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As the end-stage of prostate cancer, metastatic castration-resistant prostate cancer(mCRPC) complicates the disease and therefore challenges the doctors. In October 2018, an 87-year-old patient diagnosed with metastatic prostate cancer was admitted to Shanghai General Hospital for evaluation and treatment. Poor basic health condition plus severe side effect resulted in patient’s poor compliance with treatment and irregular follow-up. The patient progressed to mCRPC in September 2020, and was given enzalutamide as first-line therapy, after which the patient’s PSA level was under control with no side effect.
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Objective:To explore the risk factors of acute kidney injury (AKI) after robot-assisted radical prostatectomy.Methods:The clinical data of 605 patients who underwent robot-assisted radical prostatectomy in Nanjing Drum Tower Hospital from June 2017 to June 2019 were retrospectively analyzed. The independent risk factors of AKI were analyzed by Logistic regression.Results:Univariate analysis showed that age ( P = 0.001), anemia ( P = 0.036), hypoalbuminemia ( P = 0.001), coronary heart disease ( P = 0.040), hypertension ( P = 0.042), use of ACEI/ARB drugs ( P = 0.025), duration of MAP < 55 mmHg (1 mmHg = 0.133 kPa)( P = 0.000) presented statistical significance( P < 0.05). Multivariate Logistic regression analysis showed that there were significant difference in age ( P = 0.016), hypoalbuminemia ( P = 0.009), duration of MAP < 55 mmHg ( P = 0.003). Conclusions:Age, anemia, hypoalbuminemia, coronary artery disease, hypertension, use of ACEI/ARB drugs, duration of MAP < 55 mmHg are risk factors of postoperative AKI, among which age, hypoalbuminemia, duration of MAP < 55 mmHg are independent risk factors.
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Objective@#To evaluate the feasibility and safety of maintaining general anesthesia without neuromuscular blockade in oral double-balloon enteroscopy.@*Methods@#Totally 120 patients undergoing oral double-balloon enteroscopy under general anesthesia were randomly assigned into two groups: the observation group and the control group. The observation group was not given muscle relaxants for anesthesia maintenance, while the control group was given muscle relaxants punctually. Observation indexes were monitored, including the mean arterial pressure (MAP), heart rate (HR), peak airway pressure (Ppeak) and end-tidal CO2 partial pressure (PETCO2) before anesthesia (T0), immediately after intubation (T1), at the time of endoscopy placement (T2), at the end of endoscopy withdrawal (T3), and at the time of waking-up (T4). The cases of spontaneous breathing recovery before the end of endoscopy, postoperative recovery time, extubation time, length of PACU stay, postoperative adverse reactions and satisfactory rates were recorded.@*Results@#Twelve cases were removed by the exclusion criteria, and the remaining 108 cases completed the study, including 56 cases in the observation group and 52 cases in the control group. The one-time success rate of induction was both 100% in the two groups. There were no significant differences in MAP, HR, Ppeak, and PETCO2 between the two groups at each observation point (all P>0.05), and the same is true for within group comparison with T0 (all P>0.05). The recovery rate of spontaneous respiration in the observation group was significantly higher than that in the control group [100% (56/56) VS 42% (22/52), χ2=44.73, P=0.000]. The awaken time, extubation time and length of PACU stay were 6±2 min, 10±3 min, and 11±4 min, respectively, in the observation group, compared with 15±5 min (t=-12.64, P=0.000), 17±5 min (t=-8.90, P=0.000), and 17±7 min (t=-5.73, P=0.000) in the control group. None of the patients required assisted ventilation. Hypoxemia occurred in 2 cases and nausea in 3 cases in the control group, while only nausea occurred in 1 patient in the observation group. The overall incidence of adverse reactions was not statisticaly different between the two groups (P>0.05). Anesthesia satisfaction rate of two groups was 100%.@*Conclusion@#It is feasible and safe to perform oral double-balloon enteroscopy without muscle relaxants during maintaining under general anesthesia, with quick recovery of spontaneous breathing and awakening, early extubation and less cost.
