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The medical records of patients of both sexes with sleep disorders treated with multimodal sleep therapy for which patient controlled sleep with dexmedetomidine was the main method, aged≥18 yr, with body mass index of 18-30 kg/m 2, from February 2019 to January 2021, were collected.Dexmedetomidine 60 ml/h (4 μg/ml) was intravenously infused until non-rapid eye movement (NREM) Ⅲ phase was reached or the consumption of dexmedetomidine reached 1 μg/kg.Whether dexmedetomidine induced restless legs syndrome (RLS) was judged according to the Chinese guidelines for the diagnosis and treatment of restless legs syndrome (2021 edition). When the titration was stopped and on the next day after emergence from anesthesia, clinical diagnosis was performed according to Chinese guidelines for the diagnosis and treatment of restless legs syndrome (2021 edition) to determine whether RLS was combined or not.Kappa consistency analysis was used to assess the consistency between dexmedetomidine titration and the Chinese guidelines for the diagnosis and treatment of restless legs syndrome (2021 Edition) in diagnosis of RLS.The sensitivity and specificity of diagnosis of RLS by dexmedetomidine titration were calculated.A total of 39 patients were included and 8 patients had RLS symptoms which were judged accroding to dexmedetomidine titration.The results of Kappa consistency test showed that there was a strong consistency between dexmedetomidine titration and Chinese guidelines for the diagnosis and treatment of restless legs syndrome (2021 edition) (Kappa value 1.0, P<0.01). The sensitivity and specificity of dexmedetomidine titration in judging RLS were 100%.In conclusion, dexmedetomidine titration can accurately judge RLS.
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Objective To investigate the survival rate and status of cerebral performance category in patients who received cardiopulmonary resuscitation (CPR) with return of spontaneous circulation (ROSC) (abbreviated by ROSC-CPR) after discharge,and to analyze the risk factors which influencing the prognosis of these patients.Methods A retrospective analysis of the clinic data coming from the patients who received cardiopulmonary resuscitation with return of spontaneous circulation and admitted to the Department of Intensive Care Unit from January 2009 to December 2016 was carried out to find corresponding risk factors influencing the prognosis.Results A total of 185 patients who received ROSC-CPR with 59.5％ male,the average age of (67.15 ± 17.64) years old and the average Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score (28.80 ± 7.16) were divided into two groups,the survival group (n =56) and the death group (n =129).The total survival rate was 56/185 (30.3％).Compared to the death group,the usage rate of ventilation,blood purification and target temperature management in survival group was no significant (P ＞ 0.05).The most common aetiology of the survival patients was cardiogenic disease,but the number of those patients with the good cerebral performance category (CPC 1/2) discharged from hospital were 16 cases (8.6％).According to logistic analysis,high value of APACHE Ⅱ score,the duration from CPR to ROSC over 10 minutes,admission took place out-of-hospital were unfavorable predictors for the prognosis (P ＜ 0.05),while admission took place in the second four years and cases with cardiogenic aetiology were favorable predictors for the prognosis of these patients who suffered from ROSC-CPR.Conclusions The survival rate of the patients who received CPR with ROSC after discharge was still low,especially the rate of good status of CPC was very low.To shorten the duration from CPR to ROSC as possible as we can,and to strengthen target temperature management would improve the prognosis of the patients who received CPR with ROSC in our hospital in future days.
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Objective To evaluate the effect of curcumin on cognitive dysfunction in a rat model of trigeminal neuralgia.Methods Thirty healthy adult male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 3 groups (n=10 each) using a random number table:sham operation group (Sham group),trigeminal neuralgia group (TN group),and trigeminal neuralgia + curcumin group (TN + Cur group).Trigeminal neuralgia was produced by injecting cobra venom solution 4 μl into the sheath of the infraorbital nerve in TN and TN + Cur groups.Starting from 15 days after establishment of the model,1.5 ml peanut oil was injected through a gastric tube into stomach twice a day (in the morning and at night) for 28 consecutive days in TN group,and curcumin 45 mg/kg (dissolved in 1.5 ml peanut oil) was injected through a gastric tube into stomach twice a day (in the morning and at night) for 28 consecutive days in TN + Cur group.The cognitive function was assessed using Morris water maze test after the end of treatment.The escape latency,swimming speed,ratio of time of staying at the target quadrant,and the number of times the animals crossing the platform were recorded.The pathological changes in the hippocampal CA1 region were observed with an electron microscope.The ultrastructure of neurons,organelles and synapses in the hippocampal CA1 region was examined with a transmission electron microscope.Results There was no significant difference in the swimming speed between the three groups (P＞0.05).Compared with Sham group,the escape latency on 1st-4th days was significantly prolonged,the ratio of time of staying at the target quadrant was decreased,and the number of times the animals crossing the platform was decreased in TN group,and the escape latency was significantly prolonged on 3rd and 4th days in TN + Cur group (P＜0.01).Compared with TN group,the escape latency on 2nd-4th days was significantly shortened,the ratio of time of staying at the target quadrant was increased,the number of times the animals crossing the platform was increased (P＜0.01),and the pathological changes of hippocampal tissues were attenuated in TN + Cur group.Conclusion Curcumin can improve cognitive dysfunction in a rat model of trigeminal neuralgia.
