目的·通过序贯分析法确定择期剖宫产蛛网膜下腔联合硬膜外麻醉(腰硬联合麻醉)后90%产妇不发生低血压的去甲肾上腺素静脉推注剂量。方法·根据偏倚钱币序贯法依次对40例择期剖宫产的产妇进行前瞻性双盲序贯研究。主要观察指标...目的·通过序贯分析法确定择期剖宫产蛛网膜下腔联合硬膜外麻醉(腰硬联合麻醉)后90%产妇不发生低血压的去甲肾上腺素静脉推注剂量。方法·根据偏倚钱币序贯法依次对40例择期剖宫产的产妇进行前瞻性双盲序贯研究。主要观察指标为胎儿娩出前维持产妇收缩压高于其基础值80%所使用的去甲肾上腺素静脉推注剂量。次要观察指标包括头晕、胸闷、恶心、呕吐、心动过缓、继发性高血压、补救性使用阿托品的发生率、补救性使用去甲肾上腺素的发生率,以及新生儿1 min和5 min Apgar评分等。使用Isotonic回归分析估计90%有效剂量(90%effective dose,ED_(90))及其95%CI。结果·腰硬联合麻醉后预防性静脉推注去甲肾上腺素维持产妇血压的ED_(90)为[10.85(95%CI 9.20~11.67)]μg。产妇头晕、胸闷、恶心的发生率分别为2.5%、7.5%和10.0%,补救性使用去甲肾上腺素发生率为5.0%;未出现呕吐、心动过缓、继发性高血压及补救性使用阿托品。所有新生儿1 min及5 min Apgar评分均为10分。结论·建议剖宫产腰硬联合麻醉后单次静脉推注去甲肾上腺素11μg,以预防产妇麻醉后低血压的发生。展开更多
AIM:To investigate the effects of transplantation of insulin-producing cells(IPCs) in the treatment of diabetic rats after 90% pancreatectomy.METHODS:Human umbilical cord mesenchymal stem cells(UCMSCs) were isolated a...AIM:To investigate the effects of transplantation of insulin-producing cells(IPCs) in the treatment of diabetic rats after 90% pancreatectomy.METHODS:Human umbilical cord mesenchymal stem cells(UCMSCs) were isolated and induced into IPCs using differentiation medium.Differentiated cells were examined by dithizone(DTZ) staining,reverse transcription-polymerase chain reaction(RT-PCR),and real-time RT-PCR.C-peptide release,both spontaneously and after glucose challenge,was measured by ELISA.IPCs were then transplanted into Sprague-Dawley rats after 90% pancreatectomy and blood glucose levels and body weight were measured.RESULTS:The differentiated cells were positive for DTZ staining and expressed pancreatic β-cell related genes.C-peptide release by the differentiated cells increased after glucose challenge(380.6 ± 15.32 pmol/L vs 272.4 ± 15.32 pmol/L,P < 0.05).Further,in the cell transplantation group,blood sugar levels were significantly lower than in the sham group 2 wk after transplantation(18.7 ± 2.5 mmol/L vs 25.8 ± 1.25 mmol/L,P < 0.05).Glucose tolerance tests showed that 45 min after intraperitoneal glucose injection,blood glucose levels were significantly lower on day 56 after transplantation of IPCs(12.5 ± 4.7 mmol/L vs 42.2 ± 9.3 mmol/L,P < 0.05).CONCLUSION:Our results show that UCMSCs can differentiate into islet-like cells in vitro under certain conditions,which can function as IPCs both in vivo and in vitro.展开更多
文摘目的·通过序贯分析法确定择期剖宫产蛛网膜下腔联合硬膜外麻醉(腰硬联合麻醉)后90%产妇不发生低血压的去甲肾上腺素静脉推注剂量。方法·根据偏倚钱币序贯法依次对40例择期剖宫产的产妇进行前瞻性双盲序贯研究。主要观察指标为胎儿娩出前维持产妇收缩压高于其基础值80%所使用的去甲肾上腺素静脉推注剂量。次要观察指标包括头晕、胸闷、恶心、呕吐、心动过缓、继发性高血压、补救性使用阿托品的发生率、补救性使用去甲肾上腺素的发生率,以及新生儿1 min和5 min Apgar评分等。使用Isotonic回归分析估计90%有效剂量(90%effective dose,ED_(90))及其95%CI。结果·腰硬联合麻醉后预防性静脉推注去甲肾上腺素维持产妇血压的ED_(90)为[10.85(95%CI 9.20~11.67)]μg。产妇头晕、胸闷、恶心的发生率分别为2.5%、7.5%和10.0%,补救性使用去甲肾上腺素发生率为5.0%;未出现呕吐、心动过缓、继发性高血压及补救性使用阿托品。所有新生儿1 min及5 min Apgar评分均为10分。结论·建议剖宫产腰硬联合麻醉后单次静脉推注去甲肾上腺素11μg,以预防产妇麻醉后低血压的发生。
文摘AIM:To investigate the effects of transplantation of insulin-producing cells(IPCs) in the treatment of diabetic rats after 90% pancreatectomy.METHODS:Human umbilical cord mesenchymal stem cells(UCMSCs) were isolated and induced into IPCs using differentiation medium.Differentiated cells were examined by dithizone(DTZ) staining,reverse transcription-polymerase chain reaction(RT-PCR),and real-time RT-PCR.C-peptide release,both spontaneously and after glucose challenge,was measured by ELISA.IPCs were then transplanted into Sprague-Dawley rats after 90% pancreatectomy and blood glucose levels and body weight were measured.RESULTS:The differentiated cells were positive for DTZ staining and expressed pancreatic β-cell related genes.C-peptide release by the differentiated cells increased after glucose challenge(380.6 ± 15.32 pmol/L vs 272.4 ± 15.32 pmol/L,P < 0.05).Further,in the cell transplantation group,blood sugar levels were significantly lower than in the sham group 2 wk after transplantation(18.7 ± 2.5 mmol/L vs 25.8 ± 1.25 mmol/L,P < 0.05).Glucose tolerance tests showed that 45 min after intraperitoneal glucose injection,blood glucose levels were significantly lower on day 56 after transplantation of IPCs(12.5 ± 4.7 mmol/L vs 42.2 ± 9.3 mmol/L,P < 0.05).CONCLUSION:Our results show that UCMSCs can differentiate into islet-like cells in vitro under certain conditions,which can function as IPCs both in vivo and in vitro.
