1.Effects of droperidol on sodium currents in isolated rat dorsal root ganglion neurons
Meng CHEN ; Xinliang ZHUANG ; Guohui XU
Chinese Journal of Anesthesiology 1994;0(03):-
Objective To investigate the effects of droperidol on the Na+ currents in rat dorsal root ganglion neurons.Methods The rat dorsal root ganglion neurons were enzymatically dissociated. Whole-cell patch-clamp technique was applied to record Na+ current. Results 3-300?mol?L-1 Droperidol inhibited the sodium currents by 14.12%-78.46% (P0.05, n =7).Conclusions Droperidol inhibits Na+ currents in rat dorsal root ganglion neurons in a concentration- and voltage-dependent manner. The results suggest that the concentration of epidural droperidol clinically applied during epidural patient control analgesia may enhance the analgesic effects.
2.The perioperative effects of metabolic syndrome on the off-pump coronary artery bypass
Bin MAO ; Juanjuan SHAO ; Xinliang CHEN ; Jianqun ZHANG
Chinese Journal of Thoracic and Cardiovascular Surgery 2011;27(5):281-284
Objective Metabolic syndrome ( MS), a disorder involving multiple metabolic abnormalities such obesity,hypertension, diabetes or abnormal glucose tolerance and dyslipidemia, has been observed in many patients receiving coronary artery bypass procedures. In this study we try to examine the perioperative effects of metabolic syndrome on the off-pump coronary artery bypass (OPCABG). Methods A prospective study was conducted in 1060 consecutive OPCABG patients who were admited to Beijing Anzhen Hospital from July 2009 to March 2010. The patients were grouped as MS group and non-MS group according to the diagnostic criteria for Chinese metabolic syndrome. The outcomes such as mortality, atrial fibrillation,stroke, staying in ICU for more than three days, use of IABP, ECMO, dialysis, multiple organ dysfunction score ( MOOS) ,postoperative score for cardiac surgery (PSCS), PaO2/FiO2 , heart rate x central venous pressure/mean artery pressure(pressure-adjusted heart rate, PAHR) ,renal and liver function, platelets, and the dosage of vasoactive agents were analyzed and compared between the two groups by x2 test or t test. Results Three hundred and eighty-nine cases were diagnosed with MS among 1060 cases with OPCABG. In the MS group, 17 cases stayed in ICU for more than 3 days, 2 cases died, 76 had atrial fibrillation, 3 had stroke, 18 cases were treated with intra-aortic balloon counterpulsation (IABP). In the non-MS group, 47 cases stayed in ICU for more than 3 days, 12 cases died, 148 had atrial fibrillation, 3 had stroke, 48 cases were treated withIABP, 3 cases received ECMO and 4 cases received dialysis. No significant difference between MS group and non-MS group was identified in the aspects of mortality, atrial fibrillation, stroke, duration of more than three days in ICU, the use of IABP,ECMO, dialysis after OPACBG based on the x2 test(P>0.05). However, on the operative days, the MODS and PSCS in MS group were significantly higher than that in non-MS group (P < 0.05). MODS 2. 57 ± 1. 62 in MS group vs. 2. 15 ± 1.65 in non-MS group, PSCS 4.27 ±2.15 in MS group vs. 3.92 ±2.29 in non-MS group. PaO2/FiO2 in MS group was significantly lower than that in non-MS group (249.23 ± 110.99 vs. 283. 33 ± 114. 35), P < 0. 01. PAHR in MS group was significantly higher than that in non-MS group (9.98 ±3.54 vs. 9.23 ±3. 88), P <0.05. On the first postoperative days, the MODS in MS group was also significantly higher than that in non-MS group (3.05 ±1.64 vs. 2.82 ± 1.72), P<0.05. PaO2/FiO2 in MS group was significantly lower than that in non-MS group (277.11 ±122.99 vs.318.47 ±143.84), P<0.05. Conclusion MS was not a predictor for death, atrial fibrillation, stroke, duration of more than three days in 1CU, the use of IABP, ECMO, dialysis after OPACBG. However, MS had a temporary adverse effect on the respiratory and circulatory systems on the operative day and the first postoperative day after OPCABG.
