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OBJECTIVE：To study th e effects of dexmedetomidine on ventricular arrhythmia in myocardial hypertrophy model rabbits and the expression of calcium ion /calmodulin-dependent protein kinase Ⅱ（CaMKⅡ）in myocardial tissue of rabbits. METHODS： The rabbits were randomly divided into sham operation group ， model group ， dexmedetomidine low-dose ， medium-dose and high-dose groups （10，25，50 μ g/kg），CaMK Ⅱ inhibitor KN- 93 group （10 mg/kg），high-dose of dexmedetomidine+KN-93 group（50 μg/kg+10 mg/kg），with 10 rabbits in each group. Except for the sham operation group ，other groups received abdominal aortic coarctation to induce myocardial hypertrophy model. After surgery ，administration groups were given relevant dose of dexmedetomidine or/and intraperitoneal injection of KN- 93；sham operation group and model group were given constant volume of normal saline intravenously ，once every other day ，for consecutive 8 weeks. After last medication ， programmed stimulation was used to induce ventricular arrhythmia. The induction rate of early posterior depolarization （EAD）and tip torsion type ventricular tachycardia （Tdp）were recorded. Left ventricular ejection fraction （LVEF）and left ventricular shortener fraction（FS）were measured. QT interval ，transventricular wall repolarization dispersion （TDR）and transmembrane 90％ action potential duration （APD90）of endocardial and epicardial cardiomyocytes in wedge-shaped myocardium were recorded. The ratio of heart weight to body weight （HW/BW）and the thickness of left ventricular wall （LVT）were measured and calculated. The cross-sectional area of cardiomyocytes ，mRNA expression of ANP and BNP as well as protein expression of CaMK Ⅱ and p-CaMK Ⅱ in myocardial tissue was measured. RESULTS ：Compared with sham operation group ，the induction rate of EAD and Tdp ，HW/BM， LVT，mRNA expression of ANP and BNP and protein relative expression of CaMK Ⅱ and p-CaMK Ⅱ in cardiac tissue were all increased significantly ，while LVEF and FS were decreased significantly ；QT interval ，APD90 of endocardial and epicardial cardiomyocytes were all prolonged significantly ；TDR was increased significantly ，while cross-sectional area of cardiomyocytes was increased significantly in model group （P＜0.05）. Compared with model group ，induction rate of EAD and Tdp ，HW/BW （except for dexmedetomidine low-dose group ），LVT（except for dexmedetomidine low-dose group ），mRNA relative expression of ANP（except for dexmedetomidine low-dose group ）and BNP （except for dexmedetomidine low-dose group ）as well as protein relative expression of CaMK Ⅱ and p-CaMK Ⅱ were all decreased significantly in administration groups ；the levels of LVEF （except for dexmedetomidine low-dose group ） and FS （except for dexmedetomidine low-dose group ） were all increased significantly； QT interval ，APD90 of endocardial and epicardial cardiomyocytes were shortened significantly ； TDR and cross-sectional area of cardiomyocytes （except for dexmedetomidine low-dose group ）were decreased significantly （P＜0.05）；the improvement effects of dexmedetomidine high-dose group were significantly better than those of dexmedetomidine low-dose and medium-dose groups （P＜0.05）. Compared with dexmedetomidine high-dose group and KN- 93 group，the improvement of above indexes were all more significant in high-dose of dexmedetomidine+KN- 93 group（P＜0.05）. CONCLUSIONS ：Dexmedetomidine can reduce the induction rate of ventricular arrhythmia and improve myocardial hypertrophy in myocardial hypertrophy model rabbits，the mechanism of which may be associated with down-regulation of CaMK Ⅱ expression.
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Qinghai University lies in western China. There are some gaps between western and eastern universities at student level, education fund, experiment condition and technique supply for graduate students. To improve educational quality for graduate students, Department of Pathophysiology of Qinghai University focused on teaching methods, evaluation approaches and capacity of teachers and constructed a course named Clinical Pathophysiology for scientific research graduate students. The course adopted a series of measures such as combining lectures with students' self-learning (PBL, paper discussion, lecture for students), introducing experts from other schools to give lectures, establishing formative evaluation, optimizing teacher's group and so on, which have gained some achievements and improved the training quality for graduate students.
