Effect of anesthetic factor on intestinal barrier function in patients with acute intestinal obstruction: dexmedetomidine-based anesthesia / 中华麻醉学杂志

Objective:To evaluate the effect of dexmedetomidine-based anesthesia on intestinal barrier function in the patients with acute intestinal obstruction.Methods:Ninety-four patients with acute intestinal barrier obstruction, aged 33-81 yr, weighing 48-80 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, were divided into 2 groups ( n=47 each) using a random number table method: routine anesthesia group (group R) and dexmedetomidine-based anesthesia group (group D). In group D, dexmedetomidine was intravenously injected in a loading dose of 1 μg/kg at 15 min before induction of general anesthesia followed by an infusion of 0.5 μg·kg -1·h -1 until 30 min before the end of operation.Before infusing the loading dose of dexmedetomidine, at 1 day after surgery, at 3 days after surgery, and at 7 days after surgery, peripheral venous blood samples were collected to measure the concentrations of diamine oxidase, D-lactic acid, bacterial endotoxin, tumor necrosis factor-α and interleukin-6.The occurrence of postoperative complications, anal exhaust time and average length of hospital stay were recorded. Results:Compared with group R, the concentrations of diamine oxidase, D-lactic acid, bacterial endotoxin, tumor necrosis factor-α and interleukin-6 were significantly decreased at 1 and 3 days after surgery, anal exhaust time and average length of hospital stay were shortened, and the requirement for respiratory cycle support and total incidence of complications were decreased in group D ( P<0.05). Conclusion:Dexmedetomidine-based anesthesia can improve intestinal barrier function to a certain extent in patients with acute intestinal obstruction.

Effects of vasoactive drugs on crystalloid fluid kinetics in septic sheep.

PURPOSE: Crystalloid fluid and vasoactive drugs are used in the early treatment of sepsis. The purpose of the present study was to examine how these drugs alter plasma volume expansion, peripheral edema, and urinary excretion. METHODS: Twenty-five anesthetized sheep were made septic by cecal puncture and a short infusion of lipopolysaccharide. After 50 min, a slow infusion of isotonic saline was initiated: the saline either contained no drug, norepinephrine (1 µg/kg/min), phenylephrine (3 µg/kg/min), dopamine (50 µg/kg/min), or esmolol (50 µg/kg/min). Ten min later, 20 mL/kg Ringer´s lactate solution was given over 30 min. Central hemodynamics, acid-base balance, and the urinary excretion were monitored. Frequent measurements of the blood hemoglobin concentration were used as input in a kinetic analysis, using a mixed effects modeling software. RESULTS: The fluid kinetic analysis showed slow distribution and elimination of Ringer´s lactate, although phenylephrine and dopamine accelerated the distribution. Once distributed, the fluid remained in the peripheral tissues and did not equilibrate adequately with the plasma. Overall, stimulation of adrenergic alpha1-receptors accelerated, while beta1-receptors retarded, the distribution and elimination of fluid. A pharmacodynamic Emax model showed that Ringer´s lactate increased stroke volume by 13 ml/beat. Alpha1-receptors, but not beta1-receptors, further increased stroke volume, while both raised the mean arterial pressure. Modulation of the beta1-receptors limited the acidosis. CONCLUSIONS: Stimulation of adrenergic alpha1-receptors with vasoactive drugs accelerated, while beta1-receptors retarded, the distribution and elimination of fluid. The tendency for peripheral accumulation of fluid was pronounced, in particular when phenylephrine was given.

Comparative Analysis of Promoting Effects on NRK-49F Cells Proliferation by Different Sections of Velvet Antler Water Extracts / 世界科学技术-中医药现代化

This study was aimed to explore differential effects of various sections of the velvet antler on promoting cell proliferation in vitro. The NRK-49F cell line from rat kidney fibroblasts was used as the cell model. The cell proliferation rates of the water extracts from the upper, middle and lower section of fresh velvet antler were measured by the MTT method. BCA method was used in the detection of protein concentration. The SDS-PAGE method was used in the analysis of difference composition of the sample protein. The results showed that soluble protein content of the upper, middle and lower section were 17.89, 16.04 and 6.89 mg·mL-1, respectively. From the top to the base, the soluble protein content of velvet antler was decreased. After 24 h treatment, when the protein concentration of the upper and middle section samples of the velvet antler were 800 μg·mL-1 and 600 μg·mL-1, the cell proliferation promoting rates reached the maximum, which were 66.76% and 64.36%, respectively. And when the lower section sample of the velvet antler was 1 000 μg·mL-1, the cell proliferation promoting rates reached the maximum, which was 58.87%. After 48 h treatment, when the upper and middle section samples of the velvet antler were 800μg·mL-1, the cell proliferation promoting rates reached the maximum, which were 219.56% and 215.86%, respectively. And when the lower section sample of the velvet antler was 1 000 μg·mL-1, the cell proliferation promoting rates reached the maximum, which was 169.20%. The velvet antler on the proliferation of cells was much better than the 10% fetal bovine serum. The figure of SDS-PAGE showed the slight difference in the protein composition of three part of the velvet antler. It was concluded that all samples had promoting effects on cell proliferation with concentration-depen-dent, and the main protein in different part of the velvet antler had minor differences.