3.A comparative study on two surgical procedures in treatment of stress urinary incontinence in old women
Xinliang CHEN ; Min JIANG ; Li FENG ; Huaifang LI ; Xiaowen TONG
Chinese Journal of Geriatrics 2010;29(8):648-651
Objective To evaluate the safety and efficacy of two surgical procedures including retropubic space pathway and obturator foramen pathway in treatment of the old women with stress urinary incontinence (SUI). Methods Intravaginal Slingplasty (IVS) procedure by retropubic space pathway was performed in 52 cases with simple SUI from June 2003 to June 2005. And the modified Transobturator Vaginal Tape Inside-Out (TVT-O) procedure was carried out in 112 cases with simple SUI from October 2005 to October 2008, using self-tailed polypropylene mesh and helical needles. The comparative retrospective study was performed between these two groups. Results The cure rate was 80.8% (42/52) and the improvement rate was 13.5% (7/52) in IVS group. And the corresponding data were 84.8% (95/112) and 11.6% (13/112) in modified TVT-O group. The 3 (5.8%) cases failed in IVS procedure and 4 (3.6%) cases failed in modified TVT-O procedure at 1 month's follow-up. All of the 7 patients received the 'Tong's hammock procedure' and no cases failed at 6 and 12 month's follow-up. One case of vaginal erosion was found in each group although good effect of continence was observed. Meshes were removed in these two patients and then the 'Tong's hommock procedure' was performed which turned out to be good outcome. Bladder injuries were found in 3 cases when route cystoscopy was performed. No significant difference in efficacy was found between these two groups(P>0. 05). In modified TVT-O group, operative duration, blood loss and medical cost were significantly reduced as compared with IVS group (P<0. 01). Conclusions Both of the two surgical procedures of modified TVT-O versus IVS are simple, safe and mini-invasive procedures with high efficacy. However, the modified TVT-O procedure is more easy to be adopted by patients due to short operative time and lower medical cost.
4.The SWOT analysis on private hospitals in the background of new healthcare reform
Ning CHEN ; Xinliang LIU ; Meng LI ; Shuyan GUO ; Siping DONG
Chinese Journal of Health Policy 2015;(8):39-43
Objective:This study aims to ensure the private hospitals development strategy in the background of new healthcare reform and put forward some scientific suggestions to help promote their sustainable development. Methods:The SWOT analysis method was adopted to analyze the private hospitals’ internal strength, weakness, exter-nal opportunity and threats. Results: The results showed a clear property right, advanced management system and other outstanding advantages in the private hospitals. Opportunities like the improved policy environment and people’s medical demand expansion are also very prominent. Meanwhile, the private hospitals development also faces some disadvantages and challenges such as illegal operation, disorder in the market competition, vague orientation, etc. Conclusions:It suggests the strengthening of the personnel and hospital culture construction, adoption of the differen-tiation strategy, improvement of the diagnosis and treatment ability, etc.
5.Application of modified total pelvic reconstruction in the treatment of pelvic organ prolapse in elderly women
Xinliang CHEN ; Min JIANG ; Jun QIU ; Huaifang LI ; Xiaowen TONG
Chinese Journal of Geriatrics 2014;33(1):66-69
Objective To evaluate the efficacy and safety of modified total pelvic reconstruction for pelvic organ prolapse in elderly women.Methods 105 patients required operation for treatment of pelvic organ prolapse were enrolled in this study.Patients were divided into experimental group (n =68,treated with the modified total pelvic reconstruction) and control group (n=37,receiving prolift procedure).Objective indexes including bleeding volume,operative time,residual urine volume,postoperative complications,medical expenses,hospitalization time were recorded.Clinical efficacy and follow-up results were recorded and compared between the two groups at 6 months after operation.Results Bleeding volume and hospitalization costs were lower in experimental group than in control group (both P<0.05),while the operative time,residual urine volume,time out of bed,anal exhaust time,the maximum body temperature,mean postoperative hospital stay showed no significant differences between the two groups (all P>0.05).Vaginal perforation was observed in 7 cases,with 4 cases in experimental group and 3 cases in control group.No serious complications such as bladder and rectum perforation were observed.According to pelvic organ prolapse quantitation (POP-Q) score,64 cases (94.1%) were cured and 4 cases (5.9%) were invalid in experimental group,while 36 cases (97.3%) were cured and 1 case (2.7%) was invalid in control group.The noninferiority test showed that clinical efficacy in experimental group was non-inferior to that in control group (u=2.252,P<0.05).Conclusions Modified total pelvic reconstruction is an effective and safe minimally invasive surgery,which is similar to prolift surgical operation,but it is relatively inexpensive,which is easier to be accepted by Chinese patients,with a great perspective in clinical application.
