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Objective To investigate the sedative effects of different doses of dexmedetomidine with mid-azolam in spinal anesthesia. Methods 130 cases of spinal anesthesia were randomly divided into 2 groups,group D1 and group D2,with 65 cases in each group. Patients in 2 groups were given midazolam and dexmedetomidine with different doses. The heart rates ,blood pressure ,SpO2 ,Narcotrend value and Ramsay sedation scores were recorded at mutiple time points. The working time ,maintaining time of sedative effect ,and adverse reactions were compared between 2 groups. Results MAP,HR and NT decreased significantly in 2 groups(P < 0.05,respec-tively). The keeping time was relatively longer in group D1 compared with group D2(P<0.05). The working time was faster in group D2 compared with group D1. The rate of bradycardia in group D2 was relatively higher than that in group D1. Conclusion Good sedative effect can be obtained by drug in 2 groups. Group D1,with midazolam 0.05 mg/kg+dexmedetomidine 0.3μg/kg,may have a certain advantage in anaesthesia in the spinal canal.
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Objective To evaluate the effects of age factors on sedation induced by dexmedetomidine.Methods One hundred and thirty-nine patients,aged 18-103 yr,with body mass index ≤ 30 kg/m2,scheduled for elective surgeries on lower abdomen or lower extremities,were divided into4 groups according to the age:group Ⅰ (18 yr≤age≤44 yr,n=40);group Ⅱ (45 yr≤age≤59 yr,n=38);group Ⅲ (60 yr≤age≤89 yr,n=39);group Ⅳ (≥90 yr,n=22).A catheter was placed in the subarachnoid space at L3,4 interspace,and ropivacaine 10-20 mg was injected via the catheter.At 20 min after ropivacaine injection,dexmedetomidine 1 μg/kg was infused via a pump over 10 min.The onset time and duration of sedation were recorded,and the occurrence of adverse effects such as hypoxemia,bradycardia and hypotension was observed.Results There was no significant difference in the onset time of sedation and incidence of bradycardia among the 4 groups (P＞0.05).Compared with group Ⅰ,the duration of sedation was significantly prolonged in Ⅱ-Ⅳ groups (P＜0.05).Compared with Ⅱ and Ⅲ groups,the duration of sedation was significantly prolonged in group Ⅳ (P ＜ 0.05).The incidence of hypoxemia and hypotension was significantly higher in group Ⅳ than in Ⅰ-Ⅲ groups (P＜0.05).Conclusion Dexmedetomidine-induced sedation is influenced by age factors,the duration of sedation induced by dexmedetomidine is prolonged,and the occurrence of adverse effects is increased,especially if the patients ≥ 90 yr of age.
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<p><b>OBJECTIVE</b>To explore the impacts on EC50 in the remifentanil inhibition of tracheal intubation response by the transcutaneous electrical acupoint stimulation (TEAS) at Hegu (LI 4) and Neiguan (PC 6).</p><p><b>METHODS</b>Forty patients with selective surgery undergoing endotracheal intubation with intravenous general anesthesia were divided into I to II degree by the American Society of Anesthesiologists (ASA) and were randomized into an observation group and a control group, 20 cases in each one. Before general anesthesia induction, in the observation group, the transcutaneous electric stimulation was applied to bilateral Hegu (LI 4) and Neiguan (PC 6) for 30 min, with dense-disperse wave, 2 Hz/100 Hz in frequency; in the control group, the sham-stimulation was applied to the acupoints, with the lamp on, but without electric current output. Afterwards, the general anesthesia induction started. When the target concentration of propofol and remifentanil was stabilized at the preset value, the endotracheal intubation was conducted. Dixon sequential method was applied for the determination of ECs in remifentanil inhibition of tracheal intubation response.</p><p><b>RESULTS</b>The level of EC50 in remifentanil inhibition of tracheal intubation response was 3. 46 ng/mL, 95% confidence interval was 2. 80 ng/ml to 4. 27ng/mL in the observation group; those were 4. 18 ng/mL and 3. 30 ng/mL to 5. 29 ng/mL in the control group separately. The differences were significant in comparison of the two groups (P<0. 01).</p><p><b>CONCLUSION</b>TEAS apparently reduces EChe in the remifentanil inhibition of tracheal intubation response by around 17%as.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Acupuncture Points , Anesthetics, Intravenous , Intubation, Intratracheal , Pain , Pain Management , Piperidines , Transcutaneous Electric Nerve StimulationABSTRACT
