Multivariable analysis of tooth loss in subjects with severe periodontitis over 4-year natural progression / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the characteristics of severe periodontitis with various number of tooth loss during 4-year natural progression, and to analyze the factors related to higher rate of tooth loss.@*METHODS@#A total of 217 patients aged 15 to 44 years with severe periodontitis were included, who participated in a 4-year natural progression research. Data obtained from questionnaire survey, clinical examination and radiographic measurement. Tooth loss during 4-year natural progression was evaluated. The baseline periodontal disease related and caries related factors were calculated, including number of teeth with bone loss > 50%, number of missing molars, number of teeth with widened periodontal ligament space (WPDL), number of teeth with periapical lesions and etc. Characteristics of populations with various number of tooth loss and the related factors that affected higher rate of tooth loss were analyzed.@*RESULTS@#In 4 years of natural progression, 103 teeth were lost, and annual tooth loss per person was 0.12±0.38. Nine patients lost 3 or more teeth. Thirty-four patients lost 1 or 2 teeth, and 174 patients were absent of tooth loss. Molars were mostly frequent to lose, and canines presented a minimum loss. The number of teeth with WPDL, with periapical lesions, with intrabony defects, with probing depth (PD)≥7 mm, with PD≥5 mm, with clinical attachment loss≥5 mm, with bone loss > 50% and with bone loss > 65% were positively correlated to number of tooth loss. Results from orderly multivariate Logistic regression showd that the number of teeth with bone loss > 50% OR=1.550), baseline number of molars lost (OR=1.774), number of teeth with WPDL (1 to 2: OR=1.415; ≥3: OR=13.105), number of teeth with periapical lesions (1 to 2: OR=4.393; ≥3: OR=9.526) and number of teeth with caries/residual roots (OR=3.028) were significant risk factors related to higher likelihood of tooth loss and multiple tooth loss.@*CONCLUSION@#In 4 years of natural progression, the number of teeth with bone loss > 50%, baseline number of missing molars, number of teeth with WPDL, baseline number of teeth with periapical lesions and number of teeth with caries/residual roots were significantly related to higher risk of tooth loss and multiple tooth loss among Chinese young and middle-aged patients with severe periodontitis in rural areas.

Age-related changes for the predictors of benign prostatic hyperplasia in Chinese men aged 40 years or older / 亚洲男科学杂志(英文版)

A cross-sectional study was conducted to estimate the age-stratified normal levels and age-related changes in the risk predictors of benign prostatic hyperplasia (BPH) progression. A total of 4706 male participants aged 40 years or older in Zhengzhou (China) were enrolled. The values of the International Prostate Symptom Score (IPSS), prostate-specific antigen (PSA), prostate volume (PV), and postvoid residual urine volume (PVR) significantly increased with age. Nonlinear relationships between age and IPSS scores ≥8 (P for nonlinearity = 0.046), PSA level ≥1.6 ng ml-1, PV ≥31 ml, or PVR ≥39 ml (all P for nonlinearity <0.001) were observed. After the age of 61 years, the risk indicators related to BPH progression were positively correlated with age (odds ratio [OR] >1), regardless of the predictors of the IPSS score, PSA level, PV, or PVR; and the OR values increased gradually. Therefore, after the age of 61 years, the risk predictors related to BPH progression were positively correlated with age.

Distribution and drug resistance profiles of pathogens causing bloodstream infection after chemotherapy in children with acute lymphoblastic leukemia / 中国当代儿科杂志

OBJECTIVES@#To study the changes in the distribution and drug resistance profiles of pathogens causing bloodstream infection after chemotherapy in children with acute lymphoblastic leukemia.@*METHODS@#The medical data were collected from the children with acute lymphoblastic leukemia who were admitted to the First Affiliated Hospital of Zhengzhou University between January 2015 and December 2020 and developed bloodstream infection after chemotherapy. The samples were divided into the first three years group and the next three years group according to the time of testing to investigate the differences in the distribution and drug resistance profiles of pathogens as time.@*RESULTS@#A total of 235 strains of pathogens were isolated, among which there were 159 Gram-negative strains (67.7%; mainly Escherichia coli and Klebsiella pneumoniae), 61 Gram-positive strains (26.0%; mainly Staphylococcus epidermidis), and 15 strains of fungi (6.4%; mainly Candida albicans). There were no significant differences between the first three years group and the next three years group in the detection rate of Gram-negative bacteria (68.8% vs 66.9%, P>0.05) or Gram-positive bacteria (29.2% vs 23.7%, P>0.05). Compared with the first three years group, the next three years group had significant increases in the detection rate of Streptococcus mitis (5.8% vs 0.0%, P<0.05) and fungi (9.4% vs 2.1%, P<0.05). There was no significant difference in the drug resistance rate of Gram-negative or Gram-positive bacteria between the two groups (P>0.05).@*CONCLUSIONS@#Enterobacteriaceae bacteria are the main pathogens of bloodstream infection after chemotherapy in children with acute lymphoblastic leukemia, while the detection rates of Streptococcus mitis and fungi tend to increase as time, which needs to be taken seriously in clinical practice.

