Objective To evaluate the effect of hypothermia on the pharmacokinetics of rocuronium in the pigs with hemorrhagic shock.Methods Thirty-two Bama mini pigs of both sexes,aged 4-6 months,weighing 22-25 kg,were randomly divided into 4 groups (n=8 each) using a random number table:normal temperature control group (group NC),normal temperature+hemorrhagic shock group (group NH),hypothermia control group (group HC),and hypothermia+hemorrhagic shock group (group HH).NC and NH groups were put in the normal temperature environment,and HC and HH groups were put in a freezer at-15 ℃.In NC and HC groups,rocuronium 3.78 mg/kg was injected via the auricular vein after the animals were awake.In NH and HH groups,hemorrhagic shock was then induced by removing 40％ of blood volume from the right femoral artery at a constant speed within 15 min (30 ml/kg),and rocuronium 3.78 mg/kg was injected via the auricular vein at 30 min after the model was successfully established.At 0 (T0),2 (T1),4 (T2),7 (T3),10 (T4),15 (T5),20 (T6),30 (T7),60 (T8),120 (T9),180 (T10),240 (T11) and 300 min (T12) after rocuronium injection,blood samples were collected from the internal jugular vein for determination of the blood concentration of rocuronium by high performance liquid chromatography-tandem mass spectrometry method.The maximum concentration (Cmax),elimination half-life (t1/2),plasma effect-site equilibration rate content (Ke0),area under concentration curve,and mean residence time (MRT) of rocuronium were calculated.Results Compared with group NC,the blood concentration of rocuronium was significantly decreased at T5-T12 in group NH,the blood concentration of rocuronium was significantly increased at T5-T12 in group HC,and t1/2 was significantly prolonged,Ke0 was decreased,and MRT was prolonged in NH and HC groups (P＜0.05 or 0.01).Compared with group HC,the blood concentration of rocuronium was significantly increased at T4-T12,t1/2 was prolonged,Ke0 was decreased,and MRT was prolonged in group HH (P＜0.05).Compared with group NH,the blood concentration of rocuronium was significantly increased at T5-T11,t1/2 was prolonged,Ke0 was decreased,and MRT was prolonged in group HH (P＜ 0.05).Conclusion Hypothermia can reduce the pharmacokinetics of rocuronium in the pigs with hemorrhagic shock.

The aim of this study was to investigate the effects of nifedipine on stress responses to tracheal intubation. Thirty adult patients, ASA Ⅰ to Ⅱ, scheduled for elective surgery, were randomly assigned to receiving intravenous infusion of normal saline 30ml (group Ⅰ). fentanyl 5?g/kg (group Ⅱ) or nifedipine 40 ?g/kg(group Ⅲ), respectively. After intravenous thiopental, valium and atracurium. the tracheal intubation was performed. SP, DP, HR and RPP were determined before administration, immediately before and after intubation. 1, 3 and 5 min following intubation separately, and the venous blood samples were taken at correspondingly later 5 times to measure plasma concentrations of endotheline(EF), atrial natriuretic polypeptide (ANP), TXB_2 and 6-keto-PGF_1 ? by radioimmunoassay individually. Following intubation. MAP went up in group Ⅰ and transiently in group Ⅱ and Ⅲ, HR in creased by 36.6% and 33.3% in group Ⅰ and Ⅲ and remained stable in group Ⅱ, RPP rose in group Ⅰ and rept statistically unchanged in group Ⅱ and Ⅲ, ET level stayed constant in all three groups, levels of ANP and TXB_2 ascended in group Ⅰ, transiently in group Ⅱ and did not vary in group Ⅲ, 6-keto-PGF_1? level were raised in group Ⅱ, transiently in group Ⅲ and did not change in group Ⅰ, and TXB_2/6-keto-PGF_1? ratio(T/K) shoot up in group Ⅰ and reduced in group Ⅱ and Ⅲ. As compared with those in group Ⅰ, before intubation, ANP level increased in group Ⅱ and Ⅲ. 6-keto-PGF_1? level decreased and T/K rose in group Ⅲ; after intubation, levels of ANP and 6-keto-PGF_1 ? went up in group F, transiently in group Ⅲ, and TXB_2 and T/K values went down in group Ⅱ and Ⅲ. It is suggested that prophylactic intravenous nifedipine may effectively depress the cardiovascular and hormone responses to tracheal intubation, but can not take complete place of fentanyl for this procedure.

