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AIM: To observe and compare the clinical efficacy and safety of remimazolam and propofol alone and in combination in endoscopic retrograde cholangiopancreatography (ERCP) anesthesia. METHODS: A total of 120 patients undergoing elective ERCP were divided into the propofol group (P group), the remimazolam group (R group), and the remimazolam combined with propofol group (RP group) according to a random number table, with 40 patients in each group, and the three groups completed anesthesia according to the designated drug regimen (propofol in group P; remimazolam in group R; and remimazolam combined with propofol in group RP). General information, operation time and awakening time of the patients in the three groups were compared, as well as oxygen saturation (SpO
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Objective To observe the effect of subarachnoid block with 0.5% bupivacaine at different temperatures during cesarean section.Methods 100 cases of elective cesarean section were randomly divided into room temperature group and heating group,50 cases in each group.Room temperature group: bupivacaine hydrochloride injection and glucose injection equilibrated group in a constant temperature thermostatic bath of 24 degrees thermostatic bath heating for above 30 min.Heating group: bupivacaine hydrochloride injection and glucose injection heated in the constant temperature thermostatic bath of 37 degrees thermostatic bath heatingfor above 30 min.Anesthesia was injected into the subarachnoid space at different temperatures to observe the anesthetic effect.Results The anesthesia increased rapidly, and the analgesia and muscle relaxation effects were better in the heating group than room temperature group, but the heating group had hypotension rate was higher than the room temperature group (36.0% vs.16.0%).There was no obvious difference between the incidence of adverse reactions such as nausea and vomiting in both groups.Conclusion Different temperatures of bupivacaine can be used safely for section anesthesia.The anesthesia effect of the heateding bupivacaine is faster, the anesthesia level is higher, the anesthesic and muscle relaxant effect is better.Bupivacaine at room temperature has relatively small effect on hemodynamics.
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Objective To investigate the effects of compound lidocaine cream applied to tracheal tube on the recovery of tonsil with adenoidectomy in general anesthesia. Methods 120 patients undergoing elective tonsillectomy with adenoidectomy were randomly divided into the experimental group and the control group. In the experimental group, the surface of the tracheal tube was uniformly coated with compound lidocaine cream before anesthesia. In the control group, paraffin oil was given evenly to the surface of the tracheal tube. The changes of hemodynamics and the incidence of complications in the two groups were observed and recorded. Results The indexes of hemodynamics in the experimental group were more stable than those in the control group, and the control group had poor tube resistance, and the incidence of complications such as cough, irritability and sore throat was increased (P<0.05). Conclusion Application of compound lidocaine cream on tracheal tube surface can effectively reduce the cough and other stress response during the general anesthesia recovery period, decrease postoperative irritability and improve the safety of children after surgery.
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Objective To study the effects of enteral nutrition( EN) on inflammatory factors and cardiac function in elderly patients with heart failure ( HF ) . Methods A total of 96 elderly patients with HF were enrolled in this study and randomly divided into treatment group A,treatment group B and control group( n= 32 in each group) . Patients in group A were provided with 500 mL of EN daily for 1 month, and those in group B were provided with the same dose of EN for 3 months. Control group was treated with normal diet. The nutrition status of each group was assessed by NRS2002. Meanwhile,all patients were evaluated by New York Heart Association(NYHA) class and left ventricle eject fraction(LVEF). The levels of BNP,IL-6, CRP and TNF-α were also measured before and after nutrition treatment. Results In group A and group B,BMI,TSF,AMC, TP,ALB and HGB increased. Symptoms of HF alleviated quickly and LVEF increased compared to the baseline. The levels of BNP,IL-6,CRP and TNF-α were significantly lower after treatment(P<0. 05) in both treatment groups,and the change in group B was more obvious(P<0. 01) than group A. However,in control group,there is neither evident improvement in cardiac function or nutrition status,nor in inflammatory factor levels. Conclusion Adding EN support to the normal treatment of heart failure in elderly malnourished patients with HF not only improves the function of heart and nutrition status, but also helps to support immune system so as to alleviate acute inflammatory response. The benefits from EN depend on the duration of therapy.
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Objective To observe the expressions of Akt and ERK phosphorylation in abdominal aortic aneurysm of rat model, and explore the pathogenesis of abdominal aortic aneurysm. Methods The rat model of abdominal aortic aneu-rysm was established. The diameter of abdominal aorta was measured and the extended rate of the aorta was calculated. HE staining was used to observe the change of pathology. Immunohistochemistry and Western blot methods were used to detect the expressions of Akt and ERK phosphorylation in the level of protein. Results The dilation of aorta was significantly high-er in abdominal aortic aneurysm group than that of saline group and normal group (P＜0.05). HE staining showed structural disorder and inflammatory cell infiltration in abdominal aortic aneurysm group. The results of immunohistochemistry and Western blot results showed that phosphorylation of Akt expression was significantly higher in abdominal aortic aneurysm group than that of saline group and normal group (P＜0.05). There was no significant difference in phosphorylation of ERK expression between three groups (P>0.05). Conclusion PI3K/Akt signaling pathway may be involved in the development of abdominal aortic aneurysm.
