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Objective:To compare the clinical effects between proximal humerus internal locking system (PHILOS) inverted and a posterior single plate in the anterior percutaneous minimally invasive internal fixation for distal humeral shaft fractures.Methods:A retrospective study was conducted to analyze the data of 65 patients with distal humeral shaft fracture who had been treated from January 2018 to May 2021 at Department of Orthopaedics, The Second Hospital of Fuzhou. The patients were assigned into 2 groups according to different treatment methods. In the observation group of 30 cases subjected to anterior percutaneous minimally invasive internal fixation with PHILOS inverted: 20 males and 10 females with an age of (41.5±11.6) years; type A in 5 cases, type B in 14 cases, and type C in 11 cases by AO fracture classification. In the control group of 35 cases subjected to anterior percutaneous minimally invasive internal fixation with a posterior single plate: 23 males and 12 females with an age of (39.9±11.2) years; type A in 7 cases, type B in 17 cases, and type C in 11 cases by AO fracture classification. The preoperative general data, operation time, intraoperative blood loss, total incision length, fracture healing time, and shoulder and elbow VAS scores, Constant-Murley shoulder function score, Mayo elbow performance score (MEPS), and complications at the last follow-up were recorded and compared between the 2 groups.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). There were no significant differences either in operation time, fracture healing time, or shoulder or elbow VAS pain score, Constant-Murley shoulder function score, or MEPS at the last follow-up between the 2 groups ( P>0.05). The intraoperative blood loss was (59.7±26.6) mL in the observation group and (165.7±86.4) mL in the control group, and the total incision length was (10.7±2.1) cm in the observation group and (18.6±2.7) cm in the control group, showing statistically significant differences between the 2 groups ( P<0.01). There was no injury to the radial nerve or musculocutaneous nerves, incision infection or fracture nonunion in the observation group. There were 4 cases of iatrogenic radial nerve injury, 2 cases of incision infection and 1 case of fracture nonunion in the control group, yielding a complication rate of 20.0% (7/35). The difference in the incidence of complications was significant between the 2 groups ( P<0.01). Conclusion:In the treatment of distal humeral shaft fracture with anterior percutaneous minimally invasive internal fixation, PHILOS inverted has advantages of less soft tissue damage, less intraoperative bleeding, and a lower risk of iatrogenic radial nerve injury than the posterior single plate.
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@#Objective To evaluate the effect of frailty on postoperative complications in elderly patients with esophageal cancer. Methods We enrolled the patients aged≥65 years and with esophageal cancer who underwent surgical treatment in Shanghai Chest Hospital in 2021. The modified frailty index (mFI) was calculated and the patients were divided into a non-frailty group and a frailty group. The primary outcomes were the incidence of postoperative pulmonary infection, arrhythmia, anastomotic fistula and chylothorax complications. Secondary outcomes were the time of extubation, the rate of unplanned re-intubation, the length of ICU stay, hospital stay, rate of readmission within 30 days after discharge and the mortality within 30 days after operation. Results Finally 607 patients were collected. There were 273 patients in the non-frailty group and 334 patients in the frailty group. The non-frailty group had lower rates of complications including pulmonary infection (5.5% vs. 13.5%), arrhythmia (3.7% vs. 9.3%), anastomotic fistula (2.9% vs. 7.5%), and shorter ICU stay [2.0 (0.0, 4.0) d vs. 4.0 (1.0, 6.0) d] and in-hospital stay [11.5 (9.5, 13.0) d vs. 13.0 (11.0, 18.0) d], lower rates of the readmission within 30 days (2.9% vs. 6.6%) and the mortality within 30 days (0.4% vs. 1.2%) compared with the frailty group (P<0.05). Conclusion Frail elderly patients with esophageal cancer have higher rates of postoperative complications. mFI can be used as an objective index to identify high-risk elderly patients with esophageal cancer.