6.Effect of nitric oxide on proteinuria excretion in rats suffering from renal ischemia-reperfusion
Xinliang WANG ; Shansheng HUANG ; Xiaoling CHEN ; Dianhua WANG ; Yiling LING
Chinese Journal of Pathophysiology 1986;0(04):-
AIM: To investigate the urinary protein (UP) excretion in rats suffering from renal ischemia-reperfusion (I-R) and effect of nitric oxide on it. METHODS: SD rats were used to establish the renal I-R model. Sodium nitroprusside (SNP), N ?-nitro-L-arginine (L-NNA) and aminoguanidine (AG) were used to determine the effect of nitric oxide on UP excretion under renal I-R. Quantitative analysis of UP was made by chromatometry. UP species were separated by SDS-PAGE. RESULTS: Renal I-R caused significant increase in UP ( P
7.Effects of midazolam on macroscopic voltage-gated potassium currents in rat sympathetic neurons
Qinghong MAO ; Xinliang ZHUANG ; Meng CHEN ; Jun TANG ; Guohui XU ;
Chinese Journal of Clinical Pharmacology and Therapeutics 2000;0(03):-
AIM: To explore the influence of different concentration midazolam on the macroscopic voltage gated potassium currents and to discuss the relationship between potassium currents and inhibitory effect of clinical relevant concentration midazolam on sympathetic nervous system. METHODS: Superior sympathetic ganglion neurons were dissociated enzymatically from 7 to10 day old rat. Experiments were performed about 5 h after plating at room temperature (20- 24 ℃ ). Appropriate solution was chosen to separate the K + current from the other transmembrane currents. 1 ?mol?L -1 TTX was applied to the extracelluar solution to block the Na + current. Midazolam was also resolved in extracelluar solution to get various concentration ( 0.1 , 0.3 ,3,10,50,100 ?mol?L -1 ). Currents were recorded with the patch clamp technique in whole cell configuration using glass electrodes with a tip resistance of 2- 4 M . Potassium currents were evoked by test pulse from -100 mV to +30 mV with holding potential -80mV. Data were analyzed using Clampfit 6.0 and Oringih 5.0 software. Whole cell current records were corrected for leakage and capacitance by using the P/5 protocol. RESULTS: Midazolam dose dependently inhibited the whole cell potassium currents. Clinical relevant concentration midazolam ( 0.3 ?mol?L -1 ) only reduced the peak currents by 3.89 %(P= 0.88 ). The concentration required to produce 50% current inhibition(IC 50 ) was 76.065 ?mol?L -1 . CONCLUSION: Midazolam inhibits the whole cell potassium current significantly and dose dependently, but clinical relevant concentration midazolam has minor effect on the potassium currents, indicating that the inhibitory effect of midazolam on potassium current is not related to the suppression of activity of sympathetic system.
8.Comparison on blood indices after treatment of intertrochanteric fractures with conventional and minimally invasive DHS internal fixation in the elderly
Zhiqi HOU ; Xinliang WANG ; Jiongxiang KUANG ; Tao GE ; Yunfa YANC ; Ming CHEN ; Zhonghe XU
Chinese Journal of Trauma 2008;24(9):722-724
Objective To compare the changes of some blood indices after treatment of intertro-chanteric fractures with conventional and minimally invasive dynamic hip scres (DHS) internal fixation so as to understand the influence of minimally invasive technique on physiology of the organism. Meth-ods The elderly patients with intertrochanteric fractures in our department from July 2004 to May 2006 were divided randomly into two groups, ie, conventional DHS internal fixation group(Conventional group, 52 patients)and the minimally invasive DHS internal fixation group(Minimal invasion group, 54 patients). A comparison was done on data including white blood cells (WBC), hemoglobin (Hb), e-rythrocyte sedimentation rate (ESR). C reactive protein (CRP) and creatine kinase (CK) as well as re-cessive blood loss. Results The indices including transfusion, blood loss, recessive blood loss, ESR and CK in minimal invasion group showed less changes compared with conventional group. With statistical difference. But WBC and CRP showed no statisfical difference between both groups. Conclusion Minimally invasive DHS internal fvtation carl reduce operative trauma during treatment of intertrochanterie fractures in the elderly.
