Application of supraclavicular fossa puncture in coracoid approach brachial plexus block guided by ultrasound / 临床麻醉学杂志

Objective To evaluate the clinical effect of supraclavicular fossa puncture in coracoid approach brachial plexus block under ultrasonic guidance.Methods Sixty patients scheduled for distal upper extremity surgery, male 33 and female 27, BMI 18.5-28.0 kg/m2, aged 18-60 years old, falling into ASA physical statusⅠ-Ⅲ, were randomly divided into groups A and B, 30 cases in each.Coracoid approach brachial plexus block was carried out under ultrasonic guidance.The puncturing point was located in infraclavicula (group A) or supraclavicular fossa (group B), and 0.5％ropivacaine 20 ml was injected around axillary artery for each patient.The procedure time and the number of needle adjustment were recorded as primary outcome, and the onset time, sensory block score at 15 min after injection, the success rate of block and the incidence of complications were noted also.Results Compared with group A, the procedure time was shorter in group B (P<0.05).There was no significant difference in the number of needle adjustment, onset time, sensory block score at 15 min, the success rate of block and incidence of complications between the two groups.Conclusion Puncturing through supraclavicular fossa can shorten the procedure time of coracoid approach brachial plexus block guided by ultrasound.It is effective and safe, and does not increase the complications.

Preventive and therapeutic effects of different doses of penehyclidine hydrochloride on the catheter-related bladder discomfort during general anesthesia recovery period / 中国基层医药

Objective To investigate the preventive and therapeutic effects of different doses of penehyclidine hydrochloride preoperative medication on the catheter -related bladder discomfort during general anesthesia recovery period.Methods 160 adult patients who underwent general anesthesia for elective surgery were randomly dividided into four groups.40 patients in each group received intravenous injection 30min before surgery with penehyclidine hydrochloride 0.005mg/kg (group A),0.010mg/kg (group B),0.015mg/kg (group C),or normal saline (group D).All patients were catheterized with a 12 Fr Foley's catheter and the balloon was inflated with 8mL normal saline after anesthesia induction .The bladder discomfort was assessed during recovery in the post -anesthesia care unit .The severity of bladder discomfort was graded as mild , moderate and severe .Results The incidence of moderate and severe bladder discomfort in group B and group C (group B:20.0％,5.0％;group C:12.8％,2.5％) were significant lower compared with group A and group D ( group A:38.5％,12.8％;group D:46.0％ 15.4％) (χ2 =7.834, 6.764,8.163,14.172,8.362,6.943,15.413,17.512,all P<0.05).There was no significant difference between group B and group C , group A and group D .Conclusion Hydrochloride penehyclidine preoperative administration with 0.010mg/kg or 0.015mg/kg can effectively control the incidence of catheter discomfort during general anesthesia recovery period and 0.010mg/kg is appropriate for the elderly .

Study on Chemical Constituents of 70％ Ethanol Extract of Breynia fruticosa / 中国药房

OBJECTIVE:To study the chemical constituents of 70％ ethanol extract of Breynia fruticosa.METHODS:The 70％ ethanol extract of B.fruticosa were isolated and purified by D101 macroporous resin,silica gel column chromatography,RP-silica gel column chromatography,Sephadex LH-20 gel column chromatography,preparative HPLC.The structure of compound was analyzed and identified according to physicochemical characters and spectral data.RESULTS:10 compounds were separated from 70％ ethanol extract of B.fruticosa,such as Luteolin (1),Quercetin (2),Kaempferol (3),Tiliroside (4),(+)-Lyoniresinol (5),(+)-Isolariciresinol (6),(+)-Nortrachelogenin (7),(+)-Syringaresinol (8),Icariol A2 (9),5,5'-Dimethoxy-7-oxolariciresinol (10),respectively.CONCLUSIONS:Ten compounds are isolated from this plant for the first time.The study play the found for quality evaluation of 70 ％ ethanol extract of B.fruticosa.

Effects of edaravone pretreatment on pulmonary inflammatory response during selective lobar blockade in patients undergoing thoracotomy / 中华麻醉学杂志

ObjectiveTo investigate the effects of edaravone pretreatment on pulmonary inflammatory response during selective lobar blockade in patients undergoing thoracotomy,MethodsSixty ASA Ⅰ or Ⅱ patients of both sexes,aged 40-64 yr,weighing 50-80 kg,undergoing esophagectomy were randomly divided into 4 groups (n =15 each):the one-lung ventilation group (group OLV),the edaravone pretreatment + one-lung ventilation group (group E + OLV),the Univent tube selective lobar blockade group (group U) and the edaravone pretreatment + Univent tube selective lobar blockade group (group E + U).Padents in groups OLV and U were intubated with the double lumen endobronchial tube and Univent tube,respectively.Edaravone at a dose of 1 mg/kg was infused into patients at 5 min before one-lung ventilation in group E + OLV and before selective lobar blockade in group E + U,respectively.The patients in groups OLV and U received the equal volume of normal saline.The blood samples (5 ml ) were then drawn from the radial artery after anesthesia induction (T0),at 60 min after onelung ventilation (T1),at the end of operation (T2 ) and 120 min after operation (T3) for detecting the plasma concentrations of TNF-α,IL-6 and IL- 10 by enzyme-linked immunosorbent aesay.ResultsCompared with the group OLV and U,the plasma concentrations of TNF-α and IL-6 decreased at T2 and T3 in group E + OLV and group E + U (P ＜ 0.05).CondusionEdaravone pretreatment can reduce pulmonary inflammatory response during selective lobar blockade in patients undergoing thoracotomy.

Role of protocadherin 20 in spinal cord in development of bone cancer pain in rats / 中华麻醉学杂志

Objective To investigate the effects of protocadherin 20 (PCDH20) in the spinal cord in the development of bone cancer pain (BCP) in rats.Methods Thirty-six SPF female Sprague-Dawley rats,weighing 180-200 g,were randomly divided into 4 groups (n =9 each):sham operation group (group S),BCP group,lentivirus control group (group LC) and PCDH20 siRNA lentivirus group (group P).Control lentivirus and lentivirus containing PCDH20 siRNA 4 μl were injected into the ipsilateral spinal cord in groups LC and P,respectively.One week later,BCP was induced by injection of Walker 256 breast cancer cells into the upper segment of bone marrow of right tibia.The mechanical paw withdrawal threshold (MWT) was measured at 1 day before injection of lentivirus (T1),1 day before BCP (T2),and 7,14 and 21 days after BCP (T3-5).Three rats in each group were sacrificed after measurement of the MWT at 21 day after BCP and the tibia on the operated side was obtained for examination of invasion of the cancer cells with light microscope.The spinal cord was removed for determination of the expression of PCDH20 and postsynaptic density 95 (PSD95) protein (by Western blot) and mRNA (by RTPCR).Results In groups BCP,LC and P,the cancer cells grew out of the bone and destroyed the cortical bone seriously.Compared with group S,the MWT was significantly decreased at T3-5 in groups BCP,LC and P,the expression of PCDH20 and PSD95 protein and mRNA was up-regulated in groups BCP and LC,and the expression of PCDH20 was up-regulated in group P (P ＜ 0.05).Compared with BCP group,no significant change was found in the MWT and expression of PCDH20 and PSD95 protein and mRNA in group LC (P ＞ 0.05),and the MWT was significantly increased at T4,5 and the expression of PCDH20 and PSD95 protein and mRNA was down-regulated in group P (P ＜ 0.05).Conclusion PCDH20 is involved in the development of BCP through regulating the expression of PSD95 in the spinal cord and adjusting the function of excitatory synapse in rats.