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1.
Chinese Journal of Anesthesiology ; (12): 667-669, 2021.
Article in Chinese | WPRIM | ID: wpr-911255

ABSTRACT

Objective:To evaluate the relationship between degrees of biliary obstruction and levels of lipid peroxidation in patients.Methods:A total of 140 patients of both sexes, with biliary obstruction, without biliary puncture and drainage, aged 40-64 yr, with body mass index of 18.5-23.9 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, were selected.The patients with different degrees of biliary obstruction were divided into 4 groups ( n=35 each) according to Child-Pugh grade total bilirubin (TBIL) concentrations: group A (TBIL<17 μmol/L), group B (17 μmol/L≤TBIL<34 μmol/L), group C (34 μmol/L≤TBIL<51 μmol/L) and group D (TBIL≥51 μmol/L). The serum TBIL, direct bilirubin (DBIL), indirect bilirubin (IBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bile acid (TBA) and malondialdehyde (MDA) concentrations were measured.The correlation between serum MDA concentration and degree of biliary obstruction was tested by Spearman correlation analysis. Results:Compared with group A and group B, the serum DBIL, IBIL, ALT, AST, TBA and MDA concentrations were significantly increased in group C and group D ( P<0.05), and there was no significant difference in the parameters mentioned above between group A and group B ( P>0.05). Compared with group C, the serum DBIL, IBIL, ALT, AST, TBA and MDA concentrations were significantly increased in group D ( P<0.05). Serum MDA concentration was positively correlated with degree of biliary obstruction ( r=0.54, P<0.05). Conclusion:The degree of biliary obstruction can reflect the level of lipid peroxidation in patients.

2.
Chinese Journal of Anesthesiology ; (12): 311-314, 2021.
Article in Chinese | WPRIM | ID: wpr-911190

ABSTRACT

Objective:To investigate the relationship between lateral hypothalamus and melatonin-induced reduction of wakefulness in rats and the receptor mechanism.Methods:Forty clean-grade adult male Sprague-Dawley rats, weighing 250-300 g, were divided into 4 groups ( n=10 each) using a random number table method: control group (group C), melatonin group (group M), melatonin type-1/2 receptor (MT 1R) antagonist luzindole plus melatonin group (group L+ M), and melatonin type-2 receptor (MT 2R) antagonist 4P-PDOT plus melatonin group (P+ M group). In group C, 0.5 μl of 0.9% NaCl solution was microinjected into the lateral hypothalamus.In group M, 1 μmol/L melatonin 0.5 μl was microinjected into the lateral hypothalamus.In group L+ M, 1 μmol/L MT 1/2R and 1 μmol/L melatonin (0.5 μl in total) was microinjected into the lateral hypothalamus.The microinjection time was from 19: 30 to 20: 00.The changes in sleep-wake duration and the oscillating energy in different frequency bands of electroencephalogram were detected by using electroencephalogram and electromyogram recording technology. Results:Compared with group C, the percentage of wakefulness time was significantly decreased, the percentage of non-rapid eye movement sleep and rapid eye movement sleep time was increased, the energy for delta oscillation was increased, the energy for theta oscillation was decreased, and no significant change was found in the energy for alpha oscillation in M and P+ M groups ( P<0.01), and no significant change was found in the parameters mentioned above in group L+ M ( P>0.05). Compared with group M, the percentage of wakefulness time was significantly increased, the percentage of non-rapid eye movement sleep and rapid eye movement sleep time was decreased, the energy for delta oscillation was decreased, and the energy for theta oscillation was increased in group L+ M ( P<0.01), and no significant change was found in the parameters mentioned above in group P+ M ( P>0.05). Conclusion:The lateral hypothalamus may be involved in melatonin-induced reduction of wakefulness in rats, and the mechanism may be related to activating MT 1R in the lateral hypothalamus.

