Objective:To explore the effects of intravenous lidocaine infusion on intrapulmonary shunt and inflammatory response in patients with one-lung ventilation (OLV) undergoing thoracoscopic surgery.Methods:According to random number table method, sixty patients who underwent thoracoscopic pulmonary surgery under elective general anesthesia were divided into the lidocaine group (group L) and the control group (group C), with 30 cases in each group. While other anesthetics used in patients of the two groups are all the same, the patients in group L received lidocaine 1.5 mg/kg intravenously, followed by a continuous infusion of 1.5 mg·kg -1·h -1, and group C received an intravenous injection of the same amount of normal saline. Records of two groups of patients with general information and intraoperative situation. Heart rate, mean artery pressure (MAP) before tracheal intubation, 1 min after intubation, and immediately after extubation of patients in two groups were recorded. Heart rate, MAP, hemoglobin (Hb), partial pressure of oxygen (PaO 2), and the pressure of carbon dioxide (PaCO 2) of patients were recorded at the time of two-lung ventilation (T 0), 15 min of OLV (T 1), 30 min of OLV (T 2), and the intrapulmonary shunt rate was calculated. Serum interleukin (IL)-6, IL-8, tumor necrosis factor-α (TNF-α) levels were detected at T 0 and the end of surgery (T 3). Results:Compared with before tracheal intubation, the MAP and heart rate of patients in the two groups increased 1 min after intubation and immediately after extubation ( P<0.05). The MAP and heart rate of group L are lower at 1 min after intubation and immediately after extubation than the parameters in group C ( P<0.05). Compared with T 0, the levels of IL-6, IL-8 and TNF-α in the two groups were increased at T 3 ( P<0.05). The levels of IL-6, IL-8 and TNF-α in group L were lower at T 3 than the levels of the group C ( P<0.05). There was no significant difference in PaO 2, PaCO 2, intrapulmonary shunt rate, Hb, MAP and heart rate between the two groups at each time point ( P>0.05). Compared with T 0, the intrapulmonary shunt rate increased, and PaO 2 decreased at T 1 and T 2 in both groups ( P<0.05). Conclusions:Intravenous infusion of lidocaine can effectively inhibit the stress response during double-lumen bronchial intubation and extubation, reduce the release of inflammatory factors during surgery, and has no significant effect on intrapulmonary shunt in patients with OLV.

目的 探讨利多卡因对妇科腹腔镜手术患者术后早期自主神经和肠道运动功能的影响.方法 选择全麻下腹腔镜全子宫双附件切除术患者56例,年龄30～64岁,BMI 18～25 kg/m2,ASAⅠ或Ⅱ级.将患者随机分为两组:利多卡因组(L组)和对照组(C组),每组28例.L组麻醉诱导时静脉推注利多卡因1.5 mg/kg,术中泵注利多卡因1.5 mg·kg-1·h-1至手术结束,C组给予等量生理盐水.两组麻醉诱导与维持方案相同.记录术前1 d、术后第1、2天心率变异性(HRV)指标,包括总功率对数值(LogTP)、低频功率标准化值(LFnu)、高频功率标准化值(HFnu)、低频与高频功率比值(LF/HF)、全部窦性RR间期的标准差(SDNN)及相邻RR间期差值均方根(RMSSD).采用酶联免疫吸附法(ELISA)测定术前1 d、术后第1、2天血清IL-6浓度.记录术后第1、2天40项术后恢复质量(QoR-40)评分.记录术后首次肠鸣音、肛门排气、排便和耐受固体食物时间.结果 与C组比较,L组术后第1天LogTP、HFnu、SDNN、RMSSD明显升高(P<0.05),LFnu和LF/HF明显降低(P<0.05),术后第1、2天IL-6浓度明显降低(P<0.05),QoR-40恢复质量评分明显增高(P<0.05),术后首次肠鸣音、肛门排气、排便和耐受固体食物时间明显缩短(P<0.05).结论 术中静脉输注利多卡因可降低妇科腹腔镜手术患者术后早期的交感神经兴奋性,保护副交感活性,促进术后早期肠道运动功能的恢复.