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Objective To evaluate the feasibility and safety of maintaining general anesthesia without neuromuscular blockade in oral double-balloon enteroscopy. Methods Totally 120 patients undergoing oral double-balloon enteroscopy under general anesthesia were randomly assigned into two groups:the observation group and the control group. The observation group was not given muscle relaxants for anesthesia maintenance,while the control group was given muscle relaxants punctually. Observation indexes were monitored,including the mean arterial pressure (MAP),heart rate (HR),peak airway pressure (Ppeak)and end-tidal CO2 partial pressure (PETCO2 )before anesthesia (T0),immediately after intubation (T1),at the time of endoscopy placement (T2),at the end of endoscopy withdrawal (T3),and at the time of waking-up (T4). The cases of spontaneous breathing recovery before the end of endoscopy,postoperative recovery time,extubation time,length of PACU stay,postoperative adverse reactions and satisfactory rates were recorded. Results Twelve cases were removed by the exclusion criteria,and the remaining 108 cases completed the study,including 56 cases in the observation group and 52 cases in the control group. The one-time success rate of induction was both 100％ in the two groups. There were no significant differences in MAP,HR,Ppeak,and PETCO2 between the two groups at each observation point (all P>0. 05),and the same is true for within group comparison with T0 (all P>0. 05). The recovery rate of spontaneous respiration in the observation group was significantly higher than that in the control group [100％ (56/ 56)VS 42％(22/ 52),χ2 = 44. 73,P = 0. 000]. The awaken time,extubation time and length of PACU stay were 6±2 min,10±3 min,and 11± 4 min,respectively,in the observation group,compared with 15± 5 min (t= -12. 64,P= 0. 000),17±5 min (t = -8. 90,P = 0. 000),and 17±7 min (t = -5. 73,P = 0. 000)in the control group. None of the patients required assisted ventilation. Hypoxemia occurred in 2 cases and nausea in 3 cases in the control group,while only nausea occurred in 1 patient in the observation group. The overall incidence of adverse reactions was not statisticaly different between the two groups (P > 0. 05). Anesthesia satisfaction rate of two groups was 100％. Conclusion It is feasible and safe to perform oral double-balloon enteroscopy without muscle relaxants during maintaining under general anesthesia,with quick recovery of spontaneous breathing and awakening,early extubation and less cost.
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Objective To investigate the effects of angle and length of lightwand in patients with ankylosing spondylitis (AS) using three-dimensional reconstruction based on computed tomography.Methods The head and neck helical computed tomography data of 53 patients with AS(AS group)and 60 common patients without cervical spine deformity (control group) were retrospectively analyzed.Reconstructed images, obtained by three-dimensional computed tomography reconstruction technique, were printed out by the ratio of 1:1.The endotracheal tube was used to simulate tracheal intubation in patient's computed tomography images.The length of tracheal tube from midpoint of glottis to upper central incisor(L),bend angle of tracheal tube(α),distance between the upper central incisor and root of epiglottis (D1) and distance between the root of epiglottis and midpoint of glottis (D2) were recorded.Results The α and D1in AS group were significantly bigger than those in control group:(89.57 ± 15.22)°vs.(67.65 ± 13.32)°and(8.11 ± 0.69)cm vs.(7.39 ± 0.58)cm,and there were statistical differences(P<0.05).There were no statistical differences in L and D2between 2 group(P>0.05).The α, L, D1and D2in male AS patients were significantly bigger than those in female AS patients:(90.78 ± 14.51)° vs.(81.57 ± 15.01)°, (12.84 ± 0.88)cm vs.(11.56 ± 1.17)cm, (8.18 ± 0.59)cm vs.(7.69 ± 0.64)cm and(3.22 ± 0.38)cm vs.(2.30 ± 0.29)cm,and there were statistical differences(P<0.05).Conclusions Compared with that of common patients, the bent angle on lightwand with AS patients is increased,which also can be affected by patients'gender.
