Objective To observe the hemodynamic effects of open-loop target controlled infusion (OLTCI) and closed-loop target controlled infusion (CLTCI) of propofol and fentanyl for general anesthesia induction. Methods Twenty-four female patients with ASA grade I-II who were performed thyroidectomy were randomly allocated into two groups: OLTCI group and CLTCI group(n=12). In OLTCI group, anesthesia induction and maintenance were performed with propofol and fentanyl at the target concentrations of 3 ?g/mL and 3 ng/mL, respectively. In CLTCI group, double CLTCI were performed. Titrations of propofol and fentanyl were guided with bispectral index (BIS) and product of systolic pressure and heart rate (HR). Initiative concentrations of this closed-loop system were 3 ?g/mL and 3 ng/mL, step-up or step-down concentrations were 0.5 ?g/mL and 0.5 ng/mL, and the highest concentrations were 6 ?g/mL and 5 ng/mL, respectively. HR, mean arterial pressure (MAP), HR variability, BIS value and the dosages of propofol and fentanyl in various time of the two groups were recorded. Results One min after intubation and simulative incision stimulation, BIS value of both groups were increased, but the BIS value in CLTCI group was less increased than OLTCI group(P

Chronic hepatitis B(CHB)is one of the most commom cause of liver fibrosis. Accurate assessment of liver fibrosis is essential for the strategy of treatment and judgement of prognosis . Liver biopsy is the gold standard for staging fibrosis,but it is invasive with high cost,low reproducibility and poor acceptance by patients. Therefore,it is urgent to explore a noninvasive modality for the assessment of liver fibrosis. Recent evidence highlights that elastographic techniques, biochemical markers and the diagnostic model consisted of several serum markers have the potential for the diagnosis of liver fibrosis. This article reviewed the progress in noninvasive assessment of liver fibrosis in patients with CHB.

Child ; Child, Preschool ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; Gastrointestinal Tract ; diagnostic imaging ; Humans ; Infant ; Male ; Radionuclide Imaging ; Sodium Pertechnetate Tc 99m

Adolescent ; C-Reactive Protein ; metabolism ; Cell Aggregation ; Child ; Child, Preschool ; Cytodiagnosis ; methods ; Female ; Humans ; Infant ; Leukocytes ; cytology ; Male ; Meningitis, Bacterial ; blood ; cerebrospinal fluid ; diagnosis ; Meningitis, Viral ; blood ; cerebrospinal fluid ; diagnosis ; Sensitivity and Specificity

Objective To find noninvasive estimation of partial pressure of carbon dioxide in artery (PaCO2) by measuring the end-tidal CO2 partial pressure (PETCO2) in elderly patients with respiratory failure with chronic obstructive pulmonary disease (COPD). Methods All the 30 acutely exacerbated COPD subjects received routine clinical treatment including bronchodilators,mucolytics, glucocorticosteroid, antibiotics and oxygen therapy for 5-7 days, and part of them received noninvasive positive-pressure ventilation (NIPPV) treatment concurrently. They were both tested by eupnea method and prolonged expiratory method before and after treatment. Results Before treatment, PET CO2 (Q) (end-tidal CO2 pressure with eupnea, (50.72±8.93) mm Hg wassignificantly lower than PaCO2 (F=38.73, P＜0.01 ). Yet, PETCO2(P) (end-tidal CO2 pressure with prolong expiration) was (70.35±8.91) mm Hg and PaCO2 was (71.25±9.08) mm Hg. There was no significant difference between PETCO2 (P) and PaCO2 (P＞0.05). The similar results were found after treatment. By linear regression analysis, PetCO2(P) was remarkably positive correlated with PaCO2 before and after treatment (r=0.96 and 0.97, respectively, P＜0.01). According to TABG,PCO2(C) which was calculated by the average expiratory time of fitting curve was (71.78±9.04)mm Hg. And there was no significant difference between PCO2 (C) and PaCO2 (P＞0.05);Thesimilar results were founcl after treatment. By linear regression analysis, PCO2 (C) was remarkably positively correlated with PaCO2 (r=0.97 and 0.98, respectively, P＜0.01) before and after treatment. Conclusions In COPD patients with type Ⅱ respiratory failure, conventional PETCO2 (Q) is significantly lower than PaCO2. Yet, PETCO2 (P) could exactly estimate PaCO2 and is appropriate to its dynamic monitoring. And PCO2 (C) which is calculated by mode Boltzmann on eupnea curve also obtain similar results.

