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Objective:To evaluate the effect of dexmedetomidine on the quality of recovery from anesthesia in elderly patients undergoing electroconvulsive therapy (ECT) with propofol anesthesia.Methods:Sixty patients of both sexes, aged>65 yr, weighing 45-80 kg, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, scheduled for elective ECT with propofol anesthesia, were assigned into 2 groups ( n=30 each) using a random number table method: control group (group C) and dexmedetomidine group (group D). Dexmedetomidine was intravenously infused in a dose of 0.2 μg/kg (in normal saline 10 ml) over 10 min starting from onset of anesthesia induction in group D, while normal saline 10 ml was given instead in group C. Propofol 1.0-1.5 mg/kg was intravenously injected slowly.Succinylcholine 0.7 mg/kg was intravenously injected after the eyelash reflex disappeared, and oxygen was delivered via a mask to assist artificial ventilation.The mask was removed when the muscle twitching disappeared during depolarization, treatment was performed with an ETC apparatus, and electroencephalogram was monitored.The electrical stimulus intensity was set according to the age of the patient during ECT treatment, and the initial intensity was set at 0.5 times the age of the patient. When the postictal suppression index was less than 80%, a higher level of stimulus intensity was used in the next ECT treatment (the difference between adjacent intensity levels was 25.2 mc, which was 5% of the total stimulus intensity). After the end of ECT procedure, participants were manually ventilated with a mask, and the patients were transferred to postanesthesia care unit when the spontaneous breathing was completely restored.The time to recovery of spontaneous breathing and emergence time were recorded.The development of adverse cardiovascular events, nausea and vomiting, respiratory depression, headache, drowsiness, agitation and delirium during recovery from anesthesia was also recorded. Results:Compared with group C, the incidence of agitation, delirium, hypertension and tachycardia during recovery from anesthesia was significantly decreased, and no significant change was found in the other variables in group D ( P<0.05). Conclusion:Dexmedetomidine can improve the quality of recovery from anesthesia in elderly patients undergoing ECT under propofol anesthesia.
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Objective To evaluate the effect of dexmedetomidine on the quality of recovery from anesthesia in the patients undergoing modified electroconvulsive therapy (MECT) with propofol anesthesia.Methods One hundred and ten patients of both sexes,aged 18-50 yr,weighing 45-80 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective MECT with general anesthesia,were randomly assigned into 2 groups (n =55 each) using a random number table:control group (group C) and dexmedetomidine group (group D).Dexmedetomidine was infused intravenously in a dose of 0.5 μg/kg (in normal saline 10 ml) over 10 min in group D,while normal saline 10 ml was infused intravenously over 10 min in group C.Propofol 1.5 mg/kg and succinylcholine 0.5 mg/kg were injected intravenously,and MECT was performed in the two groups.The emergence time was recorded.The development of cardiovascular events,nausea and vomiting,respiratory depression,headache,somnolence and agitation during recovery from anesthesia was recorded.Results Compared with group C,the incidence of nausea and vomiting,headache and agitation during recovery from anesthesia was significantly decreased (P＜0.05),and no significant changes were found in the emergence time,and incidence of hypertension,tachycardia,respiratory depression and somnolence during recovery from anesthesia in group D (P＞ 0.05).Conclusion Dexmedetomidine (intravenously infused in a dose of 0.5 μg/kg over 10 min before anesthesia) can raise the quality of recovery from anesthesia in the patients undergoing MECT with propofol anesthesia.
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Objective This study aims to investigate the effect of Lipoxin A4 receptor on acute lung injury (ALI) induced by intestine ischemia-reperfusion (IIR). Methods Thirty-two 8-week old SD rats were randomly divided into four groups: sham, intestine ischemia-reperfusion (IIR), IIR + BML111 (BML-111), Boc-2 + IIR +BML111 (Boc-2). BML-111 (1 mg/kg) was given intraperitoneally at the onset of reperfusion in the BML-111 and the Boc-2 group. Boc-2 (50 μg/kg) was given intraperitoneally after anesthesia in the Boc-2 group. Rats were subjected to superior mesenteric artery occlusion consisting of 45-min ischemia and 6-h reperfusion, and the sham laparotomy was served as controls. The lung pathology was assayed by the H&E staining. Lung water content was detected using dry/wet ratio. Concentrations of TNF-α, IL-1β, and IL-6 in lung tissue were determined by ELISA. The protein expression of p38 MAPK and NF-κB of lung was assayed by western blot. Results IIR induced serious ALI, with poor lung pathology and increased lung water content, elevation of TNF-α, IL-1β, and IL-6 levels in lung, accompanied with activation of p38 MAPK/NF-κB pathway. However, BML-111 could inhibit the activation of p38 MAPK/NF-κB pathway, leading to the reductions of TNF-α, IL-1β, and IL-6 in lung and attenuation of IIR-induced ALI. Conclusion BML-111 treatment could attenuate inflammation in lung after IIR injury via inactivating the p38 MAPK/NF-κB signaling pathway.
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Objective To investigate the effect of predictive nursing on the living donor liver transplantation.Methods Forty patients undergoing living donor liver transplantation were divided into the intervention group and the control group with 20 patients in each group randomly.We gave routine nursing cooperation to the control group while predictive nursing besides routine nursing cooperation to the intervention group.The operation time,cold ischemia time of donor liver,nursing complication,cost of surgery and satisfaction degree of surgery cooperation were recorded.Results Compared with the control group,the operation time,cold ischemia time of donor liver,nursing complication,cost of surgery were all decreased,and the satisfaction degree of surgery cooperation was improved.Conclusions Predictive nursing can improve nursing operation quality,raise the efficiency of nursing and surgery,reduce the incidence of complication,which is beneficial to smooth progress of operation and increase satisfaction degree of doctors and nurses to nursing cooperation.