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Objective To investigate the effect of head extension angle to glottis exposure by using three-dimensional CT reconstruction sagittal plane images of upper airway.Methods There were 80 patients,aged 7-78 years old,who had been scanned by helical CT in the head and neck.Reconstructed images were obtained by AW4.4 workstation and the following parameter was measured:angle α(A0 group),the angle created by the upper central incisor and root of epiglottis(angular vertex) and midpoint of glottis.Reconstructed images were printed according to the actual size of human body in a ratio of 1∶ 1,then the images were cut off from the upper central incisor to root of epiglottis by a section of arcs.Increasing the degree of angle α by clockwise to hypothetically increase the angle of head extension.The glottis was exposed by using a paper-made laryngoscope(Macintosh) model,and the success rate of glottis exposure was recorded when the degree of angle α was respectively increased 10°(A10 group),20°(A20 group),and 30°(A30 group).Results Compared with A0 group,the success rate of glottis exposure increased significantly in A10 group,A20 group and A30 group.The success rate of glottis exposure in A20 group and A30 group was significantly higher than A10 group.Compared with A20 group,the success rate of glottis exposure obviously increased in A30 group.Conclusion Based on CT reconstruction images of upper airway,we can analog study the effect of head extension angle to glottis exposure.
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Objective To investigate the effects of angle and length of lightwand in three-dimensional reconstruction images of the upper airway based on computed tomography.Methods A total of 245 patients,aged 18-86 years,were scanned by helical computed tomography in the head and neck.Reconstructed images,obtained by Aw4.4 Workstation,were printed out by the ratio of 1 ∶ 1.The tracheal tube was used to investigate the anatomic structure of the upper airway.The length L and angle α of the tracheal tube were recorded.And two distances (D1,D2) and one angle (β) were recorded:D1,the distance between the upper central incisor and root of epiglottis;D2,the distance between the root of epiglottis and midpoint of glottis;angle β,the angle of line D1 and D2.Results The oα value in male patients was significant higher than that in female patients:(70.02 ± 15.49)° vs.(55.84 ± 14.70)°.The β value in male patients was significant higher than that in female patients:(129.74 ± 14.82)° vs.(120.40 ± 14.19)°.The L value in male patients was significant higher than that in female patients:(12.80 ± 0.85) cm vs.(11.50 ± 0.65) cm.The D1 and D2value in male patients were significant higher than those in female patients:(7.53 ± 0.66) cm vs.(6.76 ± 0.53) cm,(3.13 ± 0.52) cm vs.(2.45 ± 0.32) cm.There were significant differences (P ＜ 0.05).The 245 patients were classified to 2 groups by using the function of hierarchical cluster analysis in the statistical software.The α value in group 2 was significant higher than that in group 1:(75.45 ± 9.53)° vs.(48.17 ± 9.29)°.The 3 value in group 2 was significant higher than that in group 1:(136.27 ± 9.86)° vs.(112.31 ± 8.64)°.The age in group 2 was significant higher than that in group 1:(53.92 ± 19.64) years vs.(36.93 ± 17.21) years.Correlation analysis showed that in 245 patients,angle α was positively correlated to angle β and age (P ＜ 0.05),and angle β was positively correlated to age (P ＜ 0.05).Conclusions The bent length and angle on lightwand can be affected by both the patients' gender and ages.
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Objective To explore the effects of compound lidocaine cream applied to postoperative wound and nasal packing on postoperative sinus pain after endoscopic sinus surgery . Methods From April 2015 to June 2016, 100 cases of endoscopic sinus surgery were carried out in our hospital under general anesthesia .The patients were randomly divided into two groups , with 50 cases in each group .The group A was given compound lidocaine cream 4 g on the nasal surgery wound and medical inflation sponge for intranasal packing;the group B was given saline 4 g on the nasal surgery wound and medical inflation sponge for intranasal packing . The heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at the time of extubation (T0), 1 h after extubation (T1), 4 h after extubation (T2), 10 h after extubation (T3), and 12 h after extubation (T4), respectively.The visual analogue scale (VAS) of pain after extubation was recorded . Results The HR, SBP and DBP at T0, T1, T2 and T3 in the group A were significantly lower than those in the group B (P0.05), while the DBP was significantly lower in the group A than that in the group B (t=-2.562, P=0.012).The VAS scores were significantly lower in the group A than those in the group B at T 0, T1, T2 and T3 (P=0.000).No statistical difference was seen in VAS scores at T4 between the two groups (t=-1.199, P=0.233). Conclusions Application of compound lidocaine cream on nasal endoscopic wound and intranasal packing can effectively relieve the pain after endoscopic sinus surgery .The method has good analgesic effects and is worthy of popularization and application .
