Purpose:To observe the effect of ultrasound-guided single right stellate ganglion block (SGB) on postoperative first night sleep in patients undergoing maxillofacial surgery. Methods:This study included 120 participants who underwent maxillofacial surgery under general anesthesia from 11 April 2023 to 31 August 2024. These participants were divided into three groups, namely blank control group, 1% lidocaine group, and 2% lidocaine group, with 40 patients in each group. Their blood pressure, heart rate, blood oxygen saturation, and the visual analog scale (VAS) scores were recorded before the operation (baseline), immediately after awakening, immediately after arrival at the anesthesia intensive care unit (AICU), 1 h after arrival at the AICU, and 2 h after arrival at the AICU. The Richard-Campbell Sleep Questionnaire (RCSQ) was used to evaluate the sleep quality in the three patient groups on the first night after surgery. Complications associated with SGB and the number of sedative analgesic medication doses supplemented on the first postoperative night were recorded. Results:The RCSQ scores of the blank control group, 1% lidocaine group, and 2% lidocaine group were 44.5 (33.3, 62.0), 67.0 (54.0, 87.9), and 96.0 (65.8, 100.0), respectively, and the scores gradually increased (comparison among three groups: P < 0.0001). There was a statistical difference among the three groups in the gradual slowing down of heart rate after extubation and wakefulness, immediately after arrival at the AICU, 1 h after arrival at the AICU, and 2 h after arrival at the AICU. There were no significant complications of SGB in the three groups. The 1% and 2% lidocaine group reduced the number of postoperative sufentanil remedies. Conclusion:Ultrasound-guided single right SGB effectively improved the quality of postoperative first night sleep according to RCSQ and reduced stress reactions within 2 h in patients undergoing maxillofacial surgery. Notably, the efficacy of 4 mL of 2% lidocaine was superior to that of 4 mL of 1% lidocaine, making it a safe and effective method for improving postoperative sleep.

Purpose:Esketamine have anesthetic and analgesic properties. This study aimed to observe the enhancing effect of subanesthetic doses of esketamine (0.15-0.3 mg/kg/h) with dexmedetomidine and remifentanil during anesthesia for liposuction surgery. Patients and Methods:A total of 155 subjects were randomized with a 1:1 ratio to Group E (esketamine-dexmedetomidine/remifentanil, n=78) or Group C (saline-dexmedetomidine/remifentanil group, n=77). The primary outcome was satisfaction of patient and surgical team with the procedure. The secondary outcomes were the postoperative Athens Insomnia Scale (AIS) and Hospital Anxiety and Depression Scale (HADS) scores, hemodynamic and respiratory changes, drug consumption, adverse event rates, and predictors associated with patient satisfaction. Results:Patient and surgical team satisfaction with the procedure was significantly higher in Group E than in Group C (4.7 ± 0.6 vs 4.2 ± 0.7, P < 0.001; 4.7 ± 0.5 vs 4.4 ± 0.7, P = 0.005). The postoperative AIS (4 [1, 6] vs 5 [2, 9], P = 0.012) and HADS-A (1 [0, 3] vs 2 [0, 6], P = 0.012) scores were significantly lower in Group E than in Group C. Hemodynamic and respiratory parameters were more stable in Group E than in Group C, with the lower opioids consumption of sufentanil (0 [0, 4] vs 5 [2.5, 7.7], P < 0.001) and remifentanil (700 [480, 900] vs 800 [500, 1200], P = 0.023) in Group E compared to Group C. On ordinal logistics regression, postoperative sleep quality (OR, 0.70; 95% CI, 0.62-0.79), anxiety level (OR, 0.77; 95% CI, 0.62-0.95) and recovery time in post-anesthesia care unit (PACU) (OR, 0.69; 95% CI, 0.56-0.98) were identified as significant predictors associated with patient satisfaction. Conclusion:A subanesthetic dose of esketamine (0.15-0.3 mg/kg/h) as an adjuvant can improves the sedative and analgesic effects of dexmedetomidine and remifentanil during anesthesia for liposuction surgery. Clinical Trial Registration:ChiCTR2400080363.