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@#Objective To investigate the effect of intravenous analgesia with a wireless or traditional analgesia pump system in thoracoscopic lung resection. Methods Patients who used the patient-controlled intravenous analgesia after thoracoscopic lung resection between June 2016 and June 2021 were enrolled in the study. They were allocated into a wireless pump group (a ZigBee-based wireless analgesia pump system collecting data automatically) and a traditional analgesia pump group. Perioperative analgesia management followed the routine standard operation protocol of Shanghai Chest Hospital. The patients’ numeric rating scale (NRS) for pain and postoperative nausea and vomiting (PONV) scores were collected for analysis from the Anesthesia Information Record System. The incidence of postoperative analgesia insufficiency (defined as NRS≥4 points) within 48 h, the incidence of PONV within 24 h, and the 48 h completion rate of analgesia pump infusion were compared. Results A total of 59 431 patients were collected, including 24 855 males and 34 576 females, 17 209 patients in the wireless pump group, and 42 222 patients in the traditional analgesia pump group. The incidence of analgesia insufficiency within 48 h after operation (3.75% vs. 4.98%, P=0.007), the incidence of PONV within 24 h after operation (13.60% vs. 16.70%, P=0.030) in the wireless pump group were lower than those in the traditional analgesia pump group. The 48 h completion rate of analgesia pump infusion in the wireless pump group was higher than that in the traditional analgesia pump group (83.40% vs. 71.90%, P<0.001). The wireless pump group could monitor the pressing times and use of the analgesia pump, while the traditional analgesia pump group could not record the relevant data. Conclusion Compared with the traditional analgesia pump, the wireless analgesia management system may be convenient for timely, accurate and individualized management, and has good analgesic effect and low incidence of adverse reactions, and may be more suitable for perioperative analgesia management.
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Objective:To investigate the dose of intravenously infused cisatracurium for the maintenance of deep neuromuscular blockade during thoracic surgery.Methods:Patients of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 18-64 yr, scheduled for elective thoracic surgery under general anesthesia, were studied.The patients were connected to a muscle relaxation monitor after entering the operating room.After the completion of muscle relaxant calibration and anesthesia induction, cisatracurium was intravenously infused at a constant rate to maintain deep neuromuscular blockade (post-tetanic count [PTC]≤5 ). The infusion rate was calculated by modified Dixon up-and-down method.The first patient received cisatracurium at 0.12 mg·kg -1·h -1.If the PTC was 0 or was maintained≤5 continuously, the infusion rate was decreased 0.01 mg·kg -1·h -1 in the next patient, until PTC was >5 during operation.The mean dose for the patient was used as initial dose.Then the infusion rate was increased/decreased by 0.005 mg·kg -1·h -1.The 95% effective dose of cisatracurium (ED 95) was the median of 6 thresholds. Results:A total of 22 cases completed the study.The ED 95 of continuous intravenous infusion of cisatracurium for the maintenance of deep neuromuscular blockade was 0.108 mg·kg -1·h -1(95% confidence interval 0.105-0.125 mg·kg -1·h -1). Conclusion:The dose of intravenous infusion of cisatracurium for the maintenance of deep neuromuscular blockade during thoracic surgery is 0.108 mg·kg -1·h -1.
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Objective To evaluate the effect of epidural block on postoperative long-term quality of life in patients undergoing radical operation for lung cancer under general anesthesia. Methods A total of 348 patients with primary non-small cell lung cancer of both sexes, aged 18-80 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, with body mass index of 18-30 kg∕m2, with International Associa-tion for the Study of Lung Cancer staging criteria stage 1-2, scheduled for elective radical operation for lung cancer under general anesthesia, were divided into 2 groups ( n＝174 each) using a random number table method: general anesthesia plus patient-controlled intravenous analgesia ( PCIA) group ( group G) and general anesthesia plus epidural anesthesia plus patient-controlled epidural analgesia group ( group GE). Anesthesia was induced by target-controlled infusion of propofol and fentanyl and intravenous injection of rocuronium. The patients were tracheally intubated and mechanically ventilated to maintain the end-tidal pressure of carbon dioxide at 30-40 mmHg. Anesthesia was maintained by target-controlled infusion of propofol and intravenous injection of remifentanil. An increment of fentanyl was given immediately after chest opening and closing, and cisatracurium besylate was injected intravenously. In group GE, 0. 375%ropivacaine was epidurally injected in a initial dose of 5-8 ml followed by continuous epidural infusion at 5 ml∕h, and infusion was stopped before closing the chest. Bispectral index value was maintained at 40-60 during operation. PCIA was performed at the end of operation with fentanyl, flurbiprofen, ramosetron or palonosetron hydrochloride, and the PCA pump was set up with a 0. 5 ml bolus dose, a 15-min lockout in-terval and background infusion at a rate of 2 ml∕h in group G. Patient-controlled epidural analgesia was per-formed with 0. 15%-0. 18% ropivacaine 250 ml, and the PCA pump was set up to deliver 2-3 ml bolus dose with a 20-min lockout interval and background infusion at 4-5 ml∕h in group GE. Postoperative analge-sia was performed until 48 h after operation in both groups. Patients were followed up by telephone at half a year and 1 and 2 yr after operation. The 12-item short-form scale was used to evaluate the quality of life. Physical component summary (PCS-12) and mental component summary (MCS-12) scores were calculated. Results PCS-12 and MCS-12 scores were significantly lower at 2 yr after operation than at half a year in both groups (P＜0. 05). Compared with group G, PCS-12 and MCS-12 scores were significantly increased at 2 yr after operation in group GE (P＜0. 05). Conclusion Compared with general anesthesia alone, epi-dural block provides better effect on postoperative long-term quality of life in patients undergoing radical op-eration for lung cancer under general anesthesia.
