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急危重病人手术救治麻醉130例分析
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作者 周惠萍 翟才栋 +1 位作者 黎哲敏 刘家添 《实用临床医学(江西)》 CAS 2003年第4期49-50,共2页
关键词 醉学 手术治疗 急危重病人
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Anesthesia Management in Hereditary Pheochromocytoma and Paraganglioma:Updated Insights into Clinical Features and Perioperative Care
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作者 Yao-Han Li Le Shen 《Chinese Medical Sciences Journal》 CAS CSCD 2024年第3期217-223,共7页
Approximately 40% of pheochromocytoma and paraganglioma(PPGL) cases are familial, typically presenting earlier with more complex symptoms. This paper synthesizes literature and guidelines to inform on clinical charact... Approximately 40% of pheochromocytoma and paraganglioma(PPGL) cases are familial, typically presenting earlier with more complex symptoms. This paper synthesizes literature and guidelines to inform on clinical characteristics and perioperative care for PPGL. Pheochromocytoma in von Hippel-Lindau(VHL) disease exhibits heightened secretion activity without significant perioperative hemodynamic changes. Tumors in multiple endocrine neoplasia type 2(MEN2) have a stronger endocrine function, which may induce hemodynamic fluctuations during surgery. Therefore, pheochromocytoma screening is essential at all stages of MEN2. Neurofibromatosis type 1(NF1) often presents multisystem lesions and can result in difficult airway. Pheochromocytoma should be evaluated when NF1 patients present hypertension. Pheochromocytoma and paraganglioma type 5 may present multiple lesions of pheochromocytoma or paraganglioma. In summary, hereditary PPGLs may present with severe lesions in other systems, beyond tumor function. A multi-disciplinary team(MDT) approach is often invaluable in perioperative management. 展开更多
关键词 PHEOCHROMOCYTOMA PARAGANGLIOMA genetic disease anesthetic management HEMODYNAMIC perioperative care
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硬膜外低浓度罗哌卡因伍用吗啡用于动脉硬化闭塞症血管内超声消融术后镇痛的研究
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作者 汤泓 王勇 +2 位作者 孙树林 杨海林 王颖 《黑龙江医学》 2004年第6期407-408,共2页
目的 用低浓度的罗哌卡因复合吗啡用于DSA下超声消融术治疗动脉硬化闭塞症术后硬膜外自控镇痛 ,以寻求较好的术后镇痛。方法  6 0例ASA1~ 2级超声消融术后病人 ,硬膜外导管分别留置于L2~ 3椎间隙 ,向上 3 0cm ,0 1 %罗哌卡因维持... 目的 用低浓度的罗哌卡因复合吗啡用于DSA下超声消融术治疗动脉硬化闭塞症术后硬膜外自控镇痛 ,以寻求较好的术后镇痛。方法  6 0例ASA1~ 2级超声消融术后病人 ,硬膜外导管分别留置于L2~ 3椎间隙 ,向上 3 0cm ,0 1 %罗哌卡因维持术中麻醉 ,将上述病人随机分为 2组 :实验组 0 0 75 %罗哌卡因加0 0 0 2 4吗啡加 0 0 0 2 %氟哌利多 ;对照组 0 0 0 4 %吗啡加 0 0 0 2 %氟哌利多。每组 30例 ,观察 4 8h内心率、血压、呼吸频率、血氧饱和度、疼痛VAS分级 ,以及恶心呕吐、皮肤瘙痒、排气时间延长、尿潴留等副作用的发生率。结果 心率、血压、呼吸频率、血氧饱和度 2组病人无显著差异 ,皮肤瘙痒、尿潴溜的发生率亦无显著差异 ;排气时间延长 (对照组 >实验组 ,P <0 0 5 ) ,吗啡用量实验组 <对照组 ;VAS评分亦无显著差异。结论 0 0 75 %罗哌卡因复合低浓度吗啡能产生良好的镇痛效果 ,并且无明显运动神经阻滞作用 ,吗啡药量减少 ,副作用减轻 ,适于动脉硬化闭塞症血管内超声消融术术后镇痛 ,并有利于此类病人的预后。 展开更多
关键词 醉学 硬膜外腔 罗哌卡因 下肢动脉硬化闭塞症 超声消融术 术后镇痛
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Pharmacokinetics of Remifentanil in Chinese Patients Undergoing Elective Surgery 被引量:2
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作者 张利萍 李民 +1 位作者 张弨 张现化 《Journal of Chinese Pharmaceutical Sciences》 CAS 2006年第1期33-37,共5页
