1.Efficacy of laryngeal mask airway Supreme in patients undergoing laparoscopic surgery
Hongjun DUAN ; Ruifang JIA ; Mingzhang ZUO
Chinese Journal of Anesthesiology 2010;30(3):341-343
Objective To assess the efficacy of laryngeal mask airway Supreme (LMA Supreme) used in patients undergoing laparoscopic surgery. Methods One hundred and twenty ASA I or Ⅱ patients of both sexes aged 35-60 yr weighing 48-85 kg undergoing elective laparoscopic surgery were randomized to 2 groups ( n = 60 each): LMA Supreme group (group S) and tracheal intubation group (group T). Mallampati test was performed before operation in both groups. The patients were classified as I - Ⅲ . In group S the LMA Supreme was inserted after induction of anesthesia with sufentanil 0.2 fig/kg, propofol 2-3 mg/kg and vecuronium 0.1 mg/kg. A gastric tube was inserted through the drain tube of the LMA Supreme. In group T the patients were intubated under direct laryngoscopy. The success rate, LMA placement/intubation time, success rate of gastric tube placement, airway seal pressure, SpO2, PETCO2 , peak airway pressure and complications (hypoxemia, nausea and vomiting, choking hoarseness, sore throat and regurgitation of gastric contents) were recorded. The duration of surgery, anesthesia time, extubation time and emergence time were also recorded. Results There was no significant difference in the success rate between the two groups. The placement and removal time and recovery time were significantly shorter in group S than in group T. The airway seal pressure was (25 ±4) cm H2O in group S. SpO2, PETCO2 and peak pressure were within normal range in both groups. The incidence of postoperative hypoxemia, choking and sore throat were significantly lower in group S than in group T. Conclusion LMA Supreme can provide adequate ventilation during operation with less complications and can be used effectively for laparoscopic surgery.
2.Endothelialization of Gore-Tex vascular graft by using cryopreserved human umbilical endothelial cells
Hongjun JIANG ; Bing JIA ; Zhanggen CHEN
Chinese Journal of Thoracic and Cardiovascular Surgery 1995;0(05):-
Objective The feasibility of constructing endothelialized vascular graft by using cryopreserved HUVCs was studies. Methods Forty-two human umbilical cords were used in this study. HUVECs were isolated by means of filling umbilical veins with digestive enzyme solution. HUVECs were then cultured and observed. Endothelial cells were identified by von Willebrand factor immunofluorescence staining and scanning electron microscope examination. Endothelial cells were suspended in cryopreserving solution which contains 10% DMSO and 10% fetal bovine serum in M199 and cryopreserved in liquid nitrogen. Post-thawed cells and non-frozen cells proliferation was evaluated by measuring the metabolic activity of tetrazolium compound. The endothelial cell growth characteristics were determined by daily observation using phase contrast microscope. Post-thawed endothelial cells viability was determined by trypan blue staining test. Flow cytometry were applied to determine the apoptosis rate of post-thawed cells. Cryopreserved endothelial cells morphological examinations such as hematoxylin and eosins staining and scanning electron microscope examination were carried out in this study. After cell culture and amplification, cryopreserved HUVCs were seeded on the inner surface of Gore-Tex graft to construct tissue engineered vascular graft. Results Extreme high-purified endothelial cells could be isolated by infusing digestive solutions to the lumen of human umbilical veins. Compared with non-frozen endothelial cells, Post-thawed endothelial cells showed 95% of vitality. Post-thawed HUVEC growth curve was similar to non-frozen ones'. Post-thawed HUVEC apoptosis rate (5.85? 0.56) % was higher than non-frozen ones (5.34?0.49)%; however, the difference was not statistically different. Endothelialization of vascular graft was carried out successfully. Cryopreserved cells on Gore-Tex surface showed a good growth trend. Conclusion Cryopreserved HUVCs may be taken as a cell choice for tissue engineering. Enough high pure endothelial cells could be isolated by digestive solutions infusion of human umbilical veins. Post-thawed endothelial cells are proved to have high vitality and growth potential on Gore-Tex surface in vitro.
