Effect of muscle oxygen saturation guidance on early recovery quality of patients after spinal surgery / 中华麻醉学杂志

Objective:To evaluate the effect of muscle oxygen saturation (SmtO 2) guidance on the quality of early recovery after spinal surgery in the patients. Methods:One hundred and twenty patients of either sex, aged 18-64 yr, with body mass index of 18-35 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, with Hb concentration>100 g/L, undergoing elective spinal surgery, were selected.Routine anesthesia induction and maintenance were performed.SmtO 2 monitoring was carried out, and electrodes were applied to bilateral thenar in group S. When unilateral or bilateral SmtO 2 dropped to 70% of the baseline level for more than 60 s, the sensor position was checked, fluid infusion was accelerated, vasoconstrictors was used, and the inhaled oxygen concentration was improved and blood was transfused for treatment.In group C, only electrode sheets were applied, without monitoring.The Quality of Recovery-15 scale was used to evaluate the recovery quality of patients at 1 day before operation (T 0), 1 day after operation (T 1) and 3 days after operation (T 2). The tracheal extubation time, post-anesthesia care unit stay time and postoperative length of hospital stay were recorded.Immediately before anesthesia induction and at the end of operation, arterial blood was collected for blood gas analysis, and the lactic acid level was recorded.Postoperative hypotension, constipation, spinal nerve injury, postoperative nausea and vomiting and incisional infection were recorded. Results:Compared with group C, the level of postoperative lactic acid was significantly decreased, the incidence of postoperative constipation, postoperative nausea and vomiting and incisional infection was decreased, the extubation time and post-anesthesia care unit stay time were shortened, and the Quality of Recovery-15 scale score at T 1, 2 was increased in group S ( P<0.05). Conclusions:SmtO 2 guidance can improve the early recovery quality of patients after lumbar surgery.

Effect of Parkinson′s disease factor on sedative efficacy of dexmedetomidine / 中华麻醉学杂志

Objective:To evaluate the effect of Parkinson′s disease factor on the sedative efficacy of dexmedetomidine.Methods:The patients of either sex, aged 45-64 yr, of American Society of Anesthesiologists Physical Status classification Ⅱor Ⅲ, with body mass index of 18.5-30.0 kg/m 2, undergoing non-intracranial space-occupying lesions in neurosurgery, were selected.Patients were divided into control group (group C) and Parkinson′s disease group (group P) according to whether they had Parkinson′s disease or not.The ED 50 of dexmedetomidine was determined by using the Dixon′s up-and-down method.The initial dose of dexmedetomidine was 0.5 μg/kg in both groups, and each time the concentration increased/decreased by 0.05 μg/kg in the next patient, which was repeated until 7th independent crossover pair (loss of consciousness) appeared, and then the test was ended.The ED 50 and 95% confidence interval of dexmedetomidine inducing loss of consciousness were calculated using the probit test in a Logistic regression model.Hypertension, hypotension, bradycardia and nausea and vomiting were recorded. Results:Compared with group C, the ED 50 of dexmedetomidine inducing loss of consciousness was significantly increased in group P ( P<0.05), and no significant change was found in the incidence of adverse reactions in group P ( P>0.05). Conclusions:Parkinson′s disease factor can decrease the sedative efficacy of dexmedetomidine.

Effect of deImedetomidine on muscle relaIant effect of cisatracurium in patients with epilepsy / 中国临床药理学与治疗学

AIM: To determine the effect of dexmedetomidine on muscle relaxant effect of cisatracurium in patients with epilepsy. METHODS: Sixty patients undergoing elective neurosurgery, aged from 18 to 59 years old, were divided into three groups (n = 20) according to the maximum onset time of dexmedetomidine: immediate induction group after dexmedetomidine infusion (Group A), induction group 15 minutes after dexmedetomidine infusion (Group B) and normal saline infusion (Group C). The neuromuscular conduction function was monitored by muscle relaxation monitor, and the ulnar nerve was stimulated in TOF mode (frequency 2 Hz, wave width 0.2 ms, stimulation current 70 mA, string interval 12 s). Patients in group A were given dexmedetomidine 1 μg/kg after entering the room, and anesthesia induction was started immediately after 10 min pumping; Group B patients were given dexmedetomidine 1 μg/kg after entering the room, and anesthesia induction was started 15 minutes after 10 minutes of pump injection; Patients in group C began induction immediately after pumping the same milliliter of normal saline within 10 min. During anesthesia induction, 0.15 mg/kg cisatracurium was injected intravenously, and endotracheal intubation was performed when T

Effect of transcutaneous electrical acupoint stimulation on perioperative anxiety and postoperative pain in living kidney donors / 中华麻醉学杂志

