Quality of psychomotility recovery after propofol sedation for painless gastroscopy and colonoscopy / 北京大学学报(医学版)

OBJECTIVE@#To study the effect of propofol used for painless gastroscopy and colonoscopy on psychomotility recovery.@*METHODS@#One hundred adult patients undergoing painless gastroscopy and colonoscopy were recruited, aged 18-72 years, with American Society of Anesthesiologist (ASA) physical status Ⅰ-Ⅱ. According to age, the patients were divided into youth group (20-39 years old, 27 cases), middle age group (40-54 years old, 37 cases), and elder group (55-64 years old, 36 cases). Propofol was continuously infused according to the patients' condition to mantain the bispectal index (BIS) score 55-64. All the patients received psychomotility assesment 30 min before the operations when the discharge criteria were met including number cancellation test, number connection test and board test. The heart rate, blood pressure, saturation of pulse oximetry, electrocardiograph and BIS were monitored during the operation. The operating time, recovery time, total volume of propofol and discharge time were recorded. If the results obtained were inferior to those before operation, a third assessment was taken 30 minutes later until the results recovered or being superior to the baseline levels.@*RESULTS@#All the patients completed the first and second assessments, and 25 patients had taken the third assessment. There was no statistically significant difference in the results of psychomotility assessment when the patients met the discharge standard. Furthermore, the results were analyzed by grouping with age, and there was no statistical difference in the test results of the youth and middle age groups compared with the preoperative group, among which, the efficiency of the number cancellation test was significantly better than that before operation in the youth group (P < 0.05). However, in the elderly patients the number cancellation efficiency, number connection test and board test were significantly inferior to that before operation (P < 0.05). There was no significant difference in the accuracy of number cancellation compared with that before operation. The patients who needed the third test in the elder group were significantly more than in the other groups (P < 0.05). Compared with the preoperative results, there was no statistical difference in the test results of those who completed the third test.@*CONCLUSION@#The psychomotility function of the patients who underwent painless gastroscopy and colonoscopy was recovered when they met discharge criteria. The elderly patients had a prolonged recovery period.

Study of the neuroprotective effects and mechanisms of Tianma Gouteng Decoction on retinal ganglion cells in rat optic nerve crush model / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the mechanism of Tianma Gouteng Decoction on the protein molecular level in the optic nerve crush model rats.METHODS:Totally 36 participants 36 male Wistar rats were divided randomly into six groups(6 in every group):normal control group,negative control group,Tianma Gouteng Decoction treatment groups (con-centrations were 0.6g/mL,1.2g/mL,2.4g/mL respictively) and ginkgo biloba tablets positive control group (concentrations was 1.2mg/mL).Nothing was done in the normal control group.The optic nerve of right eye in the other groups was done with the optic nerve crush model.Normal control group and negative control group was treated only with water.The average grey scale values of the N-methyl-D-aspartic acid receptor 2B (NMDA2B) receptor protein,beta-amyloid protein (Aβ) in the average grey scale values were detected.RESULTS:The average grey scale value of Tianma Gouteng Decoction in low,medium and high dose groups about NMDA2B receptor protein was significantly less than that of the negative control group (all P＜0.001),and there was no significant difference with the positive control group (P=0.092,0.411,0.676),the difference between normal control group and negative control group was significant (P＜0.001).The high dose group of betaamyloid's average grey scale value reduced significantly than the negative control group (P=0.030,0.001).The low dose group than the negative control group was not obviously (P=0.614).The high dose group was not significantly different from the positive control group (P=0.927),the difference between normal control group and negative control group was significant (P＜0.001).CONCLUSION:Tianma Gouteng Decoction can go through the decrease of the NMDA2B receptor protein expression and the control of beta-amyloid deposition to reduce the retinal ganglion cell injury and apoptosis.

Transcriptome analysis of phosphorus stress responsiveness in the seedlings of Dongxiang wild rice (Oryza rufipogon Griff.)

