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OBJECTIVE@#To evaluate the impact of a history of vaginal delivery on anesthesia management of patients undergoing hysteroscopic surgery under intravenous general anesthesia without tracheal intubation.@*METHODS@#Ninety-nine patients undergoing hysteroscopic surgery under intravenous general anesthesia were enrolled in this study, including 43 patients with (VD group) and 56 patients without a history of vaginal delivery (NVD group). For all the patients, blood pressure, heart rate (HR), blood oxygen saturation (SpO2) and bispectral index (BIS) were recorded before anesthesia (T1), after anesthesia (T2), after cervical dilation (T3), and at 3 min after cervical dilation (T4). Propofol and etomidate doses during anesthesia induction, the total dose of propofol administered, additional intraoperative bolus dose and times of propofol, intraoperative body movement, total operation time and surgeons' satisfaction feedback scores were compared between the two groups. The postoperative awake time, recovery time, VAS score at 30 min after operation, and postoperative nausea and vomiting (PONV) were also compared.@*RESULTS@#There was no significant differences in SBP, DBP, HR, SpO2, or BIS between the two groups at T1 and T2, but at T3 and T4, SBP and DBP were significantly higher in NVD group than in VD group (P < 0.01); HR was significantly higher in NVD group only at T3 (P < 0.01). The application of vasoactive drugs did not differ significantly between the two groups. The total dose of propofol, additional intraoperative dose and times of propofol were all greater in NVD group than in VD group (P < 0.01). More body movements of the patients were observed in NVD group (P < 0.01), which also had lower surgeons' satisfaction score for anesthesia (P < 0.01), higher postoperative VAS score (P < 0.05), and shorter postoperative awake time (P < 0.05) and recovery time (P < 0.01).@*CONCLUSION@#A history of vaginal delivery has a significant impact on anesthesia management of patients undergoing hysteroscopic surgery under intravenous general anesthesia without tracheal intubation in terms of hemodynamic changes, anesthetic medication, and postoperative recovery quality, suggesting the necessity of individualized anesthesia management for these patients.
Subject(s)
Female , Humans , Pregnancy , Anesthesia, General , Anesthesia, Intravenous , Anesthetics, Intravenous , Cohort Studies , Delivery, Obstetric , Hysteroscopy , PropofolABSTRACT
<p><b>OBJECTIVE</b>To compared the efficacy of drug-coated balloon and common balloon for treatment of superficial femoral artery and popliteal artery occlusive disease.</p><p><b>METHODS</b>Forty-six patients were admitted for ipsilateral single or multiple superficial femoral artery and/or popliteal artery lesions (between 3 and 15 cm stenosis or occlusion), Rutherford grades 2 to 5, with or without other accompanying diseases in the Department of Interventional Vascular Therapy of the First Hospital of Nanjing between September, 2015 and December, 2016. The patients were randomly assigned into drug-coated balloon (DCB) group (n=23) and common balloon (CB) group (n=23). None of the patients had stent restenosis, aneurysms, acute thrombosis, pregnancy, life expectancy less than 1 year, or below-the-knee artery occlusion. The late lumen loss (LLL), improvement of the ankle brachial index (ABI), improvement of Rutherford grade, incidence of restenosis, thrombosis rate and amputation rate were compared between the two groups at 6 months after treatment.</p><p><b>RESULTS</b>The two groups of patients were comparable for general conditions, risk factors, and characteristics of the compromised vessels (P>0.05). Six months after treatment, the patients in DCB group showed significantly smaller LLL, more obvious improvement of the ABI and Rutherford grade, and lower restenosis rate and thrombosis rate than those in CB group (P<0.05). The amputation rates were similar between the two groups (P>0.05).</p><p><b>CONCLUSIONS</b>DCB shows obvious advantages over common balloon for treatment of superficial artery and popliteal artery arteriosclerosis obliterans in that it more effectively reduces LLL, restenosis rate and thrombosis rate and improves the ABI and Rutherford grade at 6 months after the treatment.</p>