Objective:To study the effect of Xiaoyao Powder on Alzheimer's disease in hippocampal CA 3βregion of rats PP-2A,GSK-3βexpression.Methods:Rats were randomly divided into four groups , including model group, western medicine group,Chi-nese medicine group were treated with intraperitoneal injection of D-gal and A-β1-42 peptide bilateral hippocampal injection mold-ing, physiological group only with equal volume of sterile saline intraperitoneal and hippocampal injection molding .The model was completed, normal group, model group were perfused with saline , western medicine group and Chinese medicine group were treated with oxiracetam solution and Xiaoyao decoction , four groups of intragastric volume was 0.5 ml/100 g, 1 time a day, continuous 28 d. After intragastric administration of isolated rat brain immediately , packet marking in 4℃4%glutaraldehyde solution of glass container , stored at 4℃.Repair piece, cut from the hippocampus, embedded in paraffin, sliced.Dilution of PP-2A for 1∶200, GSK-3βdilution of 1∶150.Images were analyzed by using Image-pro Plus 5 image analysis system, data were conducted by SPSS11.5 statistical analysis software, the comparison between 4 groups by single factor analysis of variance , between the two two groups was compared by LSD-t test, the test level of α=0.05.Results:The expression of PP-2A positive cell number and the positive area , average optical density, integral optical density index , in Xiaoyao Powder orally intervention compared with the model group increased significantly (P<0.01);GSK-3βabove indices were significantly decreased than that in model group after Xiaoyao Powder after intragastric ad -ministration (P<0.01).Conclusion:Xiaoyao Powder can up regulate the expression of PP-2A and down regulate expression of GSK-3β, may be condensed A-β1-42 peptide induced hyperphosphorylation of Tau has certain inhibition .
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Objective To investigate the sedative effects and the adverse reactions in the elderly patients received different speed of dexmedetomidine (Dex) intravenous infusion. Methods Eighty elderly cases were randomly divided into four groups. Group D0 was the control group, while the group D1, D2 and D3 were the trial groups. The heart rates, blood pressure, SpO2, Ramsay sedation score and Narcotrend value were recorded. Results The sedation onset time of the D2, D3 group was faster than those in the D0 and D1 groups (P 0.05). Conclusion Intravenous infusion of Dex by doses of 0.75 ~ 1.0 μg/(kg·h) during hip surgery in the elderly patients under spinal anesthesia could lead to a safe and effective sedation.
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Objective To investigate the application efficacy objective structured clinical exam-ination (OSCE) in assessment of interns of traditional Chinese medicine in anesthesiology department. Methods Totally 62 interns were examed by OSCE formulated by anesthesiology department before de-partmental rotation. Contents of the exam included preoperative evaluation,endotracheal intubation tech-nique,deep venipuncture,lumbar puncture,case analysis,medical documents writing,etc. Assessment was made by exam results and questionnaire survey. Quantitative data were analyzed by ANOVA and results of questionnaire were analyzed by calculating percentage of each option and describing directly. Results Test results showed that the score of medical document writing was the highest(18.25 ± 1.53),while that of case analysis was the lowest(13.49±1.46)and there was no significant difference in scores of three clinical skills. Questionnaire survey showed the OSCE method is superior to traditional method since it is more scientific,objective and fair. Conclusions OSCE method can scientifically as-sess the clinical practice effect of interns of traditional Chinese medicine in anesthesiology department. Meanwhile, it can find the shortcomings in the teaching, which is helpful in promoting the assessment and improvement of clinical teaching.