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Objective To study the efficacy of tourniquet to block the distal of radial styloid on success rate of radial artery catheterization.Methods One hundred and forty ASA Ⅰ-Ⅲ patients, aged 22-88 years,undergoing general anesthesia and requiring radial artery catheterization were in-cluded in this study and were randomly allocated into touch positioning group (group A)or tourni-quet-assisted group (group B).Radial artery catheterization was conducted after induction of general anesthesia in two groups.The invasive systolic blood pressure (ISBP ), invasive diastolic blood pressure(IDBP)and HR of patients were recorded in group B at 1 min before ischemia (T1 ),using pressure pulse blocking after 1 min (T2 ),2 min (T3 ),5 min (T4 )and the complete release of tour-niquet after 1 min (T5 ),5 min (T6 )and 10 min (T7 ).The first and total success rate of radial artery puncture,puncture times,puncture duration and complications were recorded.Results The radial ar-tery diameter was not statistically significant in group B between before and after blocking radial artery .ISBP at T2-T4 in group B was significantly higher than that at T1 (P <0.05).The first time puncture success rate and overall success rate in group B was significantly higher than that of group A,The number of puncture in group B was significantly less than that of group A,and puncture time was significantly shorter in group A (P <0.05).Conclusion Tourniquet-assisted radial artery cathe-terization could improve success rate,decrease puncture times and shorten puncture duration.
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Objective To observe the clinical effect of modified laryngeal mask airway combining fiberoptic bronchoscope intubation in difficult airways.Methods Forty patients,21 males and 1 9 females,aged 30-55 years,ASA physical status Ⅰ or Ⅱ,scheduled for elective general anes-thesia surgery after failure to direct laryngoscope two attempts were randomly divided into two groups,20 cases in each group.Patients in group LMA-FOB underwent intubation with modified la-ryngeal mask airway combining fiberoptic bronchoscope,and patients in group FOB underwent intu-bation with fiberoptic bronchoscope.The fiberoptic bronchoscope score,the intubation time and the rate of successful intubation at first attempt were recorded.All the patients were followed up postop-eratively for adverse effects.Results The fiberoptic bronchoscope scores (Ⅰ/Ⅱ/Ⅲ/Ⅳ:1 5/4/1/0 vs. 8/4/5/3,P <0.05)and the rate of once successful intubation (90% vs.60%,P <0.05)was signifi-cantly higher,and the intubation time [(75 ± 20)s vs.(105 ± 25 )s,P < 0.05 ]was significantly shorter in group LMA-FOB than that in group FOB.In group LMA-FOB,one patient had blood stain in the LMA and one patient felt slight sore throat.There were no significant adverse effects in the two groups.Conclusion Modified Laryngeal mask airway combining fiberoptic bronchoscope intubation in difficult airways was effective to improve the grade of the view of the larynn and the success rate of intubation and shorten the intubation time.No significant adverse effect postoperatively was reported. It is relatively safe,effective and promising in patients with difficult airway.