目的 探讨静脉输注利多卡因对腹腔镜手术患者术后自主神经功能和恢复的影响.方法 将全身麻醉下腹腔镜妇科手术患者70例纳入本研究,随机分为利多卡因组(L组)和对照组(C组).L组术前静脉推注利多卡因1.5 mg/kg,术中以1.5 mg/(kg·h)维持,C组给予等量生理盐水.术前、术后第1天和术后第2天动态监测心电图,分析心率变异性(HRV)指标,包括低频功率标准化值(LFnu)、高频功率标准化值(HFnu)、总功率对数值(LogTP)、低频与高频功率比值(LF/HF)、全部窦性RR间期标准差(SDNN)及相邻RR间期差值均方根(RMSSD);评估术后疼痛评分,检测血清白细胞介素-6(IL-6)浓度并采用恢复质量评定量表(QoR-40)对患者进行随访.结果 与C组比较,L组术后第1天LogTP、Hfnu、SDNN、RMSSD均较高,而LFnu、LF/HF较低,疼痛评分也较低,差异均有统计学意义(P＜0.05);L组术后第2天的IL-6浓度低于C组,QoR-40评分高于C组,差异均有统计学意义(P＜0.05).结论 利多卡因可稳定腹腔镜手术患者术后交感与副交感神经平衡,利于患者术后恢复.

目的:研究静脉给予利多卡因对妇科腹腔镜手术气腹期间自主神经功能的影响.方法:选取70例全麻下腹腔镜全子宫切除术患者,利用随机数字表法分为两组,利多卡因组诱导时静脉给予利多卡因1.5 mg/kg,术中1.5 mg/(kg·h)维持,对照组给予等量生理盐水.于入手术室后(T0),气管插管时(T1),气腹形成后即刻(T2),气腹形成后10 min(T3)、20 min(T4)、30 min(T5),拔除气管导管时(T6)采集5 min动态心电图进行心率变异性分析,评价自主神经功能,记录术中血压和心率.结果:与对照组比较,利多卡因组T1～T6时交感神经相关指标低频与高频功率比值(LF/HF)和低频功率标准化值(LFnu)降低(P<0.05),副交感相关指标高频功率标准化值(HFnu)升高(P<0.05),T3～T5时总功率对数值(lnTP)、低频功率对数值(lnLF)、全部窦性RR间期标准差(SDNN)降低(P<0.05);T1～T6时平均动脉压降低(P<0.05).结论:妇科腹腔镜手术静脉输注利多卡因可降低气腹期间交感神经兴奋性,改善自主神经功能状态.

目的 探讨术中静脉注射利多卡因对妇科腹腔镜手术患者术后镇痛和恢复质量的影响.方法 选择2020年3—12月本院收治的60例ASAⅠ-Ⅱ级的拟行妇科腹腔镜子宫切除手术患者作为研究对象,以随机数表法分为对照组和利多卡因组两组,每组各30例.利多卡因组诱导前静脉推注利多卡因1.5 mg/kg,术中泵注2 mg/kg/h维持,对照组应用等量的生理盐水.比较两组患者术中动脉压、心率和术后麻醉恢复情况、术后恶心呕吐(PONV)、排气时间、排便时间、出院时间、恢复情况QOR-40评分、术后疼痛VAS评分和镇静RSS评分.结果 利多卡因组患者的苏醒时间和拔管时间均长于对照组,差异具有统计学意义(P<0.05);而瑞芬太尼用量和术后24 h补救镇痛量均明显小于对照组,差异具有统计学意义(P<0.05);利多卡因组患者的PONV发生率显著低于对照组,差异具有统计学意义(P<0.05);利多卡因组患者的首次排气时间和排便时间显著短于对照组,差异具有统计学意义(P<0.05);但两组患者出院时间比较,差异无统计学差异(P>0.05);术后第1、3天,利多卡因组患者的QoR-40评分明显高于对照组,差异具有统计学意义(P<0.05);术后第5天,两组患者的QoR-40评分比较,差异无统计学差异(P>0.05);术后18 h、24 h、30 h、36 h,利多卡因组患者的VAS评分均低于对照组,差异具有统计学意义(P<0.05);拔管后1 min、5 min、30 min,两组患者的RSS评分比较,差异无统计学差异(P>0.05).结论 妇科腹腔镜术中静脉应用利多卡因可改善患者术后肠道功能,改善镇痛效果,提高术后恢复质量.