Abstract Background: Low phosphorus availability is a major factor restricting rice growth. Dongxiang wild rice (Oryza rufipogon Griff.) has many useful genes lacking in cultivated rice, including stress resistance to phosphorus deficiency, cold, salt and drought, which is considered to be a precious germplasm resource for rice breeding. However, the molecular mechanism of regulation of phosphorus deficiency tolerance is not clear. Results: In this study, cDNA libraries were constructed from the leaf and root tissues of phosphorus stressed and untreated Dongxiang wild rice seedlings, and transcriptome sequencing was performed with the goal of elucidating the molecular mechanisms involved in phosphorus stress response. The results indicated that 1184 transcripts were differentially expressed in the leaves (323 up-regulated and 861 down-regulated) and 986 transcripts were differentially expressed in the roots (756 up-regulated and 230 down-regulated). 43 genes were up-regulated both in leaves and roots, 38 genes were up-regulated in roots but down-regulated in leaves, and only 2 genes were down-regulated in roots but up-regulated in leaves. Among these differentially expressed genes, the detection of many transcription factors and functional genes demonstrated that multiple regulatory pathways were involved in phosphorus deficiency tolerance. Meanwhile, the differentially expressed genes were also annotated with gene ontology terms and key pathways via functional classification and Kyoto Encyclopedia of Gene and Genomes pathway mapping, respectively. A set of the most important candidate genes was then identified by combining the differentially expressed genes found in the present study with previously identified phosphorus deficiency tolerance quantitative trait loci. Conclusion: The present work provides abundant genomic information for functional dissection of the phosphorus deficiency resistance of Dongxiang wild rice, which will be help to understand the biological regulatory mechanisms of phosphorus deficiency tolerance in Dongxiang wild rice.

Dose-response relationship of sufentanil blunting responses to double-lumen endotracheal intubation when combined with propofol given by TCI in patients with pulmonary tuberculosis / 中华麻醉学杂志

Objective To determine the dose-response relationship of sufentanil blunting responses to double-lumen endotracheal intubation when combined with propofol given by target-controlled infusion (TCI) in patients with pulmonary tuberculosis.Methods One hundred patients of both sexes with pulmonary tuberculosis,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 24-58 yr,with body mass index ＜30 kg/m2,with Mallampati grade Ⅰ or Ⅱ,undergoing thoracic surgery under general anesthesia,were divided into Ⅰ-Ⅴ groups (n =20 each) using a random number table.Anesthesia was induced with iv sufentanil 0.35 μg/kg (group Ⅰ),0.40 μg/kg (group Ⅱ),0.45 μg/kg (group Ⅲ),0.50 μg/kg (group Ⅳ) and 0.55 μg/kg (group Ⅴ),and propofol TCI (target plasma concentration 3.5 μg/ml) and iv vecuronium 0.15 mg/kg.The patients were endotracheally intubated and mechanically ventilated.The response to double-lumen endotracheal intubation was defined as positive when mean arterial pressure increased by＞ 20％ of the baseline value and/or heart rate ＞ 90 bpm within 5 min after intubation.The median effective dose (ED50),ED95 and 95％ confidence interval (95％ CI) of sufentanil blunting the responses to double-lumen endotracheal intubation were calculated by Probit analysis.Results The ED50 (95％ CI) and ED95 (95％ CI) of sufentanil blunting the responses to intubation were 0.411 (0.370-0.441) μg/kg and 0.635 (0.556-0.888) μg/kg,respectively,when combined with propofol given by TCI.Conclusion When combined with propofol given by TCI (target plasma concentration 3.5 μg/ml),the ED50 and ED95 of sufentanil blunting the responses to double-lumen endotracheal intubation are 0.411 and 0.635 μg/kg,respectively,in patients with pulmonary tuberculosis.

Clinical application of the obturator nerve block beside vessel in transurethral resection of bladder tumor / 中国内镜杂志