3.
Chinese Journal of Anesthesiology ; (12): 1514-1517, 2021.
Article in Chinese | WPRIM | ID: wpr-933285

ABSTRACT

Objective:To evaluate the effect of melatonin on prefrontal cortex ischemia-induced cognitive impairment in rats and to investigate the receptor mechanism.Methods:Clean-grade adult male Sprague-Dawley rats, weighing 300 g, were selected, and a catheter was implanted into the prefrontal cortex.The experiment was performed in two parts.Experiment Ⅰ Twenty-four rats, in which catheters were successfully inserted into the prefrontal cortex, were assigned into 3 groups ( n=8 each) using a random number table method: control group (group C), model group (group M) and melatonin group (group ME). Normal saline 0.5 μl was injected into the prefrontal cortex in group C, 1 μmol/L endothelin 0.5 μl was microinjected into the prefrontal cortex in group M, and 1 μmol/L endothelin and 1 μmol/L melatonin 0.5 μl were injected into the prefrontal cortex in group ME.Experiment Ⅱ Forty-four rats, in which catheters were successfully inserted into the prefrontal cortex, were assigned into 4 groups ( n=11 each) using a random number table method: model group (group M), melatonin group (group ME), MT 1/2R antagonist luzindole + melatonin group (group L + ME) and MT 2R antagonist 4p-pdot + melatonin group (group P + ME). In group M, 1 μmol/l endothelin 0.5 μl was microinjected into the prefrontal cortex.In group ME, 1 μmol/L endothelin + 1 μmol/L melatonin 0.5 μl was injected into the prefrontal cortex.In group L + ME, 1 μmol/L endothelin + 1 μmol/L MT 1/2R antagonist + 1 μmol/L melatonin 0.5 μl was injected into the prefrontal cortex.In group P + ME, 1 μmol/L endothelin + 1 μmol/L MT 2R antagonist + 1 μmol/L melatonin 0.5 μl was injected into the prefrontal cortex.T-maze and the open field tests were performed at 1 week after administration. Results:Experiment Ⅰ There was no significant difference in the locomotor speed in open field test among C, M and ME groups ( P>0.05). The rate of correct selection in T-maze test was significantly lower in M and ME groups than in group C and higher in group ME than in group M( P<0.05). Experiment Ⅱ There was no significant difference in the locomotor speed in open field test among the four groups( P>0.05). Compared with group M, the rate of correct selection in open field test was significantly increased in ME and P+ ME groups ( P<0.05), and no significant change was found in group L+ ME ( P>0.05). Compared with group ME, the rate of correct selection in open field test was significantly decreased in group L+ ME ( P<0.05), and no significant change was found in group P+ ME( P>0.05). Conclusion:Melatonin can attenuate prefrontal cortex ischemia-induced cognitive impairment in the rats, and the mechanism is related to activation of MT 1R.

4.
Chinese Journal of Anesthesiology ; (12): 577-580, 2020.
Article in Chinese | WPRIM | ID: wpr-869908

ABSTRACT

Objective:To evaluate the effect of propofol on excitability of pyramidal neurons in orbitofrontal cortex of mice and the underlying ion channel mechanism.Methods:Brain slices of 400 μm thickness from healthy male C57 mice (aged 8-12 weeks)were prepared.This experiment was performed in two parts.Part Ⅰ The brain slices were divided into 2 groups ( n=7 each) based on the random number table method: control group (C group) and propofol group (P group). Cells were perfused with vehicle in group C and with 10 μmol/L propofol in group P. Part Ⅱ The brain slices were divided into 5 groups ( n=8 each) using the random number table method: propofol group (P group), hyperpolarization-activated non-selective cation channel antagonist ZD7288 plus propofol group (Z + P group), inward rectifier potassium channel antagonist topiramate plus propofol group(T + P group), transient activation of voltage-gated potassium channel antagonist 4-aminopyridine (4AP) plus propofol group (A + P group), and delayed activation of voltage-gated potassium channel antagonist tetraethylammonium (TEA) plus propofol group (TEA + P group). Cells were perfused with 10 μmol/L propofol for 2 min in P group, with 5 μmol/L ZD7288 and 10 μmol/L melatonin for 2 min in Z+ P group, with 5 μmol/L topiramate and 10 μmol/L propofol for 2 min in T + P group, with 10 μ mol/L 4-aminopyridine and 10 μmol/L propofol for 2 min in A+ P group, and with 10 μmol/L TEA and 10 μmol/L propofol for 2 min in TEA+ P group.The whole-cell currents, membrane potential and discharge frequency of pyramidal neurons in the orbitofrontal cortex were recorded by whole-cell patch-clamp. Results:Part Ⅰ Compared with C group, whole-cell currents were significantly increased, and the membrane potential and discharge frequency were decreased in P group ( P<0.01). Part Ⅱ Compared with P group, no significant change was found in the whole-cell currents, membrane potentials and discharge frequency in Z+ P group, T+ P group and A+ P group ( P>0.05), and the whole-cell currents were significantly decreased, and the membrane potentials and discharge frequency were increased in TEA+ P group ( P<0.05). Conclusion:Propofol can inhibit the excitability of pyramidal neurons in the orbitofrontal cortex, and the mechanism is related to activating delayed activation of voltage-gated potassium channels in mice.

