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Objective:To evaluate the efficacy of high-flow nasal cannula (HFNC) oxygen therapy in optimizing painless transesophageal echocardiography in elderly patients.Methods:Sixty American Society of Anesthesiologists Physical Status classification Ⅱ patients, regardless of gender, aged 60-75 yr, with body mass index of 18.5-23.9 kg/m 2, were randomized into 2 groups ( n=30 each) by a random number table method: group HFNC and conventional ventilation group (group C). Pure oxygen 10 L/min was inhaled for 3 min preoxygenation using the HFNC device in group HFNC. Group C inhaled pure oxygen at 6 L/min for 3 min preoxygenation via a nasal cannula. Sufentanil 0.1 μg/kg and remazolam 0.25-0.30 mg/kg were intravenously injected in turn. Group HFNC was connected to a high-flow humidification oxygen therapy device and inhaled pure oxygen at 60 L/min (37℃, FiO 2 100%). The flow rate of pure oxygen was maintained at 6 L/min (FiO 2 100 %) in group C. The patients were placed in left lateral decubitus position, esophageal ultrasound was performed after the eyelash reflex disappeared, and remazolam 0.1 mg/kg was intravenously injected intermittently when bucking and body movement were induced by operation stimulation. The occurrence of hypoxia-related adverse events, mandibular intervention and ventilation-related adverse events was observed during examination. The operation time, time of emergence from anesthesia and consumption of remazolam were recorded. Results:Compared with group C, the incidence of severe hypoxia and rate of mandibular intervention were significantly decreased (7%/0 and 53%/17%, P<0.05), the lowest intraoperative SpO 2 was increased ( P<0.05), and no significant change was found in the operation time, time of emergence from anesthesia and consumption of remazolam in group HFNC ( P>0.05). No ventilation-related adverse events occurred in both groups. Conclusions:HFNC can markedly optimize the ventilation management of elderly patients undergoing painless transesophageal echocardiography.
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Objective:To understand the status quo and problems of clinical nursing fund paper publication in China from 2015 to 2018.Methods:The clinical nursing fund papers published in 12 core nursing journals and published by Chinese Authors in WOS database were analyzed by using bibliometrics methodology. Information analyzed including year distribution, number of authors, regional distribution, the number of institutions, research nature, research type, statistical application, specialty distribution and research content.Results:From 2015 to 2018, the proportion of clinical nursing fund papers was increasing, the proportion of funded papers in Chinese and WOS was 44.06% and 51.46% respectively, the main funding sources of each project came from provinces or direct-controlled municipalities level(42.02% in Chinese and 33.06% in WOS). Chinese fund papers were mainly co-authored by four people (20.18%) and mostly from the same institution (67.83%), the fund papers collected by WOS were mainly co-authored by six people (21.14%) and mainly produced by two institutions (40.65%). Clinical trials (26.64%) were the main research types of Chinese funded papers, and statistical inference (73.15%) was the main application of statistical methods. Jiangsu (14.58%) produced the most Chinese fund papers, and the first authors of the fund papers collected by WOS mostly came from Taiwan (43.90%); the main research topics were oncology nursing (16.65% in Chinese and 22.49% in WOS) and disease and symptom nursing (23.57% in Chinese and 23.04% in WOS).Conclusions:The number of papers on clinical nursing fund was increasing year by year, the application of statistics is basically stable, the sources of fund funding were increasingly diversified, and the trend of scientific research cooperation was increasing. Economically developed areas were the main force of scientific research output. The focus of clinical nursing research was oncology nursing and disease and symptom nursing.
