【摘要】 目的 比較靶控誘導后Shikani喉鏡、Macintosh直接喉鏡和GlideScope?視頻喉鏡插管時的應激反應。 方法 選取2008年12月-2009年2月期間ASA Ⅰ~Ⅱ級、擬于全身麻醉下行擇期顱內占位病變切除術的患者30例，隨機分為Shikani喉鏡組（S組）、Macintosh直接喉鏡組（M組）與GlideScope?視頻喉鏡組（G組）。靶控異丙酚和瑞芬太尼誘導，分別采用上述3種喉鏡行經口氣管插管。記錄患者的心率、血壓，計算心率收縮壓乘積（RPP）。 結果 3組插管時間、心率、血壓和RPP比較差異無統計學意義（Pgt;0.05）。S組和M組插管后心率、血壓及RPP均較插管前顯著升高（Plt;0.05），而G組插管后的心率、60~300 s時的收縮壓、平均動脈壓和RPP與插管前比較，差異無統計學意義（Pgt;0.05）。 結論 3種喉鏡進行經口氣管插管時具有相似的血流動力學反應，GlideScope?視頻喉鏡更有利于循環穩定。【Abstract】 Objective To compare the hemodynamic responses of orotracheal intubations with GlideScope? videolaryngoscope, Macintosh direct laryngoscope, and Shikani optical stylet after target-controlled-infusion (TCI). Methods Thirty patients with American Society of Anesthesiologists (ASA) physical status Ⅰ-Ⅱ, scheduled for elective intracranial mass lesion surgery under general anesthesia were randomly allocated equally to Shikani optical stylet group (group S) Macintosh laryngoscope group (group M), and GlideScope? videolaryngoscope group (group G). After the patients became unconscious by TCI induction of propofpol and remifentanil, the endotracheal intubation were carried out through above three laryngoscope. The heart rate (HR), blood pressure and rate pressure product (RPP) were recorded. Results The differences of intubation time, HR, blood pressure and RPP in three groups were not statistically significant (Pgt;0.05). After intubation, the HR, blood pressure and RPP of group S and M were obviously higher than those before intubation (Plt;0.05); while there was no obvious change on the HR, systolic pressure at 60-300 s, mean arterial pressure and RPP of group G compared before intubation (Pgt;0.05). Conclusions There are similar hemodynamic responses in the three laryngoscope. GlideScope? is more advantageous to cycle stability.
Objective
To review the latest progress in the major biological properties of adipose-derived stem cells (ADSCs) and ADSCs assisted autologous lipotransfer in breast repair and reconstruction.
Methods
Recent literature about ADSCs assisted autologous lipotransfer in breast repair and reconstruction was reviewed.
Results
ADSCs have multipotential differentiation capacity, and they could promote angiogenesis and regulate immune reactions. ADSCs assisted autologous lipotransfer can obtain satisfactory effectiveness in breast repair and reconstruction with few complications, but more studies are needed to confirm the long-term safety.
Conclusion
ADSCs assisted autologous lipotransfer has good effectiveness in breast repaired and reconstruction. But further clinical trials are needed to confirm the long-term safety.
【摘要】 目的 探討并分析導致肺曲霉病患者誤診的原因，為早期診斷并及時正確治療提供科學的依據。 方法 回顧性分析2010年1-4月間確診為肺曲霉病的3例患者在診治過程中被誤診的原因。 結果 3例患者均缺乏明顯的特異性臨床表現和影像學表現，最后確診均依據病理學活檢證實。 結論 肺部的曲霉菌感染缺乏特異性的臨床和影像學表現，及早行纖維支氣管鏡檢查或肺組織活檢可提高早期診斷率。【Abstract】 Objective To analyze the misdiagnostic causes of pulmonary aspergillosis. Methods The clinical data of three patients with pulmonary aspergillosis from January to April 2010 were retrospectively analyzed, and the misdiagnostic causes were analyzed. Result No specific clinical and imaging findings were found in the three patients, and pulmonary aspergillosis was finally diagnosed according to the pathological biopsy. Conclusion Pulmonary aspergillus lacks specific clinical and imaging manifestations; early fiberoptic bronchoscopy or pulmonary biopsy may improve the rate of accurate diagnosis.
Objective
To explore the effect of rolling compression loading bioreactor on chondrogenesis of rabbit bone marrow mesenchymal stem cells (BMSCs) with different loading parameters.
Methods
BMSCs were isolated from New Zealand rabbits, aged 2.5 months. BMSCs at passage 3 were used to prepare BMSCs-agarose gels (4 mm in diameter and height, respectively). Samples were divided into 8 groups: 10% (group A1), 20% (group A2), and 30% (group A3) compression groups (0.4 Hz, 3 h/ d) and 20 minutes (group B1), 3 hours (group B2), and 12 hours (group B3) rolling time groups and static culture (control groups). The living cell rate, the collagen type II and Aggrecan gene expressions, and glycosaminoglycan (GAG) content were determined, and histological staining was done at 24 hours, 7 days, 14 days, and 21 days after culture.
Results
At 14 and 21 days, the living cell rates of groups A1 and A2 were significantly higher than that of group A3 (P lt; 0.05), groups B1 and B2 were significantly higher than group B3 (P lt; 0.05). Collagen type II and Aggrecan gene expressions of the experimental groups at each time point were significantly higher than those of the control groups (P lt; 0.05); at 14 and 21 days, collagen type II and Aggrecan gene expressions of groups A1 and A2 were significantly higher than those of group A3, and groups B1 and B2 were also significantly higher than group B3 (P lt; 0.05). At 14 and 21 days, the GAG contents of groups A1 and A2 were significantly higher than those of group A3 (P lt; 0.05); groups B1 and B2 were also significantly higher than group B3 (P lt; 0.05). At 21 days, toluidine blue staining showed that obvious blue-staining and even cartilage lacunae were seen in groups A2 and B2, but light and quite rare blue-staining in groups A1, A3, B1, and B3.