5.
Chinese Journal of Burns ; (6): 733-739, 2019.
Article in Chinese | WPRIM | ID: wpr-796813

ABSTRACT

Objective@#To preliminarily investigate the effect of intraoperative goal-directed fluid management (GDFM) on pulmonary function and oxygen dynamics in patients with severe burns.@*Methods@#From February 2017 to May 2018, 30 patients admitted to Burn Department of our hospital with severe burns who met the criteria for inclusion and needed escharectomy and skin grafting were enrolled in this prospective randomized controlled trial. The patients were divided into group GDFM of 15 cases [14 males and 1 female, (45±14) years old] and conventional liquid management group of 15 cases [12 males and 3 females, (42±10) years old] according to the random number table. During escharectomy and skin grafting, volume of patients in group GDFM was managed according to the GDFM scheme, based on cardiac output index, stroke volume variation, stroke volume index, hemoglobin, central venous oxygen saturation (ScvO2), and other parameters; volume of patients in conventional liquid management group was managed according to clinical experience and conventional liquid management scheme, based on mean arterial pressure, central venous pressure, urine output, hemoglobin, and other parameters. At post operation hour (POH) 1, 6, 12, and 24, arterial and venous blood was collected from patients of the two groups to determine the levels of extravascular lung water index (ELWI), global end-diastolic volume index (GEDI), oxygenation index, ScvO2, central venous-to-arterial blood carbon dioxide partial pressure difference (Pcv-aCO2), lactic acid, pH value, bicarbonate ion, and base excess routinely. Data were processed with Fisher′s exact probability test, t test, analysis of variance for repeated measurement, and least significant difference test.@*Results@#(1) The ELWI of patients in group GDFM was (4.3±1.1) mL/kg at POH 1, which was significantly lower than (6.5±3.6) mL/kg in conventional liquid management group (t=2.26, P<0.05). The ELWI levels of patients in group GDFM at POH 6, 12, and 24 were (6.8±2.2), (6.6±2.0), and (6.9±1.6) mL/kg, respectively, significantly higher than the level at POH 1 within the same group (P<0.01), and similar to (8.5±3.1), (7.8±2.3), and (8.0±3.5) mL/kg in conventional liquid management group (t=1.73, 1.53, 1.10, P>0.05). The GEDI levels between patients of the two groups were similar, and there was no significantly statistical difference between the two groups as a whole (treatment factor main effect F=2.35, time factor main effect F=0.44, interaction F=0.07, P>0.05). (2) The oxygenation index of patients in group GDFM was (350±78) mL/kg at POH 1, which was significantly higher than (259±109) mL/kg in conventional liquid management group (t=2.63, P<0.05). In conventional liquid management group, the oxygenation index of patients at POH 6 was significantly higher than that at POH 1, 12, or 24 (P<0.01). The ScvO2 levels of patients in group GDFM at POH 1, 6, and 12 were 0.516±0.105, 0.679±0.121, and 0.713±0.104, respectively, which were significantly higher than 0.382±0.194, 0.545±0.194, and 0.595±0.191 in conventional liquid management group (t=2.35, 2.27, 2.10, P<0.05). The ScvO2 levels of patients in the two groups at POH 6, 12, and 24 were significantly higher than those levels at POH 1 within the same group (P<0.01), and the ScvO2 of patients in conventional liquid management group at POH 24 was significantly higher than that at POH 6 or 12 within the same group (P<0.05 or P<0.01). The Pcv-aCO2 levels of patients in group GDFM were significantly lower than those in conventional liquid management group at POH 1 and 6 (t=2.55, 2.71, P<0.05). The Pcv-aCO2 of patients in group GDFM at POH 12 was significantly lower than that at POH 6 or 24 within the same group (P<0.05). (3) The blood lactic acid levels and pH values between patients of the two groups were similar at POH 1, 6, 12, and 24 (t=0.89, 0.19, 0.26, 0.23; 1.55, 0.71, 0.77, 0.77, P>0.05). In conventional liquid management group, the blood lactic acid levels of patients at POH 6, 12, and 24 were significantly lower than the level at POH 1 within the same group (P<0.05), and the pH values of patients at POH 6, 12, and 24 were significantly higher than the value at POH 1 within the same group (P<0.05). The levels of bicarbonate ion and base excess between patients of the two groups were similar, and there were no significantly statistical differences between the two groups as a whole (treatment factor main effect F=0.06, 0.11, time factor main effect F=2.07, 1.59, interaction F=1.45, 0.91, P>0.05).@*Conclusions@#GDFM is helpful to improve the pulmonary function and oxygen dynamics in patients with severe burns in the short term after escharectomy and skin grafting. It has certain significance in preventing and reducing pulmonary edema and pulmonary complications in patients with severe burn after operation.

6.
Chinese Journal of Medical Education Research ; (12): 631-635, 2019.
Article in Chinese | WPRIM | ID: wpr-753437

ABSTRACT

Clinical teaching round is one of main teaching methods during standardized training for residents. However, the particularity of standardized resident training in clinical anesthesia determines that it is difficult to apply the teaching round model of other disciplines. In this study, seven core contents of Mini-Clinical Evaluation Exercise (Mini-CEX) were modified after considering the characteristics of anesthesia specialty and applied to the teaching rounds of standardized training for residents of anesthesia , thus promoting the standardization and improving the quality of anesthesia teaching rounds.

