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Dexmedetomidine [DEX] induces a dose dependent sedation and has been widely used as an adjuvant sedative during regional anesthesia recently. We aimed to investigate the effective dose of intravenous single-dose DEX to induce consciousness inhibition in patients of different ages undergoing lower limb surgery with epidural anesthesia. Ninety-two patients were divided into three groups according to their ages. Patients aged 18-45 years, 46-64 years and 65-85 years in group Y, group M and group O, respectively. With the accomplishment of epidural anesthesia, a pre-calculated dose of DEX was infused for more than 10 minutes and the sedative state was assessed by Observer's Assessment of Alertness/Sedation [OAA/S] scale 30 minutes after the infusion. A modified Dixon's up-and-down method was applied to decided the dose of DEX for each sequential patient. The 50% effective dose [ED50] of DEX in the three groups were 0.40, 0.76 and 1.03 microg/kg, respectively. The 95% effective dose [ED95] in group O [0.54 microg/kg] was 45% of group Y [1.21microg/kg] and 64% of group M [0.84microg/kg]. Besides, the incidence of bradycardia was more frequent with the increase of age. The present study indicated that the appropriate single-dose of DEX to induce consciousness inhibition should reduce with the increase of age in patients undering lower limb surgery with epidural anesthesia, especially in patients over 64 years old. This result may protect the old patients from excessive sedation and dose-dependent adverse reactions
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OBJECTIVE:To construct surgery base drug management system,and to realize efficient and accurate drug man-agement in surgery room. METHODS:The functions of surgery base drug management system exploited by our hospital were intro-duced,and the effect of the system was evaluated in department of anesthesiology. RESULTS&CONCLUSIONS:The system pos-sesses the functions of surgery drug automated affiliated charge,standardized narcotics prescription autogeneration,discarded nar-cotics prescription auto-prescribing,and drug information summary statisticing and checking,etc. After the application of the sys-tem,nonstandard rate of prescription decreased from 12.7% of handwritten prescription to 0.1% of electronic prescription;the time of drug requisition and checking decreased from(8.5±1.6)min to 0 min and(7.6±1.0)min to(2.9±0.9)min(P<0.05 or P<0.01). The system standardizes medication behavior of physicians and improve their work efficiency,avoid the loophole of drug charge management,realize the consistency between the accounts and the real numbers of narcotics,improve the rate of quality pre-scriptions and narcotics management, and realize integration,automation,intellectualization and whole-course supervision of drug management in pharmacy and clinical departments.
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Objective To evaluate the effect of intrathecal ganglioside GM-1 on chronic central pain (CCP) following spinal cord injury in rats.Methods Thirty-two adult male Sprague-Dawley rats,weighing 220-250 g,in which intrathecal catheters were successfully implanted,were randomly divided into 4 groups (n =8 each) using a random number table:control group (group C); group CCP; normal saline group (group N) and ganglioside GM-1 group (group GM).CCP was induced according to modified Allen method in CCP,N and GM groups.In group GM,ganglioside GM-1 20 mg/kg was injected intrathecally once a day,for 5 consecutive days,starting from 14th day after CCP,while the equal volume of nomal saline 10 μl was injected intrathecally in group N.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 4,8,16,24 and 48 h after the end of administration.The rats were then sacrificedat at 7 d after the end of adminmistration and L1 segment of the spinal cord was removed for determination of the expression of NMDA receptor 1 (NR1) by immuno-histochemistry.Results Compared with group C,MWT and TWL were significantly decreased,and NR1 expression was up-regulated in CCP and N groups (P ＜ 0.01),and no significant changes were found in MWT,TWL and NR1 expression in group GM (P ＞ 0.05).Compared with group CCP,no significant changes were found in MWT,TWL and NR1 expression in group N (P ＞ 0.05),and MWT and TWL were significantly increased,and NR1 expression was down-regulated in group GM (P ＜ 0.05).Conclusion Ganglioside GM-1 can alleviate CCP following spinal cord injury in rats and inhibition of expression of NR1 in the spinal cord may be involved in the mechanism.
