ABSTRACT
Klebsiella pneumoniae is the most common cause of nosocomial respiratory tract,and the second most frequent cause of Gram-negative bacteraemia and urinary tract infections.Drug resistant isolates remain an important hospital-acquired bacterial pathogen,prolong hospital stays,and are especially problematic in high impact medical areas such as intensive care units.A variety of preventive measures were applied to reduce such incidences.The immune therapies for Klebsiella pneumoniae include active immunization and passive immunization.Many trials for constructing effective vaccines are followed,including inactivated vaccines,polysaccharide vaccine,conjugate vaccine,protein vaccine,and nano vaccine.This review was about the development of vaccines for the prevention ofKlebsiella pneumoniae.
ABSTRACT
<p><b>BACKGROUND</b>The effects of hydroxyethyl starch 130/0.4 (HES130/0.4) on myocardial ischemia/reperfusion (I/R) injury and its mechanism are uncertain. The aim of this study was to investigate the protective effects of HES 130/0.4 on myocardial I/R injury.</p><p><b>METHODS</b>Forty-eight Sprague-Dawley rats were assigned to sham-operation group (S group), ischemia-reperfusion group (I/R group), albumin-I/R group (A-I/R group) and HES130/0.4-I/R group (H-I/R group). The fluids were administered at 25 minutes after ischemia. H-I/R group was given 7.5 ml/kg of HES 130/0.4; I/R group and A-I/R group received the same volume of normal saline and 5% albumin, respectively. The rats in S group were sham operated and received the same fluid as I/R group. After 30 minutes of ischemia and 3 hours of reperfusion, blood samples were taken for cytokines assay, myocardium was excised for detection of NF-κB activity and myocardial infarction areas were taken for immunohistochemical analysis.</p><p><b>RESULTS</b>Hemodynamic parameters of H-I/R group were better than I/R and A-I/R groups at all designated time points. The results of 2,3,5-triphenyl-tetrazolium (TTC) and HE staining were better in the H-I/R group. Myeloperoxidase (MPO), NF-κB activity and concentrations of TNF-α, IL-1β were elevated markedly in I/R groups. HES130/0.4 lessened the release of TNF-α and IL-1β consistent with the reduction of MPO activity, and HES 130/0.4 inhibited the activity of NF-κB in H-I/R group. The number of apoptotic cells in the H-I/R group was also significantly reduced compared with I/R and A-I/R group</p><p><b>CONCLUSION</b>HES130/0.4 has a protective effect on I/R injured myocardium, probably by inhibiting NF-κB activity, reducing the release of pro-inflammatory cytokines and interfering with the apoptosis of cardiomyocytes.</p>
Subject(s)
Animals , Male , Rats , Hemodynamics , Hydroxyethyl Starch Derivatives , Therapeutic Uses , Interleukin-1beta , Metabolism , NF-kappa B , Metabolism , Peroxidase , Metabolism , Rats, Sprague-Dawley , Reperfusion Injury , Metabolism , Pathology , Tumor Necrosis Factor-alpha , MetabolismABSTRACT
Objective: To investigate the changes of alpha adrenergic receptors (α-AR) mRNA expression in heart and mesenteric artery in autonomic dysreflexia (AD) rats after spinal cord transection, so as to explore the possible mechanism of AD. Methods: The spinal cord of rats was exposed and the fourth thoracic spinal cord was transected; 4 weeks later, rats' rectum was stimulated by self-made catheter and those with a mean arterial blood pressure increased by more than 15 mmHg (1 mmHg=0.133 kPa) were chosen as AD group (n=16). Heart and mesenteric arteries along with their branches were harvested. mRNA expression of α1A-, α1B-, α1D-, α2A-, α2B- and α2C-AR was quantified by real time PCR and the result was compared with that in sham-operated group (the fourth thoracic spinal cord was exposed but not transected). Results: Compared with sham-opera ted group, rats in AD group had a lower expression of α1A-AR mRNA (P<0.05) and α1B-AR mRNA (P<0.01) in their heart, but the expression of α1D-AR mRNA had no obvious change. Also, rats in AD group had a higer expression of α1A-, α1D-, α2B-AR mRNA (all P<0.01) and α2C-AR mRNA (P<0.05) in their mesentric artery, but α1B- and α2A-AR mRNA expression had no obvious change. Conclusion: AD may occur in the chronic stage of spinal cord transection in rats. The abnormal expression of α1A- and α1B-AR mRNA in the heart and α1A-, α1D-, α2B- and α2C-AR mRNA in the mesenteric artery may be related to AD.
