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Retrospective analyses of clinical data were performed for 518 elderly cataract patients (856 eyes) of Disabled Persons' Federation in Hangzhou,Zhejiang Province.For 69 eyes (8.06％),corneal edema was a major factor of low vision during early postoperative period; for 23 eyes (2.69％),delayed cataract was an important cause of low vision during long-term postoperative period.The best corrected visual acuity of 120 eyes caused by nonsurgical factors was diabetic retinopathy (48 eyes,48.00％),senile macular degeneration (25 eyes,20.80％),high myopia retinopathy (17 eyes,14.20％),optic never injury in glaucoma (16 eyes,13.30％),macular membrane & hole (5 eyes,4.20％) and amblyopia & corneal leucoma (9 eyes,7.50％).Retinal disease is the most important reason of low vision after cataract surgery.And surgery remains the most effective treatment for cataract.
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Objective: Our purpose was to study the effect of anisodamine on the injury of myocardium after myocardial ischemia reperfusion. Methods: Eighteen patients (ASA grade Ⅱto Ⅲ) scheduled for valve replacement, were randomly divided into 2 groups during extracorporeal circulation. Anisodamine (0.25 mg/kg) was given intravenously in the anisodamine group before reperfusion. Equivalent volumes of normal saline were administered in the control group. The central venous blood samples were collected at different time after ischemia and reperfusion. We then measured the concentrations of lactic dehydrogenase (LDH), creatine kinase (CK), and malondiadehyde (MDA) with biochemical methods. Results: The levels of serum LDH, CK, and plasma MDA increased significantly in the control group during ischemia and reperfusion. In the anisodamine group, the levels of serum LDH and CK increased. But the values were lower at corresponding time than those in the control group (P<0.05) during reperfusion. The plasma level of MDA unchanged in the anisodamine group during ischemia and reperfusion. The postoperative cardiac function recovered much more better in the anisodamine group. Conclusion: Anisodamine can reduce the degree of reperfusion injury. A certain protective effect on myocardial ischemia reperfusion injury exsists during valve replacement.
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Objective:To investigate the effect of dosages of propofol on pulmonary artery pressure (PAP) and hypoxic pulmonary vasoconstriction(HPV) reaction. Method:Isolated rat lungs were perfused with whole blood at the rate of flow 10ml/min and ventilated with air+4％CO_2(n=5) or 3％ O_2+4％CO_2+93％ N_2(mixed gas, n=11).PAP was measured continuously during the whole procedure. Result:PAP decreased significantly in air+4％ CO_2 ventilation following administralion of propofol 4 mg/kg,6 mg/kg and 8 mg/kg respectively.The varied degrees at 6 mg/kg and 8mg/kg were even more marked than that at 4mg/kg. When mixed gas was ventilated into lung, PAP increased from 1.60+0.23kPa to 2.384?0.31kPa to produce HPV,PAP decreased abruptly in HPV rats when administered 4mg/kg, 6mg/kg and 8mmg/kg propofol respectively and HPV reaction was inhibited by 47％, 867％and 71％ respectively,the inhibition extent was more at 6mg/kg or 8mg/kg than that at 4mg/kg. Conclusion:Propofol can decrease PAP and inhibite HPV in dose-dependent way.
