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Objective:To explore the pharmacokinetics effect of 8 components of processed Baizhu Shaoyao San on rats.Methods:The rats were divided into processing group and unprocessing group, administered with decoction of Baizhu Shaoyao San by gavage respectively. Then, blood was collected from fundus vein at certain time to obtain the plasma. Finally, the contents of 8 components in plasma were detected and compared by UPLC-MS/MS method, and the methodology of the experiment was tested. The drug concentration in blood and the collection time of blood were analyzed by DAS software, and the time curves of different groups were obtained, the pharmacokinetic parameters were calculated.Results:The blood peak concentration, peak time, area under the drug time curve, and average residence time of 8 components in the serum of rats in the raw product group and the fried product group were different to varying degrees.Conclusion:Processed Baizhu Shaoyao San could influence the behavior of the components measured in rats, which may affect the clinical therapeutic effect of Baizhu Shaoyao San.
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Objective To explore the application value of ultrasound-guided stellate ganglion block in patients with aneurysmal cerebral hemorrhage.Methods Eighty patients with subarachnoid hemorrhage caused by aneurysm from November 2017 to March 2019 in Hangzhou Hospital of Zhejiang Medical Health Group were selected.The patients were divided into observation group and control group by random digits table method with 40 cases in each group.All patients were treated with craniotomy hematoma removal.At the conclusion of the surgical procedure,the control group was treated with nimodipine,while the observation group was treated with ultrasound-guided right stellate ganglion block on the basis of nimodipine.The blood flow velocity of middle cerebral artery before operation and 6,24 h after operation by transcranial Doppler sonography were detected to reflect cerebral vasospasm status;the blood samples from the radial artery and internal jugular bulb 24 h after operation were used to detect and count cerebral oxygen metabolism indexes,including the blood oxygen saturation of internal jugular bulb,arteriovenous oxygen content difference and cerebral oxygen uptake rate;the IgG,IgA and IgM 24 h after operation were detected.The patients were followed up at 1 week after operation,and the complication was observed.Results There was no statistical difference in the blood flow velocity of middle cerebral artery before operation between 2 groups (P＞0.05);the blood flow velocity of middle cerebral artery 6 and 24 h after operation in observation group was significantly lower than that in control group:(100.8± 8.2) cm/s vs.(123.5 ± 9.9) cm/s and (89.7 ± 5.3) cm/s vs.(118.9 ± 7.1) cm/s,and there was statistical difference (P＜0.01).The blood oxygen saturation of internal jugular bulb,cerebral oxygen uptake rate,IgG,IgA and IgM 24 h after operation in observation group were significantly higher than those in control group:0.704 ± 0.035 vs.0.598 ± 0.058,(57.5 ± 6.5)％ vs.(49.7 ± 3.6)％,(12.5 ± 0.3) mg/L vs.(5.0 ± 0.1) mg/L,(5.5 ± 0.3) mg/L vs.(2.1 ± 0.1) mg/L and (4.3 ± 0.3) mg/L vs.(1.9 ± 0.2) rg/L,the arteriovenous oxygen content difference and incidence of complication were significantly lower than those in control group:(40.8 ± 3.2) ml/L vs.(58.3 ± 8.6) ml/L and 5.0％ (2/40) vs.25.0％ (10/40),and there were statistical differences (P＜0.01 or ＜0.05).Conclusions For patients with aneurysmal intracerebral hemorrhage,ultrasound-guided stellate ganglion block therapy can effectively improve cerebral blood flow,ensure cerebral oxygen supply,improve humoral immunity,reduce the incidence of postoperative complication,and achieve the purpose of improving clinical therapeutic effect.
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Objective:To investigate the clinical efficacy of the folding lateral position fixation frame with adjustable angles.Methods:A total of 60 patients from the Department of Intensive Care Unit (ICU) between January and June in 2019 with consciousness disorder or sedation and no ability to change postures on their own were selected and randomized into treatment group ( n=30) and control group ( n=30). Patients in the treatment group were backed by the fixation fame in lateral position of 80 degrees, while those in the control group were backed by sponge triangle pillow in lateral position of 80 degrees. After 2 hours, the angles of the mattress surface and the body of patients in two groups were measured with a SanNiang digital angle ruler. The efficacy rates of maintaining lateral positions of patients in both groups were calculated. The occurrence rates of skin ulcers in both groups were observed as well. Results:The efficacy rate of maintaining a lateral position was 93.3% (28/30) in the treatment group and 33.3% (10/30) in the control group. The differences between two groups were statistically significant ( χ2 value was 23.25, P=0.000). No skin ulcers were observed in patients in the two groups. Conclusion:The folding lateral position fixation frame with adjustable angles helps to maintain the lateral position efficiently, which can smooth sputum drainage, reduce the imbalance between ventilation and blood flow, increase oxygenation and prevent pulmonary infection. Compared with sponge triangle pillow, the frame can bear more weights, which is suitable for patients with varying weights. Beside, the frame is small in size and foldable, which is convenient for storing and sterilizing. It is highly cost effective and can meet different clinical needs.