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on perioperative anxiety and postoperative pain in living kidney donors (LKDs).Methods:Seventy-two American Society of Anesthesiologists physical status Ⅰ or Ⅱ LKDs, aged 18-64 yr, with body mass index of 18-28 kg/m 2, undergoing living kidney transplantation, were selected, and divided into 2 groups ( n=36 each) using a random number table method: TEAS group (group T) and sham stimulation group (group S). In group T, TEAS was performed on the forenoon at 1 day before surgery (T 0), at 30 min before anesthesia induction on the morning of the operation day (T 1) and on the forenoon at 1 day after surgery (T 2) at bilateral Neiguan, Taichong and Yintang with a frequency 2-100 Hz, disperse-dense waves and current intensity 6-15 mA, and each TEAS lasted for 30 min.Only electrode patches were applied at the same acupoint and at the same time point, but no stimulation was applied in group S. In T and S groups, brachial venous blood samples were collected before each stimulation for measurement of the plasma 5-hydroxytryptamine (5-HT) concentration.The Hospital Anxiety Depression Scale-Anxiety subscale (HADS-A) scores at T 0, T 1, T 2, on day 3 after surgery (T 3) and before discharge (T 4) in the 2 groups were recorded.The consumption of anesthetics during operation, laryngeal mask airway removal time, requirement for rescue analgesia within 72 h after surgery and the development of postoperative complications were recorded.The LKDs were followed up by telephone at 3 months after surgery (T 5) to record the scores of HADS-A and Leeds Assessment of Neuropathic Symptoms and Sign (LANSS) scale. Results:Compared to group S, the incidence of anxiety was significantly decreased T 1, T 2 and T 3, the incidence of rescue analgesia within 72 h after surgery was decreased, plasma concentration of 5-HT was increased at T 1 and T 2, the incidence of postoperative nausea and vomiting was decreased, and the time to first flatus was shortened in group T ( P<0.05). There was no significant difference in the consumption of anesthetics during operation, laryngeal mask airway removal time, and the incidence of anxiety and neuropathic pain within 3 months after surgery between the 2 groups ( P>0.05). Conclusion:TEAS can relieve early preoperative and postoperative anxiety and alleviate postoperative pain in LKDs.

Effect of gender on neuromuscular blockade of rocuronium in epileptics / 中华麻醉学杂志

Objective:To evaluate the effect of gender on neuromuscular blockade of rocuronium in epileptics.Methods:Forty American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients, aged 18-59 yr, with body mass index of 18.5-24.0 kg/m 2, scheduled for elective surgery for treatment of epilepsy under general anesthesia, were divided into 2 groups ( n=20 each) according to gender: male group (group M) and female group (group F). Neuromuscular conduction function was monitored with a muscle relaxation monitor.Ulnar nerve was stimulated in TOF mode (frequency 2 Hz, wave width 0.2 ms, stimulation current 70 mA and interval 12 s). Rocuronium 0.8 mg/kg was injected intravenously during anesthesia induction, and endotracheal intubation was performed when T l reached maximum inhibition.The conditions of endotracheal intubation were evaluated by the modified method.When T 1 recovered to 25% during operation, rocuronium 0.15 mg/kg was intravenously injected.Sugammadex sodium 2 mg/kg was injected intravenously when T 1 recovered to 50% after surgery.The onset time (T onset), peak time (T peak), 10% recovery time (T 10%), 10%-25% recovery time (T 10%-25%), 25%-50% recovery time (T 25%-50%), 50%-75% recovery time (T 50%-75%) and 75%-90% recovery time (T 75%-90%) of rocuronium were recorded.Peripheral venous blood samples (3 ml) were collected when T 1 recovered to 25% and 75%, and the concentration of rocuronium was detected by liquid chromatography-tandem mass spectrum.The consumption of rocuronium per unit of weight per minute was calculated. Results:There was no significant difference between the two groups in terms of T onset, T peak, T 10%, T 10%-25%, T 25%-50%, T 50%-75%, T 75%-90%, endotracheal intubation conditions, blood concentration of rocuronium at varied time points, or consumption of rocuronium per unit of weight per minute ( P>0.05). Conclusion:Gender exerts no effect on the neuromuscular blockade of rocuronium in epileptics.