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Objective To compare the effects of general anesthesia and spinal anesthesia on prognosis of cesarean section in parturients with medium and severe pulmonary arterial hypertension (PAH).Methods Parturients with medium and severe PAH,at ≥ 24 weeks of gestation,aged 20-45 yr,undergoing elective cesarean section under general or epidural anesthesia from November 1,2011 to December 31,2017 in our hospital,were divided into general anesthesia group and epidural anesthesia group according to the anesthetic method.General anesthesia was combined intravenous-inhalational anesthesia.The highest temperature within 5 days after surgery,the lowest SpO2 (inhaling oxygen 2-4 L/min via a nasal tube) within 3 days after surgery,duration of intensive care unit stay,time of postoperative use of antibiotics,requirement for targeted drugs for pulmonary hypertension,results of laboratory tests (blood biochemistry,coagulation function),postoperative mechanical ventilation,length of hospital stay,and hospitalization costs were recorded.The Apgar score and weight of the newborn,postoperative complications and death of the newborn and parturients in hospital were recorded.Cox regression analysis was used to identify the risk factors after cesarean section in parturients with medium and severe PAH.Results Fifty-seven parturients were enrolled in this study,with 21 cases in general anesthesia group and 36 cases in epidural anesthesia group.Compared with general anesthesia group,the rate of postoperative mechanical ventilation was significantly decreased,the incidence of adverse events of parturients in hospital and mortality rate were decreased,the postoperative level of albumin was increased,activated partial thromboplastin time was shortened (P<0.05),and no significant change was found in the other parameters in epidural anesthesia group (P> 0.05).The results of Cox regression analysis showed that anesthetic method and preoperative SpO2difference were independent risk factors for cesarean section-related adverse events and death of parturients with medium and severe PAH.The risk of adverse events and death of parturients was significantly higher in general anesthesia group than in epidural anesthesia group (P<0.05).Conclusion Epidural anesthesia produces better prognosis than general anesthesia when used for cesarean section in parturients with moderate and severe PAH.
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BACKGROUND@#Adipocytes in the tumor microenvironment may provide the metabolic fuel or signal transduction through media and other means to promote a variety of malignant proliferation and invasion, of tumor cells, but their role in lung cancer progression is still unclear. The purpose of this study was to investigate the effect of adipocytes on lung cancer cell biology.@*METHODS@#3T3-L1 pre-adipocytes were induced into mature adipocytes. The cell morphology was observed by microscopy and Oil Red O staining. MTT assay, colony formation assay, wound-healing and Transwell methods were used to detect lung cancer cell proliferation, migration and invasion ability. The content of triglyceride in cells was determined by colorimetry.@*RESULTS@#The morphology of lung adenocarcinoma A549 cells became more slender after co-culture with mature adipocytes, and the proliferation and cloning ability were significantly enhanced (P<0.05). In addition, mature adipocytes can also promote the migration ability (P<0.05), invasion ability (P<0.01) and accumulation of intracellular lipid (P<0.05) of A549 cells.@*CONCLUSIONS@#These findings suggested that adipocytes in tumor microenvironment can promote the proliferation, migration and invasion of lung adenocarcinoma A549 cells, which may be related to lipid metabolism.
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Animaux , Humains , Souris , Cellules A549 , Adénocarcinome , Métabolisme , Anatomopathologie , Adénocarcinome pulmonaire , Adipocytes , Biologie cellulaire , Métabolisme , Mouvement cellulaire , Prolifération cellulaire , Tumeurs du poumon , Métabolisme , Anatomopathologie , Cellules NIH 3T3 , Triglycéride , Métabolisme , Microenvironnement tumoralRésumé
Objective To systematically review the efficacy of dexmedetomidine mixed with ropivacaine for brachial plexus block in the patients undergoing upper limb surgery.Methods Medline,PubMed,Embase,Web of Science,Weipu,Wanfang,Zhiwang databases were searched for randomized controlled trials involving the efficacy of dexmedetomidine mixed with ropivacaine for brachial plexus block in patients undergoing upper limb surgery from the date of database establishment up to July 2017,and the trials were published in Chinese or in English.Evaluation indexes included onset time and duration of sensory and motor blocks and analgesia time when used for brachial plexus block.Trials were selected and data were extracted independently by 2 investigators,and meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.3 software.Results Twelve randomized controlled trials were included in our metaanalysis.Compared with control group,the onset time of sensory and motor blocks was significantly shortened,the duration of sensory and motor blocks was prolonged,and analgesia time when used for brachial plexus block was prolonged in dexmedetomidine group (P<0.01).Conclusion Dexmedetomidine mixed with ropivacaine can be effectively used for brachial plexus block in the patients undergoing upper limb surgery.