Aim To study the pharmacokinetics of remifentanil in Chinese aduh patients undergoing elective surgery and compare the results with the data already published. Methods The pharmacokinetics of remifentanil was determin... Aim To study the pharmacokinetics of remifentanil in Chinese aduh patients undergoing elective surgery and compare the results with the data already published. Methods The pharmacokinetics of remifentanil was determined in 10 aduh patients undergoing elective surgery. Remifentanil 5 - 6 μg·kg^-1 was administered within 1 min after the induction of anesthesia. One point five millilitre of arterial blood samples were collected at 0 (baseline), 1,2, 3, 5,7, 10, 15, 20, 25, 30, 45, 60, and 90 min after drug administration. Remifentanil concentration was assayed by HPLC/MS/MS. Resuits The concentration-time course of remifentanil was best described by a two-compartment model. Total clearance (CL = 2. 149 ± 0. 431 L·min^-1) of remifentanil was greater than the normal hepatic blood flow. The distribution half-life (t1/2α) [ 1.56 ± 0. 52 min (0.73 - 2.31 ) ] and the elimination half-life (t1/2β) [22.07 ± 10.30 min (9, 71 -36.07)] were similar with those in previous reports. Volume of distribution ( Vd = 65. 766 ± 29. 100 L) was about two times greater than that reported in previous studies of other ethnics. Conclusion In the present study, the volume of distribution is significantly greater than thai reported in previous studies of other ethnics, indicating that there are some differences in the pharmacokinetics of remifentanil among different ethnics. 展开更多
关键词 REMIFENTANIL PHARMACOKINETICS ANESTHESIA CHROMATOGRAPHY spectrum analysis
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Iridoid Glycosides from Buddleja lindeyana 被引量:6
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作者 LUJiang-hai PUXiao-ping +1 位作者 TUGuang-zhong ZHAOYu-ying 《Journal of Chinese Pharmaceutical Sciences》 CAS 2004年第3期151-154,共4页
Aim To study the chemical constituents of Buddleja lindeyana. Methods The constituents were separated and purified by different methods of chromatography, and their structures were elucidated by IR, MS and NMR. Result... Aim To study the chemical constituents of Buddleja lindeyana. Methods The constituents were separated and purified by different methods of chromatography, and their structures were elucidated by IR, MS and NMR. Results Three iridoid glycosides and two other compounds were isolated from Buddleja lindeyana. Their structures were elucidated to be 6-O-feruloylajugol ( 1 ), erythro-6-oxo-4′-( 3-methoxyl-4-hydroxyphenylglycol-8')-feruloylaj-ugol ( 2 ), threo-6-oxo-4′-(3-methoxyl-4-hydroxyphenylglycol-8')-feruloylajugol ( 3 ), tetra-cosanoic acid 2,3-dihydroxypropyl ester (4), and galactitol (5). Conclusion All the compounds have been isolated from this plant for the first time. Compounds 1, 2 and 3 have protective effect agains MPP+ -induced apoptosis. 展开更多
关键词 iridoid glycoside Buddleja lindeyana 6-O-feruloylajugol
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Effects of ketamine on proinflammatory cytokines and nuclear factor kappaB in polymicrobial sepsis rats 被引量:3
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作者 Xue-Min Song Jian-Guo Li Yan-Lin Wang Qing Zhou Zhao-Hui Du Bao-Hui Jia Jian-Juan Ke 《World Journal of Gastroenterology》 SCIE CAS CSCD 2006年第45期7350-7354,共5页
AIM: To explore the effects of ketamine on hemodynamics, plasma proinflammatory cytokine (TNF-α and IL-6) levels and nuclear factor kappa B (NF-κB) activation during polymicrobial sepsis. METHODS: Male Sprague... AIM: To explore the effects of ketamine on hemodynamics, plasma proinflammatory cytokine (TNF-α and IL-6) levels and nuclear factor kappa B (NF-κB) activation during polymicrobial sepsis. METHODS: Male Sprague-Dawlay rats were subjected to cecal ligation and puncture (CLP) or sham operation. The rats were randomly assigned into four equal groups: sham CLP group, CLP group, ketamine (KT)Ⅰ group and KTⅡgroup. Thirty minutes before CLP, ketamine (5 mg/kg per hour and 10 mglkg per hour, respectively) was infused continuously through the left femoral vein cannula in KT Ⅰ group or KTⅡgroup. Sham