Subacute dynamic silica dust inhalation induced changes of pathology and cytokines in mouse organs / 中国职业医学

OBJECTIVE: To investigate the effects of subacute dynamic silica dust inhalation on the histopathology of major organs and the cytokine changes in lung tissues. METHODS: Male Kunming specific pathogen free mice were randomly divided into control group and dust exposure groups of 3, 14 and 28 d, with 7 mice in each group.The mice of the 3 exposure groups were given for 3, 12 and 24 days with silica dust at a concentration of 1 000.00 mg/m~3 using the self-made automatic dust inhalation device, 6 hours per day and 6 days per week. Rats in the control group were not treated with dust. After the end of treatment, rats were sacrificed. The organ coefficients of the liver, kidney, spleen and lung were calculated. The pathological changes of the organs were observed by hematoxylin-eosin staining method. The pulmonary fibrosis of lung tissues was evaluated by Masson staining method. Sirius scarlet picric acid staining was used to observe the collagen fiber area ratio in lung tissues. Enzyme-linked immunosorbent assay was used to detect the levels of interleukin(IL)-1β, tumor necrosis factor(TNF)-α, transforming growth factor(TGF)-β1 and matrix metalloproteinase 2(MMP-2) in lung tissues. Colorimetric method was used to detect the level of hydroxyproline(HYP) in lung tissues. RESULTS: After the exposure to silica dust, the histology of liver, spleen and kidney tissues were not significantly changed in the mice of the 3 dust exposure groups. The lung organ coefficients increased in the mice of dust exposure groups of 3, 14 and 28 d compared with the control group(P<0.05). The spleen coefficient of mice in dust exposure groups of 3 and 14 d were higher than that in control group(P<0.05). Among the dust exposure groups, the score of pulmonary fibrosis and HYP level in lung tissues were increased with the prolonged dust exposure time(P<0.05). The collagen fiber area ratio of collagenⅠand Ⅲ, and the levels of IL-1β, TGF-β1 and MMP-2 in lung tissues increased in the 3 dust exposure groups compared with the control group(P<0.05). The collagen fiber area ratio of collagen Ⅲ, and the level of IL-1β in lung tissues of the 14 and 28 d of dust exposure group increased(P<0.05), and the TGF-β1 level decreased(P<0.05), when compared with the 3 d group. The collagen fiber area ratio of collagen Ⅰ in lung tissues of 14 d group and the level of MMP-2 in the 28 d group were higher than that of the 3 d group(P<0.05). The level of TNF-α in lung tissues of 14 d group was higher than that of the control group(P<0.05), and while in 28 d group it was lower than those of the other 3 group(P<0.05). CONCLUSION: Subacute dynamic inhalation of silica dust can cause acute lung injury in mice. There is no obvious pathological change in liver, kidney and spleen. The pathological changes of lung tissue are inflammation and fibrosis, and the degree of fibrosis increases with the extension of dust exposure time, and cytokines also changed.

Effect of electroacupuncture preconditioning on postoperative delirium and early outcomes in pa-tients undergoing cardiac valve replacement with cardiopulmonary bypass / 中华麻醉学杂志

Objective To evaluate the effect of electroacupuncture preconditioning on postoperative delirium ( POD) and early outcomes in the patients undergoing cardiac valve replacement with cardiopulmo-nary bypass. Methods Sixty American Society of Anesthesiologists physical statusⅡorⅢpatients of both sexes, of New York Heart Association Ⅱ or Ⅲ, aged 28-64 yr, scheduled for elective cardiac valve re-placement with cardiopulmonary bypass, were divided into 2 groups ( n=30 each) using a random number table method: control group ( group C ) and electroacupuncture preconditioning group ( group EA ) . In group EA, Baihui, Yintang and Renzhong acupoints were stimulated for 30 min with an electric stimulator ( sparse-dense wave, frequency 2/15 Hz, intensity 1 mA) before skin incision. rSO2 was continuously mo-nitored during operation, and the mean rSO2 ( rSO2 mean ) , the minimal rSO2 ( rSO2min ) and the maximal percentage of decrease from baseline in rSO2 ( rSO2％max ) were calculated. Blood samples were collected be-fore the electroacupuncture, at the end of surgery, and at 6, 24 and 72 h after surgery for determination of serum tumor necrosis factor-alpha, interleukin-6 ( IL-6) , IL-10, neuron-specific enolase and S100β pro-tein concentrations by enzyme-linked immunosorbent assay. POD was assessed by Confusion Assessment Method for Intensive Care Unit, and the postoperative recovery was evaluated by Quality of Recovery-40 Questionnaire. The occurrence of POD, duration of stay in intensive care unit and length of hospital stay were also recorded. Results Compared with group C, the rSO2％max , serum concentrations of tumor nec-rosis factor-alpha, IL-6, neuron-specific enolase and S100βprotein and incidence of POD were significant-ly decreased, the rSO2min , serum IL-10 concentration and Quality of Recovery-40 Questionnaire score were increased, and the duration of stay in intensive care unit and length of hospital stay were shortened ( P＜0. 05) , and no significant change was found in rSO2mean in group EA ( P＞0. 05) . Conclusion Electroacu-puncture preconditioning decreases the occurrence of POD and improves early outcomes in the patients un-dergoing cardiac valve replacement with cardiopulmonary bypass.

