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1.
Article in Chinese | WPRIM | ID: wpr-933315

ABSTRACT

Objective:To evaluate the efficacy of esketamine for patient-controlled intravenous analgesia (PCIA) in elderly patients undergoing modified radical mastectomy for breast cancer.Methods:Ninety elderly female patients, aged 65-78 yr, weighing 46-75 kg, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, undergoing elective modified radical surgery for breast cancer under general anesthesia, were divided into 2 groups ( n=45 each) using a random number table method: esketamine PCIA group (group E) and sufentanil PCIA group (group S). Anesthesia was induced with target-controlled infusion of propofol, intravenous atracurium besylate and sufentanil and maintained with target-controlled infusion of propofol and remifentanil and intermittent intravenous boluses of cis-benzenesulfonic acid atracurium.The patients were connected to an analgesic pump for PCIA at 10 min before completion of operation.The PCIA solution in group E contained esketamine 2 mg/kg, ketorolac tromethamine 90 mg and tropisetron 5 mg in 100 ml of normal saline.The PCIA solution in group S contained sufentanil 1 μg/kg, ketorolac tromethamine 90 mg and tropisetron 5 mg in 100 ml of normal saline.The PCA pump was set up with a 1.5 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 1.5 ml/h, and the analgesia was performed until 48 h after operation.When numeric rating scale score ≥ 4 points and the efficacy of patient-controlled analgesia was not good, tramadol 100 mg was intravenously injected for rescue analgesia.Steward recovery scores were recorded at 4, 8, 24 and 48 h after operation.The requirement for rescue analgesia, effective pressing times of analgesic pump and time to first flatus were recorded within 48 h after operation.The nausea and vomiting, respiratory depression, dizziness and pruritus within 48 h after operation and delirium within 7 days after operation were recorded.The 40-item Quality of-Recovery scale was used to evaluate the early postoperative recovery of patients at 24 and 48 h after operation. Results:Compared with group S, the 40-item Quality of Recovery scale score was significantly increased at each time point, postoperative time to first flatus was shortened, the incidence of postoperative nausea and vomiting and pruritus was decreased ( P<0.05), and no significant change was found in the Steward recovery score at each time point after operation, effective pressing times of PCA and requirement for rescue analgesia in group E ( P>0.05). Conclusions:Esketamine provides better efficacy than sufentanil when used for PCIA in elderly patients undergoing modified radical mastectomy for breast cancer.