CLP group and CLP group received 0.9% saline only (5 mL/kg per hour). The right femoral artery was cannulated to monitor mean arterial pressure (MAP) and heart rates (HR),and draw blood samples. The proinflammatory cytokine (TNF-α and IL-6) levels of plasma were measured using enzyme-linked immunosorbent assays (ELISA). The hepatic NF-κB activation was determined by Western blot and HPIAS 2000 image analysis system. Twenty hours after CLP, the rats were killed by right femoral artery phlebotomization. RESULTS: CLP produced progressive hypotension, and a first increase followed by a decrease in HR. The hypotension was prevented, and the HR was slightly steady in ketamine treated rats. TNF-α levels of plasma reached a peak value at 2 h after CLP. Ketamine (KT Ⅰ group or KTⅡgroup) caused a significant decrease compared with CLP group at 2, 5 and 9 h time points after CLP (14.3 ± 1.9 vs 4.3 ± 0.9, 9.7 ± 1.4 vs 4.3 ± 0.9; 9.3 ± 1.5 vs 4.3 ± 0.9, 8.7 ± 1.4 vs 4.3 ±0.9; 6.0 ± 1.5 vs 5.0 ± 1.7, 5.3 ± 0.8 vs 5.0 ± 1.7; P 〈 0.01, respectively). The IL-6 levels of plasma firstly ascended and then descended in CLP group, and reached a peak value at 9 h after CLP. Ketamine (KT I group or KTH group) caused a significant decrease compared with CLP group at 5, 9 or 20 h after CLP (135.0 ± 52.6 vs 60.0 ± 16.3, 112.5 ± 52.6 vs 60.0 ± 16.3; 410.0 ± 68.7 vs 62.5 ± 12.5, 250.0 ± 28.0 vs 62.5 ± 12.5; 320.0 ± 25.9 vs 52.5 ± 10.1, 215.0 ± 44.6 vs 52.5 ± 10.1; P 〈 0.05, respectively). The IL-6 levels of plasma in KTⅡgroup were lower than those of KT Ⅰ group at 9 h after CLP (250.0 ± 28.0 vs 410.0 ± 68.7; P 〈 0.05). In addition, CLP increased hepatic NF-κB expression compared with sham CLP. Ketamine suppressed NF-κB activation in a dose-dependent manner at 4 h after CLP (237.7 ± 3.5 vs 246.9 ± 3.1; P 〈 0.05). CONCLUSION: Ketamine stabilizes the hemodynamics, attenuates the proinflammatory cytokine responses, and inhibits hepatic NF-κB activation. These findings suggest that ketamine has protective effects against polymicrobial sepsis in rats. 展开更多
关键词 KETAMINE SEPSIS HEMODYNAMICS Tumor necrosis factor α Interleukin 6 Nuclear factor kappa B
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Continuous wound infusion of local anaesthetic agents following colorectal surgery:Systematic review and meta-analysis 被引量:4
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作者 Alan Karthikesalingam Stewart R Walsh +3 位作者 Sheraz R Markar Umar Sadat Tjun Y Tang Charles M Malata 《World Journal of Gastroenterology》 SCIE CAS CSCD 2008年第34期5301-5305,共5页
AIM:To provide a specifi c review and meta-analysis of the available evidence for continuous wound infusion of local anaesthetic agents following midline laparoto-my for major colorectal surgery. METHODS: Medline, Emb... AIM:To provide a specifi c review and meta-analysis of the available evidence for continuous wound infusion of local anaesthetic agents following midline laparoto-my for major colorectal surgery. METHODS: Medline, Embase, trial registries, conference proceedings and article reference lists were searched to identify randomised, controlled trials of continuous wound infusion of local anaesthetic agents following colorectal surgery. The primary outcomes were opioid consumption, pain visual analogue scores (VASs), return to bowel function and length of hospital stay. Weighted mean difference were calculated for continuous outcomes. RESULTS: Five trials containing 542 laparotomy wounds were eligible for inclusion. There was a sig- nificant decrease in post-operative pain VAS at rest on day 3 (weighted mean difference: -0.43; 95% CI: -0.81 to -0.04; P = 0.03) but