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Objective To investigate the effect of ultrasonograpy (US )-guided bilateral superior laryngeal nerve (SLN)block by different concentrations of lidocaine combined with intrave-nous anesthesia for polypectomy of vocal cord by laryngoscope.Methods Sixty patients,aged 18-65 years, ASA physical status Ⅰ or Ⅱ, scheduled for elective polypectomy of vocal cord by laryngoscope were divided into 3 groups (n=20 each)using a random number table:US-guided bilat-eral SLN block by 2% lidocaine (group A),S-guided bilateral SLN block by 1% lidocaine (group B), and traditional SLN block by 2% lidocaine (group C).HR,MAP,SpO2and plasma concentration of NE were detected at the time of patients entering the operating room (T0),immediately after intuba-tion(T1),suspensing laryngoscopy (T2),5 min after suspensing laryngoscopy (T3),immediately af-ter extubation(T4),5 min after extubation(T5).Extubation time and side effects such as dysphagia and dyspnea in two hours after extubation were recorded as well.Results HR and MAP in the three groups at T1-T5were increased compared to T0(P<0.05).Compared with group C,HR and MAP in groups A and B were decreased at T1-T5(P<0.05).Plasma concentration of NE of groups A and B was more significantly decreased than group C (P<0.05),and extubation time of groups A and B was less than that of group C (P <0.05 ).Conclusion US-guided bilateral SLN block by 1% lidocaine has definite effect and better comfort level,with stable haemodynamics and less extubation time.
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Objective To evaluate the accuracy of different biomarkers for early diagnosis of acute kidney injury ( AKI ) in the patients undergoing cardiovascular surgery under cardiopulmonary bypass ( CPB) . Methods A total of 200 patients, aged 22-86 yr, weighing 46-87 kg, scheduled for elective cardiovascular surgery under CPB, were enrolled in this study. The concentration of serum creatinine was determined at 1 day before operation and 1-7 days after operation. At 1 day before operation and 0, 2, 6 and 12 h after operation, the concentrations of urine neutrophil gelatinase-associated lipocalin (NGAL), cystatin C ( Cys C) , tissue inhibitor of matrix metalloproteinase type 2 ( TIMP-2) and insulin-like growth factor binding protein-7 ( IGFBP-7) were determined. The TIMP-2 and IGFBP-7 product ( TI) was calcu-lated. AKI was diagnosed after surgery according to Kidney Disease Improving Global Outcomes criteria. The receiver operating characteristic curve was plotted, and the area under receiver operating characteristic curve ( AUC) was calculated. Results The incidence of AKI was 20. 5％. The AUC of AKI diagnosed by the concentration of urine NGAL was 0. 689, 0. 709, 0. 713 and 0. 803 at 0, 2, 6 and 12 h after opera-tion, respectively ( P<0. 05) . The AUC of AKI diagnosed by the concentration of urine Cys C was 0. 639, 0. 762, 0. 774 and 0. 812 at 0, 2, 6 and 12 h after operation, respectively ( P<0. 05) . The AUC of AKIdiagnosed by TI was 0. 687, 0. 721, 0. 740 and 0. 779 at 0, 2, 6 and 12 h after operation, respectively ( P<0. 05) . The AUC of AKI diagnosed by combined three indices the parallel test was 0. 694, 0. 773 and 0. 794 at 0, 2 and 6 h after operation, respectively ( P<0. 05) . The AUC of AKI diagnosed by the serial test was 0. 610, 0. 631 and 0. 667 at 0, 2 and 6 h after operation, respectively. Conclusion Urine NGAL or Cys C concentrations or TI single detection and parallel test have a certain accuracy for early diag-nosis of AKI in the patients undergoing cardiovascular surgery under CPB.
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Objective To investigate the effects of interlukin-10 (IL-10) on lipopolysaccharide (LPS)-induced liver injury in rats.Methods One hundred male Wistar rats,aged 10-14 weeks,weighing 250-300 g,were randomly divided into 5 groups (n =20 each):control group (C group),LPS group,IL-10 group,HO-1 inducer cobalt protoporphyrin-Ⅸ group (Co group) and HO-1 inhibitor zinc protoporphyrin-Ⅸ group (Zn group).The animals in LPS,IL-10,Co and Zn groups received intraperitoneal LPS 20 mg/kg.IL-10,Co and Zn groups received recombinant human IL-10 1 μg at 3 h before LPS injection.Co and Zn groups received cobalt protoporphyrin-Ⅸ and zinc protoporphyrin-Ⅸ 25 mg/kg at 2 h before administration of recombinant human IL-10.Ten rats in each group were chosen at 24 h after LPS injection and blood samples were collected from the heart for determination of the levels of serum alanine aminotransferase (ALT),aspartate transaminase (AST),tumor necrosis factor-α (TNF-α) and interlukin-1β (IL-1 β).The animals were then sacrificed and lungs removed for determination of glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) activities,malonodialdehyde (MDA) content and expression of HO-1 mRNA in lung tissues.The left 10 rats in each group were chosen and the survival rates within 72 h after LPS administration were recorded.Results Compared with C group,the levels of serum ALT,AST,TNF-αand IL-1 β and MDA content in lung tissues were significantly increased,and GSH-Px and SOD activities in lung tissues and survival rates were decreased in LPS,IL-10,Co and Zn groups (P ＜ 0.05).Compared with LPS group,the levels of serum ALT,AST,TNF-α,IL-1β and MDA content in lung tissues were significantly decreased,GSH-Px and SOD activities in lung tissues and survival rates were increased,and the expression of HO-1 mRNA was up-regulated (P ＜ 0.05).Compared with IL-10 group,the levels of serum ALT,AST,TNF-α and IL-1β and MDA content in lung tissues were significantly increased,and GSH-Px and SOD activities in lung tissues and survival rates were decreased in group Zn (P ＜ 0.05),and no significant change in the parameters mentioned above was found in Co group (P ＞ 0.05).Conclusion IL-10 can attenuate LPS-induced liver injury in rats by inducing the expression of HO-1.