Effect of the acupressure wristbands combined with tropisetron on quality of recovery during early period after radical mastectomy / 临床麻醉学杂志

Objective To evaluate the effect of the acupressure wristbands combined with tro-pisetron on the effect in preventing postoperative nausea and vomiting (PONV)and the quality of re-covery during early period after radical mastectomy.Methods Seventy-five patients,aged 35-68 years,ASA physical status Ⅰ or Ⅱ,scheduled for elective radical mastectomy,were randomly as-signed into three groups (n=25):acupressure wristband group (group A),tropisetron group (group B)and acupressure wristbands combined with tropisetron group (group C).At 30 min before the sur-gery,the acupuncture pins were placed on Nei Guan point till 24 h after the surgery in group A.At 30 min before the end of the surgery,tropisetron 6 mg was intravenously injected in group B.At 30 min before the surgery,the acupuncture pins were placed on Nei Guan point till 24 h after the surgery;at 30 min before the end of the surgery,tropisetron 6 mg was intravenousy injected in group C.The three groups received total intravenous anesthesia.The occurrence of nausea and vomiting was recor-ded immediately after extubation,6 h after surgery and 6-24 h after surgery.The global QoR-40 ag-gregate scores were recorded between the three groups on the day before surgery and 1 day after sur-gery.Results Compared with groups A and B,the incidence of PONV was significantly decreased in group C between the time immediately after extubation-6 h after surgery (P<0.05);and the severity of PONV was significantly decreased in group C (P<0.05 ).Compared with groups A and B, patients in group C produced higher physical comfort scores,emotional state scores,and pain scores (P<0.05 or P<0.01);the global QoR-40 scores of group C were significantly increased on 1 day after surgery (P<0.01).Conclusion The acupressure wristbands combined with tropisetron can re-duce the incidence and the severity of PONV,improve the quality of recovery during the early period after radical mastectomy.

Effects of different anesthetics on recovery of neurological function after intracranial aneurysm em-bolization / 中华麻醉学杂志

Objective To compare the effects of different anesthetics on the recovery of neurologi-cal function after intracranial aneurysm embolization. Methods One hundred patients of both sexes with aneurysmal subarachnoid hemorrhage, aged more than 18 yr, with body mass index of 18. 5-24. 0 kg∕m2 , of American Society of Anesthesiologists physical status Ⅱ or Ⅲ and WFNS grade Ⅰ-Ⅳ, with the thick-ness of subarachnoid hemorrhage more than 4 cm, were divided into 2 groups (n= 50 each) using a random number table: propofol group (group P) and sevoflurane group (group S). After anesthesia induction, group P received intravenous infusion of propofol 100-300 μg·kg-1 ·min-1 , while the end-tidal sevoflu-rane concentration was maintained at 1. 4％-3. 5％ in group S. Immediately before induction (T0 ), imme-diately after the end of induction (T1 ), immediately after successful embolization of aneurysm (T2 ) and at 1, 2, 3 and 5 days after surgery (T3-6 ), central venous blood samples were collected for determination of plasma neuron-specific enolase and S100β protein concentrations by enzyme-linked immunosorbent assay. The development of postoperative cerebral vasospasm and delayed ischemic neurological deficit was recorded. The patients were followed up, and the Glasgow outcome score and occurrence of newly developed cerebral infarction were recorded within 6 months after surgery. Results There was no significant difference in the concentrations of plasma neuron-specific enolase and S100β protein at each time point, incidence of postop-erative cerebral vasospasm and delayed ischemic neurological deficit, or Glasgow outcome score and inci-dence of newly developed cerebral infarction within 6 months after surgery between two groups (P>0. 05). Conclusion Propofol and sevoflurane exert no effect on the recovery of neurological function after intracra-nial aneurysm embolization.