3.Efficacy of laryngeal mask airway i-gel in patients undergoing laparoscopic cholecystectomy
Hongjun DUAN ; Ruifang JIA ; Yingbin SHI ; Mingzhang ZUO
Chinese Journal of Anesthesiology 2010;30(7):805-807
Objective To assess the efficacy of the laryngeal mask airway i-gel (LMA i-gel) in patients umdergoing laparoscopic cholecystectomy. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients of both sexes,aged 34-62 yr, weighing 45-90 kg, undergoing elective cholecystectomy using fiberoptic laparoscope, were randomized into 2 groups (n =60 each): LMA i-gel group (group I) and LMA ProSeal group (group P). After induction of anesthesia with sufentanil 0.2 μg/kg, propofol 2.5 mg/kg and vecuronium 0.1 mg/kg, LMA i-gel and LMA ProSeal were inserted in group I and P respectively. A gastric tube was inserted through the drain tube of the LMAs. The number of attempts, success rate, success rate of gastric tube placement, airway seal pressure, SpO2 ,PETCO2, peak airway pressure and complications (hypoxemia, nausea and vomiting, choking hoarseness, sore throat and regurgitation of gastric contents) were recorded. The fiberoptic laryngoscope scores were assessed after sccessful LMA placement. The anesthesia time, duration of surgery, extubation time and emergence time were also recorded. Results There was no significant difference in the anesthesia time, duration of surgery, extubation time and emergence time between the two groups ( P > 0.05). The SpO2, PETCO2 and peak airway pressure were within the normal range during operation in both groups. The first attempt success rate of LMA placement and fiberoptic bronchoscopic scores were significantly higher, and the LMA placement time was significantly shorter in group Ⅰ than in group P (P < 0.05). The success rate of LMA and gastric tube placement was 100% in both groups. The incidence of sore throat was significantly lower in group I than in group P ( P < 0.05). Conclusion LMA i-gel can provide adequate ventilation during operation with less complications and can be used effectively for cholecystic laparoscopic surgery.
4.Clinical observation of sevoflurane for anesthetic induction in elderly patients
Hongjun DUAN ; Ruifang JIA ; Hai LI ; Dahang LI
Chinese Journal of Geriatrics 2009;28(2):125-127
Objective To observe the onset time,cardiovascular system reactions and side effects of anesthetic introduction with sevoflurane and to explore its reliability and safety in elderly patients. Methods Sixty American Society Anesthesiologists(ASA)Ⅰ~Ⅲ patients aged 65~78 years who were scheduled for selective operation were selected in the study.They were randomly divided into sevoflurane inhalation induction group(sevoflurane group)and propofol induction group (control group).In sevoflurane group,the concentration of inhaled sevoflurane was regulated according to downgrading method during the induction,and it was decreased by 1% every 30 seconds from the initial concentration of 7% to the maintained concentration of 4%.In control group,propofol was titrated by 1.5~2.5 mg/kg.When bispectral index(BIS)was≤60,sufentanil was administered intravenously and the patients were paralyzed with rocuronium and intubated.The extinction time of lash reflex and the achievement time of BIS≤60 in two groups were recorded.The mean arterial blood pressure(AMBP),heart rate(HR),oxygen saturation(Sp02)and BIS of the basic values before intubation,and 1 min,3 min,5 min after intubation were also recorded,respectively.The side effects during intubation such as laryngeal spasm,body movements,irritating cough,restless movement during intubation were noted.The consciousness during intubation and satisfaction with induction were followed in patients after operation. Results The extinction time of lash reflex and the achievement time of BIS≤60 were significantly longer in sevoflurane group than those in control group (both P<0.01).In sevoflurane group.there were no differences in MBP and HR between 1 min postintubation and pre-intubation.Whereas,in control group,AMBP and HR were lower before intubation than basic values,and were higher 1 rain post-intubation than pre-intubation(P<0.05).There were irritating cough cases both in sevoflurane group and in control group(5 vs.3),and there was no laryngeal spasm case.All patients were satisfied with the anesthesia and had no consciousness during intubation. Conclusions Sevoflurane is a safe and effective induction agent and has little side effects.It is an ideal choice for elderly patients.
5.Application of streamline liner of pharyngeal airway in airway management of general anesthesia
Hongjun DUAN ; Ruifang JIA ; Dahang LI ; Mingzhang ZUO
Chinese Journal of Postgraduates of Medicine 2010;33(21):6-8
Objective To evaluate the efficacy of streamline liner of pharyngeal airway ( SLIPA) in airway management of general anesthesia. Methods Sixty ASA Ⅰ -Ⅱ patients undergoing elective breast surgery were randomized into 2 groups (30 cases each): SLIPA group (group S) and laryngeal mask airway (LMA) classic group (group L). Anesthesia was induced with propofol 2 mg/kg, sufentanil 0.15 μ g/kg and vecurium 0.08 mg/kg. SLIPA or LMA was inserted with digital manipulation. Anesthesia was maintained with 1% - 2% sevofluran and 50% N2O in 50% oxygen. The parameters of controlled ventilation were same in both groups. The attempt times, seal pressure and grade of fiberoptic (FOB ) laryngoscopy were measured. SpO2, PErCO2 and peak airway pressure were monitored every 15 minutes after successful laryngeal mask insertion. The complications such as regurgitation of gastric contents and sore throat were assessed by anesthesiologist after surgery. Surgery time, anesthesia time, extubation time and emergence time were recorded. Results Success rate of LMA insertion in both groups were 100%. The first attempt success rates were 90%( 27/30) in group S and 60%( 18/30) in group L (P< 0.05), the FOB grade 4 were 67%(20/30) in group S and 37% (ll/30)in group L(P< 0.05), the maximum seal pressures were (23.6 ± 4.7)cmH2O (1 cm H2O = 0.098 kPa) in group S and (18.8 ± 4.5) cm H2O in group L (P<0.05). SpO2, PErCO2 and peak airway pressure were within normal ranges. The occurrence of sore throat was similar in group S and group L (7 cases vs 6 cases). No signs of regurgitation were detected. Conclusion The SLIPA proved to be a simple, safe and effective airway instrument with little complications during the course of general anesthesia.