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Objective To investigate the clinical features and pathogenic characteristics of different types of deep sternal wound infection in dif?ferent types after cardiac surgery. Methods A retrospective study was performed. From January 2012 to December 2014,84 patients with sec?ondary DSWI after cardiac surgery underwent the pectoralis major muscle flap transposition in our department were recruited for the study. Re?sults The average age of 84 patients with DSWI was 54.6 ± 14.8 years old,of which typeⅡDSWI patients were the most common(49/84, 58.3%). Both typeⅠand typeⅡDSWI patients showed typical clinical manifestations and early chest X?ray or Computerized tomography(CT) showed mediastinal widening(P0.05),but the pathogenic results of the 3 types of those DSWI patients showed such a trend:typeⅠDSWI patients with GNB is was more common,and typeⅡDSWI patients was more prone to complicated infection. Conclusion Different types of DSWI may dis?play different features,the prevention and treatment of DSWI should be closely combined with the clinical manifestations and local pathogenic char?acteristics.
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Objective To evaluate the analgesic effect of curcumin on trigeminal neuralgia in rats. Methods Thirty healthy adult male Sprague?Dawley rats, weighing 200-250 g, aged 7-8 weeks, were divided into 3 groups ( n=10 each) using a random number table: sham operation group ( group S) , tri?geminal neuralgia group (group TN) and trigeminal neuralgia + curcumin group (group Cur). Trigeminal neuralgia model was established by injecting cobra venom solution into the sheath of the infraorbital nerve ( ION) . Starting from 15 days after establishment of the model, curcumin 45 mg∕kg was intragastrically ad?ministered twice a day for 28 consecutive days in group Cur, while the equal volume of peanut oil was ad?ministered in group TN. Before establishment of the model (baseline), and on 4, 7, 14, 21, 28, 35 and 42 days after establishment of the model, the mechanical pain threshold was measured, the free behav?iors were observed, and the time and frequency of face?grooming and exploratory behaviors were recorded. After observation of the free behaviors, the ION and medulla oblongata on the affected side were removed for examination of the ultrastructure using transmission electron microscopy. Results Compared with group S, the mechanical pain threshold was significantly decreased, the time of face?grooming behaviors was signifi?cantly prolonged, the frequency of face?grooming behaviors was significantly increased, the time of explora?tory behaviors was significantly shortened, and the frequency of exploratory behaviors was significantly de?creased on 4-42 days after establishment of the model in group TN (P<0.05 or 0.01). Compared with group TN, the mechanical pain threshold was significantly increased, and the time of face?grooming behav?iors was significantly shortened on 28-42 days after establishment of the model, and the frequency of face?grooming behaviors was significantly decreased, the time of exploratory behaviors was significantly pro?longed, and the frequency of exploratory behaviors was significantly increased on 21-42 days after estab?lishment of the model in group Cur ( P<0.05 or 0.01) . Microscopic examination revealed that the changes in demyelination of the ION and medulla oblongata were significantly attenuated in group Cur as compared with group TN. Conclusion Intragastrically administered curcumin 45 mg∕kg ( twice a day for 28 consecutive days) can attenuate trigeminal neuralgia in rats, and the mechanism is related to the attenuated changes in demyelination of the ION and medulla oblongata.
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Objective To observe the clinical effects and intubation condition of different doses of domestic cisatricurium(CA) in children. Methods Forty-five peadiatric patients aged 2 to 12 years old scheduled for selective surgery were randomized to three groups of 2 ED_(95) CA(0. 08 mg/kg), 3ED_(95) CA(0. 12 mg/kg) and 4ED_(95) CA(0. 16 mg/kg) (C_2, C_3, C_4 groups). Neuromuscular blockade was monitored with TOF-Guard. The conditions for trachea[intuDation were scored and the onset time, clinical duration, recovery index were recored. ResultsTracheal intubation was performed successfully in all patients. The conditions for tracheal intubation were scored greater 5 points in groups of C_3 and C_4 ,which was only 33. 3% of patients in group C_2. The onset time was shortened and the duration of action was prolonged as the dose of CA increased. But the recovery index of three groups were smilar. Conclusion An increase of CA dosage can shorten the onset time and prolong the duration of action and 3ED_(95) CA is suitable for tracheal intubation in children.
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@#Objective To investigate the effect of thiopental on lipopolysaccharide(LPS)-induced activation of nuclear factor kappa B(NF-κB) under different concentration or after different time in rat glioma cells in vitro.Methods The rat C 6 glioma cells were treated with,in the presence or Absence of various concentrations(10-3 mol/L,10-4 mol/L and 10-5 mol/L)of thiopental for 1 h.30 min before harvest,the cells were exposed to LPS(10 ng/ml).The other C 6 cells were treated with 10-5 mol/L thiopental with different time(0.5 h,1 h,2 h,4 h).30 min before harvest,the cells were exposed to LPS(10 ng/ml).Nuclear extracts from C 6 cells were harvested using standard procedures,and the LPS-induced NF-κB expression was determined with electrophoretic mobility shift assays(EMSA) and measured with densitometry(Bio-Rad).Results The width of the bands of NF-κB under thiopental with different concentrations were similar,but they were narrower than that of the control(treated only with LPS),the density was less than that of the control(P<0.05).The width of the bands of NF-κB under thiopental with different time decreased with the time(P<0.05),and they were much narrower and shallower than that of the control(P<0.05),and the density was significantly less than that of the control(P<0.05).Conclusion Thiopental suppressed the activation of transcription factor NF-κB,and the inhibition was concentration-independent but time-dependent.
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0 05) The incidences of atherogenesis and intimal thickening and the ratio of the atherosclerotic area to total area (intimal area plus intraluminal area) and the ratio of intimal area to total area , were remarkably lower inTEA group than those in hypercholesterol group(P