目的 观察3种喉镜辅助经鼻气管插管的临床效果.方法 选取2019年5月至2021年1月中国医学科学院北京协和医学院整形外科医院择期全身麻醉下行颌面外科手术的患者132例,随机分为Macintosh直接喉镜组(MA组)、Tosight视频喉镜组(TO组)和MDH电子软镜组(MD组),每组44例.记录导管到达口咽部时间、声门暴露时间、置入导管时间及插管总时间;记录插管次数、首次插管成功率、有无按压气管环、是否旋转导管置入和有无口鼻腔黏膜出血;记录患者血流动力学改变情况;记录术后2 h咽喉部并发症发生情况.结果 TO组和MD组能较好地暴露声门,均为44例,全部为C-L分级I级,高于MA组(36例),差异有统计学意义(P＜0.05);TO组和MD组首次插管成功率均为100.0％,高于MA组的90.9％,差异有统计学意义(P＜0.05);3组Mallampatti分级和插管总成功率差异无统计学意义(P＞0.05).与MA组和TO组比较,MD组鼻导管置入或软镜到达口咽部时间[(9.7±5.5)s]、声门暴露时间[(14.5±8.9)s]、置入导管时间[(27.9±13.9)s]、插管总时间[(52.0±14.9)s]均最长,但黏膜出血发生率(4.5％)及术后咽痛发生率(2.3％)最低,差异均有统计学意义(P＜0.05).3组插管过程血流动力学稳定,术后咽部不适、声音嘶哑发生率比较,差异均无统计学意义(P＞0.05).结论 3种喉镜均能很好地完成鼻插管,Tosight视频喉镜和MDH电子软镜能更好地暴露声门,首次插管成功率高;MDH电子软镜辅助经鼻插管时间长,但黏膜出血及术后咽痛发生率低.

Objective To summarize the palliative care consultations proposed by the Emergency Department of Peking Union Medical College Hospital. Methods A retrospective study was conducted on 22 palliative care consultations in the Emergency Department of Peking Union Medical College Hospital from January 2017 to June 2020. Results A total of 18 patients (6 males and 12 females) received palliative care consultations in the Emergency Department,with the average age of (65±8) years (36-88 years).Specifically,10 and 6 patients received once and twice consultations,respectively,and 2 patients did not complete the consultation.Of the patients receiving palliative care consultations,15 had malignant tumors and 3 had non-neoplastic diseases.The reasons for palliative care consultations included communication (61.1%,11/18) and pain relief (61.1%,11/18).In terms of the place of death,8 patients died in the hospital and 6 patients in other medical institutions. Conclusion There is a clear demand for palliative care consultation in the Emergency Department of Peking Union Medical College Hospital,and the consultation can bring help to both emergency doctors and patients.

目的 通过与Air-Q气管插管型喉罩的比较,评估SaCoVLM可视喉罩直视下指导儿童气管插管的临床效果.方法 选取2021年2-8月中国医学科学院北京协和医学院整形外科医院择期行全身麻醉下外耳再造手术患儿120例,采用随机数字表法分为Air-Q插管型喉罩组(A组)和SaCoVLM喉罩组(S组),每组60例.喉罩置入到位后,A组联合可视插管软镜完成插管,S组则在视频直视下实施气管插管.记录喉罩置入时间、喉罩退出时间及经喉罩气管插管时间和次数、调节手法;测量喉罩密封压;记录可视软镜在喉罩开口处的声门暴露分级、SaCoVLM可视喉罩声门暴露分级以及术后并发症的发生情况.结果 A组喉罩置入时间和喉罩退出时间短于S组[(14.1±7.2)s比(19.5±12.2)s、(18.4±5.1)s比(30.7±8.6)s],差异均有统计学意义(P＜0.05);A组气管插管时间长于S组[(39.8±9.5)s比(32.4±17.1)s],差异有统计学意义(P＜0.05);S 组密封压高于 A 组[(260±52)mmH2O比(204±48)mmH2O,1 mmH2O=0.009 8 kPa],差异有统计学意义(P＜0.05).拔除喉罩后,A组有4例喉罩尖端带血,S组有8例喉罩尖端带血、10例喉罩背面带血,两组比较差异有统计学意义(P＜0.05).结论 SaCoVLM可视喉罩可在喉罩内视频的指导下直接完成气管插管,插管时间明显缩短且较Air-Q插管型喉罩,且能获得更高的密封压.而Air-Q插管型喉罩的置入和退出更为容易,损伤相对较小.