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Objective To investigate the clinical value of tissue and blood long noncoding RNA(lncRNA) detection in the patients with hepatocellular cancer(HCC).Methods The HCC tissue sample,blood sample, suspected HCC puncture sample and blood sample from the persons undergoing healthy physical examination were selected for conducting the study.The six lncRNAs which were more than 5-fold expression amount were picked out in the 338 transcripts with abnormal high expression.The expression amount of lncRNA AK057037 in HCC tissue and serm tissue was detected by using the real time quantitative polymerase chain reaction and in situ hybridization.Then the results were statistically analyzed.Results The six lncRNAs were highly ex-pressed in the tissues and blood of the liver cancer,and the difference was statistically significant(P<0.05). Compared with healthy people,the relative expression of AK057037 in the tissues and blood of the liver cancer increased significantly,and the relative expression level in tumor and paracancerous tissues was statistically significant(P<0.05).As the tumor progresses,the relative expression of AK057037 was further enhanced. There was a higher relative expression in advanced liver cancer especially,and the difference was statistically significant(P<0.05).The results of the receiver operating characteristic curve showed that the area under curve of AK057037 was 0.834(95% CI 0.705-0.918)in the blood specimen,and its diagnostic efficiency was better than that of commonly used nucleic acid marker miR-29a.Conclusion lncRNA AK057037 is highly ex-pressed in HCC sample and blood,and can be used for clinical detection of HCC.
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Objective To investigate the effects of different values of PEEP on cardiac index (CI), stroke volume variation (SVV) and oxygen transport index (DO2I) in patients monitored by FloTrac/Vigileo system, and to provide some references for the hemodynamic management and improvement of oxygenation for patients. Methods Sixty patients scheduled for elective television (TV) auxiliary thoracoscope radical operation for esophageal cancer were included in this study. Data of CI, SVV and DO2I were observed by the FloTrac/Vigileo system. Changes of CI, SVV and DO2I were recorded after anesthesia induction and turn left side (T0), artificial pneumothorax with 0 PEEP after 5 minutes (T1), artificial pneumothorax with 5 PEEP after 5 minutes (T2), artificial pneumothorax with 10 PEEP after 5 minutes (T3), and artificial pneumothorax with 15 PEEP after 5 minutes (T4). Results Compared with T0, CI decreased and SVV increased significantly at T1, T2, T3 and T4(P<0.05). Compared with T1, CI decreased and SVV increased at T4. DO2I increased at T2 and T3 compared with that of T1(P<0.05). Conclusion PEEP may have a certain influence on CI and SVV in the process of operation. The values of 5-10 PEEP can significantly improve oxygenation and have a less influence on hemodynamics, which can be appropriately used in clinical care.
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Objective To investigate the effect of different operation positions on cardiac index (CI) and stroke volume variation (SVV) in the patients monitored by FloTrac/Vigileo system to provide some references for the hemodynamic management and liquid treatment of the patients.Methods Sixty patients scheduled for elective TV auxiliary thoracoscope radical operation of esophageal cancer.The CI and SVV changes were observed by using the FloTrac/Vigileo system.CI,SVV and CVP were recorded at 5 min after anesthesia induction (T0),5 min after converting to the position of head low feet high (T1),5 min after converting to the position of head high feet low (T2).Results Compared with T0,CI at T1 and T2 was decreased(P<0.05);compared with T0,SVV at T1 was decreased and CVP was increased;SVV at T2 was increased and CVP was decreased(P<0.05).Conclusion The operation position change may have a significant impact on the patient's CI,SVV and CVP.Focusing on the corresponding change can provide some references for the intraoperative hemodynamic management and liquid treatment.
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Objective To investigate the effect of remote ischemic preconditioning (RIPC) on the lung injury during one-lung ventilation (OLV) in the patients undergoing thoracic surgery.Methods Eighty patients scheduled for elective radical operation for esophageal cancer,were randomly divided into 2 groups (n=40 each) using a random number table.control group (group C) and group RIPC.At 0 (T1),30 min (T2),1 h (T3) and 2 h (T4) of OLV,blood samples were obtained from the radial artery for blood gas analysis and determination of plasma concentrations of tumor necrosis factor-α (TNF-α),interleukin-1β (IL-1ββ) and IL-10.Oxygenation index(OI),respiratory index(RI) and PaO2/PAO2 were calculated.Exhaled breath condensate was collected and the pH value was measured.Results Compared with group C,Oxygenation index was significantly increased,and respiratory index was decreased at T2-T4,the plasma concentrations of TNF-α and IL-1β were decreased,and the pH value of exhaled breath condensate was increased at T3-T4,and the plasma concentration of IL-10 was increased at T4 in group RIPC.Conclusion RIPC can inhibit inflammatory responses and reduce airway acidification,thus attenuating the lung injury during OLV in the patients undergoing thoracic surgery.