Changes in expression of spinal endothelin-1 and its receptors in a mouse model of bone cancer pain / 中华麻醉学杂志

Objective To evaluate the changes in the expression of spinal endothelin-1 (ET-1) and its receptors in a mouse model of bone cancer pain (BCP).Methods Ninety-six healthy male SPF C3H/HeN mice,aged 4-6 weeks,weighing 20-25 g,were divided into 2 groups (n=48 each) using a random number table:sham operation group (group S) and BCP group.BCP was produced by injecting α-MEM 20 μl containing 1×104 cells/μ1 NCTC 2472 osteosarcoma cells into the distal medullary cavity of the right femur bone.In group S,t-MEM 20 μl was injected into the distal medullary cavity of the right femur bone.Mechanical paw withdrawal threshold (MWT) and the number of spontaneous flinches (NSF) were measured on 1 day before inoculation (T0) and 4,7,10,14 and 21 days after inoculation (T1-5).Twelve mice of each group were randomly sacrificed at T0,2,4,5,and the lumbar enlargement segments of the spinal cord were harvested to detect the expression of ET-1,endothelin type A receptor and endothelin type B receptor protein and mRNA (using Western blot or real-time polymerase chain reaction).Results The MWT was significantly lower and the NSF was higher at T1 in group S and at T1-5 in group BCP than at T0 (P＜0.05).Compared with group S,the MWT was significantly decreased and the NSF was increased at T2-s,and the expression of ET-1,endothelin type A receptor and endothelin type B receptor protein and mRNA was down-regulated at T2,4,5 in group BCP (P＜0.05).Conclusion The pathophysiological process of BCP is associated with down-regulating the expression of spinal ET-1 and its receptors in mice.

Effect of transcutaneous electric acupoint stimulation on prognosis in patients at high risk of postop-erative pulmonary complications / 中华麻醉学杂志

Objective To evaluate the effect of transcutaneous electric acupoint stimulation (TEAS)on prognosis in the patients at high risk of postoperative pulmonary complications. Methods Sixty American Society of Anesthesiologists physical statusⅡorⅢpatients of both sexes, aged 65-72 yr, with body mass index of 18-25 kg∕m2, scheduled for elective thoracoscopic and laparoscopic radical resection of e-sophageal cancer, were divided into placebo control group(group C, n=30)and TEAS group(n=30). In group TEAS, bilateral Zusanli(ST36), Hegu(LI4)and Feishu(BL13)acupoints were stimulated for 30 min(disperse-dense waves, frequency 2∕100 Hz, intensity of currents 8-12 mA)starting from 30 min be-fore anesthesia induction.In group C, electrodes were placed on the same acupoints before anesthesia induc-tion, but no current was given.General anesthesia was performed in two groups.Before one-lung ventilation, at 30 min and 2 h of one-lung ventilation and at 1 h after operation(T1-4), blood samples were drawn from the radial artery for blood gas analysis, and oxygenation index and alveolar-arterial oxygen partial pressure difference were calculated.Blood samples were collected from the internal jugular vein at T1-3and 24 h after surgery(T5)for determination of plasma tumor necrosis factor-alpha, interleukin-6(IL-6)and IL-10 con-centrations.The development of postoperative pulmonary complications, time for removal of drainage tube and length of hospital stay were recorded. Results Compared with group C, the oxygenation index at T2-4and plasma IL-10 concentrations at T3were significantly increased, the alveolar-arterial oxygen partial pressure difference at T2,3, plasma tumor necrosis factor-alpha concentrations at T2,3, plasma IL-10 concentrations at T3,5and incidence of postoperative pulmonary complications were decreased, and the time for removal of drainage tube and length of hospital stay were shortened in group TEAS(P<0.05). Conclusion TEAS can improve prognosis in the patients at high risk of postoperative pulmonary complications.

Effect of goal-directed fluid therapy on hemodynamic and regional cerebral oxygen saturation in the elder patient undergoing one-lung ventilation / 临床麻醉学杂志