9.The kinetic alteration of nitric oxide formation in the lungs in the development of pulmonary fibrosis of rats
Xiaoling CHEN ; Shansheng HUANG ; Yingmin LI ; Wenbin LI ; Xinliang WANG ; Qiuhong WANG
Chinese Journal of Pathophysiology 2001;17(6):534-537
AIM: To observe the kinetic alteration of nitric oxide formation in the lungs in the development of pulmonary fibrosis in the rat. METHODS: The contents of hydroxyproline in the lungs, NO-2/NO-3 (nitrite/nitrate) in out-flowing and in-flowing pulmonary blood (OPB, IPB) were assayed on the day 7, 14, 21, 30 and 70 after intratracheal administration of bleomycin A5 . The content of NO-2/NO-3 in supernatants of culture of the alveolar macrophages (AMs) and the amount of iNOS positive stain cells in lung tissue section were also observed in the rat on 14th day after-bleomycin A5 administration. RESULTS: The content of lung hydroxyproline had no change on the 7th day, increased on the 14th day (P<0.05), increased significantly on the 21th day, 30th day and 70th day post-bleomycin A5 compared with control rats. On the 7th day and 14th day, the content of NO-2/NO-3 increased in OPB and decreased in IPB (P<0.01). On the 21th day, the content of NO-2/NO-3 abated in OPB (P>0.05) but still decreased in IPB (P<0.01). On the 30th day and the 70th day, the NO-2/NO-3 level recovered both in OPB and IPB. AMs from rats on the 14th day post-bleomycin A5 showed significant elevation (P<0.01) in NO-2/NO-3 level. The amount of iNOS positive stain cells increased in rats on the 14th day post-bleomycin A5. CONCLUSION: The amount of NO in the lungs was high in the initial phase of fibroproliferative reaction induced by bleomycin A5 ,and these might be associated with the enhanced ability of AMs to release NO and the increased amount of iNOS.
10.Observation on the effect of preoperative radiotherapy on the local advanced middle and low rectal cancer
Xiaoyun TIAN ; Xinliang ZHANG ; Chenglong HAN ; Bin ZHOU ; Kai JIANG ; Qun ZHANG ; Yuanyuan CHEN
Cancer Research and Clinic 2015;27(12):810-813
Objective To discuss the treatment efficacy and radiotherapy side effects of the preoperative long-course radiochemotherapy and preoperative short-course radiotherapy.Methods 64 patients with local advanced middle and low rectal cancer who got the treatment from April 2004 to April 2010 were analyzed retrospectively.40 patients got the preoperative long-course radiochemotherapy under the dose of DT 45-50 Gy/25 F,1.8-2.0 Gy/F,5 F/W,combining with the synchronous capecitabine chemotherapy (1 650 mg/m2,2 F/d,d1-14/d21-35),and accepted operation 4-6 weeks after the radiotherapy.The rest 24 patients underwent the preoperative short-course radiotherapy under the dose of DT 25 Gy/5 F,5 Gy/F,5 F/W,and got the operation in 2 weeks after the radiotherapy.Results The radical and anus reservation rates in preoperative long-course radiochemotherapy group [85.0 % (34/40),65.0 % (26/40)] were higher than those in preoperative short-course radiotherapy group [58.3 % (14/24),33.3 % (8/24)] (x2 =5.689,P =0.019;x2 =6.040,P =0.041).There were no significant differences between the two groups on the index of remission rates,radiation injury,surgical complications,and overall survival rate of 1,3,5 years (all P > 0.05).Conclusions The remission rate and overall survival time between the preoperative long-course radiochemotherapy group and preoperative short-course radiotherapy have no significant difference.But the preoperative long-course radiochemotherapy may improve the anus reservation rate and the radical resection rate,without increasing the radiation injury and surgical complications.