6.Analysis on Drug Using Regularity of Rehmanniae Radix in National Standard for Chinese Patent Drugs
Qiang JIA ; Dan SHEN ; Defeng LI ; Yi ZHANG ; Hongjun YANG
Chinese Journal of Information on Traditional Chinese Medicine 2014;(9):17-20
Objective To analyze the composition principles of Chinese patent drugs containing Rehmanniae Radix;To provide reference for clinical application and new drug research and development.Methods Based on the software Traditional Chinese Medicine Inheritance Support System (V2.0), the authors built prescription database containing Rehmanniae Radix in National Standard for Chinese Patent Drugs (NSCPD). Then the authors adopted the statistical module by using data mining methods such as association rules and improved mutual information method, with a purpose to analyze the attending disease, combination rules and the core groups in prescriptions containing Rehmanniae Radix.Results In 357 prescriptions containing Rehmanniae Radix, 17 most commonly used drug combinations were mined. Meanwhile, two diseases, namely, insomnia and vertigo were chosen from the 22 diseases that Rehmanniae Radix was most frequently used to make deeper analysis, showing that Rehmanniae Radix can achieve different therapeutic effects through different compatibility.Conclusion Prescriptions containing Rehmanniae Radixin NSCPD mainly concentrate on clear heat and cool blood, and nourish Yin. The composition principles obtained from the research that Rehmanniae Radix used when curing different diseases can fully play the efficacy of RehmanniaeRadix and provide evidence for clinical scientific formulae.
7.Management in the Prevention and Treatment of Influenza A(H1N1) According to the Law
Yingjie ZHUANG ; Hongbin MA ; Hongjun JIA ; Jing YANG ; Keping LI
Chinese Journal of Nosocomiology 2009;0(24):-
OBJECTIVE To discuss management in the prevention and treatment of infectious diseases and influenza A(H1N1) the according to law.METHODS The requirements of prevention and treatment for infectious diseases and influenza A(H1N1),were set out according to "Communicable Disease Prevention Act" and other relevant laws and regulations.RESULTS The prevention and control strategies and measures of influenza A(H1N1) still existed some problems.CONCLUSIONS The key doing a good job of prevention and control for infectious diseases and influenza A(H1N1) is according to the law scientificly and orderly.
8.64-slice spiral CT appearance of congenital anomalies of the inferior vena cava
Cuiyu JIA ; Dawei ZHAO ; Ning HE ; Feng CHEN ; Bin SUN ; Wei WANG ; Hongjun LI
Chinese Journal of Radiology 2010;44(2):156-159
Objective To evaluate the imaging findings of congenital anomalies of inferior vena eava (IVC) with 64-slice spiral CT. Methods Between January 2008 and May 2009, 6986 patients who had routine abdominal 64-row multi-detector computed tornography were retrospectively analyzed for congenital anomalies of IVC. Results Among 6986 cases, 25 cases with congenital anomalies of IVC were identified. Six case were left IVC, showing IVC left to the aorta inferior to the renal hilum. Ten cases were double IVC, showing two IVC besides the aorta inferior to the renal hilum. Five cases were abnormal renal vein, showing retroaortic and circumaortic left renal vein. Two cases were IVC interruption with collateral circultion by azygous or hemiazygous vein, contrast-enhanced CT scan showing deficiency of the IVC between hepatic and renal hilums, the enlarged azygos vein communicating with IVC at renal level and the hepatice vein draining into the right atrium. Venography showed that IVC draining into the superior vena cava through azygous or hemiazygous veins. One case was interruption of the IVC with portal vein continuation, contrastenhanced CT scan showing the communication between the IVC and portal vein. One case was hemiazygos continuation of a left IVC, contrast-enhanced CT scan demonstrating dilatation hemiazygos continuation of a left IVC and jointed the azygos vein. Conclusion The 64-slice spiral CT can be a diagnostic standard for congenital anomalies of inferior vena cava.