Objective To observe the effect of goal-directed fluid therapy on hemodynamic and regional cerebral oxygen saturation (rSO 2 )in the elder patient undergoing one-lung ventilation. Methods Fifty-eight patients scheduled for esophagus cancer resection(44 males,14 females,aged 65-79 years,ASA physical status Ⅱ or Ⅲ),were randomly divided into two groups (n =29 each)u-sing a random number table:conventional fluid therapy group (group C)and goal-directed fluid ther-apy group (group G).Implementing radial artery puncture and internal jugular vein puncture under local anesthesia in order to monitor BP and CVP.The Flotrac/Vigileo system was used to monitor cardiac output (CO),stroke volume variation (SVV)and cardiac index (CI)in the both group.As mentioned all above,group C received conventional fluid therapy based on MAP,CVP and urine vol-ume,whereas group G received goal-directed fluid therapy (GDFT)based on SVV with the goal of CI at 2.5-4.0 L·min-1·m-2 .Intraoperative continuous monitoring of rSO 2 was performed and the sur-gery rSO 2 average (rSO 2 ),the minimal surgery rSO 2 (rSO 2min )and the maximal percentage of the decreased rSO 2 compared to baseline values (rSO 2%max )were calculated in the both group.The varia-tion of MAP,HR,CVP,SVV and CI at the onset of the monitoring (T1 ),the momment before one-lung ventilation (T2 ),30 min after one-lung ventilation (T3 ),1 h after one-lung ventilation(T4 )and the end of the surgery (T5 )were recorded.The requirement for crystalloid and colloid,total volume of fluid infused,bleeding volume,urine volume,and requirement for vasoactive agents were recorded during operaton.Results Compared with group C,MAP at T3 ,T4 and CI at T3-T5 in group G were increased significantly,while CVP at T3-T5 and SVV at T2-T5 in group G were decreased (P <0.05). The rSO 2%max in group G was significantly lower than that in group C (P <0.05).No statistically sig-nificant difference was observed in the rSO 2 and rSO 2min between the two groups.Compared with group C,the requirement for crystalloid [(668±187)ml vs (1052±221)ml and total volume of fluid infused [(1212±318)ml vs (1519±329)ml],urine volume [(211±47)ml vs (278±54)ml]and vasoactive agents [4 cases (14%)vs 14 cases (48%)]were significantly decreased (P <0.05),the requirement for colloid were increased [(544±103)ml vs (467±94)ml,P <0.05].Conclusion The goal-directed fluid therapy based on SVV stabilizes the hemodynamic effectively,improves the CI and the perfusion of brain,and maintains the cereral oxygen metabolism in the elder patient undergoing one-lung ventilation.

Effect of oxycodone on early recovery after microvascular decompression on treating trigeminal neuralgia / 临床麻醉学杂志

Objective To evaluate the efficacy and safety of oxycodone in patients undergoing microvascular decompression in treating trigeminal neuralgia and oxycodone versus sufentanil on early recovery after microvascular decompression in treating trigeminal neuralgia.Methods Eighty-six patients (38 males, 48 females, aged 18-65 years, BMI 18-30 kg/m2, ASA physical status Ⅰ or Ⅱ) scheduled for microvascular decompression in treating trigeminal neuralgia, were randomly divided into either oxycodone group (group O) and sufentanil group (group S) using a random number table, n=43 in each group.All patients received combined intravenous-inhalational anesthesia, as well as oxycodone 0.3 mg/kg injected intravenously in group O, sufentanil 0.4 μg/kg injected intravenously in group S for anesthesia induced analgesia.When the epidural was closed, oxycodone 0.07 mg/kg was injected intravenously in group O, sufentanil 0.1 μg/kg was injected intravenously in group S.On preoperative day 1 and 4, 24, 48 hours after surgery, numeric rating scale (NRS) was used to assess the incision pain and facial pain.When NRS scores≥4, oxycodone 3 mg in group O and sufentanil 5 μg in group S was injected intravenously as rescue analgesic.On preoperative day 1 and 3 days after surgery, the global QoR-40 aggregating score was used to assess the quality of patients recovery.The requirement for rescue analgesics was recorded.The occurrences of nausea and vomiting were recorded.Extubation time and discharge were recorded.The other adverse events (bradycardia, dysuria, dizziness and pruritus) were recorded.Results Compared with group S, the physical comfort score, the emotional state score, the psychological support score, the pain score and the global QoR-40 scores were higher in group O 3 days after surgery (P<0.05).Compared with group S, the incidence of nausea and vomiting was significantly lower in group O (20.9% vs 37.2%) (P<0.05).Conclusion In surgery less than 5 hours of microvascular decompression on treating trigeminal neuralgia, oxycodone 0.3 mg/kg can be safely and effectively used for anesthesia induction, oxycodone 0.07 mg/kg and 3 mg can be respectively used for postoperative prophylactic analgesia and remedial analgesia.Compared with sufentanil, oxycodone can improve the quality of recovery during the early period after microvascular decompression on treating trigeminal neuralgia, and decrease the incidence of nausea and vomiting.

Application of flexible laryngeal mask in transnaso-sphenoidal microsurgery for pituitary adenoma / 临床麻醉学杂志