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Objective To evaluate the accuracy of non?invasive blood pressure monitoring in bilat?eral upper and lower extremities in lateral position in patients undergoing surgical procedures. Methods Forty patients of both sexes, aged 24-64 yr, BMI 20-27 kg∕m2 , of American Society of Anesthesiologists physical statusⅠ or Ⅱ, scheduled for elective neurosurgical procedures, were included in this study. Blood pressure of bilateral upper and lower extremities was monitored and recorded using appropriate cuffs. At 5 min after induction of anesthesia ( T0 ) , 10 min after the patients were turned to lateral position ( T1 ) , 30, 60 and 90 min after start of surgery ( T2-4 ) , and 10 min after the patients were turned to supine posi?tion ( T5 ) , non?invasive blood pressure was measured, and invasive blood pressure was recorded. Results Compared with the value measured on the healthy side, systolic blood pressure ( SBP ) and diastolic blood pressure (DBP) of upper extremities on the affected side were significantly decreased at T1-4, and SBP of lower extremities on the healthy side was significantly increased at T0-5 (P0.05) . There was no significant differ?ence between non?invasive SBP and invasive SBP of lower extremities on the healthy side, and between non?invasive DBP and invasive DBP of lower extremities on the healthy side (P>0.05). Conclusion For the patients undergoing surgical procedures, the blood pressure of upper extremities is higher on the healthy side than on the affected side when the patients are in lateral position, and there is no significant difference in the blood pressure between bilateral lower extremities; and there is no significant difference between non?invasive blood pressure and invasive blood pressure of lower extremities on the healthy side.
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Objective To analyze retrospectively the correlation between the difficult airway and thyromental height by three-dimensional reconstruction among the Chinese. Methods Eithty patients who had been scanned by helical CT in the head and neck were allocated into two groups according to Cormack-Lehane grading:paients with Ⅰ-Ⅱ grade were allocated into group 1, and paients with Ⅲgrade were allocated into group 2. Reconstructed images were obtained by AW4.4 workstation and the following parameters were recorded and analyzed:the length from the oral to the under jaw(a), the length from the under jaw to the skin of the neck (b), the vertical distance from the under jaw to the neck was equal to thyromental height(c), the vertical distance from the oral to the cervical vertebra(d), the angle with the under jaw as the vertices and with two lines (a and b) for edge (angle ofα). Results The c value in two groups had no significant difference:(3.97 ± 0.82) cm vs. (3.64 ± 0.62) cm, P>0.05. The d value in group 2 was significantly higher than that in group 1:(8.69 ± 0.48) cm vs. (8.25 ± 0.80) cm, P<0.05. The c/d value and c/a value in group 2 were significantly lower than those in group 1: 0.42 ± 0.07 vs. 0.48 ± 0.12, 0.80 ± 0.18 vs. 0.95 ± 0.25, P<0.05. Conclusions Thyromental height by three-dimensional reconstruction has no significant differences in evaluating the difficult airway among the Chinese. The ratio of the vertical distance from the under jaw to the neck and the vertical distance from the oral to the cervical vertebra, and the ratio of the vertical distance from the under jaw to the neck and the length from the oral to the under jaw shows negative correlation with difficult airway.
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Objective To explore the accuracy rate of classical anatomical landmark technique ( anterior , central , and posterior ap-proach) for internal jugular vein (IJV) by ultrasound technique.Methods Sixty-four patients with selective operation were included in this study.The anesthetist marked the anterior approach , central approach, and posterior approach for internal jugular vein at 0°(neu-ral), 30°,and 80°of head rotation, respectively.The accuracy of each anatomical landmark were examined by other anesthetist with ul -trasound technique .Results The accuracy rate of anterior approach and central approach were significantly higher than posterior ap -proach at 0°of head rotation, respectively.The accuracy rate of anterior approach was higher than posterior approach at 30°of head rota-tion.The accuracy rate was similar among anterior , central, and posterior approach at 80°of head rotation.Conclusion The accuracy rate was different in different approach of anatomical landmark for internal jugular vein .