In situ mining is a practical and feasible technology for extracting oil shale. However, the extracted oil shale is subject to formation stress. This study systematically investigates the pyrolysis–mechanics–seepage problems of oil shale exploitation, which are subject to thermomechanical coupling using a thermal simulation experimental device representing a closed system, high-temperature rock mechanics testing system, and high-temperature triaxial permeability testing device. The results reveal the following. (i) The yield of gaseous hydrocarbon in the closed system increases throughout the pyrolysis reaction. Due to secondary cracking, the production of light and heavy hydrocarbon components first increases, and then decreases during the pyrolysis reaction. The parallel first-order reaction kinetic model shows a good fit with the pyrolysis and hydrocarbon generation processes of oil shale. With increasing temperature, the hydrocarbon generation conversion rate gradually increases, and the uniaxial compressive strength of oil shale was found to initially decrease and then increase. The compressive strength was the lowest at 400 °C, and the conversion rate of hydrocarbon formation gradually increased. The transformation of kaolinite into metakaolinite at high temperatures is the primary reason for the increase in compressive strength of oil shale at 400–600 °C. (ii) When the temperature is between 20 and 400 °C, the magnitude of oil shale permeability under stress is small (~10−2 md). When the temperature exceeds 400 °C, the permeability of the oil shale is large, and it decreases approximately linearly with increasing pore pressure, which is attributed to the joint action of the gas slippage effect, adsorption effect, and effective stress. The results of this research provide a basis for high efficiency in situ exploitation of oil shale.

目的 探讨术中不同吸入氧浓度对整形外科全身麻醉女性患者氧合指数(动脉血氧分压/吸入氧浓度百分比,PaO2/FiO2)和呼吸指数(respiratory index,RI)的影响.方法 选取2019年1-5月中国医学科学院整形外科医院全身麻醉下行动脉血气分析的成年女性患者337例.根据麻醉中氧气和氧化亚氮(nitrous oxide,N2O)使用情况,将患者分为两组,A组89例,术中给予纯氧;B组248例,给予40％的氧气混合60％的N2O.收集机械通气1h动脉血气分析结果,计算PaO2/FiO2、PaO2、肺泡动脉氧分压差[P(A-a)O2]及RI.结果 B组PaO2/FiO2比A组明显升高,RI、PaO2及P(A-a)O2较A组明显降低,差异有统计学意义(P＜0.05).两组动脉血pH和PCO2比较差异无统计学意义(P＞0.05).结论 整形外科全身麻醉女性患者术中吸入40％的氧气可获得较高的PaO2/FiO2与较低的RI,可明显改善肺的氧合功能.

[目的]探讨异丙酚联合脐带间充质干细胞上清液冻干粉对部分肝切除术(partial hepatectomy,PHT)大鼠血管再生及肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)、C-反应蛋白(C-reactive protein,CRP)、血管内皮生长因子(vascular endothelial growth factor,VEGF)及中性粒细胞百分比的影响.[方法]将雄性Wistar大鼠按照随机数字法分为3组,每组12只,其中A组麻醉用异丙酚进行诱导和维持,打开胸腔暴露肝脏(假手术组);B组麻醉用异丙酚加生理盐水干预进行诱导和维持,行PHT;C组麻醉用异丙酚联合间充质干细胞上清液干预进行诱导和维持,行PHT.在术后5d将大鼠处死,取出再生的肝脏,称重并评估;收集大鼠血清,用于检测TNF-αα、CRP和VEGF的表达水平.[结果]与A组比较,B、C两组TNF-αα和VEGF水平显著升高;与B组比较,C组TNF-αα水平显著降低,而VEGF水平明显升高;与B组比较,C组CRP血浆水平和中性粒细胞百分比显著降低;与B组比较,C组平均肝再生率显著升高,差异均有统计学意义(P＜0.05).[结论]异丙酚联合脐带间充质干细胞上清液冻干粉可有效降低TNF-αα、CRP水平和显著上调VEGF的表达,促进残肝再生.