沉水植物作为湖泊、河流等生态系统的主要高等植物,在修复富营养化水体中的作用日益受到重视,合理利用沉水植物是去除富营养化水体氮磷的有效途径.沉水植物对水体氮磷的迁移转化影响包括生长和腐解两个阶段.文章综述了沉水植物生长对富营养化水体氮、磷的净化效果和净化机制,分析了沉水植物腐解对氮、磷迁移转化的持续影响,并提出了今后沉水植物净化氮、磷的研究方向,为沉水植物推广应用于修复富营养化水体提供理论基础.

AIM:To analyze the clinical significance of axial length, diopter and retinal nerve fiber layer thickness in hyperopia children with anisometropia amblyopia. ·METHODS: From January 2015 to January 2017 in our hospital for treatment, 103 cases, all unilateral, were diagnosed as hyperopia anisometropia amblyopia. The eyes with amblyopia were as experimental group ( 103 eyes), another normal eye as control group (103 eyes). We took the detection with axial length, refraction, foveal thickness, corrected visual acuity, diopter and the average thickness of retinal nerve fiber layer. ·RESULTS: Differences in axial length and diopter and corrected visual acuity were statistically significant between the two groups (P<0. 05). The two groups had no significant difference in retinal nerve fiber layer thickness (P>0. 05). There was statistical significance difference on the foveal thickness (P<0. 05). There was a negative correction correlation between the visual acuity, axial length with foveal and peripapillary nerve fiber layer thickness, but no significant difference in correlation ( P>0. 05 ). The positive correlation between diopter with nerve fiber layer thickness of foveal and around the optic disc were no statistically significant difference (P>0. 05). ·CONCLUSION:Retinal thickness of the fovea in the eye with hyperopic anisometropia amblyopia were thicker than those in normal eyes;the nerve fiber layer of around the optic disc was not significantly different between the amblyopic eyes and contralateral eyes. The refraction and axial length had no significant correlation with optic nerve fiber layer and macular foveal thickness.

目的:分析人工泪液联合维生素B12滴眼液治疗干眼症的临床疗效.方法:选取本院眼科门诊收治的105例干眼症患者,按照门诊号奇偶数法分成两组.对照组患者给予人工泪液治疗,观察组患者给予人工泪液联合维生素B12滴眼液治疗.连续治疗4周观察治疗效果.结果:治疗后对照组总有效率为80.77％.观察组总有效率为94.34％,组间存在显著的统计学差异(P<0.05).结论:人工泪液与维生素B12滴眼液联合治疗干眼症可起到协同增效的作用,值得临床推广应用.

Study on the method of quantitative assessment for regional ecosystem is significant in constructing and protecting re-gional ecosystem. The concepts of eco-affecting distance,eco-source and eco-efficacy are led into regional ecosystem assessment for the first time based on the theory of the radioactive resource. The method of quantitative assessment for regional ecosystem is put forward,and the numerical formulas for impact of human disturbance analysis on regional ecosystem is established based on land-scape spatial pattern. The analysis results from the Xinzhuang region in Ganduo Town and Yandang region in Hengjing Town suggest that the method is a valuable uncomplicated tool with concise of conception and intuitional results. It could be widely used for quan-titatively scientific assessing the impact of human disturbance on regional ecosystem.