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Objective To compare the development of intraoperative atrial fibrillation in elderly patients undergoing thoracic surgery using different anesthetic methods in a large sample clinical trial.Methods A total of 1 380 patients of both sexes,aged 60-80 yr,with body mass index of 16-33 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective radical operations for lung or esophageal cancer,were divided into 3 groups (n =460 each) using a random number table:general anesthesia group (group G),general anesthesia combined with paravertebral block group (group GP),and general anesthesia combined with epidural block group (group GE).After induction of anesthesia,an epidural catheter was placed at T4-7 interspace on the operated side,and 0.375％ ropivacaine 8 ml was administrated via the catheter in group GP.After induction of anesthesia,the patients were tracheally intubated and mechanically ventilated,and the end-tidal pressure of carbon dioxide was maintained at 35-45 mmHg in the 3 groups.Maintenance of anesthesia was as follows:propofol was given by target-controlled infusion with the target plasma concentration of 2.5-4.0 μg/ml in the 3 groups;intermittent iv boluses of sufentanil 10 μg were given,and the total dosage was not expected to exceed 1.0 μg/kg in group G;sufentanil 10 μg was injected intravenously when necessary in group GP;0.25％ ropivacaine 5 ml was injected epidurally every 1.5 h in group GE;bispectral index value was maintained at 40-60;rocuronium was injected intravenously according to the condition in the 3 groups.The development of intraoperative atrial fibrillation was recorded.Results The incidence of intraoperative atrial fibrillation was 6.1％,3.7％ and 2.2％ in G,GP and GE groups,respectively.Compared with group G,the incidence of intraoperative atrial fibrillation was significantly decreased in group GE (P＜0.05),and no significant change was found in the incidence of intraoperative atrial fibrillation in group GP (P＞0.05).Conclusion Compared with general anesthesia,general anesthesia combined with epidural block can decrease the development of intraoperative atrial fibrillation,it is more suitable for this type of patients,however,general anesthesia combined with paravertebral block produces no improvement in the development of intraoperative atrial fibrillation in elderly patients undergoing thoracic surgery.