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Objective To study the influence of intravenous-inhalation combined anesthesia and total intravenous anesthesia on postoperative immune function and inflammatory mediators in patients having underwent modified radical mastectomy during same anesthetic depth. Methods The clinical data of 106 patients having underwent modified radical mastectomy from August 2013 to December 2016 were retrospectively analyzed. In the patients, intravenous-inhalation combined anesthesia was in 56 cases (combined anesthesia group), and total intravenous anesthesia was in 50 cases (intravenous anesthesia group). The peripheral blood cellular immune indexes CD4+, CD8+ and CD4+/CD8+; serum humoral immunity indexes IgA, IgG and IgM; serum inflammatory mediators interleukin (IL)-6, IL-10, tumor necrosis factor(TNF)-α and C-reactive protein(CRP)2 h after operation were compared between 2 groups.Results The CD4+and CD4+/CD8+levels 2 h after operation in combined anesthesia group were significantly higher than those in intravenous anesthesia group (0.31 ± 0.04 vs. 0.29 ± 0.03 and 1.28 ± 0.15 vs.1.17 ± 0.13),the CD8+was significantly lower than that in intravenous anesthesia group (0.34 ± 0.04 vs. 0.36 ± 0.04), and there were statistical differences (P<0.01 or <0.05). The IgA, IgG and IgM levels 2 h after operation in combined anesthesia group were significantly higher than those in intravenous anesthesia group:(1.18 ± 0.15)g/L vs.(0.97 ± 0.11)g/L,(7.96 ± 0.88)g/L vs.(7.18 ± 0.85)g/L and (0.82 ± 0.09) g/L vs. (0.72 ± 0.08) g/L, and there were statistical differences (P<0.05). The IL-6, IL-10,TNF-α and CRP levels 2 h after operation in combined anesthesia group were significantly lower than those in intravenous anesthesia group:(39.68 ± 4.52)ng/L vs.(50.37 ± 6.18)ng/L,(7.05 ± 0.88)ng/L vs. (11.19 ± 2.41) ng/L, (62.38 ± 7.19) ng/L vs. (78.54 ± 9.17) ng/L and (22.53 ± 3.18) mg/L vs. (39.47 ± 4.51)mg/L,and there were statistical differences(P<0.01).Conclusions Compared with total intravenous anesthesia, the intravenous-inhalation combined anesthesia at the same anesthesia depth is helpful to reduce the postoperative immune suppression and systemic inflammatory response in patients undergoing modified radical mastectomy.
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Objective To explore the efficacy of self-made adjustable tracheal cannula in obese patients with tracheotomy. Methods A corresponding model of tracheal cannula was taken and cut with a length of 16 cm. It is noted that the inflation catheter of the airbag should not be broken. A further trim was done along the longitudinal side of the inflation catheter. The inflation catheter was retained. A rubber cork from a nutrient solution bottle was chosen, and a hole was trimmed with the same length of the diameter of the tracheal cannula, through which the tracheal cannula was put. A disposal oxygen mask was trimmed into two wings like a butterfly, the middle of which was made into a hole with the same length of the diameter of the tracheal cannula. Two rectangular holes were made on the two wings in order to fit the rubber cork. The fixed wings of and rubber cork were put together through sutures. The other end of the tracheal cannula was cut and put on a connector and sterilized with ethylene oxide in the supply room. The intraoperative method was the same as the conventional tracheotomy. After the cannula was inserted, the length of the cannula was adjusted by moving the rubber cork up and down according to the obesity of the patient′s neck. Results Compared with regular tracheal cannula, the self-made adjustable tracheal cannula could be easily inserted into the trachea of patients no matter how obese their necks were. It could be connected to ventilator, keep patient′s airway clear and effectively drain phlegm. No slippage was observed in our practice. It was simple, accessible and lower in cost. Conclusions The application of self-made adjustable tracheal cannula in obese patients with tracheotomy can meet the clinical therapeutic needs, and it also proves to be affordable for patients.