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OBJECTIVE:To observe analgesia,sedation effects and safety of flurbiprofen axetil combined with hydromorphone for postoperative patient-controlled intravenous analgesia (PCIA) after orthopedics surgery. METHODS:Totally 90 patients with combined spinal epidural anesthesia underwent lower limb surgery were selected from anesthesology department in the Affiliated Hospital of Chengde Medical College during May 2016-Jan. 2018. They were divided into SF group,H group and KH group according random number table,with 30 cases in each group. The postoperative PCIA pump drug liquid formula of SF group included Sufentanil citrate injection 2-3 μ g/kg+Tropisetron hydrochloride for injection 10 mg+0.9% Sodium chloride injection diluted to 100 mL;that of H group included Hydromorphone hydrochloride injection 0.12 mg/kg+Tropisetron hydrochloride for injection 10 mg+0.9% Sodium chloride injection diluted to 100 mL;that of KH group included Hydromorphone hydrochloride injection 0.12 mg/kg+Flurbiprofen axetil injection 50 mg+Tropisetron hydrochloride for injection 10 mg+0.9% Sodium chloride injection diluted to 100 mL. The operation time, intraoperative medication (epidural application frequency of additional ropivacaine,frequency of ephedrine and atropine),effective pressing times of analgesic pump and the analgesic effect of PCIA were observed in 3 groups. VAS score and Ramsay sedation score were observed 2,6,12,24,48 h after surgery. The hospital anxiety and depression scale (HAD) score,profile of mood states (POMS) score and the occurrence of ADR were observed before and after surgery. RESULTS:There was no statistical significance in operation time,epidural application frequency of additional ropivacaine or frequency of ephedrine and atropine among 3 groups (P＞0.05). The effective pressing times of analgesic pump in KH group were significantly lower than SF group and H group. The proportion of patients with excellent and good anesthesia effect in KH group was significantly higher than SF group and H group (P＜0.05);there was no statistical significance between SF group and H group(P＞0.05). VAS score of 3 groups 48 h after surgery were significantly lower than 6, 12,24 h after surgery;that of KH group was significantly lower than SF group and H group(P＜0.05);there was no statistical significance between SF group and H group(P＞0.05). There was no statistical significance in Ramsay score among 3 groups at different time points(P＞0.05). Before surgery,there was no statistical significance in HAD score or POMS score among 3 groups (P＞0.05). After surgery,HAD score and POMS score of KH group and H group were significantly lower than before surgery and SF group(P＜0.05);there was no statistical significance in KH group and H group,before and after surgery in SF group(P＞0.05). No vomiting,respiratory depression,pruritus and digestive tract bleeding were observed in 3 groups. The incidence of dizziness and nausea in H group and KH group were significantly lower than SF group (P＜0.05);there was no statistical significance between KH group and H group(P＞0.05). CONCLUSIONS:The flurbiprofen axetil combined with hydromorphone show good analgesic and sedative effect for PCIA after orthopedics operation,and can significantly improve emotion and mood of patients with good safety.