9.P2X7R in periaqueductal gray matter participates in nociception modulation of chronic neuropathic pain
Zhuqiang CHENG ; Jie ZHANG ; Haofei CHEN ; Hongmei ZHU ; Hongbin JIA ; Hongjun LIU ; Xiaoming LIU ; Yi JIN
The Journal of Clinical Anesthesiology 2016;32(3):284-287
Objective To observe the distribution and possible mechanism of P2X7R in periaq-ueductal gray matter (PAG)in a rat model with chronic neuropathic pain in vivo.Methods The in-trathecal catheterization and sciatic nerve injury (SNI)were performed.All animals were randomly assigned into 3 groups with 26 rats in each,which was group Sham,control group (group C)and brilliant blue G (BBG)group (group BBG),respectively.Normal saline or BBG 10 μl were intrathe-cally injected after SNI and repeated for seven days.Paw-withdrawal mechanical thresholds (PWT) were measured on day 0,day 7,day 14,and day 21 after SNI.The rats were sacrificed and PAG tis-sues were collected on day 14 and day 21,separately.The distributions of P2X7R were observed by immunofluorescence.The protein contents of P2X7R and GFAP were assessed by Western blot assays.Results The P2X7R was expressed in PAG in rats.The PWTs of the control group showed a significant decrease during the 21-day period compared with the sham group.The P2X7R signals were predominantly expressed in astrocytes in PAG after SNI.Both P2X7R and GFAP expression remark-ably increased.Administration of BBG increased the PWTs,and inhibited the P2X7R and GFAP ex-pressions compared with those atthe same point of time of the control group.Conclusion These results indicated that P2X7R in PAG might participate in nociception modulation in the midbrain in chronic neuropathic pain.
10.Effects of nAChR antagonist α-conotoxin Eb1.6 on thermal pain threshold and spinal astrocytes activa-tion and IL-βexpression in rats using L5 nerve transaction model
Xianzhong GAO ; Chunlong CHEN ; Ning ZHOU ; Qingzhen LIU ; Hongjun LIU ; Hongbin JIA ; Gongjian LIU ; Yi JIN
The Journal of Clinical Anesthesiology 2014;(6):610-613
Objective To observe the effects of nAChR antagonistα-conotoxin Eb1.6 on ther-mal pain threshold and spinal IL-1βexpression levels and astrocytes activation in rats using L5 spinal nerve transaction (SNT)model.Methods Fifty male Sprague-Dawley rats were randomly assigned into 5 groups with each group 10 rats:sham group,different doses of α-CTX Eb1.6 (0.1 5,1.5 and 1 5 nmol/kg)groups and the saline group after SNT.Saline solution or different doses of Eb1.6 were intraperitoneally injected seven days after the surgery when the model was stable and the treatment continued for seven days.Measured the TWLs of all groups of the rats 1,2,4,7,12 hours after the in-jection on 7 d and 13 d.The rats were sacrificed and L5 spinal cord tissues were collected immediately after the behavioral tests on 13 d.The expression of GFAP and IL-1βwere assessed by Western blot assay and enzyme linked immunosorbent assay (ELISA)separately.Results Groups E1,E2,E3 and C had shorter TWL before the injection on 7 d and 13 d than group N(P <0.05).The TWLs of the rats in groups E1,E2 and E3 of 1 h,2 h and 4 h after the injection on 7 d were significantly higher than that before the injection(P <0.05)with 2 h after the injection showed the most obvious change.The TWL of 1 h,2 h,4 h and 7 h after the injection of the rats in group E1,E2 and E3 and those of 12 h after the injection of the rats in group E2 and E3 on 13 d were significantly higher than that before the injection(P <0.05 )and also higher than TWL of the respective time points on 7 d(P < 0.05 ),also with 2 h after the injection showed the most obvious change.The TWLs of 2 h after the injection a-mong group E1,E2 and E3 showed significant differences both on 7 d and 13 d (P <0.05).Rats spi-nal IL-1βand GFAP expression levels of group E1,E2,E3 and C were significantly higher than those of group N(P <0.05).Rats spinal IL-1β and GFAP expression levels of groups E1,E2,E3 signifi-cantly decreased compared with group C(P <0.05).There were significant differences among the spi-nal IL-1βand GFAP expression levels of group E1,E2 and E3(P <0.05).Conclusion Eb1.6 dose-de-pendently reduced the thermal hyperalgesia induced by L5 spinal nerve transection.Repeated treat-ment of Eb1.6 could produce better analgesic effect,which might be partly attribute to the inhibition of spinal IL-βlevels and astrocytes activation.