Transauricular arterial access for hepatic artery embolization in rabbit VX2 liver tumor

Purpose: The purpose of this study is to evaluate the feasibility of percutaneous transauricular artery access for hepatic artery catheterization using a peripherally inserted central catheter (PICC) device and hepatic artery catheterization through auricular approach. Methods: Ten New Zealand White rabbits were used to establish a VX2 liver tumor model. Hepatic artery angiography and embolization were performed 3 weeks after inoculation. The rabbits were restrained in supine position under anesthesia. Intra-arterial access was accomplished with percutaneous Seldinger technique through the auricular artery using a PICC device. The hepatic artery catheterization was performed with a microcatheter and guide wire. The rate of technical success and procedure time was investigated. Results: Two rabbits failed initial percutaneous transauricular arterial access, with success in a contralateral attempt. Thus, percutaneous transauricular arterial access was achieved in 10 of 12 auricular arteries, with a technical success rate of 83.3%. The time needed to obtain intra-auricular access was 7.2 ± 3.1 min. Hepatic artery catheterization, angiography, and embolization were accomplished through the auricular approach in all 10 rabbits. Conclusion: Arterial access in rabbits can be achieved through the auricular artery. Hepatic artery catheterization, angiography, and embolization can be performed through auricular arterial access

Preparation and in vitro evaluation of folic acid-albumin nanoparticles co-loaded with paclitaxel and nanosilver / 中草药

Objective Paclitaxel and nanosilver were co-encapsulated into folic acid-albumin nanoparticles to increase the toxicity and uptake of the drug and improve the targeting ability of tumor that highly expressed folic acid (Fa) receptor. Methods The mean Fa binding number of bovine serum albumin (BSA) was determined by ultraviolet absorption method. The nanoparticles were prepared through self-assemble method and then its shape, partical size, Zeta potential, and encapsulation efficiency were characterized with the dynamic light scattering (DLS) and transmission electron microscope (TEM). In addition, the cellular uptake of nanoparticles and the in vitro anti-tumor effect of drug-loaded nanoparticles were investigated on the KB cells model of oral epithelial carcinoma. Results Ultraviolet absorption results showed that the average Fa binding number of Fa-BSA was 11. The nanoparticles were discrete and uniform spheres with the average size of (98.20 ± 3.58) nm and Zeta potential of (-39.90 ± 1.98) mV. Cellular uptake experiments showed that folate-modified albumin nanoparticles were more easily taken up by KB cells. Cytotoxicity and apoptosis assay indicated that the modification of folic acid and co-loaded nanosilver could increase the inhibition of tumor cell proliferation and promote KB cells apoptosis. Conclusion The prepared nanoparticles have small particle size and high encapsulation efficiency, which can enhance the ability of the nanoparticles to be uptaken and the toxicity of the drug-loaded nanoparticles against tumor cells.

Application of borneol and menthol in promoting nanopreparations across physiological barriers / 中草药

In this review, the ability of borneol and menthol as the common penetration enhancers in traditional Chinese medicines was summarized, and the effect of borneol and menthol on the ability of nanopreparations across the main physiological barriers of the human body promoting drug absorption or increasing the distribution of drugs was also reviewed, which aims to provide reference for promoting the treatment effect of nanopreparations through the combination of traditional Chinese medicine and modern preparation technology.