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Objective To investigate the phenotype and the immunoregulatory function of CD8αα+TCRαβ+regulatory T cells in peripheral blood samples from mice.Methods The distribution profile and the phenotype of CD8αα+TCRαβ+regulatory T cells in C57BL/6 mice were detected by flow cytometry.The cytokines released by CD8αα+TCRαβ+regulatory T cells upon the stimulation with anti-CD3 antibody were analyzed by cytometric bead array.The in vitro immunosuppressive activity of CD8αα+TCRαβ+regulatory T cells on activated CD4+T cells was analyzed by using flow cytometry and carboxyfluorescein succinimidyl ester ( CFSE ) .An adoptive cell transfer assay was set up to evaluate the immunoprotective effects of CD8αα+TCRαβ+ regulatory T cells in a mouse model of experimental autoimmune encephalomyelitis ( EAE) .Results CD8αα+TCRαβ+regulatory T cells were detected in liver, spleen and peripheral blood samples collected from na?ve C57BL/6 mice.Compared with CD8αβ+TCRαβ+regulatory T cells, CD8αα+TCRαβ+regulatory T cells showed a memory-activated phenotype of CD25+CD122high CD44high CD62Llow CD69high NK1.1+DX5+.CD8αα+TCRαβ+regulatory T cells could produce IL-2 after 24 hours stimulation with anti-CD3 antibody, followed by producing IFN-γ, TNF-α, IL-4, IL-17A and traces of IL-6 and IL-10. In vitro, CD8αα+TCRαβ+regulatory T cells specifically suppressed the proliferation of activated CD4+T cells ( P<0.01 ).Moreover, they could delay the onset of EAE in mice and reduce clinical score (P<0.01).Conclusion CD8αα+TCRαβ+regulatory T cells were a unique population with immunoregula-tory function, which could be used as a potential therapeutic target in the treatment of autoimmune disease.
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Objective To investigate the influence of different respiratory parameter setting during gynecological laparoscopic surgery on early postoperative cognitive function.Methods Eighty patients undergoing elective ovarian cancer or cervical cancer were grouped randomly into groups A, B,C and D.In group A patients were ventilated with respiratory parameters of VT 8 ml/kg,RR 12 times/min.While patients in groups B,C and D with identical minute volume 105 ml/kg though with respective RR of 12,1 5 and 18 times/min respectively.Patients in four groups were all graded by the MMSE at time points of preoperation(T0 ),postoperative 1 h(T1 ),6 h(T2 ),24 h(T3 ),48 h(T4 ), 72 h(T5 ).PaCO2 of arterial blood gas were tested before pneumoperitoneum(Ta)and immediately af-ter pneumoperitoneum(Tb).Results PaCO2 at Tb was higher in each group than that at Ta(P <0.05).Patients in group A showed the highest PaCO2 at Tb while PaCO2 in group C were lowest. The MMSE scores in group C were significantly higher than those in other groups at T1-T3 (P <0.05).The values at T4 in group A were lower (P <0.05)than those in other groups.Values at T1-T4 in group A were lower than that at T0 (P <0.05).In groups B and D at T1-T3 MMSE scores were lower than those at T0 and patients in group C showed lower MMSE scores at T1 and T2 (P <0.05).Conclusion Early postoperative cognitive function can be improved by regulating intraoperative respiratory parameters properly and increasing minute volume adequately in gynecological laparoscopic surgery.