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Objective To compare the influences of propofol and ketamine on mean pulmonary arterial pressure (MPAP), Ca 2+ content and the ultrastrcture of lung tissues during acute hypoxia Methods Twenty one Wistar rats were randomly divided into 3 group: infusion with propofol 8mg kg -1 h -1 in P group and ketamine 8 mg kg -1 h -1 in K group ,21% O 2 gas was inhaled in 15 min followed by inhalation of mixture gas of 10% O 2 and 90% N 2 for 20 min in the both groups ; continuous infusion with normal saline with 21% O 2 inhalation for 35 min in C group Carotid blood gas was analysed, pulmonary Ca 2+ content was measured with absorption spectrophotometry and the lung ultrastructure was detected with electron microscopy at the end of the experiment Results Compared with those in C group, MAP and PaO 2 decreased significantly and MPAP increased markedly in P and K groups , with MPAP in P group being lower than that in K group (P
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To investigate the inhibiting effects of ketamine on arterial plasma TNF-? concentration and lung injury in septic shock rat. Method: 40 Wister rats were divided into five groups. 15mg?kg~(-1) endotoxin (LPS) was intravenously injected alone (group Ⅰ)or ip ketamine 50,100 and 200mg?kg~(-1) before LPS, then ketamine was infused at 10mg?kg~(-1)?min~(-1) (Ⅱ, Ⅲ and Ⅳgroup). TNF-? was assessed with ELISA, and at the same time the arterial blood oxygen tension and lung water content were measured. Result: In contrast to normal control level, arterial plasma TNF-? levels and lung water content increased and arterial oxygen tension decreased after LPS in group Ⅰ, but in the rats of giving ketamine, plasma TNF-? level decreased more than that in the rats of giving LPS alone (group Ⅰ), change of arterial blood oxygen tension and lung water content in former groups were better than that of later, in dosage-dependent way. Conclusion: Ketamine can dose-relatedly decrease TNF-? concentration and lung injury degree induced by endotoxin.
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To evaluate the effects of tetramethylpyraze (TPZ) on the collapsed lung during one lung ventilation (OLV), 2.4 adult patients with esophageal cancer,ASA grade Ⅰ-Ⅱ,undergoing esopha-goesophagostomy, were randomly allocated to receiving intravenous infusion with TPZ 4mg?kg~(-1) (group T,n=12) or equivalent volume of normal saline (group C,n=12) in 5 mins before onset of OLV respectively. The ultrastracture of collapsed lungat 90th min following OLV showed that in group C mitochondia swelled, the cristae disappeared, and large vecule appeared, but in group T those remained normal. As compared with those in group C,the Ca~(2+) content in erythrocyte decreased significantly 30 and 60 mins following OLV (P
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ve When a new drug is introduced for intrathecal (IT) administration, its effect on spinal cord should be studied for safety reason. The aim of this study was to determine the ultra-microstructure of spinal cord and Ca2+ content in spinal cord after IT administration of ropivacaine in dogs. Methods Eighteen mongrel dogs of either sex weighing about 10kg were randomly assigned to one of three groups according to the dose of ropivacaine administered IT: group A received normal saline 2ml IT and served as control; group B received 0.5% ropivacaine 2ml(10mg) IT; group C received 1% ropivacaine 2ml(20mg) IT. Anesthesia was induced with intramuscular ketamine 20mg.kg-1 and atropine 0.05mg?kg-1 and maintained with intermittent iv boluses of ketamine 3mg?kg-1 and fentanyl 5?g?kg-1 Left internal jugular artery was cannulated for intra-arterial pressure monitoring. An incision was made in the back at L3-4 and lumbar puncture was confirmed by aspiration of cerebral-spinal fluid (CSF). Normal saline or ropivacaine was then injected over 20 seconds. 3 hours after IT administration the animals were sacrificed and L1-2 segment of spinal cord and nerve roots were immediately removed for Ca content determination and electron microscopic examination. Results The Ca2+ content of spinal cord was significantly higher in group C than that in group A and B. Electron microscope revealed that in group A and B neurolemma of the nerve root and mitochondria and endoplasmic reticulum of the neurons in spinal cord were intact, while in group C neurolemma was stratified and partly disrupted and mitochondria and endoplasmic reticulum underwent swelling and there was vacuole degeneration. Conclusions Ropivacaine of high concentration or at high dose may be injurious to spinal cord.