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Objective To evaluate the effects of nail polish on measurement of pulse oxygen saturation (SpO2) by different brands of monitors in healthy volunteers.Methods Twenty healthy female volunteers were enrolled in the study.Nine fingers of each volunteer were chosen randomly,8 nails were painted 8 different colors (transparent color,red,yellow,green,blue,purple,black,white),respectively,and the left 1 nail served as blank control.SpO2 and pulse rate (PR) were measured using TuffSat Handheld Oximeter (GE) and MP70 (Philip) and PM-9800 (Mindray) monitors.SpO2 of the 9 nails monitored and the response time for SpO2 and PR were recorded.Results (1) Compared with blank control,when MP70 monitor was used,no significant change was found in each color-induced effect on the value of SpO2 obtained (P ＞ 0.05),and blue prolonged the response time for PR and SpO2 (P ＜ 0.05) ;When PM-9800 monitor was used,black could decrease the value of SpO2 measured (P ＜ 0.05),and no significant change was found in each color-induced effect on the response time for SpO2 and PR (P ＞ 0.05) ; when TuffSat Handheld Oximeter was used,green and blue could decrease the value of SpO2 monitored,and the value of SpO2 obtained was significantly lower when blue was used (P ＜ 0.05).Black,blue,purple and white could sequentially prolong the response time for PR (P ＜ 0.05),and no significant change was found in each color-induced effect on the response time for SpO2 (P ＞ 0.05).(2) For green and blue nail polish,the value of SpO2 measured with TuffSat Handheld Oximeter was significantly lower than that measured with MP70 and PM-9800 monitors(P ＜ 0.05) ; for red,yellow and green nail polish,the response time for PR obtained with TuffSat Handheld Oximeter was significantly shorter than that obtained with MP70 and PM-9800 monitors (P ＜0.05) ; for blank control group and 8 colors of nail polish,the response time for SpO2 measured with TuffSat Handheld Oximeter was significantly shorter than that measured with MP70 and PM-9800 monitors (P ＜ 0.05).For black nail polish,the value of SpO2 measured with PM-9800 monitors was significantly lower than that measured with MP70 and TuffSat Handheld Oximeter(P ＜ 0.05).Conclusion The ability for nail polish recognition and identification is different for each monitor and the color of nail polish can exert obvious effect on the value and response time for SpO2 obtained.The results of this study shows that blue nail polish-induced effect on the value of SpO2 obtained with TuffSat Handheld Oximeter is obvious,and MP70 monitor is the most stable instrument and TuffSat Handheld Oximeter is the most sensitive instrument in obtaining the value of SpO2.
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Objective To investigate the characteristics of sagittal anatomic structure of the upper airway in patients with ankylosing spondylitis using three-dimensional reconstruction based on computed tomography (CT).Methods Thirty-one male patients with ankylosing spondylitis,aged 20-60 yr (AS group),and 41 common patients (male) without difficult airways,aged 20-60 yr (control group),who underwent spiral CT scan of the head and neck using Helical CT from January 2007 to February 2011 in our hospital,were enrolled in the study.Reconstructed images of the upper airway were obtained using AW4.4 workstation and six distances (D1-D6) and four angles (α-δ) were recorded and analyzed:(1)D1,the arc distance between the upper central incisor and root of epiglottis; D2,the distance between the upper central incisor and root of epiglottis; D3 and D4,the lengths of maxilla and mandible ; D5,the distance between the root of epiglottis and midpoint of glottis; D6,the distance between the end of mandible and midpoint of glottis; (2) angle α,the angle of line D2 and D5; angle β,the angle of line D2 and the lower edge of the upper central incisor to the midpoint of glottis; angle γ,the angle of line D4 and D6; angle δ,the angle of the point of the lower edge of the upper central incisor to the trailing edge of the hard palate and then to the root of epiglottis.Results Compared with control group,no significant change was found in D1,D2,D3,D4 and D5 (P ＞ 0.05),and D6,angle α and angle δ were significantly increased,whereas angle β and angle γ were decreased in AS group (P ＜ 0.05).Conclusion The anatomic structure of the upper airway has the characteristics of specific changes and a laryngoscope blade with a large degree of curvature may be helpful for successful tracheal intubation in patients with ankylosing spondylitis.