7.
Chinese Journal of Anesthesiology ; (12): 726-729, 2019.
Article in Chinese | WPRIM | ID: wpr-755642

ABSTRACT

Objective To evaluate the efficacy of acetate Ringer's solution for fluid therapy in the patients with dangerous placenta previa undergoing cesarean section. Methods One hundred fifty-two pa-tients, aged 22-41 yr, with body mass index of 20-30 kg/m2 , of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective cesarean section under general anesthesia, were allocated to 2 groups ( n=76 each) using a random number table method: acetate Ringer's solution group ( group AR) and lactated Ringer's solution group ( group LR) . Acetate Ringer's solution and lactated Ringer's so-lution 500 ml were intravenously infused at an initial rate of 15 ml·kg-1 ·h-1 followed by an infusion of 10 ml·kg-1·h-1 until patients leaved the operating room in two groups. Blood samples were collected from the left radial artery immediately before fluid replacement, at the end of fluid replacement and at 6 h after sur-gery for blood gas analysis. The development of arrhythmia was recorded during fluid replacement. The postpartum hemorrhage at 2 h after surgery was calculated. Results Compared with group LR, the Mg2+level was significantly increased and blood glucose was decreased at the end of fluid replacement, the inci-dence of arrhythmia was decreased ( P < 0. 05) , and no significant change was found in each parameter of blood gas analysis at 6 h after surgery, postpartum hemorrhage at 2 h after surgery or consumption of ephed-rine in group AR ( P>0. 05) . Conclusion Acetate Ringer's solution can be effectively used for fluid ther-apy, maintain the internal environment stable and prevent the occurrence of arrhythmia effectively during cesarean section in the patients with dangerous placenta previa.

8.
Chinese Journal of Anesthesiology ; (12): 688-690, 2019.
Article in Chinese | WPRIM | ID: wpr-755632

ABSTRACT

Objective To evaluate the relationship between prefrontal cortex and propofol-induced cognitive dysfunction in rats. Methods SPF healthy male Sprague-Dawley rats, weighing 300-350 g, aged 16 weeks, were used in this study. Thirty rats in which catheters were successfully implanted into the prefrontal lobe were divided into 2 groups ( n=15 each ) using a random number table method: control group (group C) and propofol group (group P). In group P, 50μmol/L propofol 0. 5μl was microinjected into the prefrontal cortex at day 7 after operation, and the equal volume of normal saline was given instead in group C. T-maze test and open field test were performed at 15 min after administration. Results Com-pared with group C, the correct rate of selection in T-maze was significantly decreased ( P<0. 05) , and no significant change was found in the total locomotor or number of rearing in open field test in group P ( P>0. 05) . Conclusion Prefrontal cortex may be involved in propofol-induced cognitive dysfunction in rats.

9.
Chinese Journal of Anesthesiology ; (12): 471-474, 2019.
Article in Chinese | WPRIM | ID: wpr-755584

ABSTRACT

Objective To evaluate the changes in the expression of Talin1 and F-actin during ser-um-induced proliferation of pulmonary artery smooth muscle cells ( PASMCs) of rats with hepatopulmonary syndrome ( HPS) . Methods Twenty healthy male Sprague-Dawley rats, weighing 220-250 g, were used for producing HPS by chronic ligation of the common bile duct. Blood samples from the abdominal aorta were collected to prepare serum. Primarily cultured PASMCs obtained from rats were seed in 6- or 96-well plates and divided into 2 groups using a random number table method: control group ( group C) and HPS group ( group HPS) , with 24 wells in each group ( for 6-well plates) or with 30 wells in each group ( for 96-well plates) . In C and HPS groups, normal rat serum or HPS rat serum were added, respectively, with the final concentration of 5%. At 24, 48 and 72 h of incubation, the expression of Talin1, F-actin and G-actin was determined by Western blot, the F-actin∕G-actin ratio was calculated, and the proliferation of PASMCs was measured by 3H-TdR incorporation and CCK-8 assays. Results Compared with group C, the proliferation of PASMCs was significantly enhanced, the expression of Talin1 was up-regulated, and the F-actin∕G-actin ratio was increased in group HPS ( P<0. 05) . The proliferation of PASMCs was gradually en-hanced, the expression of Talin1 was gradually up-regulated, and the F-actin∕G-actin ratio was gradually increased with the prolonged incubation time in group HPS (P<0. 05). Conclusion The mechanism by which the HPS rat serum induces proliferation of PASMCs may be related to up-regulating the expression of Talin1 and F-actin.

