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Objective:To investigate the effect of right stellate ganglion block (RSGB)-serratus anterior plane block (SAPB) combined with general anesthesia in thoracoscopic radical resection of lung cancer.Methods:A total of 90 patients who planned to undergo thoracoscopic radical resection of lung cancer in Xiangya Changde Hospital from March 2020 to September 2021 were prospectively selected and divided into 3 groups by random number table method: general anesthesia group (G group), (SAPB)+ general anesthesia group (SG group), RSGB+ SAPB+ general anesthesia group (RSG group), 30 cases in each group. The SG group received SAPB on the operative side before general anesthesia, and the RSG group received RSGB+ SAPB on the operative side before general anesthesia. After the blocking effect was determined, all patients were given general anesthesia in the same scheme according to their weight, and patients were given patient-controlled intravenous analgesia (PCIA) after surgery. The mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia (T 0), before intubation (T 1), 1 min after intubation (T 2), 5 min after intubation (T 3), at extubation (T 4) and 5 min after extubation (T 5). The intraoperative dosage of remifentanil, incidence of nausea and vomiting (PONV) within 24 hours after surgery, number of additional PCIA within 24 hours, the Visual Analogue Scale (VAS) of static and dynamic pain, the Bruggrmann Comfort Scale (BCS) and Richard Campbell Sleep Questionnaire (RSCQ) 24 hours after surgery were recorded. Results:Compared with T 0, the MAP and HR in 3 groups were increased 1 min after intubation (T 2) and at extubation (T 4), but the increases in RSG group were significantly less than those in G and SG groups (all P<0.05). The remifentanil dosage, PONV incidence and PCIA supplemental times in SG and RSG groups were less than those in G group, and the BCS score and RSCQ score were higher than those in G group (all P<0.05); the BCS score and RSCQ score in RSG group were higher than those in SG group (all P<0.05). Conclusions:RSGB+ SAPB combined with general anesthesia in thoracoscopic radical resection of lung cancer has little circulation fluctuation, good postoperative analgesia effect, less adverse reactions and high comfort level.
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Objective To study the clinical manifestations,imaging features,treatment and outcome of umbilical venous catheters/peripherally inserted central venous catheters (UVC/PICC) associated pericardial effusion (PCE) and cardiac tamponade (CT) in neonates.Method Clinical data of cases with UVC/PICC associated PCE/CT that were found in neonatal intensive care unit of five hospitals in Shanxi province from January 2017 to December 2018 were extracted and retrospectively reviewed.Result In total,there were 632 cases received UVC/PICC insertions in 5 hospitals.7 cases of which were identified as PCE (1.0％) on echocardiography during the period of catheter indwelling,among which 5 cases suffered from PCE complicated CT (0.7％).7 cases with PCE included 6 premature infants and 1 full term infants with mean gestational age (32.6 ± 3.8) weeks and mean birth weight 1 550 (1 200,3 960) g.The mean age of PICC/UVC insertion was 14 h (1 ～ 19 h),the mean age of PCE/CT developed was 69 h (13 ～104 h) after insertion.The most common presentations included apnea/respiratory distress (7 cases),cyanosis/desaturation (7 cases),tachycardia (3 cases),bradycardia/asystole (5 cases).UVC/PICC tip ectopic was found in 6 cases after the symptoms of PCE emerged (4 cases at T6-T7 and 1 case at T12 vertebra level on chest X-ray,and 1 case at right atrium on echocardiogram).UVC/PICC tip was normal in 1 case (tip at T7-T8 vertebra level on chest X-ray).5 cases recovered after removal of catheter,pericardiocentesis and drainage of effusion;1 case recovered after removal of UVC without pericardiocentesis;1 case underwent pericardiocentesis,continued infusion for 5 h after extubated the UVC into inferior vena cava,then deceased.Conclusion UVC/PICC tip ectopic is the main cause of UVC/PICC associated PCE/CT.Immediate bedside echocardiography should be performed to any patient with UVC/PICC indwelling,who develops sudden unexplained apnea/respiratory distress,cyanosis,tachycardia/bradycardia/asystole.Timely removal of catheter and pericardiocentesis drainage may be life-saving.