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Objective To evaluate the ventilation modes and factors influencing the tidal volume(VT)in the nonventilated lung during one-lung ventilation(OLV)in patients undergoing thorascopic surgery using electrical impedance tomography.Methods Thirteen American Society of Anesthesiologists physical statusⅠ or Ⅱ patients of both sexes,aged 45-64 yr,weighing 45-80 kg,undergoing elective pulmonary surgery performed via video-assisted thoracoscope,were enrolled in the study.After anesthesia induction,a double lumen tube was placed,and correct tube placement was confirmed with a fiberoptic bronchoscope.Two-lung ventilation and OLV were performed sequentially when in supine position with a fixed VT of 8 ml/kg and respiratory rate(RR)of 12 breaths/min.When the patients were turned to lateral position(with the operated lung on the upper side),correct placement of the tube was reconfirmed with a fiberoptic bronchoscope.Bilateral lungs were ventilated with VT of 8 ml/kg and RR of 12 breaths/min,and unilateral lungs were then ventilated in the following modes in sequence:VT 8 ml/kg and RR 12 breaths/min for the lung on the upper side;VT 8 ml/kg and RR 12 breaths/min for the lung on the lower side;VT 8 ml/kg,RR 12 breaths/min and positive end-expiratory pressure(PEEP)4 cmH2O for the lung on the lower side;VT 6 ml/kg and RR 16 breaths/min for the lung on the lower side;VT 4 ml/kg and RR 24 breaths/min for the lung on the lower side.Each ventilation mode stabilized for 2 min.At 2 min of OLV in each mode,electrical impedance tomography was used to record the ventilation mode in the nonventilated lung,anesthesia machine was used to record VT in the nonventilated lung,and the percentage of VT on nonventilated side in VT on ventilated side(VT-non/VT-ven%)was calculated.When the unilateral lung on the lower side was ventilated in lateral position,logistic regression analysis was used to analyze the correlation between VT on ventilated side(no PEEP)and that on nonventilated side.Results Opposite ventilation was found in the nonventilated lung during OLV.VT-non/VT-ven% was significantly higher in lateral position than in supine position(P<0.05).VT-non/VT-ven% was significantly higher when the lung on the lower side was ventilated than that when the lung on the upper side was ventilated(P<0.05).Four cmH2O PEEP exerted no effect on VT-non/VT-ven%.When the lung on the lower side was ventilated in lateral position,there was a linear positive correlation between VT on ventilated side(no PEEP)and that on nonventilated side(r=0.899,P<0.05).Conclusion During OLV in patients undergoing thorascopic surgery,there is opposite ventilation in the nonventilated lung,and VT is influenced by body positions and VT in contralateral lungs.
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The strategy of optimizing anesthetic management was carried out in all the patients un?dergoing thoracic surgery in our hospital from January 1, 2012: the patients were monitored using routine electrocardiogram combined with invasive arterial blood pressure monitoring, double?lumen central venous catheter pathway was established, and when severe bradycardia ( heart rate0?05) , and the incidence of cardiac arrest was decreased by 45% after optimizing anesthetic management. In conclusion, the strategy of optimizing anesthetic management is helpful in decreasing the occurrence of cardiac arrest during thoracic surgery.
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Objective To evaluate the effects of different doses of compound Xuelian capsule on bone cancer pain (BCP) in rats.Methods Fifty pathogen-free adult female Sprague-Dawley rats,weighing 200-220 g,aged 7-8 weeks,were randomly divided into 5 groups (n =10 each) using a random number table:sham operation group (group S),group BCP,and compound Xuelian capsule 50,100 and 200 mg · kg-1 · d-1 groups (group CX50,group CX100 and group CX200).BCP was produced by injecting Walker256 mammary gland carcinoma cells into the intramedullary space of the right femur bone.At 11-21 days after inoculation of the tumor ceils,normal saline containing compound Xuelian capsule 50,100 and 200 mg · kg 1 · d 1 was injected through a tube into stomach once a day in CX50,CX100 and CX200 groups,respectively.The mechanical paw withdrawal threshold (MWT) and limb use score were measured at 1 day before inoculation of the tumor cells (baseline) and 4,7,11,14,17,19,and 21 days after inoculation of the tumor cells.Results Compared with group S,the MWT at 4-21 days after inoculation of the tumor cells was significantly decreased,and limb use score was significantly decreased at 11-21 days after inoculation of the tumor cells in BCP,CX50,CX100 and CX200 groups (P＜0.05).Compared with group BCP,the MWT was significantly increased at 19-21 days after inoculation in group CX50,at 17-21 days after inoculation in group CX100 and at 14-21 days after inoculation in group CX200,and limb use score was significantly increased at 14-21 days after inoculation in group CX100 and at 17-21 days after inoculation in group CX200 (P＜0.05).Conclusion Compound Xuelian capsule 50,100 and 200 mg· kg 1 · d 1 (for 11 consecutive days) can reduce BCP in a dose-dependent manner in rats.