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Objective The article was to speed up the dissolution rate of poorly soluble drugs, reduce the configuration time and improve the allocative efficiency by analysis on factors influencing dissolution and adoption of proper allocative approaches accord-ing to different characteristics of insaluble drugs. Methods 5 insaluable drugs were chosen for the study, which were ornithine as-partate, mezlocillin sodium and sulbactam sodium, teicoplanin, omeprazole sodium injection and imipenem and cilastatin sodium.The control group were allocated by routine configuration approach, while the experiment group were improved by increasing the amount of solvent, loosing the powder inside the bottle before configuration, reducing the bubble, adopting special solvent and increasing the dis-solution temperature.Observation and comparative experiment were made on two groups along with the timing from configuration to com-plete dissolution into clear transparent liquid. Results As to the average complete dissolution time of 5 drugs, significant difference was found between two groups([42±5]s vs [246±35]s, [3±1]min vs [30±3]min, [5±1]min vs [10±3]min, [5±3]min vs [10± 5]min, [2±1]min vs [10±1]min, P<0.05).Compared with the control group, the dissolution time of 5 drugs was cut down by 83%, 90%, 50%, 50%, 80%in experiment group. Conclusion Appropriate increase of solvent, loose powder, bubble reduction, special solvent and increased solution temperature contribute to shortening the dissolution time of insoluble drugs and improving the configura-tion efficiency of pharmacy intravenous admixture.
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Background Endophthalmitis is a serious,sight-threatening condition.Identifying the causative microorganisms is very important for available treatment of endophthalmitis.Objective This survey was to analyze the spectrum of organisms causing culture-proven endophthalmitis and their sensitivities to commonly antimicrobial agents.Methods Medical data of patients with culture-proven endophthalmitis at Zhongshan Ophthalmic Center from January 2003 through December 2010 were respectively reviewed.The outcomes included intravitreal isolates and antibiotic sensitivities were analyzed.Results Four hundred and sixty-nine strains of organisms were isolated from 447 eyes of 447 patients with infective endophthalmitis,including 22 eyes of polymicrobial infection.In the organisms,gram-positive organisms were 241 (51.4％),fungi were 125 (26.7％) and gram-negative organisms were 103 (22.0％).The most common organisms were Staphylococcus epidermidis in 29.4％,Aspergillus in 7.7％ and Pseudomonas aeruginosa in 5.3％.In this group of infective patients,the most common clinic settings were posttraumatic endophthalmitis (72.7％),and then were postoperative endophthalmitis (10.5％),endogenous endophthalmitis (9.8％) and keratitis (6.9％).Most gram-positive organism and gram-negative organism were sensitive to levofloxacin and cefoperazone.The susceptibility rate of gram-positive organism to chloromycetin was increased in 2007-2010 years compared with 2003-2006 years (x2=5.398,P＜0.05).The susceptibility rate to ciprofloxacin of gram-negative organisms declined (x2 =5.398,P ＜ 0.05),but that to rifampicin increased in the duration of 2007-2010 compared with 2003-2006 (x2 =4.500,P ＜ 0.05).Conclusions Gram-positive organisms are the most commonly causative organisms of endophthalmitis.Most bacterial organisms are sensitive to levofloxacin and cefoperazone.Local data of culturing and susceptibility test offers a guideline for the treatment of infectious endophthalmitis.
