七氟醚、丙泊酚麻醉对结肠癌根治术患者围手术期血液流变学的影响

目的研究丙泊酚与七氟醚麻醉对结肠癌根治术患者围手术期血液流变学的影响。方法从2014年11月至2015年11月到我院接受治疗的结肠癌根治术患者抽取110例作为研究对象,并严格按照随机原则将其分为行丙泊酚麻醉组与行七氟醚麻醉组,均为55例。比较两组患者麻醉前、麻醉后30 min、麻醉后90 min血浆黏度、细胞变形指数、红细胞聚集指数、血浆纤维蛋白原及全血黏度(高切、中切、低切)情况。结果麻醉后,两组患者三个时间点各项指标差异较小(P>0.05)。与麻醉前相比,两组患者行麻醉后血浆黏度、全血高切黏度、全血中切黏度、全血低切黏度与血浆纤维蛋白原、红细胞变形指数与红细胞聚集指数皆明显下降(P<0.05)。结论将丙泊酚与七氟醚麻醉运用于结肠癌根治术患者,均可明显降低血液黏度,有助于防止血栓形成的相关并发症。

银杏叶片对慢性肺心病肺动脉高压的影响

目的 :探讨银杏叶片对慢性肺源性心脏病患者肺动脉高压的影响 ,以及对动脉氧分压(PaO2 )及血流变的作用。方法 :2 4例慢性肺心病患者分成二组 ,治疗前分别测肺动脉压、血气分析、血流变。治疗组服银杏叶片 4 0 0mg 3次 /日 ,对照组服用氨茶碱 0 .2 3次 /日 ,半月后复查上述检查。结果 :服用银杏叶片组肺动脉压、PaO2 、血浆粘度的改变明显优于对照组 ,经统计学处理P <0 .0 5。结论 :银杏叶片具有较好的降低肺动脉压 ,改善缺氧及降低血粘度的作用 ,其可成为慢性肺原性心脏病患者辅助治疗药物。

Effects of Lingzhi (Ganoderma lucidum) on Hemorrheology Parameters and Symptoms of Hypertensive Patients with Hyperlipidemia and Sequelae of Cerebral Thrombosis

The effects of Lingzhi(Ganoderma lucidum)on hemorrheology parameters and symptoms of hypertensive patients with hyperlipidemia,sequelae of cerebral thrombosis and coronary heart disease are studied.The Lingzhi extract was given to 33 patients(15 male,18 female,65±8 years old)in dosage of 110mg qid po for 2 weeks.The blood viscosity was im- proved after treatment.The results showed that whole blood viscosity(at high shear rate and low shear rate)and plasma viscosity were significantly decreased(P<0.01).Lingzhi showed the effect of reducing blood pressure simultaneously.Several symptoms were also improved. However,there were no significant changes in haematocrit and erythrocyte sedimentation rate (P>0.05).In a few cases there occurred adverse reactions of palpitation and restlessness.

The changes of nitric oxide and hemorheology in steroid-induced avas-cular necrosis of femoral head

Objective: To explore the pathogenesis of avascular necrosis of femoral head (ANFH), the early diagnosis index and the treatment effective index of ANFH in clinical practice. Methods: Twenty-four Japanese rabbits were divided into 2 groups: model group and control group. ANFH models were produced by intramuscular injection of large dosage of steroid to rabbits for 8 weeks. On the 4 th, 8 th week after the injection, two rabbits each time from each group were taken to observe the structure of femoral head by light microscope and scanning electron microscope. Four other stomach-empty rabbits from each group were also used to test the contents of Nitric Oxide (NO), contents of the hemorheology indexes. Results: Compared with the control group, the rabbits in the model group exhibited osteoporosis of femoral head and more bone lacuna and more fat cells through light microscope. Through scanning electron microscope observation bone trabecula were broken and sunk, and collagen fibers on the surface of bone matrix became loosen and broken, more osteocyte had pyknosis, adipocyte in the medullary cavity were enlarged and subchondral arterioles and capillaries of the femoral head were pressed by adipocyte. Compared with the control group, the model rabbits contained less NO and obvious increase of the plasma viscosity (PV), low blood viscosity (LBV), erythrocyte hematocrit (HCT), indices of erythrocyte rigidity (TK) and indices of erythrocyte aggregation (AI), plasma fibrin level (PFL) (P<0. 01) and an increase of erythrocyte electrophoresis rate (ERT) (P< 0.05). High blood viscosity (HBV), and erythrocyte sedimentation rate (ESR) were unchanged. Conclusion: The steroid-induced ANFH might be related to less NO and the abnormal hemorheology; and NO and hemorheology should be considered as an early diagnosis index for ANFH in clinical practice.

