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AIM: To observe and compare the clinical efficacy and safety of remimazolam and propofol alone and in combination in endoscopic retrograde cholangiopancreatography (ERCP) anesthesia. METHODS: A total of 120 patients undergoing elective ERCP were divided into the propofol group (P group), the remimazolam group (R group), and the remimazolam combined with propofol group (RP group) according to a random number table, with 40 patients in each group, and the three groups completed anesthesia according to the designated drug regimen (propofol in group P; remimazolam in group R; and remimazolam combined with propofol in group RP). General information, operation time and awakening time of the patients in the three groups were compared, as well as oxygen saturation (SpO
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AIM:To look for a way of produ cing mild therapeutic hypothermia through regulating transient re-ceptor potential cation channel subfamily V member 1 (TRPV1) pathway by dihydrocapsaicin (DHC).METHODS:Mice were subcutaneously injected with DHC at different doses (2 mg/kg, 3 mg/kg and 4 mg/kg) in order to find the best dose for reaching the target temperature (32~34℃).20%DMSO dissolved in normal saline was used as control group .After a single subcutaneous injection of DHC at an optimal dose was given , awaken CD1 mice were continuously infused with DHC at dose of 1 mg? kg-1? h-1 for providing a more rapid and stable temperature drop and duration of therapeutic mild hypothermia.The adult mice (9~10 weeks) and aged mice (24~27 months) were subcutaneously injected with DHC at the same dose, and the changes of the body temperature were monitored .RESULTS:DHC at 2 mg/kg resulted in a de-crease in the core temperature within the target therapeutic range (32~34 °C).After a bolus dose (2 mg/kg) was deliv-ered at 0 min followed by continuous infusion (1 mg? kg-1? h-1 ) beginning at 30 min, a rapid drop of body temperature to 34 ℃was achieved and the body temperature was maintained within the ranges of 32 to 34℃for the duration of the 6 h continuous infusion .DHC-mediated hypothermia did not lose its effectiveness in the adult and aged models .CONCLU-SION:DHC-induced activation of TRPV1 pathway produces mild therapeutic hypothermia .Besides, this method achieves stronger and longer center hypothermia and is suitable for the animals at different ages .
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Objective To investigate the effect of minocycline on isoflurane-induced hippocampal neuroapoptosis and cognitive dysfunction in aged rats. Methods Forty-five male SD rats were randomly assigned into 3 groups ( n=15): blank control group ( group C) , 1.5% isoflurane group ( group I) and 50 mg??kg-1 minocycline+1.5% isoflurane group ( group M+I) . Minocycline was injected intraperitoneally 12 h before the start of anesthesia for group M+I.Group I and group M+I were exposed to 1.5% isoflurane for 4 h, while group C were exposed to 30% O2-70% N2.At the end of anesthesia, five rats in each group were randomized to analyse arterial blood gas. The other rats in each group were sent back to their home cage until they were fully awake.Fourteen days after anesthesia, Morris water maze was used to assess the cognitive function, and then hippocampi of rats were dissected for detection of the expression of cleaved caspase3, Bax and Bcl-2. Results No difference was found in arterial gas analysis among the 3 groups (P>0.05).Compared with group C, the rats in the group I spent more time locating the platform on the third and fourth training days and the time percentage that the rats in group I spent in the target quadrant was much less (P<0.05).However, these changes were reversed in group M+I (P<0.05).The isoflurane-induced increased level of Bax and cleaved caspase3 and decline of anti-apoptotic factor Bcl-2 were restored by minocycline pretreatment ( P<0.05) . Conclusion Minocycline could attenuate cognitive dysfunction induced by isofluranein aged rats.The mechanism is associated with inhibition of hippocampal neuroapoptosis which is increased by isoflurane.
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Objective To investigate the distribution,variability and antibiotic resistance of the pathogen sisolated from bloodstream infections.Methods The bacterial strains were routinely isolated from blood samples and identified.Brucella trains were identified by PCR and gene sequencing.Antimicrobial susceptibility were routinely tested for these isolates.Results A total of 2 152 strains,excluding coagulase negative Staphylococcus,were isolated from blood specimens during the 5-year period from 2009 through 2013.Gram-positive cocci,gram-negative bacilli and fungi accounted for 35.3% (761/2 152), 57.7% (1 242/2 152)and 6.9% (149/2 152),respectively.The top three gram-positive bacteria were S.aureus,E.faecium and E.faecalis.E.coli,K.pneumoniae,P .aeruginosa,A.baumannii,and Brucella were the most frequently isolated gram-negative bacteria.In 2009,only one Brucella melitensis was isolated,but increased to 50 in 2013 (7.1%),including one strain of Brucella suis .The prevalence of MRSA was 54.1% in S.aureus.No staphylococcal isolate was found resistant to vancomycin or linezolid.More than 60% of the E.faecalis isolates still showed low resistance (70%)except glycopeptides and linezolid.E. coli and K.pneumoniae isolates displayed low resistance rate ( were still the most common pathogens in blood stream infections.Attention should be paid to the increasing prevalence of Brucella in blood stream infections.Various levels of antibiotic resistance are found in the pathogens of blood stream infections.Antibiotics should be prescribed reasonably according to local susceptibility testing data.
