A proteomic study of peripheral blood mononuclear cells in patients undergoing cardiopulmonary bypass / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To explore the effect of cardiopulmonary bypass (CPB) on the profile of protein expression in peripheral blood mononuclear cells (PBMCs).</p><p><b>METHODS</b>Eleven patients undergoing cardiac surgery under cardiopulmonary bypass were enrolled in the study. Peripheral blood samples were collected before CPB (T0), 1 h after CPB (T1) and at the end of operation (T2), and PBMCs were obtained by gradient centrifugation. The profile of protein expression was analyzed using 2-D gel electrophoresis (2-DE) and mass spectrometry. The candidate proteins were further identified by Western blotting.</p><p><b>RESULT</b>Compared to protein profile at T0, 12 protein spots were identified to be up-regulated in PBMCs at T1 (P <0.05), among which S100A9 reached the peak level at T1 and decreased after operation,but not returned to its initial level.</p><p><b>CONCLUSION</b>Results indicate that 12 proteins are likely to be involved in CPB, however, their roles need to be elucidated.</p>

Intravenous injection rate and site of fentanyl affect the incidence and onset time of fentanyl-induced cough / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the effect of intravenous injection rate and site of fentanyl on the incidence and onset time of fentanyl-induced cough.</p><p><b>METHOD</b>Seventy-five ASA class I or II patients were randomized into 3 groups and received intravenous fentanyl administration at 4 microg/kg in different manners. In group A, fentanyl was injected within 2 s into the forearm veins; in group B, fentanyl was injected in 2 s through the dorsal foot veins or the great saphenous vein anterior to the ankle; in group C, fentanyl was injected in 15 s by the same route as in group A.</p><p><b>RESULTS</b>The incidence of cough was 44%, 52% and 8%, with cough onset time of 16.1-/+2.7 s, 21.9-/+3.7 s and 23.3-/+3.2 s in groups A, B and C, respectively. Compared with group A, group B had a delayed onset of cough (P<0.05), and group C had both a lowered incidence of cough (P<0.05) and delayed onset of cough (P<0.05).</p><p><b>CONCLUSIONS</b>The rate of fentanyl injection through the same peripheral venous access at the same dose may affect the incidence and onset time of cough. At the same dose and injection rate of fentanyl, forearm venous access of injection resulted in earlier onset of cough than lower limb venous access, but the incidence is similar.</p>

Low-dose ketamine combined with fentanyl for intravenous postoperative analgesia in elderly patients / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the clinical efficacy of and complications arising from low-dose ketamine combined with fentanyl for intravenous postoperative analgesia in comparison with the exclusive use of fentanyl in elderly patients.</p><p><b>METHODS</b>Eighty elderly patients were randomized into two equal groups following thoracoabdominal surgery, and received intravenous analgesia with the combination of 0.5 mg/ml ketamine, 5.0 microg/ml fentanyl and 50 microg/ml midazolam (KF group) and with 7.5 microg/ml fentanyl plus 50 microg/ml midazolam (FT group), respectively. The drugs used were diluted in 200 ml normal saline. For analgesic administration, a loading dose (2-4 ml) was given followed by a background infusion (2.5-3.5 ml), with patient-controlled bolus doses of 2.0-3.0 ml with lock-out time of 20 min via PCA pump (Automedical, Korea). The static pain score (VAS), sedation score, and incidences of nausea, vomiting, pruritus and hallucinations were recorded during the initial 48 h after the surgery.</p><p><b>RESULTS</b>The total analgesic dosage and PCA dosage in the two groups were similar (P>0.05). With similar VAS in the two groups (P>0.05), the sedative effect in KF group was much better than that in FT group (P<0.05) during the initial 48 h postoperatively. The incidences of nausea, vomiting and itching were lower in KF group than in FT group (P<0.05), and no illusion was reported in two groups during the initial 48 h.</p><p><b>CONCLUSION</b>For producing comparable postoperative analgesic effect, low-dose ketamine combined with fentanyl can markedly reduce fentanyl requirement in the elderly patients and lowers the incidences of nausea, vomiting and itching in comparison with the exclusive use of fentanyl.</p>