10.
Chinese Journal of Anesthesiology ; (12): 221-223, 2019.
Article in Chinese | WPRIM | ID: wpr-755525

ABSTRACT

Objective To evaluate the effects of melatonin on the excitability of pyramidal neurons in the prefrontal cortex and the role of melatonin receptor 1 (MT1 R)-cyclic adenosine monophosphate (cAMP)-protein kinase A (PKA) signaling pathway.Methods Brains were obtained from male SpragueDawley rats between 14 and 21 days after birth.The brain slices of 350-μm thick were prepared and placed in artificial cerebrospinal fluid.The brain slices were divided into 5 groups (n =6 each) using a random number table method:control group (C group),melatonin group (M group),MT1/2R antagonist luzindole plus melatonin group (L+M group),MT2R antagonist 4P-PDOT plus melatonin group (P+M group) and PKA inhibitor Rp-cAMPS plus melatonin group (R+M group).Cells were perfused for 2 min with artificial cerebrospinal fluid in group C.Cells were perfused for 2 min with 1 μmol/L melatonin in group M.Cells were perfused for 2 min with the mixture of 1 μmol/L MT1/2R antagonist luzindole and 1 μmol/L melatonin in group L+M.Cells were perfused for 2 min with the mixture of 1 μmol/L MT2R antagonist 4P-PDOT and 1 μmol/L melatonin in group P+M.In group R+M,1 mmol/L PKA inhibitor Rp-cAMPS was continuously added to the pipette solution,and cells were perfused for 2 min with 1 μmol/L melatonin.The whole-cell patch-clamp technique was used to record the membrane potential and clamp current of pyramidal neurons in the prefrontal cortex.Results Compared with group C,the clamp current was significantly increased,and the membrane potential was decreased in group M (P<0.05).Compared with group M,the clamp current was significantly decreased,and the membrane potential was increased in L + M and R + M groups (P<0.05),and no significant change was found in the clamp current or membrane potential in group P+M (P>0.05).Conclusion Melatonin inhibits the excitability of pyramidal neutrons in the prefrontal cortex,and the mechanism is related to activating MT1 R-cAMP-PKA signaling pathway.

11.
Chinese Journal of Anesthesiology ; (12): 230-233, 2018.
Article in Chinese | WPRIM | ID: wpr-709730

ABSTRACT

Objective To evaluate the effect of regional hypothermia on limb ischemia-reperfusion (I/R) injury in a rabbit model of hemorrhagic shock.Methods Eighteen healthy adult New Zealand white rabbits of both sexes,weighing 2.0-2.5 kg,were divided into 3 groups (n=6 each) using a random number table:sham operation group (S group),limb I/R group (I/R group) and regional hypothermia group (RH group).Rabbits were shot with 0.25 g steel ball with a 7.62 mm smoothbore at the middle and lower 1/3 of the left hindlimb in I/R and RH groups.When the blood pressure was stable for 30 min after injury,blood was drawn via the right femoral artery at a rate of 2 ml/min until mean arterial pressure decreased to 45-50 mmHg.Then a rubber tourniquet was used to ligate left hindlimbs 10 min later.The injured limb was cooled down for 4 h after applying tourniquet to maintain the subcutaneous temperature at 9-11 ℃ in group RH.After tourniquet was applied for 4 h,perfusion was restored and lasted 6 h.After catheterization (T0) and at 2,4 and 6 h of reperfusion (T1-3),blood samples were collected from the right femoral artery for blood gas analysis and for determination of tumor necrosis factor-α (TNF-α),interleukin-2 (IL-2) and IL-6 concentrations in serum (by enzyme-linked immunosorbent assay).The animals were sacrificed at T3,and tissues around the margin of the inferior lobe of right lung were obtained for examination of the pathological changes which were scored and for determination of wet to dry weight ratio (W/D ratio).Results Compared with group S,the respiratory rate was significantly increased and PaCO2 was decreased at T2,3,the pathological score and W/D ratio were increased,and the concentrations of TNF-α,IL-2 and IL-6 in serum were increased at T1-3 in I/R and RH groups (P<0.05).Compared with group I/R,the respiratory rate was significantly decreased and PaCO2 was increased at T2,3,the pathological score and W/D ratio were decreased,and the concentrations of TNF-α,IL-2 and IL-6 in serum were decreased at T1-3 (P<0.05),and the pathological score was significantly attenuated in group RH.Conclusion Regional hypothermia can reduce limb I/R injury in a rabbit model of hemorrhagic shock,and the mechanism may be related to inhibiting systemic inflammatory responses.

12.
Chinese Journal of Anesthesiology ; (12): 40-43, 2018.
Article in Chinese | WPRIM | ID: wpr-709684

ABSTRACT

Objective To compare the quadratus lumborum block and transversus abdominis plane block for postoperative analgesia in elderly patients undergoing abdominal surgery. Methods Seventy?two elderly patients of both sexes, aged 65-72 yr, with body mass index of 18-25 kg∕m2, of American Society of Anesthesiologists physical statusⅡorⅢ, scheduled for elective laparoscopic cholecystectomy, were di?vided into 2 groups(n=36 each)by coin toss: transversus abdominis plane block group(group T)and quadratus lumborum block group(group Q). Anesthesia was induced and maintained routinely. Bilateral subcostal transversus abdominis plane block was performed under ultrasound guidance in group T. Bilateral paravertebral approach to quadratus lumborum block was performed under ultrasound guidance in group Q. The height of sensory block was assessed at 30 min after block. Ramsay sedation scores and Bruggrmann comfort scale scores were recorded at 30 min after block and 1, 6, 12, 24 and 48 h after operation. The requirement for parecoxib and fentanyl as rescue analgesics and complications such as nausea, vomiting, block of lower extremities and local anesthetic intoxication were recorded within 48 h after operation. Re?sults The height of sensory block was kept at T4?L1, and the main blocking area was T6?11in group T. The height of sensory block was kept at T4?L4, and the main blocking area was T6?L1in group Q. Compared with group T, the blocking area was enlarged, the requirement for parecoxib and fentanyl and incidence of nausea and vomiting were significantly decreased(P<0.05), and no significant change was found in Ram?say sedation scores or Bruggrmann comfort scale scores in group Q(P>0.05). Conclusion Quadratus lumborum block provides better efficacy for postoperative analgesia than transversus abdominis plane block in elderly patients undergoing abdominal surgery.

