In this work, a benzo[ d ]imidazole-derived fluorescent probe, DCBIF , was developed for the carbon dioxide (CO 2 ) detection and imaging in living lung cells. On the basis of investigating previous reports and modifying the test method, the in -solution experiments showed that DCBIF exhibited the fluorescence response at 420 nm to CO 2 under the excitation of 350 nm. The response was steady and rapid in physiological conditions. The linear range of the detecting system covered the practical necessity, and the limit of detection was 0.002 mL/min. There were few reports for detecting CO 2 depicted the intracellular imaging while the cells were not pulmonary. Herein, in all the tested groups including oxygen -rich, hypoxia, and hypoxia recovered, DCBIF realized the imaging of the CO 2 level in living A549 lung cells. This work was meaningful for developing fluorescent implements and imaging scenarios.

目的 分析并探讨探讨超声引导下臂丛复合肋间臂神经(intercostobrachial nerve,ICBN)阻滞对肱骨远端骨折手术患者的临床应用效果.方法 回顾性研究 2019 年 3 月至 2022 年 3月本院收治的 92例肱骨远端骨折手术的患者,根据麻醉方式分为对照组超声引导下单纯臂丛神经阻滞与观察组超声引导下臂丛联合ICBN阻滞,各 46例.对比两组患者一般资料、阻滞相关指标、血流动力学指标、炎症相关指标和镇痛效果指标.结果 两组患者的一般资料无统计学差异(P＞0.05).观察组阻滞完善时间、阻滞起效时间均短于对照组,阻滞持续时间长于对照组,(P＜0.05);与组内T0 相比,观察组T1、T2 时间点SBP、DBP、HR均升高,对照组T1、T2、T3、T4 时间点 SBP、DBP、HR均升高,但对照组变化更明显(P＜0.05).两组T4、T5、T6 血清IL-6、IL-10 水平均升高,对照组变化更明显(P＜0.05).对照组接受镇静治疗及使用其他镇痛药物比率、术毕VAS评分、术中舒芬太尼使用量高于观察组(P＜0.05).结论 与超声引导下臂丛神经阻滞比较,超声引导下臂丛复合肋间臂神经阻滞在肱骨远端骨折手术中阻滞、镇痛效果更好,并且对患者术后炎症反应有缓解作用.

目的:探讨不同麻醉方法对妇科腹腔镜手术的麻醉效果,分析对患者胃动素、术后恶心呕吐等胃肠动力的影响.方法:选取 2021 年 5 月—2021 年 11 月本院收治的 120 例接受妇科腹腔镜手术患者,按照麻醉方式随机均分为全凭静脉麻醉(TIVA)组 60 例、静吸复合麻醉(CIVIA)组 60 例.比较两组麻醉效果、胃动素水平以及术后恶心呕吐发生率.结果:CIVIA组术后自主呼吸恢复时间(9.27±2.31 min)、术后睁眼时间(10.15±2.04 min)、拔管时间(13.52±2.78 min)和定向恢复时间(16.08±2.49 min)均短于 TIVA 组(12.09±1.95 min、13.72±2.26 min、15.34±2.63 min、19.63±2.52 min),术毕和术后 24h胃动素水平(354.23±79.05 pg/ml、318.62±69.48 pg/ml)高于 TIVA组(321.47±82.41 pg/ml、290.56±76.32 pg/ml),恶心呕吐发生率(26.7%)高于TIVA组(11.7%)(均P＜0.05);术后肛门首次排气时间两组无差异(P＞0.05).结论:相比TIVA方式,选择 CIVIA 的妇科腹腔镜手术患者的苏醒和恢复更快,但须注意药物控制胃动素的释放,以有效降低术后恶心呕吐等不良胃肠反应的发生.

