Effect of transcutaneous electrical acupoint stimulation with midnight-noon ebb-flow acupoint selection on postoperative delirium in patients undergoing radical resection of colorectal cancer / 中华麻醉学杂志

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation with midnight-noon ebb-flow acupoint selection on postoperative delirium (POD) in the patients undergoing radical resection of colorectal cancer.Methods:A total of 93 patients of either sex, aged ≥18 yr, with body mass index <30 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱor Ⅲ, scheduled for elective radical resection of colorectal cancer under general anesthesia, were divided into 3 groups ( n=31 each) using a random number table method: control group (group C), common TEAS group (group CT), and midnight-noon ebb-flow acupoint selection TEAS group (group MT). The patients received TEAS at bilateral Hegu, Quchi and Shousanli acupoints at 6: 00 in group MT and at 18: 00 in group CT on the day of operation and 1-3 days after surgery, with a frequency of 2/100 Hz, disperse-dense waves, intensity the maximum current that could be tolerated, and each TEAS lasted for 30 min. In group C, only the electrodes were pasted at the same acupoints without electric current at 6: 00 am. The POD was evaluated by the Confusion Assessment Method (CAM) at 1, 3 and 5 days after operation (T 1-3). Blood samples were collected for determination of serum interleukin-1beta (IL-1β), IL-6 and tumor necrosis factor-alpha (TNF-α) concentrations at 1 day before operation and at T 1. The time to first flatus and defection and adverse reactions after operation were recorded. Results:Compared with group C, the CAM scores at each time point and incidence of POD were significantly decreased, the concentrations of IL-1β, TNF-a and IL-6 in serum were decreased at T 1, the time to the first flatus and defecation was shortened, and the incidence of abdominal distension after surgery was decreased in MT and CT groups ( P<0.05). Compared with group CT, the CAM scores at T 3 and incidence of POD were significantly decreased, the concentrations of TNF-a and IL-6 at T 1 were decreased, and the time to first defecation after operation was shortened in group MT ( P<0.05). Conclusions:TEAS guided by midnight-noon ebb-flow acupoint selection provides better efficacy than common TEAS in decreasing the risk of POD in the patients undergoing radical resection of colorectal cancer, which is helpful for the early postoperative recovery of patients.

Accuracy of modified thyromental height in predicting difficult laryngoscopy / 中华麻醉学杂志

Objective To evaluate the accuracy of modified thyromental height (MTMH) in predicting difficult laryngoscopy.Methods Two hundred and sixty-three patients of both sexes requiring endotracheal intubation,aged over 17 yr,with body mass index less than 33 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective surgery under general anesthesia,were selected.The modified Mallampati test (MMT) score,thyromental height (TMH) and MTMH ("sniffing" thyromental height) were assessed after admission to the operating room.MMT grade Ⅲ or Ⅳ was set as positive predicting index.Direct laryngoscope was placed after induction of anesthesia to expose the glottis,and difficult laryngoscopy was defined as Cormack-Lehane grade Ⅲ or Ⅳ after external laryngeal manipulation.The area under the receiver operating characteristics curve (AUC) was used to evaluate the accuracy of MMT,TMH and MTMH in predicting difficult laryngoscopy.Results Difficult laryngoscopy was found in 24 patients and non-difficult laryngoscopy in 239 patients,the incidence of difficult laryngoscopy was 10.0％,and there were no failed intubations.The AUC (95％ confidence interval) of MTMH in predicting difficult laryngoscopy was 0.966 (0.396-0.984),the best cut-off value was 46.83 mm,and Youden index was 0.8456.The sensitivity and specificity of MTMH in predicting difficult laryngoscopy was 91.67％ and 92.89％,respectively,and the odds ratio was 143.647.The AUC of MTMH in predicting difficult laryngoscopy was significantly enlarged when compared with that of MMT and TMH (P＜0.05).Conclusion MTMH can accurately predict difficult laryngoscopy with the best cut-off value of 46.83 mm in patients.

Accuracy of thyromental height in predicting difficult airway / 中华麻醉学杂志

Objective To evaluate the accuracy of thyromental height (TMH) in predicting difficult airway.Methods Three hundred and thirty patients of both sexes requiring endotracheal intubation,aged ＞18 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective surgery under general anesthesia,were selected.The modified Mallampati test (MMT) score,thyromental distance (THD),sternomental distance (SMD) and TMH were measured following admission to the operating room.Direct laryngoscope was placed after induction of anesthesia to expose the glottis,and the Cormack-Lehane grade was recorded.Difficult airway was defined as Cormack-Lehane grade Ⅲ or Ⅳ.The receiver-operating characteristics curve was used to evaluate the accuracy of MMT,THD,SMD and TMH in predicting difficult airway.Results The diagnostic threshold of TMH in predicting difficult airway was 39.04 mm,the sensitivity 88.24％,the specificity 90.42％,the area under the curve (95％ confidence interval) 0.897 (0.859-0.928),and the odds ratio 70.750.Compared with MMT,THD and SMD,the area under the curve of TMH in predicting difficult airway was significantly increased (P＜0.05).Conclusion TMH can accurately predict difficult airway,and the diagnostic threshold is 39.04 mm in patients.