Conclusion
The rolling compression loading bioreactor has great promotion effect on chondrogenesis of rabbit BMSCs with rolling parameters of 0.4 Hz, 3 hours, and 20% compression.
【摘要】 目的 對季也蒙念珠菌感染患者的臨床及微生物學特征進行分析，為臨床診治提供參考。 方法 收集2006年1月-2008年12月病原菌培養為季也蒙念珠菌的10例住院患者資料進行回顧性分析。 結果 季也蒙念珠菌感染患者存在多種基礎疾病，大多數患者（8/10）有易感因素，其中7例使用廣譜抗菌藥物。10例中有8例為深部真菌感染。其臨床表現與感染部位有關，主要累及泌尿道、呼吸道和皮膚軟組織。多數深部感染患者（6/8）在感染前存在同部位細菌感染，部分患者（3/8）在相同部位還可分離出其他真菌。全部季也蒙念珠菌菌株對兩性霉素B敏感，大多數菌株（9/10）對氟康唑敏感。僅1例患者因肺部感染、呼吸衰竭死亡，其余患者經氟康唑、伊曲康唑或特比萘芬等抗真菌藥物治愈。 結論 季也蒙念珠菌感染多發生于有基礎疾病、存在真菌易感因素者，感染部位多為原細菌感染部位，常合并其他細菌或真菌感染。部分菌株對氟康唑和伊曲康唑中敏或耐藥，治療應根據藥敏進行選擇。【Abstract】 Objective To analyze the clinical and microbiologic characters of candida guilliermondii to improve the clinical diagnosis and treatment. Methods The clinical data of 10 patients with candida guilliermondii infection diagnosed in our hospital from January 2006 to December 2008 were retrospectively analyzed. Results All the patients had several underlying conditions; eight patients had predisposing factors and seven patients were prescribed with broad-spectrum antibacterials. Eight patients had deep mycoses, whose clinical manifestation was associated with the infectious sites, mainly involved in urinary tract, respiratory tract and skin-soft tissues. Most deep mycoses (6/8) had prior bacterial infection at the candida guilliermondii infection site; some patients (3/8) had other fungous infection at the same time. All the strains were sensitive to amphotericin B; most fungous strains (9/10) were sensitive to fluconazole. One patient died of pulmonary infection and respiratory failure, and the others were cured by fluconazole, itraconazole or terbinafine. Conclusion Candida guilliermondii infection mainly occurs in patients with underlying conditions and predisposing factors. The infectious sites have prior bacterial infection and bacterial infection or fungous infection at the same time. Since some candida guilliermondii strains were not sensitive to fluconazole and itraconzole, drug sensitive test should be consulted.
【摘要】 目的 探討術中應用曲馬多、芬太尼對全麻蘇醒期鎮痛效果的影響。 方法 2009年10月-2010年4月將80例靜脈麻醉下行胃癌根治術的患者隨機分為4組:Q1組曲馬多1 mg/kg、F1組芬太尼1 μg/kg、Q2組曲馬多2 mg/kg、F2組芬太尼2 μg/kg。各組分別于術畢前30 min靜注給藥。手術結束后送恢復室，比較4組的呼喚睜眼時間、拔管時間、拔管后即刻疼痛評分（VAS評分）、術前術后平均動脈壓（MAP）、心率（HR）、脈搏血氧飽和度（SpO2）的變化以及不良反應的發生情況。 結果 4組患者呼喚睜眼時間差異無統計學意義（Pgt;0.05），F2組的拔管時間明顯長于其他3組（Plt;0.05），Q1組和F1組的疼痛評分明顯高于Q2組和F2組（Plt;0.05），在T2時點，Q2組和F2組的MAP值明顯低于Q1組和F1組（Plt;0.05）。 結論 曲馬多2 mg/kg與芬太尼2 μg/kg的鎮痛效果的效果相當，但安全性更高，更加適合全麻蘇醒期的鎮痛治療。【Abstract】 Objective To investigate the effects of tramadol and fentanyl on analgesia in the early recovery period after general anesthesia. Methods A total of 80 patients who underwent the operation of gastric cancer under general anesthesia from October 2009 to April 2010 were randomly divided into four groups: group Q1 received tramadol 1 mg/kg, group F1 received fentanyl 1 μg/kg, group Q2 received tramadol 2 mg/kg, and group F2 received fentanyl 2 μg/kg. Thirty minutes before the end of surgery, intravenous administration was performed on all of the patients. In the recovery room, the wake-up time, extubation time, pain level evaluated by Visual Analogue Scale (VAS), the mean arterial pressure (MAP), heart rate (HR) and pulse oxygen saturation (SpO2) before and after the surgery, and incidence of complications were recorded. Results No significant differences in wake-up time among the four groups were found (Pgt;0.05). The extubation time was longer in group F2 than that in the other three groups (Plt;0.05). The VAS scores in group Q1 and F1 were higher than those in group Q2 and F2. At the T2 time point, MAP in group Q2 and F2 were lower than those in group Q1 and F1 (Plt;0.05). Conclusion The analgesic efficacy of tramadol 2 mg/kg is similar to that of fentanyl 2 μg/kg, but tramadol is more suitable for analgesic treatment in recovery period after general anesthesia due to the higher security.