Application of nanotechnology in improving druggability of active ingredients of Chinese materia medica / 中草药

Nanotechnology has broad prospects and great potential in improving the druggability of active ingredients of Chinese materia medica (CMM). This article systematically summarized the methods and advantages of nanotechnology in improving oral absorption, changing the distribution in the body, increasing the targeting ability, and improving transdermal and mucous membrane absorption of active ingredients of CMM. In addition, we analyzed the problems in the development of improving the druggability of active ingredient of CMM by nanotechnology, put forward the strategies for solving these problems, and discussed the research prospects.

Percutaneous mechanical thrombectomy with subsequent iliac vein stent implantation accomplished by single-procedure for acute deep venous thrombosis of lower extremity: preliminary results in 12 cases / 介入放射学杂志

Objective To evaluate the feasibility,safety and effectiveness of percutaneous mechanical thrombectomy (PMT) and iliac vein stent implantation which are accomplished by single-procedure in treating acute deep venous thrombosis (DVT) of lower extremity.Methods During the period from December 2014 to January 2016,a total of 12 patients with acute DVT of lower extremity,including 3 males and 9 females with a mean age of (50.42±16.21) years old,were admitted to authors' hospital to receive treatment.Clinically,all patients presented with left leg swelling and pain.Central type of DVT was seen in 3 patients and mixed type of DVT was found in 9 patients.Preoperative placement of inferior vena cava filter was employed in all patients,which was retrieved after the treatment.PMT by using Angio Jet thrombus removal catheter,balloon angioplasty,and iliac vein stent implantation were successively carried out during the same procedure.When residual thrombus was identified on checkup angiography the catheter sheath would be reserved,and the thrombolytic therapy would be adopted.The patients were followed up at outpatient clinic at one,3,6 and 12 months after the treatment,and reexamination of color ultrasound and/or lower limb venography was used to assess the blood flow in the deep veins and in the stents.Results The combination of several therapies was accomplished in a single procedure,the technical success rate was 100％.The used time for the operation was 60-110 minutes,with a mean of (96.25±14.32) minutes.The used time for thrombus aspiration was 51-280 seconds,with a mean of (199.92±74.89) seconds.Thrombus clearance rate of grade Ⅲ was obtained in 10 patients,and thrombus clearance rate of grade Ⅱ was seen in 2 patients;the clinical symptoms were improved in all patients.Except some patients complained of different degrees of pain during the performance of balloon dilatation of left common iliac vein,no serious complications such as pulmonary embolism,severe hemorrhage,etc.occurred.The patients were followed up for (5.58±2.75) months;color ultrasound and/or lower limb venography performed in 11 patients showed that the blood flow in deep veins and iliac vein stents was unobstructed,and relapse of DVT was observed in one patient with cerebral astrocytoma.Conclusion For the treatment of DVT of lower extremity,PMT combined with iliac vein stent implantation that is accomplished by single-procedure is safe and feasible,its preliminary clinical results are satisfactory.

Effect of opioid receptors on acute stress-induced changes in recognition memory / 生理学报

Although ample evidence has shown that acute stress impairs memory, the influences of acute stress on different phases of memory, such as acquisition, consolidation and retrieval, are different. Experimental data from both human and animals support that endogenous opioid system plays a role in stress, as endogenous opioid release is increased and opioid receptors are activated during stress experience. On the other hand, endogenous opioid system mediates learning and memory. The aim of the present study was to investigate the effect of acute forced swimming stress on recognition memory of C57 mice and the role of opioid receptors in this process by using a three-day pattern of new object recognition task. The results showed that 15-min acute forced swimming damaged the retrieval of recognition memory, but had no effect on acquisition and consolidation of recognition memory. No significant change of object recognition memory was found in mice that were given naloxone, an opioid receptor antagonist, by intraperitoneal injection. But intraperitoneal injection of naloxone before forced swimming stress could inhibit the impairment of recognition memory retrieval caused by forced swimming stress. The results of real-time PCR showed that acute forced swimming decreased the μ opioid receptor mRNA levels in whole brain and hippocampus, while the injection of naloxone before stress could reverse this change. These results suggest that acute stress may impair recognition memory retrieval via opioid receptors.

