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麻醉中肌肉松弛药与逆转剂应用指南—法国麻醉与重症监测治疗学会(SFAR 2020)

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中华麻醉学杂志 2022年第7期42卷 771-793页

作者： Benoît Plaud Christophe Baillard jean-Louis Bourgain Gaëlle Bouroche Laetitia Desplanque jean-michel Devys Dominique Fletcher Thomas Fuchs-Buder Gilles Lebuffe Claude Meistelman Cyrus Motamed Julien Raft Frédérique Servin Didier Sirieix Karem Slim Lionel Velly Franck Verdonk Bertrand Debaene 巴黎大学巴黎公共援助医院麻醉和重症监护科圣路易医院巴黎75010法国巴黎大学巴黎公共援助医院麻醉和重症监护科科钦医院皇家港巴黎75014法国古斯塔夫-鲁西研究所麻醉科犹太城94800法国里昂贝拉尔中心麻醉科里昂69008法国巴黎公共援助医院麻醉和重症监护科克劳德·贝尔纳德医院巴黎75877法国罗斯柴尔德基金会医院麻醉和重症监护科巴黎75019法国凡尔赛-伊夫林地区圣康坦大学巴黎公共援助医院安布鲁瓦兹·帕雷医院麻醉科布洛涅-比扬古92100法国洛林大学南锡大学中心医院麻醉和重症监护科南锡地区54511法国里尔大学赫里兹医院麻醉和重症监护科里尔59037法国洛林癌症研究所麻醉科南锡地区54519法国 Marzet-Navarre集团综合医院麻醉科波城64000法国奥弗涅大学消化和肝胆外科埃斯坦医院克莱蒙费朗63100法国艾克斯-马赛大学蒂莫内医院麻醉和重症监护科马赛13385法国索邦大学圣安托万医院巴黎75012法国普瓦提埃大学麻醉和重症监护科普瓦提埃大学中心医院普瓦提埃86021法国

目的为更新1999年法国共识"麻醉中肌肉松弛药与逆转剂的应用"特召集16名专家成立共识委员会。编写开始时宣布庄重的利益声明与分歧监督原则,并在编写过程中予以执行,本指南编写全过程不依赖任何商业资助。所有作者均需遵循推荐分级的评... 详细信息

目的为更新1999年法国共识"麻醉中肌肉松弛药与逆转剂的应用"特召集16名专家成立共识委员会。编写开始时宣布庄重的利益声明与分歧监督原则,并在编写过程中予以执行,本指南编写全过程不依赖任何商业资助。所有作者均需遵循推荐分级的评价、制定与评估系统的原则(Grading of Recommendations,Assessment,Development and Evaluation,GRADE?),以评估这些推荐意见的证据质量,规避基于低质量证据做出强推荐的可能性。故有少数推荐意见仍未分等级。方法专家组的讨论主要集中在以下8个问题:(1)在无面罩通气困难标准的情况下,是否有必要在注射肌肉松弛药前检查面罩通气的可行性?面罩通气是否有必要使用肌肉松弛药?(2)为便于气管插管是否有必要使用肌肉松弛药?(3)是否有必要使用肌肉松弛药以便于声门上气道装置的置入及管理相关并发症?(4)是否有必要应用神经肌肉阻滞监测来进行气道管理?(5)是否有必要应用肌肉松弛药以利于手术的进行?如有必要,是哪种手术?(6)术中是否有必要监测神经肌肉阻滞程度?(7)防治肌肉松弛药残留阻滞作用的策略是什么?(8)在特殊人群中(如电休克治疗、肥胖、儿童、神经肌肉疾病、肝/肾功能衰竭、老年患者)使用肌肉松弛药和逆转剂的适应证及注意事项是什么?所有问题都采用研究对象、干预、对照和预后(Population,Intervention,Comparison and Outcome,PICO)模型中的临床问题予以阐明,并生成证据档案,最后采用GRADE?系统评估文献分析的结果并进行推荐。结果SFAR指南专家组提出了31项关于麻醉中应用肌肉松弛药与逆转剂的推荐意见。在这些推荐意见中,有11项是属于强推荐(GRADE 1±),有20项是属于弱推荐(GRADE 2±),有5项应用GRADE?系统无法给出推荐意见,其中2个问题生成了专家意见。经过2轮讨论和1次修订后,所有指南和方案都获得了专家组的一致同意。结论关于麻醉中应用肌肉松弛药与逆转剂的多项强推荐意见,专家间意见基本一致。SFAR推荐在整个麻醉过程中使用神经肌肉功能监测仪来监测神经肌肉阻滞程度。

