Sevoflurane-N2O inhalation anaesthesia with laryngeal mask airway and propofol-ketamine intravenous anaesthesia in strabismus surgery / 中南大学学报(医学版)

OBJECTIVE@#To investigate the advantages and disadvantages of sevoflurane-N2O inhalation anesthesia with laryngeal mask airway (LMA) and propofolketamine total intravenous anaesthesia in children undertaking strabismus surgery.@*METHODS@#Eighty children undertaking strabismus surgery were randomly divided into sevoflurane-N2O inhalation anaesthesia group with LMA (volatile group, n=40) and propofol-ketamine total intravenous anesthesia group (TIVA group, n=40). LMA was used to secure respiratory airway in the volatile group, but LMA or endotracheal intubation was not used in the TIVA group. All children breathed spontaneously during operative period. The anesthesia was maintained with 2%-3% sevoflurane-50% N2O-50% O2 in the volatile group, and continuous intravenous infusion with propofol 5-10 mg/(kg x h) plus ketamine 1-2 mg/(kg x h) in the TIVA group. The incidence of SpO2 less than 95% and the movement of the limbs and head induced by operative stimulation, oculocardiac reflex (OCR) and postoperative vomiting (POV) were recorded in all children.@*RESULTS@#The incidence of limbs and head movement, the incidence of SpO2 less than 95% and OCR were significantly lower in the volatile group than those in the TIVA group (P < 0.01); but the incidence of POV was significantly higher in the volatile group than that in the TIVA group (P < 0.01).@*CONCLUSION@#Sevoflurane-N2O-O2 anesthesia with LMA can secure respiratory airway of patients, avoid hypoxemia, and have good anesthetic quality and low OCR incidence. It is a new anesthesia method with more advantages in children undertaking strabismus surgery, but the prevention and treatment of POV must be noticed.

Impaired endothelium-dependent vasodilation and arterial elasticity in patients with coronary artery disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the change in endothelium-dependent vasodilation and arterial elasticity and the association between them in patients with coronary artery disease (CAD).</p><p><b>METHODS</b>Thirty patients with CAD and thirty control subjects were recruited for this study. Flow-mediated dilation (FMD) in the brachial artery was evaluated by ultrasound Doppler flow method. They also underwent a non-invasive assessment of C(1) large artery and C(2) small artery indices by using pulse wave analysis.</p><p><b>RESULTS</b>FMD was significantly reduced in CAD group compared with that in control group [(5.17 +/- 2.13)% vs (11.1 +/- 4.36)%, P < 0.05], C(1) large artery elasticity index was similar between the two groups [(11.59 +/- 4.56) ml/mm Hg x 10 vs (12.11 +/- 3.82) ml/mm Hg x 10, P > 0.05]. However, C(2) small artery elasticity index was significantly reduced in CAD group compared with that in control group [(4.20 +/- 1.80) ml/mm Hg x 100 vs (6.26 +/- 2.36) ml/mm Hg x 100, P < 0.05]. There was a positive association between reduced C(2) small artery elasticity index and impaired FMD (r = 0.53, P < 0.05).</p><p><b>CONCLUSIONS</b>There were impaired endothelium-dependent vasodilation and reduced C(2) small artery elasticity index in the patients with CAD, which were closely correlated with each other. The present study suggested that the measurement of C(2) small artery elasticity might be used as a novel index for the determination of endothelial function.</p>

Change in endothelial progenitor cells and endothelial function in patients with unstable angina pectoris / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the relationship between endothelial progenitors cells (EPCs) and endothelium-dependent vasodilation in patients with unstable angina pectoris.</p><p><b>METHODS</b>Thirty patients with unstable angina pectoris (UAP) and thirty control subjects were recruited. Flow-mediated dilation (FMD) in the brachial artery was evaluated by using ultrasound Doppler flow method. The number of circulating EPCs was analyzed by flow cytometry analysis. Total mononuclear cells were isolated from peripheral blood by Ficoll density gradient centrifugation, and then the cells were plated on fibronectin-coated culture dishes. CD34 antigen of adherent cells was identified by immunohistochemical assay. EPCs were characterized as adherent cells double positive for FITC-UEA-I binding and DiI-acLDL uptake by direct fluorescent staining under inverted fluorescent microscope.</p><p><b>RESULTS</b>FMD was significantly impaired in the UAP group compared with the control group (5.93% +/- 2.67% vs 11.1% +/- 4.36%, P < 0.05). There was no significant difference in NMD between two groups (13.60% +/- 5.03% vs 14.18% +/- 4.50%, P > 0.05). The number of CD34(+) cells significantly increased in the UAP group compared with the control group (0.13% +/- 0.05% vs 0.09% +/- 0.04%, P < 0.05). There was a negative association between impaired FMD and increased CD34(+) cell (r = -0.385, P < 0.05). A positive antigen of CD34 of adhesion cells and double positive adhesion cells were found.</p><p><b>CONCLUSION</b>This study shows that the levels of peripheral CD34(+) cells in patients with UAP increase with an impaired endothelial function. The increase in EPCs may be an important compensatory response to acute coronary ischemia and impaired endothelium in patients with UAP.</p>