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Objective To evaluate the anatomical factor and risk assessment of right internal jugular vein (IJV) puncture-related damage to the vertebral artery (VA) at different neck planes in pediatric patients.Methods Two hundred and ten pediatric patients of both sexes,aged 6 months-10 yr,with body mass index less than 28 kg/m2,undergoing elective surgery,were enrolled in this study.At the cricoid cartilage plane,supraclavicular area plane and intermediate plane,the right IJVs and VAs were examined using ultrasound.The VA position relative to the IJV,diameters of IJVs and VAs (the diameter ratio of VAs to IJVs was calculated),extent of overlap between IJVs and VAs,and horizontal and vertical distance from VAs to IJVs were recorded,and the risk coefficient of accidental VA puncture was calculated.Results Ninety-seven percent of VAs lay deep and lateral to right IJVs.There was no significant difference in each parameter of VA position relative to IJVs between the three planes (P＞0.05).The diameter ratio of VAs to IJVs was decreased with the decreasing neck plane,the horizontal and vertical distance from VAs to IJVs was significantly shortened,the overlapping rate between VAs and IJVs was increased,and the risk coefficient of accidental VA puncture was increased (P＜0.05 or 0.01).The vertical distance from VAs to IJVs was not correlated with age,body weight or height (P＞0.05).The risk coefficient of VA damage was not correlated with age,body weight or height at the cricoid cartilage plane and intermediate plane (P ＞ 0.05).The risk coefficient of VA damage was positively correlated with the weight of pediatric patients at the supraclavicular area plane (P＜0.05,r=0.215).Conclusion Right VAs come nearer IJVs with the decreasing neck plane;the risk of VA damage increases gradually with the lowering of neck planes in pediatric patients.
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Objective To evaluate the effects of propofol on apoptosis and invasiveness of human lung cancer cell line A549 cells.Methods Human lung cancer cell line A549 were seeded onto 96-well plates (100 μl/well) and 6-well plates (2 000 μl/well) at a density of 2× 105 cells/ml,and cultured for24 h at 37 ℃ in 5％ CO2.The cells were randomly divided into 2 groups (n =60 each) using a random number table:dimethyl sulfoxide (DMSO) group and propofol group (group P).In group P,propofol with the final concentration of 100 μmoYL was added.In group DMSO,0.5％ DMSO with the final concentration of 0.5％ was added.At 24 h of incubation with drugs,caspase-3 expression was detected by high content screening (HCS); the expression of matrix metalloproteinase (MMP-2) was detected by Western blot analysis.At 0.5,1 and 5 h of incubation,ERK1/2 expression was also measured using Western blot analysis.Results Compared with group DMSO,the expression of caspase-3 was up-regulated,the expression of MMP-2 was down-regulated,ERK1/2 expression was up-regulated at 0.5 of incubation and down-regulated at 1 h of incubation,and no significant change was found in ERK1/2 expression at 5 h of incubation in group P.Conclusion Propofol can promote apoptosis in A549 cells and inhibit invasiveness of human lung cancer cell line A549 cells.
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Objective To investigate the effect of breviscapine on lung injury in children undergoing open heart surgery with cardiopulmonary bypass(CPB).Methods Forty-five ASA Ⅱ or Ⅲ children aged 3-65 months weighing 5-21 kg undergoing open heart surgery with CPB were randomly assigned to 3 groups ( n =15 each):control group (group C),low dose breviscapine group (group B1 ) and high dose breviscapine group (group B2).Normal saline 15 ml(group C),breviscapine 0.5 mg/kg (group B1 )or 1.0 mg/kg(group B2 ) were injected iv over 30min after anesthesia induction.Blood samples were taken before operation ( T0 ),at 30 min and 1 h of aortic unclamping (T1,T2 ),at 3 h and 6 h after operation (T3,T4 ) for determination of plasma procalcitonin (PCT)and neutrophil elastase(NE) concentrations.PaO2 and PaCO2 were recorded at T0,T3,T4 for caculation of oxygenation index (OI) and alveolo-arterial oxygen partial pressure difference (PA-a O2 ).Results There were no significant differences in OI and PA-a O2 among the 3 groups( P ＞ 0.05).Plasma concentration of PCT was higher at T1～4in 3 groups,and plasma concentration of NE was higher at T1 in group C than that at T0 ( P ＜ 0.01 ).Plasma concentrations of PCT and NE were lower in groups B1 and B2 than in group C ( P ＜ 0.01).There were no significant differences in plasma concentrations of PCT and NE between groups B1 and B2 ( P ＞ 0.05).Conclusion Breviscapine(0.5,1 mg/kg) can inhibite systemic inflammatory response and attenuate lung injury in children undergoing open heart surgery with CPB.