Research of autophagy activity between rat bone marrow mesenchymal stem neural differentiation / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To study the autophagy activity between rat bone marrow stem cells (BMSCs) neural differentiation in order to explore the mechanism involve in this process.</p><p><b>METHODS</b>BMSCs were passed by 3 generation, then was induced with the revulsant 2% (DMSO) + 200 µmol/L (BHA), NSE expression was detected by immunocytochemical stain, the mRNA expression of autophagy associated genes L3B, Beclinl, Atg5, Atg7, Atg10 were detected by RT-PCR, the autophagy protein LC3B was examined by Western blot and flow cytometry analysis.</p><p><b>RESULTS</b>BMSCs were passed by 3 generation, the purity of BMSCs could reach more than 90%, the morphology of cells were like fibroblasts, after the revulsant 2% DMSO + 200 µmol/L BRA induced, cells were extended long neurites, like nerve cells, positive rate of NSE staining was (83±5) %, RT-PCR results showed that the expression of autophagy associated genes LC3B, Beclinl, Atg5, Atg7 Atg0 were rised after BMSCs neural differentiation, Western blot analysis showed that the LC3B-II protein expression was increased after neural differentiation and the MFI of L3B was highten by flow cytometry.</p><p><b>CONCLUSION</b>Autophagy is increased after rat BMSC neural differentiation.</p>

Accuracy of remifentanil target-controlled infusion system in children / 中华麻醉学杂志

Objective To evaluate the accuracy of remifentanil target-controlled infusion (TCI) system in children.Methods Thirty ASA Ⅰ patients (aged 3-12 years and weighing 10-40 kg) scheduled for elective ear-nose-throat or urological surgery were randomly divided into two groups (n =15 each):2 ng/ml remifentanil group (group Ⅰ) and 4 ng/ml remifentanil group (group Ⅱ).Anesthesia was induced with intravenous injection of propofol 2 mg/kg and TCI of remifentanil.Remifentanil was administered with a specific TCI system incorporating the pharmacokinetic parameters of Minto.The target plasma concentration of remifentanil was set at 2 or 4 ng/ml.Tracheal intubation was facilitated with vecuronium 0.1 mg/kg after the children lost consciousness.The children were mechanically ventilated.Anesthesia was maintained with TCI of remifentanil,intravenous infusion of propofol and intermittent intravenous injection of boluses of vecuronium.The target plasma concentration of remifentanil remained unchanged and bispectraI index value was maintained at 45-65 or auditory evoked potentials index value ＜ 30 through adjusting the infusion rate of propofol.Arterial blood samples were taken at 5,10,20,30,40,50 and 60 minutes after TCI of remifentanil was started for determination of blood remifentanil concentrations by high performance liquid chromatography.Median prediction performance error (MDPE),median absolute performance error (MDAPE) and wobble of remifentanil TCI system were calculated.Results The measured concentrations of remifentanil were significantly higher than the target plasma concentrations jn both groups (P ＜ 0.05).The MDPE,MDAPE and wobble were 20.0％,30.0％ and 25.0％ respectively in group Ⅰ,and 17.5％,17.5％ and 12.5％ respectively in group Ⅱ.The MDAPE and wobble were significantly decreased in group Ⅱ compared with group Ⅰ (P ＜ 0.05).Conclusion When remifentanil is administered using a specific TCI system incorporating the pharmacokinetic parameters of Minto in children of 3-12 years old,the accuracy is not high.

Different anesthesia in elderly patients with gastric cancer surgery influence blood concentrations of melatonin and its correlation with postoperative agitation / 安徽医科大学学报

To evaluate the different anesthesia in elderly patients with gastric cancer surgery influence blood con-centrations of melatonin and its correlation with postoperative agitation. The agitation scroes were evaluated and re-corded,and the blood samples were taken twice:before induction as well as just at the end of surgery,then making correlation analysis. The agitation scroes were significantly lower in group ET than in group T(P<0.01);the level of postoperative blood concentrations of melatonin was higher in group ET than that in group T(P<0.01);the agi-tation scroes and the level of postoperative blood concentrations of melatonin were negatively correlated ( r =-0.429,P<0.05).