Objective To observe the effect of flexible laryngeal mask (FLMA) in transnaso-sphenoidal microsurgery for pituitary adenoma on airway management and variation of stress response.Methods One hundred patients (71 males, 29 females, aged 18-65 years, BMI 21-28 kg/m2, ASA physical status Ⅰ or Ⅱ) undergoing transnaso-sphenoidal microsurgery for pituitary adenoma were randomly divided into two groups: the FLMA group (group F) and the reinforced endotracheal tube group (group T) using a random number table, 50 cases in each group.The plasma concentration of epinephrine and norepinephrine were measured before anesthesia induction (T0), at the time of inserting the FLMA or reinforced endotracheal tube (T1), 1 min (T2) and 5 min (T3) after insertion.The Berry scores of the preoperative and postoperative airway exposure by branchofiberoscope in group F were assessed.The time of removal of FLMA (endotracheal tube) and the occurrence of choking, laryngeal spasm, sore throat, hoarseness and other adverse reactions were recorded.Results The levels of epinephrine and norepinephrine were were significantly lower at T2 and T3 in group F than those in group T (P<0.05).There was no significant difference in airway Berry scores.The time of extubation was shorter in group F than that in group T [(9±3) min vs (17±6) min] (P<0.05).The incidence of choking (2% vs 22%) and sore throat (4% vs 30%) were significantly lower in group F than those in group T (P<0.05).Conclusion Compared with the reinforced endotracheal tube, FLMA can be applied safely and effectively to transnaso-sphenoidal microsurgery for pituitary adenoma, reduces stress respond associated with anesthesia and post-extubation complications, improves the recovery of patients.

Analysis of clinical efficacy of LTCBDE in patients with secondary extrahepatic bile duct stones / 实用医学杂志

Objective To investigate the effect of laparoscopic cholecystectomy (LTCBDE) in treatment of patients with secondary extrahepatic bile duct stones. Methods Eighty-seven cases of our hospital patients with secondary to extrahepatic bile duct stones were randomly divided into the laparoscopic bile duct exploration and T tube drainage surgery (LCBDE) treatment group and the laparoscopic transcystic duct exploration of common bile duct lithotomy (ltcbde) treatment group. The observation focused on the operation time, bleeding volume , postoperative transfusion , postoperative drainage time , postoperative hospitalization time , cost of hospitalization, postoperative recovery time and complications compared clinical efficacies. Results LTCBDE group of patients in operation time (2.1 ± 0.5) was longer than that of the control group (1.6 ± 0.4), (P <0.001), while the bleeding volume, postoperative fluid volume, postoperative drainage time, postoperative hospitalization time, hospitalization expenses and postoperative recovery time were (17.4 ± 5.4), (6 550.4 ± 1 076.9), (3.5. 1.6), (4.1 ± 1.7), (12 243.5 ± 2 379.6), (11.3 ± 3.5) were lower than that of the group LCBDE (22.1 ± 7.5), (8 304.2 ± 1 394.8), (32.9 ± 10.4), (6.4 ± 2.4), (14 098.1 ± 2 897.3), (16.1 ± 5.7) P, respectively (P values were defined as 0.001, 0, 0, 0.015, 0.001, 0 individually); LTCBDE group of patients with bile leakage, acute peritonitis rates were 1/46,1/46,in which those were lower than the corresponding LCBDE in 6/41, 7/41 (P values were 0.033, 0.016, separately). Conclusion According to indications, LTCBD surgery has the advantages of less injury, less cost, less complications and so on. It has important significance to improve the condition of patients with secondary extrahepatic bile duct stones.

Effect of electroacupuncture pretreatment on expression of NLRP3 in neurons during cerebral ischemia-reperfusion in rats / 中华麻醉学杂志

Objective To evaluate the effect of electroacupuncture (EA) pretreatment on NODlike receptor pyrin domain-containing 3 (NLRP3) in neurons during cerebral ischemia-reperfusion (I/R) in rats.Methods Fifty-four adult male Sprage-Dawley rats,aged 7 weeks,weighing 250-280 g,were randomly divided into 3 groups (n =18 each) using a random number table:sham operation group (group S),group I/R,and EA pretreatment group (group E).Cerebral I/R was induced by occlusion of the right middle cerebral artery for 90 min using a nylon thread inserted into the internal carotid artery and advanced intracranially to block the blood flow,followed by reperfusion.In group E,the acupoint Baihui was stimulated with an electric stimulator (sparse-dense wave,frequency 2 Hz/15 Hz,intensity ≤ 1 mA) for 30 min once a day for 5 consecutive days,and the model of cerebral I/R was established at 24 h after the last stimulation.At 72 h of reperfusion,neurological function was assessed and scored.The rats were then sacrificed,and their brains were removed for determination of cerebral infarct volume (using TTC staining),expression of NLRP3,caspase-1 and interleukin-1beta (IL-1β) in brain tissues (by Western blot),and expression of NLRP3 protein in neurons (by immunofluorescence histochemistry).The percentage of cerebral infarct volume was calculated.Results Compared with group S,the percentage of cerebral infarct volume and neurological scores were significantly decreased,and the expression of NLRP3,caspase-1 and IL-1β in brain tissues was significantly up-regulated in group I/R (P＜0.05).Compared with group I/R,the percentage of cerebral infarct volume and neurological scores were significantly increased,and the expression of NLRP3,caspase-1 and IL-1β in brain tissues was significantly down-regulated ingroup E (P＜0.05).Conclusion The mechanism by which EA pretreatment reduces inflammatory responses during cerebral I/R injury may be related to down-regulation of NLRP3 expression in neurons in rats.