Pharmacokinetic Study on Luteolin and Cynaroside in Rats / 中国药房

OBJECTIVE:To establish the method for pharmacokinetic study of luteolin and cynaroside in rats and to determine pharmacokinetic parameters. METHODS:16 SD rats were randomly divided into luteolin group (sublingual iv,1.34 mg/kg) and cynaroside group(sublingual iv,0.64 mg/kg). 0.5 ml blood were collected before administration and 0,15,30 min and 1,2,3,4,6, 8,12,24,48 h after administration respectively to prepare plasma. UPLC-TQ-MS was adopted to determine plasma concentration, and pharmacokinetic parameters were calculated. A CORTECSTM UPLC? C18(100 mm×2.1 mm,1.6 μm)column was used with mobile phase consisted of acetonitrile-water (containing 0.1% formic acid) at a flow rate of 0.4 ml/min,the column temperature was set at 40 ℃,and quercetin was used as internal standard. RESULTS:The linear range of luteolin and cynaroside were 2.5-500 ng/ml (r=0.998 2) and 10-2 500 ng/ml (r=0.993 5). The lowest quantitation limits were 1 and 2.5 ng/ml,and extraction were 70.75%-87.72% and 75.40%-91.18%(n=6);RSD of inter-day and intra-day were all lower than 10%(n=3). Pharmacokinetic parameters as t1/2 were (1.88 ± 0.32) and (1.57 ± 0.08) h;CL were (0.77 ± 0.18) and (0.06 ± 0.01) L/(h·kg);AUC0-6 h were (189.60±40.04)and(1 093.14±187.36)ng·h/ml;AUC0-∞ were(195.18±38.37)and(1 097.11±188.07)ng·h/ml. CONCLU-SIONS:The method can be used for pharmacokinetic study of luteolin and cynaroside in rats,and the pharmacokinetics of them in rats are in line with two-compartment model.

Effects of different doses of remifentanil on short-term learning and memory ability in the developing rats / 临床麻醉学杂志

Objective To investigate the effects of different doses of remifentanil on learning and memory ability,the expression of hippocampal tissue phosphorylation of cAMP response element binding protein (p-CREB)in developing rats.Methods A total of 72 Sprague-Dawley rats (1 9-23 g) were randomly divided into 4 groups (n =18 each):Group C:normal saline control group;R1,R2, R3 group received continuous intraperitoneal remifentanil 1,5,10 μg·kg-1 ·min-1 for 2 hours re-spectively.Both total volume of remifentanil and saline were 2 ml.The SpO 2 and pulse rates were mo-nitored during the experiment.Step-down test was used to evaluate the learning and memory ability, while Western blot analysis was performed to measure the expression of hippocampal p-CREB protein in 4 h,24 h,1 week when the rats were awake.Results Compared with group C,group R1 and R2, pulse rates of group R3 decreased significantly (P <0.05 ),but the changes of SpO 2 in each group were not statistically significant.At 4 h point:compared with group C and group R1,the error times in step-down test were increased in both group R2 and R3,the latencies were shortened (P <0.05);Compared with group R2,the error times were increased in group R3,latency was shortened (P <0.05).At 24 h point,compared with group C and group R1,the error times were increased in group R2,R3,latencies were shortened (P < 0.05 );Compared with group R2,the error times were in-creased in group R3,latency was shortened (P <0.05 ).The error times and latency of each group had not statistical significance in one week.At 4 h point,the expression of p-CREB protein in hippo-campus of group R3 downregulated compared with group C and group R1,R2,respectively (P <0.05).At 24 h point,the expression of p-CREB protein in hippocampus of group R2,R3 decreased compared with group C and group R1 respectively(P <0.05);The expression of p-CREB protein in each group had no statistical significance in one week.Conclusion 5-10 μg · kg-1 · min-1 dose of remifentanil can result in a decline of learning and memory ability in the developing rats in short-term,and the mechanism may relate to the inhibition of p-CREB protein expression in hippocampus.

Effects oftwo kinds of crystals priming on levels of glucose and lactic acidin pediatrics withcardiopul-monary bypass during congenital heart surgery / 实用医学杂志

Objective To compare the effect of Acetate Sodium Potassium Magnesium Calcium and lactate ringers′ as priming solution in pediatrics with cardiopulmonary bypass (CPB) during congenital heart surgery. Methods Sixty children, aged 1-6 years, weighting 8 to 20 kg, with ASA Ⅱ to Ⅲ class and with ventricular or atrial septal defect elective , received heart surgery with CPB. They were randomly divided into two groups: the lactate ringers′ group (R) and the sodium acetate, potassium, magnesium and calcium glucose injection pre-filled group (L). Levels of artery blood gas, lactic, gluclose, electrolytes were detected at the time points of induction of anesthesia (T1), aortic cross damping (T2), stopping before (T3), and closing chest later (T4). Results Levels of the blood glucose and lactic acid in the two groups post-CPB were increased (P 0.05). Conclusion Sodium, potassium , magnesium , calcium and glucose injection as children CPB priming crystalloid fluid could provide energy substrate, reduce lactic acid concentration, with little effect on electrolyte and blood gas.

