ABSTRACT
Objective To evaluate the efficacy of oxycodone for improvement of general anesthesia for laparoscopic cholecystectomy in elderly patients.Methods A total of 160 patients of both sexes,aged 65-75 yr,with body mass index ＜30 kg/m2,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,scheduled for elective laparoscopic cholecystectomy,were divided into 2 groups (n =80 each) using a random number table method:general anesthesia group (group GA) and oxycodone + general anesthesia group (group OX+GA).Anesthesia induction:propofol was given by closed-loop infusion at the initial target plasma concentration of 2 μg/ml,the target bispectral index (BIS) value was set at 50,and 2 min later remifentanil was given by target-controlled infusion at the target plasma concentration of 4 ng/ml,and cisatracurium 0.2 mg/kg was intravenously injected when BIS value was decreased to 70.Laryngeal mask airways were inserted and the patients were mechanically ventilated when BIS value was decreased to 50 and TOF ratio was decreased to 25％,and end-tidal pressure of carbon dioxide was maintained at 35-45 mmHg.Anesthesia maintenance:propofol was given by closed-loop infusion,the target BIS value was set at 50,cisatracurium 0.1 mg/kg was intravenously injected when TOF ratio was increased to 10％;remifentanil was given by target-controlled infusion at the target plasma concentration of 4-6 ng/ml.Oxycodone 0.07 mg/kg was intravenously injected at 5 min before stretching internal organs.Before anesthesia,at 5 min after laryngeal mask airway placement,at skin incision and while stretching internal organs,analgesia nociception index value and perfusion index value were recorded,the development of intraoperative cardiovascular events,emergence time,time for removal of laryngeal mask airway,time of post-anesthesia care unit stay and development of nausea and vomiting and back and shoulder pain within 48 h after surgery were also recorded.Results Compared with group GA,the analgesia nociception index value and perfusion index value were significantly increased while stretching internal organs,and the incidence of intraoperative hypertension,tachycardia,and nausea and vomiting and back and shoulder pain within 48 h after surgery were decreased in group OX-GA (P＜0.05).Conclusion Oxycodone can inhibit nociceptive stimuli,is helpful in maintaining stable hemodynamics and reduces postoperative complications in elderly patients undergoing laparoscopic cholecystectomy under combined general anesthesia.
ABSTRACT
Objective To evaluate transoral Orvil EEA stapler (OrVil) procedure in laparoscopic total gastrectomy for cardiac carcinoma compared with conventional anvil head method (purse-string suture).Methods From May 2014 to December 2014 20 cases were included into OrVil group,and 25 cases into purse-string suture group.Results The two groups had similar mean numbers of dissected lymph nodes [(25 ± 3) vs.(24 ± 4),t =1.067,P =0.292],the mean time of operation,intraoperative blood loss,and postoperative complications (5 vs.6,P =0.938).The length of incision was significantly shorter [(5 ±1) cm vs.(11 ± 2) cm,t =-10.724,P ＜ 0.0l] and the esophagojejunostomy time was significantly less [(28 ± 4) min vs.(39 ± 5) min,t =-7.996,P ＜ 0.01] with the use of OrVil.The time to first flatus and postoperative hospital stay were (3.7 ± 0.9) d vs.(4.4 ± 1.0) d,t =-2.485,P =0.017 and (13 ± 5) d vs.(16 ±4) d,t =-2.184,P =0.035.Conclusions OrVil is a technically safe and feasible surgical procedure for esophagojejunostomy in laparoscopy assisted total gastrectomy in the treatment of cardiac carcinoma.