2.
Article in Chinese | WPRIM | ID: wpr-869975

ABSTRACT

Objective:To evaluate the optimized efficacy of thoracic paravertebral nerve block and subcostal transversus abdominis plane block combined with general anesthesia for elderly patients undergoing thoracic combined with laparoscopic radical resection of esophageal cancer.Methods:Eighty American Society of Anesthesiologists physical status Ⅰ orⅡ patients of both sexes, aged 66-78 yr, weighing 46-80 kg, undergoing elective thoracoscopic combined with laparoscopic radical resection of esophageal cancer, were divided into 2 groups ( n=40 each) using a random number table method: general anesthesia group (group G) and thoracic paravertebral nerve block and subcostal transversus abdominis plane block combined with general anesthesia group (TSG group). Both groups received target-controlled infusion of propofol and remifentanil and intravenous injection of cisatracurium besilate for anesthesia induction and maintenance, with BIS value maintained at 45-60 during operation.Thoracic paravertebral nerve block on the affected side was performed under ultrasound guidance after the end of anesthesia induction, and 0.5% ropivacaine 15 ml was injected in TSG group.The patients were turned to the supine position after the thoracic operation was completed, and the bilateral subcostal approach to the transversus abdominis plane block was performed under ultrasound guidance, and 0.3% ropivacaine 20 ml was injected into each side.Sufentanil was used for patient-controlled intravenous anesthesia (PCIA) after operation.The background infusion rate was 0.05 μg·kg -1·h -1, PCA was 0.04 μg/kg, and the lockout interval was 10 min in group G. The background infusion rate was 0.03 μg·kg -1·h -1, PCA was 0.025 μg/kg, the lockout interval was 10 min in group TSG.Both groups received analgesia until 48 h after operation, and VAS score was maintained ≤3.When VAS score ≥ 4, tramadol 100 mg was intravenously injected for rescue analgesia.At 1 day before operation (T 0), immediately before anesthesia induction (T 1), at 1 h after emergence from anesthesia (T 2), and 4, 8, 12, 24 and 48 h after operation (T 3-7), venous blood samples were collected for determination of serum norepinephrine, epinephrine and cortisol concentrations (by enzyme-linked immunosorbent assay). The intraoperative consumption of remifentanil and occurrence of cardiovascular events were recorded.The pressing times of PCA, consumption of sufentanil and requirement for rescue analgesia within 48 h after operation were recorded.The occurrence of nerve block-related complications (hematoma at the puncture site, infection, local anesthetic poisoning, etc.) and adverse reactions such as nausea and vomiting, respiratory depression and pruritus were recorded within 48 h after the operation. Results:Compared with group G, the concentrations of serum epinephrine, norepinephrine and cortisol were significantly decreased, the consumption of intraoperative remifentanil and postoperative sufentanil and pressing times of PCA were reduced, the rate of rescue analgesia was decreased, scores of satisfaction with analgesia were increased, and the incidence of intraoperative cardiovascular events and postoperative adverse reactions such as nausea and vomiting, pruritus and respiratory depression were decreased in group TSG ( P<0.05). Conclusion:Thoracic paravertebral nerve block and subcostal transversus abdominis plane block combined with general anesthesia can reduce the perioperative consumption of opioids and inhibit perioperative stress responses and postoperative hyperalgesia with fewer adverse reactions when used for the elderly patients undergoing thoracic combined with laparoscopic radical resection of esophageal cancer.

3.
Article in Chinese | WPRIM | ID: wpr-709766

ABSTRACT

Objective To investigate the effect of dexmedetomidine pretreatment on hippocampal endoplasmic reticulum stress-induced cell apoptosis after asphyxial cardiac arrest-resuscitation in rats. Methods A total of 60 pathogen-free male Sprague-Dawley rats, aged 6-8 weeks, weighing 200-300 g, were divided into 3 groups (n= 20 each) by using a random number table: control group (C group), as-phyxial cardiac arrest-resuscitation group ( CA group) and dexmedetomidine pretreatment group ( Dex group). The anaesthetized rats were intubated with a 16G tracheal catheter which was connected to a rodent ventilator for mechanical ventilation. Cardiac arrest was induced by clamping the tracheal tube at the end of the exhalation until systolic blood pressure decreased to 25 mmHg lasting for 5 min, and then resuscitation was started. At 5 min before cardiac arrest, dexmedetomidine 4. 0 μg∕kg was intravenously injected in group Dex, and the equal volume of normal saline was given instead in C and CA groups. Rats were sacri-ficed at 6 h after successful resuscitation, brain tissues were removed for determination of wet to dry weight ratio ( W∕D ratio), and hippocampal tissues were obtained for examination of the pathological changes (with a light microscope) and ultrastructure (with an electron microscope) and for determination of cell ap-optosis (by TUNEL), expression of CCAAT∕enhancer-binding protein homologous protein (CHOP) and ac-tivated transcription factors (ATF4) and X-4 box binding protein 1 (XBP1) mRNA (by real-time polymer-ase chain reaction) and expression of CHOP, Bcl-2, Bax and caspase-3 (by Western blot). The apoptosis rate was calculated. Results Compared with group C, W∕D ratio of brain tissues was significantly in-creased, the apoptosis rate of hippocampal tissues was decreased, the expression of XBP-1, ATF4 and CHOP mRNA was up-regulated, the expression of CHOP, Bax and caspase-3 was up-regulated, and the expression of Bcl-2 was down-regulated in CA and Dex groups (P<0. 05). Compared with group CA, W∕D ratio of brain tissues was significantly decreased, the apoptosis rate of hippocampal tissues was decreased, the expression of XBP-1, ATF4 and CHOP mRNA was down-regulated, the expression of CHOP, Bax and caspase-3 was down-regulated, the expression of Bcl-2 was up-regulated (P<0. 05), and the pathological changes were significantly attenuated in group Dex. Conclusion The mechanism by which dexmedetomi-dine pretreatment mitigates brain injury after asphyxial cardiac arrest-resuscitation may be related to inhibi-ting cell apoptosis induced by endoplasmic reticulum stress in rats.

