Effect of volatile anesthetics on the circular dichroism of bilirubin bound to human serum albumin

The characteristic circular dichroism of bilirubin bound to human serum albumin undergoes a remarkable sign inversion on addition of halothane, chloroform and other volatile anesthetics. This sign inversion, which is completely reversed by removal of the anesthetic, reflects a pronounced conformational change of the bound ligand; probably a complete inversion of chirality. The observation suggests that association of volatile anesthetics with proteins can markedly alter the internal topography of receptor sites and potentially influence the stereoselectivity of ligand binding.     

Suitability of urethane anesthesia for physiopharmacological investigations in various systems Part 1: General considerations

Summary The suitability of urethane anesthesia for physiopharmacological investigations is reviewed. Total dose administered and route of administration are recognized as factors having a great influence on both resting parameters and biological responses to drugs. A peculiar characteristic of urethane is represented by its ability to induce a surgical plane of anesthesia without affecting neurotransmission in various subcortical areas and the peripheral nervous system. This makes urethane a suitable general anesthetic for studying neural function in both central and peripheral nervous systems and accounts for the preservation of a number of reflex responses in urethane-anesthetized animals.     

针刺麻醉与镇痛泵在肩关节术后镇痛领域中的应用及评价

以行肩关节手术的患者作为研究对象,比较和评价了针刺麻醉与肩峰下自控型镇痛泵对术后镇痛的疗效与安全性,指标包括疼痛视觉模拟评分（VAS）、肩关节活动度（ROM）、Lovett肌力分级等,结果显示镇痛泵组的胃肠道不良反应发生率（7/64）、基础病复发率（4/64）,及总体不良反应发生率（16/64）均显著高于针刺组（0/70）(0/70)(4/70),在轻度疼痛者中,2组的VAS未见差异,但针刺组的ROM更大,在中、重度疼痛者中,镇痛泵组的VAS低于针刺组,但2组的ROM及肩关节肌力未见差异,说明针刺麻醉的安全性极佳,可促进术后康复,适用于轻度疼痛者及合并相关内科基础病的中、重度疼痛者。     

不同麻醉深度下大鼠脑活动的复杂性分析

为了研究大鼠在不同麻醉深度下大脑活动的变化，探测麻醉深度对其脑电信号（EEG）的影响，采用KC复杂度和谱熵对不同麻醉深度下的EEG及其4个主要频段信号进行了复杂性分析．结果发现：随着麻醉深度的加深，EEG的KC复杂度和谱熵的值都随之减小，反之亦然，且KC复杂度在区分麻醉深度的变化方面比谱熵更为灵敏、准确；在麻醉状态下，delta频段是EEG信号的优势频段，正是它的动态变化主导了EEG信号的变化过程．     

确定硬膜外麻醉阻滞平面的临床方法

目的探讨测定硬膜外麻醉阻滞平面的3种方法的可行性。方法 326例下腹部手术病人均取T12～L1间隙进行硬膜外穿刺,头向置管3.5 cm。注入局麻药后依次用触摸皮肤摩擦阻力改变法、酒精接触皮肤冷感觉消退法、针刺皮肤痛觉消退法来测定阻滞平面上界。其中24例不能表达感觉消退区域者用触摸皮肤摩擦阻力改变法测定。结果对一般患者3种方法均能测出麻醉平面,并且反应出各神经不同的阻滞范围。对24例不能表达感觉消退区域的患者通过用指腹感觉皮肤摩擦阻力变化均能测出交感神经阻滞平面,从而推断出感觉神经阻滞平面。结论临床上3种测定阻滞平面的方法均应掌握,提倡用酒精接触代替针刺,以免给患者造成伤害;用手指触摸皮肤摩擦阻力改变测试平面,对某些患者如痴呆、听觉障碍、语言不通、精神过度紧张者有重要意义。     

全麻高频通气下显微支撑喉镜手术400例分析

目的:总结分析全麻高频通气麻醉的优点及显微喉镜手术的疗效。方法:对2000年1月至2010年12月间我院采用全麻高频通气麻醉下显微支撑喉镜下声带息肉切除手术400例病例进行临床观察。结果:400例手术麻醉效果良好,手术时间短,声带损伤小,术后嗓音恢复快。随访半年无复发。结论:全麻高频通气安全性好,显微支撑喉镜手术操作简便,疗效高,值得基层医院推广应用。     

持续性硬膜外微泵法镇痛分娩50例临床观察

目的：探讨持续性硬膜外阻滞用于分娩的镇痛效果及对母儿的影响。方法：随机选择要求无痛分娩的产妇，施行持续性硬膜外阻滞，同期同条件的50例产妇作对照。观察镇痛效果、两组产程、分娩方式、产后出血、使用催产素情况及新生儿阿氏评分，并进行统计学处理。结果：镇痛有效率高，宫颈扩张速率镇痛组较对照组快(p＜0．01)，两组第二产程时间、产后24h出血量、新生儿Apgar评分(1min)、催产素使用率、阴道顺产、助产、剖宫产比较均无显差异。结论：持续性硬膜外镇痛分娩，镇痛效果确切、安全、对母儿无不良影响。     

全麻病人心律失常的探讨──附84例报告

本文对年龄在42～78岁之间的84例全麻病人术中出现心律失常的原因及类型进行分析。麻醉方法为快速诱导后行气管插管.静吸复合麻醉维持深度，术中连续心电监测。其结果是：28例于麻醉前即有心律失常的病人手术中仍存在，麻醉期间出现的56例中诱导时发生39例占70％，维持期发生17例占30％。其原因与麻醉用药、交感神经或利交感神经活动增强或平衡失调及手术操作有关，给予相应处理后均得以纠正。提示要预防心律失常的发生应做到：术前充分估计病情，术中尽量避免以上原因。及时发现，及时处理。     

浅析我国注射死刑制度

中国将逐步以注射方法执行死刑的消息引起社会的广泛反响，它标志着我国在严厉打击刑事犯罪的同时，死刑执行制度正向文明化、人道化迈进。就我国采用注射方法执行死刑的现状做了说明，分析了我国采取注射方式执行死刑的必然性和正确性。同时，也就其在执行过程中产生的问题和争议谈了看法。     

Application of Teleonic Principles in the Search for Systemic Causes of Accidents in Anesthesia

Safety of patients in anesthesia has always been one of the major concerns of the anesthetist. It is clear from studies of safety in general that many accidents and critical incidents occur as the result of latent systemic failures to which a great number of factors contribute (Reason, 1990). An ideal way to approach this problem would be within a systemic framework, such as teleonics, developed by Járos and his co-workers (Cloete, 1999; Járos and Cloete, 1987, 1993). In this framework the events and procedures in anesthesia are considered to be part of a very complex network of process systems (teleons). It is postulated that teleonic uncertainty (telentropy) in this complex network is a factor that might lead to accidents. In a previous paper presented to the World Congress at Toronto in 2000, the principles of teleonics were described in a mathematico symbolic way (Horváth et al., 2000). This paper contains selected examples of application of these principles to the identification of possible systemic causes of accidents in anesthesia.