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Objective The purpose of this study was to assess the effects of heat stress response (HSR) on i of pulmonary arterial endothelium cells (PAEC)incubated with TNF-?. We tried to illustrate the mechanism of injury to PAEC caused by TNF-? and the effects of HSR.Methods The study consisted of four groups.In group Ⅰ confluent monolayer of calf PAEC were directly incubated with TNF-? at final concentrations of 500, 1 000 and 2 000 u/ml for 24 h.In group Ⅱ PAEC were first bathed in 42℃ water for 20 min and then allowed to recover for 24 h.In turn they were incubated with TNF-? at the same concentrations.In group Ⅲ PAEC were not heated and incubated with TNF-?.In group Ⅳ PAEC were heated but not incubated with TNF-?.i of PAEC was assayed by fluorospectrophotometry and i of four groups were compared.The change in i before and after incubation of PAEC with TNF-?(?i) was calculated.Results (1) i was considerably higher in group Ⅰ than that in group Ⅲ at different concentrations in dose-dependent way.(2) Although i was higher in group Ⅳ than that in group Ⅲ, HSR could inhibit the further increase in i of PAEC incubated with TNF-?.Conclusions HSR may decrease the i in PAEC incubated with TNF-?.It indicates that HSR can prevent PAEC from calcium overload and provide protection on PAEC against injuries.
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Objective: To investigate the relationship between the plasma concentration of nitric oxide (NO) and prognosis of the hemorrhagic shock. Method:The blood levels of NO and Lactate (LA) were measured with fluorophotometry and colorimetry in 30 hemorrhagic shock patients,and another 30 patients for elective surgery served as a control. Result :Concentration of NO was significantly lower and that of LA was significantly higher in hemorrhagic shock group than that of control group. NO level had a negative correlation with LA level and injury index. NO level in the patients complicated by sepsis were still lower than the control. Conclusion:Decrease of NO level may result in disturbance of microcirculation and increase of LA. So nitroglycerin should be used as early as possible in the hemorrhagic shock patients.
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Objective It was reported that pretreatment with small dose of lipopolysaccharide (LPS) could protect the animal from lethal dose endotoxin. The purpose of this study was to investigate the effects of pretreatment with small dose of LPS on cardiac function in endotoxemic rats and the possible mechanism. Methods Sixty male Wistar rats weighing 200-280 g were randomly divided into 3 groups: group I normal saline(NS) ( n = 12); group Ⅱ LPS (n = 24) and group Ⅲ LPS-pretreatment ( n = 24). Group Ⅱ and group Ⅲ were further divided into 3 groups: 2 h,4 h and 6 h subgroups based the time when blood sample was taken and the animal was sacrificed. The table shows the LPS given in the 3 groups:groupⅠⅡ Ⅲ0hNSNSLPS 0.25 mg?kg-1ip24 hNSNSLPS0.5mg?kg-1ip96 hNSLPS 10 mg?kg-1 Ⅳ LPS 10 mg?kg-1 TVThe animals were anesthetized with 3 % pentobarbital 30 mg?kg ip and intubated. Right femoral artery and vein were cannulated for MAP monitoring and fluid infusion. Cardiac catheter was placed in the left ventricle for measurement of left ventricular systolic pressure (LVSP) and?dp/dt max. Blood samples were taken 2 h,4 h and 6 h after intravenous LPS (10 mg?kg-1) for determination of plasma levels of L-lactate-dehydrogenase (LDH) and creatine kinase (CK) . The animals were sacrificed right after blood sampling and the heart was removed for determination of myocardial HSP 70 expression using immuno-histochemical staining. Results LVSP and?dp/dt max gradually decreased 1h after intravenous administration of LPS in group Ⅱ (LPS group); while in group DI (pretreatment group) the cardiac contractility was maintained and LVSP,?dp/dt max did not decrease as compared with the baseline value. Plasma LDH concentration and CK activity increased significantly 4 h and 6 h after intravenous IPS in group Ⅱ . The plasma LDH and CK levels were significantly lower in groupⅢthan those in group Ⅱ ( P