Objective To investigate the effect of propofol on C-fos expression and glutamate concentration in rat cerebral cortex induced by ketamine. Methods Twenty-eight male Wistar rats weighing 260-280 g were randomly divided into four groups of seven animals: group 1 received normal saline intraperitoneally (ip) (group NS); group 2 received NS + ketamine 100mg?kg-1 ip (group K); group 3 received propofol 100 mg?kg-1 + ketamine 100mg?kg-1 ip (group PK); group 4 received diazepam 10mg?kg-1 + ketamine 100 mg?kg-1 ip (group DK). The interval between the two intraperitoneal injections was 5 min in each group. The animals were decapitated 30 min after ip injection. C-fos mRNA expression was detected by RT-PCR method and fos protein expression by immuno-histochemical technique. Another forty Wistar rats were randomly divided into 4 groups of 10 animals as was described above. Two hours after ip injection, five animals in each group were decapitated for microscopic examination and the other five animals for determination of water and glutamate content of cerebral cortex.Results C-fos mRNA expression increased at 30 min after intraperitoneal ketamine. Ketamine induced significant increase in Fos protein expression, and glutamate and water content in cerebral cortex 2 h after ip injection. Propofol and diazepam inhibited the increases induced by ketamine ( P

Objective To evaluate the effect of sevoflurane on liver injury in a pig model of hemorrhagic shock.Methods Twenty-four Bama miniature pigs of both sexes,weighing 20-25 kg,aged 3-5 months,were equally randomized into 3 groups using a random number table:sham operation group (group S);hemorrhagic shock group (group HS);sevoflurane group (group Sev).Hemorrhagic shock was induced by withdrawing 40％ of blood volume from the right femoral artery within 15 min (30 ml/kg) in HS and Sev groups.The animals inhaled 2％ sevoflurane for 30 min after establishment of the model in group Sev.Before hemorrhagic shock (T0),and at 30,60,90,120,180 and 240 min after hemorrhagic shock (T1-6),blood samples were collected from the femoral artery for determination of plasma alaninc aminotransferase (ALT) and betaine-homocysteine S-methyltransferase (BHMT) concentrations (by enzymelinked immunosorbent assay).After blood sampling at T6,the animals were sacrificed,and the right lobes of livers were removed for examination of the pathological changes with light microscope.Results Compared with group S,the plasma ALT concentrations were significantly increased at T4-6,the plasma BHMT concentrations were significantly increased at T3-6 (P＜0.05),and significant liver pathological changes were observed in HS and Sev groups.Compared with group HS,the plasma ALT concentrations were significantly decreased at T4-6,the plasma BHMT concentrations were significantly decreased at T3-6 (P＜0.05),and the liver pathological changes were significantly attenuated in group Sev.Conclusion Sevoflurane can mitigate liver injury in a pig model of hemorrhagic shock.

Three hundred and one piglets of Suzh ong line 1 and 2 were chosen for halothane test(HT), with the halothane positive rate of 1.33%. 34 halothane negative(HN) piglets were randomly selected for gen otype testing and 6 of them were found to be heterozygous. The results showed th at genotype frequencies of HalNN, HalNnand Halnn w ere 81.26 %, 17.4% and 1.33%, respectively, while the frequencies of N gene and n gene wer e 89.97% and 10.03%, separately. 4 pigs with genotype Halnn gave worst meat quality appearing 3 typical and 1 slight PSE meat. Pigs with genotype Hal N Nor HalNndid not show PSE meat. 208 offspring from 20 HN sows mat ed wit h halothane positive(HP) boars, 21 piglets from 4 litters were HP, with low dail y gain, low feed efficiency and bad meat quality but high dressing percentage, l arge loin-eye area and high lean meat percentage.

