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Objective To establish spastic cerebral palsy model of macaque by partial resection of motor cortex and explore its evaluation method.Methods Four individuals of 3-month-old macaques were divided into healthy control group and operation model group according to random number table.Partial resection of the motor cortex was carried out in operation model group,in which precentral gyrus cortex from above the right lateral cerebral fissure to the inter-hemicerebral fissure,together with the posterior-superior frontal gyrus (about 0.3 to 0.5 cm in front of the anterior median sulcus) cortex were removed with the depth of about 0.5 to 0.6 cm.After the operation,the continuous camera shooting was used to record whether left limb motor dysfunction and abnormal posture existed or not.Muscle tension was assessed by manual examination of muscle tone with reference to the modified Ashworth scale.The quantitative indexes of the two groups were detected by using the gross motor and fine motor assessment scale.9.4T magnetic resonance imaging (MRI) was used to detect the brain imaging changes.Results After operation,the macaque in the operation model group immediately showed left hemiparesis,left upper limb abnormal lifting,left lower limb paralysis,left limb claudication,and eating mainly relied on the right side of the body.After 6 weeks of operation,left limb activity of the operation model group was significantly lower than that of the healthy control group,and the gross motor scores and fine motor scores were significantly lower than those of the healthy control group(Friedman test:χ2=33.939,P<0.05;χ2=37.526,P<0.05).The macaque in the operation model group showed some symptoms that abnormal posture mainly tilted to the left for the rest,sitting in a corner of the monkey cage,left arm was put on the cage to maintain postural balance,and movement was left slightly inclined,which had simulated the typical clinical manifestations of human spastic hemiplegic cerebral palsy.Muscle tension was checked by hand,and the left limb paralysis and muscle tension decreased after operation in the model group,and the left muscle tension increased gradually after 5 weeks,and gradually increased to score 4 points and the score remained 3 after 10 weeks.Brain MRI of 3 weeks postoperatively suggested scar tissue formation after right motor cortex resection,which supported the pathological changes of the hemiplegic cerebral palsy models.Conclusions Through the partial resection of the motor cortex,the model of spastic cerebral palsy was established successfully.The results of behavioral evaluation and MRI showed that the model was consis-tent with spastic hemiplegia.
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Objective To evaluate the effect of conventional or goal-directed fluid management on hemodynamics in patients undergoing orthopaedic arthroscopic shoulder surgery in beach chair po-sition.Methods Thirty healthy adult patients,male 1 7 cases,female 13 cases,aged 18-65 years, weight 49-68 kg,ASA Ⅰor Ⅱ,undergoing elective arthroscopic shoulder surgery,were enrolled.Pa-tients were randomly assigned to the group R(Routine group,n = 1 5 )and the group S(SVV/CI/MAP-directed,n =1 5).All patients received 10 ml/kg of hydroxyethyl starch rapidly in group R;while in group S,if SVV > 13%,patients would receive 3 ml/kg of hydroxyethyl starch in 5 min, then the changes of each index were observed;if SVV 2.5 L·min-1 ·m-2 .At 5 min after anesthesia induc-tion,patients were placed in a 60° upright position.The hemodynamic changes were monitored by FloTrac/Vigileo system.Heart rate (HR),mean artery pressure(MAP),cardiac index(CI),stroke volume variation(SVV),stroke volume index (SVI),were recorded on pre-induction (T1 ),post-induc-tion (T2 ),immediately after in beach chair position (T3 ),5 min after in beach chair position(T4 ),30 min after in beach chair position(T5 ),and at the end of surgery(T6 ).The duration of surgery,crys-talloid requirements,colloid requirements,urinary output,the dose of vasoactive drugs and the inci-dence of hypotension were recorded.Results Compared with T1 ,MAP,CI and SVI at T3-T5 point (after in BCP to the end of the surgery)were higher in both group(P <0.05 ).Compared with T2 , SVV in group R at T3-T5 were significantly increased (P <0.05),while SVV in group S only at T3 was slightly increased (P <0.05).Compared with group R,MAP,CI and SVI at T3-T5 were signif-icantly higher respectively,while SVV were higher at T3-T5 in group R (P <0.05).Compared with group R,the colloid requirements and total requirements in group S were significantly increased(P <0.05).Compared with group R,the doses of dopamine and ephedrine,the urinary output,the inci-dence of hypotension in group S were significantly reduced(P <0.05).Conclusion SVV/CI/MAP-di-rected fluid management is safer,more effective and renders much more stable hemodynamic than the routine fluid management.