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OBJECTIVE: To evaluate the value of early identification and endovascular treatment of iliac vein compression syndrome (IVCS), with or without deep vein thrombosis (DVT). MATERIALS AND METHODS: Three groups of patients, IVCS without DVT (group 1, n = 39), IVCS with fresh thrombosis (group 2, n = 52) and IVCS with non-fresh thrombosis (group 3, n = 34) were detected by Doppler ultrasonography, magnetic resonance venography, computed tomography or venography. The fresh venous thrombosis were treated by aspiration and thrombectomy, whereas the iliac vein compression per se were treated with a self-expandable stent. In cases with fresh thrombus, the inferior vena cava filter was inserted before the thrombosis suction, mechanical thrombus ablation, percutaneous transluminal angioplasty, stenting or transcatheter thrombolysis. RESULTS: Stenting was performed in 111 patients (38 of 39 group 1 patients and 73 of 86 group 2 or 3 patients). The stenting was tried in one of group 1 and in three of group 2 or 3 patients only to fail. The initial patency rates were 95% (group 1), 89% (group 2) and 65% (group 3), respectively and were significantly different (p = 0.001). Further, the six month patency rates were 93% (group 1), 83% (group 2) and 50% (group 3), respectively, and were similarly significantly different (p = 0.001). Both the initial and six month patency rates in the IVCS patients (without thrombosis or with fresh thrombosis), were significantly greater than the patency rates of IVCS patients with non-fresh thrombosis. CONCLUSION: From the cases examined, the study suggests that endovascular treatment of IVCS, with or without thrombosis, is effective.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Angioplasty, Balloon , Constriction, Pathologic/therapy , Diagnostic Imaging , Iliac Vein/pathology , Peripheral Vascular Diseases/complications , Retrospective Studies , Stents , Thrombectomy , Vascular Patency , Vena Cava Filters , Venous Thrombosis/complicationsABSTRACT
<p><b>BACKGROUND</b>Large animal models with toxin-mediated pancreatic damage have been used extensively in researches with respect to diabetes mellitus and cardiovascular diabetic complications. The present study aimed to establish Chinese Guizhou minipig models with streptozotocin (STZ)-induced diabetes and characterize the animal models by analyzing inflammatory cytokine levels in aortic wall, such as tumor necrosis factor (TNF)-alpha, interleukin-1beta (IL-1beta) and interleukin-6 (IL-6).</p><p><b>METHODS</b>Twenty-two male Chinese Guizhou minipigs (age, 4 to 6 months; weight, 20 kg to 30 kg) were divided into STZ-induced diabetic group (n = 12) and control group (n = 10). STZ (125 mg/kg) was administrated to induce hyperglycemia and afterwards insulin was used to control fasting blood glucose levels below 10 mmol/L. Oral glucose tolerance test (OGTT) was performed before and one month after STZ administration and serum concentrations of alanine transaminase, asparagine transaminase, albumin, blood urea nitrogen, creatinine, lipids and white blood cell count were measured before and six months later. Animals in both groups were euthanized after six months and pancreas was examined immunohistochemically for islet beta cells. Aortic intima of diabetic minipigs and controls was analyzed for TNF-alpha level in tissue conditioned medium by Western blot. TNF-alpha, IL-1beta and IL-6 mRNA levels in aortic intima were assayed by reverse transcription and polymerase chain reaction (RT-PCR).</p><p><b>RESULTS</b>Significant elevation in serum glucose levels was observed one month and six months after STZ induction (P < 0.001) and markedly increased OGTT values were noted, compared with baseline data. The normal pancreas had many irregular sized islets and small clusters of islet beta cells, while in pancreas of diabetic minipigs islet beta cells almost disappeared. No statistical difference was notified in serum concentrations of biochemical examinations before and six months after STZ induction. Western blot demonstrated dramatically increased TNF-alpha level in aotic intima conditioned medium, and significant elevation of TNF-alpha, IL-1beta and IL-6 mRNA levels was revealed by RT-PCR.</p><p><b>CONCLUSIONS</b>The present study has established Chinese Guizhou minipig models with STZ-induced diabetes. Inflammatory cytokines (TNF-alpha, IL-1beta and IL-6) significantly elevated in aortic intima of diabetic minipigs.</p>