not on post-operative day 1 and 2. Local anaesthetic infusion was associated with a signifi cant reduction in pain VAS on movement on all three post-operative days (day 1 weighted mean difference: -1.14; 95% CI: -2.24 to -0.041; P = 0.04, day 2 weighted mean difference: -0.97, 95% CI: -1.91to -0.029; P = 0.04, day 3 weighted mean difference: -0.61; 95% CI: 1.01 to -0.20; P = 0.0038). Local an- aesthetic wound infusion was associated with a signifi - cant decrease in total opioid consumption (weighted mean difference: -40.13; 95% CI: -76.74 to -3.53; P = 0.03). There was no signifi cant decrease in length of stay (weighted mean difference: -20.87; 95% CI: -46.96 to 5.21; P = 0.12) or return of bowel function (weighted mean difference: -9.40; 95% CI: -33.98 to 15.17; P = 0.45). CONCLUSION: The results of this systematic re- view and meta-analysis suggest that local anaesthetic wound infusion following laparotomy for major color- ectal surgery is a promising technique but do not pro- vide conclusive evidence of benefi t. Further research is required including cost-effectiveness analysis. 展开更多
关键词 Colorectal surgery LAPAROTOMY Local anaesthesia INFUSION Wound healing
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Plants as Objects: Challenges for anAesthetics of Flora
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作者 John Charles Ryan 《Journal of Philosophy Study》 2011年第3期222-236,共15页
This paper presents the conceptual challenges to an aesthetic model of living plants based in embodied interaction with flora through smell, taste, touch, sound and sight. I argue that the science of aesthetics is det... This paper presents the conceptual challenges to an aesthetic model of living plants based in embodied interaction with flora through smell, taste, touch, sound and sight. I argue that the science of aesthetics is deterministically visual. Drawing from theories of landscape aesthetics put forth by Carlson and Berleant, I outline four primary obstacles to an embodied aesthetics: plants as objects of sight, plants as objects of art, plants as objects of disinterestedness and plants as objects of scientific discourse. A multi-sensorial aesthetics of flora requires auto-centric proximity and degrees of intersubjectivity between the appreciator and the appreciated plant that raise important philosophical questions about aesthetic experience of the natural world. 展开更多
关键词 AESTHETICS philosophy environment PLANTS Berleant CARLSON EMBODIMENT
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Stable transfection of extrinsic Smac gene enhances apoptosis-inducing effects of chemotherapeutic drugs on gastric cancer cells 被引量:5
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作者 Li-DuanZheng Qiang-SongTong +2 位作者 LiangWang JunLiu WeiQian 《World Journal of Gastroenterology》 SCIE CAS CSCD 2005年第1期79-83,共5页
AIM: To explore the feasibility of enhancing apoptosis-inducing effects of chemotherapeutic drugs on human gastric cancer cells by stable transfection of extrinsic Smac gene. METHODS: After Smac gene was transferred i... AIM: To explore the feasibility of enhancing apoptosis-inducing effects of chemotherapeutic drugs on human gastric cancer cells by stable transfection of extrinsic Smac gene. METHODS: After Smac gene was transferred into gastric cancer cell line MKN-45, subclone cells were obtained by persistent G_(418) selection. Cellular Smac gene expression was determined by RT-PCR and Western blotting. After treatment with mitomycin (MMC) as an apoptotic inducer, in vitro cell growth activities were investigated by trypan blue-staining method and MTT colorimetry. Cell apoptosis and