4.
Article in Chinese | WPRIM | ID: wpr-752097

ABSTRACT

To determine there characteristic components content of Tibetan Medicine Triphala through establishing a HPLC method and its total tannin content through spectrophotometry. The chromatographic column of Agilent ZORBAX SB-Aq (250 × 4.6 mm, 5 μm) with methanol-0.1% formic acid/water as the mobile phase, the flow rate 1 mL/min, and the detection wavelength 270 nm was applied to determine the Gallic acid, colijing and ellagic acid content in medicinal materials and the tannin parts of Tibetan Medicine Triphala. With the gallic acid as control group, total tannin content of Triphala and its tannin parts was determined through spectrophotometry. It revealed in the HPLC test that the linear range of gallic acid, coracine and ellagic acid was 0.91-4.55 μg, 0.274-1.368 μg and 0.329-2.634 μg respectively. It also showed that the average recovery rates of the three components in the medicinal materials were 101.06%, 101.72%and 100.27% respectively. And the average recovery rates of the three components in the tannins were 100.4%, 100.85%and 101.70% respectively. The result of spectrophotometry showed that gallic acid was linear in1.008-10.08 μg·mL-1, and that the recovery rate of medicinal materials and tannin parts were 100.25% and 100.52% respectively. The method is rapid, accurate and repeatable, and it can provide basis for the quality control of Tribescens and its tannins.

5.
Article in Chinese | WPRIM | ID: wpr-752096

ABSTRACT

Triphala consists of Terminalia chebula Retz, Terminalia bellirica (Gaertn.) Roxb. and Phyllanthus emblica L, which are made into Dasanguo Powder. Triphala is rich in a variety of chemical components, including tannins, phenolic acids, triterpenoids and flavonoids. The content of tannin is abundant in Triphala, which are often used as the main indicators of analysis. Modern research found that Triphala has a variety of pharmacological activities such as prevention of gastrointestinal diseases, antibacterial, anti-inflammatory, anti-oxidation, anti-tumor and so on. This paper briefly summarized the chemical constituents and pharmacological effects of Triphala, combining the relevant national and international literature in recent years to provide reference for the development and further study of Triphala.

6.
Chinese Journal of Geriatrics ; (12): 1224-1228, 2017.
Article in Chinese | WPRIM | ID: wpr-669011

ABSTRACT

Objective To explore the clinical efficacy and safety of Hydromorphone combined with Propofol therapy in painless gastroscopy combined with colonoscopy examination in elder patients.Methods Sixty-one patients aged 65-80 years underwent a painless gastroscopy combined with colonoscopy examination in the Affiliated Tumor Hospital of Zhengzhou University from June 2015 to January 2016.The patients were randomly divided into the Hydromorphone combined with Propofol group (Group H,n=31) and the Fentanyl combined with propofol group (Group F,n=30).Results The levels (H vs F group) of VAS at 5,15,30 min after anesthetic recovery were lower in H group thanin F group[(2.4±0.5) vs (3.4±0.6),(2.0±0.5) vs (3.2±0.6),(1.6±0.4) vs (2.6±0.7) respectively,(all P<0.05)],and those of ramsay sedation scores at 5,15,30,45,and 60 min after anesthetic recovery were lower in H group than in F group[(2.6 ± 0.4) vs (3.3 ± 0.5),(2.3±0.5) vs (2.9±0.4),(2.1±0.3) vs (2.6±0.3),(1.9±0.3) vs (2.2±0.3),(1.8±0.3) vs (2.0±0.3) (all P<0.05)] respectively.Additionally,the incidence rates (H vs F group) of nausea and vomit (3.2% vs.26.7%),respiratory depression (0.0% vs.33.3%) and restlessness (6.5% vs.30.0%) within 60 min after anesthetic recovery were lower in the group H than in the group F (all P< 0.05).However,there were no statistical differences in the indexes of postoperative gastrointestinal function between two groups (all P>0.05).Conclusions The clinical efficiency of hydromorphone combined with propofol used in painless gastroscopy combined colonoscopy examination is favourable and safe without increasing postoperative adverse reactions in elder patients.Hydromorphone combined with propofol is superior to fentanyl combined with propofol as a general intravenous anesthesia.