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Objective To evaluate the effects of ischemic postconditioning (IPO) on c-fos protein expression during renal ischemia-reperfusion (I/R) in rats.Methods Seventy-five adult male Sprague-Dawley rats,aged 8-12 weeks,weighing 200-250 g,were randomly allocated into 3 groups (n =25 each) using a random number table:sham operation group (group S),I/R group and IPO group.Renal I/R injury was induced by clamping the bilateral renal pedicles for 1 h followed by 24 h of reperfusion in I/R and IPO groups.Five animals were sacrificed at 1,3,6,12 and 24 h of reperfusion and the left kidneys were removed for microscopic examination and for determination of the expression of c-fos protein by immunohistochemistry.Results Compared with S group,the expression of c-fos protein was significantly up-regulated at each time point during reperfusion in I/R and IPO groups.Compared with I/R group,the expression of c-fos protein was significantly down-regulated at each time point during reperfusion in group IPO.The pathologic changes were significantly attenuated in group IPO as compared with group I/R.Conclusion The mechanism by which IPO attenuates renal I/R injury is related to down-regulation of c-fos protein expression in the renal tissues of rats.
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<p><b>OBJECTIVE</b>To discuss the value of bronchofiberscopy laryngeal mask airway coupled with foreign body forceps in the removal of children airway foreign bodies.</p><p><b>METHODS</b>Bronchofiberscopy laryngeal mask airway and its mating foreign body forceps were designed. Ninety-two children with airway foreign bodies were hospitalized from Jan. 2011 to Oct. 2013 underwent removal surgeries through bronchofiberscopy via laryngeal mask airway coupled with the mating foreign body forceps under fast induction general anesthesia. The fluctuation of the patients' blood pressure (BP), heart rate (HR), saturation of pulse oxygen (SpO2) and pressure of end-tidal carbon dioxide (PetCO2) were recorded. SPSS 13.0 software was used to analyze the data.</p><p><b>RESULTS</b>All the operations were successful, and the haemodynamics indexes of the patients were stable with good ventilation. No side effect and complications were found. Compared with the basic value before anesthesia, there was no statistically significant difference in pulse blood pressure PetCO2 between immediately after laryngeal mask, laryngeal mask after 3 minutes, bronchoscope into the glottis instantly, immediately after laryngeal mask. SpO2 increased after laryngeal mask (F = 3.04, P < 0.05).</p><p><b>CONCLUSION</b>Bronchofiberscopy laryngeal mask airway coupled with foreign body forceps applied in the removal surgery of children airway foreign body is safe, effective and with less complication.</p>
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Child , Humans , Anesthesia , Anesthesia, General , Bronchoscopes , Carbon Dioxide , Foreign Bodies , General Surgery , Laryngeal Masks , Oxygen , Surgical InstrumentsABSTRACT
Objective To prepare melanoma antigen n(MAGEn)protein vaccine and to investigate the immune responses and anti-tumor effects of MAGE-n protein vaccine accompanied by CpG-containing oligodeoxynucleotide(CpG-ODN)adjuvant.Methods The DH5? containing the MAGE-n prokaryotic expression plasmid pGEX-MAGE-n was induced and the protein was purified as protein vaccine.The CpG-ODN was synthesized as adjuvant and the C57BL/6 mice were inoculated.The cellular and humoral immune responses were detected by ELISPOT,cytotoxicity assay and enzyme linked immunosorbent assay(ELISA).The antitumor effects were detected through tumor volume and life span.Results The MAGE-n protein accompanied by CpG-ODN could induce strong MAGE-n-specific cellular and humoral immune responses.In the MAGE-n positive B16 tumor model of C57BL/6,the growth velocity of tumor was decreased and the life span was prolonged with the treatment of vaccine.Conclusion MAGE-n protein vaccine accompanied by CpG-ODN adjuvant can induce strong immune responses and anti-tumor effects against MAGE-n positive B16 tumor,which provides a new way for tumor therapy.
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Objective To investigate whether oral propofol has any inhibitory effects and dose-response relationship on the pain inducing tissue injury in mice. Methods The effect of propofol on pain was observed in formalin test and acetic acid writhing test in mice. Formalin was injected subcutaneously into the plantar surface of one hind paw. Spontaneous nocuous responses were immediately scored by counting the number of flinches of the injected hindpaw at every 5-minute interval during a 60-minute period. The number of writhing caused by intraperitoneal injection of 0.6% acetic acid was also observed in mice. Results Oral propofol in a dose of 100mg/kg did not significantly inhibit nocuous stimulation. With higher doses, propofol inhibited both the phases 1 and 2 of persistent spontaneous pain induced by subcutaneous formalin injection. Orally taken propofol also inhibited the number of writhing after intraperitoneal acetic acid injection in a dose dependent manner. Conclusion Oral propofol is effective in inhibiting pain induced by formalin and acetic acid.