13.
Chinese Journal of Anesthesiology ; (12): 968-971, 2017.
Article in Chinese | WPRIM | ID: wpr-666789

ABSTRACT

Objective To evaluate the efficacy of stroke volume variation (SVV) combined with controlled low central venous pressure (CLCVP)-directed fluid therapy in the patients undergoing liver cancer resection.Methods Seventy American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 40-60 yr,with body mass index of 20-25 kg/m2,scheduled for elective liver cancer resection under general anesthesia,were divided into 2 groups (n=35 each) using a random number table:routine fluid replacement group (R group) and SVV combined with CLCVP-guided fluid replacement group (SC group).In R group,routine fluid replacement included compensatory volume expansion,physiological requirement,cumulative loss,continued loss (intraoperative blood loss) and 3rd space losses,maintaining mean arterial pressure>70 mmHg,central venous pressure<4 cmH2O and heart rate < 100 bpm.Central venous pressure was maintained <4 cmH2O and SVV < 12% during operation in SC group.The operation time,total amount of crystalloid and colloid solution infused,urine volume and development of intraoperative hypotension and bradycardia were recorded.Blood samples from the left radial artery and central vein were collected before anesthesia induction and at the end of operation for measurement of the blood lactate concentration,and the oxygen supply index,oxygen consumption index and oxygen uptake rate were calculated.Blood samples from the ulnar vein were collected before anesthesia induction and at the end of operation for determination of serum β2-microglobulin concentrations.The development of intraoperative adverse cardiovascular events was recorded,and the occurrence of postoperative complications was observed.Results Compared with R group,the total amount of crystalloid solution infused was significantly decreased,the total amount of colloid solution infused and urine volume were increased,the incidence of intraoperative hypotension and bradycardia was decreased,oxygen supply index,oxygen consumption index and oxygen uptake rate were increased at the end of operation,and the lactate concentration in arterial blood,serum β2-microglobulin concentration and rate of postoperative pulmonary infection were decreased in SC group (P<0.05).Conclusion SVV combined with CLCVP-directed fluid therapy produces better efficacy than routine fluid replacement in the patients undergoing liver resection.

14.
The Journal of Practical Medicine ; (24): 2826-2829, 2017.
Article in Chinese | WPRIM | ID: wpr-661240

ABSTRACT

Objective To dynamically observe the SDF-1 level in plasma,bone marrow,liver,lung and kidney,and to investigate their significance in obstructive jaundice and its complications. Method 48 male SD rats weighing about 200g were randomly divided into Sham group and CBDL group. The serum ALT ,AST and se-rum total bilirubin(TBIL)were detected at 7 d,14 d and 21 d after operation. General condition of rats in the two groups were observed. ELISA was applied in detecting expression of SDF-1 in plasma and supernate of tissue ho-mogenate. And mRNA expression of SDF-1 at different time was detected by qPCR assay. Results ALT,AST,TB increased rapidly after CBDL operation,the difference was significant compared with Sham group(P <0.05). The SDF-1 expression of plasma,liver tissue,lung tissue in CBDL rats at different time points were significantly higher than in Sham group. No significant difference was found in renal tissue. SDF-1 expression of bone marrow in 7 d,14 d,21 d was significantly lower in CBDL group than in Sham group. Conclusion Expression of SDF-1 in liver and lung tissues of obstructive jaundice rats significantly increased ,and decreased in marrow bone. This change may promote related stem cells mobilization and contribute to the pathological changes of obstructive jaun-dice.

15.
The Journal of Practical Medicine ; (24): 2826-2829, 2017.
Article in Chinese | WPRIM | ID: wpr-658321

ABSTRACT

Objective To dynamically observe the SDF-1 level in plasma,bone marrow,liver,lung and kidney,and to investigate their significance in obstructive jaundice and its complications. Method 48 male SD rats weighing about 200g were randomly divided into Sham group and CBDL group. The serum ALT ,AST and se-rum total bilirubin(TBIL)were detected at 7 d,14 d and 21 d after operation. General condition of rats in the two groups were observed. ELISA was applied in detecting expression of SDF-1 in plasma and supernate of tissue ho-mogenate. And mRNA expression of SDF-1 at different time was detected by qPCR assay. Results ALT,AST,TB increased rapidly after CBDL operation,the difference was significant compared with Sham group(P <0.05). The SDF-1 expression of plasma,liver tissue,lung tissue in CBDL rats at different time points were significantly higher than in Sham group. No significant difference was found in renal tissue. SDF-1 expression of bone marrow in 7 d,14 d,21 d was significantly lower in CBDL group than in Sham group. Conclusion Expression of SDF-1 in liver and lung tissues of obstructive jaundice rats significantly increased ,and decreased in marrow bone. This change may promote related stem cells mobilization and contribute to the pathological changes of obstructive jaun-dice.