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Objective To screen the risk factors for postoperative residual neuromuscular blockade (RNMB) in the patients undergoing thoracic surgery.Methods A total of 733 patients undergoing elective thoracic surgery with general anesthesia,without neuromuscular disease,skin temperature ≥32 ℃,were transferred to the postanesthesia care unit (PACU) after surgery and given synchronized intermittent mandatory ventilation.Neuromuscular blockade was monitored immediately after admission to the PACU,and the occurrence of postoperative RNMB was defined as a train of four (TOF) ratio ＜90％ at the time of extubation.The patients were divided into RNMB group and nonRNMB group according to whether or not postoperative RNMB occurred.Each parameter of baseline patient characteristics,complications,sites and methods of surgery,anesthesia time,requirement for muscle relaxants during surgery,TOF ratio on arrival to the PACU,requirement for muscle relaxant antagonists in the PACU,and extubation time were recorded.The risk factors of which P values were less than 0.05 would enter the multivariable logistic regression analysis to stratify the risk factors for postoperative RNMB.Results A total of 385 patients developed postoperative RNMB,and the incidence was 52.5％.The results of multivariate logistic regression analysis showed that complications such as diabetes,intraoperative application of two kinds of muscle relaxants,average intraoperative consumption of cisatracurium ≥ 0.14 mg · kg-1 · h-1,TOF ratio on arrival to the PACU ≤ 0.5,and extubation time ≤ 30 min were independent risk factors for postoperative RNMB (P＜0.05).Conclusion Complications such as diabetes,intraoperative application of two kinds of muscle relaxants,average intraoperative consumption of cisatracurium 0.14 mg · kg-1 · h-1,TOF ratio on arrival to the PACU ≤ 0.5,and extubation time ≤ 30 min are independent risk factors for postoperative RNMB in the patients undergoing thoracic surgery.
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From August 2006 to June 2011 among consecutive 18 294 patients underwent thoracic surgery from Shanghai Chest Hospital,41 developed adverse events during peri-anesthesia period and the incidence was 0.224％,and the constituent ratios of the predictable and unpredictable events were 15％ and 85％,respectively.Cardiac arrest and massive hemorrhage were the main clinical manifestation of the adverse events and the constituent ratios were 37％ and 24％,respectively.Among the inducements for adverse events,patient's factor,surgical factor,anesthesia factor,patient-surgery factor,patient-anesthesia factor and patient-surgery-anesthesia factor accounted for 12.2％,48.8％,12.2％,7.3％,7.3％ and 12.2％,respectively.The ratio of death from adverse events was 17％ (7 cases),and among the inducements for adverse events causing death,surgical factor,patient-surgery factor and patient-surgery-anesthesia factor accounted for 43％,43％ and 14％,respectively.The incidence of adverse events was 1.093％ in the patients underwent operation on trachea,which was significantly higher than that in the patients underwent operation on lung (0.223％),mediastinum (0.236％) and esophagus (0.194％).In conclusion,although the adverse events which occurred during peri-anesthesia period in the patients underwent thoracic surgery were rare,they threatened the safety of patients.Surgical factor was not only the main inducement,but also the risk factor for death,and cardiac arrest and massive hemorrhage were the main clinical manifestation of the surgery-related adverse events.For cardiac arrest,as long as it was found in time and treated appropriately,the serious consequences could be avoided.For massive hemorrhage,more attention should be paid due to be the main reason of death,and the prevention depended on the surgeon's improvement of diagnosis and surgery.It was difficult to predict patient-related the adverse events and careful monitoring was required.For the anesthesia-related adverse events,they were mostly due to the poor airway management,so preoperative airway assessment should be strengthened.
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Objective To investigate the application of small dose of ketamine during induction of anesthesia in patients after coronary artery bypass grafting neutrophil superoxide generation effect .Methods 30 patients undergoing elective coronary artery bypass grafting operation were randomly divided into 2 groups ,in the fentanyl induced respectively based on combined with small dose of ketamine (ketamine group) or normal saline (control group) ,a blood sample collection time points :before ,immediately after extracorporeal circulation operation ,operation after 1-6 days .Neutrophil function by using (12-) fourteen acid and phorbol ester (-13-) acetate (PMA) ,yeast polysaccharide or formyl-methylthio-light-phenylalanine after stimulation of superoxide production de-termination method .Results During general anesthesia combined with low dose ketamine inhibits superoxide anion increases .In ad-dition ,ketamine reduces perioperative 2 -6 days of the neutrophil percentage .Conclusion Ketamine can reduce the activation of neutrophils after cardiopulmonary bypass .