关键词：肌肉松弛药逆转剂神经肌肉监测专家指南更新

VNUS Closure<sup>®</sup>FAST Radiofrequency of the Great Saphenous Vein for Superficial Venous Insufficiency: Experience of the CH of Cholet in France

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World Journal of Cardiovascular Surgery 2021年第5期11卷 43-50页

作者： Birama Togola Laurent Muller Bréhima Bengaly Drissa Traoré Drissa Ouattara Cheick Sekou Ahmed Touré Mahamadou Coulibaly Abdoulaye Kanté Hamadoun Dicko Boubacar Diallo michel Peret Nouhoum Ongoiba jean Louis Debrux Department of Surgery “B” of the CHU Point “G” Bamako Mali Department of Vascular and Thoracic Surgery of the CH de Cholet France Department of Anesthesia and Intensive Care of the “CHU Point G” Bamako Mali Department of Thoracic and Cardiovascular Surgery CHU Angers France

Background:The objective of this work was to evaluate the first results of the radio ablation of the great saphenous vein in the processing of chronic venous insufficiency. Method: This is a monocentric retrospective study of radio ablation of the great saphenous vein using VNUS Closure® FAST for superficial venous insufficiency of the great saphenous vein, between January 2012 and December 2014. Results: 42 patients (57 limbs) were operated on with this technology. There were 33 women and 9 men (mean age: 46.5 years). Thirty-nine patients (92. 8%) were symptomatic. Thirty-two patients (76.1%) were classified CEAP 2. The average diameter of the saphenous vein was 8.5 ± 1.5 mm. Three patients (7.1%) had a percutaneous approach. A perfect occlusion of the saphenous vein was observed in all patients. No incident or undesirable event was observed during the procedure. One case of delayed deep-vein thrombosis was observed. At one month of follow-up, six patients (14.2%) had induration opposite to the occluded vein. Forty-three percent of the patients stated they were very satisfied with the procedure. Conclusion: The effectiveness, security and simplicity of the closure method are real. More studies are necessary to assess the long-term results of this procedure.

关键词： Varicose Great Saphenous Vein Endovenous Therapy Radiofrequency Ablation

Antioxidant Xanthones,Anthraquinones and Semi-synthetic Derivatives from Vismia rubescens and ***

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Antioxidant Xanthones,Anthraquinones and Semi-synthetic Deri...

Antioxidant and Antifungal Activities of the Essential Oils of Ocimum gratissimum from Yaounde and Dschang （Cameroon）

多学科交叉，产学研联合，实现西部药用植物资源的可持续利用——第十届全国药用植物及植物药学术研讨会

作者： michel F.Tala Hippolyte K.Wabo Pierre Tane jean D.D.Tamokou Patricia D. Tchakam Jules R.Kuiate Department of Chemistry Faculty of ScienceUniversity of Dschang State Key Laboratory of Phytochemistry and Plant Resources in West China Kunming Institute of BotanyChinese Academy of Science Department of Biochemistry Faculty of ScienceUniversity of Dschang

Chemical investigation of the methanol extract from *** yielded seven known compounds:friedelin, friedelanol,lupeol,1,7-dihydroxyxanthone(1),1,4,8-trihydroxyxanthone(2),1,2,8-trihydroxyxanthone(3)and physcion(4);that of the extract of *** also gave seven known compounds:laurenquinone A(5), laurenquinone B(6),xanthone V(7),laurentixanthone C(8),bivismiaquinone(9),vismiaquinone(10)and vismiaquinone B(11).Laurenquinone B(6)and xanthone V(7)were subjected to acetylation to afford two new acetylated derivatives:methyl 5,7-diacetoxy-6,11-dihydro-2,2,9-trimethyl-6,11-dioxo-2H-naphto[2,3-g]chromene-