ABSTRACT
All the examination results of anesthesia interns from 1996 to 2003 were analyzed.The content and criteria of examination in anesthesia intern which was formulated by our university was evaluated.The cause of deficiency reflected by examination results and problems existing in education were analyzed to improve clinic training for anesthesia intern and cultivate excellent anesthesia specialist.
ABSTRACT
Objective: To observe the controlled hypotension effects of nicardipine in 2 different ways for spinal tumor operalion. Methods: Twenty-four adult patients, scheduled for selective spinal tumor operation, were randomly divided into 2 groups. In groupⅠ(n=12), the nicardipine was infused at a rate of 10 μg*kg-1*min-1 and the infusion continued until MAP was at the level of 7.33-8.66 kPa, and then the rate was decreased to 1 μg*kg-1*min-1. In Group Ⅱ(n=12), nicardipine was given 0.01-0.02 mg/kg as the load dose, then infused at 1-2 μg*kg-1*min-1. Results: During the period of controlled hypotension, cardiac index(CI) increased significantly, other hemodynamic variables were stable and no hypertension rebound occurred in both groups. Reaching time of target blood pressure in groupⅡ was shorter than that in groupⅠ（P＜0.05）. The dose required to obtain target blood pressure in group Ⅱwas less than that in group Ⅰ（P＜0.05）. BP recovery time from discontinuing nicardipine infusion to pre-hypotension level,bleeding volume and transfusion volume were similar between 2 groups（P＞0.05）.During mass bleeding, serious arrhythmia and oliguria did not occur in any case. Conclusion: Controlled hypotension with nicardipine is rapid, stable and easily controlled without hypertension rebound. Nicardipine has considerable protective effects on heart and kidney during mass bleeding. The method of bolus injection followed with intravenous infusion is more suitable to clinical application.
ABSTRACT
Objective: To observe the inhibitory effect of scopolamine(Spm) and chlopromazine (Clo) on withdrawal syndromes in morphine dependent rats. Methods: The intensity of withdrawal syndromes on the model of morphine dependent rats was recorded after single or muiltiple subcutaneous administration(sc) of Spm and Clo at different doses. Results: Withdrawal syndromes were markedly decreased when single Spm 1 mg/kg and Clo 0.5 mg/kg combined with morphine were injected (P<0.05). Spm+Clo(sc) had much stronger effects on inhibiting withdrawal syndromes after intraperitoneal (ip) naloxone in morphine dependent rats (P<0.01). Conclusion: Spm can act on Ach-receptor and relieve morphine withdrawal syndromes. Clo may have a synergistic action with Spm via α2-receptor in the locus coeruleus of the rat brain stem.
ABSTRACT
Objective: To investigate jugular bulb venous oxyg en partial pressure(PjO2)， hemoglobin saturation (SjO2) and the arterial t o jugular bulb venous oxygen content difference(AjDO2) during anesthesia with desflurane and isoflurane in patients with brain tumor. Methods: Fifty-six patients with brain tumor were randomized into desflur ane or isoflurane for maintaining anesthesia. PjO2, SjO2 and AjDO2 in pati ents were measured during normoventilation, hyperventilation and hypoventilation . Results: During normoventilation， SjO2 and PjO2 in desflu rane group was significantly higer than those in isoflurane group（P<0.05 or P<0.01）, and AjDO2 in desflurane group was significantly lower than that in isoflurane group（P<0.05）.Except that PjO2 in desflurane group was si gnificantly higer than that in isoflurane group during hyperventilation （P< 0.01）, there were no differences in SjO2, PjO2 or AjDO2 between the 2 g roups during hyperventilation or hypoventilation. While anesthesia with desflura ne and isoflurane, there was a positive correlation between PaCO2 and SjO2. Conclusion: At the same anesthetic effect concentration, desflur ane can significantly increase SjO2 and PjO2 in comparison to isoflurane un der normoventilation, suggesting that desflurane may have stronger effect of rel axing cerebral vessel than isoflurane.