Objective:To investigate the effect of penehyclidine hydrochloride on respiratory mechanics, arterial blood gas, and inflammatory factors in patients undergoing one-lung ventilation during thoracoscopic lobectomy.Methods:A total of 100 patients who underwent thoracoscopic lobectomy with one-lung ventilation at Jinhua Central Hospital from January to November 2022 were included in this randomized controlled study. They were divided into groups A and B ( n = 50 per group) using a random digital number table. Patients in group A received an intravenous infusion of 0.02 mg/kg of pentylenethyclidine hydrochloride 30 minutes before surgery, while patients in group B received an equal amount of 0.9% sodium chloride injection 30 minutes before surgery. Clinical indicators, respiratory mechanical indicators (peak airway pressure, lung compliance), arterial blood gas analysis indicators (blood oxygen saturation, arterial pressure of oxygen, oxygenation index), inflammatory factor levels (interleukin-6, interleukin-8, tumor necrosis factor level-α), and pulmonary complications were compared between the two groups. Results:There were no significant differences in mechanical ventilation time or total infusion volume between the two groups (both P > 0.05). At the end of surgery (T1) and 1 day after surgery (T2), peak airway pressure in group A was (17.43 ± 2.69) cm H 2O and (16.81 ± 2.28) cm H 2O (1 cm H 2O = 0.098 kPa), respectively, which were significantly lower than (19.23 ± 3.40) cm H 2O and (18.29 ± 2.06) cm H 2O in group B, respectively ( t = 2.94, 3.41, P = 0.002, < 0.001). At T1 and T2, lung compliance in group A was (34.67 ± 2.93) cm H 2O and (36.26 ± 3.11) cm H 2O, respectively, which were significantly higher than (32.23 ± 2.85) cm H 2O and (33.84 ± 2.87) cm H 2O in group B, respectively ( t = 4.22, 4.04, P = 0.000, < 0.001). At T1 and T2, blood oxygen saturation, arterial partial pressure of oxygen, and oxygenation index in group A were significantly higher than those in group B ( t = 8.12, 3.07, 10.47, 3.16, 3.81, 4.15, all P < 0.05). At T1 and T2, interleukin-6, interleukin-8, and tumor necrosis factor-α levels in group A were significantly lower than those in group B ( t = 11.67, 13.55, 9.60, 15.71, 6.13, 11.50, all P < 0.001). The incidence of complications in group A was 4% (2/50), which was significantly lower than 16% (8/50) in group B ( χ2 = 4.00, P < 0.05). Conclusion:Penehyclidine hydrochloride has a good effect on respiratory mechanics, arterial blood gas, and inflammatory factors in patients undergoing thoracoscopic lobectomy with one-lung ventilation and thereby deserves clinical promotion.

目的 分析超声下髂筋膜神经阻滞对高龄股骨近端骨折患者的麻醉效果,及其对血流动力学与术后疼痛的影响,探讨一种安全、有效的麻醉方法,为临床提供参考依据.方法 选取金华市中心医院麻醉科2019年3月至2020年12月的100例高龄股骨近端骨折患者,根据不同麻醉方法将其分成PCB组与FICB组,每组50例.PCB组行超声下腰大肌神经阻滞麻醉,FICB组行超声下髂筋膜神经阻滞麻醉,对比2组的神经阻滞效果、血流动力学指标、术后疼痛以及股四头肌肌力评分.结果 FICB组运动、感觉的阻滞起效时间与恢复时间均短于PCB组,P<0.05;FICB组注药后5 min、注药后30 min、术毕时的动脉压均高于PCB组,心率均低于PCB组(P<0.05);FICB组术后1、6、12、24 h的视觉模拟评分法(VAS)评分均低于PCB组,P<0.05;FICB组术后24、48、72 h的股四头肌肌力评分均高于PCB组(P<0.05).结论 超声下髂筋膜神经阻滞对高龄股骨近端骨折患者的麻醉效果显著,神经阻滞效果佳,且患者术中血流动力学较稳定,术后疼痛轻微,有助于患肢股四头肌肌力恢复.

目的 比较丙泊酚与七氟烷分别联合硬膜外麻醉对老年腹腔镜结肠癌患者术后康复的影响.方法 选取80例老年结肠癌患者作为研究对象,将其随机分为丙泊酚联合硬膜外麻醉组(丙泊酚组)及七氟烷联合硬膜外组(七氟烷组),观察围手术期临床指标,应用统计学方法进行相关性分析.结果 丙泊酚组术后苏醒时间、拔管时间、进食时间、住院时间、肛门排气时间、恶心呕吐及麻黄碱应用量优于七氟烷组,差异有统计学意义(P<0.05).丙泊酚组认知功能恢复及IL-6抑制情况均高于七氟烷组,差异有统计学意义(P<0.05).结论 丙泊酚联合硬膜外麻醉便于麻醉医师术中管理,同时可降低结肠癌患者围术期治疗所致不适,对围术期快速康复有积极作用.