ABSTRACT
Objective To observe the effect of continuous pumped dexmedetomidine on hemodynamics, awakening quality and stress response in double -lumen tube extubation patients.Methods 60 patients with thoracic surgery were divided into saline group(group N,n =30)and Dex group(group D,n =30).Both two groups were continuously pumped NS and dexmedetomidine respectively 20min before anesthesia.MAP,HR and SpO2 at different time points during the surgery were recorded.Extracted 5ml arterial blood at the time point of T0 and T3,centrifugated and stored at -80 ℃ for testing renin levels.The extubation time,restlessness incidence,orientation recovery time, extubation quality score were recorded.Results The values of MAP in group D at time points of T0,T1,T2,T3,T4 were (97 ±15)mmHg,(102 ±12)mmHg,(103 ±11)mmHg,(98 ±12)mmHg,(96 ±13)mmHg.The values of HR in group D at different time points were (69 ±9)times/min,(80 ±6)times/min,(90 ±7)times/min,(74 ±5)times/min,(73 ±6)times/min.The values of SpO2 in group D at different time points were (95 ±3)%,(98 ±2)%,(98 ± 2)%,(95 ±3)%,(96 ±2)%.The values of MAP in group N at time points of T0,T1,T2,T3,T4 were (96 ± 15)mmHg,(112 ±16)mmHg,(120 ±12)mmHg,(117 ±14)mmHg,(102 ±15)mmHg.The values of HR in group N at different time points were (68 ±7)times/min,(84 ±8)times/min,(105 ±6)times/min,(89 ±6)times/min, (80 ±7)times/min.The values of SpO2 in group N at different time points were (96 ±2)%,(98 ±2)%,(97 ± 3)%,(93 ±3)%,(92 ±4)%.The values of MAP,HR,SpO2 at different time points in group D were significantly lower than those in group N,the differences were statistically significant (the t values of MAP at different time points were tT1 =2.74,tT2 =5.72,tT3 =25.63,tT4 =1.66,all P <0.05;the t values of HR at different time points were tT1 =2.20,tT2 =8.91,tT3 =10.52,tT4 =4.16,all P <0.05;the t values of SpO2 at different time points were tT1 =0.00,tT2 =1.52,tT3 =2.58,tT4 =4.9,PT3 <0.05,PT4 <0.05).There was significant difference between the two groups in orientation recovery time[(3.3 ±2.2)min vs (5.2 ±2.3)min,P =0.0018].There was significant difference between the two groups in agitation score[(1.3 ±0.9)vs (2.4 ±1.2)].There was significant difference between the two groups in extubation quality score[(2.1 ±1.2)vs (3.2 ±1.4),P =0.0018].There was statistical difference between the two groups in T3 adrenal hormones[(N:120 ±25.3)pmol/L,(D:93.4 ±23.2)pmol/L,P =0.00].The dose of sufentanil (60.5 ±9.2)μg in group N was higher than (40.4 ±10.2)μg in group D (P =0.001).The dose of remifentanil (3.3 ±0.8)mg in group N was higher than (2.4 ±0.9)mg in group D (P =0.001).Conclusion Continuous pumped dexmedetomidine can effectively improve awakening quality of patients with double -lumen tube.
ABSTRACT
Objective There is close relationship between ubiquitin-specific protease 9X(USP9X) and the biological behav-ior of some tumor.The aim of this study is to investigate the expression and clinical significance of USP 9X in pancreatic carcinoma of elderly patients. Methods The expression of USP9X was detected in 30 pieces of surgically resected primary pancreatic carcinoma tissue and adjacent nontumorous pancreatic tissue of elderly patients by streptavidin -perosidase immunohistochemical method . Results The rate of USP9X positive expression was 56.7%, there was not positive expression in adjacent nontumorous pancreatic tissue .There was no relation between the expression of USP 9X with gender, age, the tumor positin, the tumor size and degree of differentiation (P>0.05), while it was significantly correlated with lymph node metastasis and TNM stages (P<0.05).By using Cox proportional haz-ards analysis, multivariable analysis revealed that TNM stages , lymph node metastasis and USP9X expression were independent risk factor(P<0.05). Conclusion The results indicated that USP9X may play a role in the pathogenesis and prognosis of pancreatic cancer of elderly patients .
ABSTRACT
Objective To investigate the current status about the knowledge,attitude and practice of medical staff for fast-track surgery (FTS) in third-grade class-A general hospital in Xuzhou,and provide reference for the popularization of the FTS concept.Methods The self-administered questionnaires were employed to survey 130 medical staff in the general surgical department of one third-grade class-A general hospital in Xuzhou.Results The FTS knowledge score was (20±8).The differences of knowledge scores were statistically significant because of different age,degree of education and positional title.The FTS attitude score was (66±20).And the differences of attitude scores were statistically significant because of different age and degree of education.The FTS practice score was (64.50±13.25).There was no statistical significance on the practice scores between the medical staff with different characteristics.Attitude was correlated with knowledge and practice while knowledge was not correlated with practice.Conclusions The FTS knowledge of medical staff was not rich.The FTS attitude was not so positive,and there were also few clinical practice.Medical staff should study the FTS concept and its contents actively.They also should apply FTS in clinic scientifically in order to better control the iatrogenic injury and promote the rehabilitation of patients effectively.