ABSTRACT
Objective: To observe the controlled hypotension effects of nicardipine in 2 different ways for spinal tumor operalion. Methods: Twenty-four adult patients, scheduled for selective spinal tumor operation, were randomly divided into 2 groups. In groupⅠ(n=12), the nicardipine was infused at a rate of 10 μg*kg-1*min-1 and the infusion continued until MAP was at the level of 7.33-8.66 kPa, and then the rate was decreased to 1 μg*kg-1*min-1. In Group Ⅱ(n=12), nicardipine was given 0.01-0.02 mg/kg as the load dose, then infused at 1-2 μg*kg-1*min-1. Results: During the period of controlled hypotension, cardiac index(CI) increased significantly, other hemodynamic variables were stable and no hypertension rebound occurred in both groups. Reaching time of target blood pressure in groupⅡ was shorter than that in groupⅠ（P＜0.05）. The dose required to obtain target blood pressure in group Ⅱwas less than that in group Ⅰ（P＜0.05）. BP recovery time from discontinuing nicardipine infusion to pre-hypotension level,bleeding volume and transfusion volume were similar between 2 groups（P＞0.05）.During mass bleeding, serious arrhythmia and oliguria did not occur in any case. Conclusion: Controlled hypotension with nicardipine is rapid, stable and easily controlled without hypertension rebound. Nicardipine has considerable protective effects on heart and kidney during mass bleeding. The method of bolus injection followed with intravenous infusion is more suitable to clinical application.
ABSTRACT
Objective: To observe the inhibitory effect of scopolamine(Spm) and chlopromazine (Clo) on withdrawal syndromes in morphine dependent rats. Methods: The intensity of withdrawal syndromes on the model of morphine dependent rats was recorded after single or muiltiple subcutaneous administration(sc) of Spm and Clo at different doses. Results: Withdrawal syndromes were markedly decreased when single Spm 1 mg/kg and Clo 0.5 mg/kg combined with morphine were injected (P<0.05). Spm+Clo(sc) had much stronger effects on inhibiting withdrawal syndromes after intraperitoneal (ip) naloxone in morphine dependent rats (P<0.01). Conclusion: Spm can act on Ach-receptor and relieve morphine withdrawal syndromes. Clo may have a synergistic action with Spm via α2-receptor in the locus coeruleus of the rat brain stem.
ABSTRACT
Objective: To investigate jugular bulb venous oxyg en partial pressure(PjO2)， hemoglobin saturation (SjO2) and the arterial t o jugular bulb venous oxygen content difference(AjDO2) during anesthesia with desflurane and isoflurane in patients with brain tumor. Methods: Fifty-six patients with brain tumor were randomized into desflur ane or isoflurane for maintaining anesthesia. PjO2, SjO2 and AjDO2 in pati ents were measured during normoventilation, hyperventilation and hypoventilation . Results: During normoventilation， SjO2 and PjO2 in desflu rane group was significantly higer than those in isoflurane group（P<0.05 or P<0.01）, and AjDO2 in desflurane group was significantly lower than that in isoflurane group（P<0.05）.Except that PjO2 in desflurane group was si gnificantly higer than that in isoflurane group during hyperventilation （P< 0.01）, there were no differences in SjO2, PjO2 or AjDO2 between the 2 g roups during hyperventilation or hypoventilation. While anesthesia with desflura ne and isoflurane, there was a positive correlation between PaCO2 and SjO2. Conclusion: At the same anesthetic effect concentration, desflur ane can significantly increase SjO2 and PjO2 in comparison to isoflurane un der normoventilation, suggesting that desflurane may have stronger effect of rel axing cerebral vessel than isoflurane.
ABSTRACT
Objective:To summarize our experience in perioperative anesthetic management for fulminant hepatic failure (FHF)patients receiving liver transplantation.Methods:The clinical anesthetic data of 48 FHF patients receiving orthotopic liver transplantations(OLT)from January 2006 to January 2007 were retrospectively analyzed,and the anesthetic management expe- rience was summarized.General anesthesia was applied;the hemodynamics was monitored during the operation and doses of adrenaline and phenylephrine were adjusted according to the monitoring results.Blood samples were obtained before operation, before anheptic,30 min after anhepatic phase,5 min before neohepatic phase,and 5 min,30 min and 60 min after neohepatic phase for blood gas and electrolyte analysis and for determination of coagulation function;the drugs were subsequently adjusted according to analysis results.Results:All the 48 patient underwent successful anesthetic management and there was no death dur- ing opearation.The average blood loss during operation was(5 219?478)ml.Mild alkalosis,hypokalemia,hyponatrium,and hy- pocalcemia were present before operations,pH,BE and HCO_3~- were obviously reduced 30 min after anhepatic phase and in- creased 60 min after neohepatic phase.Kalemia was obviously increased 30 min following anhepatic phase and began to increase 60 min following neohepatic phase.Calium concentration was decreased at the end of preanhepatic phase(P