Objective To compare the operational feasibility and efficacy of inguinal obturator nerve block (ONB) beside the vessel by ultrasound combined with nerve stimulation and traditional ONB guided by nerve stimulation preventing obturator nerve reflex. Methods Forty patients with American Society of Anesthesiology (ASA)Ⅰ or Ⅱ, aged 35~91 years who underwent transurethral electric excision of bladder tumor in our hospital in 2014 were ran-domly divided into beside vessel group (group V, = 20) and traditional group (group T, = 20). Adductor strength was measured before and after the block. Frequencies of obturator nerve block puncture, operation time, visual ana-log scale (VAS) pain score, and incidence of complications were recorded during and after ONB. Results The suc-cess rate of the first puncture was significantly higher in group V than that in group T ( <0.01). The operation time in group V was significantly shorter than that in group T ( < 0.01). The decreased degree of adductor strength has significant difference of the two groups ( < 0.05 or < 0.01). The VAS pain score in group T was higher than that in groups V ( < 0.01). There are two cases contract blood vessel in group T, while none in group V ( < 0.01). There was no case with the local anesthetic toxicity and paresthesia in the area of the obturator nerve and the obtu-rator nerve injury in the two groups. Conclusion Compared with traditional ONB guided by nerve stimulation, in-guinal ONB beside the vessel by ultrasound combined with nerve stimulation showed more accurate positioning, less adjustment, less puncture time, more comfortable and safe.

Comparison of efficacy of three kinds of neurolytic celiac plexus block in patients with upper abdominal cancer pain / 中华麻醉学杂志

Objective To compare the efficacy of three kinds of neurolytic celiac plexus block (NCPB) in the patients with upper abdominal cancer pain.Methods Sixty-seven patients of both sexes,with upper abdominal cancer,aged 45-64 yr,weighing 52-69 kg,were randomly divided into 3 groups using a random number table:single-needle NCPB using crura of diaphragm space approach group (group S,n =23),double-needle NCPB via an anterior and posterior crura of diaphragm space approach group (group D,n =22),and continuous NCPB via crura of diaphragm space approach group (group C,n =22).In S and D groups,NCPB was performed with single injection of anhydrous alcohol 25-30 ml after CT-guided successful single and double punctures,respectively.In group C,a catheter was inserted into the crura of diaphragm space and then anhydrous alcohol 25-30 ml was injected via the catheter once a day for 3 consecutive days to perform NCPB.Before treatment,at 1 week after treatment,1,2,4 and 6 months after treatment,the daily consumption of morphine and VAS score were recorded.The therapeutic efficacy was evaluated using VAS weighted value calculation.The development of adverse effects such as diarrhea,hypotension,dysuria and damage to nerves was recorded.Results Compared with S or D groups,the daily consumption of morphine was significantly decreased at 4-6 months after treatment,the rate of effective treatment was increased at 4-6 months after treatment,and the incidence of hypotension was decreased in group C.The incidence of diarrhea was significantly higher in D and C groups than in group S.Conclusion For the patients with upper abdominal cancer pain,continuous NCPB via crura ofdiaphragm space approach provides perfect efficacy with fewer adverse reactions,and the efficacy is better than that of single-needle NCPB using crura of diaphragm space approach or double-needle NCPB via an anterior and posterior crura of diaphragm space approach.

Effects of permissive hypercapnia on inflammatory factor of pulmonary tuberculosis patients with one-lung ventilation / 中华传染病杂志

Objective To study the effects of permissive hypercapnia (PHC) on inflammatory factors of pulmonary tuberculosis patients with one-lung ventilation (OLV).Methods Sixty pulmonary tuberculosis patients with selective thoracic operation who were hospitalized at Hangzhou Red-cross Hospital from October 2010 to October 2013 were randomized into three groups by means of random digits table.Twenty patients were enrolled as control group whose arterial partial pressure of carbon dioxide (PaCO2) was maintained at 35-45 mmHg (1 mmHg=0.133 kPa),20 patients as lower PHC group whose PaCO2 were maintained at 50-55 mmHg,and 20 patients as higher PHC group whose PaCO2 were maintained at 56-60 mmHg.The concentrations of serum interleukin (IL)-6 and IL-8 were measured at the time when the patients were in supine position by two-lung ventilation after induction of anesthesia (T1),15 minutes (T2) and 30 minutes after OLV (T3) in lateral position,two hours (T4) and 6 hours after operation (T5).Quantitative data were analyzed by t-test.Results IL-6 at T3 time point in the three groups increased significantly compared with T1 time point (control group:[4.94± 1.60] pg/mL vs [3.32±1.34] pg/mL,t=3.47,P＜0.01; lower PHC group:[5.38±1.42] pg/mL vs [3.69±1.35] pg/mL,t=3.86,P＜0.01; higher PHC group:[5.57±± 1.34] pg/mL vs [3.50 ± 1.22] pg/mL,t=5.11,P＜0.01).IL-8 at T4 time point increased significantly compared with T1 time point (control group:[342.09±56.12] pg/mL vs [194.58 ± 30.07] pg/mL,t =10.36,P＜0.01; lower PHC group:[349.48±43.49] pg/mL vs [193.16±26.27] pg/mL,t=13.80,P＜0.01; higher PHC group:[351.55±38.13] pg/mL vs [186.02±21.08] pg/mL,t=16.99,P＜0.01).IL-6 at the T4 and T5 time points in both lower PHC group and higher PHC group decreased significantly compared with control groupatthe same time points (T4..[38.49± 9.70] and [43.41± 9.01] pg/mL vs [62.35±7.83] pg/mL,t=8.56 and 7.10,both P＜0.01; T5:[56.39±7.47] and [54.77±7.12] pg/mL vs [107.32± 13.97] pg/mL,t=-14.38 and-14.99,both P＜0.01].Conclusions The serum IL-6 and IL-8 levels in pulmonary tuberculosis patients with OLV increase after selective thoracic operation.PHC through low tidal volume could decrease the release of IL-6 and attenuate the pulmonary inflammatory injury in the tuberculosis patients with operation.