目的 探讨人脐带间充质干细胞(UC-MSCs)对急性颅脑创伤(TBI)大鼠受损脑组织超氧化物歧化酶(SOD)和白细胞介素-12(IL-12)的影响.方法 将45只Sprague-Dawley大鼠依据随机数字法分为对照组、TBI模型组和TBI干细胞治疗组,每组15只.采用免疫组织化学法、反转录聚合酶链反应、蛋白印迹法及酶联免疫吸附试剂盒等检测各组受损脑组织区域SOD和IL-12(含血清浓度)的表达情况,并比较各组脑组织IL-12信使RNA(mRNA)、SOD mRNA、SOD蛋白、IL-12蛋白的表达和SOD阳性细胞数以及血清IL-12水平.结果 与对照组相比,TBI模型组脑组织IL-12 mRNA、SOD mRNA、IL-12蛋白和SOD蛋白表达水平均明显上调[(0.689±0.093)比(0.430±0.151)、(0.414±0.092)比(0.332±0.114)、(0.733±0.091)比(0.364±0.106)、(0.494±0.063)比(0.402±0.101)](P<0.05);TBI干细胞治疗组SOD mRNA和SOD蛋白表达水平明显上调[(0.630±0.163)比(0.332±0.114)、(0.774±0.103)比(0.402±0.101)](P<0.05),IL-12 mRNA和IL-12蛋白表达水平比较差异无统计学意义(P>0.05).与TBI模型组相比,TBI干细胞治疗组IL-12 mRNA和IL-12蛋白表达水平明显下调[(0.386±0.104)比(0.689±0.093)、(0.413±0.164)比(0.733±0.091)](P<0.05),SOD mRNA和SOD蛋白表达水平明显上调(P<0.05).对照组、TBI模型组、TBI干细胞治疗组大鼠SOD阳性细胞数分别为(0.031±0.007)、(0.069±0.006)、(0.123±0.013),TBI模型组和TBI干细胞治疗组大鼠SOD阳性细胞数明显多于对照组(P<0.01),TBI干细胞治疗组明显多于TBI模型组(P<0.01).对照组、TBI模型组、TBI干细胞治疗组大鼠血清IL-12水平分别为(0.378±0.045)pg/mL、(5.450±0.941)pg/mL、(1.467±0.321)pg/mL,TBI模型组血清IL-12水平高于对照组(P<0.05),TBI干细胞治疗组低于TBI模型组(P<0.01).结论 UC-MSCs移植可提高TBI大鼠脑损伤区域SOD的表达,并抑制氧化应激反应,降低IL-12表达水平,有效控制炎症级联反应,有利于受损脑组织的恢复.

目的 探讨头面部手术中应用右美托咪定联合瑞芬太尼维持中度镇静镇痛的有效性和安全性,比较手控输注与靶控输注瑞芬太尼的效果.方法 60例ASA分级Ⅰ或Ⅱ级的择期头面部整形手术患者,随机分为靶控输注瑞芬太尼组(靶控组)30例和手控输注瑞芬太尼组(手控组)30例.2组右美托眯定均为负荷剂量1 μg/kg,维持剂量0.2～1.0μg/(kg· h);靶控组瑞芬太尼初始靶浓度2.5 μg/L,术中根据呼吸抑制情况和疼痛反应每次递减或递增靶浓度0.3 μg/L;手控组瑞芬太尼负荷剂量0.5 μg/kg,维持剂量0.1 μg/(kg·min),调整梯度为0.02 μg/(kg·min);术中调整输注速度或靶浓度以维持中度镇静水平(改良警觉/镇静评分4～3分).比较2组术中中度镇静成功率、患者满意度等有效性指标,低氧血症、呼吸抑制情况等安全性指标,术中疼痛、咪达唑仑补救和术中记忆等发生情况.结果 靶控组术中中度镇痛成功率(86.7％)和低氧血症发生率(20.0％)与手控组(73.3％、26.7％)比较差异无统计学意义(P＞0.05);靶控组呼吸过缓和/或呼吸暂停发生率(23.3％)低于手控组(50.0％)(P＜0.05),术中疼痛反应(30.0％)、咪达唑仑补救(36.7％)、术中记忆(43.3％)、术后恶心呕吐(16.7％)发生率及术后患者满意度(100.0％)与手控组(26.7％、30.0％、40.0％、23.3％、96.7％)比较差异无统计学意义(P＞0.05).结论 右美托咪定联合瑞芬太尼中度镇静镇痛可满足头面部手术要求,镇静深度可控性强;靶控输注瑞芬太尼对呼吸频率影响小,低氧血症发生率与手控输注无明显差异.

