ABSTRACT
Objective:To evaluate the optimization efficacy of ropivacaine mixed with nalbuphine for epidural labor analgesia through comparison with ropivacaine mixed with sufentanil in primiparas.Methods:Four hundred and forty primiparas with a singleton fetus in vertex presentation without abnormal fetus, aged 19-36 yr, at 37-42 weeks of gestation, who were suitable and volunteered to receive epidural labor analgesia, were selected and randomly divided into observation group (NR group, n=220) and conventional group (C group, n=220).Epidural labor analgesia solution contained nalbuphine 40 mg and ropivacaine 120 mg in 150 ml of normal saline in group NR.Epidural labor analgesia solution contained sufentanil 50 μg and ropivacaine 120 mg in 150 ml of normal saline in group C. The analgesia pump was set up to deliver a 5 ml bolus dose with a 20-min lockout interval, programmed intermittent bolus 10-15 ml/h and background infusion at 2 ml/h after an initial dose of 15 ml to maintain VAS score <3.The length of labor, adverse reactions during labor analgesia, neonatal Apgar score, parameters of umbilical artery blood gas analysis and neonatal behavioral neurological assessment score were recorded. Results:Compared with group C, the incidence of urinary retention, pruritus, nausea and vomiting and fever at birth was significantly decreased in group NR ( P<0.05).The duration of the first and second stages of labor, neonatal Apgar score, pH value of umbilical artery blood, lactate concentrations, and neonatal behavioral neurological assessment score were within the normal range in both groups, and there was no significant difference between the two groups ( P>0.05). Conclusions:Compared with conventional medication, nalbuphine mixed with ropivacaine has the same efficacy when used for epidural labor analgesia in primiparas, but it has a certain optimization efficacy in terms of safety.
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The effects of different doses of r-ray on cochlea are reported in this paper. Significant hearing loss and severe cochlea hair cells injury were found while radiation dose was more than 80 Gy. With 40 Gy to 60 Gy, slight hearing loss, but cochlea hair cells and support cells impairment were observed. With 20 Gy, no hearing loss and no hair cell damage were found. The results indicated that the damage increases with a dose of radiation and there is a delay effect of radiation on cochles.
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One hundred cases with pneumatized sphenoid sinus were studied, based on the cranial X-ray film, sagittal tomograms and coronal CT scan as well as the observation during the course of operation. A new bilateral combination classification scheme was suggested and used in this study. It was shown that the identical type was 58% and non-identical, 42% and the former could be further divided into 5 subtypes and the latter, 10 subtypes. The incidence of supra-sphenoid-ethmoidal cell (SSEC) was 22%. Some of SSEC may be mistaken for sphenoid sinus, if the surgeons are not familiar with its anatomy. We emphasize that the bilateral combination classification is very important for selecting a suitable method from among different trans-naso-sphenoid approaches.
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Fifty-nine patients (62 cases ) with chronic antritis were operated by Caldwell-Luc's operation with middle meatal antrostomy and followed up for 0.5 ~5 years. It was found that curative effect of the oper ation was quite well. Eghty patients treated with Caldwell-Lucs operation were followed up as control at the same time. Caldwell-Luc's operation with middle meatal antrostomy was found safe, easy to operate and not injurious to agger nasi, as well as partially recoverable to sinus function.
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Male guinea pigs were exposed to 750ppm or l000ppm or 1 500ppm toluene (8h/d, for 14d), and their hearing thresholds were tested by means of Madsen ERA 2250 system 3d and 14d after exposure. Hearing impairment was observed in all groups. The degree of impairment was related to the exposure concentration and had a tendency to further damage in two weeks. The results indicate that toluene can cause acute hearing impairment even if its concentration is as low as 750ppm and the impairment develops from bad to worse at least in two weeks.
ABSTRACT
The changes of hair cells after acute radiation injury to cochlea were studied with scanning electron microscope in guinea pigs. Outer hair cell cilia were disordered, fused, and lost in the early stage after 40Gy ?-ray irradiation of the bullae of guinea pigs. From 15 to 30d after radiation, reconstruction of cilia besides early changes, and ball shape materials on the side of inner hair cells were found. The possible mechanism of these changes is also discussed
ABSTRACT
In order to study the effect of chronic noise exposure on auditory center, seven guinea pigs were .exposured to 105 dB A noise 8h daily for 45 d. Then the animals were killed by decapitation. The superior olive and inferior colliculus were taken immediately to make the samples of electron microscope. The mitochondria swelling, membrane rupture, cristae breaking, ballooning degeneration were found. The rough surfaced endoplasmic reticulum was swollen and expanded. The lysosome and secondary lysosome were increased. The cell interstitial edema and synaptic besicle decrease were observed. The nuclear chromatid was decreased and nucleolus was kept to the side. The laminae of neurilemma of nerve fibers were dissociated, swollen and broken. The results indicate that the ultrastructure, neural cells and fibers in the auditory center are damaged by chronic noise exposure and most of these damages are irreversible.