ABSTRACT
Thirty-six spontaneous intracranial hypotension patients with multiple-level leakages of cerebrospinal fluid were enrolled in the study.After 30 patients received targeted epidural blood intervention for 2 times and 6 patients received targeted epidural blood intervention for 3 times,the clinical symptoms were completely relieved.During injection of autologous blood,pain at the puncture site occurred in 24 cases,radiating pain in upper extremities in 5 cases,numbness in the upper extremity in 9 cases,radiating pain in lower extremities in 6 cases,numbness in lower extremities in 7 cases,headache in 4 cases,dizziness in 3 cases and transient bradycardia in 3 cases.Most of these symptoms were self-relieved after the end of injection or after slowing the injection rate,and some were self-relieved hours later.Neck stiffness was found in 2 cases and self-relived within a few hours or days after operation,and no severe nervous systemrelated complications were found.Recurrence happened in 2 cases at 3 months after the end of treatment,and the symptoms were self-relieved after receiving targeted epidural blood intervention for a second time.The patients were followed up for 15-36 months,and no serious nervous system-related complications were observed.Therefore,targeted epidural blood intervention is safe and effective when used to treat spontaneous intracranial hypotension caused by multiple-level leakages of cerebrospinal fluid in patients.
ABSTRACT
Objective:To observe the effect of dexmedetomidine used in ophthalmic surgery anesthesia on the recovery quality in children. Methods:Totally 126 children with ophthalmic surgery were randomly divided into the control group and the observation group with the same induction program. The control group was given propofol with target controlled infusion during the operation, while the observation group was given dexmedetomidine 0. 6μg·kg-1 before the induction, and infused up in 10min, propofol with target controlled infusion was used during the operation, and stopped infusion 10min before the end of the operation. The cough number and degree, the occurrence of agitation and extubation time of the two groups were observed and compared during the anesthesia recovery period. Results:The cough incidence and agitation incidence was 36. 51% and 4. 76% in the observation group, respectively, which were significantly lower than those in the control group (74. 60% and 33. 33%, P0. 05). Conclusion:Dexmedetomidine used in ophthalmic surgery anesthesia of children can effectively control cough frequency and degree during the recovery period and reduce the agitation to improve the quality of clinical anesthesia recovery.
ABSTRACT
Six patients(3 male,3 female)aged 33-66 yr, Course of disease 6-35 days, diagnosed with spontaneous intracranial hypotemion in Sir Run Run Shaw Hospital from November 2007 to May 2008,Were treated with on epidural autologus blood patch trader X-ray guidance. According to the results of CT myelography. the puncture site Was chosen in the 1-2 vertebral interspaees below the site of a single eerebrospinal fluid leak. For patients with multiple cerebrospinal fluid leaks.the procedure was performed at the spinal cord segment of the most severe leak. The mixture of augous blood and Omnipaque(300g/100 ml)at a ratio of 2:1 was injected into the epidural space to cover the spinal cord segment of the leaks under C-arm fluoroscopic guidance.Side effects were recorded during and after the injection of autologus blood.The treatment was repeated one week later if the former one failed.One patient was treated with epidural blood patch 3 times.and the rest 5 patients were treated with epidural blood patch 1 time.During the injeetion of autologus blood,5 patients complained of pain in the purtclure site,2 experienced pain radiating to the upper limb,2 felt,numbness in the right leg and all of these syndromes could be self-relieved.No side effects were observed after the injection of autologus blood.All the patients were Cured and no recurrence was observed during a 2-6 month follow-up.
ABSTRACT
Objective To observe the effects of pretreatment in rats with prostaglandin E1 on expression of kidney caspase-3, and TNF-α mRNA and iNOS mRNA after hemorrhagic shock and resuscitation(HSR). Method Totally 32 male S-D rots were randomly divided into four groups: group A (normal group, n=8), rats didn't receive any treatment; group B(sham, n=8), rats were pretreated with normal saline and underwent all experi-mentation procedures except bleeding; group C (HSR, n=8): rats were anesthetized with intraperitoneal sodium pentobarbital(30 mg/kg) and then subjected to hemorrhagic shock followed by resuscitation; group D (lipo-PGEl +HSR, n=8): rats were pretreated with lipo-PGEl one hour before HSR. The expressions of TNF-α mRNA and iNOS mRNA was measured by Northern blotting analysis and the expression of caspase-3 at 6 hours was determined by immunohistochemistry after HSR. Data were analyzed by ANOVA (SNK-q test), and P<0.05 was considered as significantly different. Results There were no differences in TNF-α mRNA and iNOS mRNA between normal group and sham group [(0.029±0.002) vs. (0.030±0.003),(0.029±0.002) vs. (0.030±0.003), P> 0.05]. HSR led to overexpression of caspase-3. The expression of kidney TNF-α mRNA and iNOS mRNA also increased in HSR group, compared with normal group [(0.651±0.028) vs. (0.030±0.003), (0.524±0.022) vs. (0.026±0.003), P<0.05] and sham group[(0.651±0.028) vs. (0.029±0.002), (0.524±0.022) vs. (0.025±0.003), P<0.05]. Pre-treatment with lipo-PGEl markedly reduced the expression of Caspase-3, which was consitent with decrease in expressions of TNF-α mRNA and iNOS mRNA 6 hours after HSR[(0.250± 0.019) vs. (0.651±0.028), (0.203±0.020) vs. (0.524±0.022), P<0.050]. Conclusions Lipo-PGEl could reduce the expressions of kidney Caspase-3 after HSR. The mechanisms might be attributed to inhibiting the expression of TNF-α mRNA and iNOS mRNA.
ABSTRACT
Objective To investigate modulatory effects of prostaglancdin E1 on the expressions of NF-?B and cytokines in serum, and to explore the protection mechanisms of PGE1 in ALI.Methods Forty-five male SD rats were randomly divided into three groups: group A(normal group,n=15), group B(LPS group,n=15) and group C(LPS +lipo-PGE1 group,n=15). The pathological changes and activity of NF-?B in the lung tissue, TNF-?, IL-10 and IL-12 concentration in serum at 1 hours,2 hours and 4 hours after intraperitoneal LPS were observed.Results Hyperemia and edema of lung tissue in the LPS +lipo-PGE1 group was obviously less than that in the LPS group. Activity of NF-?B and serum concentrations of TNF-? and IL-12 in the LPS +lipo-PGE1 treated group were more decreased than that in the LPS group, and serum IL-10 concentration was obviously increased in the LPS +lipo-PGE1 group. Conclusion PGE1 reduced LPS-induced ALI through doun-regulating NF-?B activity and inhibiting expression of harmful inflammatory cytokines.