Clinical investigate and epidemiological of rotavirus enteritis in children / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>Study on the infection rate,influence factors and clinical characteristic of rotavirus diarrhea in children.</p><p><b>METHODS</b>634 hospitalized diarrhea children was collected from 2006 June to 2010 October. The gold immunochromatographic double-antibody sandwiched assay was used to detect the antigen of Rotavirus directly. The age of onset, incidence, clinical features and multiple organ damage and other aspects were summarized and analyzed.</p><p><b>RESULTS</b>308 cases was detected positively in the 634 specimens, the positive rate was 48.6%. In 6 to 12 months old children 197 cases was detected positively, accounted for 66.3%. Rotavirus was detected all the year round and the positive rate was higher in the first quarter and the forth quarter and was 63.8% and 62. 6% respectively. 68.6% accompanied with myocardial damage, 41.2% with lower respiratory tract infection, 13.3% with liver damage, 14.9% with renal damage, 9.4% with convulsions in 4.9%, accompanied by the damage of blood system.</p><p><b>CONCLUSION</b>Rotavirus is the leading cause of pediatric diarrhea the main pathogens, 6-12 months infants with the highest infection rate, the first, the fourth quarter is higher. Rotavirus infection can cause multiple organ dysfunction.</p>

Treatment strategies and indications for interventional management of pseudoaneurysms / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Pseudoaneurysms (PAs) are common vascular abnormalities predominantly arising from a disruption in the integrity of the arterial wall. The potential complications of PAs are usually unpredictable and carry high rates of morbidity and mortality. This paper presents our experience with various treatment strategies for PAs.</p><p><b>METHODS</b>Fifty-four patients with 55 PAs were diagnosed by non-invasive imaging examination. The etiology of PAs included trauma (33/55), infection (5/55), iatrogenic (6/55), and idiopathic (11/55). Different procedures including ultrasound (US)-guided compression, endovascular treatment, and surgery were performed depending on the location of PAs, size of the sac and neck, and characteristics of the donor artery. The methods of endovascular treatment included embolization of parent artery, the PA sac, or implantation of a stent-graft. Follow-up was performed using US or CT and ranged from 1 day to 24 months (average 16.7 months).</p><p><b>RESULTS</b>In all 54 patients, 3 patients with superficial PAs were treated by US-guided compression, while 44 patients with 45 PAs located in the head and neck (n = 20), viscera (n = 10) or extremities (n = 15) were treated by endovascular treatment. Nine patients with PAs located in the head and neck (n = 2) or extremities (n = 7) were treated by surgery. Among them, one patient underwent endovascular treatment combined with surgery and 1 was treated by surgery after unsuccessful US-guided compression. In the 3 patients treated with US-guided compression, 2 were successfully treated while the remaining patient required additional surgery. Primary technical success of endovascular management was 97.7% (43/44) and the cure rate was 95.5% (42/44). In the surgery group, 4 patients recovered well, 1 patient was cured by endovascular treatment combined with surgery, 2 cases underwent amputation, 1 patient died of multi-organ failure and 1 patient was paralysed.</p><p><b>CONCLUSIONS</b>Minimally invasive interventional techniques are established treatment methods for PA with favorable success rates and minimal morbidity. The therapeutic options should be tailored to the location, size and rupture risk of PA, condition of the donor artery and existing comorbidity.</p>

Accuracy of remifentanil target-controlled infusion system in children / 中华麻醉学杂志

Objective To evaluate the accuracy of remifentanil target-controlled infusion (TCI) system in children.Methods Thirty ASA Ⅰ patients, aged 3-12 yr, weighing 10-40 kg, scheduled for elective ear-nosethroat or urological surgery, were randomly divided into 2 groups with 15 patients in each group:2 ng/ml remifentanil group (group Ⅰ) and 4 ng/ml remifentanil group (group Ⅱ). Anesthesia was induced with iv injection of propofol 2 mg/kg and TCI of remifentanil. Remifentanil was administered with a specific TCI system incorporating the pharmacokinetic parameters of Minto.The target plasma concentrations of remifentanil were set at 2 or 4 ng/ml. Tracheal intubation was facilitated with vecuronium 0.1 mg/kg after the children lost consciousness. The children were mechanically ventilated.Anesthesia was maintained with TCI of remifentanil, iv infusion of propofol and intermittent iv boluses of vecuronium. The target plasma concentration of remifentanil remained unchanged and bispectral index value was maintained at 45-65 or auditory evoked potentials index value ＜ 30 by adusting the infusion rate of propofol.Arterial blood samples were taken at 5, 10, 20, 30, 40, 50 and 60 min after TCI remifentanil was stared for determination of blood remifentanil concentrations by high performance liquid chromatography. Median prediction performance error (MDPE),median absolute performance error (MDAPE) and wobble of remifentanil TCI system were calculated. Results The measured concentrations of remifentanil were significantly higher than the target plasma concentrations in both groups (P＜0.05). The MDPE, MDAPE and wobble were 20.0% , 30.0% and 25.0% respectively in group Ⅰ , and 17.5%, 17.5% and 12.5% respectively in group Ⅱ . TheMDAPE and wobble were significantly decreased in group Ⅱ compared with group Ⅰ(P＜0.05).Conclusion When remifentanil is administered using a specific TCI system incorporating the pharmacokinetic parameters of Minto in children of 3-12 years old, the accuracy is not high.