16.
Chinese Journal of Anesthesiology ; (12): 609-612, 2017.
Article in Chinese | WPRIM | ID: wpr-620894

ABSTRACT

To evaluate the effect of exogenous hydrogen sulfide on phenotypic transformation of alveolar macrophages in a mouse model of endotoxin-induced acute lung injury (ALI).Methods Thirty pathogen-free healthy male C57BL/6 mice,aged 8 weeks,weighing 18-20 g,were divided into 3 groups (n =10 each) using a random number table:sham operation group (group Sham),group ALI and exogenous hydrogen sulfide group (group NaHS).In group Sham,normal saline was intratracheally instilled and intraperitoneally injected.In ALI and NaHS groups,lipopolysaccharide 20 mng/kg was intratracheally instilled,and normal saline and sodium hydrosulfide (28 μmol/kg) 100 μl were intraperitoneally injected,respectively,every day.Mice were sacrificed at day 3 after administration of lipopolysaccharide,and lungs were removed for measuremnent of the lung coefficient and expression of inducible nitric oxide synthase (iNOS) and arginase (by immunohistochemistry) and for microscopic examination of the pathological changes.Lung injury was evaluated by the index of quantitative assessment (IQA).Results Compared with group Sham,the lung coefficient and IQA were significantly increased,and the expression of iNOS and arginase in lung tissues was up-regulated in group ALI (P<0.05).Compared with group ALI,the lung coefficient and IQA were significantly decreased,the expression of iNOS in lung tissues was down-regulated (P<0.05),and no significant change was found in the expression of arginase in lung tissues in group NaHs (P>0.05).Conclusion Exogenous hydrogen sulfide mitigates endotoxin-induced ALI through inhibiting phenotypic transformation of alveolar macrophages to M1 subtype in mice.

17.
Chinese Journal of Anesthesiology ; (12): 498-500, 2017.
Article in Chinese | WPRIM | ID: wpr-619513

ABSTRACT

Objective To evaluate the effect of etomidate on the activity of nuclear factn kappa B (NF-κB) during lung ischemia-reperfusion (I/R) injury in rats.Methods Sixty SPF healthy adult male Sprague-Dawley rats,weighing 180-220 g,were divided into 4 groups (n =15 each) using a random number table:sham operation group (group S),lung I/R group (group I/R),etomnidate group (group E) and fat emulsion group (group F).Lung I/R was induced by 45 min occlusion of the left hilum of the lung followed by 120 min reperfusion.At 3 min before reperfusion,normal saline 1 ml was injccted via the auricular vein in I/R and S groups,and etomidate 0.3 mg/kg and fat emulsion 0.3 mg/kg (diluted to l nl in normal saline) were injected via the auricular vein in E and F groups,respectively.The rats were sac rificed at the end of reperfusion,and the lungs were removed for examination of the pathological changes (using haematoxylin and eosin staining) and for determination of the wet to dry weight ratio (W/D ratio),cell apoptosis (by TUNEL),expression of NF-κB in nucleoprotein (by Western blot) and content of tumor necrosis factor-alpha (TNF-α) in lung tissues (by enzyme-linked immunosorbent assay).Apoptotic index (AI) was calculated.Results Compared with group S,the W/D ratio,AI and content of TNF-α in lung tissues were significantly increased,and the expression of NF-κB in nucleoprotein was up-regulated in group I/R (P<0.05).Compared with group I/R,the W/D ratio,AI and content of TNF-α in lung tissues were significantly decreased,and the expression of NF-κB in nucleoprotein was down-regulated in group E (P<0.05),and no significant change was found in the parameters mentioned above in group F (P>0.05).The pathological changes of the lung were significantly attenuated in group E as compared with group I/R.Conclusion The mechanism by which etomidate reduces lung I/R injury is related to inhibition of NF-κB activity in rats.