Supreme喉罩是一次性双管喉罩,除咽部密封外,最新版的Supreme喉罩加入了创新的食道密封功能以降低误吸风险[1]. 国内外研究已充分证实Supreme喉罩的安全性和有效性[1-3]. AuraGain喉罩为新型一次性插管型双管喉罩,其通气道与上呼吸道解剖曲线相似,除了可用于术中气道维持外,还可作为引导气管插管的通道. 现有研究证实,其在临床应用中具有优异的表现,但各研究关于密封压的结果 并不一致. 本研究观察和比较Supreme喉罩与AuraGain喉罩用于乳腺整形手术的安全性和有效性,为临床使用提供参考.

化疗是治疗肿瘤的常用手段，化疗药物可以反常性地增加肿瘤细胞的增殖和扩散，也逐渐被医生们认识。本文对化疗与肿瘤转移的相关性进行分析，探讨可能的作用机制和应对方法，期待保留化疗药物治疗疗效的同时降低转移发生概率，提醒医生对化疗药物导致肿瘤转移不良的后果引起重视。

目的 探讨Levitan用于经鼻气管插管的可行性和安全性.方法 选取2019年3～8月中国医学科学院北京协和医学院整形外科医院100例经鼻气管插管的全麻患者,随机分为Levitan组(L组)和Macintosh组(M组),记录两组插管时间、插管次数、声门显露分级及插管相关并发症发生情况.结果 患者全部成功插管,L组和M组首次插管成功率分别为98％(49/50)和96％(48/50);L组声门显露更佳、插管时间更短[(32.1±12.8)s比(39.4±9.8)s,P＜0.05];两组鼻出血及术后咽痛的发生率差异无统计学意义.结论 Levitan和Macintosh喉镜均可安全有效地用于经鼻气管插管,且Levi-tan声门显露更好、插管时间更短.

近年来,定量CT逐渐成为评估慢性阻塞性肺疾病(COPD)的新方法.定量CT克服了临床肺功能检查只能评估患者肺部整体情况的不足,可分析肺部细微结构的改变.定量CT可直接评估COPD患者肺气肿情况,并可通过测量气道相关参数、空气潴留情况以及血管情况,直接或间接反映气道的病变情况.此外,定量CT评估获得的相关参数也与肺功能部分指标存在一定的相关性.未来定量CT将向着更精确的测量方法和更低的辐射剂量方向发展,从而为COPD治疗和预后提供更大的帮助.

目的 对比观察颌面手术咽后壁纱布填塞及手术部位对术后咽喉痛的影响.方法 选取2017年9月至2018年5月中国医学科学院整形外科医院70例美国麻醉医师协会(American Society of Anesthesiologist,ASA)分级Ⅰ级的颌面手术患者,随机分为A组(无咽后壁纱布组,35例)和B组(咽后壁纱布组,35例),处理方式为全身麻醉后有或无咽后壁纱布填塞,观察术后1h、4h、12h、24 h患者咽喉痛情况及术区在口裂上、下时的咽喉痛情况.结果 术后1h、4h、12h、24 h,A组咽喉痛的发生率分别为80.0％、91.4％、91.4％、82.8％,B组发生率分别为68.6％、88.6％、88.6％、80.0％,组间比较差异无统计学意义(P＞0.05).术区仅涉及口裂以上者,术后咽喉痛的总体发生率为61.1％;术区涉及口裂下者,术后咽喉痛的发生率为100％,差异有统计学意义(P＜ 0.001).结论 颌面手术是否应用咽后壁纱布,对术后咽喉痛发生率可能无影响,手术损伤可能是颌面手术咽喉痛的主要原因之一.