Comparison of the effect between combined spinal epidural anesthesia and continous epidural anesthesia for elective cesarean section / 中国基层医药

Objective To investigate the feasibility and superiority of combined spinal epidural anesthesia incesarean section.Methods 100 lying-in women who experienced cesarean section were collected and divided into combined spinal epidural anesthesia group(CSEA,n=50)and continuous epidural anesthesia group(CEA,n=50).The change of heart rate(HR),blood pressure(BP)and saturation of peripheral oxygen(SpO2),HR and BP of lyingin womeu in pre-anesthesia,5min,15min post-anesthesia and the time of taking effect,time between beginning of anesthesia and laboar of newborn were observed.The side effects of surgical anesthesia and Apgar score of newborn were compared between the two groups.Results There were no difference in clinical data,change of HR,BP and spO2 between two groups.The anaesthetic time of taking effect and the time between beginning of anesthesia and labour of newborn in group CSEA were shorter than in group CEA(all P＜0.05).Conclusion The combined CSEA and CEA was safe and efficient in cesarean section,and CSEA had greater efficacy than CEA in cesarean section.

Relationship between intracranial excitatory aminoacid levels and postoperative cognitive dysfunction in elderly patients after general anesthesia / 中华麻醉学杂志

Objective To investigate the relationship between the changes in intracranial excitatory amino acid(EAA) levels and the incidence of postoperative cognitive dysfunction (POCD) in eldedy patients after general anesthesia. Methods Forty ASA Ⅰ-Ⅲ patients of both sexes aged 65-79 yr weighing 48-76 kg undergoing elective non-cardiac surgery under general anesthesia were studied.Anesthesia was induced with midazolam,fentanyl,etomidate and succinylcholine and maintained with continuous iv infusion of propofol,remifentanil,isoflurane inhalation and intermittent iv boluses of vecuronium.The right internal jugular vein was cannulated with a catheter which was advanced cephalad until jugular bulb.The jugular bulb venous blood samples were taken before (T0,baseline),at the end of (T1) and at 24,48 and 72h(T2-4) after operation for measurement of plasma concentrations of glutamate (Glu),aspartate (Asp) and glycine (Gly) by RP-HPLC.The cognitive function was evaluated by mini-mental state examination (MMSE) at T0 and T4.Results Eleven of the 40 patients developed POCD (28%).The plasma Gh,Asp and Gly concentrations were significantly increased after operation as compared with the baseline values in POCD patients and were significantly higher than in non-POCD patients.The plasma concentrations of Glu and Asp were negatively correlated with MMSE score(Glu:r=-0.86.P<0.01;Asp:r=-0.99,P<0.01).Conclusion Elderly patients may develop POCD after operation performed under general anesthesia through increase in intracranial EAA levels.

Anesthetic management for CO2 laser treatment of laryngeal papilloma under self-retaining laryngoscope in children / 中华麻醉学杂志

Twenty-eight children with laryngeal papilloma aged 10 months -3.5 yr weighing 8-15 kg received CO2 laser treatment under serf-retaining laryngoscope from May 2003 to May 2007. There were 17 patients without laryngeal obstruction, 7 patients with 1st degree laryngeal obstruction and 4 patients with 2rid or 3rd degree laryngeal obstruction. Different techniques of anesthesia were used for patients with different degrees of laryngeal obstruction. In patients without laryngeal obstruction anesthesia was induced with intramuscular ketamine 5 mg/kg. After the patients lost consciousness midazolam 0.1 mg/kg, ketamine 1-2 mg/kg or fentanyl 2 μg/kg was given iv. Tracheal intubation was facilitated with succinyl-cboline 1.5 mg/kg. In patients with 1st degree laryngeal obstruction, ketamine 5 mg/kg was given ira. The patients kept spontaneous breathing. Tracheal intubaiion was pedormed under topical anesthesia with 1% tetracaine. In patients with 2nd and 3rd degree laryngeal obstruction tracheal intubation was performed awake without any premedication under topical anesthesia with 1% tetracaine. The trachea was intubated with the tracheal tube 1 size smaller than the regular size. Anesthesia was maintained with propofol 3-5 mg·kg1·h-1 and intermittent iv boluses of ketamine 1-2 mg/kg and vecuronium 0.05-0. 1 mg/ kg. Dexamethasone 0.2-0.3 mg/kg was given iv at the end of operation. The patients were extubated when the patients regained consciousness and SpO2≥ 96% on air. In one patient with Ist degree laryngeal obstruction emergency tracheotomy was performed during induction of anesthesia. Anesthesia was otherwise smooth and recovery was uneventful.