Abstracting and Indexing as Topic ; Neoplasms ; Periodicals as Topic

To observe the effect of intracarotid administration of adrenomedullin (AM) on the spontaneous electrical activity of area postrema (AP) neurons, 78 spontaneous active units were recorded from 63 sino-aortic denervated Sprague-Dawley rats using extracellular recording technique. The results obtained are as follows. (1) Following intracarotid administration of AM (0.3 nmol/kg), the discharge rate of 47 out of 78 units increased markedly from 2.99+/-0.24 to 4.79+/-0.29 spikes/s (P<0.001), 20 units decreased from 3.24+/-0.46 to 1.97+/-0.37 spikes/s (P<0.001), and the remaining 11 showed no response. Blood pressure (BP) and heart rate (HR) did not change throughout the experimentation. (2) Pretreatment with intracarotid administration of calcitonin gene-related peptide receptor antagonist CGRP8-37 (3 nmol/kg) did not change the effects of AM. (3) Following intracarotid injection of NO precursor L-arginine (30 mg/kg), the excitatory effect of AM was attenuated. The above results indicate that AM can excite spontaneous electrical activity of AP neurons, this effect is not mediated by calcitonin gene-related peptide receptor but may be attenuated by NO precursor L-arginine.
Action Potentials ; physiology ; Adrenomedullin ; pharmacology ; Animals ; Aorta ; innervation ; physiology ; surgery ; Area Postrema ; physiology ; Carotid Sinus ; innervation ; physiology ; surgery ; Denervation ; Injections, Intra-Arterial ; Male ; Neurons ; physiology ; Rats ; Rats, Sprague-Dawley

We have constructed an immunotoxin(Ng76-TCS),which was composed of a monoclonalantibody directed against human melanoma and trichosanthin(TCS)——a single chain ribosomeinactivating protein.The cultured human melanoma cells(M21)were inhibited effectively byNg 76-TCS.The cytotoxicity of Ng76-TCS to M21 cells was 2,000-fold higher than that of free TCS and Ng76 mixture.A conjugate,which was prepared with normal mice immunoglobulinand TCS(NIgG-TCS),was 160-fold less cytotoxic to M21 cells.Meanwhile Ng76-TCS was125-fold less cytotoxic to nontarget cells Hela.These results showed that the immunotoxinNg76-TCS was a potent and specific anti-human melanoma agent.

Objective To improve the knowledge and diagnostic ability of imagiology on neonatal respiratory distress syndrome (NRDS) computed radiograph(CR).Methods The doubtful patients were done to photographs bedside using the high resolution imaging plate, 50 cases of newborn with NRDS were selected whose clinical diagnosed clearly and had been treated and had the complete CR image documents.The CR change and clinical characteristics were observed dynamically.Results Nine of 50 cases were combined with aspirated pneumonia,8 cases with infective pneumonia,3 cases with intra-alveolar hemorrage,and 2 cases with pneumothorax.Accoding to X-ray manifestations,all cases were divided into four stages:Ⅰ stage(n=5), Ⅱ stage(n=20),Ⅲ stage(n=22),Ⅳstage(n=3).Typical CR signs included:the pulmonary lucency decreasd,wide-ranging net and grain shadowes of high density, and in companing with a lot of air brunchus sing.Conclusions Computed radiography is the most important imaging method in diagnosis of NRDS bedside ,and shall be improved the ability of diagnosis and differential of NRDS combined with the clinic.

Diverse subtypes of voltage-gated sodium channels (VGSCs) have been found throughout tissues of the brain, muscles and the heart. Neurotoxins extracted from the venom of the Asian scorpion Buthus martensi Karsch (BmK) act as sodium channel-specific modulators and have therefore been widely used to study VGSCs. α-type neurotoxins, named BmK I, BmK αIV and BmK abT, bind to receptor site-3 on VGSCs and can strongly prolong the inactivation phase of VGSCs. In contrast, β-type neurotoxins, named BmK AS, BmK AS-1, BmK IT and BmK IT2, occupy receptor site-4 on VGSCs and can suppress peak currents and hyperpolarize the activation kinetics of sodium channels. Accumulating evidence from binding assays of scorpion neurotoxins on VGSCs, however, indicate that pharmacological sensitivity of VGSC subtypes to different modulators is much more complex than that suggested by the simple α-type and β-type neurotoxin distinction. Exploring the mechanisms of possible dynamic interactions between site 3-/4-specific modulators and region- and/or species-specific subtypes of VGSCs would therefore greatly expand our understanding of the physiological and pharmacological properties of diverse VGSCs. In this review, we discuss the pharmacological and structural diversity of VGSCs as revealed by studies exploring the binding properties and cross-competitive binding of site 3- or site 4-specific modulators in VGSC subtypes in synaptosomes from distinct tissues of diverse species.
Animals ; Binding Sites ; Binding, Competitive ; Brain ; metabolism ; Heart ; physiology ; Humans ; Insect Proteins ; antagonists & inhibitors ; genetics ; metabolism ; Insecta ; Ion Channel Gating ; drug effects ; physiology ; Kinetics ; Mammals ; Muscles ; metabolism ; Neurotoxins ; chemistry ; classification ; pharmacology ; Protein Binding ; Scorpions ; chemistry ; Sodium ; metabolism ; Sodium Channel Blockers ; pharmacology ; Sodium Channels ; classification ; genetics ; metabolism ; Synaptosomes ; drug effects ; metabolism