Subject(s)
Animals , Male , Aorta , Chemistry , Diabetes Mellitus, Experimental , Allergy and Immunology , Pathology , Glucose Tolerance Test , Immunohistochemistry , Interleukin-1beta , Blood , Interleukin-6 , Blood , Pancreas , Pathology , Streptozocin , Swine , Swine, Miniature , Tumor Necrosis Factor-alpha , BloodABSTRACT
AIM: To compare the pharmacokinetics and relative bioavailability of the domestic and imported sustained-release tablets of gliclazide in healthy volunteers. METHODS:The study was performed by an four-period crossover design with singledose and multiple-dose administration. The plasmadrug concentrations of twenty male healthy volunteers were determined by liquid chromatography with mass spectrum detector method (LC-MS). RESULTS:The pharmacokinetic parameters after a single oral dose of the domestic and imported gliclazide tablets were (7.2+s 1.5) h and (6.9 +1.4) h for tmax, (13.4 ±1.2) h and (13.7 +1.3) h for t1/2, (2.4 +0.8) mg ·L-1and (2.3 ±0.6) mg· L-1 forcmax, (48 ±14)mg · h · L-1 and (48 +14) mg· h · L-1 forAUC0-60,(51+15) mg· h· L-1 and (50±14) mg· h· L-1for AUC0-∞, (22.4 ± 1.9 ) h and (22.8 ± 1.9 ) h for MRT, respectively. The steady state pharmacokinetic parameters after multiple doses of the domestic and imported gliclazide tablets were (6. 1 ± 1.4) h and (6.5+1.4) h for tmax, (4.6±0.9) mg· L-1 and (4.7±1.1) mg· L-1 for cmax, (0.23 ±0.08) mg ·L-1and (0.26±0.08) mg· L-1 forcmin, (1.6±0.3) mg·L-1 and (1.6±0.3) mg · L-1 for mean value of steady plasma-drug concentration (cav),(94±19) mg· h · L-1 and (95 ±20) mg · h · L-1forAUCss, (282 ±33)% and (283 ±43)% for degree of fluctuation DF ), respectively. The relative bioavailability of the domestic gliclazide tablet to the imported gliclazide tablet following a single and multiple dose were ( 102 ± 9) % and (99 ± 10 ) %, respectively. Main pharmacokinetic parameters between the two formulations in both single and multiples dose studies showed no statistical difference ( P >0.05 ). CONCLUSION: The result of two one side t-test shows that the two formulations are bioequivalent.
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OBJECTIVE: To established an HPLC method for the determination of main component and related substances in amlodipine maleate dispersible tablets. METHODS: The separation was performed on a Lichrospher C18 column. The mobile phase consisted of methanol-0.03 mol?L-1 potassium dihydrogen phosphate (70 ∶ 30) at the flow rate of 1 mL?min-1. The detection wavelength was set at 237 nm and column temperature was 30 ℃. RESULTS: The linear range of amlodipine maleate were 31.94～127.75 ?g?mL-1 (r=0.999 8, n=5). The average recovery was 99.5% (RSD=0.39%, n=9). The contents of related substance were all lower than 0.38%. CONCLUSION: The method is simple, rapid, accurate and specific for the quality control of amlodipine maleate dispersible tablets.
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OBJECTIVE: To valuate the antibiotic effects in vitro of Pazufloxacin combined with Cefoperazone/Sulbactam against 90 common pathogenic bacteria from hospital acquired infection. METHODS: The protocol was designed by checkerboard method. The MIC of two antibiotics alone or in combination against 90 strains (including 30 staphylococcus aureus, 30 Escherichia colis, 30 Pseudomonas aeruginosas) were detected by broth dilution method and the FIC index was calculated according to MIC values. RESULTS: The MIC of Pazufloxacin combined with cefoperazone/sulbactam against 90 strains was reduced significantly. The percentage of the FIC index maintained at less than 0.5, 0.5～1, 1～2, above 2 were 60.7%～80.0%, 20.0%～33.3%, 3.3%～6.6%, and 0% respectively. CONCLUSION: The antibiotic activity of Pazufloxacin combined with cefoperazone/sulbactam against 90 common iatrogenic strains from hospital acquired infection was enhanced significantly. Their antibacterial action in vitro was characterized by synergism and additive action instead of antagonistic effect.