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Objective To evaluate the effects of peritoneal jet ventilation on peritoneal oxygenation in pigs.Methods Twenty-four pigs of both sexes (12-16 weeks,35-45 kg) were randomly divided into 3 groups (n=8 each): sham operation group (group S) ; peritoneal regular frequency jet ventilation group (16 bpm)(group N) and peritoneal high-frequency jet ventilation group (150 bpm) (group H).Oral tracheal intubation was performed.The animals were mechanically ventilated (VT 8-12 ml/kg,RR 12-16 bpm,I:E 1.0:1.5,FiO2 100％) via airway.Endotracheal tubes were inserted into abdomen through the incisions in the left lower (for peritoneal jet ventilation) and right upper quadrant (for outlet of air).Arterial blood PaO2 and PaCO2 were measured before (baseline) and at 30,60,90,120,150,180,210 and 240 s of peritoneal jet ventilation.Peritoneal jet ventilation was started after the lungs being mechanically ventilated for 35 min.Peritoneal jet ventilation was terminated when SpO2 dropped to SpO2 ＜ 90 ％.The duration of safe apnea (DSA,from the moment of begging of peritoneal jet ventilation to the time when PaO2 ＜ 60 mm Hg).Results PaO2 was significandy higher and DSA longer in group H than in groups S and N.But there was no significant difference in PaCO2 among the 3 groups.Conclusion Peritoneal high-frequency jet ventilation can significantly enhance the efficiency of peritoneal oxygenation and prolong DSA,while peritoneal regular frequency jet ventilation has no effect on peritoneal oxygenation.
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Objective To investigate the relationship between noninvasive brachial artery blood pressure (B) and radial artery blood pressure (R) of the right arm.Methods Two hundred and ninetyfive patients with 149 males and age of (47 ± 16) years were studied.The height of patients was 163 ± 8 cm,and weight of patients was (61.2 ± 7.8) kg.The patients with peripheral vascular disease,wounds of arm skin or subcutaneous tissue infection were all excluded.Their B (with adult cuffs) and R (with infant cuffs) of the right arm were measured and analyzed after the patients under general anesthesia and stable hemodynamics.The relationships between B and R were analyzed by linear regression,the differences between B and R of each interval were compared using one-way ANOVA and then followed by SNK procedure.Results Right brachial artery blood pressure was significantly lower than radial artery blood pressure.The differences between the two varied from 13 to 18 mmHg in systolic BP (SBP),diastolic BP (DBP) and mean blood pressure (MAP).And linear regression was most applicable to describe their correlation [r=0.841 (SBP),0.808 (DBP),0.833 (MAP),all P＜0.01].Conclusions Radial artery blood pressure measured with infant cuffs can well reflect the variation of brachial artery blood pressure.
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Objective To observe the oxygenation and heartbeat duration effect of peritoneal ventilation with oxygen on a rabbit asphyxia model so as to provide a basis for treatment of severe respiratory damage with peritoneal oxygenation technique. Methods Twenty-four New Zealand rabbits were randomized into control group,air group and oxygen group,eight rabbits per group.Trachea dissection and intubation,carotid artery and vein catheter and placement of peritoneal cavity in and out of air duct were performed.An asphyxia model was built by clamping the tracheal catheter and was administered with peritoneal ventilation (with air in air group and oxygen in oxygen group).Indices including blood gas and mean arterial pressure (MAP) before and at an interval of one minute after asphyxia and heartbeat duration were observed,and their differences between groups were compared. Results The arterial partial pressure of oxygen ( PaO2 ) in the oxygen group was higher than that in the control group within four minutes after asphyxia.The partial pressure of carbon dioxide ( PaCO2 ) [ (77.6 ± 11.2) mm Hg] in the oxygen group was significantly lower than (89.1 ± 10.1 )mm Hg in the control group at four minutes after asphyxia.The heartbeat duration [ (6.48 ± 0.89 ) minutes ] in the oxygen group was longer than (5.03 ± 0.51 ) minutes in the control group.MAP had no obvious changes in the three groups. Conclusion The transperitoneal ventilation with gaseous oxygen can alleviate the decrease of PaO2,increase of PaCO2 and prolong the duration of heartbeat in an asphyxia rabbit model.
