ABSTRACT
To investigate the sedative effect of dexmedetomidine in spinal-epidural anesthesia on hysteromyomectomy a total of 100 hysteromyomectomy patients were randomly divided into the control group and the observation group with 50 in each group. Patients in the control group received the general anesthesia, while those in the observation group received spinal-epidural anesthesia, and intravenous injection of dexmedetomidine. For maintenance of anesthesia, ropivacaine was adopted for both groups. Before anesthesia, at 30 min and 60 min after anesthesia, we measured the heart rate [HR], bispectral index [BIS] and sedative effect. Before anesthesia, HR, BIS and Ramsay scores were compared between two groups, and the results showed that differences had no statistical significance [p>0.05]; but at 30 min after anesthesia, HR and BIS of patients in the observation group were significantly lower than those in the control group [p<0.05], and Ramsay score was higher than the control group [p<0.05]. No statistical significance was found in differences of the incidence rate of adverse reactions between two groups [p>0.05]. Application of dexmedetomidine in spinal-epidural anesthesia gains promising sedative effect and safety in hysteromyomectomy, which is worthy of being promoted in clinical treatment
ABSTRACT
<p><b>OBJECTIVE</b>Based on the distribution of genetic polymorphisms regarding phase I metabolic enzyme cytochrome P450 1A1 (CYP1A1) and phase II metabolic enzymes glutathione S-transferase GSTM1 and GSTT1 genotypes in acute leukemia patients and health controls among general population of Hunan in China, this study was to explore the relationship between these gene polymorphisms and the susceptibility to acute leukemia.</p><p><b>METHODS</b>Using case-control methodology, we studied 204 healthy controls and 232 patients with acute leukemia, of which 112 patients were suffering acute lymphoblastic leukemia (ALL) and 120 with acute non-lymphoblastic leukemia (ANLL). The frequencies of the genotypes were detected by PCR and PCR-RFLP techniques.</p><p><b>RESULTS</b>The variation frequencies of CYP1A1 gene (Msp I polymorphisms, site 3801T-C variation) in ALL and ANLL groups were 74.1% and 70.8% respectively which were higher than 63.3% appeared in the healthy controls. However, the differences between patients (ALL or ANLL) and healthy controls were not statistically significant (P > 0.05 for both). The null genotype of GSTM1 (GSTM1 -/-) in ALL group was 60.7%, which was not significantly different from the controls (55.4%). However, GSTM1 -/- genotype in ANLL group was 68.3%, significantly different from the controls (P < 0.05). The null genotypes among GSTT1 (GSTT1 -/-) in ALL, ANLL and control group were 50.9%, 55.0% and 49.0% but their differences were not statistically significant (P > 0.05). The incidences of GSTM1 -/- and GSTT1 -/- combined genotype in ALL, ANLL and control group were 33.0%, 40.0% and 27.5%, of which the difference between ANLL group and control group was statistically significant (P < 0.05) and CYP1A1 gene heterozygous mutation type or homozygous mutation type combined with GSTM1 -/- and GSTT1 -/- increased the risk of ANLL (OR value 1.890, 95% CI: 1.084-3.295).</p><p><b>CONCLUSION</b>These results indicated that both the variation of CYP1A1 gene or GSTT1 -/- genotype alone might not be associated with the susceptibility of acute leukemia while GSTM1 -/- genotype alone or combined with GSTT1 -/- or the 3801 T-C variation of CYP1A1 gene were correlated with ANLL. These findings suggest that GSTM1 - / - genotype alone or in combination with other defective genotypes might serve as risk factors to the etiology of ANLL.</p>