七氟烷复合瑞芬太尼用于腹腔镜胆囊切除术的麻醉效果观察

目的 观察七氟烷和瑞芬太尼复合麻醉方案在腹腔镜胆囊切除术中的使用效果。方法 80例行腹腔镜胆囊切除术的患者,随机分为两组:七氟烷组和丙泊酚组,各40例。七氟烷组给予七氟烷、瑞芬太尼复合麻醉方案,丙泊酚组给予丙泊酚、瑞芬太尼联合方案麻醉,对两组麻醉效果进行比较。结果 两组苏醒时间、苏醒评分、术后头痛发生率差异无统计学意义(P>0.05)。七氟烷组的优良率高于丙泊酚组,瑞芬太尼用量低于丙泊酚组,差异有统计学意义(P<0.05)。结论 七氟烷、瑞芬太尼联合用于腹腔镜胆囊切除术,麻醉效果良好。     

异丙酚与普鲁卡因复合麻醉用于小儿腺样体手术的观察

异丙酚是快速,短效全麻药。小儿腺样体手术麻醉具有特殊性。我们随机观察异丙酚麻醉组(Ⅰ组)与普鲁卡因复合麻醉组(Ⅱ组)各20例,监测注药前,注药后2分钟,插管后1分钟,及手术后血压、心率及脉搏血氧饱和度的变化。结果:诱导后血压、心率Ⅰ组与注药前相比相差显著(*P<0.05,**P<0.01),麻醉清醒时间两组相比相差显著(*P<0.01)。提示:异丙酚麻醉在小儿腺样体手术麻醉中就清醒快速、完全而言优于普鲁卡因复合麻醉。     

舒芬太尼复合氟比洛芬酯、格拉斯琼用于开胸术后静脉镇痛的临床观察

目的:观察比较等效剂量的舒芬太尼与芬太尼分别复合氟比洛芬酯、格拉斯琼用于胸科手术术后静脉镇痛的临床效果及不良反应.方法:选择开胸手术成年患者78例,随机均分为两组,观察组(S组)术毕前15min静注舒芬太尼10g+氟比洛芬酯50mg+格拉斯琼3mg,后接PCIA泵,泵内药物为舒芬太尼2.5g/kg+氟比洛芬酯200mg+格拉斯琼6mg;对照组(F组)术毕前15min静注芬太尼0.1mg+氟比洛芬酯50mg+格拉斯琼3mg,后接PCIA泵,泵内药物为芬太尼25g/kg+氟比洛芬酯200mg+格拉斯琼6mg.记录各组术后第4、12、24、36、48h各时间点生命体征、镇痛、镇静及不良反应情况.结果:两组患者术后第4、12、24h时间点心律(HP)、平均动脉压(MPA)差异有显著性(P＜0.05);两组术后镇痛均取得了较好的效果,但S组各时间点镇痛VAS评分明显低于F组(P＜0.05),术后第4、12h时间点镇静评分S组明显高于于F组(P＜0.05).结论:舒芬太尼与芬太尼复合氟比洛芬酯、格拉斯琼均可用于开胸手术术后静脉镇痛,但舒芬太尼复合氟比洛芬酯、格拉斯琼用于开胸手术术后镇痛、镇静效果更确切、安全、不良反应低,是一种值得推广的方法.     

Cardioprotective effects of anesthetic preconditioning in rats with ischemia-reperfusion injury: propofol versus isoflurane

Objective: We compare the cardioprotective effects of anesthetic preconditioning by propofol and/or isoflurane in rats with ischemia-reperfusion injury. Methods: Male adult Wistar rats were subjected to 60 min of anterior descending coronary artery occlusion followed by 120 min of reperfusion. Before the long ischemia, anesthetics were administered twice for 10 min followed by 5 min washout. Isoflurane was inhaled at I MAC (0.016) in I group, whereas propofol was inhaled intravenously at 37.5 mg/(kg.h) in P group. A combination ofisoflurane and propofol was administered simultaneously in I+P group. Results: In control (without anesthetic preconditioning, C group), remarkable myocardial infarction and apoptosis accompanied by an increased level of cardiac troponin T were noted 120 rain after ischemia-reperfusion. As compared to those of control group, I and P groups had comparable cardioprotection. In addition, I+P group shares with I and P groups the comparable cardioprotective effects in terms of myocardial infarction and cardiac troponin T elevation. Conclusion: A combination of isoflurane and propofol produced no ad-ditional cardioprotection.     

