Change of gene rstn expression in brain tissues after traumatic brain injury / 中华创伤杂志

Objective To investigate the change of gene rstn expression in brain tissues following traumatic brain injury (TBI). Methods A total 90 SD rats were involved in the study and divided into normal control group (5 rats), sham operation group (10 rats), mild, moderate and severe trauma groups (25 rats per group). Rat model was made with sap pressure clash method and RT-PCR assay was employed to detect expression change of gene rstn at 3, 6, 24, 72 h and 1, 2, 4 weeks after TBI. The change of peripheral blood glucose concentration was measured in moderate trauma group to observe its relationship with gene rstn expression in brain tissue. Results Postoperative expression of gene rstn was increased in severe trauma group at 24 hours, in moderate trauma group at 72 hours and in mild trauma group at four weeks (P＜0.05). The expression of gene rstn was increased in hippocampus, thalamus and cortex of all trauma groups at four weeks postoperatively, when the hippocampus showed the highest expression while the thalamus showed the least (P＜ 0.05). Moreover, the expression of gene rstn showed high level in injury side but low level in contralateral side in different districts (P ＜ 0.05). The expression of gene rstn was increased the most obviously in severe trauma group (P ＜0.05). Peripheral blood glucose concentration showed a linearity positive correlation with gene rstn expression in brain tissue (R=5.32,P＜0.05). Conclusions Expression of gene rstn shows obvious increase after TBI, and the time course correlates with the injury severity. The gene rstn expresses the most in the ipsilateral hippocampus. There shows a certain correlation between gene rstn expression and peripheral blood glucose concentration in brain tissues after TBI.

Influence of Blood Glucose Level on Acid-Base Balance / 대한구급학회지

BACKGROUND: This study was performed to evaluate whether blood glucose concentrations have a significant influence on acid-base balance. METHODS: We studied 157 adult patients who underwent intra-abdominal operations under general anesthesia. Postoperative blood samples were withdrawn from radial artery and blood glucose concentrations, gas values, and chemistry values were measured. All patients were divided into three groups according to the postoperative blood glucose level. The group 1 contained the patients who had postoperative blood glucose level lower than 126 mg/dl, the group 2, the patients with glucose level higher than 126 mg/dl, lower than 180 mg/dl, and the group 3, the patients with glucose level higher than 180 mg/dl. RESULTS: Metabolic acidosis rate was significantly higher in group 3 than in group 1, group 2 and arterial blood pH was significantly lower in group 3 than that in group 1, group 2. Regression analysis showed that [H+] was correlated with blood glucose level. Strong ion difference (SID) was significantly lower in group 3 than group 1 and PaCO2 level was significantly lower in group 2 and group 3 than that in group 1. In regression analysis, there was a negative correlation between blood glucose concentration and SID. [H+] had a negative correlation with SID and PaCO2 was correlated with SID. CONCLUSIONS: These findings suggest that blood glucose level affects acid-base balance and a disturbance in SID is accompanied with respiratory compensation.

Influence of replacement with Ringer's lactate for preoperative NPO deficits on blood glucose concentration in children undergoing strabismus surgery

BACKGROUND: We investigated the effect that replacement with Ringer's lactate (RL) for preoperative NPO deficits might have on blood glucose concentration in children undergoing strabismus surgery. METHODS: Sixty children scheduled for strabismus surgery were enrolled in this study and RL was administered to all subjects for replacement of preoperative NPO deficits.Patients were randomly assigned to three groups according to the types of maintenance fluid employed during anesthesia.RL, 5% dextrose in one-fourth strength normal saline (D51/4NS), and an equal volume of D(5)1/4NS and RL each were used as maintenance fluids for Group 1, 2, and 3, respectively.After glycopyrrolate 0.004 mg/kg IV, anesthesia was induced with propofol 3 mg/kg and rocuronium 0.6 mg/kg.After tracheal intubation, anesthesia was maintained with 2-3 vol% sevoflurane in 50% air with oxygen.Blood glucose concentrations were checked from blood samples through a 22 gauge catheter inserted into a saphenous vein at the time of induction, 30 and 60 min after induction of anesthesia. RESULTS: There were no significant differences in baseline blood glucose levels at the time of induction of anesthesia among three groups.And the mean blood glucose concentrations remained unchanged throughout the study period in all groups.None of the patients were found to be hypoglycemic or hyperglycemic throughout the study period. CONCLUSIONS: This study shows that the replacement of preoperative NPO deficits with RL maintains the blood glucose concentration within physiological range throughout the operation and anesthetic recovery phase, regardless of the types of maintenance fluid.

Effects of Steroid Administration on Blood Glucose Concentration during Brain Surgery / 대한마취과학회지

BACKGROUND: Steroids are normally used in neurosurgery, especially when treating brain edema and reducing the intracranial pressure. Methylprednisolone is known to increase the blood glucose concentration. However, the effect of a single methylprednisolone injection on the blood glucose concentration is unknown. Therefore, this study measured and compared the blood glucose concentration in a methylprednisolone group with that in a placebo group at the same interval. METHODS: Thirty-three adult patients were enrolled in this study. The patients were scheduled to undergoing an elective craniotomy with the procedure lasting 4 hours or longer. The candidates were divided in two groups. One group was the methylprednisolone group (patients receiving methylprednisolone 125 mg, n = 18), and the other group was the placebo group (n = 15). The exclusion criteria were a clinical diagnosis of diabetes mellitus, an impaired glucose tolerance and had received steroid previously. Before injecting 125 mg of either methylprednisolone or the placebo, the blood glucose concentration was checked by glucose analyzer. After the injection, blood glucose concentration was checked every 30 minutes for more than 4 hours. RESULTS: The blood glucose concentration increased significantly over time compared with the baseline concentration in both groups. The glucose concentration increased significantly in the methylprednisolone group than in the placebo group (P < 0.05). The magnitude of this difference was greater in those who received methylprednisolone (54 mg/dl increase over 4 hours) than in the placebo group (11 mg/dl increase over 4 hours). CONCLUSIONS: In this study, compared with placebo controls, an injection of methylprednisolone (125 mg) produced a significant increase in the blood glucose concentration over a 4 hours period. Therefore, we recommend that the blood glucose level be monitored carefully in cases of brain surgery and/or when steroids are used.

Capability of SMBG instrument and its progress / 医疗卫生装备

Diabetes is a vulgar malady of metabolism and incretion. It is important to monitor and control the blood glucose for the diagnosis and treatment of diabetes. In particular, it is one of the most effective means for physicians or patients to do so through self-monitoring of blood glucose (SMBG) instruments. In this paper, SMBG instruments are discussed in detail and classified as the minimally invasive one, the non-invasive one and the continuous glucose monitoring system (CGMS). The needle or laser applied to blood sampling, the technology of the minimally invasive one is relatively mature, and the result of measurement is exact, but this way is achy for the patients. Reverse iontophoresis and spectral analysis adopted, the non-invasive has an increasing accuracy. The CGMS can perform the periodical measurement and record of the value of blood glucose automatically for several days.