Effect of methylprednisolone pretreatment on pulmonary permeability and dipalmitoylphosphatidylcholine content in rabbits with reexpansion pulmonary edema / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of methylprednisolone pretreatment on pulmonary lung permeability index and the content of the pulmonary surfactant dipalmitoylphosphatidylcholine (DPPC) in a rabbit model of reexpansion pulmonary edema.</p><p><b>METHODS</b>Twenty-one male New Zealand white rabbits were randomly divided into control group, reexpansion, and reexpansion+methylprednisolone pretreatment groups. The rabbit model of reexpansion pulmonary edema was established using Sakaos method. A bolus dosage of methylprednisolone (3 mg/kg) in reexpansion+methylprednisolone group group or 2.0 ml/kg normal saline in the other two groups was administered intravenously 20 min before reexpansion pulmonary edema. Bronchoalveolar lavage fluid (BALF) and arterial blood samples were collected for measurement of the total protein (TP) and DPPC contents 4 h after reexpansion, and the pulmonary permeability index was calculated.</p><p><b>RESULTS</b>The pulmonary permeability index in methylprednisolone pretreatment group was significantly lower than that in the reexpansion group (0.007∓0.002 vs 0.177∓0.004, P<0.05). Methylprednisolone pretreatment significantly increased DPPC concentration in the BALF as compared with saline treatment in the reexpansion group (61.815∓28.307 vs 101.955∓24.544 µg/ml, P<0.05).</p><p><b>CONCLUSION</b>Methylprednisolone pretreatment can increase pulmonary surfactant content and improve pulmonary permeability in the rabbit model of reexpansion pulmonary edema.</p>

Narcotrend index monitoring can predict the recovery of consciousness in patients undergoing abdominal surgery / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the value of Narcotrend (NT) index monitoring versus standard hemodynamic parameters in predicting the recovery of consciousness in patients undergoing abdominal surgery.</p><p><b>METHODS</b>Forty ASA I or II patients undergoing elective abdominal surgery were randomized into two groups to receive sevoflurane-sufentanil anesthesia monitored by NT index or solely by clinical parameters. Anesthesia was induced with the inhalation of 8% sevoflurane and sufentanil target-controlled infusion at 0.2-0.5 ng/ml. The values of NT stage (NTS), NT index (NTI), and hemodynamic parameters (MAP and HR) were recorded during the period of recovery. The prediction probability (Pk) of each parameter was calculated and compared.</p><p><b>RESULTS</b>NTS and NTl were closely correlated to the changes of consciousness during the recovery from general anesthesia. The Pk values of NTS and NTI in predicting eye opening and orientation recovery were 0.95, 0.92, and 0.92, 0.89, respectively, obviously higher than the Pk values of MAP and HR (P<0.05).</p><p><b>CONCLUSION</b>NT monitoring can be used to effectively predict the recovery of consciousness in patients undergoing abdominal surgery and facilitates a significant reduction of the recovery time and sufentanil dosage during a sevoflurane-sufentanil anesthesia.</p>

Time window for intubation after rocuronium administration during target-controlled infusion of propofol and sulfentanil / 南方医科大学学报

<p><b>OBJECTIVE</b>To define the ideal time window for intubation after rocuronium administration during target-controlled infusion (TCI) ofpropofol and sulfentanil.</p><p><b>METHODS</b>One hundred and twenty elective surgical patients (age range 18-55 years) were randomized into 4 groups (n=30) according to the intubation time after administration of the muscle relaxant. Patients with predicted difficult airway were excluded. General anesthesia was induced by TCI of propofol and sulfentanil. A senior anesthesiologist blinded for the randomization performed the intubations at 1, 2, 3, or 4 min after injection of rocuronium, and the vocal card visibility was evaluated upon full exposure of the vocal cord and the intubation conditions assessed according to Cooper's score.</p><p><b>RESULTS</b>The intubation conditions were excellent or good in all patients, but the vocal cord visibility at 2-4 min differed significantly from that at 1 min after rocuronium administration (P<0.01). Suppression of the neuromuscular function 1 min after rocuronium administration differed significantly from that at other time points (P<0.01).</p><p><b>CONCLUSION</b>The condition of vocal cord can be more suitable for intubation at 2-4 min than at 1 min after rocuronium administration as the ideal time window for intubation during TCI of propofol and sulfentanil.</p>

The retrospective study of sudden cardiac death in 118 cases / 法医学杂志

The sudden cardiac death (SCD) is the primary cause of death in adults. 118 cases of sudden cardiac death from 1998 to 2005 in Shanxi area were studied. The results showed that there as 5.9 times of males as females. There were 55.1% coronary artery diseases, 17.8% myocarditis, 9.3% cardiomyopathy, 2.5% each of congenital heart diseases, valvular heart diseases, and rupture of dissecting aneurysm of aorta, and 4.55 of other diseases. The data indicate that SCD happened in males more often than in females and coronary artery disease was the most common disease. Myocardititis was more common in adolescents and cardiomyopathy was more prevalent in young adults resulting in SCD. The cardiac disease without abnormal structure changes might also be a serious threat to human health.