18.
Chinese Journal of Anesthesiology ; (12): 1520-1523, 2017.
Article in Chinese | WPRIM | ID: wpr-709679

ABSTRACT

Objective To evaluate the efficacy of domestic electronic vaporizer when used for sevoflurane anesthesia in rabbits.Methods Ninety healthy pathogen-free New Zealand rabbits of both sexes,aged 4-5 months,weighing 2.5-3.5 kg,were divided into 3 groups (n=30 each) using a random number table:mechanical vaporizer group (group M),domestic electronic vaporizer group (group E) and Zeus electronic vaporizer group (group Z).In group M,the mechanical vaporizer was used,the sevoflurane vaporizer dial was adjusted to 2%,with the fresh air flow set at 2 L/min.In E and Z groups,BR850 domestic electronic vaporizer and Zeus electronic vaporizer were used,respectively,and the concentration of sevoflurane inhaled was 2%.Sevoflurane was inhaled for 2 h in each group.The formula method and weighing method were used to calculate the consumption of sevoflurane in group M.The electronic calculation method and weighing method were used to calculate the consumption of sevoflurane in Z and E groups.The stable value of end-tidal sevoflurane concentration (ETCsev) and time for ETCsev reaching the stable value were recorded.ETCsev was recorded every 10 min after reaching the stable value (T1T12).Results Compared with group M,the consumption of sevoflurane (weighing method) was significantly reduced,and the time for ETCsev reaching the stable value was shortened in Z and E groups (P< 0.05).Compared with group Z,the consumption of sevoflurane (weighing method) was significantly increased (P<0.05),and no significant change was found in the time for ETCsev reaching the stable value in group E (P>0.05).Compared with the consumption of sevoflurane (weighing method),no significant change was found in the consumption of sevoflurane (electronic method) in group Z (P>0.05),and the consumption of sevoflurane (electronic method) was significantly increased in group E (P<0.05).There was no significant difference in the stable value of ETCsev between the three groups (P<0.05).There was no significant difference in ETCsev between and within groups (P>0.05).Conclusion The domestic electronic vaporizer achieves automatic and precise control of volatile concentrations of inhalation anesthetics and can be effectively used for sevoflurane anesthesia in rabbits.When compared with Zeus electronic vaporizer,the precision of the domestic electronic vaporizer needs further improvement,but the cost is obviously low,the compatibility is strong,and it has clinical application value.

19.
Chinese Journal of Anesthesiology ; (12): 1308-1310, 2017.
Article in Chinese | WPRIM | ID: wpr-709626

ABSTRACT

Objective To evaluate the effect of dexmedetomidine on pulmonary microvascular en-dothelial cell(PMVEC)injury induced by the serum of mice with renal ischemia-reperfusion(I∕R)injury. Methods Renal I∕R was induced by clamping bilateral renal pedicles for 60 min followed by 24 h of reper-fusion. Primary PMVECs of mice were divided into 3 groups(n=20 each)using a random number table:control group(group C), serum of mice underwent I∕R group(group I∕R)and dexmedetomidine group (group Dex). PMVECs were cultured with 10% serum of mice underwent sham operation in group C. PM-VECs were cultured with 10% serum of mice underwent I∕R injury in group I∕R. PMVECs were incubated for 3 h with dexmedetomidine at the final concentration of 0.1 μmol∕L before incubation with serum in group Dex. At 24 h of culture or incubation, the cell survival rate was detected by CCK8 assay, cell apoptosis by Hoechst 33258 staining, caspase-3 activity using colorimetric method, and the expression of Bcl-2 and Bax using Western blot. Results Compared with group C, the cell survival rate was significantly decreased, the apoptosis rate and activity of caspase-3 were increased, the expression of Bcl-2 was down-regulated, and the expression of Bax was up-regulated in I∕R and Dex groups(P<0.01). Compared with group I∕R, the cell survival rate was significantly increased, the apoptosis rate and activity of caspase-3 were de-creased, the expression of Bcl-2 was up-regulated, and the expression of Bax was down-regulated in group Dex(P<0.01). Conclusion Dexmedetomidine can reduce PMVEC injury induced by the serum of mice with renal I∕R injury, and the mechanism is related to regulating the expression of Bcl-2 and Bax and inhib-iting mitochondrial apoptosis pathway.

20.
The Journal of Practical Medicine ; (24): 540-542, 2017.
Article in Chinese | WPRIM | ID: wpr-512874

ABSTRACT

Objective To evaluate the effect of autophagy inhibitor 3-methyladenine (3-MA) on phenotype transformation and proliferation of rat pulmonary arterial smooth muscle cells (PASMCs).Methods Cultured PASMCs were treated with different concentrations of 3-MA (low-dose group,2.0 mmol/L;middle-dose group,4.0 mmol/L;high-dose group,8.0 mmol/L;control group,0 mmol/L).The protein expression of LC3 Ⅱ,OPN and Vimentin was detected by Western blotting.Cell proliferation was detected by MTT assay.Results The autophagy of PASMCs was decreased with the increase of the concentration of 3-MA.Compared with the control group,significantly down-regulated protein expression of LC3 Ⅱ,OPN and Vimentin was observed in 3-MA-treated cells,with significantly lower proliferation activity.Conclusion The autophagy inhibitor 3-MA significantly down-regulated the expression of LC3 Ⅱ,OPN and Vimentin in PASMCs,with inhibiting the proliferation of PASMCs.

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