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Objective To explore the relationship between different hemorrhage position,hemorrhage volume,surgical time and outcome of treatment with surgical methods of HICH.Methods A total of 1310 patients were admitted from six hospitals from January 2004 to January 2008,the 1310 patients were divided into six groups according to different operation:craniotomy through bone flap (group A),craniotomy through small bone window (group B),stereotactic drilling drainage (group C1 and group C2),neuron-endoscopy operation (group D) and external ventricular drainage (group E),considering hemorrhage position,hemorrhage volume,surgical time and result of surgical methods were reviewed and analyzed.Results ①Craniotomy through bone flap should be selected with the case of superficial or deep hematoma volume (＞ 80 mL),median line structure distinct motion,metaphase or advanced stage of hernia of brain.②Craniotomy through small bone window and neuron-endoscopy should be selected with the case of moderate hematoma volume (50-80 mL) ③Drilling drainage should be selected with the case of small hematoma volume in superficial or deep hematoma volume (20-50 mL) ④Extemal drainage should be selected in dealing with ventricular hemorrhage.Small bone window or neuron-endoscopy should be selected in ventricular casting mould.⑤The appropriate operation time for patients with hematoma volume less than 80 mL should be 6-12 hours and large hematoma should be immediately operated to save lives.The operation time should depend on patients detail condition.Conclusions Craniotomy through bone flap was suitable for large hematoma and hernia of brain; Stereotactic drilling drainage should be selected in patients with hematoma volume less than 80mL; and the operation results in dealing with HICH would be improved via suitable operation time and surgical methods and adividual according to Hemorrhage position and Hemorrhage volume.
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[Objective] To investigate the relation among the polymorphism of interleukin-8 (IL-8) gene A-251T and apolipoprotein E (ApoE) gene with late-onset Alzheimer's disease (LOAD). [Methods] Polymerase chain reaction and restrietive fragment length polymorphism (PCR-RFLP) were used to detect the polymorphism distribution of IL-8 gene A-251T and ApoE gene of 185 people in Han ethnicity of Guangdong province (study group: 88 LOAD patients, eontrolled group: 97 people). The correlation of these genes was analyzed. [Results] (1) The differences of genotypes and alleles of IL-8 gene A-251T between study group and controlled group had no statistical significance. (2) The frequency of ApoE 64 allele in study group was significantly higher than that in controlled group, as risk factor of LOAD (OR=2.272, P=0.003). (3) Study group and controlled group were both divided into two groups by carrying ApoE ε4 allele or not. The differenees of IL-8 genotypes were no significant whether in carrying ApoE ε4 allele group or not (carrying ε4 group: P=0.965; no carrying ε4 group: P=0.523). [Conclusion] It is suggested that lL-8 gene A-251T polymorphism perhaps has no relation with LOAD and has no interaction with ApoE ε4 allele.
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Objective To analyze infarcts distribution and vascular malformation in patients with multiple infarcts in the posterior circulation and to investigate their correlation with the disease prognosis.Methods Thirty-four patients who had more than one infarct in the posterior circulation as shown on MRI were enrolled in the study.The digital subtraction angiography (DSA) of aortic arch and whole brain were performed on all patients and the images were analyzed and re-evaluated by two senior clinicians respectively.All the patients were assessed using Modified Rankin Scale (MRS) at discharge and correlation of infarcts distribution and vascular malformation with prognosis was evaluated.Results Infarct lesions most often involved pons (22 patients) and the middle (pons and anterior inferior cerebellum) plus distal territories (rostral brainstem, superior cerebellum and occipital and temporal lobes, 12 patients).Vascular abnormality was found in 76.5% (26/34) of the patients.The common vascular lesions involved vertebral artery (14 patients), intracranial vertebral artery (13 patients) and basilar artery (7 patients).The incidence of poor prognosis was 20.6% with 17.6% the severe disability rate and 2.9% the mortality rate.Patients with multiple lesions in proximal, middle and distal territories or basilar artery were likely to have poor prognosis.Conclusion Vascular abnormality is the main etiological factor for multiple infarcts in the posterior circulation.Infarcts distribution and the location of vascular lesions were key factors in predicting prognosis.
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@# ObjectiveTo explore the clinical features and early diagnosis of virus encephalitis with mental disorder as initial symptoms.MethodsThe materials of 46 cases of virus encephalitis with mental disorder as initial symptoms from 1999 to 2003 were analyzed retrospectively.ResultsAfter antivirus treatment, most patients had good prognosis, only one patient who had fever and coma suddenly two weeks after onset was in vegetative statement.ConclusionTo the patients beginning with acute mental disorder, if they have infection, diarrhea, over-fatigue, oral herpes before disease and exhibit intelligence retardation, incontinence of stool or urine, fever, epilepsy during disease course, it is necessary to complete relative examination and monitor the disease, so as to make sure the diagnosis and guide the treatment.