Effects of cardiopuimonary bypass on plasma nitric oxide and asymmetric dimethyl arginine concentrations in patients with congenital heart disease complicated with pulmonary hypertension / 中华麻醉学杂志

Objective To investigate the effects of eardiopulmonary bypass(CPB)on plasma nitric oxide (NO)and asymmetric dimethyl arginine(ADMA)concentrations in patients with congenital heart disease complicated with pulmonary hypertension undergoing open heart surgery.Methods Eighteen ASA Ⅱ or Ⅲ patients aged 11-40 yr weighing 26-59 kg undergoing open heart surgery under CPB were divided into 3 groups according to pulmonary arterial systolic pressure(PASP)(n=6 each):group Ⅰ PASP<30 mm Hg;group Ⅱ PASP 30-50 mm Hg and group Ⅲ PASP>50 mm Hg.Arterial blood samples were taken before induction of anesthesia (To,baseline),at the start and termination of CPB(T1,2)and 3,6,24 h after CPB(T3-5)for determination of plasma NO and ADMA concentrations.Results The three groups were comparable with respect to M/F sex ratio,age,body weight and CPB time.The plasma ADMA concentrations were significantly increased while NO concentrations were significantly decreased at termination of CPB(T2)and 3 and 6 h after CPB(T3,4)as compared with the baseline at T0 in group Ⅱ and Ⅲ.The plasma ADMA concentration were significantly higher and No concentrations were significantly lower at all time points in groupⅡand Ⅲthan in group Ⅰ.Conclusion CPB can increase plasma ADMA concentration and decrease plasma NO concentration in patients with congenital heart disease complicated with pulmonary hypertension undergoing open heart surgery.

Antioxidant xanthones from Securidaca inappendiculata / 中国中药杂志

<p><b>OBJECTIVE</b>To study the antioxidant constituents from the roots of Securidaca inappendiculata.</p><p><b>METHOD</b>The bioassay-guided isolation of antioxidant constituents was carried out by the column chromatographic techniques. The combination of IR, MS, NMR and 2D-NMR spectroscopics methods was used to identify their structures.</p><p><b>RESULT</b>Two new xanthones, 1, 2, 5-trihydroxy-6, 8-dimethoxy-9H-xanthen-9-one(1), 1, 5-dihydroxy-2, 6, 8-trimethoxy-9H-xanthen-9-one (2), along with seven known ones, 3, 8-dihydroxy-1, 4-dimethoxy-9H-xanthen-9-one(3), 4, 6-dihydroxy-1, 5, 7-trimethoxy-9H-xanthen-9-one(4), 7-hydroxy-1, 2, 3, 8-tetramethoxy-9H-xanthen- 9-one(5), 1, 7-dihydroxy-9H-xanthen-9-one(6), 4-hydroxy-3, 7-dimethoxy-9H-xanthen-9-one(7), 1,7-dimethoxy-9H-xanthen-9-one(8) and aucuparin(9), were isolated from the roots of S. inappendiculata.</p><p><b>CONCLUSION</b>Compounds 1 and 2 were new xanthones, and compound 3 was isolated as a natural product for the first time, and compounds 4 and 6 were isolated for the first time from this genus. The antioxidant activities of all compounds were evaluated by ABTS, FRAP and DPPH assays respectively. Compound 9 showed significant activity by the ABTS and FRAP assays. Compound 1 showed significant activity with IC50 value of 0.31 mg x L(-1) in DPPH assay. Scavenging capacity of all compounds determined by all assays were well correlated between ABTS and FRAP assay (r = 0.9555).</p>