Effect of qubi zhentong recipe on synovial gene expression in collagen-induced arthritis in rats / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of the Chinese medical formula Qubi Zhentong Recipe(, QZR) on the synovial gene expression profile in collagen-induced arthritis (CIA) rats.</p><p><b>METHODS</b>Ten rats were randomly chosen from 60 rats as the control group, and the other 50 rats were used for the CIA models. The CIA model group was constructed by bovine injection of type II collagen through the rats' neck and tail. Twenty rats were randomly chosen from 34 successful CIA models and randomly assigned into two groups: the model group (n =10) and the QZR group (n=10). The QZR group was fed intragastrically with QZR 22.9 g/(kg·d) (10 times the clinical adult dose), and the CIA model group was given the same dose of normal saline. Both model and QZR groups were administered treatment once a day. Total RNA was collected from the knee joint synovium after 30 days. The change in gene expression profile was analyzed by a whole gene chip.</p><p><b>RESULTS</b>A total of 76 genes showed a difference in expression between CIA model group and the control group; 35 genes were down-regulated and 41 were up-regulated. A total of 67 genes showed a difference in expression between the model group and the QZR group; 48 genes were down-regulated and 19 were upregulated.</p><p><b>CONCLUSIONS</b>QZR may affect CIA by stimulating multiple genes and targets, which are related to oncogenes, apoptosis, metabolism, the immune system, ion channels, and transport proteins.</p>

Effects of qubi zhentong recipe on the expressions of IL-1beta, IL-8, and VEGF in the synovial of rats with collagen-inducing arthritis / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To research the effects of Qubi Zhentong Recipe (QZR) on the expressions of interleukin-1beta (IL-1beta), interleukin-8 (IL-8), and vascular endothelial growth factor (VEGF) in the synovial of rats with collagen-inducing arthritis (CIA), and to discuss its mechanisms of action.</p><p><b>METHODS</b>Healthy male Wistar rats were recruited and randomly divided into the model group ( n = 50) and the normal control group (n = 10). Rats of the model group were injected with type II collagen of bovine (BC II) emulsion in the tail and nape to establish the CIA model. After successful modeling, 30 successfully modeled rats were selected and randomly divided into three groups, i.e., the model group (n = 10), the QZR group (n = 10), and the methotrexate (MTX) group (n = 10). Rats in the normal control group and the model group were administered with physiological saline by gastrogavage, while those in the QZR group were administered with QZR at 22.9 g/kg by gastrogavage. All medication was performed once daily. The rats in the MTX group were administered with MTX suspension at 0.78 mg/kg by gastrogavage, once per week. After 30-day treatment, the levels of IL-1beta, IL-8, and VEGF in the synovial were detected by immunohistochemical method. The arthritis index (AI) was scored before and after medication.</p><p><b>RESULTS</b>After treatment the AL score of the QZR group and the MTX group was obviously lower than that of the model group (P < 0.01). The AI score of the two drug groups were lower than that before treatment (P < 0.01). Compared with the normal control group, the expression levels of IL-1beta, IL-8, and VEGF obviously increased in the model group (P < 0.01). Compared with the model group, the expression levels of IL-1beta, IL-8, and VEGF were significantly lower in the two drug groups (P < 0.01). But there was no statistical difference between the QZR group and the MTX group (P > 0.05).</p><p><b>CONCLUSION</b>Decreasing the expression levels of IL-1beta, IL-8, and VEGF in the synovial of CIA rats may be one of the mechanisms for treating CIA by QZR.</p>