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Objective To determine the effects of enflurane and isoflurane on the spontaneous neural discharge of central amygdaloid nucleus in rats Methods SD rats (30 60 d) of either sex were decapitated Brain was immediately removed and kept in 4℃ artificial cerebral spinal fluid(ACSF) which was balanced with 95% O 2 and 5% CO 2 gas mixture Braine tissue containing central amyfdaloid nucleus was cut into slices of 300 400?m thick which were immersed in ACSF Enflurane and isoflurane were administered by balancing ACSF with enflurane (1 5%,3 0%,4 5%) or isoflurane (1 1%,2 2%,3 3%) The spontaneous neural discharge of central amygdaloid nucleus was measured before and after enflurane or isoflurane using whole cell patch clamp techniques Results Enflurane and isoflurane inhibited the frequencies of spontaneous neural discharge of central amygdaloid nucleus in a dose dependent manner The spontaneous neural discharge inhibited by enflurane (3 0%) and isoflurane (2 2%) could recover after the slices being washed with normal ACSF for 5 min Conclusions The results indicate that the spontaneous neural discharge of central amygdaloid nucleus can be inhibited reversibly by enflurane and isoflurane Central amygdaloid nucleus may by one of the sites of action of enflurane and isoflurane in central nervous system
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Objective To investigate whether spinal cord is involved in the analgesic effect of propofol.Methods Fifteen adult SD rats of both sexes weighing 195～223g were randomly divided into three group of five animals each: control group received normal saline intraperitoneally(ip), fentanyl group received fentanyl 0 1mg/kg and propofol group propofol 100mg/kg ip 2 min later 4% formalin 150?l was injected subcutaneously into the planta region of right hindpaw 1h after formalin injection animals of all three groups were anesthetized with pentobarbital sodium ip After induction of anesthesia chest was open and 100 ml of normal saline was infused via left ventricle then followed by 4% formalin infusion for fixation of tissue, 90 min later spinal cord, L 3 5 sect, was removed for determination of c fos expression in spinal cord using fos immunohistochemistry technique Results In control group in less than 10 s after formalin intraplantar injection the animals were agitated, restless, lame and paw licking In fentanyl group and propofol group the righting reflex was suppressed for (19 4?7 8) min and (7 2?1 5)min and no pain response was seen during this period When righting reflex recovered the pain response was much lighter than that in the control group Formalin stimulation induced c fos expression was seen only in the ipsilateral spinal cord Both fentanyl and propofol significantly suppressed c fos expression evoked by formalin stimulation The number of fos like immunoreactivity neurons(FLIN) decreased by 57 8% and 36 3% respectively(P
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Tumor vaccine is current hotspot of medicine. The article explicates the status quo, merit, side effects of tumor vaccine and brings up the ethic principle we should follow in clinic application.
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Objective To investigate the expression and co-existence of fos-protein and enkephalin in CNS following enflurane anesthesia. Methods Twelve adult SD rats of both sexes weighing 195-223g were divided randomly into two equal groups: control group and enflurane group: The animals in enflurane group breathed 2% enflurane for 2h. The animals in control group underwent the same experimental steps except enflurane inhalation. Before experiment the animals were kept in a quiet place for 24h and strong light was avoided. After enflurane inhalation, chest was opened and 100 ml of normal saline was infused via left ventricle to wash Out blood from whole body, then followed by infusion of 4% polymerized formaldehyde 0.1mol/L PB 500 ml for fixation of tissue. 90 mm later the whole brain and spinal cord were harvested for determination of fos-protein and enkephalin expression and their location using double-labelled immunohistochemical technique. Results The control group showed more ELI(enkephalin like immunoactivity) neurons, less FLI(fos like immuneactivity) neurons and FLI/ELI(fos and enkephalin like immunoactivity) neurons were very rare. The enflurane group showed more FLI, ELI and FLI/ELI neurons. They were mainly distributed in frontal-cortex, lateral septal nucleus, basolateral amygdaloid nucleus, hippocampus CA1, paraventricular nucleus, ventral posterolateral nucleus, habenular nucleus, ventromedial hypothalamus nucleus, supraoptic nucleus, substantia nigra nucleus, interpeduncular nucleus, periaqueductal gray and dorsal horn. In enflurane group the number of FLI and ELI neurons in these nuclei was significantly higher(P