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Journal of Pharmacy and Pharmacology 2014年第4期2卷 257-268页

作者： jean Baptiste Hzounda Fokou Pierre michel Jazet Dongmo Fabrice Fekam Boyom Elizabeth Zeuko'o Menkem Issakou Bakargna-Via Ide Flavie Kenfack Tsague Marguerite Simo Kamdem Paul Henri Amvam Zollo Chantal Menut Department of Biochemistry University of Yaounde L Yaounde Cameroon Department of Biochemistry University of Douala Douala Cameroon Department of Food Science and Nutrition National Advanced School of Agro-industrial Sciences Ngaoundere Cameroon Institute of Biomolecules Max Mousseron Faculty of Pharmacy Montpellier 999019 France

Due to the harmful effect of free radical on physiological and pathological state of our body on one hand, and the increase of the fungal infection on the other hand, drug that can reduce free radical and inhibit fungal growth is needed. This work aims to evaluate the antioxidant and antifungal activities of the Ocimum gratissimum L. essential oils from center and west region of Cameroon. Essential oil was analyzed by GC （gas chromatography） and GC coupled with MS （mass spectrometry）. The antioxidant activities of essential oils were studied by the Diphenylpicrylhydrazyl method and the β-carotene bleaching test. The antifungal activities were assessed using micro-dilution technique for yeasts and agar dilution method for Aspergillus. Thymol and γ-terpinene, eugenol and thymol were the major compounds for Yaounde and Dschang, respectively. The scavenging capacity of sample from Dschang was higher than that of Yaounde. Also, the β-carotene bleaching tests of the sample from Dschang were better than that from Yaounde. The antifungal activity of the sample from Yaounde was higher than that from Dschang on yeasts and Aspergillus isolates, respectively. This work presents and compares the chemical composition, antioxidant and antifungal activity of Ocimum gratissimum essential oil from center and west region of Cameroon.

关键词： Ocimum gratissimum L. antioxidant antifungal gas chromatography gas chromatography coupled with mass spectrometry.

Cardiometabolic Phenotype and Arterial Stiffness in HIV-Positive Black African Patients

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Open Journal of Preventive Medicine 2014年第4期4卷 182-192页

作者： Daniel Lemogoum William Ngatchou Philippe Van De Borne Valérie Ndobo Marc Leeman Euloge Yagnigni Emiline Tiogou Elisabeth Nga Charles Kouanfack Luc Van Bortel jean-Paul Degaute michel P. Hermans Department of Cardiology Central Hospital Yaounde Cameroon Department of Endocrinology and Nutrition Cliniques Universitaires St-Luc Brussels Belgium Heymans Institute of Pharmacology Ghent Uni-versity Ghent Belgium Hypertension Clinic Erasme University Hospital Brussels Belgium

Objective: To test the hypothesis that Human Immunodeficiency Virus (HIV) infection in Black patients is associated with increased cardiometabolic risk factors that may increase aortic stiffness assessed by pulse wave velocity (PWV). Methods: We matched 96 Cameroonian Controls to 238 (Un) treated HIV-positive patients [HIV] for age. In each participant, aortic PWV (ComplioR), blood pressures (BP), lipid profile and fasting blood glucose (FPG) were measured. Results: Waist circumference was lower in HIV than in Controls (both p g·dl-1), and of diabetes (FPG > 125 mg·dl-1) were higher in HIV than in the Controls (50% vs 27%, and 23% vs 1%, respectively;both p 0.05). HIV patients exhibited a twice-higher prevalence of MetS (AHA/NHLBI score 33/5) than that of the Controls (41% vs 21%;p 0.01). Similarly, severity of MetS phenotype was higher in HIV as compared to the Controls (2.14% vs 1.59%;p < 0.0001). PWV adjusted for age, mean BP and gender was faster in HIV in comparison to the controls (7.33 m/s vs 6.86 m/s, respectively;p = 0.036). Conclusions: HIV infection is associated with higher prevalence of MetS and its phenotype in Black African patients that may induce increased aortic stiffness.