Determination of Warfarin and Its Metabolite in Human Plasma by Ultra Performance Liquid Chromatog-raphy Tandem Quadrupole Mass Spectrometry (UPLC-MS/MS) / 中国药师

Objective:To establish an ultra performance liquid chromatography-tandem quadrupole mass spectrometry method for the determination of warfarin and its metabolite 7-hydroxywarfarin in human plasma. Methods: An ACQUITY UPLC? BEH C18 (50 mm × 2. 1 mm, 1. 7 μm) column was used as the stationary phase at 40℃. The mobile phase consisted of acetonitrile and water (con-taining 0. 1% formic acid) with gradient elution at a flow rate of 0. 4 ml·min-1 . Warfarin-d5 was used as the internal standard. The analytes were detected on a triple-quadrupole mass spectrometer equipped with an ESI interface in a positive mode. Results:The reten-tion time of warfarin and 7-hydroxywarfarin was 1. 8 min and 1. 5 min, respectively. Excellent linear calibration curve of warfarin and 7-hydroxywarfarin was obtained within the concentration range of 25-2 000 ng · ml-1 ( r =0. 999 3 ) and 5-500 ng · ml-1 ( r =0. 999 6), respectively. The lower limit of quantification of warfarin and 7-hydroxywarfarin was 5 ng·ml-1 and 2. 5 ng·ml-1 with the average recovery of 96. 9%-105. 3% and 97. 1% -103. 3%, respectively. The intra-and inter-day standard deviations were both less than 10%. Conclusion: The method is accurate and simple, and suitable for the determination of warfarin and its metabolite 7-hydroxywarfarin in human plasma.

Changing levels of serum iron and hemoglobin in Streptococcus pneumoniae-induced rat pneumonia model / 中国感染与化疗杂志

Objective To examine the changing levels of serum iron and hemoglobin in Streptococcus pneumoniae-induced rat pneumonia model and the relationship among infection severity,serum iron and hemoglobin.Methods Sixty Sprague Dawley (SD)rats were randomly assigned to one of the four groups,1 5 SD rats in each group,including three treatment groups and one control group. Low, medium and high doses of bacteria were administered to the animals in the treatment groups respectively through tracheal cannula.The severity of pneumonia was indicated by the level of bacterial load.The animals in the control group did not receive bacterial challenge.The mean serum iron and hemoglobin levels were calculated on day 3,5, and 7 to analyze the relationship between bacterial dose and serum iron or hemoglobin levels.Results The serum iron level in the animals receiving medium or high doses of bacteria was significantly lower compared with that in control group on day 3 (P=0.009,P=0.005).The serum iron level in the animals receiving low dose of bacteria showed significant difference compared with that in the control group on day 5 (P=0.007).The hemoglobin level in the animals receiving medium or high doses of bacteria was significantly different from that in the control group on day 5 (P=0.031,P=0.046).The hemoglobin level in the animals receiving low dose of bacteria did not show significant difference compared with that in the control group on day 3,5 or 7.The bacterial dose level was negatively correlated with the mean level of serum iron (correlation coefficient r=-0.65,r=-0.53,r=-0.61,respectively).There was no definite correlation between the bacterial dose and the mean hemoglobin level.Conclusions Streptococcus pneumoniae infection may be associated with lower serum iron and hemoglobin levels in rats.The severity of infection is negatively correlated with serum iron level,but not hemoglobin level.

Experimental Study on in Vitro and in Vivo Bacteriostatic Actions of Ganmaoreduqing Oral Liquid / 中国药房

OBJECTIVE:To study the in vitro and in vivo bacteriostatic actions of Ganmaoreduqing oral liquid(GMRDQ) METHODS:The bacteriostatic actions of GMRDQ were observed with conventional in vitro and in vivo tests RESULTS:GMRDQ could significantly inhibit Staphylococcus aureus,?-hemolytic streptococcus,?-hemolytic streptococcus,Streptococcus pneumoniae and Hemophilus influenzae and it could protect mice from death induced by intraperitoneal injection of S aureus CONCLUSION:GMRDQ has in vitro and in vivo bacteriostatic actions

Design and application of individual drugs parcel for seawise soldier / 医疗卫生装备

This paper discusses the structure,functions,characteristics and the convenience of individual drugs parcel for seawise soldier.The parcel can be used for peacetime training and wartime service.