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Objective:To investigate the application of non-intravenous dexmedetomidine(DEX)in the pediatric patients underwent lower abdomen and limb surgery,and to observe the sedative effect of DEX in this procedure. Methods:Sixty patients undergoing the general anesthesia for lower abdomen and limb surgery were selected and randomly devided into ropivacaine sacral block(RS)group,intranasal DEX+ ropivacaine sacral block(ID)group, ropivacaine + DEX sacral block(DS)group,20 cases in each group.The children in ID group received intranasal DEX 1 μg·kg-130 min before operation and the children in RS and DS groups received physiological saline. 1 mL·kg-1propofol was infused intravenously in the children who could not smoothly enter into the operating room as well as the intolerance to oxygen mask or sevoflurane inhalation while induction.The children in RS and ID groups received 0.25% ropivacaine 1 mL·kg-1,and the children in DS group received the same dose of ropivacaine mixed with 1 μg·kg-1DEX,and the total volume of drugs was 20 mL.The general information of each child was recorded;the sedation status when separated from their parents and induction period mask and sevoflurane acceptance scores were assessed;the satisfaction of separation with parents,oxygen mask and sevoflurane inhalation were recorded;the time of operation,induction,extraction of laryngeal mask and anesthesia awake were recorded;delayed awakening,laryngismus and awakening period agitation score were recorded.The scores of anesthesia recovery and the dosage of propofol were recorded;the sedation scores 4,8,12,16,20,and 24 h after operation were recorded.Results:Compared with RS and DS groups,the sedation scores of the children when they were separated from their parents and mask induction and sevoflurane inhalation acceptance,the satisfaction degree of separation,mask and sevoflurane acceptance in ID group were increased(P<0.05);the dosage of propofol in ID group were decreased(P<0.05).The time of operation,extraction of laryngeal mask and anesthesia awake had no significant differences between three groups(P>0.05),the induction time of children in ID group was shorter than those in RS and DS groups(P<0.05).There was no delayed awakening in three groups,and the laryngismus and the awakening period agitation score in RS group were higher than those in ID and DS groups(P<0.05).There was no differences in the consciousness,respiration,activity scores and the scores of anethesia recovery between three groups(P>0.05).The sedation scores in the three groups were less than 3 points 4 h after operation. Compared with RS group,the sedation scores in ID and DS groups were decreased 8 h after operation(P<0.05). Compared with RS and ID groups,the sedation scores in DS group 12,16 and 20h after operation were decreased (P<0.05).There were no significant differences in the sedation scores between three groups 24 h after operation (P>0.05).Conclusion:When non-intravenous DEX is used in the pediatric patients underwent lower abdomen and limb surgery,the children can quietly and co-operationly enter into the operating room and quickly and smoothly complete the induction process;the incidence of revival restlessness is significantly reduced,and it can play a role in the early postoperative sedation.
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Objective: To investigate the application of non-intravenous dexmedetomidine (DEX) in the pediatric patients underwent lower abdomen and limb surgery, and to observe the sedative effect of DEX in this procedure. Methods: Sixty patients undergoing the general anesthesia for lower abdomen and limb surgery were selected and randomly devided into ropivacaine sacral block (RS) group, intranasal DEX + ropivacaine sacral block (ID) group, ropivacaine + DEX sacral block (DS) group, 20 cases in each group. The children in ID group received intranasal DEX 1 μg · kg-1 30 min before operation and the children in RS and DS groups received physiological saline. 1 mL · kg-1 propofol was infused intravenously in the children who could not smoothly enter into the operating room as well as the intolerance to oxygen mask or sevoflurane inhalation while induction. The children in RS and ID groups received 0.25% ropivacaine 1 mL · kg-1, and the children in DS group received the same dose of ropivacaine mixed with 1 μg · kg-1 DEX, and the total volume of drugs was 20 mL. The general information of each child was recorded; the sedation status when separated from their parents and induction period mask and sevoflurane acceptance scores were assessed; the satisfaction of separation with parents, oxygen mask and sevoflurane inhalation were recorded; the time of operation, induction, extraction of laryngeal mask and anesthesia awake were recorded; delayed awakening, laryngismus and awakening period agitation score were recorded. The scores of anesthesia recovery and the dosage of propofol were recorded; the sedation scores 4, 8, 12, 16, 20, and 24 h after operation were recorded. Results: Compared with RS and DS groups, the sedation scores of the children when they were separated from their parents and mask induction and sevoflurane inhalation acceptance, the satisfaction degree of separation, mask and sevoflurane acceptance in ID group were increased (P0.05), the induction time of children in ID group was shorter than those in RS and DS groups (P0.05). The sedation scores in the three groups were less than 3 points 4 h after operation. Compared with RS group, the sedation scores in ID and DS groups were decreased 8 h after operation (P0.05). Conclusion: When non-intravenous DEX is used in the pediatric patients underwent lower abdomen and limb surgery, the children can quietly and co-operationly enter into the operating room and quickly and smoothly complete the induction process; the incidence of revival restlessness is significantly reduced, and it can play a role in the early postoperative sedation.