关键词： Metabolic Syndrome Pulse Wave Velocity Arterial Stiffness Human Immunodeficiency Virus Infection Black Cameroonian Patients

Effect of Plant Growth Hormones and Liquid Fertilizer on Rooting and Tuberization of Yam (<i>Dioscorea rotundata</i>Poir.) Vine Cuttings

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American Journal of Plant Sciences 2019年第10期10卷 1903-1920页

作者： Dibi Konan Evrard Brice Kouakou Amani michel Amari Ler-Ogn Dadé Georges Elisée Brouth Lorng jean Bernard Dossou-Aminon Innocent Essis Brice Sidoine N’zue Boni Dick Acka Emmanuel Root and Tuber Crops Program Food Crops Research Station National Centre for Agronomic Research-CNRA Bouake Cote d’Ivoire Laboratory of Plant Physiology Biosciences Training and Research Unit Felix Houphouet-Boigny University Abidjan Cote d’Ivoire Faculty of Science and Technology of Dassa University of Abomey-Calavi Abomey-Calavi Benin

Vine cutting is an effective solution to solve the problem of seed availability in yam cultivation. This study was conducted to improve the recovery and rooting rate of vine cuttings of Dioscorea rotundata. Two-node cuttings from five (5)-month-old hybrid plants were grown in liquid media consisting of phytohormones (AIA3 and GA3) and liquid fertilizer (NPK 8-8-8) at different concentrations. Observations were made weekly from the 21st day after transplanting and focused on the survival rate of the cuttings, the number of roots emitted and the number of minitubers initiated. The results obtained showed a significant effect of the different growing media on the survival rate, rooting and production of minitubers. The best survival rates were obtained for cuttings grown in NPK (8-8-8) at 0.25% (100%) and AIA3 at 25 ppm (93.3%). The highest averages root number was recorded with growing media containing 0.25% NPK 8-8-8 (20.3) and 25 ppm AIA3 (17.7). Growing media with 0.25% NPK (8-8-8) and 25 ppm AIA3 provided the highest average numbers of minitubers initiated, respectively 5 and 4.6. Growing medium containing 0.25% NPK 8-8-8 has been identified as the one that allows better roots emission and minitubers production by yam vines cuttings.

关键词： Yam Vine Cutting Yam Seed Growing Medium Dioscorea rotundata

Acute Coronary Syndromes: Epidemiological, Clinical and Management Aspects in Thies (Senegal)

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World Journal of Cardiovascular Diseases 2023年第3期13卷 114-123页

作者： Désiré Alain Affangla jean-Paul Degue Wally Niang Mboup Stéphanie Claudia Akanni Sheikh Mouhamadou B. M. Diop Malick Ndiaye jean-michel Amath Dione Hugues Elie Elame Ngwa Adamson Phiri Djibril Marie Ba Mohamed M. C. B. O. Leye Cardiac Unit Saint Jean de Dieu Hospital Thies Senegal Health Sciences Training and Research Unit University of Thies Thies Senegal

Purpose: To describe the epidemiological, clinical and management characteristics of acute coronary syndromes (ACS) in Thies, Senegal. Methods: This was a prospective study that included consecutively from October 1st, 2018 to March 03rd, 2019, patients aged 18 years or older admitted for an ACS at the DIABCARMET department of the Saint jean de Dieu Hospital in Thies. Results: Of the 516 patients admitted, 29 had ACS, the prevalence was 5.62%. The average age of the patients was 64.2 ± 11.6 years. Nineteen patients (65.5%) were male and 10 (34.5%) were female, the sex ratio was 1.91. The number of direct admissions was 18 (62%) versus 11 patients (38%) referred. The mode of transport was a private vehicle in 19 patients (65.5%), an ambulance in 7 patients (24.1%) and public transport in 3 patients (10.3%). STEMI (ST segment elevation myocardial infarction) was the most common presentation observed in 19 patients (65.5%). Fifteen patients (51.7%) were admitted before the 12th hour. Of the 19 patients with STEMI, 11 (57.9%) had arrived in hospital before the 12th hour and 10 patients had streptokinase thrombolysis. No patients received primary PCI. Ten patients (34.5%) had heart failure and five patients (17.2%) died during hospitalization. Conclusion: Delayed consultation and high mortality characterize ACS in Thies. Prevention must be the rule.

