不同剂量舒芬太尼对Disposcope内窥镜气管插管血流动力学的影响

为评价不同剂量舒芬太尼复合靶控输注丙泊酚对Disposcope内窥镜气管插管血流动力学的影响,选择60例择期行气管插管全身麻醉患者,依据不同剂量舒芬太尼,分为三组(n=20):A组0.2μg/kg,B组0.3μg/kg与C组0.4μg/kg.结果显示插管后1min,A组呼吸频率(HR)、收缩压(SBP)明显高于B组与C组(P＜0.05);插管时,C组SBP＜90mmHg的例数明显多于A组与B组(P＜0.05);插管后1min～5min期间,A组SBP＞140mmHg、HR＞90次/分的例数明显多于B组与C组(P＜0.05),而C组HR＜60次/分的例数明显多于A组与B组(P＜0.05).因此,0.3μg/kg舒芬太尼复合靶控输注丙泊酚诱导Disposcope内窥镜气管插管血流动力学稳定.     

不同剂量舒芬太尼对Disposcope内窥镜气管插管血流动力学的影响

为评价不同剂量舒芬太尼复合靶控输注丙泊酚对Disposcope内窥镜气管插管血流动力学的影响,选择60例择期行气管插管全身麻醉患者,依据不同剂量舒芬太尼,分为三组（n=20）：A组0.2μg/kg,B组0.3μg/kg与C组0.4μg/kg.结果显示插管后1min,A组呼吸频率（HR）、收缩压（SBP）明显高于B组与C组（P＜0.05）;插管时,C组SBP＜90mmHg的例数明显多于A组与B组（P＜0.05）;插管后1min～5min期间,A组SBP＞140mmHg、HR＞90次/分的例数明显多于B组与C组（P＜0.05）,而C组HR＜60次/分的例数明显多于A组与B组（P＜0.05）.因此,0.3μg/kg舒芬太尼复合靶控输注丙泊酚诱导Disposcope内窥镜气管插管血流动力学稳定.     

舒芬太尼-丙泊酚与瑞芬太尼-丙泊酚全凭静脉麻醉用于腹腔镜阑尾切除术的比较

选择ASAⅠ或Ⅱ级行腹腔镜阑尾切除术的患者50例,随机等分为舒芬太尼复合丙泊酚组（PS组）和瑞芬太尼复合丙泊酚组（PR组）。观察两组麻醉效果和术后12h内的不良反应。丙泊酚复合舒芬太尼或瑞芬太尼均取得理想的麻醉效果,但前者术后短期内镇痛、镇静效果优于后者;PR组患者苏醒期躁动发生率明显高于PS组。     

右美托咪定对胃肠道开腹手术瑞芬太尼诱发痛觉过敏的影响

探讨术中泵注右美托咪定对瑞芬太尼所致术后痛觉过敏及不良反应的影响。60例择期开腹胃肠道手术患者,随机分成右美托咪定组（Ⅰ组,n=30）和对照组（Ⅱ组,n=30）。分别记录术后自主呼吸恢复时间、唤醒时间、拔管时间;记录术后30min、1h、2h、4h、6h的疼痛视觉模拟评分（VAS）及Ramsay镇静评分;记录术后24h内静脉镇痛泵的使用情况及术后不良反应。两组患者的术后恢复自主呼吸时间、唤醒时间及气管导管拔管时间相当,差异无统计学意义（P〉0．05）;术后30rain、1h、2h,Ⅰ组患者的VAS评分明显低于Ⅱ组患者,差异有统计学意义（P〈0．05）;Ⅰ组患者在术后30min、1h、2h、4h的Ramsay评分明显高于对照组,差异有统计学意义（P〈0．05）;Ⅰ组患者在术后初次按压镇痛泵的时间较Ⅱ组患者明显延长,24h内镇痛泵的按压次数Ⅰ组较Ⅱ组患者减少（P〈0．05）;两组患者术后均无呼吸抑制的发生,但Ⅰ组比Ⅱ组其他不良反应的发生率降低,差异有统计学意义（P〈0．05）。在开腹胃肠道手术的麻醉中使用右美托咪定可有效减少瑞芬太尼全身麻醉后痛觉过敏的发生率,并减少术后镇痛药的用量。     

酮咯酸氨丁三醇复合丙泊酚-瑞芬太尼麻醉用于门诊宫腔镜检术的效果观察

观察和评价酮咯酸氨丁三醇复合丙泊酚一瑞芬太尼麻醉用于门诊宫腔镜检术的临床效果。选取无痛门诊宫腔镜检术患者60例,依据随机数字表法将患者随机分为瑞芬太尼组（R组）和酮咯酸氨丁三醇组（K组）。统计患者麻醉满意度、围术期心血管用药情况和术毕2h内不良反应发生情况。结果与K组相比,R组手术开始时（T1）、手术开始10min（T2）循环和呼吸抑制较明显（P〈0．05）,麻醉起效时间相对较长（P〈0．05）,术毕镇静效果较差（P〈0．01）,麻醉满意度较低（P〈0．01）,同时心血管用药次数增多（P〈0．05）。两组患者术后均未发生严重不良反应,但K组患者术后镇痛效果明显好于R组（P〈0．05）。酮咯酸氨丁三醇复合丙泊酚一瑞芬太尼麻醉应用于门诊无痛宫腔镜检术能够使患者呼吸循环更加平稳,提高麻醉满意度,减少围术期心血管用药次数和有效缓解术后疼痛的发生。     