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To meet the cultivation objectives of postgraduate of anesthesiology from TCM colleges, the anesthesiology department carried out reform and exploration on cultivation program.This method has trained professionals of anesthesiology with the features of integrated traditional and western medicine knowledge.
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Objective: To evaluate the effects of isoflurane-nitrous oxide on hemodynamics in patients undergoing cardiac valve replacement. Method:Hemodynamics values were measured with Swan-Ganz technique. Thirty-nine patients were divided into two groups according to their cardiac function before surgery. The patients with cardiac function Ⅱ degree were belong to group Ⅰ and those with cardiac function Ⅲ-Ⅳ degree to group Ⅱ. Result:CI,LVWI, RVWI,HR and MAP decreased significantly in both groups after induction of anesthesia without change in SI. During tracheal intubation and sternotomy,CI and LVWI decreased,PTRI and SVRI increased,particularly in group Ⅱ. During aorta and vena cava intubation the changes of hemodynamics were relatively complicated with CI and SI improved in group Ⅱ and further decreased in group Ⅰ. After CPB,MPAP,PAWP,PTRI and SVRI were decreasad in different degree in both groups with significant increased in CI and SI in group Ⅱ. Conclusion:Induction and maintenance anes thesia with 1.0%-1.5% isoflurane and 40%-50% N_2O are suitable in patients with impaired cardiac function.
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Objective:To observe the hemodynamic effects of sevoflurane or sevoflurane-N_2O inhalation during induction and maintenance of anesthesia in patients undergoing cardiac valve replacement Method:Forty-four patients were randomly divided into two groups. Group I with 1.0 MAC sevoflurane and groupⅡwith 1.2 MAC sevoflurane-N_2O inhalation. Hemodynamic monitoring was performed with Swan-Ganz catheter technique. Result:The incidence of breath holding, coughing and movement could he hardly observed during the induction. There were no significant changes in HR,PTRI,PVRI and SVRI during the induction,but MAP,CI,LVWI,LVSWI,RVWI and RVSWI decreased significantly (P
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Objective: To observe the changes of the pulmonary ventilatory function during cardiac valve operation under cardiopulmonary bypass(CPB). Method: Thirty-four patients undergoing cardiac valve operation were selected. The pulmonary function was measured with side stream spirometer. Result: P_(peak) and P_(plat) did not have any significant changes within 60 min after CPB, but increased significantly at the end of surgery and after closure of sternum(P
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The effects of normothermic or hypothermic cardiopulmonary bypass(CPB)on hemodynamics, plasma levels of endothelin(ET)and atrial natriuetic peptide(ANP)were comparatively studied in dogs with Swan-Ganz catheter technique and radioimmunoassay. The results showed the total peripheral resistance(TPR)during hypothermic CPB was significantly higher than that of the normothermic. Plasm ET levels increased significantly during hypothermic CPB but remained stable during normothermic CPB. Plasma ANP levels almost unchanged during either CPB. Plasma ET level was positively correlated to TPR but ANT level was not. The results suggest that the increased ET levels may be one of the causes of higher TPR during hypothermic CPB;the stable ET levels contributes to the maintenance of cardiovascular function during and after normothermic CPB and the ANP amount secreted beyond the heart has little effect on the plasma level and hemodynamics during CPB.
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Objective To study the effects of sitting position on pulmonary hemodynamics and intrapulmonary shunt (Qs/Qt) during neurosurgery. Methods Twenty eight patients scheduled for posterior fossa and posterior cervical spinal surgery, were anesthetized with sevoflurane fentanyl pancuronium or enflurane fentanyl pancuronium after intravenous induction. Pulmonary hemodynamics were monitored with Swan Ganz catheter technique and Qs/Qt was calculated from the data of arterial and mixture venous blood gas analysis, including the following parameters: CI, RAP, MPAP, PCWP, PVRI, pHa, PaCO 2, PaO 2, PaO 2/FiO 2 and Qs/Qt. The detection time points were as the follow: before anesthesia induction, before sitting position, immediately ,60 min and 120min after sitting position, and at the supine position after termination of surgery.Results After induction of anesthesia and during operation at sitting position, CI decreased significantly (P0.05).Conclusions During neurosurgical procedure under general anesthesia and sitting position, pulmonary vascular auto regulation can be preserved and pulmonary oxygenation can be kept in normal.