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BACKGROUND: Open reduction and internal fixation is commonest surgical method for calcaneal fractures, but its postoperative complications are troublesome. Thereafter, choosing an appropriate treatment scheme is of great significance for reducing postoperative complications and promoting patients' functional recovery. OBJECTIVE: To compare the curative efficacy of the modified minimally invasive internal fixation with cannulated screws through tarsal sinus and traditional extended lateral "L-shape" incision with plate fixation for calcaneal fractures. METHODS: Sixty-eight cases of unilateral calcaneal fractures (Sanders II and III) were selected, followed by treated with modified minimally invasive internal fixation with cannulated screws through tarsal sinus (modified group, n=33) or traditional extended lateral "L-shape" incision with plate fixation (traditional group, n=35). The operation time, blood loss, and Visual Analogue Scale scores were compared between two groups; the preoperarive and postoperative American Orthopedic Foot and Ankle Society scores, Bohler angle, and Gissane angle as well as postoperative complications were detected and compared between both groups. Besides, the postoperative pain, range of motion, and ankle stability were evaluated. RESULTS AND CONCLUSION: (1) The American Orthopedic Foot and Ankle Society scores at 6 months postoperatively in both two groups were significantly higher than those at baseline, and the scores in the modified group were significantly higher than those in the traditional group (P < 0.05). (2) The Bohler angle, Gissane angle, and calcaneal width in the modified group were significantly improved compared with the traditional group at 1 week, 6 and 12 months postoperatively (P < 0.05). (3) Compared with the traditional group, the operation time, blood loss, and Visual Analogue Scale scores in the modified group were significantly improved (P < 0.05). (4) The incidence of complications in the modified group was significantly lower than that in the traditional group (P < 0.05). (5) These results manifest that compared with the traditional extended lateral "L-shape" incision with plate fixation for calcaneal fractures, the modified minimally invasive internal fixation with cannulated screws through tarsal sinus can significantly alleviate pain, and improve the range of motion and stability of the ankle joint.
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Tumor necrosis factor-alpha (TNF-α) has been found to be centrally involved in the development of ischemia-reperfusion injury (IRI)-induced inflammation and apoptosis. Knockdown of TNF-α gene using small interfering RNA (siRNA) may protect renal IRI. Renal IRI was induced in mice by clamping the left renal pedicle for 25 or 35 min. TNF-α siRNA was administered intravenously to silence the expression of TNF-α. The therapeutic effects of siRNA were evaluated in terms of renal function, histological examination, and overall survival following lethal IRI. A single systemic injection of TNF-α siRNA resulted in significant knockdown of TNF-α expression in ischemia-reperfusion injured kidney. In comparison with control mice, levels of BUN and serum creatinine were significantly reduced in mice treated with siRNA. Pathological examination demonstrated that tissue damage caused by IRI was markedly reduced as a result of TNF-α siRNA treatment. Furthermore, survival experiments showed that nearly 90% of control mice died from lethal IRI, whereas more than 50% of siRNApretreated mice survived until the end of the eight-day observation period. We have demonstrated for the first time that silencing TNF-α by specific siRNA can significantly reduce renal IRI and protect mice against lethal kidney ischemia, highlighting the potential for siRNA-based clinical therapy.
Subject(s)
Animals , Humans , Mice , Apoptosis , Disease Models, Animal , Genetic Therapy , Inflammation , Genetics , Pathology , Therapeutics , Kidney , Wounds and Injuries , Pathology , RNA, Small Interfering , Genetics , Reperfusion Injury , Genetics , Pathology , Therapeutics , Tumor Necrosis Factor-alpha , GeneticsABSTRACT
Objective To determine the expression level of microRNA-25 in animal models of diabetic nephropathy and human renal tubular epithelial cells (HK-2) cultured in different conditions, and to explore its regulating effect on the fibrosis in diabetic nephropathy. Methods The expression of microRNA-25 was detected by real-time PCR. The downstream target protein of microRNA-25 was verified by bioinformatic prediction, transient transfection of cells and Western blotting. Results MicroRNA-25 was down-regulated in animal models of diabetic nephropathy and HK-2 cells which were cultured in high-glucose medium (P<0. 01). MAP2K4 might be the downstream target protein of microRNA-25. Overexpression of microRNA-25 reduced the protein expression of MAP2K4 and α-SMA (P<0. 01). Conclusion MicroRNA-25 inhibits the fibrosis in diabetic nephropathy by regulating the expression of MAP2K4.