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@#ObjectiveTo verify the homology hypothesis of depression and insomnia.Methods All-night physiological signals of electroencephalogram (EEG), electrosculogram (EOG) and electromyogram (EEG) of 30 depression cases and 30 insomnia cases were recorded and analyzed with polysomnogram.ResultsThe rapid eye movement (REM) sleep of depression patients was more active, and there was a significant difference in all REM indexes compared with insomnia cases (P<0.01). Characteristics of insomnia cases were poor sleep continuity, easy wake after sleep-onset, and depression of slow wave sleep and REM sleep. There was no slow wave sleep in some insomnia cases.Conclusion The sleep patterns of depression and insomnia are different, REM sleep is hyperactive in depression; non-REM sleep is disturbance in insomnia.
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BACKGROUND: Quite a number of in vitro experiments indicate that low dose He-Ne laser can stimulate the cell growth and blood vessel regeneration therefore to improve the damages caused by ischemia. However, it needs further study on the in vivo experiments.OBJECTIVE: To study the protective effects of intravascular low dose laser irradiation to ischemic reperfusion of rats and explore its mechanism.DESIGN: A randomised and controlled trial based on experinental animals.SETTING: Department of Neurology of a hospital of a university.MATERIALS: The experiment was completed in the Surgery Experimental Animal Center of West China Hospital of Sichuan University. Healthy male SD rats of class Ⅱ which aged between 5 to 6 months with weight of 372 to 418 grams[mean weight(388.48 ± 10. 57) g] were provided by Animal Research Center of Sichuan University.INTERVENTIONS: Middle cerebral artery ischemia model of rats was prepared. Forty SD rats were randomly divided into treatment group and control group with each of 20 rats. Intravascular low dose He-Ne laser irradiation was conducted to rats in treatment group one time every other day, 20 minutes per time and 3 times for a course. Vein puncture was conducted to rats in control group without laser input.MAIN OUTCOME MEASURES: Ratio of infarcted volume RESULTS: The ratio of the cerebral infarction volume in treatment group was (10.43 ± 1.04) and is much lower than that of control group(16.78 ± 1.12).There was statistical difference between two groups( t = 27.14, P ＜ 0.05).CONCLUSION: Intravascular low dose He-Ne laser irradiation has protective effects to cerebral ischemia of rats.
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beta-CIT was labeled with 131I by the peracetic acid method. Cat model of Parkinsonism was set up with MPTP. Each of normal and PD model cats was given an injection of 74 MBq/0.5 ml 131I-beta-CIT into the femur vein. Then the blood samples were obtained at 4 h and 20 h, the radioactivity was counted with calibrator. The biodistribution data of 131I-beta-CIT in cat body was calculated (ID%/g). The cats were subjected to imaging at 0.5 h, 1 h, 2 h, 4 h, 20 h after the administration of radiopharmaceutical. The radioactivity in striatum and cerebellum was measured and striatal specific binding ratios were calculated. The Results showed that the radio chemical purity of 131I-beta-CIT was 97.62% +/- 0.31%. The 131I-beta-CIT remained stable for at least 4 h after incubation with water and serum respectively. Following intravenous administration in cats, 131I-beta-CIT showed high accumulation in striatum. The study of imaging in cats showed that striatal specific uptake of 131I-beta-CIT at 20 h after injection was 4.83 +/- 0.82 in normal cats and 2.92 +/- 0.66 in PD cats. There was a significant reduction of striatal tracer uptake in PD cats, compared to the controls. The results of biodistribution study was in agreement with the results of imaging study. These results suggest that beta-CIT is an ideal agent for dopamine transporter imaging and can be used for the diagnosis of Parkinson's disease.
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Animales , Gatos , Femenino , Masculino , Ratones , Encéfalo , Metabolismo , Cocaína , Metabolismo , Modelos Animales de Enfermedad , Proteínas de Transporte de Dopamina a través de la Membrana Plasmática , Glicoproteínas de Membrana , Metabolismo , Proteínas de Transporte de Membrana , Metabolismo , Ratones Endogámicos , Proteínas del Tejido Nervioso , Metabolismo , Enfermedad de Parkinson , Diagnóstico por Imagen , Metabolismo , Tomografía Computarizada de Emisión de Fotón ÚnicoRESUMEN
Objective To investigate the relationship between the apnea events and the correspondent sleep stage. Methods 68 normal volunteers were studied with polysomnography to confirm the sleep stage of the apnea events. Results Sleep apnea events were found in each different sleep stage. The events happened frequently in light sleep stage, most in stage 2. There were no significant sleep stage distribution difference in different sex .The number and severity of apnea events were also not relative with the sleep stage distribution. Conclusion Apnea events happened most frequently in light sleep stage. The reason is still unclear.