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ObjectiveTo investigate the application of dexmedetomidine attenuating hemodynamic fluctuation in patients with cerebral aneurysm during anesthesia induction.Methods Sixty patients undergoing elective interventional procedure with cerebral aneurysm were divided into low dose of fentanyl group (group LF),high dose of fentanyl group (group HF),and low dose of fentanyl and dexmedetomidine combination group(group FD) by random digits table method with 20 cases each.Before induction of anesthesia,the patients in group FD received dexmedetomidine 1 μ g/kg for 10 minutes,and the others received 0.9％ sodium chloride with the same volume.During anesthesia induction,fentanyl 3 μ g/kg in group LF and group FD,and fentanyl 5 μ g/kg in group HF.Other anesthetics were equalized.Systolic blood pressure (SBP),diastolic blood pressure (DBP) and heart rate (HR) were monitored and recorded at 3 min utes after lying on table (T0),before intubation (T1),immediately and 3 minutes after intubation (T2,T3).The differences between the maximum and the minimum of SBP,DBP and HR were calculated in these time points as fluctuation values,named as △SBP,△DBP and △HR.Results△SBP,△DBP and △HR in group FD [ (26.9 ± 14.8) mm Hg( 1 mm Hg =0.133 kPa),(10.7 ± 8.9) mm Hg,(12.5 ± 4.3 ) times/min ]were lower than those in group LF [ (40.4 ± 15.6) mm Hg,(20.3 ± 9.4) mm Hg,(30.1 ± 15.0) times/min ](P ＜ 0.05 ),as well as △SBP and △HR in group HF [ (29.8 ± 16.8 ) mm Hg,( 19.5 ± 7.4) times/min ]were lower than those in group LF(P ＜ 0.05).While △HR in group FD was lower than that in group HF (P ＜0.05).The usage of atropin in three group had no statistical significance during anesthesia induction (P =0.364),but more ephedrine was used in group HF than in group LF [30％(6/20) vs.5％(1/20),P=0.032 ].Conclusion Dexmedetomidine 1μ g/kg injected before anesthesia induction,which could prevent intubation reaction,blood pressure serious falling after intubation,and provide more stable hemodynamics,is particularly applicable for anesthesia induction in patients with cerebral aneurysm.
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Objective To summarize the surgical experience in robotic-assisted laparoscopic partial nephrectomy,and to investigate the efficacy and safety of this surgery.Methods The clinical data of 12 patients who underwent robot-assisted laparoscopic partial nephrectomy in Changhai Hospital from March to July in 2012 were analyzed.All the patients were male and the age range was 43-66 years.In 4 cases the tumors were in the left kidney,and 8 in the right.In 7 cases the tumors were in the dorsal part of the kidney,and 2 in the ventral part.There were 3,5 and 4 cases in the upper,middle and lower pole of the kidney respectively.Preoperative GFR test was normal in all cases.Kidney CT scan showed the maximum diameters of the tumors were 2.0-5.8 cm,with an average of 3.3 cm.The pre-operative stages in all cases were T1N0M0.Results The surgery was successfully completed in all cases.The mean duration of the surgery was 160-310 min,with an average of 242 min.The blood loss was 30-300 ml,with an average of 135 ml,and the intraoperative blood transfusion was unnecessary.The warm ischemia time was 20-49 min,with an average of 31 min.There was no intraoperative morbidity,and no conversion to open surgery.The postoperative length of hospitalization was 9-31 d,with an average of 14 d.Gross hematuria arose in 1 patient at 1 week after the surgery.The post-operative pathology showed renal clear cell carcinoma with Furhman Grade Ⅱ in 11 cases,and renal angiomyolipoma in 1 case.The maximum diameters of the tumors were 2.0-5.0 cm,with an average of 3.5 cm.The tumor resection margin was negative in all cases.Conclusions Robot-assisted laparoscopic partial nephrectomy is safe and effective for local renal tumors.This surgery has significant advantage over traditional laparoscopic partial nephrectomy,in terms of the resection of the renal tumors and the reconstruction of the kidney.
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Objective To compare the efficacy of alfentanil and remifentanil in minimizing the propofol injection pain. Methods A total of 175 adult female patients undergoing gynecological procedures with general anesthesia were randomly divided into four groups.Patients received alfentanil 1mg(2 mL,AL group,n=43),remifentanil 0.01 mg(2 mL,REM1 group,n=43),remifentanil 0.02 mg(2 mL,REM2 group,n=45) or normal saline(2 mL,control group,n=44) 30 seconds prior to propofol administration.Visual analogue scale(VAS) was employed to evaluate the subjective feelings of pain due to propofol injection,and adverse effects were recorded. Results One patient in REM2 group and one patient in control group were excluded due to difficulty in venous catheterization.The injection pain in AL group,REM1 group and REM2 group was significantly less severe than that in control group(P
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Objective:To investigate the role of protein tyrosine phosphatase 1B(PTP-1B) in pathogenesis of type 2 diabetes. Methods: Thirty-four patients were divided into 3 groups: type 2 diabetes with normal BMI group(CDM), obese type 2 diabetes group (ODM) and control group. Fasting blood glucose, fasting insulin and body mass were determined. Expression of PTP-1B in adipose tissues were determined by Western blot. Results: Compared with control group, CDM and ODM groups had insulin resistance, though there was no significant difference between CDM and ODM groups. Expression of PTP-1B in control, CDM and ODM groups were 3.39?0.94,11.57?1.89 and 36.53?14.82, respectively. After controling for age and sex, expression of PTP-1B was positively related with BMI(r=0.67, P