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Objective To explore a new method for establishing an animal model of cochlear ischemia.Methods Thirty guinea pigs were randomized into three groups:normal group,operation group,ischemia group.Anterior inferior cerebellar artery(AICA)was exposed surgically via a skull base approach.In ischemia group,a small piece of filter paper containing FeCl3 was placed upon the AICA to induce thrombus formation.In operation group,AICA was only exposed.In normal group,nothing was done to animal.The blood flow of cochlea(CoBF)was continuously monitored with laser Doppler flowmeter.The thresholds of auditory brainstem response(ABR)were measured before,after each experiment,and one week after operation.The AICAs of ischemia group and operation group were resected and pathological sections were perfomed for observation of the details.Results After the administration of FeCl3,the CoBF decreased to 50% of the base level at 30 min.In the AICA pathological sections of ischemia group,white thrombus composed of cellulose,blood platelets and erythrocytes could be seen.The threshold of ABR in ischemia group increased significantly.Conclusion The method provides a relatively ideal model for ischemis of the inner ear and this model may be helpful in studying the mechanisms of hearing loss caused by chronic microcirculatory disorders.
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Objective To establish a method for the content determination of naringin and hesperidin in Fructus Aurantii Immaturus.Methods HPLC was performed on the Merck-Lichrospher RP-C18 column(4.6?250 mm,5 ?m);CH3CN-H2O(23 ∶77) served as mobile phase and the detection wavelength was at 283 nm,the column temperature at 30 ℃and the flow rate being 1.0 mL/min.Results The content of naringin ranged from 4.65 to 12.50 mg/g and that of hesperidin from 1.60 to 6.75 mg/g.Conclusion This method is simple,sensitive,specific and can be used for the quality control of Fructus Aurantii Immaturus.
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Objective To develop a quality standard for Dongfengju oral liq ui d (DOL). Methods Atalantia buxjfolia, Radix Scrophulariae, Fructus Aurantii in DOL was identified by TLC. Results The obtained TLC spots of Atalantia buxj folia, Radix Scrophulariae, Fructus Aurantii in DOL occurred at the correspond ing positions compared to the controls. Conclusion The method is proved to be simple, sensitive, precise and reproducible and can be used for the quality con trol of DOL.
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The protective effect of selenium against irradiation were studied by measuring the content of lipid peroxide (LPO) and activity of glutathione peroxidase (GSH-Px) in liver and spleen of BALB/C mice. The results showed that LPO contents in liver and spleen of whole-body-irradiated mice were higher than those of the control group on the third day after irradiation with 3 Gy 60Co ?-ray, while the GSH-Px activity of these tissues was significantly decreased. However, when the animals were given sodium selenite solution 0.2ml (12.5?g selenium) per day via mouth successively for 7 days before irradiation, there were remarkably reduced LPO level and increased GSH-Px activity in liver and spleen of irradiated mice. It is suggested that selenium supplementation may prevent mice from radiation injury by reducing LPO level and increasing GSH-Px activity in liver and spleen.
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Mice were fed basic diet or basic diet plus vitamin E 50 mg or 500 mg per kg of diet for 4 weeks. The animals were killed at 6 or 14 days after one exposure to 400 rad X-ray whole body radiation and the number of lymphocytes of spleen and thymus and blastogenic responses of splenocytes were tested. The results showed; (1) the number of lymphocytes both in spleen and thymus were significantly decreased in mice fed basic diet in com-parision with that in mice fed with basic diet plus vitamin E (P