforase （DIA）, superoxide dismutase （SOD）, glutamate oxalacetate transaminase （GOT）, peroxidise （PX） and phosphogluco isomerise （PGI）, which were used to array allelic diversity at five polymorphic loci. The estimation of genetic diversity in 64 plants of the same cultivars was studied using inter simple sequence repeats （ISSRs） as molecular marker. The genetic variation described by ISSR suggests that the polymorphism detected appears to be poorly informative at the taxonomic level. For statistical analysis, unweighted pair group method with arithmetic mean （UPGMA） based dendrograms and minimum spanning trees were constructed using Nei＇s distance and Jaccard＇ s similarity coefficient.

Qatar as an Emerging Islamic Finance Hub

The principal objectives of this research are to provide information, commentary, and analysis of the potential opportunities for Qatar in developing its Islamic financial services and industry. This research examines how competitive Qatar is today and its future prospects in Islamic finance. This research provides policy makers and Islamic finance stakeholders with a superior understanding of the role of the key competitive factors in Islamic fmance. It is anticipated that this research will influence the growth and diversification of Islamic financial services in Qatar.

Solutions to Right Conflicts and Integrated Protection of Diverse Interests in Real EstateDevelopment and Operation

In the development and operation of real estate, real estate development enterprises as the principal subject would often establish contractual relationships with subjects of diverse interests including removed households, banks, construction project contractors, and buyers. At times, conflicts of interests might occur among these contractual subjects requesting civil and commercial claims of the same subject matter based on agreements or legal rights. As for the causes of these conflicts and their solutions, a majority of existing researches still stay at the superficial causes from the perspective of civil and commercial law, and the solution of determining the order of priority of compensation of related rights. Due to the lack of research into deep-seated reasons and solutions from the perspective of economic law, the current legislative and judicial approaches to this kind of problems tend to give more protection to the rights of one subject while lack sufficient attention to other subjects. This paper attempts to carry out analyses and research on the causes and solutions to this kind of conflicts from the perspective of economic law, to achieve integrated protection of diverse interests in real estate development and operation so as to better safeguard the order in real estate development and operation and facilitate the healthy and ordered development of the real estate industry.

The effects of local anesthetics on intracellular Ca2+ release from ryanod ine-sensitive Ca2+ stores in gerbil hippocampal neurons

OBJECTIVE: To examine the effects of procaine and lidocaine on intracellular Ca(2+) release from sarcoplasmic reticulum ryanodine-sensitive Ca(2+) stores. METHODS: The experiment was performed on hippocampal slices from 60-80 g male Mongolian gerbils. Levels of intracellular Ca(2+) concentration in the slices were measured by microfluorometry. The slices were perfused with 50 mmol/L KCl containing medium for 30 seconds. Then, the medium was switched to physiological medium. After 5 min of incubation, the slice was perfused with 20 mmol/L caffeine containing physiology medium for 2 min. Following incubation, the slice was superfused with physiological medium until the end of the experiment. The effects of procaine and lidocanin (100 micro mol/L) on caffeine-evoked Ca(2+) release were evaluated by adding them to the medium after high K(+) medium perfusion. RESULTS: Caffeine induced a marked increase in intracellular Ca(2+) concentration which was then decreased 12% upon the addition of procaine (P

The effects of local anesthetics on intracellular Ca^(2+) release from ryanodine-sensitive Ca^(2+) stores in gerbil hippocampal neurons

To examine the effects of procaine and lidocaine on intracellular Ca 2+ release from sarcoplasmic reticulum ryanodine sensitive Ca 2+ stores Methods The experiment was performed on hippocampal slices from 60-80 g male Mongolian gerbils Levels of intracellular Ca 2+ concentration in the slices were measured by microfluorometry The slices were perfused with 50 mmol/L KCl containing medium for 30 seconds Then, the medium was switched to physiological medium After 5 min of incubation, the slice was perfused with 20 mmol/L caffeine containing physiology medium for 2 min Following incubation, the slice was superfused with physiological medium until the end of the experiment The effects of procaine and lidocanin (100 μmol/L) on caffeine evoked Ca 2+ release were evaluated by adding them to the medium after high K + medium perfusion Results Caffeine induced a marked increase in intracellular Ca 2+ concentration which was then decreased 12% upon the addition of procaine ( P 【0 05); however, lidocaine, did not induce a similar inhibitory reaction Conclusion Procaine inhibits ryanodine receptor mediated Ca 2+ release from intracellular Ca 2+ stores, while lidocaine may inhibit Ca 2+ release through other mechanisms

Efficacy of amiodarone and lidocaine for preventing ventricular fibrillation after aortic cross-clamp release in open heart surgery:a meta-analysis of randomized controlled trials

Objective： The relative preventative efficacy of amiodarone and lidocaine for ventricular fibrillation（VF） after release of an aortic cross-clamp（ACC） during open heart surgery has not been determined. This meta-analysis was designed to systematically evaluate the influence of amiodarone, lidocaine, or placebo on the incidence of VF after ACC. Methods： Prospective randomized controlled trials（RCTs） that compared the VF-preventative effects of amiodarone with lidocaine, or amiodarone or lidocaine with placebo were included. Pub Med, EMBASE, and the Cochrane Library were searched for relevant RCTs. Fixed or randomized effect models were applied according to the heterogeneity of the data from the selected studies. Results： We included eight RCTs in the analysis. Pooled results suggested that the preventative effects of amiodarone and lidocaine were comparable（relative risk（RR）=1.12, 95% confidence interval（CI）： 0.70 to 1.80, P=0.63）, but both were superior to the placebo（amiodarone, RR=0.71, 95% CI： 0.51 to 1.00, P=0.05; lidocaine, RR=0.63, 95% CI： 0.46 to 0.88, P=0.006）. The percentage of patients requiring electric defibrillation counter shocks（DCSs） did not differ significantly among patients administered amiodarone（RR=0.21, 95% CI： 0.04 to 1.19, P=0.08）, lidocaine（RR=2.44, 95% CI： 0.13 to 44.02, P=0.55）, or the placebo（RR=0.56, 95% CI： 0.25 to 1.25, P=0.16）. Conclusions： Amiodarone and lidocaine are comparably effective in preventing VF after ACC, but the percentage of patients who subsequently require DCSs does not differ among those administered amiodarone, lidocaine, or placebo.