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The hemodynamics of 49 scheduled patients during anesthesia and opration for mitral and aortic valve replacement were studied with the insertion of SwanGanz catheter and by the method of thermodilution technics.Pre-anesthesia CI and LVWI were in the nor mal range with abnormal MPAP, PCWP, PTRI and RVWI.Increase of RAP and decrease in MPA,PCWP, MAP, CI, LVWI and RVWI were observed during induction of anesthesia. The hemodynamic parameters returned to or exceded the pre-anesthesia values after trachcal intubation and sternotomy. The CI, MAP, MPAP, PCWP, LVWI and RVWI decreased signifi- cantly after insertion of aorta and vena cava catheter. The reduction of MPAP, P(IWP,PTRI and RVWI post-cardiopulmonary bypass (CPB) were significant and persistent with no change of PVRI.The lower MAP,SVRI and deterioration of cardiac performance post-CPB indicate that the administeration of positive inotropir agents and restoration of hematocrit are nec essary as early as possible.
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Objective To investigate the effect of aprotinin on the inflammation response to reinfusion of shed blood during operation after being aspirated, filtered and washed using cell saver.Methods Twenty-four ASA I - II patients undergoing elective spinal surgery under general anesthesia were randomly divided into 2 groups: aprotinin group ( n = 12) and control group ( n = 12) .The patients were premedicated with intramuscular pentobarbital 0.1 g and atropine 0.5 mg. Anesthesia was induced with propofol 2 mg ? kg -1 , fentanyl 2-4 ?g ? kg-1 and vecuronium 0.1-0.3 mg ? kg-1 and maintained with isoflurane, propofol infusion and intermittent i. v. boluses of fentanyl and vecuronium. The patients were mechanically ventilated after tracheal intubation. In aprotinin group aprotinin 10 ? 105 IU was given before skin incision and another dose of aprotinin 10 ? 105 IU was continuously infused during operation. The blood shed during operation was collected, anticoagulated with heparin, filtered, washed and reinfused using AutoLog cell saver. Blood samples were taken from CVP line before skin incision (T1 , baseline), 30 min after reinfusion of salvaged bloods (T2) and at the end of operation (T3 ) for WBC and neutrophil granulocyte counts and determination of expression of CD11b and CD18 on the surface of neutrophil granulocytes using flow cytometry. Results The two groups were similar with respect to the general condition of the patients, duration of operation and account of shed blood reinfused. (676? 353) ml was reinfused in control group. The expression of CD11b and CD18 on the surface of neutrophil granulocytes increased significantly at T2 and T3 as compared to the baseline at T1 in control group ( P
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Objective To establish a method for the determination of baicalin in Huangqin Eye Drops by HPLC. Methods A HPLC was performed on Shim- pack VP- ODS column(4.6 mm? 250 mm), a mixture of methanol- 0.2 % phosphoric acid (44 ∶ 55)was used as the mobile phase and the detection wavelength was 276nm. The flow rate was 1.0 mL/min with injection volume of 20 ? L and the column temperature was 35 ℃ .Results The linearity of baicalin was good in the range of 0.08～ 0.80 ? g (r=0.9997), and the average recovery was 100.10 % , with RSD 0.81 % . Conclusion This method was simple, sensitive and accurate , and can be used for quality control of Huangqin Eye Drops.
