Observation on the anesthesia effect of general anesthesia assisted by auricular-plaster therapy in gynecological surgery / 中国针灸

<p><b>OBJECTIVE</b>To observe the impacts on anesthetic dosage and postoperative pain under general anesthesia assisted by auricular-plaster therapy.</p><p><b>METHODS</b>One hundred and twenty cases of gynecological laparoscopic surgery were randomized into three groups, 40 cases in each one. In auricular point group A, the magnetic beads were stick on the auricular points which were Shenmen (TF4), Lung (fei, CO14), Spleen (pi,CO13), Stomach (wei, CO4), Large Intestine (dachang, CO7), Adrenal (shenshangxian, TG2 (P)), Endocrine (neifenmi, CO18), Uterus and Pelvic Cavity(penqiang, TF5) etc. In auricular point group B, the magnetic beads were stick on the preauricular points and the corresponding retroauricular points of the ears. In a placebo group, the plasters of the same appearance were stick on the corresponding auricular points of the ears. The anesthetic method was same in three groups and the anesthesia effect were assessed and compared among the three groups.</p><p><b>RESULTS</b>In surgery, the dosage of sufentanil, the narcotic analgesic was (22.08 +/- 7.11) microg in auricular point group A and was (20.19 +/- 7.21) microg in auricular point group B, which were reduced as compared with (26.13 +/- 9.04) microg in the placebo group (both P < 0.05). The difference in the dosage of propofol, the anesthetic was not significant statistically among three groups (P > 0.05). On the 1st day after surgery, the score of pain visual analogue scale (VAS) was (1.77 +/- 1.65) in auricular point group A and was (1.80 +/- 1.96) in auricular point group B, which were reduced as compared with (2.62 +/- 1.46) in the placebo group (both P < 0.05). Before surgery, the serum beta-endorphin (beta-EP) was (198.8 +/- 124.1) pg/mL in auricular point group A and was (207.2 +/-102.7) pg/mL in auricular point group B, which were higher apparently as compared with (143.6 +/- 87.1) pg/mL in the placebo group (both P < 0.05). The differences in the above indices were not significant statistically between the two auricular point groups.</p><p><b>CONCLUSION</b>The auricular-plaster therapy reduces the dosage of anesthetic, alleviates postoperative pain and acts on tranquilization and analgesia. The effect is not intensified apparently in the treatment for the magnetic beads sticking on both preauricular points and the corresponding retroauricular points of the ears.</p>

Involvement of cAMP-PKA pathway in group Ⅱ metabotropic glutamate receptors-mediated regulation of respiratory rhythm from neonatal rat brainstem slice / 生理学报

The study aims to identify the role of cAMP-PKA pathway in the group Ⅱ metabotropic glutamate receptors (mGluRs)-mediated regulation of respiratory rhythm from the brainstem slice. Neonatal (aged 0-3 d) Sprague-Dawley rats of either sex were used. The brainstem slice containing the medial region of the nucleus retrofacialis (mNRF) and the hypoglossal nerve rootlets was prepared, and the surgical procedure was performed in the modified Kreb's solution (MKS) with continuous carbogen (95% O2 and 5% CO2) bubbling, and ended in 3 min. Respiratory rhythmical discharge activity (RRDA) of the hypoglossal nerve rootlets was recorded by suction electrode. Eighteen brainstem slice preparations were divided into 3 groups. In group 1, group Ⅱ mGluRs specific antagonist (2S)-α-ethylglutamic acid (EGLU) was added into the perfusion solution for 10 min. In group 2, after application of Forskolin for 10 min, washout with MKS, the slice was perfused with Rp-cyclic 3', 5'-hydrogen phosphorothioate adenosine triethylammonium salt (Rp-cAMPS) alone for another 10 min. In group 3, after application of Rp-cAMPS for 10 min, additional EGLU was added into the perfusion for another 10 min. The results showed EGLU shortened respiratory cycle (RC), but the changes of integral amplitude (IA) and inspiratory time (TI) were not statistically significant. Forskolin induced significant decreases in RC, and increased TI, IA. Rp-cAMPS could make the opposite effect compared with the changes of RRDA with Forskolin. The effect of EGLU on the RRDA was inhibited after blocking the cAMP-PKA pathway. Taken together, cAMP-PKA pathway may play an important role in the group Ⅱ mGluRs-mediated regulation of RRDA in the brainstem slice of neonatal rats.

