ABSTRACT
Objective To evaluate the treatment effects of epidural labor analgesia on syndecan-1 in patients with preeclampsia.Methods During Jan.,2016 and Dec.,2017,150 unipara females with preeclampsia and gestational age＞37 weeks were enrolled in the prospective cohort study.They were devided into intervention and control group (n =75 in each group) with and without epidural labor analgesia,based on whether epidural labor analgesia applications were made by the patients at the first examination of cervical dilation of 2 cm.The primary outcomes were mean change and change rate of syndecan-1 from baseline to 2 h post-treatment,and the secondary outcomes were visual analogue scale (VAS),IL-6 level and mean arterial pressure (MAP).Results Absolute change of syndecan-1 from baseline to 2 h post-baseline was (-11.49 ± 82.80) ng/mL in the intervention group and (45.09 ± 55.14) ng/mL in the control group,respectively.There was a significant difference in mean change of syndecan-1 between the two groups (P＜0.001).Similarly,the intervention group exhibited a greater reduction in change rate of syndecan-1 compared with the control group (P＜0.001).Moreover,the intervention group had greater reduction in VAS and MAP compared with the control group (P＜0.001 for both).There was no significant difference in IL-6 level between the two groups.Conclusions Epidural labor analgesia was associated with greater reduction in syndecan-1,VAS and MAP compared with the control condition.In contrast,administration of epidural analgesia did not significantly change IL-6 level.
ABSTRACT
Objective: To observe the changes of mu-opioid receptors (MOR) expression in acute inflamed knee joint synovium tissue of dogs, so as to discuss the feasibility of using peripheral local opioid for analgesia in acute inflammation. Methods: Knee joint synovium tissues were taken from 9 dogs with acute arthritis and 8 dogs with normal knee joints. The expression of MOR protein and mRNA was examined by immunohistochemistry and real-time quantitative PCR. Results: The expression of MOR mRNA in the acute inflamed group was significantly higher than that in the normal control group ([34.40±5.48] % vs [16.54±8.03] %, P<0.05). Immunohistochemical result showed more positive staining of MOR particles and stronger signal in the acute arthritis group than in normal control group. The immunohistochemical index of MOR positive cells in the acute arthritis was significantly higher than that in normal control group ([323 175.00±92 614.94] vs [175 444.10±75 149.06], P< 0.05). Conclusion: MOR exists in the knee joint synovium tissue of dogs, and acute inflammation can enhance the expression of MOR.
ABSTRACT
Objective:To summarize our experience on perioperative anesthesia management of patients with crush syndrome caused by earthquake under field condition.Methods:The clinical anesthesia data of 10 patients with crush syndrome caused by China Wenchuan earthquake,who were treated under field condition,were retrospectively analyzed,and our experience on perioperative anesthesia management was summarized.Results:After volume therapy,urine alkalization,and stabilization of internal environment,the 10 patients underwent dehridement,decompression by fasciotomy or amputation under epidural anesthesia or brachial plexus block plus psychological therapy and moderate tranquillizer.During the operation,the patients showed smooth respiratory and cardiovascular characteristics without pain.Conclusion:Under field condition,regional anesthesia can provide adequate analgesic effect during and after the surgery.Early fluid resuscitation and life support are vital to the safety and life of patients.
ABSTRACT
Objective:To summarize our experience in perioperative anesthetic management for fulminant hepatic failure (FHF)patients receiving liver transplantation.Methods:The clinical anesthetic data of 48 FHF patients receiving orthotopic liver transplantations(OLT)from January 2006 to January 2007 were retrospectively analyzed,and the anesthetic management expe- rience was summarized.General anesthesia was applied;the hemodynamics was monitored during the operation and doses of adrenaline and phenylephrine were adjusted according to the monitoring results.Blood samples were obtained before operation, before anheptic,30 min after anhepatic phase,5 min before neohepatic phase,and 5 min,30 min and 60 min after neohepatic phase for blood gas and electrolyte analysis and for determination of coagulation function;the drugs were subsequently adjusted according to analysis results.Results:All the 48 patient underwent successful anesthetic management and there was no death dur- ing opearation.The average blood loss during operation was(5 219?478)ml.Mild alkalosis,hypokalemia,hyponatrium,and hy- pocalcemia were present before operations,pH,BE and HCO_3~- were obviously reduced 30 min after anhepatic phase and in- creased 60 min after neohepatic phase.Kalemia was obviously increased 30 min following anhepatic phase and began to increase 60 min following neohepatic phase.Calium concentration was decreased at the end of preanhepatic phase(P