目的 探讨失巢环境下肿瘤源性外泌体调控结肠癌细胞增殖和凋亡的相关机制.方法 采用低黏附细胞培养板将结肠癌细胞系SW480培养建立结肠癌抗失巢凋亡细胞株.采用超速离心法收集抗失巢凋亡细胞和常规结肠癌细胞的外泌体,利用透射电镜观察外泌体的形态,采用Western blot法检测外泌体标志物CD63和CD81的表达.采用CCK-8试剂盒、Edu试剂盒和AV-PI试剂盒检测在两种细胞源性外泌体的刺激下结肠癌细胞的增殖和凋亡能力.采用RT-PCR和Western blot法检测细胞外信号调节激酶5(ERK5)、凋亡相关因子B淋巴细胞瘤-2基因(Bcl-2)、B淋巴细胞瘤-2基因相关启动子(Bad)和半胱氨酸蛋白酶-3(Caspase-3)的mRNA和蛋白的表达水平.结果 透射电镜观察结果显示,外泌体为直径50～150 nm的双层膜囊泡状结构.Western blot结果显示,外泌体的分子标志物CD81和CD63表达阳性.失巢环境下提取的外泌体与结肠癌细胞共培养的过程中,可见结肠癌细胞可以摄取并内化PKH67标记的外泌体.抗失巢凋亡结肠癌细胞的细胞凝集能力要明显高于常规结肠癌细胞,差异有统计学意义(P<0.05).CCK-8和Edu染色结果显示,抗失巢凋亡结肠癌细胞外泌体与结肠癌细胞共培养后细胞的增殖能力要明显高于常规结肠癌细胞组(P<0.05).RT-PCR和Western blot等结果显示,抗失巢凋亡结肠癌细胞组的ERK5、Caspase-3和Bad的表达水平均明显低于常规结肠癌组(均P<0.05),而Bcl-2高于常规结肠癌组(P<0.05).AV-PI试剂盒检测结果显示,抗失巢凋亡结肠癌细胞外泌体组细胞凋亡率明显低于常规结肠癌外泌体组(P<0.05).结论 抗失巢凋亡结肠癌细胞外泌体可以通过ERK5信号通路促进细胞的增殖,抑制细胞的凋亡.

目的:研究盐酸戊乙奎醚在单肺通气时对肺的作用.方法:选取88例食管癌患者随机分成实验组(44例)与对照组(44例),术前半小时实验组静滴盐酸戊乙奎醚0.5mg,对照组为生理盐水.对比两组的呼吸力学、动脉血气指标及炎症因子.结果:术毕、术后24h,实验组气道峰压、血氧分压及白介素-6、白介素-8、肿瘤坏死因子低于对照组,肺顺应性、氧合指数高于对照组,P＜0.05.结论:盐酸戊乙奎醚对单肺通气者有肺保护作用,可改善呼吸力学与动脉血气指标,减轻炎症.

目的 探讨二羟丙茶碱在胸腔镜下肺叶切除术中的肺保护作用.方法 选取2017年1—9月该院收治并择期实施胸腔镜下肺叶切除手术患者90例,随机分为观察组与对照组各45例.麻醉诱导前观察组应用二羟丙茶碱2mg/kg,对照组应用等容量生理盐水.比较两组气管插管即刻(T0)、术中1小时(T1)、术毕(T2)、术后24小时(T3)炎症因子、肺顺应性相关指标、肺通气相关指数及并发症.结果 T1、T2时观察组的气道平台压、气道阻力、气道峰压、肺泡动脉氧分压差均明显低于对照组;T1～3时的肺有效动态顺应性、动脉血氧分压和氧合指数均明显高于对照组;T2～3时的TNF-α、IL-8水平低于对照组,IL-10高于对照组;并发症发生率(4.4％)明显低于对照组(22.2％);差异均有统计学意义(P<0.05).结论 二羟丙茶碱在胸腔镜下肺叶切除术中应用可减轻炎症反应,提高肺顺应性,降低气道平台压、气道阻力、气道峰压水平,改善肺氧合功能,减少并发症,从而起到肺保护作用.