异丙酚联合小剂量咪唑安定在无痛胃镜检查中的应用

目的 :研究异丙酚和小剂量咪唑安定在胃镜检查中麻醉效果及安全性。方法 :将进行胃镜检查 30例 ,随机分为对照组 (n=15 )和麻醉组 (n=15 ) ,对照组患者 ,咽部喷雾局麻药后 ,常规进行胃镜检查 ;麻醉组患者 ,咽部局麻后 ,静脉注射咪唑安定 (1.5～ 2 .0 mg)和异丙酚 (1.5 mg/ kg) ,患者意识消失后 ,立即进行胃镜检查。两组患者在胃镜检查中均监测血压、心率、氧饱和度的变化 ,观察检查中患者的反应以及操作时间和成功率 ,并在检查后询问患者的感受。结果 :麻醉组心率和血压与对照组相比均有明显下降 (P<0 .0 5 ) ;两组氧饱和度无显著差异 (P>0 .0 5 ) ;麻醉组不良反应明显低于对照组 ,愿意接受再次检查的明显高于对照组 ;而麻醉组检查成功率、操作时间与对照组比较 ,无统计学差异。结论 :异丙酚联合小剂量咪唑安定进行胃镜检查是一种安全有效、舒适、易被接受的无痛苦胃镜检查。

不同时间注射咪唑安定防止全麻患者术中知晓的效果及对麻醉苏醒的影响

目的:研究在不同时间注射咪唑安定防止全麻患者术中知晓的效果及对苏醒时间的影响。方法:选择45例胸腹部手术的全麻患者,随机分为对照组(C组)、D1、D23组(每组15例)。用芬太尼、异丙酚和维库溴铵静脉注射诱导后行气管内插管。对照组不辅加镇静剂,D1和D2两组分别在诱导时和诱导30min后注射咪唑安定。在脑电双频谱(BIS)保持同等状态下比较术中全麻药的用量及手术结束至拔气管导管时间。术后检验术中感知和回忆情况。结果:加用咪唑安定避免全麻患者术中知晓效果优于对照组,诱导时注射咪唑安定预防术中知晓的效果优于诱导30min后注射,麻醉苏醒所需时间短。结论:与诱导同时注射咪唑安定效果最佳,且能减少全麻药用量,缩短麻醉苏醒时间,稳定病情。

持续静脉泵入咪达唑仑治疗小儿癫痫持续状态的护理

本文探讨应用持续静脉泵入咪达唑仑治疗小儿癫痫持续状态的护理。应用持续静脉泵入咪达唑仑治疗22例小儿癫痫持续状态,观察其疗效、副作用,并对其副作用采取相应的护理措施。应用持续静脉泵入咪达唑仑能维持有效的血药浓度,治疗过程顺利,控制癫痫持续状态有效率达90.9%,副作用少,无严重并发症。同时密切观察患儿生命体征,保持静脉通道通畅。

Combination of "low-dose" ribavirin and interferon alfa-2a therapy followed by interferon alfa-2a monotherapy in chronic HCV-infected nonresponders and relapsers after interferon alfa-2a monotherapy