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Objective To investigate the diagnostic value of serum human epididymis protein 4 (HE4 ) for ovarian cancer . Methods Electrochemiluminescence immunoassay was employed to detect the serum HE 4 of 91 patients with ovarian cancer (ovari-an cancer group) ,69 patients with benign ovarian disease(benign group) and 60 healthy people(control group) .Area under the curve(AUC ) of receiver operator characteristic (ROC ) curve for HE4 was calculated .Results Serum HE4 level [(146 .81 ± 81 .29)pmol/L] of patients in ovarian cancer group was significantly higher than those in control group [(43 .16 ± 25 .64) pmol/L] and benign group[(59 .86 ± 39 .87) pmol/L](P<0 .01) .Set serum HE4≥140 pmol/L as positive cutoff value ,the diagnostic sensi-tivity of serum HE4 detection for ovarian cancer was 82 .4% (75/91) ,specificity 89 .9% (62/69) and diagnostic efficiency 85 .6% . Serum HE4 levels of patients with serous adenocarcinoma ,endometrial adenocarcinoma or other ovarian cancer were markedly high-er than that with mucinous adenocarcinoma (P<0 .01) .Serum HE4 levels of patients with stage Ⅲ ,Ⅳ ovarian cancer were obvious-ly higher than those with Ⅰ ,Ⅱ stage(P<0 .01) .Conclusion HE4 detection has clinical value for the auxiliary diagnosis of ovarian cancer .
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Objective To establish the reference interval of 3-14 years old children in Nanhai district of Foshan city .Methods 2 032 cases of 3-14 years old healthy children were detected and analyzed using MINDRAY BC-5800 automatic blood cell analy-zer .The levels of WBC ,RBC ,Hb ,PLT ,Hct ,MCV ,MCH ,MCHC ,RDW were analyzed .Results The levels of WBC ,RBC ,Hb , PLT ,Hct ,MCV ,MCH ,MCHC ,RDW in 2 031 cases were non normal distribution .The levels of Hb ,Hct had no statistical signifi-cance between male children and female children (P>0 .05);The levels of WBC ,RBC ,PLT ,MCV ,MCH ,MCHC ,RDW had statis-tical significance between male children and female children (P<0 .05) .Conclusion It is very important to establish the reference interval of 3-14 years old children in Nanhai district of Foshan city .
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Objective To investigate the median effective dose (ED50) of cisatracurium priming accelerating the onset of neuromuscular block in patients of different genders. Methods Ninety ASA Ⅰ or Ⅱ patients aged 18-55 yr undergoing elective abdominal operation under general anesthesia were divided into 2 groups ( n = 45 each): male group (group M) and female group (group F). Neuromuscular block was monitored with accelerograph F (TOF-Watch SX). A single twitch stimulation of ulnar nerve was used to monitor neuromuscular function.Anesthesia was induced with midazolam 0.04 mg/kg and fentanyl 1 μg/kg. Accelerograph F was opened after the patients lost consciousness. The priming dose of cisatracurium was injected intravenously, then fentanyl 5 μg/kg and propofol 2 mg/kg were injected intravenously 3 min later and the left dose of cisatracurium for intubation was injected intravenously 4 min later. Tracheal intubation was performed when the ratio of the single twitch stimulation value to control value (T/Tc). decreased to 10%. Anesthesia was maintained with iv infusion of propofol and remifentanil and inhalation of isoflurane. The priming dose of cisatracurium was determined by up-and-down sequential trial. The initial priming dose was set at 5 μg/kg. The ratio of two successive doses was 1.2. T/Tc, time to 90% block, onset time, maximal neuromuscular block and clinical duration were recorded 4 min after the administration of the priming dose. The ED50 and 95% confidence interval (CI) of cisatracurium priming required to accelerate the onset were caculated. Results Time to 90% block was significantly longer-in group M than in group F (P ＜0.05). No significant difference was found in the other parameters among the groups. The ED50 and 95% CI of cisatracurium priming required to accelerate the onset were 21.36 μg/kg (95% CI 20.52-22.23 μg/kg)in group M and 14.53 μg/kg (95% CI 13.77-15.33 μg/kg) in group F. The ED50 was significantly higher in group M than in group F ( P ＜ 0.05). Conclusion The ED50 of cisatracurium priming accelerating thd onset is 21.36 and 14.53 μg/kg in male and female respectively and it is significantly higher in male than in female.
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Objective To compare the effects of desflurane and propofol on systemic hemodynamics and arterial oxygenation undergoing one-lung ventilation (OLV) during video-assisted thoracoscopic surgery (VATS)Methods Twenty patients,ASA physical status Ⅱ or Ⅲ, scheduled for elective VATS undergoing OLV , were prospectively randomized into two groups : desflurane group(group D,n=10) and propofol group (group P,n=10) Anesthesia was induced with intravenous propofol 2mg?kg -1(group P) or thiopental 5 mg?kg -1( group D) combined with intravenous fentanyl 4?g?kg -1 ,vecuronium 01mg?kg -1 and succinylcholine 100mg , and was maintained with infusion of propofol at rate of 2-8 mg? kg -1?h -1 (group P) or inhalation of desflurane 2%-4% (group D) The Carlen double-lumen endobronchial tube was intubated to ventilated mechanically with 100% oxygen MAP and HR were monitored during the entire procedures, and blood gas analysis was made before operation, 30 min following two-lung ventilation, 30 min and 60 min following OLV in both groups,respectively Results PaO 2 were decreased significantly following OLV in both groups(P005)Conclusions Desflurane can be used as safely as propofol with one-lung ventilation during video-assisted thoracoscopic surgery