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Objective:To evaluate the optimized efficacy of sevoflurane inhalation combined with caudal ropivacaine for abdominal surgery in low birth weight neonates.Methods:Eighty low birth weight neonates of either sex, with gestational age<37 weeks, weighing 1.5-2.5 kg, of American Society of Anesthesiologists physical statusⅡorⅢ, scheduled for elective laparotomy, were divided into 2 groups ( n=40 each) using a random number table method: sevoflurane combined with caudal block with ropivacaine group (SCB group) and sevoflurane plus remifentanil group (SR group). Anesthesia was induced and maintained with sevoflurane inhalation in the two groups.Caudal anesthesia was performed with 0.2% ropivacaine 1 ml/kg in the left lateral position after successful intubation in group SCB.Cis-atracurium 0.1 mg/kg was given, and remifentanil was infused at 0.5 μg·kg -1·min -1 in group SR.Inhaling sevoflurane was stopped at the end of operation in the two groups, and rescue analgesia was performed when the FLACC score was greater than 3 within 6 h after operation.The operation time, emergence time, extubation time, and duration of postanesthesia care unit (PACU) stay were recorded.The occurrence of adverse reactions during the emergence period and PACU stay and requirement for rescue analgesia within 6 h after surgery were recorded.The complications of caudal block were recorded in group SCB. Results:There was no significant difference in the operation time between the two groups ( P>0.05). Compared with group SR, the emergence time, extubation time, and duration of PACU stay were significantly shortened, and the incidence of adverse reactions during the emergence period and PACU stay and requirement for rescue analgesia within 6 h after surgery were decreased in group SCB ( P<0.05). The caudal block-related complications were not found in group SCB. Conclusion:Sevoflurane combined with caudal ropivacaine can be used as an optimized strategy helpful for the quality of anesthesia recovery in low birth weight newborns undergoing abdominal surgery.
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Objective:To evaluate the role of microRNA-21 (miR-21) in sepsis-induced lung injury and the relationship with transient receptor potential melastatin 2 (TRPM2) expression in rats.Methods:Forty-eight clean-grade Wistar rats, half male and half female, weighing 250-300 g, were divided into 4 groups ( n=12 each) by a random number table method: sham operation group (SH group), sepsis group (S group), miR-21 inhibitor group (group MI), and miR-21 inhibitor plus TRPM2 blocker Gd3 + group.Sepsis was induced by cecal ligation and puncture (CLP) in anesthetized rats.In MI group and MIG group, miR-21 inhibitor and miR-21 inhibitor plus TRPM2 blocker Gd3 + were injected through the tail vein, respectively, at 12 h before CLP.Carotid artery blood samples were collected at 24 h after CLP for blood gas analysis, PaO 2 was recorded, and oxygenation index was calculated.Animals were sacrificed, and lung tissues were removed for microscopic examination of the pathological changes which were scored and for determination of wet to dry weight ratio (W/D ratio), expression of miR-21 and TRPM2 mRNA (quantitative real-time polymerase chain reaction), levels of malondialdehyde (MDA) and superoxide dismutase (SOD) (by spectrophotometer colorimetry) and levels of interleukin-6 (IL-6), IL-8 and tumor necrosis factor-alpha (TNF-α) in serum (by enzyme-linked immunosorbent assay). Results:Compared with group SH, the oxygenation index and SOD activity were significantly decreased, and W/D ratio, lung injury score, MDA content, serum IL-6, IL-8 and TNF-α concentrations were increased in the other three groups, and the expression of miR-21 mRNA was up-regulated, and the expression of TRPM2 mRNA was down-regulated in group S ( P<0.05). Compared with group S, the oxygenation index, SOD activity and serum IL-6, IL-8 and TNF-α concentrations were significantly increased, and W/D ratio, lung injury score and MDA content were decreased in group MI, and the expression of miR-21 mRNA was down-regulated, and the expression of TRPM2 mRNA was up-regulated in MI and MIG groups ( P<0.05). Compared with group MI, the oxygenation index and SOD activity were significantly decreased, W/D ratio, lung injury score, MDA content, serum IL-6, IL-8 and TNF-α concentrations were increased, and the expression of TRPM2 mRNA was down-regulated in group MIG ( P<0.05). Conclusion:Up-regulated expression of miR-21 and down-regulated expression of TRPM2 are involved in the process of sepsis-induced lung injury in rats.