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Objective To compare the eficacy and safety of flexible laryngeal mask (FLMA) and endotracheal tube (ETT) in children undergoing adenoidectomy and tonsillectomy. Methods Forty children with snoring disease scheduled for selective adenoidectomy and tonsillectomy surgery under intravenous compound inhalation general an-esthesia were divided randomly into either FLMA group or ETT group. MAP,HR and SpO2 were recorded before an-esthesia induction(T0 ), 1 (T1 ),3 (T2 ),5 (T3 ) min after intubation,1(T4 ),3 (T5 ) min after extubation. Param-eters for respiratory mechanics included peak airway pressure (Ppeak ), mean airway pressure (Pmean ), end tidal CO2 (PetCO2 ),and airway sealing pressure. All of the above indicators were recorded 5 min (T6 ) after intubation, 10 (T7 ),20 (T8 ) min after put in mouth gag,5 (T9 ) min after removing mouth gag. Meanwhile,chievement ratio of first time insertion,incidence of regurgitation aspiration,bucking,laryngospasm,wheezing when extubation and af-ter extubation,anesthesia time,surgery time,extubation time were recorded. Complications such as nausea and vomi-ting,pharyngeal pain,hoarseness were followed up 24 hours after surgery. Results MAP, HR during T1 , T2 , T3 , T4 ,T5 were significantly higher in group T than T0 , and those in group FLMA (P<0.05). MAP, HR were not sig-nificantly changed in group FLMA during each time. Ppeak , Pmean was significantly lower in group FLMA than that in group ETT. The extubation time was shorter and the incidence of coughing and pharyngalgia after operation was low-er in group FLMA than that in group ETT. Conclusion Compared with endotracheal intubation, on the basis of not affecting surgical operation, FLMA is an effective, safe anesthesia for adenoidectomy and tonsillectomy surgery in children, with the advantages of hemodynamic stability, mild airway trauma,and is a easy handling method, with minor laryngeal stimulation during intubation and extubation, more stable hemodynamics, reliable respiratory me-chanics and low incidence of postoperative upper airway complications.
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ObjectiveTo investigate the effects of morphine preconditioning on myocardial ischemiareperfusion (I/R) injury and the expression of phosphorylated extracellular signal-regulated kinase 1/2 (p-ERK1/2)in rats with chronic heart failure.MethodsForty-eight healthy male SD rats weighing 220-250 g were randomly divided into 6 groups ( n =8 each):control group (group C),sham operation group (group S),I/R group and preconditioning with low,median and high doses of morphine groups (groups MP1-3 ).Chronic heart failure was induced by iv edriamycin 2.0 mg/kg once a week for 6 weeks in groups S,I/R and MP1-3.Left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) were measured using ultrasound,and left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were calculated at the end of 14th day after the end of adriamycin administration.Blood samples from the carotid artery were collected after ultrasonography for determination of the plasma brain natriuretic peptide (BNP) concentration.Myocardial I/R was induced by 30 min occlusion of left anterior descending branch of coronary artery followed by 120 min reperfusion at 2 day after ultrasonography in groups I/R and MP1-3.In groups MP1-3,iv morphine 0.015,0.030 and 0.050 mg/kg were repeated 3 times at 5 min interval at 30 min before ischemia respectively,while normal saline 5 ml/kg was given in group I/R.The animals were sacrificed at the end of reperfusion in groups S,I/R and MP1-3,and the hearts were removed to measure the area at risk (AAR),infarct size (IS),and IS/AAR ratio was calculated.The p-ERK1/2 expression in myocardium was assessed by Western blot.ResultsThe LVESD and plasma BNP concentration were significantly higher,while the LVEF and LVFS lower in the other 5 groups than in group C (P ＜0.01).No myocardial infarction was found in group S.The p-ERK1/2 expression was significantly lower in groups I/R and MP1 than in group S (P ＜ 0.05).IS and IS/AAR ratio were significantly lower,and p-ERK1/2expression was significantly higher in groups MP2.3 than in group I/R ( P ＜ 0.05).There were no significant differences in IS,IS/AAR ratio and p-ERK1/2 expression between groups MP1 and I/R (P ＞ 0.05).IS and IS/AAR ratio were decreased gradually,and the p-ERK1/2 expression was up-regulated gradually in groups MP1-3 ( P ＜0.05).ConclusionMorphine preconditioning can confer cardioprotection against myocardial I/R in a dose-dependent manner in rats with chronic heart failure.Up-regulation of p-ERK1/2 expression is involved in the underlying mechamism.