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the effects of salidroside (sal) on the expressions of Bcl-2, Bax and caspases-3 proteins in cultured rat subventricular zone (SVZ) neural stem cells (NSCs) exposed to hypoxia injury.</p><p><b>METHODS</b>Primarily cultured SVZ NSCs from adult SD rats were incubated with salidroside (120 and 240 µmol/L) for 24 h prior to exposure to hypoxia. The cell viability was assessed with MTT assay, and the cell apoptosis was analyzed using TUNEL staining and flow cytometry. Western blotting was performed to detect the expressions of Bcl-2, Bax and caspase-3 in the cells.</p><p><b>RESULTS</b>Salidroside pretreatment of the cells for 24 h resulted in an obvious resistance to hypoxia-induced cell apoptosis and decrement of cell viability (P<0.05). Salidroside also antagonized the effect of hypoxia exposure in lowering Bcl-2/Bax ratio apoptosis of rat neural stem cells and decreased the expression of caspases-3 protein (P<0.05).</p><p><b>CONCLUSION</b>Salidroside can significantly resist hypoxia-induced. The neuroprotective effect of salidroside may be related to the modulation of expressions of apoptosis-related proteins.</p>
Subject(s)
Animals , Rats , Caspase 3 , Metabolism , Cell Hypoxia , Cells, Cultured , Flow Cytometry , Glucosides , Pharmacology , Neural Stem Cells , Phenols , Pharmacology , Proto-Oncogene Proteins c-bcl-2 , Metabolism , Rats, Sprague-Dawley , bcl-2-Associated X Protein , MetabolismABSTRACT
OBJECTIVE@#To investigate the relationship between behavioral changes and cell proliferation in subventricular zone (SVZ) after intracerebral hemorrhage (ICH) in adult rats.@*METHODS@#Forty male Sprague-Dawley rats were randomly assigned into a behavioral test group (n = 19) and a bromodeoxyuridine (Brdu) immunohistochemical staining group (n = 21). ICH was induced by stereotactial injection of collagenase type VII into straitum. Proliferating cells were labeled by injection intrapenitoneally of bromodeoxyuridine in a pulse protocal. Rats were killed on day 2, 7, 14, and 28 after the ICH. Behavioral test and bromodeoxyuridine immunohistochemical staining were performed.Behavioral change was tested by forelimb placing test, Berderson's grade and corner turn test in rats. Cell counting of bromodeoxyuridine immunoreactive cells in SVZ was performed.@*RESULTS@#There were marked neurological deficits by day 2 after the ICH, with progressive recovery of function over 4 weeks. A significant increase in the number of bromodeoxyuridine immunoreactive cells in the ipsilateral and cortralateral SVZ was observed from 2 to 14 days with a peak at day 7 after the ICH compared with the sham group.The bromodeoxyuridine immunoreactive cells decreased to control level 28 days after the ICH.@*CONCLUSION@#Proliferation of cells in SVZ corresponds well with behavioral recovery after the ICH, which indicates SVZ cells may be involved in the repairing process after the ICH.
Subject(s)
Animals , Male , Rats , Behavior, Animal , Physiology , Cell Proliferation , Cerebral Ventricles , Pathology , Intracranial Hemorrhages , Pathology , Random Allocation , Rats, Sprague-DawleyABSTRACT
Objective To explore the effect of Ligustrazine on neurogenesis in cortex after focal cerebral ischemia in rats. Methods Focal cerebral ischemia was induced by left middle cerebral arteryocclusion with asuture. Two hours later, injection of Ligustrazine (80 mg/kg, 1 time/d) was performed peritoneally. Four hours after the ischemia,5-bromodeoxyuridine (BrdU) (50 mg/kg, 1 time/d) was injected peritoneally. At 7 d, 14 d and 21 d after ischemia,BrdU positive cells in the cortex were observed by immunohistochemical staining. Results In ischemic model group, at 7 day, sparsely-distributed BrdU positive cells were observed in the Ⅱ - Ⅵ layers of the ipsilateral cortex, with a band-like distribution in ischemic penumbra. With the prolongation of ischemia, the number of BrdU positive cells increased.In Ligustrazine group, BrdU positive cells were also observed in the Ⅱ - Ⅵ layers of the cortex, with an intense distribution in ischemic penumbra. The numbers of BrdU positive cells at 7 d, 14 d and 21 d were more than those in ischemic model group respectively. Conclusion Ligustrazine increases the proliferated cells in cortex after focal cerebral ischemia in rats. The results suggest that it may be useful for promoting self-repair after ischemia.
ABSTRACT
Objective To investigate the proliferative response and time course of endogenous neural stem/progenitor cells after cerebral cortical concis in the adult rats. Methods Eighty adult male Sprague-Dawley rats were used in this study. Cumulative BrdU labeling was employed to detect the proliferating cells. At 1 d, 3 d, 7 d, 14 d, and 21 d after cerebral cortical concis, the rats were killed for BrdU immunohistochemical staining and cell counting in the injured ipsilateral SVZ. Results Little BrdU immunoreactivity cells was present in SVZ of the control rats from day 7 to day 21 after sham operation. The number of BrdU immunoreactivity cells in the injured ipsilateral SVZ increased at day 1 and peaked at day 7 after cerebral cortical concis. Conclusion After cerebral cortical concis of the adult rats, neural stem/progenitor cells in the injured ipsilateral SVZ markedly proliferated with a peak at day 7. This finding may be important for manipulating SVZ cells to promote the recovery from cerebral cortical concis.