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ObjectiveTo assess the effects of fentanyl (F),alfentanil (A),sufentaril (S),butorphanol (B),dezocine (D) and pentazocine (P) on human sperm motility in vitro.MethodsTwenty samples of semen with normal sperm motility were collected.The semen was mixed with HTF liquid culture medium and sperm concentration was adjusted to (40-80) × 106/ml.Then semen suspension 50 μl was added into the culture dishes.The semen suspensions were randomly divided into 3 groups:group Ⅰ control-semen suspension 50 μl + 0.9％ NaCl 50 μl.GroupⅡ single opioid-semen suspension 50 μl + 50 μl of 4 concentrations of F,A,S,B,D and P (10-3,10-4,10-5,10-7 mol/L).Group Ⅲ combined opioid-naloxone-semen suspension 50 μl + 25 μl of 3concentrations of naloxone (2 × 10-8,1 × 10-7,2 × 10-7 mol/L) + 25 μl of 4 concentrations of F,A,S,B and D.After being incubated for 1 h the sperm motility was assessed by sperm analyzer and the amplitude of change in sperm motility was calculated.Median inhibition concentration (IC50) and complete inhibition concentration ( IC100 ) of the 6 opioids were calculated from concentration-response curve.Results( 1 ) The shape of concentration-response curve for F,A and S was straight line.The maximal decrease in sperm motility was (56 ± 5)％(F),(58±7)％ (A) and(79±:6)％ (S).(2) The shape of concentration-response curve for B,D and P was sigmoid.Low concentrations of B,D and P did not affect sperm motility.Median and high concentrations of B and D could inhibit sperm motility.The maximal inhibition was 100％.High concentration of P increased sperm motility.The maximal increase was (19 ± 6)％.(3) Naloxone shifted the concentration-response curve for F,A,S,B and D to the right,and decreased the maximal inhibitory effect of F,A and S dose-dependently but did not affect the maximal inhibitory effect of B and D.(4) IC50 was in the order of A≈ F ＞ D ＞ S≈- B.IC100 was D ＞ B.ConclusionF,A and S inhibit sperm motility by acting on opioid receptor on human sperms while B and D act through opioid or nonopioid pathways.P can increase sperm motility.
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Objective To investigate the relationship between hepatic potential capacity and the pharmcodynarnics of rocuroniurn.Methods The indocyanine green (ICG) excretion test waspertormed one day before operation in 71 patients with decompensated hepatic cirrhosis scheduled to receive devascularization combined with splenectomy.On the basis of ICG retention at 15 min(ICGR_(15)),the patients were divided into groups of I_1(22 cases,ICGR_(15)≤10),I_2(35 cases,10<ICGR_(15)≤20)and I_3(14 cases,ICGR_(15)>20).Another 20 healthy people(group C)were taken as thecontrols.Rocuronium 0.6 mg/kg was intravenously infused and 0.3 mg/kg rocuronium、was addedwhen T_1 value recovered to 25%control value.The twitch high of adductor pollicis muscle wasrecorded.The time of onset,T1 maximum depression,the clinical duration of initial dose,and thespontanous recovery index were recorded.The clinical duration of repeated maintenance doses and themean dosage of each group were recorded as well.Results The onset time,25% TOF responsePeriod and the recovery index after operation were significantly prolonged in groups of I_2 and I_3compared with those in groups of C and I_1(P<0.05 or P<0.01).No response period of grouP I_3was longer than that of other three groups(P<0.0 1).When the maintenance dose of rocuronium wasadded for more than four times,the clinical action time also showed to be prolonged in an older of I_3>I_2＞I_1 and mean dose reduced in an order of I_3<I_2<I_1.Conclusion ICGR_(15) is usefulin direcring theuse of rocuronium in the patients with decompensated hepatic cirrhosis.