关键词： ACS Myocardial Infarction Thrombolysis Thies Senegal

从上腭获取移植结缔组织会有出血的风险：是真的吗？

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中国口腔医学继续教育杂志 2009年第6期12卷 1-8页

作者： Sophie-Myriam Dridi michel Chousterman Marc Danan jean Francois Gaudy 王宪娥（译）徐莉（审）不详北京大学口腔医院牙周科 100081

为获得较好的上皮下结缔组织移植的临床效果．大多数作者都把重点放在手术技术上。然而．很少有研究报道这种手术干预可能引发的并发症。尽管手术并发症并不是经常出现且没有生命危险．但并发症确实存在。这些并发症让手术者产生了担心... 详细信息

为获得较好的上皮下结缔组织移植的临床效果．大多数作者都把重点放在手术技术上。然而．很少有研究报道这种手术干预可能引发的并发症。尽管手术并发症并不是经常出现且没有生命危险．但并发症确实存在。这些并发症让手术者产生了担心．而最使手术者担心的并发症是术中及术后出血．而这种情况是否发生取决于腭黏膜固有的血管分布的密度。本文是一项人类解剖学的研究，作者证实了硬腭形态学与腭大血管神经束的分布之间的关系．由此证实此关系是否是选择治疗方案的决定因素。本研究包括了与应用解剖有关的两部分：骨学（第一部分）及解剖（第二部分）。第一部分包括30个不同形状和不同缺失牙牙列的上颔骨，作者观察和比较了腭大血管神经束、硬腭形态与拔牙和戴入可摘局部义齿后骨重建之间的关系；第二部分包括12个新鲜的人类尸体上的上颌骨．向其动脉系统注入彩色乳胶后，切开标本，观察腭大神经血管束的分布。运用不同的组织获取技术对两个不同形态的上腭进行解剖手术。这样．手术者就可以首先详细了解硬腭的血管分布状况．然后估算获取结缔组织区域与腭大血管神经束分支的关系，最后制定出预防出血的方法。

关键词：结缔组织移植出血性风险人类硬腭腭动脉

Cardiac Tamponade: Epidemioclinical, Therapeutic and Evolutionary Aspects at the University Hospital of Brazzaville

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World Journal of Cardiovascular Diseases 2021年第12期11卷 572-582页

作者： Solange Flore Mongo Ngamami Armel Landry Batchi-Bouyou Evariste Pabingui Christian michel Kouala Landa Bertrand Fikahem Ellenga Mbolla jean Joseph Ekwa Sima Méo Stéphane Ikama Suzy-Gisèle Kimbally Kaky Department of Cardiology University Hospital of Brazzaville Brazzaville Republic of the Congo Department of Doctoral Studies Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo

Objectives: Contribute to improving the management of cardiac tamponade in Congo. Background: Cardiac tamponade is an acute or subacute compression of the heart chambers by pericardial effusion responsible for uncertain prognosis for patients. The objective of this study is to help improve the management of patients with cardiac tamponade. Patients and Methods: We conducted a retrospective and descriptive study at the University Hospital of Brazzaville, from January 2015 to December 31, 2019. Included were all patients hospitalized for cardiac tamponade. Epidemioclinical, therapeutic and evolutionary data were analyzed. Results: An overall of 14 patients were divided into 9 men (64.2%) and 5 women (35.7%), i.e. a sex ratio of 1.8. The mean age of patients was 34.2 ± 15.1 years old (18 years to 64). The most represented comorbidity was hypertension (n = 2;14.3%). The most frequent clinical sign was dyspnea (n = 14;100%). The ECG showed diffuse and concordant repolarization disturbances (n = 14;100%), sinus tachycardia (n = 13;92.8%), microvoltage (n = 12;85.7%). Cardiomegaly was constant (n = 14;100%). In terms of transthoracic ultrasound, we found: diastolic compression of the right ventricle (RV) (n = 12;85.7%), dilation of the inferior vena cava (IVC) (n = 12;85.7%). Treatment consisted of crystalloid vascular filling in all patients, pericardial punc

关键词： Cardiac Tamponade Clinical Presentation Treatment Congo