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Objective To compare the effects of different doses of dexmedetomidine in inhibition of cardiovascular response to endotracheal intubation. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients, aged 18-60 yr, weighing 45-80 kg, scheduled for upper abdominal surgery, were randomly assigned to one of 4 groups (n = 30 each): control group (group C); low, median and high doses of dexmedetomidine groups (group M1-3) .In group M1-3, 15 min before anesthesia induction, dexmedetomidine 0.25, 0.5 and 1.0 μg/kg were infused over 15 min respectively, while normal saline 15 ml was given instead of dexmedetomidine in group C. After anesthesia induction, tracheal intubation was performed when the BIS value ≤ 60 and it was maintained for 5 s. The patients were mechanically ventilated. BP and HR were recorded before infusion of dexmedetomidine (T0), before intubation (T1), immediately after intubation (T2) and at 1, 3, 5 and 10 min after intubation (T3-6). Venous blood samples were also taken at the same time to measure the plasma concentrations of epinephrine (E) and norepinephrine (NE). Results Compared with T0, HR was significantly decreased at T1 in group M1-3, BP was significantly increased at T1 in group M3, and the plasma concentrations of E and NE were significantly increased at T4-6 in group C and M1(P ＜0.05). BP and HR were significantly lower at T2, while higher at T3-5 in group C and M1than at T1 (P ＜ 0.05). BP at T1-6 was significantly higher in group M3 than in group M2 (P ＜ 0.05). Conclusion When the dose of dexmedetomidine reaches 0.5 μg/kg, it may effectively inhibit the stress reaction to noxious stimulation.
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Aim To investigate the effect of intracerebroventricular morphine postconditioning against ischemia-reperfusion injury in rat heart and the mechanism of the central nervous system opioid receptor.Methods Forty-two Sprague-Dawley Rats were established intracerebroventricular catheter placement and myocardial ischemia/reperfusion models and randomly assigned to 7 groups:Sham group(Sham),control group(CON),intravenous control group(VCON),morphine postconditioning group(POC),intracereborventricular morphine postconditioning group(MOC).According to the dosage of intracerebroventricular morphine(3 ?g?kg-1,0.3 ?g?kg-1,0.03 ?g?kg-1),MOC group was assigned to three groups :MOC 1,MOC 2,MOC 3.Infarct size(IS),a percentage of the area at risk(AAR) was determined by triphenyltetrazolium(TTC) staining.c-fos expression in nucleus of tractus solitarius was determined by immunohistochemical method and Cardiac TroponinI(cTnI) of serum was observed at 120 min of reperfusion.Results Compared with control group,IS,IS/AAR and cTnI were significantly reduced in POC and MOC groups(P0.05).c-fos expression in nucleus of tractus solitarius were significantly reduced in MOC 2,POC(P