Effect of sevoflurane versus propofol-remifentanil anesthesia on neuromuscular blockade by continuous cisatracurium infusion / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the effects of sevoflurane and propofol-remifentanil anesthesia on neuromuscular blockade produced by continuous cisatracurium infusion.</p><p><b>METHODS</b>Forty ASA I or II patients undergoing selective surgery were randomly divided into sevoflurane and propofol-remifentanil anesthesia groups (n=20). Neuromuscular blockade was monitored using train-of-four (TOF) stimulation by recording the contraction force of the adductor pollicis muscle with a muscle relaxation monitor. A bolus dose of cisatracurium of 0.15 mg/kg was administered to facilitate endotracheal intubation, followed by continuous infusion adjusted manually to maintain the first twitch (T1) < or = 5% of the control level. The following variables were recorded including the infusion rate, total amount of cisatracurium, spontaneous recovery index (RI), and the time interval from termination of infusion cisatracurium to recovery of TOF ratio (TOFR) to 0.9.</p><p><b>RESULTS</b>With the maintenance of a 95%-99% neuromuscular blockade, the infusion rate was significantly lower in sevoflurane group than in propofol-remifentanil group (P<0.05), and stabilized in both groups after 120 min. No significant differences were found in RI or the time to TOFR of 0.9 between the two groups (P>0.05).</p><p><b>CONCLUSION</b>During the maintenance of stable neuromuscular blockade by continuous cisatracurium infusion, both sevoflurane and propofol-remifentanil anesthesia can time-dependently enhance the effect of cisatracurium without producing significant differences in the recovery properties.</p>

Effect of doxapram on the respiratory rhythmical discharge activity in the brainstem slice of neonatal rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of doxapram on the respiratory rhythmical discharge activity (RRDA) in the brainstem slices of neonatal rats.</p><p><b>METHODS</b>Thirty neonatal SD rats (of either sex, 0-3 days old) were randomly divided into 6 equal groups (groups I-VI), and the brainstem slices which contained the medial region of the nucleus retrofacialis (mNRF) were prepared. All the slices were perfused with modified Kreb's solution (MKS), and in group I (control group), the slices were perfused with MKS only; in groups II to IV, the slices were perfused with doxapram in MKS continuously at the concentrations of 2, 5, and 10 micromol/L, respectively; in groups V and VI, the slices were perfused with 20 micromol/L propofol and 20 micromol/L propofol plus 5 micromol/L doxapram, respectively. The RRDA in the hypoglossal nerve was recorded by suction electrode. The discharge time course of the inspiratory (TI), expiratory (TE), respiratory cycle (RC) and integral amplitude of the inspiratory discharge (IA) were recorded at 1, 3, 5, 10, 15, and 30 min after the application of the drugs.</p><p><b>RESULTS</b>The hypoglossal nerve in groups I, II and VI showed no significant changes of RRDA in the entire course of the experiment (P>0.05). In groups III and IV, the TI, IA increased and TE decreased significantly 5 min after doxapram application (P<0.05), and the RC was shortened only at 10 min. In group V, the TI and IA decreased and the RC and TE increased significantly after the drug application (P<0.05).</p><p><b>CONCLUSION</b>Doxapram (>5 micromol/L ) can directly stimulate the RRDA and prevent propofol-induced inhibitory effects in the brainstem slice of neonatal rats, and the effects are mediated by its actions upon the inspiratory neurons in the mNRF.</p>

Group II metabotropic glutamate receptors is involved in the modulation of respiratory rhythmical discharge activity in neonatal rat medullary brain slices / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the role of group II metabotropic glutamate receptors in the modulation of basic respiratory rhythm.</p><p><b>METHODS</b>Neonatal (0-3 days) SD rats of either sex were used. The medulla oblongata brain slice containing the medial region of the nucleus retrofacialis (mNRF) and the hypoglossal nerve rootlets was prepared, and the surgical procedure was performed in the modified Kreb's solution (MKS) with continuous carbogen (95% O2 and 5% CO2) within 3 min. The brain slices were quickly transferred to a recording chamber and continuously perfused with oxygen-saturated MKS at a rate of 4-6 ml/min at 27-29 degrees celsius. Eighteen medulla oblongata slices were divided into 3 groups and treated for 10 min with group II metabotropic glutamate receptor-specific agonist 2R,4R-4-aminopyrrolidine-2,4-dicarboxylate (APDC) (at concentrations of 10, 20, 50 micromol/L), group II metabotropic glutamate receptor antagonist (2S)-alpha-ethylglutamic acid (EGLU) (300 micromol/L), or APDC (50 micromol/L)+EGLU (300 micromol/L) after a 10 min APDC (50 micromol/L) application. Respiratory rhythmical discharge activity (RRDA) of the rootlets of the hypoglossal nerve was recorded by suction electrodes.</p><p><b>RESULTS</b>APDC produced a dose-dependent inhibitory effect on the RRDA, prolonging the respiratory cycle and expiratory time and decreasing the integral amplitude and inspiratory time. EGLU induced a significant decrease in the respiratory cycle and expiratory time. The effect of APDC on the respiratory rhythm was partially reversed by the application of APDC+EGLU.</p><p><b>CONCLUSION</b>Group II metabotropic glutamate receptors are probably involved in the modulation of the RRDA in isolated neonatal rat brainstem slice.</p>