Objective To investigate the supernatant of umbilical cord-derived mesenchymal stem cells (UCMSCs) on tumor necrosis factor-α(TNF-α) and apoptosis protein caspase-3 in diabetic rats model with skin ulcer. Methods 45 Sprague-Dawley rats were randomly divided into control group (acute wounds group), phosphate buffered saline (PBS) group and UCMSCs supernatant group. The diabetic rat model was constructed by injecting with alloxan by tail vein and feeding with high-fat diet. Diabetic skin ulcer (DSU) rat model was constructed by scratching a wound and infusing suspension of Staphylococcus aureus. In the control group, the diabetic rats (n=15) were scratched to form a wound and treated by tail vein injection of 100μl PBS. In the PBS group, DSU rats (n=15) were treated by tail vein injection of 100μl PBS, and then 100μl PBS was dropped at the ulcer site. In the UCMSCs supernatant group, freeze-dried powder of UCMSCs supernatant was dissolved in 200μl PBS, 100μl of which was injected into the tail vein of DSU rats (n=15), and other 100μl was dropped at the ulcer site. After 5 days of the treatments, the levels of serum TNF-αwere detected by radioimmunoassay method, and the expression of TNF-αand caspase-3 in the ulcer tissues of rats was detected by polymerase chain reaction and Western Blot. Results The levels of TNF-αin the PBS group [(35.9±3.7)μg/L] were significantly higher than that of the control group [(11.4±4.9)μg/L] and the UCMSCs group [(14.7±6.6)μg/L] (all P<0.05). The levels of mRNA and protein expression of TNF-αand caspase-3 in the UCMSCs group were significantly lower than those of the PBS group (all P<0.05), and have no significant differences with respect to those of the control group (all P>0.05). Conclusions UCMSCs supernatant treatments can effectively down-regulate the expression of TNF-αand caspase-3 in ulcer tissue of DSU rats, and play an anti-inflammatory and anti-apoptotic effect.

目的 观察无管芯环状弯曲气管导管用于患儿气管插管的效果.方法 择期全麻气管插管下完成整形外科手术患儿105例,男88例,女17例,年龄4～12岁,ASA Ⅰ或Ⅱ级,按气管导管的弯曲方式随机分成三组,每组35例:环状弯曲组(RB组)、自然弯曲组(NB组)和管芯弯曲组(SB组).记录声门暴露时间、插管时间、插管次数、一次插管成功情况、插管后喉镜片是否带血;记录术后2h咽喉部并发症的发生情况.结果 三组声门暴露时间差异无统计学意义.NB组插管时间明显短于SB组[(22.7±13.6)s vs (25.2±10.6)s,P＜0.05].SB组全部一次完成气管插管,RB组和NB组分别有2例(6％)和8例(23％)需要第二次完成气管插管.RB组一次插管成功率明显高于NB组(94.3％ vs 77.1％,P＜0.05).RB组和NB组各有1例喉镜有血,SB组无一例喉镜有血.SB组有9例(26％)术后咽部疼痛,明显多于RB组的2例(6％)和NB组的1例(3％)(P＜0.05).结论 无管芯环状弯曲气管导管可相对提高患儿首次插管成功率,术后咽部不适明显减少,是一种安全便捷有效的插管方式.