7.
Article in Chinese | WPRIM | ID: wpr-696113

ABSTRACT

PK-PD binding model is a powerful tool to study the relationship between drug time-concentration,concentration-effect and time-effect,which is of great significance and widely used in guiding clinical medicine.The PK-PD binding model is applied to the study of traditional Chinese medicine (TCM),which is helpful to elucidate the basis of drug substance and its mechanism.It is of great significance to the development of TCM and its preparation.In this paper,recent applications of PK-PD binding model in the composition and effective part of TCM,single herbal medicine and TCM compound were made,which could provide references for future PK-PD study of chemical constituent.

8.
Article in Chinese | WPRIM | ID: wpr-696100

ABSTRACT

High performance liquid chromatography (HPLC) fingerprint technology is an important means of quality control of traditional Chinese medicine (TCM) preparations,which can reflect the whole process of raw materials as well as the whole process and quality of finished products.It has become the primary quality control method of modern TCM preparations.In this paper,recent advances in HPLC fingerprints and their combination techniques in the quality control of TCM preparations were reviewed,which provided the basis for quality control of TCM preparations.

9.
Article in Chinese | WPRIM | ID: wpr-696060

ABSTRACT

This study was aimed to optimize the extraction method for total polyphenol from Phyllanthus emblica through multi-target orthogonal experiment,in order to provide data reference for its industrial production.The comprehensive evaluation indexes included the extraction yield,extraction percentage of total polyphenol,chebulagic acid,gallic acid,mucic acid-2-O-gallate,were verified.The ethanol concentration,solid-liquid ratio and extraction time were crucial indexes for orthogonal design.The results showed that the best extraction process was using 10 times dosage 70% ethanol,to extract the medical material three time,90 minutes for every time.It was concluded that the extraction technology was reliable.This method was stable,quick and simple.It laid a fundamental foundation for the extraction method exploration.

10.
Article in Chinese | WPRIM | ID: wpr-696033

ABSTRACT

This article was aimed to study the stability of tannin parts in Phyllanthus emblica L.in artificial gastric and intestinal juice,in order to provide a foundation for in vivo studies of Phyllanthus emblica L.HPLC-UV was used to determine the contents of main ingredients.The results showed that stability of main ingredients of tannin parts in Phyllanthus emblica L.,including gallic acid (GA),corilagin and ellagic acid (EA),in the artificial gastric juice.The content change was not obvious.The residual content was within 100%.The half-life was above 90 h.They were unstable in the artificial intestinal juice.The content was first increased and then decreased.The residual content was 100-300%.The half-life was above 10 h.It was concluded that the tannin parts in Phyllanthus emblica L.was stable in artificial gastric juice.And content changes of main components were not obvious.The tannin parts in Phyllanthus emblica L.were unstable in artificial intestinal juice.The main ingredients were first increased and then decreased.It was speculated that macromolecule can hydrolyze tannin part into small molecules.Hnwever,as time increases,all components may be decomposed.