Adjuvant effect of transcutaneous electrical acupoint stimulation in propofol-fentanyl anesthesia in partial mastectomy / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the adjuvant effect of transcutaneous electrical acupoint stimulation (TEAS) in propofol-fentanyl anesthesia in partial mastectomy.</p><p><b>METHODS</b>Ninety patients undergoing partial mastectomy were randomly divided into 3 groups (n=30), namely group A with propofol-fentanyl anesthesia (PFVA), group B with PFVA and TEAS at Hegu-Laogong and Neiguan-WaiGuan acupoints, and group C with PFVA and TEAS at Hegu-Laogong, Neiguan-Waiguan, and bilateral Jianjing acupoints. The bispectral index (BIS), heart rate (HR), saturation of pulse oxygen (SpO2), blood pressure (BP), the reaction of patients to the incision and awakening quality were observed at different time points. Blood samples were obtained from the dorsal artery of the foot to determine the levels of adrenaline and beta-endorphin using the enzyme-linked immunosorbent assay before TEAS (entry into the OR in group A) and at 30 min after TEAS (30 min after entry into the OR in group A), 5 min after incision, end of the surgery and awakening.</p><p><b>RESULTS</b>Thirty minutes after TEAS (or 30 min after entry into the OR in group A), BIS, BP and HR were all decreased significantly in groups B and C (P<0.05) but remained stable in group A (P>0.05). The plasma propofol concentration of groups B and C were significantly lower than that in group A, and group B had the highest plasma propofol concentration (P<0.05). The total dose of propofol in groups B and C were decreased by 19% and 27% in comparison with that in group A, respectively. Compared with the basal value, the content of beta-endorphin in groups B and C increased obviously 30 min after TEAS, being the highest in group C (P<0.05); the adrenaline level in groups B and C remained stable after TEAS (P>0.05).</p><p><b>CONCLUSION</b>TEAS provides an adjuvant effect in propofol-fentanyl anesthesia and obviously enhances the analgesia effect.</p>

Effect of glial cell metabolism on respiratory rhythmical discharge activity in neonatal rat medulla oblongata slices / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the role of glial cell metabolism in the generation and regulation of central respiratory rhythm.</p><p><b>METHODS</b>The medulla oblongata slices (600-700 microm) containing the medial region of the nucleus retrofacialis (mNRF) with the hypoglossal nerve rootlets retained from 12 neonatal (0-3 days) Sprague-Dawley rats were prepared and perfused with modified Kreb's solution (MKS). Upon recording of respiratory rhythmical discharge activity (RRDA) of the rootlets of the hypoglossal nerve, the brain slices were treated with glial cell metabolism antagonist L-methionine sulfoximine (L-MSO, 50 micromol/L) for 20 min followed by application of glial cell metabolism agonist L-glutamine (L-GLN, 30 micromol/L) for 20 min, or with L-MSO for 20 min with additional L-GLN for 20 min. The changes in the RRDA of the rootlets of the hypoglossal nerve in response to the treatments were recorded.</p><p><b>RESULTS</b>L-MSO prolonged the respiratory cycle (RC) and expiratory time (TE), and reduced the integral amplitude (IA) and the inspiratory time (TI) in the brain slices. L-GLN induced a significant decrease in RC and TE, but IA and TI showed no obvious variations. The effect of L-MSO on the respiratory rhythm was reversed by the application of L-GLN.</p><p><b>CONCLUSION</b>Glial cell metabolism may play an important role in the modulation of RRDA in neonatal rat brainstem.</p>

Preliminary results of postoperative adjuvant treatment with tamoxifen in colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate estrogen receptor (ER) expression and the effects of anti-estrogen therapy on the prognosis of colorectal carcinoma.</p><p><b>METHODS</b>ER was measured in fresh colorectal cancer tissues by Dextran-coated charcoal (DCC) assay. The relationships between ER expression and clinicopathological parameters in colorectal cancer were analyzed. Tamoxifen was administrated postoperatively as adjuvant treatment.</p><p><b>RESULTS</b>The positive rate of ER in colorectal tumor tissues was 37.0%. The 5-year survival rates of tamoxifen group and control group were 66.7% and 72.5% respectively, and there was no significant difference between the two groups. The distant metastasis rate of Tamoxifen group was significantly lower than that of control group (3% versus 20%).</p><p><b>CONCLUSION</b>Some colorectal carcinomas are hormone-dependent tumors, and anti-estrogen therapy has no effect on them.</p>

Generation of transgenic mice expressing human lysozyme in mammary gland / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility of generating animal mammary gland bioreactors expressing human lysozyme (hLYZ).</p><p><b>METHODS</b>The recombinant vector p205C3-hLYZ, as a result of connecting the hLYZ cDNA with the mammry gland expression vector p205C3, was used to generate transfer genic mice by microinjection.</p><p><b>RESULTS</b>A total of 136 F0 mice were obtained, of which 7 (2 females and 5 males) and 4 (1 females and 3 males) were found to contain the transfer-gene by PCR and Southern blotting respectively. The results of Western blotting indicated that the expressed protein had the same molecular weight as that of normal hLYZ. From the F1 generation on, the mice mated only with their brothers or sisters and a colony of F7 transgenic mice was obtained. Among the offspring, the female transgenic mice maintained and expressed the transfer-gene stably with an expression level as high as 750 mg/L. The expressed protein had strong tissue specificity, and in addition to the mammary glands, some degree of ectropic expression in the spleens and intestines of the transgenic mice was confirmed by dot blotting assay.</p><p><b>CONCLUSION</b>These data indicate that the mice mammary gland bioreactors expressing hLYZ have been successfully generated.</p>