its rates were determined by electronic microscopy, annexin V-FTTC and propidium iodide staining flow cytometry. Cellular caspase-3 protein expression and its activities were assayed by Western blotting and colorimetry. RESULTS: When compared with MKN-45 cells, the selected subclone cell line MKN-45/Smac had significantly higher Smac mRNA (3.12±0.21 vs 0.82±0.14, t=7.52, P<0.01) and protein levels (4.02±0.24 vs0.98±0.11, t=8.32, P<0.01). After treatment with 10 μg/mL MMC for 6-24 h, growth inhibition rate of MKN-45/Smac (15.8±1.2-54.8±2.9%) was significantly higher than that of MKN-45 (5.8±0.4-24.0±1.5%, t=6.42, P<0.01). Partial MKN-45/Smac cancer cells presented characteristic morphological changes of apoptosis under the electronic microscope with an apoptosis rate of 36.4±2.1%, which was significantly higher than that of MKN-45 (15.2±0.8%, t=9.25, P<0.01). Compared with MKN-45, caspase-3 expression levels in MKN-45/Smac were improved significantly (3.39±0.42 vs0.96±0.14, t=8.63, P<0.01), while its activities were 3.25 times as many as those of MKN-45 (0.364±0.010 vs0.112±0.007, t=6.34, P<0.01). CONCLUSION: Stable transfection of extrinsic Smac gene and its over-expression in gastric cancer cell line can significantly enhance cellular caspase-3 expression and activities, ameliorate apoptosis-inducing effects of mitomycin C on cancer cells, which is a novel strategy to improve chemotherapeutic effects on gastric cancer. 展开更多
关键词 Gastric cancer Mitomycin C Extrinsic Smac gene APOPTOSIS TRANSFECTION
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Ca^(2+) cytochemical changes of hepatotoxicity caused by halothane and sevoflurane in enzyme-induced hypoxic rats 被引量:4
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作者 Wei-Feng Yu Li-Qun Yang Mai-Tao Zhou Zhi-Qiang Liu Quan Li 《World Journal of Gastroenterology》 SCIE CAS CSCD 2005年第32期5025-5028,共4页
AIM: To investigat the relation between hepatotoxicity of halothane and sevoflurane and altered hepatic calcium homeostasis in enzyme-induced hypoxic rats. METHODS: Forty-eight rats were pretreated with phenobarbita... AIM: To investigat the relation between hepatotoxicity of halothane and sevoflurane and altered hepatic calcium homeostasis in enzyme-induced hypoxic rats. METHODS: Forty-eight rats were pretreated with phenobarbital and randomly divided into six groups (eight in each group) and exposed to O2/N2/1.2 MAC anesthetics for 1 h: normal control (NC), 21% O2/79% N2; hypoxic control (HC), 14% O2/86% N2; normal sevoflurane (NS), 21% O2/ N2/1.2MAC sevoflurane; hypoxic sevoflurane (HS), 14% O2/N2/1.2MAC sevoflurane; normal halothane (NH)21%O2/79%N2/1.2MAC halothane; hypoxic halothane (HH), 14%O2/N2/1.2MAC halothane. Liver specimens and blood were taken 24 h after exposure to calcium and determined by EDX microanalysis. RESULTS: The liver of all rats given halothane (14% O2) had extensive centrilobular necrosis and denaturation. Morphologic damage was accompanied with an increase in serum glutarnic pyruvic transminase. In groups NH and HH, more calcium was precipitated in cytoplasm and mitochondria. CONCLUSION: These results suggest that halothane increases cytosolic Ca^2+ concentration in hepatocytes. Elevation in Ca^2+ concentration is implicated in the mechanism of halothane-induced hepatotoxicity. sevoflurane is less effective in affecting hepatic calcium homeostasis than halothane. 展开更多
关键词 Ca^2+ cytochemistry HEPATOTOXICITY Calcium homeostasis HALOTHANE SEVOFLURANE
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Ketamine Abuse-Induced Obstructive Nephropathy and Kidney Injury