目的 比较设定不同BIS目标值的丙泊酚闭环靶控输注,在整形外科脂肪抽吸术镇静镇痛麻醉中的效果.方法 选择2017年10月至2018年4月中国医学科学院整形外科医院镇静镇痛麻醉下接受脂肪抽吸术女性患者40例,ASA分级I～Ⅱ级,采用随机数字表法分为A、B组,每组20例,BIS靶目标分别为A组(60±5)和B组(55±5).静脉滴注咪达唑仑0.05 mg/kg,瑞芬太尼0.05 μg/(kg· min)持续泵入,5 min后选择丙泊酚Marsh模型行血浆靶控输注,初始血浆靶浓度为2 μg/ml.两组均在靶控输注开始10 min后改为闭环麻醉,BIS靶目标分别为(60±5)和(55±5).比较两组术中平均BIS值、丙泊酚平均效应室浓度、调节丙泊酚和瑞芬太尼次数以及呼吸抑制和体动的发生.结果 B组的平均BIS值、体动和调节丙泊酚的频率均低于A组(P＜0.05),丙泊酚平均效应室浓度高于A组(P＜0.01).结论 脂肪抽吸手术接受镇静镇痛麻醉时,丙泊酚闭环麻醉设定BIS值为(55±5)的临床效果更好,麻醉时需要注意呼吸道的管理.

目的 探讨脐带间充质干细胞(UC-MSC)对急性卵巢缺血再灌注损伤小鼠卵巢组织中过氧化物歧化酶(SOD)和白细胞介素-12(IL-12)表达的影响.方法 30只C57BL/6NCrl雌性小鼠随机分为假手术组、模型组及干细胞组,每组10只.假手术组小鼠仅在手术侧卵巢动脉下穿线,不结扎(不阻断血供);模型组、干细胞组小鼠结扎手术侧卵巢动脉30 min后剪断结扎线恢复血液供应;干细胞组小鼠于恢复卵巢血液供应后24 h经尾静脉注射1.0×106个UC-MSC,假手术组、模型组小鼠均于同时间点尾静脉注射等体积的生理盐水.尾静脉注射72 h后处死各组小鼠,取手术侧卵巢组织,实时定量聚合酶链反应法检测各组小鼠卵巢组织中IL-12、SOD mRNA表达,Western blot法检测各组小鼠卵巢组织中IL-12、SOD蛋白表达.结果 模型组小鼠卵巢组织中IL-12 mRNA、IL-12蛋白表达显著高于假手术组(P＜0.05);干细胞组小鼠卵巢组织中IL-12 mRNA、IL-12蛋白表达显著低于模型组(P＜0.05).模型组和干细胞组小鼠卵巢组织中SOD mRNA、SOD蛋白表达高于假手术组(P＜0.05),干细胞组小鼠卵巢组织中SOD mRNA、SOD蛋白表达高于模型组(P＜0.05).结论 UC-MSC移植可降低小鼠缺血再灌注损伤卵巢组织中IL-12表达,提高SOD表达,抑制炎症反应,改善氧化应激损伤,有益于受损卵巢功能的恢复.

目的 评价Tosight视频喉镜全麻气管捅管对术后咽喉痛的影响.方法 选取2017年10月至2018年3月中国医学科学院整形外科医院拟在经口气管插管全身麻醉下实施择期手术的整形外科患者,美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级Ⅰ～Ⅱ级.采用随机数字表法将其分为A组(Tosight视频喉镜组)和B组(Macin-tosh喉镜组).麻醉快速诱导后分别采用Tosight视频喉镜或Macintosh喉镜完成插管,观察记录气管插管时喉镜暴露的Cormach-Lehane分级、插管次数、带管时间、术后(1、4、12、24 h)咽喉痛情况.结果 共纳入120例患者,A、B两组各60例,A组的声门显露效果明显优于B组(P＜0.05);A组和B组的一次插管成功率分别为96.7％和88.3％,差异无统计学意义(P＞0.05).术后1h咽喉痛的发生率,A组和B组分别为15.0％和28.3％,差异无统计学意义(P＞0.05);术后4、12、24 h咽喉痛的发生率A组明显低于B组,差异有统计学意义(P＜0.05).两组术后4h咽喉痛的发生率均为最高.结论 Tosight视频喉镜可显著改善声门暴露分级,提高一次插管成功率,明显降低术后咽喉痛的发生率.