速避凝治疗急性脑梗塞48例

目的 观察速避凝治疗急性脑梗塞的疗效。方法 对 96例发病在 4 8小时内的急性脑梗塞患者随机分为治疗组与对照组 ,分别给予速避凝及普通治疗。结果 治疗组与对照组总有效率有极显著的差异 (P<0 .0 1)。结论 速避凝为新一代抗栓药 ,具有疗效好及副作用少等优点 。

Electrical stimulation of acupoint combinations against deep venous thrombosis in elderly bedridden patients after major surgery

OBJECTIVE:To compare the effects of electrical stimulation of different acupoint combinations among postoperative bedridden elderly patients on hemorheology and deep venous blood flow velocity and investigate the role of electrical stimulation against deep vein thrombosis(DVT).METHODS:From November 2010 to October 2011,a total of 160 elderly bedridden patients after major surgery were divided into the conventional care group,invigorating and promoting Qi group,blood-activating and damp-eliminating group,and acupoint-combination stimulation group.Whole blood viscosity,plasma viscosity,D-dimer levels,lower limb skin temperature,lower limb circumference,and flow velocities of the external iliac vein,femoral vein,popliteal vein,and deep calf veins in all patients were documented and compared among the four groups.RESULTS:Whole blood viscosity,plasma viscosity,D-dimer levels,and lower limb circumference were significantly reduced in the blood-activating and damp-eliminating group compared with the conventional care group(P<0.05) and were almost equal to those in the acupoint-combination stimulation group(P>0.05).Lower limb venous flow velocities were accelerated in the invigorating and promoting Qi group compared with the other groups,excluding the acupoint-combination stimulation group(P<0.05).CONCLUSION:Hemorheological indices in postoperative bedridden elderly patients were improved after combined electrical stimulation at Yinlingquan(SP 9) and Sanyinjiao(SP 6).Combined electrical stimulation at Zusanli(ST 36) and Taichong(LR 3),on the other hand,accelerated lower limb venous flow.

Effects of different directions of moxibustion therapy on hemorheology in rats with blood stasis due to cold retention

Objective： To investigate the effects of different directions of moxibustion therapy on hemorheology in rat models with blood stasis due to cold retention. Methods： A total of 32 Wistar rats were randomly divided into 4 groups, based on the random digits table, including a normal group, a model group, a moxibustion along the meridian group, and a moxibustion against the meridian group, with 8 rats in each group. Except the normal group, the other 3 groups were used to make the rat models with blood stasis due to cold retention. Rats in the moxibustion along and against the meridian groups accepted moxibustion therapy in different directions on the trunk segment of the Bladder Meridian after successful modeling. Moxibustion for 10 min every day, and 7 d as a course of treatment. Two courses of treatment（a total of 14 d） were carried out. Quantitative score of signs and symptoms change was observed once a week, with a total of 7 times. Hemorheological indexes of rats were detected when the treatment finished. Results： The quantitative scores of signs and symptoms in the model, moxibustion along the meridian and against the meridian groups were significantly higher than those in the normal group after modeling（P〈0.05）. When the treatment finished, the quantitative score of signs and symptoms in the model group was significantly higher than that in the normal group（P〈0.05）; the quantitative scores of signs and symptoms of rats in the moxibustion along and against the meridian groups were significantly lower than that in the model group（P〈0.05）; the quantitative score of signs and symptoms in the moxibustion along the meridian group was significantly lower than that in the moxibustion against the meridian group（P〈0.05）; the whole blood viscosity and erythrocyte aggregation index in the model group were significantly higher than those in the normal group（P〈0.05）, however the increases of erythrocyte hematocrit and erythrocyte sedimentation rate were not obvious（P〈0.05）; whole blood viscosity and erythrocyte aggregation index in the moxibustion along and against the meridian groups were significantly lower than those in the model group（P〈0.05）, while there were no statistically significant differences between the moxibustion along the meridian group and moxibustion against the meridian group（P〈0.05）. Conclusion： Moxibustion along and against the meridian both showed different degrees of improvement for hemorrheology and symptoms of blood stasis due to cold retention. Improvement for symptoms of blood stasis due to cold retention was better in the moxibustion along the meridian group than that in the moxibustion against the meridian group. The influence on rat hemorrheology showed no significant difference between moxibustion along the meridian and moxibustion against the meridian.

Mechanical behavior of the erythrocyte in microvessel stenosis

The passage of red blood cells （RBCs） through capillaries is essential for human blood microcirculation. This study used a moving mesh technology that incorporated leader-follower pairs to simulate the fluid-structure and structure-structure interac- tions between the RBC and a microvessel stenosis. The numerical model consisted of plasma, cytoplasm, the erythrocyte membrane, and the microvessel stenosis. Computational results showed that the rheology of the RBC is affected by the Reynolds number of the plasma flow as well as the surface-to-volume ratio of the erythroeyte. At a constant inlet flow rate, an increased plasma viscosity will improve the transit of the RBC through the microvessel stenosis. For the above reasons, we consider that the decreased hemorheology in microvessels in a pathological state may primarily be attributed to an increase in the number of white blood cells. This leads to the aggregation of RBCs and a change in the blood flow structure. The present fundamental study of hemorheology aimed at providing theoretical guidelines for clinical hemorheology.