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BACKGROUND: As a kind of filling material for wedge-shaped defects, GC Fuji Ⅸ glass-ionomer cement has arose more and more attention. However, the comparison of repair results between GC Fuji Ⅸ glass-ionomer cement and reinforced glass-ionomer cement are poorly understood. OBJECTIVE: To compare the clinical effect of GC Fuji Ⅸ glass-ionomer cement and reinforced gtass-ionomer cement for repairing wedge-shaped defects of old people. METHODS: Totally 80 teeth were randomly divided into 2 groups, and filled by GC Fuji Ⅸ glass-ionomer cement (experimental group) and reinforced glass-ionomer cement (control group), respectively. The clinical effect of 2 materials were evaluated on color match, edge density heterozygosity, restoration integrity, occurrence of secondary caries and pulp symptom at immediately, 3 months, 6 months and 1 year after placement. RESULTS AND CONCLUSION: The color match of the experimental group was better than that of the control group at 3 months, 6 months and 1 year after placement (P < 0.05); and the edge density heterozygosity of the experimental group was superior to the control group at 6 months and 1 year after placement (P < 0.05); in addition, the restoration integrity of the experimental group was surpass the control group at 1 year after placement (P < 0.05). It demonstrated that GC Fuji IX glass-ionomer cement is an ideal choice for wedge-shaped defects of old people, which exhibits superior effects to reinforced glass-ionomer cement in 1-year follow-up.
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OBJECTIVE To explore the application of hydrogen dioxide hypothermic plasma sterilizing system(STERRAD 100S) in operating room,and study the cost.METHODS The cost of sterilizing endoscopic instruments in operating room was analyzed.And the method of using medical material was improved as follows: use the non-woven fabrics and transparent packing bags repeatly to increase the utilization efficiency of medical material.RESULTS Compared with the traditional method,the cost of sterilizing instruments by STERRAD 100S decreased 2-3 times,which brought much economic benefit.CONCLUSIONS 100S Can improve the working efficiency,reduce inventory level of endoscopic instruments and sterilizing cost,which can relief patient economic burden and ensure patient interest.
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Objective To investigate the effect of leptin (LEP) pretreatment on hypoxia-reoxygenation (H/R) induced apoptusis in human L02 liver cells. Methods Human L02 liver cells were obtained from pharmacology laboratory, Zhong-Shan University and cultured in DMEM liquid culture medium in an incubator filled with 5% CO_2 at 37℃. The cells were divided into 6 groups ( n = 6 each) : group control (group C) ; grouphypoxia-reoxygenation (group H/R); group Ⅰ-Ⅳ pretreatment with LEP 100, 200, 400 and 800 μg/L + H/R. In group H/R and group Ⅰ-Ⅳ L02 cells were exposed to 95% N_2-5% CO_2 for 12 h followed by 12 h reoxygenation. In group Ⅰ-Ⅳ the cells were pretreated with LEP 100, 200, 400, 800 μg/L respectively before H/R. At the end of 12 h of reoxygenation, the cells were centrifuged and the supematant was collected for determination of ALT and AST concentrations. Apoptosis in L02 cells was detected by Hoechst 33342/PI staining. Fluorescent quantitative PCR was used to detect Bax and Bcl-2 mRNA expression. Results (1) ALT and AST concentrations were significantly increased after H/R. The increase in ALT and AST concentrations was ameliorated by pretreatment with LEP. (2) The H/R-induced apoptotic changes of the cells were attenuated by pretreatment with LEP. (3) The Bax mRNA and Bcl-2 mRNA expression was significantly increased in group H/R as compared with group C. Leptin pretreatmcnt significantly reduced Bax mRNA expression and increased Bcl-2 mRNA expression as compared with group H/R. Conclusion LEP pretreatment can decrease H/R-indtwed apoptosis in the L02 liver cells by down-regulation of Bax mRNA expression and up-regulation of Bcl-2 mRNA expression.
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Objective To determine the risk factors for development of early acute renal failure (ARF) after orthotopic liver transplantation (OLT) in patients with normal renal function.Methods Sixty ASA Ⅱ or Ⅲ patients aged 28-64 yr weighing 35-88 kg undergoing OLT were studied.Their preoperative serum Cr and BUN were within normal range.Early ARF was defined as serum Cr≥132 μmol/L and/or BUN≥18 mmol/L within 24 h after operation.The patients were divided into 2 groups: ARF group and non-ARF group.Arterial blood samples and urine specimens were collected before induction of anesthesia for determination of blood β2-micreglobulin(β2-MG) and urinary β2-MG and N-acetyl-β-D-glucurenidnse (NAG). Factors including preoperative liver function,preoperative blood and urinary β2-MG,the amount of urine output and bank blood infused during operation,MAP during anhepatic and neohepatic phase,the amount of vnsoactive drugs and diuretics used during operation,hypotension and arrbythmia during operation were recorded.The risk factors were identified by logistic regression analysis.Results Logistic analysis indicated that serum β2-MG higher than normal value before operation and persistent hypotensien during operation were closely correlated with development of early ARF after OLT.Conclusion Serum β2-MG higher than the normal value before operation.and persistent hypotension during operation are the risk factors for early ARF after OLT.