11.
Article in Chinese | WPRIM | ID: wpr-696005

ABSTRACT

This paper was aimed to establish the HPLC fingerprint of T.Billerica (Gaertn.) Roxb.tannin fraction.The analysis was performed on Atlantic T3 (250 mm × 4.6 mm,5 μm) C18 column.The mobile phase was acetonitrile-0.2% glacial acetic acid aqueous solution with gradient elution.The flow rate was 1.0 mL·min-1.The injection size was 20 μL.The temperature was maintained at 30℃.Eleven batches of T.Billerica (Gaertn.) Roxb.tannin fraction of chromatographic data was analyzed by similarity of chromatographic data,SPSS software and SIMCA software.There were 20 common peaks in the diagram.The similarity analysis of 11 samples revealed that the similarities were between 0.832 and 0.973.Only the similarity of tannin parts from Xinjiang was below 0.9.The cluster analysis classified the tannin parts into 3 types,which shared the similar results as the principal components analysis (PCA).PLS-DA found that peak 1,13 and 14 may be the main chromatographic peaks to identify tannins fraction.The HPLC-MSn information of 14 compounds in T.billerica (Gaertn.) Roxb.was summarized.It was concluded that chemometrics analysis method can be used to analyze the HPLC fingerprint of T.billerica (Gaertn.) Roxb.tannin fraction.This method was rapid,simple,and reproducible.It can be used as one of the effective methods for the quality control of T.billerica (Gaertn.) Roxb.tannin fraction.

12.
Chinese Journal of Anesthesiology ; (12): 1089-1093, 2016.
Article in Chinese | WPRIM | ID: wpr-507854

ABSTRACT

Objective To evaluate the effects of dexmedetomidine pretreatment on extracellular sig?nal?regulated kinase ( ERK) pathway during acute lung injury in a rat model of liver transplantation. Meth?ods Sixty male Sprague?Dawley rats, weighing 235-250 g, were divided into 4 groups ( n=15 each) u?sing a random number table: sham operation group (group S), liver transplantation group (group LT), low?dose dexmedetomidine pretreatment group ( group LD ) and high?dose dexmedetomidine pretreatment group ( group HD) . In LT, LD and HD groups, the model of orthotopic liver transplantation was estab?lished, and the operation time was about 4 h. Dexmedetomidine 2?5 and 5?0μg·kg-1 ·h-1 were intrave?nously infused for 1 h starting from 1 h prior to clipping the hepatic artery and portal vein in LD and HD groups, respectively. The rats were sacrificed after the end of operation, and the lungs were removed for determination of wet to dry weight ratio ( W∕D ratio) , cell apoptosis and expression of ERK mRNA, ERK, phosphorylated ERK ( p?ERK) , Bcl?2 and Bax in lung tissues and for examination of the pathological chan?ges ( with light microscope) and ultrastructure of lung tissues ( with transmission electron microscope) . The injured alveolus rate ( IAR) , apoptosis index ( AI) and ratio of Bcl?2 to Bax expression ( Bcl?2∕Bax ratio) were calculated. Results Compared to group S, the W∕D ratio, IAR, AI, expression of ERK?1 mRNA, ERK?2 mRNA, p?ERK, Bcl?2 and Bax and Bcl?2∕Bax ratio were significantly increased in LT, LD and HD groups ( P<0?05) . Compared to group LT, the W∕D ratio, IAR and AI were significantly decreased, the expression of ERK?1 mRNA, ERK?2 mRNA, p?ERK and Bcl?2 and Bcl?2∕Bax ratio were significantly increased, and the expression of Bax was significantly down?regulated in LD and HD groups (P<0?05). Compared to group LD, the W∕D ratio, IAR and AI were significantly decreased, the expression of ERK?1 mRNA, ERK?2 mRNA, p?ERK and Bcl?2 and Bcl?2∕Bax ratio were significantly increased, and the ex?pression of Bax was significantly down?regulated in group HD ( P<0?05) . The pathological changes of lung tissues were significantly attenuated in LD and HD groups as compared with group LT, and in group HD as compared with group LD. Conclusion The mechanism by which dexmedetomidine pretreatment mitigates cell apoptosis during acute lung injury is related to activation of ERK pathway in a rat model of liver trans?plantation.