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Objective To establish a one-step recombinase polymerase amplification (RPA) method for pathogen screening and rapid detection in the field targeting for five hemorrhagic fever related viruses (Zaire ebola virus, Sudan ebola virus, Marburg virus, Lassa virus and Yellow fever virus). Methods The specific nucleic acid (NA) fragments of each virus were selected as target genes by genome sequence analysis, and the primers and probes for RPA assays were designed according to the sequence. A series of diluted template genes were used for RPA detection to determine the sensitivity. The hemorrhagic fever-related viral nucleic acids were used for RPA detection to determine the specificity. The amplification experiments were carried out at different temperature ranging from 37℃ to 42℃ to validate the reaction temperature range. Results The RPA reaction systems of the five hemorrhagic fever viruses could effectively amplify the target genes, the sensitivities were between 1.5×102 and 1.5×103 copies. No cross reactions existed with the other hemorrhagic fever-related viral genes. Meanwhile, RPA assay could effectively amplify the target genes at 37-42℃. Conclusion The isothermal RPA assays of five hemorrhagic fever viruses are established, which may amply target genes fast and react at a wide temperature range, and be potentially useful for in field pathogens detection.
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Objective To construct the pseudovirus containing nucleic acid(NA)fragments of Marburg virus,Zaire Ebola virus,Sudan Ebola virus,Lassa fever virus and Yellow fever virus by using a lentiviral vector system in order to provide a reference standard for the detection of the five viruses.Methods The gene fragments of the above five viruses were synthesized in vitro,connected into a single gene by fusion PCR technique,and cloned into lentiviral vectors with its auxiliary vector.After co-transfecting into 293T cells,the supernatants were collected on 48 h and 72 h post transfection. The naked NA was cleaned from the supernatants using DNase and RNase digestion before pseudotype virus was purified and concentrated.After the NA of the pseudotype virus,were extracted normal PCR and real-time PCR were conducted. Results Sequence analysis showed that the five target genes in vitro synthesis were properly connected and inserted into lentivirus vectors.Using the NA of the pseudotype virus as the template,both normal PCR and real-time PCR could sensitively amplify the target gene with the primers and probes of the above five,viruses respectively.The result indicated that the pseudovirus particles containing the five kinds of hemorrhagic fever virus target genes were successfully packaged. Conclusion The pseudovirus particles containing gene fragments of five viruses are constructed,which can be used as a common reference standard for NA detection.
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Glucagonoma is a kind of neuroendocrine tumor of the pancreas,which is rarely seen in clinical practice.Glucagonoma is characterized by necrolytic migratou erythema (NME),diabetes,anemia and body weight loss,and NME is the most characteristic clinical manifestation.The most important laboratory basis of glucagonoma is the levels of fasting plasma glucagon.Various imaging examinations are helpful for the localization of the tumor.Operation is the main method for the treatment of glucagonoma.A patient with glucagonoma was admitted to the Affiliated Hospital of Binzhou Medical College in December 2013,and the experiences in the diagnosis and treatment of glucagonoma were shared based on the data of this patient.
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In order to adapt to the demand of culturing high quality talents and to strengthen student's comprehensive quality,pathophysiology department of medical college of Qinghai University carried on the reform on the pathophysiological experiment examination system.After researches and practices in recent years,we established a set of relatively sound examination system including experiment operating and experiment report in normal study,report for designable experiment and experiment skill and theory exam.Investigation results demonstrated that examination system after reform functioned well in training the students' operation ability,observation ability and ability to analyze and solve questions.
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AIM:To provide evidence for the molecular mechanism of homocysteine (Hcy) as an independent risk factor in atherosclerosis (AS) by investigating the effect of Hcy on phenotype transformation and proliferation of vascular smooth muscle cells(VSMCs) in rats.METHODS:After treated with different concentrations of Hcy for 24 h,the cultured VSMCs were assayed for cell proliferation rate by MTT method,cell cycle by flow cytometry,the expression of SM22-? mRNA by semi-quantitative RT-PCR and the observation of morphological characteristics and the phenotype transformation by transmission electron microscopy.RESULTS:Hcy increased the cell proliferation rate and gradually reduced the proportion of the cells in G0 /G1 phase.Hcy down-regulated the expression of SM22? mRNA and the most significant effect was observed at concentration of 1 000 ?mol/L.The observations of transmission electron microscopy revealed an abundant endoplasmic reticulum,Golgi's complex,loose nucleus and puffy chromatin in VSMCs treated with high concentration of Hcy.CONCLUSION:Hcy promotes the proliferation and phenotype transformation of VSMCs simultaneously.