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Objective To investigate the efficacy of dexmedetomidine in preventing postoperative delirium in elderly patients undergoing laparoscopic radical resection for cervical cancer. Methods Eighty American Society of Anesthesiologists physical status Ⅱor Ⅲ patients, aged 65-75 yr, weighing 45-80 kg, scheduled for elective laparoscopic radical resection for cervical cancer, were divided into 2 groups (n= 40 each) using a random number table: dexmedetomidine group (group D) and routine group (group R). Dexmedetomidine was infused at a rate of 0. 5 μg·kg-1 ·h-1 after anesthesia induction until the end of operation in group D, while the equal volume of normal saline was given instead in group R. Delirium rating scale was used to assess the development of delirium within 3 days after operation. Blood samples were collected from the jugular bulb before anesthesia induction (T0 ), at the end of operation (T1 ) and at 1, 6 and 24 h after operation (T2-4 ) to determine the serum concentrations of S100β protein, neuron-spe-cific enolase, tumor necrosis factor-alpha and interleukin-1beta (IL-1β) by enzyme-linked immunosorbent assay. Results Compared with group R, the incidence of postoperative delirium was significantly de-creased (38％∕2％), the serum concentrations of S100β protein, neuron-specific enolase, tumor necrosis factor-alpha and IL-1β were decreased at T1-4 , and the serum concentrations of IL-1β protein were de-creased at T2-4 in group D (P<0. 05). Conclusion Infusing dexmedetomidine at 0. 5 μg·kg-1 ·h-1 from the end of anesthesia induction until the end of operation can effectively prevent the development of delirium following laparoscopic radical resection for cervical cancer, and the mechanism is related to inhibiting in-flammatory responses and reducing brain injury in elderly patients.
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Objective To explore the success rate and the risk of establishment of the acute myocardial infarction model between the beagle dogs and the mini-pigs by interventional technique ,further to provid theoretical basis for choose a more suitable animal model .Methods 6 dogs and 6 mini-pigs were anaesthetized ,then underwent the coronary arteriography via femoral artery .After is-chemic preconditioning the coronary balloon was inflated to occlude the middle left anterior descending coronary for 180 minutes . The electrocardiogram was examined throughout the operation and the pathological sections were examined until the animals were executed one week later .Results All beagle dogs survived ,while 1 case of mini-pigs dead(1/6) .There was 1 cases(1/6) of beagle dogs had acute myocardial infarction ,while 5(5/6)cases in mini-pigs .All mini-pigs had malignant arrhythmia(6/6) but never seen in beagle dogs .The time needed for building a model was similar between the two groups ,the difference had no statistical signifi-cance(P>0 .05) .Conclusion The risk of establish myocardial infarction model in mini-pigs is higher than beagle dogs ,but the suc-cess rate is still high ,it might be the better choice .
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In the process of cultivating TCM clinical postgraduates of TCM clinical college in Shanxi university of Chinese medicine,we emphasized the importance of clinical application ability and innovation ability in scientific research,stressed the clinical practice and check management,to formulate the objective,effective and quantified assessment index system in keeping with the real institution of our college,so as to improve the all-round quality of TCM clinical postgraduates.
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Objective To design and manufacture the simple lower fixtures of WXX2000 field medical box group, the medical boxes ZT-4-1 as an example. The principle, instrument, process and the applying of the device were introduced. Methods Based on the guidance principle of the ZT-4-1 medical box, the size of lower space and ampoule of the ZT-4-1 medical box were measured and design its layout, and then suitable instruments and materials of the device was selected, and external fixed wooden box and foam stuffing were produced step by step. Results The simple lower fixture is available for fixed and transportation safety. Conclusion The simple device is effective for fixed effect and can be used extensively.