AIM To report on the efficacy, safety and tolerability of interferon alfa-2a combined with a "low dose" of ribavirin for relapsers and non responders to alpha interferon monotherapy.METHODS Thirty-four chronic hepatitis C virus-infected non-responders to interferon alfa2a monotherapy (a course of at least 3 months treatment) and 13 relapsers to interferon alfa 2a monotherapy (a dose of 3 to 6 million units three times per week for at least 20 weeks but not more than 18 months) were treated with the same dose of interferon alfa-2a used before (3 to 6 million units three times per week) and ribavirin (10 mg/ kg daily) for 6 months. In complete responders, interferon alfa-2a was administered for further 6 months at the same dose used before as monotherapy.RESULTS Seven (20.6%) of 34 non-responders stopped the combined therapy due to adverse events, including two patients with histological and clinical Child A cirrhosis. In 17/27 (63%)non-responders, the combined therapy was stopped after three months because of non-response. Ten of the 27 non-responders completed the 1;2-month treatment course. At a mean follow up of 28 months (16- 37 months)after the treatment, 4/10 (15%) previous non-responders still remained complete responders,All 13 previous relapsers completed the 12-month treatment course. At a mean follow up of 22months (9 - 36 months) after treatment, 6/13(46%) the previous relapsers were stillsustained complete responders.CONCLUSION Our treatment schedule of the combined therapy for 6 months of interferon alfa2a with a low dose of ribavirin (10 mg/kg/day)followed by 6 months of interferon alfa-2amonotherapy is able to induce a sustainedcomplete response rate in 15% of non-responders and 46% of relapsers with chronic hepatitis C virus-related liver diseases comparable to those obtained with the standarddoses of ribavirin 1000 - 1200 mg/day.Randomized prospective controlled trials using lower total amounts of ribavirin in combination with interferon should be performed.

Effects of chitosan on dental bone repair

Objectives: Bone defects following tumor resection and osteolysis due to dental and bone lesions and periodentium tissue disorders are serious challenges. One of these materials used is chitosan, a derivative of crustaceans’ exoskeleton. The aim of this study was to assess effects of chitosan on socket repair after dental extraction. Methods: Twenty four dental sockets of 15-24 years old patients were visited by a maxillofacial surgeon for extracting premolar teeth for orthodontic purposes. The sockets in one side were filled-in by chitosan. In the other side, the sockets were left unfilled. After 10 weeks, periapical radiographs were obtained from the repair sites, were digitalized and then evaluated for densitometry using Adobe Photoshop Software. Each socket was divided into coronal, middle and apical. Dental density of each socket in case and control groups was recorded. The density of regenerated bone was compared against the maximum bone density of each individual. Wilcoxon signed range test and paired t-test were used for data analysis. Results: Bone density in middle and apical sections in case group was significantly more than control group. In apical section in case group regenerated bone reached up to 98.2% of normal bone density. In each patient, the bone density in epical and middle sections was increase 29.3% and 10.8% of normal bone density. Conclusions: Chitosan significantly increased bone density in epical and middle sections. Chitosan can be used for bone repair in cases of bone loss. Various densitometry studies for evaluating chitosan effects in different bone defects are suggested.

“No Need to Get Salty” Or Is There? Sodium Functionality as a Consideration in Nutrition Public Health Policy

Aim: Public health professionals focus on both downstream (individual) and upstream (population-level) interventions to reduce sodium consumption and prevent sodium-related chronic diseases. Effective upstream interventions specifically aimed at reducing dietary sodium intake include the implementation of comprehensive nutrition standards that restrict the amount of sodium contained in foods available for purchase. The aim of this work was to identify sought-after foods that did not meet the Philadelphia Nutrition Standards’ sodium limits and reformulate those foods to be standards-compliant and consumer-acceptable. Subject and Methods: Two foods were reformulated for compliancy with the Philadelphia Nutrition Standards’ sodium limits and consumer acceptability: the hoagie roll and soft pretzel. Reformulation included sensory testing and engaging potential manufacturing partners to investigate products’ commercial potential. Results: While hoagie roll reformulation led to a local company manufacturing and selling the reformulated product, soft pretzel reformulation stalled due to lack of consumer acceptability of the reformulated product. Salt contributes desirable characteristics in the texture, taste, and appearance of the soft pretzel, the absence of which consumers found unacceptable. Conclusion: Product reformulation holds great potential to create lower-sodium foods that otherwise have all of the characteristics of the higher-sodium “original” products but requires an understanding of the role of salt in product recipes. Reducing salt without considering its multiple functions in food may result in a product that is unacceptable or even unsafe. A simple four-step tool can help public health practitioners evaluate the extent to which products are suitable for reformulation.