ABSTRACT
Objective: To compare the efficiencies of cisatracurium and rocuronium during tracheal intubation for general anesthesia. Methods: Sixty ASA I-II patients undergoing elective surgery were randomly divided into 3 groups in which patients received a single bolus of rocuronium 0.6 mg/kg (A group, n = 20), cisatracurium 0.1 mg/kg (B group, n = 20), or 0.15 mg/kg (C group, n = 20). Anesthesia was induced with midazolam, etomidate, and fentanyl. Neuromuscular function was assessed using accelerography with TOF. First twitch (T 1) was used as the study parameter. Patients received a rapid bolus administration of study drugs within 10 seconds after T1 became stable at 100%; meanwhile, mask oxygen inhalation was offered for 2 min and then intubation was carried out. The systolic pressure, diastolic pressure, and heart rate were recorded at baseline level, before and 1,2,3,4,5,10, and 15 min after intubation. The intubation conditions were assessed. Whether intubation could be carried out successfully or not and T1 25% recovery time after the initial bolus were also recorded. The adverse effects and respiratory complication during operation and after operation were observed. Results: The hemodynamic changes within 15 min after intubation were not significantly different compared with those before induction in 3 groups (P>0.05). Maximal neuromuscular block rates in group A,B, and C were (99.4±2.7)%, (99.1±1.9)%, and (99.9±0.3)%, respectively, with no significant differences found between the three groups (P>0.05); the onset time periods of the 3 groups were (1.9±1.1) min, (3.6±2.1) min, and (3.3±1.5) min, respectively, with that of group A significantly shorter than those of B and C groups (P0.05). The glottis exposure degree in group A was significantly better than that of B and C groups (P0.05). Conclusion: Rocuronium is superior to cisatracurium in induction intubating for general anesthesia in terms of clinical effect time and glottis exposure degree, and it can provide better intubating conditions.
ABSTRACT
To investigate the effect of GST-KGDX (glutathione S-transferase-Lys-Gly-Asp-X) fusion protein, GP IIb/IIIa receptor antagonist, on platelet function in vitro. The KGDX (Lys-Gly-Asp-X) gene was assembled from 2 synthetic oligonucleotides, 36 bp in length, using BamH I and Xho I restriction enzyme sites at the end of the gene for cloning into the expression vector pGEX4T-1. Expression of fusion protein was directed by the tac promoter. The Escherichia coli DH5a contained the plasmid pGEX-4T-1-KGDX was expressed by 37 degrees C heat induction. The fusion protein of KGDX with glutathione S-transferase (GST-KGDX) was purified in one step from the bacterial lysate by glutathione-agarose beads for affinity chromatography. GST-KGDX was found to be soluble and abundant, the yield of 35 mg/L of cultures was obtained. The GST-KGDX was expressed in E. coli to a level of 48.02% of total cellular protein. GST-KGDX inhibited ADP-induced human platelet aggregation stronger than GST (P < 0.05 or < 0.01). In flow cytometry assay for fibrinogen binding, both GST and GST-KGDX inhibited platelet aggregation by binding with high affinity to GPIIb/IIIa. Mean fluorescence intensity of GST-KGDX fusion protein was significantly higher than that of GST. It is concluded that the GST-KGDX fusion protein can be produced by E. coli and used as an antiplatelet agent.