Effects of permissive hypercapnia ventilation on cerebral oxygen metabolism and postoperative cognitive function in elderly patients / 中华麻醉学杂志

Objective To investigate the effects of permissive hypercapnia ventilation on cerebral oxygen metabolism and postoperative cognitive function in elderly patients.Methods One hundred and twenty ASA Ⅰ-Ⅲ patients,aged 65-80 yr,undergoing elective lower abdominal surgery under general anesthesia,were randomly divided into 2 groups (n=60 each): routine ventilation group (group R) and permissive hypercapnia ventilation group (group H).In group H,VT=6-8 ml/kg,RR=12-14 bpm,I: E=1: 2,and PaCO2 was maintained at 45-65 mm Hg and pH value ＞ 7.2,while in group R,VT=10-12 ml/kg,RR=14-16 bpm,I:E=1:2,and PaCO2 was maintained at 35-45 mm Hg.Blood samples were taken from the radial artery and jugular bulb for blood gas analyses at 0,5,15 and 30 min after tracheal intubation (T0.3).Cerebral A-V O2 content differences (Da-jvO2)and cerebral O2 extraction rate (CERO2) were calculated at the same time.Cognitive function was assessed by Mini-Mental State Examination (MMSE) at 1 day before operation,and 24 h,48 h,1 week and 2 weeks after operation.Results Compared with group R,PEr CO2 andPaCO2 were significantly increased,and pH value,Da-jvO2 and CERO2 were significantly decreased at T1.3,MMSE score was significantly increased after operation,and the incidence of post-operative cognitive dysfunction was significantly decreased after operation (P ＜ 0.05 or0.01).Compared with the baseline value at T0,Da-jvO2 and CERO2 were significantly decreased at T1-3 in both groups,PETCO2 and PaCO2 were significantly increased,and pH value,Da-jvO2 and CERO2 were significantly decreased at T1-3 in group H,and MMSE score was significantly decreased at 24 h,48 h,1 week and 2 weeks after operation in both groups (P ＜ 0.01).Conclusion Permissive hypercapnia ventilation can improve the cerebral oxygen metabolism during operation,and reduce post-operative cognitive dysfunction in the elderly patients.

Influence of wall polymer and preparation process on the particle size and encapsulation of hemoglobin microcapsules / 生物工程学报

Methoxypoly (ethylene glycol)- block-poly (DL-lactide) (PELA) microcapsules containing bovine hemoglobin (BHb) were prepared by a W/O/W double emulsion-solvent diffusion process. The P50 and Hill coeffcient were 3466 Pa and 2.4 respectively, which were near to the natural bioactivity of bovine hemoglobin. The results suggested that polymer composition had significant influence on encapsulation efficiency and particle size of microcapsules. The encapsulation efficiency could reach 90% and the particle size 3 - 5 microm when the PELA copolymer containing MPEG 2000 block was used. The encapsulation efficiency and particle size increased with the concentration of PELA. Increasing the concentrations of NaCl in outer aqueous solution resulted in the increase of encapsulation efficiency and the decrease of particle size. As the concentration of stabilizer in outer aqueous solution increased in the range of 10 g/L to 20 g/L, the particle size reduced while encapsulation efficiency was increased, further increase of the stabilizer concentration would decrease encapsulation efficiency. Increasing of primary emulsion stirring rate was advantageous to the improvement of encapsulation efficiency though it had little influence on the particle size. The influence of re-emulsion stirring rate was complicated, which was not apparent in the case of large volume of re-emulsion solution. When the wall polymer and primary emulsion stirring rate were fixed, the encapsulation efficiency decreased as the particle size reduced.