ABSTRACT
Objective To compare the response of haemodynamics and intraocular pressure (IOP) to laryngeal mask airway (LMA) and tracheal intubation (TT) in children with glaucoma.Methods A prospective,randomized study was conducted in 50 glaucomatous children,scheduled to undergo trabeculectomy and divided into LMA group (25 cases) and TT group (25 cases) by random digits table method.Endotracheal intubation or placement of the laryngeal mask operation time and the dosage of midazolam was noted in each patient.Heart rate (HR),mean arterial pressure (MAP),tip perfusion index (TPI),IOP were measured after anesthesia induction (T1),endotracheal intubation or placement laryngeal mask immediately (T2),endotracheal intubation or placement after laryngeal mask 1 min (T3),2 min (T4),3 min(T5),5 min(T6).Results There was no significant difference in endotracheal intubation or placement of the laryngeal mask operation time and the dosage of midazolam between two groups (P ＞ 0.05).Compared with T1,HR,IOP were increased at T2-T4,MAP was increased at T2-T3,TPI was decreased at T2-T5 in TT group,there was significant difference(P ＜ 0.05).There was no significant difference in HR,MAP,TPI,IOP among different points in LMA group (P ＞ 0.05).HR,MAP,IOP in LMA group at T2-T4 were lower than those in TT group [HR:(119.3 ±8.9),(117.6 ±8.5),(115.2 ±6.9) beats/min vs.(131.3 ±7.1),(128.1 ±6.8),(123.2 ± 8.6)beats/min,MAP:(36.9 ± 5.1),(37.1 ±4.8),(34.7 ±4.6) mmHg (1 mmHg =0.133 kPa) vs.(44.1 ± 4.9),(42.8 ± 5.5),(41.9 ± 7.1) mmHg,IOP:(27.6 ± 2.5),(27.0 ± 2.0),(25.9 ± 2.3) mmHg vs.(34.2 ± 2.2),(32.9 ± 1.6),(31.1 ± 2.2) mmHg],TPI at T2-T5 was higher than that in TT group (3.25 ± 0.28,2.99 ± 0.26,3.15 ± 0.31,3.40 ± 0.30 vs.2.69 ± 0.29,2.22 ± 0.27,2.41 ± 0.30,2.66 ± 0.33),and there was significant difference (P ＜0.05).Conclusion Insertion of LMA in glaucomatous children is not associated with significant changes in haemodynamics and IOP response and offers advantages over tracheal intubation.
ABSTRACT
An old male patient visited the hospital due to shortness of breath and palpitation for 6 h, with fever 3 days before and pump failure at admission. Having no risk factor of coronary diseases such as hypertension, diabetes mellitus and obesity, with ST-T changes and abnormal Q wave on ECC, the signs were compatible with those of acute anterior wall myocardial infarction, while the characteristics of cardiac biomarkers ( significant increase in Troponin I and creatine kinase's isoform, and normal creatine kinase) were not in accordance with those of acute myocardial infarction. Emergency angiography was performed, which indicated normal coronary artery, normal pulmonary artery and global systolic dysfunction of left ventricle. The diagnosis of acute severe myocarditis was established, and intra-aortic balloon pump (IABP) was employed to provide hemodynamic support. Severe myocarditis mimicking acute myocardial infarction may be fatal, and can be easily misdiagnosed. Careful analysis of clinical manifestations, early diagnostic angiography and possible IABP placement are important for the successful treatment.
ABSTRACT
Objective To analyse the changes of nitric oxide and nitric oxide synthase in rat retina under acute high ocular pressure and study the effect of nitric oxide in rat retinal damage under hypertension. Methods Sixty Wistar rats were divided randomly into five groups:Ocular hypertension 30 min,60 min,90 min and 12 h,24 h after reperfusion.Elevation of the ocular pressure in the anterior chamber of the rat eye caused retina ischemic damage.The changes of retinal nitric oxide content were observed indirectly by measuring NO 2 -/NO 3 - content in retina.The distribution and changes of neuronal constitutive nitric oxide synthase (ncNOS)were studied by immunocytochemical localization of ncNOS. Results ncNOS positive neurons were distributed in the inner nuclear layer (INL),ganglion cell layer (GCL) and the inner plexiform layer of the normal and ischemic rat retina.During acute high IOP 30 min,60 min and 90 min,NO content decreased gradually and ncNOS immune activity weakens.During reperfusion,NO content increased remarkably (P