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Objective To evaluate the effects of exogenous hydrogen sulfide (H2S) on nitric oxide (NO) and nitric oxide synthase (NOS) during lung ischemia-reperfusion in a rat model of lung transplantation.Methods Forty pathogen-free male Sprague-Dawley rats,weighing 250-350 g,aged 2-3 months,were used as donor and recipient rats in this study.The animals were randomly divided into 4 groups (n =10 each):sham operation group (group S); lung transplantation group (group L); lung transplantation + H2S synthesis-CSE inhibitor D,L-propargylgylcine (PPG) group (group PPG); lung transplantation + exogenous H2S donor NaHS group (group NaHS).The donor lungs were removed from live donor rats and placed in low potassium dextran solution at 4 ℃.Orthotopic left lung transplantation was performed using modified three-cuff technique and the time for cold ischemia was 50-70 min.In PPG and NaHS groups,PPG 37.5 mg/kg and NaHS 14 μmol/kg were injected intraperitoneally at 5 min before opening of the hilum of the transplanted lung.The implanted donor lungs were ventilated and reperfused.The donor lungs were removed after being implanted,ventilated and reperfused for 2 h for microscopic examination and for determination of wet to dry lung weight (W/D) ratio and the levels of malondialdehyde (MDA),myeloperoxidase (MPO),inducible NOS (iNOS),endothelial NOS (eNOS),and NO.Results Compared with group S,W/D ratio and the levels of MDA,iNOS,NO and MPO were significantly increased,and the content of eNOS was decreased in group L,and no significant change was found in the parameters mentioned above in group NaHS.Compared with group L,W/D ratio and the levels of MDA,iNOS,NO and MPO were significantly increased,and the content of eNOS was decreased in group PPG,and W/D ratio and the levels of MDA,iNOS,NO and MPO were decreased,and the content of eNOS was increased in group NaHS.The pathological changes of lungs were significantly attenuated in group NaHS as compared with group L.Conclusion Exogenous H2S can attenuate the lung ischemia-reperfusion injury in a rat model of lung transplantation,and decreased iNOS activity and increased eNOS activity are involved in the mechanism.
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Objective To explore the method of anesthesia and intra-operative management for robotic thoracic surgery. Methods Twelve patients who underwent robotic thoracic surgery using the Da Vinci surgical system were anesthetized with general anesthesia combined with T4-8 paravertebral block. After induction of anesthesia, a double-lumen endotracheal tube was positioned by bronchofibroscope to allow onelung ventilation during intra-operative procedure. Hemodynamics and respiratory function were routinely monitored and arterial blood gas (ABG) were tested during operation. Results All patients could tolerate the anesthesia for robotic thoracic surgery and there was no hospital mortality. The arterial carbon dioxide tension (PaCO2) and arterial oxygen tension (PaO2) after induction were (35.2 ± 3.6) mm Hg( 1 mm Hg =0.133 kPa) and (213.3 ± 57.5) mm Hg respectively; PaCO2 and PaO2 30 min after one -lung ventilation were (37.9 ± 4.8) mm Hg and ( 125.3 ± 36.5) mm Hg respectively. When the one-lung ventilation started about 58% (7/12) of the patient developed temporarily low SpO2 (over 0.90) and recovered to 0.95 soon when using 3 - 5 cm H2O( 1 cm H2O = 0.098 kPa) positive end expiratory pressure (PEEP). The anesthesia time was ( 291.5 ± 99.4) min, the time for one-lung ventilation was (206.3 ± 93.4) min, the volume of blood loses in operation was ( 171.7 ± 110.3 ) ml and the tracheal catheter extration time was ( 16.3 ± 4.5 ) min, all the patients left ICU on the second day after surgery. Conclusions The anesthesia for robotic thoracic surgery with Da Vinci surgical system is multiplicity, the hemodynamics and respiratory function can be instable, it is a new challenge for the technology and management of anesthesia. Good one-lung ventilation is important for this surgery, ventilation parameter need to be adjusted when hypoxia occurred and PEEP could be used to the ventilated lung. General anesthesia combined with paravertebral block will be a good option for postoperative pain control and minimal hemodynamics disturb ance.