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作者 Jun Wang Hua-lin Qi +1 位作者 Feng Liu Hai-dong Yan 《Chinese Medical Sciences Journal》 CAS CSCD 2014年第2期122-124,共3页
KETAMINE is an anaesthetic agent characterized by a rapid onset and short duration of action, but it has increasingly been abused as a "clubdrug" since the late 1980s. It can causeinflammation and contraction of the... KETAMINE is an anaesthetic agent characterized by a rapid onset and short duration of action, but it has increasingly been abused as a "clubdrug" since the late 1980s. It can causeinflammation and contraction of the bladder, leading to possibly irreversible kidney damage. Since 2007, case reports are appearing in the medical literature describing severe bladder dysfunction and kidney injury in ketamine abusers. In this article, we report a case of obstructive nephropathy and kidney injury in a ketamine abuser. 展开更多
关键词 KETAMINE kidney injury HYDRONEPHROSIS
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Protective effect of liposome-mediated glial cell line-derived neurotrophic factor gene transfer in vivo on motoneurons following spinal cord injury in rats 被引量:6
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作者 鲁凯伍 陈哲宇 侯铁胜 《Chinese Journal of Traumatology》 CAS 2004年第5期275-279,共5页
Objective: To investigate the effect of liposome-mediated glial cell line-derived neurotrophic factor (GDNF) gene transfer in vivo on spinal cord motoneurons after spinal cord injury (SCI) in adult rats. Methods: Sixt... Objective: To investigate the effect of liposome-mediated glial cell line-derived neurotrophic factor (GDNF) gene transfer in vivo on spinal cord motoneurons after spinal cord injury (SCI) in adult rats. Methods: Sixty male Sprague-Dawley rats were divided equally into two groups: GDNF group and control group. The SCI model was established according to the method of Nystrom, and then the DC-Chol liposomes and recombinant plasmid pEGFP-GDNF cDNA complexes were injected into the injured spinal cord. The expression of GDNF cDNA 1 week after injection was detected by RT-PCR and fluorescence microscope. We observed the remaining motoneurons in the anterior horn and the changes of cholinesterase (CHE) and acid phosphatase (ACP) activity using Nissl and enzyme histochemistry staining. The locomotion function of hind limbs of rats was evaluated using inclined plane test and BBB locomotor scale. Results: RT-PCR and fluorescence observation confirmed the presence of expression of GDNF cDNA 1 week and 4 weeks after injection. At 1, 2, 4 weeks after SCI, the number of motoneurons in the anterior horn in GDNF group ((20.4)±(3.2), (21.7)±(3.6), (22.5)±(3.4)) was more than that in control group ((16.8)±(2.8), (17.3)±(2.7), (18.2)±(3.2), P<(0.05)). At 1, 2 weeks after SCI, the mean gray of the CHE-stained spinal motoneurons in GDNF group ((74.2)±(25.8), (98.7)±(31.6)) was less than that in control group ((98.5)±(32.2), (134.6)±(45.2), P<(0.01)), and the mean gray of ACP in GDNF group ((84.5)±(32.6), (79.5)±(28.4)) was more than that in control group ((61.2)±(24.9), (52.6)±(19.9), P<(0.01)). The locomotion functional scales in GDNF group were higher than that in control group within 1 to 4 weeks after SCI (P<(0.05)). Conclusions: GDNF gene transfer in vivo can protect motoneurons from death and degeneration induced by incompleted spinal cord injury as well as enhance locomotion functional restoration of hind limbs. These results suggest that liposome-mediated delivery of GDNF cDNA might be a practical method for treating traumatic spinal cord injury. 展开更多
关键词 Spinal cord injury Motor neurons LIPOSOME Gene therapy
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