ABSTRACT
Objective To compare the effect of three kinds of reverse trendelenburg position angle in block plane of prone position after subarachnoid anesthesia, in order to acquire the conformable reverse trendelenburg position angle of prolapse and hemorrhoids (PPH). Methods Sixty patients having underwent the selective PPH were divided into 10° group, 20° group and 30° group by random digits table method with 20 cases each. Subarachnoid puncture was performed in the L3 - 4 processus spinosus gap, then 0.5%heavy density ropivacaine 2 ml was injected. After anesthesia, the operation bed was adjusted to reverse trendelenburg position 10° (10° group), 20° (20° group) and 30° (30° group). At the same time the patients changed to prone position, and the operation bed was changed to horizontal position before operation. The patients changed to jackknife position 10 min after drug injection of subarachnoid anesthesia. The sensory blockade after drug infusion, circulation function change, anesthetic effect and perioperative adverse reaction were observed. Results There were no statistical differences in operation start time and fixed time of anesthesia plane among 3 groups (P>0.05). The upper bound of sensory nerve block before horizontal position, upper bound of sensory nerve block before jackknife position, highest plane of sensory nerve block in 10° group were significantly higher than those in 20° group and 30° group: T(10.47 ± 0.65) vs. T(12.36 ± 0.72) and T(12.50 ± 0.54), T(10.12 ± 0.56) vs. T(11.82 ± 0.66) and T(11.99 ± 0.72), T(9.53 ± 0.71) vs. T(11.32 ± 0.78) and T(11.54 ± 0.83), and there were statistical differences (P0.05). The systolic blood pressure and diastolic blood pressure levels 15 and 20 min after drug infusion in 10° group were significantly lower than those in 20° group and 30° group, systolic blood pressure:(120.40 ± 7.38) mmHg (1 mmHg=0.133 kPa) vs. (131.82 ± 7.88) and (130.47 ± 7.57) mmHg, (119.55 ± 7.65) mmHg vs. (131.25 ± 9.67) and (130.23 ± 8.69) mmHg, diastolic blood pressure: (63.74 ± 6.54) mmHg vs. (71.36 ± 8.49) and (74.32 ± 7.54) mmHg, (61.59 ± 6.23) mmHg vs. (72.98 ± 7.39) and (73.75 ± 6.34) mmHg, and there were statistical differences (P0.05). No patients′ anesthesia effect was poor in 3 groups, but 4 cases in 30° group were good. Hypotension and tachycardia occurred in 2 cases in 10° group, respectively. Conclusions Immediately prone position after subarachnoid anesthesia can be adjusted by reverse trendelenburg position angle to get the appropriate level of anesthesia, and conformable reverse trendelenburg position angle of PPH is 20°.
ABSTRACT
In order to investigate the effects of rhGM-CSF on apoptosis of HL-60 cells induced with VP-16 treatment, HL-60 cells were first incubated with rhGM-CSF before they were treated with VP-16. The apoptosis processes and the changes in apoptosis related gene bcl-2 and fas expression were observed. The morphological and ultrastructural changes were observed under optics microscope and electromicroscope. DNA fragmentation were detected by agarose gel electrophoresis, the apoptotic rate, bcl-2 and fas expression with flow cytometry. Our results showed that rhGM-CSF inhibited the apoptosis of HL-60 cells induced with VP-16 treatment, which enhanced the down-regulation of bcl-2 expression, but inhibited the up-regulation of fas expression. So it suggested that rhGM-CSF can decrease the sensitivity of HL-60 cells to VP-16, probably by down-regulation of fas expression.