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Objective To investigate the effect of L-N6-(1-iminoethyl) Lysine(L-NIL) on ischemia-reperfusion (I/R) -induced lung injury in a rat model of lung transplantation. Methods Pathogen free male SD rats weighing 250-350g were used as donor and recipient rats in this study. The animals were randomly divided into 3groups (n = 6 each): sham operation group (group S); lung tratsplantation group (group L) and lung transplantation + L-NIL (selective iNOS inhibitor) group (group L-NIL). In group L and L-NIL orthotopic left lung allograft transplantation was performed. In group L-NIL 3 mg/kg was injected iv at the beginning of reperfusion. The donor lungs were removed from live donor rats and placed in Euro-collins solution at 4 ℃. The lung transplantation was performed under microscope and non-suture cuff technique was used. The implanted donor lungs were ventilated and reperfused. 0.5% Evans blue 0.2 ml was injected iv during reperfusion. The donor lungs were removed after being implanted, ventilated and reperfused for 2 h for microscopic examination and determination of iNOS, endothelial NOS (eNOS) and myeloperoxidase (MPO) activity and malondialdehyde (MDA) and Evans blue content in the lung tissue and W/D lung weight ratio. Results Lung transplantation significantly inceased W/D ratio, iNOS and MPO activity, and Evans blue and MDA content in the lung tissue and decreased eNOS activity in group L as compared with group S. L-NIL iv significantly attenuated the increase in the variables mentioned above and ameliorated capillary congestion and inflammatory cell infiltration in the lung. Conclusion Intravenous L-NIL administered at the beginning of reperfusion can reduce I/R injury to the transplanted donor lungs.
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Objective To establish a rat model of bone cancer pain by intra-tibia inoculation of Walker 256 mammary gland carcinoma cells. Methods Sixty female Wistar rots weighing 180-200 g were randomly divided into 4 groups (a=15each):groupⅠ normal control; group Ⅱsham operation; group Ⅲtumor cell inoculation + normal saline (NS) and group Ⅳtumor cell inoculation + flurbiprofen. NS 0.2 nd and flurbiprofen 10 mg/kg in 0.2 ml were injected IV at 2 h before determination of pain threshold on 14 and 17 d after inoculation oftumor cells in groupⅢand Ⅳ respectively. On day 0, 4, 7, 10, 14, 17 and 21 after inoculation pain threshold was measured after determination of body weight. X-ray examination of the tibia was performed on day 14 after inoculation. The animals were killed on day 21 after inoculation for microscopic examination of the inoculated tibia. Results The animals started losing weight and the threshold to yon Frey hair stimulation was decreased from dhy 10 after inoculation in group Ⅲand Ⅳ. X-ray examination showed destruction of bone and microscopic examination showed tumor growing in tibia. Flurbiprofen significantly decreased mechanical hyperalgesia in group Ⅳ. There was no significant difference in paw withdrawal latoney to radiant heat among the 4 groups. Conclusion A model of bone cancer pain can be made by inoculation of Walker 256 mammary gland carcinoma cells into tibia characterized by mechanical hyperalgesia.
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Objective To evaluate the effect of 6% hydroxyethyl starch (HES) 200/0.5 on the pulmonary capillary permeability in oleic acid induced acute lung injury (ALI) and investigate the possible mechanism of the therapeutic effect of HES. Methods Forty male SD rats weighing 280-370 g were randomly divided into four groups: group I balanced solution (control); group II 6% HES 200/0.5; group III gelatin and group IV dextran 40. The animals were anesthetized with intraperitoneal 3% pentobarbital 30-40 mg?kg-1 . Right external jugular vein was cannulated. Oleic acid 0.06 ml?kg-1 was given iv.10 ml?kg-1 of the above-mentioned different solutions was infused over 1.5 h in the four groups. Then 0.5% Evan's blue 1ml was injected iv. Four hours later the animals were sacrificed and lungs removed for pathologic examination under microscope, and determination of lung water content [ (wet weight -dry weight)/wet weight ? 100% ] . Lung Evan's blue content was determined by formamide extracting method. Lung MDA content and MPO activity were also determined.Results Lung water and Evan's blue contents were significantly lower in group II than those in any other groups. MPO activity and MDA level in group II were lowest among the four groups. Conclusions HES can decrease pulmonary capillary permeability, attentuate pulmonary edema and lung injury, and depress MPO activity and MDA level. The underlying mechanism may be due to its depressant effect on PMN aggregation and lipid peroxidation.