Comparison of 1.5% lidocaine and 0.5% ropivacaine epidural anesthesia combined with propofol general anesthesia guided by bispectral index

Objective： To compare the effects of epidural anesthesia with 1.5% lidocaine and 0.5% ropivacaine on propofol requirements, the time to loss of consciousness （LOC）, effect-site propofol concentrations, and the hemodynamic variables during induction of general anesthesia guided by bispectral index （BIS） were studied. Methods： Forty-five patients were divided into three groups to receive epidurally administered saline （Group S）, 1.5% （w/w） lidocaine （Group L）, or 0,5% （w/w） ropivacaine （Group R） Propofol infusion was started to produce blood concentration of 4 lag/ml. Once the BIS value reached 40-50, endotracheal intubation was facilitated by 0.1 mg/kg vecuronium. Measurements included the time to LOC, effect-site propofol concentrations, total propofol dose, mean arterial blood pressure （MABP）, and heart rate （HR） at different study time points. Results： During induction of anesthesia, both Groups L and R were similar for the time to LOC, effect-site propofol concentrations, total propofol dose, MABP, HR, and BIS. The total doses of propofol administered until 1 min post-intubation were significantly less in patients of Groups R and L compared with Group S. MABP and HR were significantly lower following propofol induction compared with baseline values in the three groups, or MABP was significantly increased following intubation as compared with that prior to intubation in Group S but not in Groups R and L while HR was significantly increased following intubation in the three groups. Conclusion： Epidural anesthesia with 1.5% lidocaine and 0.5% ropivacaine has similar effects on the time to LOC, effect-site propofol concentrations, total propofol dose, and the hemodynamic variables during induction of general anesthesia.     

不同分娩方式新生儿脐血肾素-血管紧张素-醛固酮系统的变化

研究了不同分娩方式对新生儿脐血肾素-血管紧张素-醛固酮(RAS)系统的影响。采用放射免疫法检测了阴道分娩组(31例)、择期剖宫产组(37例)的脐血血浆肾素(PRA)、血管紧张素(AⅡ)和醛固酮(A ld)水平。结果表明:择期剖宫产组新生儿脐血PRA明显高于阴道分娩组(P<0.05),脐血AⅡ、A ld明显低于阴道分娩组(P<0.05)。     

If You Build It and They Still Don't Come: Effective versus Successful Alternative Teacher Preparation

The continuing shortage of special education teachers, combined with increased ideological critiques of teacher education programs, has spurred the growth of alternative models of teacher preparation. Only recently have professional standards for alternative models been proposed. This paper summarizes two years of a program based on professional standards. External influences, internal design, and implementation elements are presented. Results suggest that there is value in distinguishing between the effectiveness of alternative programs and their success.     

新课程背景下学生体育学习评价体系的构建

随着学校体育指导思想的转变,健康教育纳入了素质教育的轨道,并推出了新的学校体育课程标准。针对新的课程体系,必须实施新的评价方法与之相适应。本文运用文献资料法、专家访谈法等方法,构建了学生体育学习评价体系,以期在实践中能更好地激励学生参与体育学习。     

试析美国教师资格证书制度存在的问题及原因

20世纪90年代以来,美国各州对教师资格证书制度进行了一系列改革。由于各州教师资格证书制度的差异,在实施的过程中,教师资格证书制度仍然存在许多问题。教师资格标准的差异、教师资格考试效度、国家高级教师资格标准等方面存在的问题直接影响了教师资格证书制度的有效实施。     

美国教育博士专业学位研究生教育的经验与启示

美国教育博士专业学位在发展与变革的进程中积累了丰富的经验：高等教育变革是教育博士专业学位产生与发展的前提基础,现代大学制度建设是教育博士专业学位发展的根本保障,不断地发展与变革是解决教育博士专业学位存在问题的基本措施。美国的教育经验启示我们：创造教育博士专业学位研究生教育的环境;构建教育博士专业学位研究生教育的质量保障体系;形成我国教育博士专业学位教育的制度体系。     

学分制下高职院校体育课教学新模式的研究

为了研究高职院校体育课教学改革如何适应学分制管理的要求，本文通过对我校学生的问卷调查结果和我校的现状进行分析，针对现行体育课教学模式存在的问题，提出了改革的措施和方案；建议高职院校应根据本校的特点和具体情况，建立具有本校特色的学分制下体育课教学新模式。     

J2EE与.NET技术平台分析比较

J2EE技术是SUN公司推出的用于构建基于Web系统的标准平台和环境,.NET是Microsoft XML Web Services平台,它们都是目前从系统平台到软件体系结构可供选择的主要技术平台。     

新"纲要"新"标准"下普通高校体育与健康课程考试评价体系的研究

采用文献资料法、问卷调查法、实验法、访谈法、特尔斐法等。对普通高校体育与健康课程考试评价方法存在的问题进行分析，构建了新纲要、新标准下符合实际的普通高校体育与健康课程考试评价新体系．