单独持续输注瑞芬太尼用于纤维支气管镜检术清醒镇静的临床探讨

观察单独输注瑞芬太尼用于支气管纤维镜检术的临床效果和安全性.120例患者随机分为瑞芬太尼单用组（A组）和瑞芬太尼、异丙酚联用组（B组）.记录不同时间点的血流动力学指标与脑电双频指数数值以及不良反应.B组患者诱导时间较A组明显缩短、呼吸抑制几率较高、T1~T4各时间点平均动脉压、心率和脑电双频指数较T0时均明显下降（P＜0.05）,而A组各指标则均无明显变化（P＞0.05）;两组操作满意度均较高（P＞0.05）.单独瑞芬太尼0.1μg/（kg min）持续输注用于支气管镜清醒插管,临床效果良好.     

舒芬太尼与芬太尼复合罗哌卡因用于小儿术后镇痛效果比较研究

为了观察舒芬太尼或芬太尼复合罗哌卡因用于小儿术后镇痛的效果及其不良反应,选择ASAⅠ-Ⅱ级行择期下腹部手术的小儿50例,随机分为两组,各25例,术后分别使用0．5μg·m^-1舒芬太尼或2μg·ml^-1芬太尼复合0．1％罗哌卡因行硬膜外病人自控镇痛,观察术后24h镇痛效果及其不反应。结果显示,舒芬太尼组术后24h静态和活动时镇痛效果优于芬太尼组（P〈0．05）,恶心、呕吐发生率低,程度轻（P〈0．05）。因此,舒芬太尼复合罗哌卡因可安全用于小儿下腹部术后镇痛,效果优于芬太尼复合罗哌卡因。     

舒芬太尼复合曲马多用于幼儿开胸术后静脉自控镇痛的临床观察

在择期开胸术后4h、8h、12h、24h、48h,通过对年龄为1岁～3岁的幼儿术后应用舒芬太尼联合曲马多或单纯舒芬太尼行静脉持续镇痛、镇静效果及恶心、呕吐、呼吸抑制等不良反应发生率对比观察,结果发现舒芬太尼复合曲马多用于幼儿开胸术后静脉镇痛,效果满意,安全性高,不良反应发生率低。     

舒芬太尼复合曲马多用于幼儿开胸术后静脉自控镇痛的临床观察

在择期开胸术后4h、8h、12h、24h、48h,通过时年龄为1岁～3岁的幼儿术后应用舒芬太尼联合曲马多或单纯舒芬太尼行静脉持续镇痛、镇静效果及恶心、呕吐、呼吸抑制等不良反应发生率对比观察,结果发现舒芬太尼复合曲马多用于幼儿开胸术后静脉镇痛,效果满意,安全性高,不良反应发生率低.     

无痛人流不同麻醉的比较

为了更好地实行无痛人流,提高无痛人流的镇痛效果、降低麻醉风险及提高患者满意度,用比较治疗学的理念及方法对目前国内报道的一些主要无痛人流的麻醉方法进行比较和分析。结果发现镇静药丙泊酚与强效镇痛药复合应用于无痛人流安全有效。比较治疗学方法有助于无痛人流不同麻醉的临床抉择。     

幽门螺杆菌感染治疗新进展

在中国幽门螺杆茵(Helicobacter pybri,Hp)有非常高的感染率,国人感染率约55%,所以Hp感染处理中的临床问题是目前Hp研究领域中的重点课题,Hp感染治疗中的重要问题主要包括以下几方面:(1)哪些病人应该治疗?(治疗适应证问题);(2)如何治疗?(治疗方案问题);(3)如何避免或克服Hp对抗生素的耐药性问题?Hp对抗生素的耐药是Hp根除失败的主要原因,所以本文还要重点讨论Hp对抗生素的耐药牲,Hp根除失败的补救治疗及其治疗研究进展.     

Love is Better than Knowledge: Paul,Luther and a Theology of Being Human

It is said in several contemporary theologies that in acting on their proclivities, homosexuals act as a law unto themselves rather than subordinate their desires to God's law. In linking homosexuality with the notion of a selfish individualism, these theologies cast homosexuals as incapable of exercising community-building love. They sustain a reductive model of the human person that issues from an anxiety about the presence of the “secular” ideology of individualism in theology. I suggest that we rehabilitate a vision of love based on a re-reading of the Apostle Paul's understanding of love as God-given and life-giving in 1 Corinthians and Romans, and use it as the basis for a revitalized vision of being human. Guided by Martin Luther's hermeneutic and contemporary thought, this vision recognizes the interdependent relationship between self- and other-concern, and proposes that we prioritize love over reductive knowledge claims in our theologies.     