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Objective To investigate the changes in gastric intramucosal pH (pHi) and the effect of propofol on microcirculatory perfusion after myocardial ischemia-reperfusion injury in rabbits. Methods Twenty healthy adult rabbits of both sexes, weighing 2.0-2.7kg were randomly divided into two groups: A control group (n=10) and B propofol group (n = 10) . The animals were anesthetized with 2% sodium pentothal iv. Anesthesia was maintained with intermittent iv boluses of fentanyl and vecuronium. The animals were tracheotomized and mechanically ventilated during fluid and propofol infusion. PaCO2 was maintained at 35-40 mm Hg. Right internal jugular vein was cannulated for fluid and propofol infusion. Left carotid artery was cannulated for BP and HR monitoring and blood sampling. TRIP tonometry catheter (14F) was placed in the stomach. Lactated Ringer's solution was infused at 6-8 ml-kg-1 h-1 during experiment. In group B propofol was infused at 5mg-kg-1-h-1 when BP and HR were stabilized for 10 min, chest was opened and heart exposed. Left anterior descending artery (LAD) was tied for 60 min and then released for reperfusion. Hemodynamics and pHi were measured before myocardial ischemia (T0) , 60 min after myocardial ischemia (T1), 60 min (T2), 90min (T3) and 180min (T4) after reperfusion was started. Results There was no significant difference in BP and HR from T0 to T4 between the two groups. pHi decreased significantly after myocardial ischemia-reperfusion injury in both groups. pHi was significantly lower at T3 in propofol group than that in control group (P
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Objective To develop a target-controlled infusion (TCI) system incorporating population pharmacokinetics of propofol for children and evaluate its accuracy. Methods The TCI system was composed of a Samsung Q20 laptop computer, Graseby 3500 infusion pump, Stanpump software (Version 1.0 designed by Shafer et al. Stanford) and pharmacokinetic parameter set for propofol in children reported by Lian et al. Twenty-four ASA Ⅰ children undergoing elective orthopedic or urological surgery under general anesthesia were divided into 2 age groups: group A 3-5 yrs ( n = 12) and group B 5-10 yrs (n = 12). Radial artery and internal jugular vein were cannulated. The pediatric patients were sedated with ketamine 4 mg?kg-1 IM (uncooperative patients) or 2 mg? kg-1 Ⅳ( cooperative patients) . Anesthesia was induced with fentanyl 3 ?g?kg-1, propofol by TCI and vecuronium 0.1 mg?kg-1. Target plasma concentration of propofol was set at 3 ?g?ml-1. TCI of propofol was maintained for 60 min. Arterial blood samples were taken at 1, 3, 5, 10, 20, 30, 40, 50 and 60 min after TCI was started and at 2.5, 5, 10, 20 and 30 min after termination of TCI for determination of blood propofol concentration by HPLC. The median performance error ( MDPE) , MDPE without first five minutes ( MDPE1) , median absolute performance error ( MDAPE), wobble and divergence were calculated. Results During the first 40 minutes of TCI there was a remarkable difference between the measured plasma propofol concentration ( Cm) and the target plasma concentration (Cp). The difference was narrowing gradually until the 50 min of TCI. After the termination of TCI the Cm was significantly lower than Cp. The MDPE was 27% in group A and 26% in group B; MDPE1 was 7% (A) and 12% (B) and MDAPE 27% (A) and 26% (B) during TCI. The wobble was 23 % (A) and 24% (B) and the divergence - 0.75%?h-1 (A) and -0.80%?h-1 respectively. Conclusion The bias and divergence of our TCI system for propofol are small and the accuracy is high and a stable plasma concentration of propofol can be maintained in children.
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Objective To investigate the pharmacokinetics of propofol in children of different ages after a single dose. Methods Thirty-five ASA Ⅰ or Ⅱ children were divided into 3 age groups: group A