ABSTRACT
Objective To investigate the cerebral protection of dexmedetomidine in patients with heart valve replacement under CPB.Methods Totally 80 cases of patients with heart valve replacement under CPB in Seventh people's hospital of Zhengzhou city from January 2015 to December 2015 were selected and divided into observation group and control group,40 cases in each group.Patients in observation group were treated with dexmedetomidine before anesthetic induction and during the operation,and patients in control group were treated with same dose of saline solution.The arterio-venous oxygen content difference (Da-jvO2),jugular venous oxygen saturation (SjvO2),cerebral oxygen extraction rate (CERO2),serum myelin basic protein (MBP),serum neuron-specific enolase (NSE),and S1003 protein content before anesthetic induction (T0) and when the ascending aorta open (T1),After 10 min of CPB (T2) and postoperative 6 h (T3) were compared between two groups,and occurring rates of MMSE and POCD were also compared.Results SjvO2 values of two groups at T1 were significant higher than T0 (P ＜ 0.05),Da-jvO2,and CERO2 were significant lower than T0 (P ＜ 0.05),SjvO2 values of observation group at T1 and T2 were significant higher than those of control group and Da-jvO2 and CERO2 were significant lower than those of control group (P ＜ 0.05);At T2 and T3,MBP levels of observation group and control group were significant higher than T0 (P ＜ 0.05),and those in observation group were significant lower than control group (P ＜ 0.05);At T1,T2,and T3 of observation group and control group were significant higher than T0 (P ＜0.05),and NSE levels of observation group at T1,T2,T3 were significant lower than those of control group (P ＜ 0.05),S-100β levels of observation group at T2 and T3 were significant lower than those of control group (P ＜ 0.05).After 7 d,MMSE score of observation group was significant higher than that of control group and POCD occurring rate was lower (P ＜ 0.05).Conclusion Dexmedetornidine can improve cerebral ischemia hypoxia state and reduce brain damage in patients with heart valve replacement under CPB.
ABSTRACT
In 1957. we discovered a new species of Trombicula in gaohu, Qingtian. mountainous region of south Zhejiang. which is the dominant species in that locality. Its seasonal and geographical distribution are consistent with tbe epidemic of tsutsugamushi disease. The Rickettsia tsutsugamushi had been isolated from the larva hosts and patients at the same time. It was confirmed by epidemiological investigation that this tsutsugamushi is a new vector of tsutsugamushi disease. This Trombicula was discovered first time in Gaohu and was named Trombicula (Leptotrombidium) Caohuensis nov sp. This rteport had been published in 1960.In July 1984. we tested a biting experiment by setting 11 larvae of the tsutsugamushi on our own forearms and confirmed that the Trombicula had the ability of stinging and biting human bodies, and that this ability persisted after the changing of hosts (from mouse to man). This test provided a new evidence of vector effect of Trombicula Caohuensis nov sp in ecology.