右美托咪定与丙泊酚在胸科手术中的麻醉效果对比

观察右美托咪定（Dex）联合瑞芬太尼在胸科手术麻醉过程中的应用。选取择期全麻下行开胸手术患者78倒,按随机分为两组（每组39例）：试验组采用Dex、瑞芬太尼和七氟烷静吸复合麻醉（I组）,对照组采用瑞芬太尼、丙泊酚和七氟烷静吸复合麻醉（Ⅱ组）。试验组患者苏醒期躁动明显少于对照组（P〈0．05）,两组苏醒时间差异无统计学意义（P〉0．05）。因此,Dex联合瑞芬太尼在胸科手术麻醉中能够安全有效地抑制双腔气管插管反应,保持血流动力学的稳定,同时明显减少患者在苏醒期躁动。     

Better safe than sorry: Precautionary reasoning and implied dominance in risky decisions

In four studies, student and nonstudent participants evaluated the possible outcomes of binary decisions involving health, safety, and environmental risks (e.g., whether to issue a dam‐failure evacuation order). Many participants indicated that false positives (e.g., evacuation, but no dam failure) were better than true negatives (e.g., no evacuation and no dam failure), thereby implying that the more protective action dominated the less protective action. A common rationale for this response pattern was the precautionary maxim “better safe than sorry.” Participants apparently evaluated outcomes partly on the basis of the decisions that might lead to them, in conflict with consequentialist decision models. Consistent with this explanation, the prevalence of implied dominance decreased substantially when the emphasis on decisions was reduced. These results demonstrate that an initial preference for a decision alternative can alter the evaluation of possible consequences of both the preferred alternative and a competing alternative, suggesting positive feedback loops that reinforce the initial preference. The rationality of considering the decision itself as an attribute of possible outcomes is discussed. Copyright © 2009 John Wiley & Sons, Ltd.     

Better (or worse) for some than others: Individual differences in the positivity offset and negativity bias

People tend to respond with more positive than negative affect to mildly emotional stimuli (i.e., positivity offset) and respond more strongly to very negative than to matched positive stimuli (i.e., negativity bias). In the current study, the authors examine individual differences in the positivity offset and negativity bias and demonstrate that both are stable over time and generalize across different kinds of stimuli (e.g., pictures, sounds, words, games of chance). Furthermore, the positivity offset and negativity bias are not redundant with traditional personality measures and exhibit differential predictive validity, such that both types of measures predict behavior in meaningful ways. Implications for a comprehensive understanding of affect and emotion and their relationship to physical and mental health are discussed.     

Processing impairments in OCD: it is more than inhibition!

The study aimed to address a significant gap in the literature on inhibition impairments in OCD, by concurrently studying facilitation and inhibition processes and the effect of threat on these twin mechanisms. Participants were 20 persons with symptomatic OCD, 11 with remitted OCD, 20 with panic disorder and 20 normal control participants. Participants were required to respond to words that were either neutral or personally threatening, which during an immediately preceding trail, were responded to as targets (facilitation) or inhibited as non-targets (inhibition). OCD participants displayed greater facilitation and reduced inhibition, differences that were related to their diagnostic status but unrelated to symptomatic status. Threat had no effect on facilitation, but exacerbated inhibition problems in the symptomatic OCD and panic groups. This research suggests that underlying differences in both facilitation and inhibition, combined with influences of activated threat-schema on inhibition may play a role in the development and maintenance of OCD.     

Accuracy of National Stereotypes in Central Europe: Outgroups Are Not Better than Ingroup in Considering Personality Traits of Real People

In a study on national stereotypes in central Europe—composed of Austria, the Czech Republic, Germany, Poland and Slovakia—2241 participants rated their autostereotype (a typical representative of their own country) and heterostereotypes (typical representatives of the other countries) by using National Character Survey (NCS). Existing data from 17377 participants including self‐reports or observer ratings on Revised NEO Personality Inventory and NCS were compared with the national autostereotypes and heterostereotypes. Although national autostereotypes converged with personality traits of real people in Poland and an adult subsample in the Czech Republic, national heterostereotypes did not correspond to personality traits of real people in any of the studied countries. National stereotypes were shared within as well as across countries. In heterostereotypes, raters from similar cultural backgrounds speaking similar languages agreed better as compared with raters from more distant cultures. Target country played a role in agreement of raters from different countries, showed in the highest convergence between autostereotypes and heterostereotypes of a typical German. Sharing of national stereotypes is influenced by political and economic significance of the target country. Although national autostereotypes clearly differentiated between typical representatives of central European countries, the comparison of personality profiles of their inhabitants showed remarkable resemblance. Copyright © 2013 European Association of Personality Psychology.