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The result regarding the application of McAbs against PwMJ-SAg in the detection of the circulating antigens(CAg) in sera from the patients (early stage and nonpulmonary type) with paragonimiasis westermani was reported in this paper. CAg in the sera from 35 patients in the early stage and 15 nonpulmonary type of patients was 100% positive by using McAb IB1 and JB4 out of 8 McAbs against PwMJ-SAg. Furthermore, these two McAbs didnot react crossly with the sera from 25 normal subjects, 15 patients with clonorchiasis, 15 patients with fasciolopsiasis, 15 patients with schistosomiasis japonica, 16 patients with Brugian filariasis or 10 patients with pulmonary tuberculosis. However, they crossly reacted with 8 samples of sera from 15 patients (53.3%) with pagumogonimiasis skrjabini. The McAb IB1 and IB4, threfore, are appropriate as the reagents to diagnose paragonimiasis westermani (early stage or nonpulmonary type). Moreover, they are also valuable, to a certain degree, to diagnose pagumogonimiasis skrjabini.The projet was supported by NNSFC Department of parasitology .Anhni Medical University, Hefei
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In this study, antibody-dependent murine neutrophil-mediated cytotoxicity (ADCC)against schistosomula of Schistosoma japonicum (Chinese strain) were demonstrated in vitro by use of immune effector mechanism analysis system. The results showed that neutrophils from the normal mice could mediate the antibody-dependent ADCC reaction against the schistosomula of Schistosoma japonicum, This ADCC reaction was not dependent on the complements, the complements could not enhance the ADCC reaction mediated by the neutrophils.
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In this study the ability of the monoclonal anti-idiotypic antibody NP30 was tested as a substitute of diagnostic antigen in detecting antibody of Schistosoma japonicum from human sera by use of ELISA. The results showed that the seropositive rate was 98% with NP30 in the group of acute infection, which was comparable to 94% with gut associated antigens (GAA)and 98% with the soluble egg antigens (SEA); 87% with NP30 in the group of chronic infection which was comparable to 86% with GAA but lower than that of 98% with SEA. The false positive rate was about 3% for all three diagnostic antigens. The results also showed that the geometric mean titer (GMT) of antibody to NP30 was higher than that to GAA but lower than that to SEA in the acute infection group and the GMT of antibody to NP30 was lower than both those to GAA and to SEA in the chronic infection group,suggesting that the antibody to NP30 appeared earlier and decayed more quickly during the process of infection. The authors suggested that NP30 could be used for the diagnosis of schistosomiasis japonica.
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Eight murine monoclonal antibodies against surface determinants of Schistosoma japoni-cum (Chinese mainland strain) schistosomula were generated,of which only one monoclonal IgM antibody (N15D9) gave protection at level ranging from 14 to 39% in experiments of passive transfer or inhibition of infectivity while the others did not exhibit significant levels of passive protection.Further characterization of N15D9 antigen specificity showed that 96 and 14 kDa antigen molecules in cercaria,and 132 and 10 kDa in schistosomula could be recognized by N15D9 in Western blot assay.Furthermore,the 96 and 132 kDa molecules could also be recognized by pooled infected human sera while 14 kDa and 10 kDa only by sera from mice vaccinated with 3-hour schistosomula.The molecules recognizable by N15D9 were surface epitopes repeatedly expressed on cercaria,in vitro 3-hour mechanically transformed schistosomula and 5 day lung-stage schistosomula,as demonstrated by indirect immuno-fluorecence surface binding assay.
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Naive and chronically infected C57BL/6 mice were challenged percutaneously over the ear pinna with Schistosoma japonicum cercariae. After 15 hours, the number of EOS increased significantly in the skin of chronically infected mice. Inflammatory cells aggre-gated in the vicinity of schisto.somula or entrapped intact and disintegrated schistosomula, forming granulocytic micro-abscesses in both groups. Ultrastructure studies revealed that flattened EOS tightly attached to the schistosomulum surface and degranulated. Local tegument damage occurred in the area of attacbment. NEU adherence did not seem to be as intimate as EOS, and degranulation was not seen. The tegument of the attached schis-tosoniulum remained normal. The result suggested that EOS appeared to be the efficient killer cell against skin phase schistosomula of S. japonicum (Figs. 1-6).