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Objective:To evaluate the effect of donor dexmedetomidine preconditioning on the renal function of patients undergoing living-related kidney transplantation.Methods:Sixty American Society of Anesthesiologists physical status Ⅲ-Ⅳ patients, regardless of gender, aged 20-64 yr, with body mass of 18.5-28.0 kg/m 2, undergoing living-related kidney transplantation, were selected.Sixty corresponding donors, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, regardless of gender, aged 20-64 yr, with body mass index of 18.5-28.0 kg/m 2, were selected.The patients and donors were divided into 2 groups using a random number table method: control group (group C) and dexmedetomidine group (group D), with 30 pairs in each group.Before induction of anesthesia, dexmedetomidine was intravenously infused over 10 min in a loading dose of 1 μg/kg followed by an intravenous infusion of 0.5 μg·kg -1·h -1 until the time point when the renal artery was blocked immediately in the donors of group D, while the equal volume of normal saline was given instead until the time point when the renal artery was blocked immediately in the donors of group C. In both groups, total intravenous anesthesia was applied in donors and recipients, Nacotrend values were maintained at 40-60 during operation, mean arterial pressure and heart rate were maintained within the normal range, and dopamine was intravenously infused when necessary.The warm ischemia time and cold ischemia time of donor kidneys were recorded in the two groups.Peripheral venous blood samples were collected from the donors immediately before renal artery occlusion and from the recipients before renal artery opening (T 0) and at 1, 12 and 24 h after renal artery opening (T 1-3) to determine the serum creatinine (Cr), urea nitrogen (BUN) and cysteine protease inhibitor C (CysC) concentrations.The intraoperative volume of fluid infused, urine volume and consumption of propofol, remifentanil and dopamine were recorded in the receptors of two groups. Results:There was no significant difference in the concentrations of Cr, BUN and CysC and warm ischemia time and cold ischemia time of kidneys in between the two groups of donors ( P>0.05). There was no significant difference in the consumption of propofol, remifentanil and dopamine, volume of fluid infused and urine volume during surgery between the two groups of recipients ( P>0.05). Compared with group C, the concentrations of Cr, BUN and CysC were significantly decreased in at T 1 in group D ( P<0.05). Conclusion:Donor dexmedetomidine preconditioning is helpful in improving the perioperative renal function of patients undergoing living-related kidney transplantation.
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Objective Transesophageal Doppler monitoring ( TDM) has been widely applied to fluid therapy in some major op-erations but rarely used in aortic valve replacement.The purpose of this study was to assess the value of TDM in fluid therapy, vasoactive drugs use, and left ventricular function in patients undergoing aorta valve replacement after cardiopulmonary bypass. Methods This study included 40 patients undergoing aotic valve replacement after cardiopulmonary bypass in Anhui Provincial Hospital from March 2014 to June 2015, which were randomly assigned to a TDM and a control group of equal number.TDM was used for the guidance of fluid infu-sion and vasoactive drug administration for the patients in the former group, while central venous pressure, mean arterial pressure, and heart rate were employed for those in the latter.The fluid volume infused, urine volume, blood loss, hemodynamics, arterial blood lac-tate, and outcomes were compared between the two groups. Results Compared with the control, the TDM group showed significantly increases in the colloidal fluid volume ([303 ±60] vs [373 ±65]mL, P<0.05), crystal fluid volume ([533 ±87] vs [596 ±83]mL, P<0.05), and urine volume ([274 ±95] vs [338 ±84]mL, P<0.05), but remarkable decreases in the red blood cell count, blood plasma vol-ume, postoperative extubation time, doses of dopamine and dobu-tamine, and length of hospital stay (all P<0.05).The hemodynamics were more stable and arterial blood lactate was lower in the TDM group than in the control (P<0.05). Conclusio n Transesophageal Doppler monitoring can timely and exactly manifest the hemodynamic changes and left ventricular function of the patient undergoing aotic valve replacement and provide precise guidance for fluid therapy and vasoactive drug administration.
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Objective To investigate the efficiency and safety of agkistrodon hemocoagulase on coagulation function in pa?tients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB). Methods In this prospective,randomized controlled trial,80 eligible patients accepted valve replacement were assigned to control group (n=20) and agkistrodon hemoco?agulase groups (H1, H2, H3) according to the different timing of administration. Twenty patients were given treatment 20 minutes before anesthesia induction (H1 group), 20 patients were given treatment 20 minutes after CBP (H2 group) and 20 patients were given treatment after CBP (H3 group). Coagulation parameters including prothrombin time (PT), activated partial thromboplas?tin time (APTT), thrombin time (TT), fibrinogen (Fib) and platelet (PLT) were detected 20 minutes before surgery (T0), immedi?ately after surgery (T1) and 24 hours after surgery(T2). Data of 24-h postoperative drainage of mediastinal and pericardial, dura?tion of mechanical ventilation, stay time of intensive care unit (ICU), the actual days of hospitalization and hospital costs were recorded. The clinical parameters were also recorded including blood transfusion after surgery, secondary thoracotomy, aller?gies, liver and kidney dysfunction, deep vein thrombosis and neuropsychiatric symptoms. Results Compared with control group, values of PT, APTT and TT at T1 and T2 were significantly lower in H1, H2 and H3 groups (P<0.05). Compared with T0, values of PT, APTT and TT at T1 and T2 were significantly higher in all groups of patients (P<0.05). Values of PT and TT at T1 and T2 were significantly decreased in H3 group than those of H1 group (P<0.05). The pericardial and mediastinal drainage, the duration of ventilation support within 24-h after surgery were significantly lower in H1, H2 and H3 groups than those of control group (P<0.05). There was no significant difference in the incidence of adverse events between groups. Conclusion Agkis?trodon hemocoagulase is safe and effective in patients undergoing cardiac valve replacement with cardiopulmonary bypass.