13.
Article in Chinese | WPRIM | ID: wpr-496979

ABSTRACT

Objective To evaluate the effect of penehyclidine hydrochloride on the damage to the non-ventilated lung in the pediatric patients undergoing one-lung ventilation (OLV).Methods One hundred and twenty pediatric patients of both sexes,aged 2-6 yr,with body mass index of 17-24 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or lⅡ and New York Heart Association class Ⅰ or Ⅱ,undergoing elective lobectomy performed via video-assisted thoracoscope,were randomly divided into 2 groups (n=60 each) using a random number table:control group (group C) and penehyclidine hydrochloride group (group P).At 10 rmin before anesthesia induction,penehyclidine hydrochloride 0.05 mg/kg was injected intravenously in group P,and the equal volume of normal saline was given in group C.At 5 min after drug intervention (T0),immediately after onset of OLV (T1),at 60 min of OLV (T2),immediately after the end of OLV (T3),at the end of surgery (T4),and at 24 h after surgery (T5),venous blood samples were collected for determination of serum tumor necrosis factor-alpha (TNF-o),interleukin-6 (IL-6) and IL-8 concentrations by enzyme-linked immunosorbent assay.The specimens of normal lung tissues around the lung lobe to be resected were obtained at T1 and T3 for determination of the injured alveolus count (with a light microscope) and cell apoptosis (using TUNEL) and for examination of the ultrastructure of epithelial cells (with a transmission electron microscope).The injured alveolus rate (IAR) and apoptosis index (AI) were calculated.Results Compared to the value at T0,the IAR and AI were significantly increased at T3,the serum TNF-α,IL-6 and IL-8 concentrations were significantly increased at T2-5 (P<0.05),and the pathological changes were obvious in the two groups.Compared to group C,the IAR and AI were significantly decreased at T3,the serum TNF-α,IL-6 and IL-8 concentrations were significantly decreased at T2-5 (P<0.05),and the pathological changes were significantly reduced in group P.Conclusion Penehyclidine hydrochloride can attenuate the damage to the non-ventilated lung in the pediatric patients undergoing OLV,and the mechanism is probably related to inhibition of systemic inflammatory responses and cell apoptosis in lung tissues.

14.
Article in Chinese | WPRIM | ID: wpr-671248

ABSTRACT

Phyllanthus emblica L.,related to common Tibetan medicine,has a function on clearing heat and cooling blood,promoting digestion and invigorating stomach,and producing saliva and slaking thirst.The compound of Dasanguo,made of Phyllanthus emblica,F.terminalia billericae and F.chebula,was a widely used preparation in Tibetan medicine,and was also a basic formula in other prescriptions.This study summarized the untilization of Phyllanthus emblica in traditional Tibetan medicine and elucidated the effects of Phyllanthus emblica in the compounds of Tibetan medicine,which provided a reference for the studies of Tibetan medicine and its modern application.

15.
Article in Chinese | WPRIM | ID: wpr-671247

ABSTRACT

This study aimed to investigate the effects of tannins extracted from Tibetan medicine Phyllanthi Fructus on cytochrome P450 enzyme of liver microsomes in rats.Cocktail probe substrates were incubated with liver microsomes in vitro.Metabolic elimination percentages of the six probe substrates,including dapsone,dextromethorphan hydrobromide,coumarin,phenacetin,chlorzoxazone and tolbutamide,were determined by HPLC.The effects of tannins extracted from Tibetan medicine Phyllanthi Fructus on the enzymatic activity of rat liver microsomal P450s was evaluated.It was found that tannins extracted from Phyllanthi Fructus did not impact P450 enzymes.The IC50 values of CYP3A4 and CYP1A2 were over 200 μg·mL-1,while the IC50 value of CYP2C9 was superior to 500 tg·mL-1.In conclusion,Tannins extracted from Tibetan medicine Phyllanthi Fructus did not significantly affect cytochrome P450 enzymes.