A cross-sectional investigation on health-related knowledge and skills of patients in Chongqing City and its influencing factors / 重庆医学

Objective To investigate the status on health‐related knowledge and skills among the patients in the Chongqing area and to provide basis for developing public health‐related knowledge and skills .Methods Seven hundred and sixty‐eight patients from 8 general hospitals were sampled ,using the stratified random sampling method .A cross‐sectional investigation on health literacy was conducted with questionnaire“ health awareness survey of patients”,and SAS8 .0 was used to statistically analyze the data .Results The awareness rate of health literacy in Chongqing was 4 .82% .As for the 3 health literacy related aspects including basic health concept and knowledge ,health lif‐estyle and behaviors ,and the health related skills ,the rates were 16 .28% ,2 .21% and 38 .41% respectively .Besides ,the rate of the 5 as‐pects including health conception ,the prevention of infection ,the prevention of chronic diseases ,the safety and the first aid ,the basic medical treatment of analysis were 10 .68% ,20 .31% ,8 .59% ,23 .57% ,10 .68% respectively .There noticed significant differences in different re‐gions ,education ,profession ,the condition of relatives engaged in medical ,medical insurance category(P<0 .05) .Profession and the condition of relatives engaged in medical were the main influencing factors on the level of health‐related knowledge and skills among the patients(P<0 .05) .Conclusion The prevalence of basic health‐related knowledge and skills is low in Chongqing city and we should make comprehensive interventions to improve health liter of patients .

The effect of vaccinating turbot broodstocks on the maternal immunity transfer to offspring immunity.

The study was designed to explore the effect of vaccinating turbot broodstocks on the immunity of offsprings. The expression of IgM, C3, TGF-ß1, IL-1ß, transferrin, lysozyme and their concentrations were detected respectively with quantitative real-time PCR and Elisa kits in offsprings at different stages from both naive and vaccinated brood stocks. The survival rate of offsprings in pathogen challenge experiment and their pathogen inhibition rate were also detected. The results shown that the maternal transfer of genes and proteins both existed in turbot. In the expression level, from eggs to 5 dpf (days past fertilization), the immune related genes expressed far more in vaccinated broodstocks offsprings, after hatching, the phenomenon disappeared. In protein level, transferrrin, C3 and IL-1ß kept a stable level in concentration from eggs to 25 dph (days past hatching), and increased sharply at 45 and 55 dph. While, IgM and lyzozyme had a much higher concentration at 5 dpf in the embryos from vaccinated broodstocks, and we concluded that vaccinating broodstocks enhanced the production or maternal transfer of IgM and lyzozyme. Vibrio anguillarum challenge experiment showed that the vaccinated offsprings of 4 dpf and 14 dph had a better anti-pathogen ability than the ones from naive brood stocks. Throughout the study, it was concluded that vaccinating broodstocks could strength the maternal transfer of immune factors in gene and protein level, and the gene expression level during hatching was also enhanced at the early stage of development.

Replication Kinetics of Coxsackievirus A16 in Human Rhabdomyosarcoma Cells / 中国病毒学·英文版

Coxsackievirns A16(CVA16),together with enterovirus type 71(EV71),is responsible for most cases of hand,foot and mouth disease(HFMD) worldwide.Recent findings suggest that the recombination between CVA16 and EV71,and the co-circulation of these two viruses may have contributed to the increase of HFMD cases in China over the past few years.It is therefore important to further understand the virology,epidemlology,virus-host interactions and host pathogeuesis of CVA16.In this study,we describe the viral kinetics of CVAI6 in human rhabdomyosarcoma(RD) cells by analyzing the cytopathic effect(CPE),viral RNA replication,viral protein expression,viral RNA package and viral particle secretion in RD cells.We show that CVA16 appears to first attach,uncoat and enter into the host cell after adsorption for 1 h.Later on,CVA16 undergoes rapid replication from 3 to 6 h at MOI 1 and until 9 h at MOI 0.1.At MOI 0.1,CVA16 initiates a secondary infection as the virions were secreted before 9 h p.i.CPE was observed after 12 h p.i.,and viral antigen was first detected at 6 h p.i.at MOI 1 and at 9 h p.i.at MOI 0.1.Thus,our study provides important information for further investigation of CVA16 in order to better understand and ultimately control infections with this virus.