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This article was aimed to explore theeffect of Pi-Zhen(PZ) on 5-hydroxytryptamine(5-HT) in nerve end-ings tension painrabbitmodel. Forty-two healthy male big ear whiterabbits of three months old were randomly divided into 5 groups, which were the normal group,model group, drug group, Hao-Zhen (HZ) group, and PZ group. Nerve endings tension pain modelswere established. No operation was made in the normal group. The amount of 1 ml saline was injected to the operative sitebetween the shallow and deep fascia in each rabbit and then draw out at 5, 10, 20, 30, 40, 50, 60 min after operation. The 5-HT level in extracting solution of different groups was determined with ELISA method. The results showed that PZ interventioncan reducethe 5-HT level ofextracting solution in operative site; and with the increasing of time, the level of 5-HT was gradually reduced. Compared with the model group, the contents of 5-HT in the treatment group were significantly decreased at different time points(P<0.01). The content of 5-HT in the PZ group was significantly higher than that of the normal group at 5 min (P<0.01). Compared with the drug group, the contents of 5-HT in the HZ group and PZ group were significantly increased at 5, 10, 20, 30, 40 min (P<0.01). Compared with the normal group, the contents of 5-HT in the PZ group was significantly decreased at 40, 50, 60 min (P<0.05). Compared with the HZ group, the contents of 5-HT were significantly decreased at 20, 30, 40, 50, 60 min (P<0.01). There was no difference at other time points. It was concluded that PZ can ease pain through reducing the tension of local soft tissues, decreasing 5-HT releasing, and promoting its degradation.
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OBJECTIVE To investigate the conditions and associated risk factors of nosocomial infections caused by Stenotrophomonas maltophilia.METHODS Thirty isolates of S.maltophilia causing nosocomial infections were collected and identified with API 20NE test strips.Minimal inhibitory concentration(MIC) of 14 antimicrobial agents against 30 isolates was determined by broth microdilution method.Case-control study and multivariate Logistic regression analysis were used for statistics to verify risk factors of infections caused by S.maltophilia.RESULTS Thirty isolates of S.maltophilia were highly resistant to imipenem,meropenem,cefotaxime, aztreonam and amikacin,but showed certain susceptibility to cefoperazone/sulbactam,piperacillin/tazobactam,trimethoprim-sulfamethoxazole and ticarcillin/clavulanic acid(96.7%,76.7%,73.3% and 60.0%,respectively).The independent risk factors leading to infections of S.maltophilia were mechanical ventilation(OR=7.629) and over 60 days of length of stay(OR=4.466).CONCLUSIONS S.maltophilia shows multiresistance to commonly used antimicrobial agents.The mechanical ventilation and over 60 days of length of stay are the independant risk factors for nosocomial infections caused by S.maltophilia.
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To investigate the changes of cell apoptosis genes in pulmonary tissue of tail suspended rats during simulated weightlessness, 40 Spragno Dawley male rats were divided into 4 groups: suspended for 7d,control of 7d, suspended for 21d, and control of 21d.Tail suspension(-30?) was used as weightlessness simulation.The condition of bcl 2/bax in pulmonary tissues was detected by in situ hybridization. The results showed that the level of bcl 2 mRNA in pulmonary tissue of 7d tail suspended rats decreased significantly( P 0 05). The results also showed that the level of bax mRNA in pulmonary tissue of 7d tail suspended rats increased significantly( P 0 05).It can be concluded that there are certain changes of cell apoptosis genes in pulmonary tissue of 7d tail suspended rats during simulated weightlessness.
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To investigate the changes of vascular endothelial growth factor mRNA (VEGFmRNA) in pulmonary tissues of tail suspended rats during simulated weightlessness,the experiments were conducted on 40 Spragno Dawley male rats,divided into 4 groups:suspended for 7d,control of 7d and suspended for 21d,control of 21d.Tail suspension(-30?) was used as weightlessness simulation.The condition of VEGFmRNA in pulmonary tissues was examined by hybridization in situ. The results showed that the level of VEGFmRNA in pulmonary tissues of 7d tail suspended rats increased significantly( P
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10 years. Pulmonary functions were determined routinely and followed for 10 years. Results Comparison between the values of pulmonary functions at the beginning and end of a 10- year follow-up showed very significant difference in the groups of Ⅲ, Ⅳ and Ⅴ. Among the parameters examined, FEV_1, PEF, MMEF, and MVV showed significant increase in these 3 groups (P
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To investigate the changes of inducible nitric oxide synthase mRNA (iNOSmRNA) in pulmonary tissues of tail suspended rats during simulated weightlessness, experiments on 40 Spragno Dawley male rats were conducted. The rats were divided into 4 groups:suspended for 7d, and its control, suspended for 21d, and its control tail suspension(-30 ) was used as weightlessness simulation.The condition of iNOSmRNA in pulmonary tissues was examined by hybridization in situ.The results showed that the level of iNOSmRNA in pulmonary tissues of 7d tail suspended rats increased significantly( P
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To study changes of lung function for 10 years in the elder patients with chronic obstructive pulmonary diseases (COPD) who have quitted smoking for more than 10 years, 45 elder patients with COPD who had quitted smoking for more than 10 years were selected, and 11 elder patients with COPD who had never smoked were enrolled too. Routine lung function tests were performed. Initial values of VC, FVC, FEV 1 , PEF, MMEF, and MVV were compared with those 10 years later, and it was found the difference was significant ( P