16.
Article in Chinese | WPRIM | ID: wpr-671246

ABSTRACT

Phyllanthus emblica L.has a long history and is abundant in the world.It was used for treating various diseases in nearly twenty countries or nations in regard to traditional medicine system.By retrieving Tibetan medicine in classical books,recent literatures and clinical studies,the application of Phyllanthus emblica in traditional Tibetan medicine system was introduced,including its utilization in hypertension,indigestion,abdominal distension,cough and arthralgia and their related diseases.In the sight of modern pharmacological research,the theory Tibetan medicine of explained Phyllanthus emblica scientifically.Its related researches and development prospects were also deliberated for further researches and various applications,which demonstrated the value of the development of new drugs and health products.

17.
Article in Chinese | WPRIM | ID: wpr-671245

ABSTRACT

Phyllanthus emblica L.and Terminalia chebula Retz.were the most common Tibetan medicines.The combination of Phyllanthus emblica L.,Terminalia chebula Retz.and Term inalia bellirica (Gaertn.) Roxb.was known as Triphala,which was the basis of the most frequently-used prescriptions.The present study summarized and made a further comparison between Phyllanthus emblica L.and Terminalia chebula Retz.over chemical constituents and pharmacological activities,which provided evidence for their clinical use and the basic theory.

18.
Article in Chinese | WPRIM | ID: wpr-671244

ABSTRACT

Phyllanthus emblica L.is related to traditional tibetan medicine,containing diversified pharmacological and physiological functions,such as anti-tumor effects,anti-inflammatory effects,anti-oxidation funtions,slow down in glycemia and blood pressure and the prevention of cardio-cerebral vascular diseases,etc.In this study,the research progress on the anti-tumor efficacy of monomer compounds and the extraction of Phyllanthus emblica L.were reviewed,providing references for the anti-tumor studies of Phyllanthus emblica L.

19.
Article in Chinese | WPRIM | ID: wpr-426910

ABSTRACT

Objective To investigate the effects of different degrees of neuromuscular blockade (NMB) induced by rocuronium on facial nerve evoked-electromyographic (EEMG) monitoring in patients undergoing resection of acoustic neuroma.Methods Thirty-five ASA Ⅰ or Ⅱ patients of both sexes,aged 20-64 yr,with body mass index ≤30 kg/m2,scheduled for elective resection of acoustic neuroma under general anesthesia,were included in the study.Anesthesia was induced with midazolam,fentanyl and propofol.The patients were mechanically ventilated after tracheal intubation.Facial nerve EEMG monitoring and peripheral NMB monitoring were performed simultaneously during operation.Facial nerve EEMG was monitored using the Epoch XP2000 multichannel electrophysiological nerve monitoring system (Axon Co.,USA),facial nerve was stimulated and evoked potential of orbicularis oculi was recorded during operation.Peripheral NMB degrees were monitored with TOF-Watch SX monitor (Organon Co.Holland).After rocuronium 0.6 mg/kg was injected intravenously,the facial nerve EEMG responses were monitored when the degree of NMB (T1) was at 100%,75%,50%,25% and 0 of the control height.The amplitude and latency of EEMG were recorded.The amplitude reservation ratio (the ratio of the amplitude of EEMG monitored to the baseline value) was calculated.Linear correlation of the amplitude reservation ratio or latency of EEMG with the degree of NMB was analyzed.Results No EEMG response was elicited when the degree of NMB was 100% in 6 patients.The lirear regression equation of the interaction between the degree of NMB (X) and the amplitude reservation ratio (Y) was Y =1 - 0.787 X,the coefficient of determination was 0.898 ( P < 0.05) and the correlation coefficient was - 0.947 ( P < 0.05).The correlation coefficient between the latency of EEMG and the degree of NMB was 0.328 ( P < 0.05).Conclusion When the degree of NMB is maintained at 25 %-50%,facial nerve EEMG can be monitored effectively and body movement can be avoided during resection of acoustic neuroma.

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