Objective To evaluate the effect of hemorrhagic shock factor on the pharmacokinetics of rocuronium in pigs.Methods Sixteen pathogen-free Bama miniature pigs of both sexes,aged 3-5 months,weighing 22-25 kg,were divided into 2 groups (n=8 each) using a random number table:control group (group C) and hemorrhagic shock group (group HS).In group C,rocuronium 3.78 mg/kg was injected via the auricular vein.In group HS,the animals were subjected to volume-controlled hemorrhage,about 40％ of blood volume was withdrawn from the left femoral artery over 15 min (30 ml/kg),and rocuronium 3.78 mg/kg was injected via the auricular vein after the model was successfully established.At 0,2,4,7,10,15,20,30,60,120,180,240,300,360 and 420 min after rocuronium injection,blood samples were collected from the internal jugular vein for determination of the plasma concentration of rocuronium by high-performance liquid chromatography-tandem mass spectrometry.The pharmacokinetic parameters of rocuronium were calculated.Results Compared with group C,the plasma concentration of rocuronium was significantly increased at 20 and 60-420 min after rocuronium injection,the elimination half-life and mean residence time were prolonged,and the plasma effect-site equilibration rate constant was decreased in group HS (P＜0.05).There was no significant difference in the maximal concentration and area under the concentration-time curve between the two groups (P＞ 0.05).Conclusion The elimination of rocuronium is slower in a pig model of hemorrhagic shock.

Objective:To assess the clinical value of Gore C-TAG stent-graft segmented release mode combined with 'periscope’ technique in dealing with distal reentry tear of aortic dissection after thoracic endovascular aortic repair (TEVAR).Methods:The clinical data of 5 patients of distal false lumen enlargement after thoracic endovascular aortic repair for Stanford type B aortic dissection (TBAD) from 2019 to 2020 was retrospectively analyzed.Results:All five patients were male. Combining Gore C-TAG stent-graft segmented release mode with 'periscope’ technique was used. All five patients successfully underwent secondary endovascular repair, no intraoperative thoracotomy or major postoperative complications during hospitalization occurred . Compared to aortic CTA imaging in pre- and post-secondary endovascular repair, the curative efficacy of this method in the treatment of distal reentry tear of aortic dissection was evaluated. It showed that distal reentry tears were covered completely without reperfusion of aortic false lumen, as well as branch stents with well-perfusion based on aortic CTA imaging during the first year following-up.Conclusions:Gore C-TAG stent-graft segmented release mode combined with 'periscope’ technique in dealing with distal reentry tear of aortic dissection is technically applicable and highly successful with satisfactory short-term results.

Child ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell

Objective To study the imaging manifestations and characters of infectious atypical pneumonias.Methods The imaging materials of 80 cases of infectious atypical pneumonias which were proved by clinical were collected, the characters of imaging manifestations were analysed.Results The abnormal appearance of lung appeared after fever occured, the average time was 2.3 days. The most appearance was high density patchy and was found in every lung field. The multiple focuses were 43.8% in all the cases. The focuses changed fast. CT could have some help in early diagnosis and prognosis observation of infectious atypical pneumonias. Conclusion Medical imaging can play important part in the diagnosis and determining the treatment effect of infectious atypical pneumonias.

Objective To evaluate the safety and efficiency of transcatheter anastomotic leakage closure after surgical procedures for non-infected ascending aortic pathology with different occlusion devices. Methods From Dec. 2013 to Sep. 2015, six cases received interventional therapy for anastomotic leakage after surgical procedures for non-infected ascending aortic pathology using occluders. Four cases were with proximal graft-vessel anastomotic leakage, including two pseudoaneurysms at the site of aortic roots and two ascending aorta to right atrium shunts. The other two cases were with artificial grafts to intraoperative stent anastomotic leakage leading to endoleak type Ib. The anastomotic leakage was totally occluded by single ADOⅡrespectively in four cases. Two detachable coils were implanted in one case with artificial graft to intraoperative stent anastomotic leakage, but mild residual shunt to false lumen was detected by DSA and follow-up CTA. The second interventional procedure was carried out one month later, and one ADO Ⅱ was used to close the residual leakage totally. One PDA occluder was implanted along arteriovenous guide-wire track via aortic root to right atrium fistula in one case. Results All the anastomotic leakages of the six cases were totally excluded by different occlude devices percutaneously. The technical success rate was 100%. Follow-up time was from 1 month to 4 years. The patients' clinical condition improved obviously. Follow-up CTA showed no recurrence of anastomotic leakage. Complete thrombosis and marked shrinkage of the pseudoaneurysm were achieved in two cases, and the partial thrombosis and shrinkage of the false lumen were achieved in 2 cases. Conclusion Trans-catheter closure is an alternative treatment for ascending aortic surgical anastomotic leakage, which may achieve satisfactory short-and mid-term results.