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Objective To analyze the phenotype and genotype of three patients with yon Willebrand disease (vWD),and to explore its molecular pathogenesis.Methods Bleeding time (BT),APTT,ristocetin induced platelet aggregation (RIPA),von Willebrand factor (vWF):ristocetin cofactor (Rco)(vWF∶ Rco),vWF antigen (vWF∶ Ag),vWF activity (vWF∶ A) test,vWF collagen binding assay (vWF∶ CB) and multimer analysis were detected for phenotype diagnosis.The dynamic process of blood coagulation was evaluated by using the thrombelastography.Genomic DNA was extracted from the peripheral blood.The vWF gene mutation was detected by sequencing.Results APTT,BT were prolonged in the three probands.Plasma vWF∶ Rco,vWF∶ Ag,vWF∶ A and vWF∶ CB were decreased in different degrees.RIPA was reduced in probands B and C.vWF multimer analysis found the lost of the large molecular weight multimers in proband B,while basically normal in probands A and C.The dynamic process of blood coagulation of proband C presented obvious hypocoagulability by using the thrombelastography.Heterozygous missense mutation g.106782G > T resulting in Cys1130Phe in exon 26,g.110988G > A resulting in Gly1579Arg in exon 28 and g.110373C >T resulting in Arg1374Cys in exon 28 were found in the probands A,B and C,respectively.Conclusion Three probands were diagnosed as type 1,type 2A or type 2MvWD by phenotype detection.Heterozygous missense mutation Cys1130Phe,Gly1579Arg and Arg1374Cys induced vWD of three probands,respectively.
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Objective To explore the role of potassium channel in cardiomyocyte apoptosis induced by ischemia/reperfusion process. Methods Cell viability,caspase-3 activity,intracellular reactive oxygen species(ROS)levels and cell membrane integrity were observed in apoptotic model of mouse cardiomyocytes induced by ischemia/reperfusion(I/R).Experiment groups included negative control,positive control(I/R)and drug treatment group(I/R + potassium channel blocker).Results (1)Potassium channel blockers potently inhibited cardiomyocyte apoptosis induced by I/R.Cell viability in Quinine(81.1%)and BaCl2(82.3%)groups were higher than in positive group (52.1%)(all P<0.01).(2)Compared with positive control group(482.3%),potassium channel blockers(188.3% in Quinine group and 191.4% in BaCl2 group)inhibited caspase-3 activity significantly 24 hours after reperfusion(P<0.01).(3)In both positive control and drug groups,the cell lactate dehydrogenase(LDH)leakage was less than 10% at 96 hours after reperfusion.Conclusions Potassium channel blockers can protect injured cardiomyocyte by inhibiting caspase-3 activity and ROS production in I/R process.
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Objective To analyze the sibling relationship and genetic diversity of four certified Radix Gentianae (RG) species by RAPD and ISSR methods. It provided molecular biological proof for species identification and breeding of certified RG. Methods PCR reaction systems of RAPD and ISSR were optimized, and the agarose gel electrophoresis results were analyzed into statistic data. Results Ten RAPD primers and four ISSR primers were selected respectively from 100 RAPD primers and 32 ISSR primers. The statistic data were analyzed to construct cluster analysis dendrogram by genetic distance UPGMA method. Conclusion The PCR reaction systems of this experiment gets ideal RAPD and ISSR results that suit to the analysis of certified RG species in genetic diversity and sibling relationship.
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AIM:To investigate whether the chloride/bicarbonate (Cl-/HCO-3) exchanger is involved in staurosporine (STS) induced mouse cardiomyocyte apoptosis,and further understand the function of Cl-/HCO-3 exchanger in cell apoptosis. METHODS:To induce mouse cardiomyocyte apoptosis and to explore the effect of Cl-/HCO-3 exchanger,STS was used with two methods:⑴ different blocker,the chloride channel as well as exchanger blocker DIDS and the chloride channel blocker NPPB; ⑵ different culture medium with or without HCO-3 component. RESULTS:The cell viability and caspase-3 activity of DIDS and NPPB on STS-induced cardiomyocyte apoptosis were 59.7% and 47.2%,175.0% and 212.0% respectively with significant statistic differences (both P0.05,n=20). The cell viability and caspase-3 activity of STS-induced cardiomyocyte apoptosis in culture medium with or without HCO-3 were 29.8% and 41.6%,553.4% and 424.7%,respectively (both P