1.Protection System Against and Its Effect Occupational Exposure to Hepatitis B Virus
Yuan YAO ; Lihuan MU ; Yingxin ZHAO
Chinese Journal of Nosocomiology 2009;0(23):-
OBJECTIVE To understand the condition of occupational exposure in hospital,and analyze the tendency during last four years.METHODS Occupational exposure in medical personnel were investivated through questionnaireand reviwed the survey report of quantitative detection of the five serological markers of hepatitis B,in the workers exposed in HBV.RESULTS The rate of occupational exposure had declined year by year during 2005-2008,but the result was opposite for HBV.CONCLUSIONS It′s very effective to decrease occupational exposure by strenghening standardization and putting professional protective knowledge in routine work.After setting up and developing protective system against occupational exposure,it′s more prompt in updating information,protective treatment and follow-up test in serum.It shows that this system is helpful to normalize medical personnel action of occupational exposure.In fact,vaccination is an effective way to avoid medical personnel of infecting HBV.
2.Anesthetic management for orthotopic heart transplantation
Mingzheng LIU ; Lihuan LI ; Mu JIN
Chinese Journal of Anesthesiology 1995;0(12):-
From June 2004 to December 2005 anesthesia was done for 43 patients undergoing orthotopic heart transplantation (OHT) in Fuwai Hospital. Most patients were premedicated with oral diazepam 5-10 mg, and intramuscular morphine 0.2 mg?kg-1 and scopolamine 0.1-0.3 mg. Radial artery was cannulated and Swan-Ganz catheter was placed. ECG, direct BP, HR, CVP, PAP, CO, SpO2, SvO2, PETCO2 were monitored before and during operation. Anesthesia was induced with midazolam 1-3 mg, etomidate 0.2-0.3 mg?kg-1 , fentanyl 5-15?g?kg-1 or sufentanil 50-100?g, vecuronium 0.1 mg?kg-1 or rocuronium 0.6 mg?kg-1 , and maintained with isoflurane inhalation and propofol infusion and intermittent i. v. boluses of fentanyl or sufentanil and vecuronium. Hemodynamic suppression was mild during anesthesia. The average duration of aortic cross-clamping and CPB was 57-133 min and 123-230 min. The cardiovascular support used for weaning the patients from CPB included dopamine, ephedrine and isoproterenol. Nitroglycerin, NO and iloprost were administered for pulmonary artery vasodilation. Pacing was started at the termination of CPB because of bradycardia in 1 of 43 patients. Sinus rhythm appeared after the patients were weaned from CPB and the function of the transplanted heart was satisfactory. Basiliximab, cyclosporine A, cellcept and methyl prednisolone were administered for immunosuppression during perioperative period. Forty-two of the 43 patients were discharged from hospital without any rejection episodes or other complications. One patient died of multiple organ failure after heart-kidney transplantation.
3.A model of cardiopulmonary bypass in Dahl salt-sensitive rats
Mu JIN ; Bin ZHU ; Qing MA ; Lihuan LI
Chinese Journal of Anesthesiology 2012;32(6):657-660
ObjectiveDahl salt-sensitive (Dahl/SS) rats are hereditary salt-sensitive hypertensive rats.Its pathogenesis is similar to that of human primary hypertension,CPB established in Dahl/SS rats provides an animal model for the study of CPB in patients with primary hypertension.MethodsMale 14-16 weeks old Dahl/SS rats weighing 360-390 g were fed with high salt (8% NaCl) diet for 4 weeks before the experiment.Ten Dahl/SS rats were randomly divided into 2 groups ( n =5 each) according to the CPB time:groups Ⅱ and Ⅲ underwent CPB for 120 and 75 min respectively.Another 7 male 14-16 weeks old ordinary SD rats weighing 410-490 g undergoing CPB for 120 min were used as control group (group Ⅰ ).Anesthesia was induced with isoflurane inhalation.Orotraeheal intubation was performed.The animals were mechanically ventilated.Right jugular vein and tail artery were cannulated for venous drainage and arterial inflow from CPB circuit.Blood was oxygenated with a customized mini-oxygenator.Blood gases were analyzed and blood glucose concentration was determined.MAP was recorded before (baseline) and at 30 and 60 min of CPB and 30 and 90 min after CPB.The rate of changes in MAP and blood glucose concentration and survival rate at 7 d after termination of CPB were recorded.ResultsThere was no significant difference in blood gases among the 3 groups.The rates of change in MAP and blood glucose concentration were significantly higher during and after CPB in Dahl/SS rats than in control SD rats in a duration of CPB dependent manner.The survival rate at 7 d after CPB was 7/7 (in group Ⅰ ),1/5 (in group Ⅱ ) and 4/5 (in group Ⅲ ) respectively.ConclusionA model of 75 min CPB is established successfully in Dahl/SS rats.