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Objective To evaluate the effects of remifentanil preconditioning on the renal injury induced by limb ischemia-reperfusion (I/R) in rats.Methods Twenty-seven healthy male Sprague-Dawley rats,weighing 200-250 g,were randomly assigned into 3 groups (n =9 each):sham operation group (Sham group),I/R group and remifentanil preconditioning group (RPC group).Limb ischemia was induced by clamping bilateral femoral arteries and veins for 2 h,followed by 24 h reperfusion in I/R and RPC groups.Remifentanil 1.0 μg· kg-1 · min-1 was infused via the caudal vein for 30 min before ischemia in RPC group,while the equal volume of normal saline was given in Sham and I/R groups.Blood sample was taken from the inferior vena cava at 24 h of reperfusion to measure blood urea nitrogen (BUN) and creatinine (Cr) concentrations in serum.The rats were sacrificed and the left kidney was removed for determination of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) contents,cell apoptosis and microscopic examination of pathological changes.Apoptosis index was calculated.Results Apoptosis index and concentrations of BUN and Cr in serum,TNF-α and IL-6 contents,and apoptosis index were significantly higher,and the pathological changes were more severe in I/R and RPC groups than in Sham group.Compared with group I/R,concentrations of BUN and Cr in serum,TNF-α and IL-6 contents,and apoptosis index were significantly decreased,and the pathological changes were attenuated in RPC group.Conclusion Remifentanil preconditioning can attenuate renal injury induced by limb I/R in rats,and inhibition of inflammatory responses and cell apoptosis in kidney may be involved in the mechanism.
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Objective To compare the bronchial blocker and double-lumen tube for one-lung ventilation in patients undergoing esophageal cancer resection.Methods Forty ASA physical status Ⅰ-Ⅲ patients of both sexes,aged 42-63 yr,scheduled for elective esophageal cancer resection,were randomly divided into 2 groups (n =20 each):double-lumen endotracheal tube group (group DLT) and bronchial blocker group (group BB).After induction of anesthesia,the patients were intubated with a left-sided double-lumen endotracheal tube and correct positioning was verified by fiberoptic bronchoscopy in group DLT.After induction of anesthesia,the patients were intubated with a conventional single-lumen endotracheal tube,and then the bronchial blocker was inserted under the guidance of fiberoptic bronchoscope in group BB.The intubation time,one-lung ventilation time,time to achieve lung collapse,operation time,extubation time,tube malposition and hypoxemia were recorded.The lung collapse was scored at the end of operation.Hoarseness and throat sore within 2 days after extubation and pulmonary infections within 7 days after operation were recorded.Results Compared with group DLT,intubation time and time to achieve lung collapse were significantly prolonged,and the incidence of hoarseness and throat sore within 2 days after extubation was decreased in group BB (P ＜ 0.05).There was no significant difference in the one-lung ventilation time,operation time,extubation time,lung collapse score,incidence of tube malposition,hypoxemia and pulmonary infections within 7 days after operation between the two groups (P ＞ 0.05).Conclusion The efficacy of bronchial blocker is similar to that of double-lumen tube when used for one-lung ventilation in patients undergoing esophageal cancer resection.
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Objective To investigate the effect of sevoflurane postconditioning on the renal injury induced by hind limb ischemia-reperfusion (I/R) in rats.Methods Twenty-four healthy male Sprague-Dawley rats,weighing 200-250 g,were randomly assigned into 3 groups (n =8 each):sham operation group (group S),group I/R and sevoflurane group (group Spo).Limb ischemia was induced by occlusion of bilateral hind limbs for 4 h followed by 6 h reperfusion.In group Spo,sevoflurane was inhaled for 6 h at the end-tidal concentration of 2.5 ％ before reperfusion,while pure oxygen was inhaled instead of sevoflurane in groups S and I/R.Blood samples were taken from the inferior vena cava at 6 h of reperfusion to determine the serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations.The rats were then sacrificed and the kidney was removed for determination of superoxide dismutase (SOD) activity and contents of malondialdehyde (MDA),tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and for microscopic examination.Results The levels of BUN,Cr,MDA,TNF-α and IL-6 were significantly higher,the SOD content was significantly lower (P ＜ 0.05),and the pathological damage was severer in groups I/R and Spo than in group S.Compared with group I/R,the levels of BUN,Cr,MDA,TNF-α and IL-6 were significantly decreased,the SOD content was significantly increased (P ＜ 0.05),and the pathological damage was attenuated in group S.Conclusion Sevoflurane postconditioning can reduce the renal injury induced by hind limb I/R in rats,and the reduction of oxygen radical release and inhibition of inflammatory response may be involved in the mechanism.
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Objective To evaluate the clinical efficacy of expulsive therapy using alpha 1-selective adrenoblocker and prostaglandin synthetase inhibitor for distal ureteral stones.Methods 94 patients with distal ureteral stone were randomly divided into study group and control group.In study group,47 cases received tamsulosin 0.2mg daily and dielofenac rectal suppositories 50mg 2 times daily,while watchful waiting without tamsulosin and diclofenac suppository in 47 cases of control group.Observation lasted 2 weeks and also stone expelled as end point.Results No severe adverse reactions related to the drugs were noted and no patients withdrew from the study.The stone-free rate was 91.5%(43/47) of the study group and 25.5% (12/47) of the control group (P＜0.01).A mean stone expelling date of the control group was(8.9±4.3)d and that of the study group was(6.4±3.7)d(P＜0.01).Rates of renoureteral colic recurred in the study group and the control group were 4.3%(2/47) and 48.9%(23/47),respectively (P＜0.01).Conclusion Treatment of distal ureteral stones wlth tamsulosin and dielofenac suppository can increase the stone-free rate,shorten mean stone expelling date,decrease rate of renottreteral colic recurred.