1.Clinical observation of whether pretreatment with a low dose of esmolol can reduce propofol injection pain
Huifang JIANG ; Jun FANG ; Yanhong LIAN
The Journal of Clinical Anesthesiology 2014;(7):676-678
Objective To investigate the effect of esmolol pretreatment on propofol injection pain..Methods Ninety patients undergoing breast cancer surgery under general anesthesia were ran-domly assigned into three groups (n=30 each).Group E were pretreated with 5 mg/ml(total 2 ml)es-molol group L with 20 mg/ml (total 2 ml)lidocaine and group N with 2 ml normal saline.After one minute,each group was administrated propofol intravenouly.The pain and hemodynamic data were re-corded.Results Compared with group N,propofol injection pain degree decreased obviously in groups E and L (P <0.05).propofol injection pain occurred in 25 (83.3%)in group N,was signifi-cantly higher than that of 12 (40.0%)in group E and 14 (46.7%)in group L (P <0.05),propofol injection pain had no significant difference between groups E and L.Compared with T1 ,SBP,DBP decreased in groups E and L at T2 ,SBP decreased in group N at T2 significantly (P <0.05).Com-pared with T2 ,DBP was significantly higher at T3 in group E (P <0.05).Conclusion Pretreatment with low dose esmolol was effective in attenuating pain during propofol injection.
2.Comparison of effect of different dose of dexmedetomidine on postoperative analgesia and sedation
Qicheng WU ; Jun FANG ; Yanhong LIAN
Chinese Journal of Primary Medicine and Pharmacy 2017;24(3):365-369
Objective To compare the effects of different doses of dexmedetomidine on postoperative analgesia and sedation.Methods From January 2014 to November 2015,60 cases who needed postoperative analgesia and sedation in our hospital were selected.According to the dosage of dexmedetomidine,they were divided into control group and observation group,30 cases in each group.Two groups of patients were given analgesia pump for analgesia, with 0.5μg·kg-1·h-1,1.0μg·kg-1·h-1 two doses of dexmedetomidine,and analgesia 48 h.At different time points,the VAS pain score,Ramsay sedation score of the two groups were compared,the calm satisfaction in both two groups was recorded,the average incidence of delirium and delirium score in the process of the treatment and the occurrence of adverse reactions were observed.Results With the extension of time of postoperative analgesia,VAS scores in each group decreased,VAS scores in the observation group after 4h,8h,12h were (3.01 ±0.53)points, (1.95 ±0.58)points,(1.52 ±0.35)points,which were lower than those of the control group[(3.92 ±0.32)points, (2.86 ±0.67)points,(2.25 ±0.78)points],the differences were statistically significant (t=3.42,4.11,2.43,all P<0.05).After 24h,48 h,VAS score between the two groups had no significant difference(P>0.05).Postoperative 4h Ramsay score between the two groups had no significant difference (P >0.05 ).With increased postoperative analgesia time,Ramsay scores in two groups decreased,postoperative 8h,12h,Ramsay scores in the observation group [(2.95 ±0.83)points,(2.22 ±0.55)points]were lower than the control group[(3.76 ±0.78)points,(2.98 ± 0.89)points,t=3.45,2.38,all P<0.05].Postoperative 24h,48 h,the Ramsay scores between the two groups had no significant difference(P>0.05).The sedation satisfaction of the observation group (96.67%)was higher than the control group (86.67%),the incidence rate of delirium and delirium average score [3.33%,(15.11 ± 2.03)points]were lower than the control group[13.33%,(19.23 ±2.21 )points],the differences were significant between the two groups (t =4.32,4.32,3.27,all P<0.05 ).After treatment,the adverse reactions were mainly bradycardia,nausea,vomiting,drowsiness,respiratory depression,urinary retention.The overall incidence rate of adverse reactions between the two groups had no significant difference (P >0.05 ).Conclusion The effect of 1 .0μg·kg-1 · h-1 concentration dexmedetomidine within 24h of postoperative analgesia sedative is best,it can reduce the incidence of postoperative delirium,and without obvious drug side effects.
3.Comparative study of HLA-A antigen typing by DNA chip and serology in 120 donor-recipients
Jiaquan XIAO ; Minhua KANG ; Yanhong FANG
Chinese Journal of Organ Transplantation 2005;0(12):-
Objective To evaluate the accuracy and clinical practicality of DNA chip in comparison with serology in typing of human leukocyte antigen A (HLA-A) in Han's individuals of donor-recipients of transplantation. Methods 120 peripheral blood samples were obtained from donor-recipients of transplantation. Each sample was divided into two parts and HLA-A antigens were identified by DNA chip in one part and by serology in another. Samples in which the HLA-A typing results by these 2 methods were discordant were verified by polymerase chain reaction with sequence specific primers (PCR-SSP). Accuracy and clinical practicability of both methods were compared according to the typing results. Results Serological typing for HLA-A took 3 h, while DNA chip typing 4. 5-5 h. 112 samples have been typed successfully. Typing results were same in 91 samples and discordant in 21 cases. The verified results showed that DNA chip made 2 incorrect typing and the error rate was 2%. Meanwhile, serology made 19 mistakes, consisting of 5 antigens being incorrectly interpreted and 14 "blanks" turning out to be definable alleles. The discrepancy rate was 17 %. Conclusions DNA chip typing for HLA-A is suitable for clinical application in Chinese Han's population with a greater precision than serology. It may replace the serology in future after being improved and perfected.
4.Effect of potato homogenate on the treatment of drug extravasation caused by intravenous injection
Ou SUN ; Yanhong ZHANG ; Ling FANG ; Hong GUAN ; Liyan SHA
Chinese Journal of Practical Nursing 2012;(34):37-38
Objective To explore the treatment effect of potato homogenate on the treatment of drug extravasation during intravenous injection.Methods 320 cases of drug extravasation patients during the intravenous infusion were randomly divided into the potato homogenategroup,named group A; patato slice group named group B and magnesium sulfate group as group C.The group A,B and C were separately treated with the external application of potato homogenate,thin slice of fresh potato and 33% magnesium sulfate.The therapeutic effects of the 3 groups were compared.Results The therapeutic effect of group A was superior to that of group B and C,and the healing time in group A was much shorter than that in group B and C,and group B was batter than group C,there was significant difference between the above comparison groups.Conclusions The therapeutic effect of external application of fresh potato in the treatment of extravasation injury caused by the drugs is remarkable.Potato homogenate can improve the treatment effect and shorten healing time when compared with potato slice.
5.Changes in expression of acid-sensing ion channel 3 in dorsal root ganglion in a rat model of bone cancer pain
Fang QIU ; Weixiu YUAN ; Weidong MI ; Xiaoli WEI ; Yanhong LIU
Chinese Journal of Anesthesiology 2012;(10):1214-1217
Objective To investigate the changes in the expression of acid-sensing ion channel 3 (ASIC3)in the dorsal root ganglion (DRG) in a rat model of bone cancer pain.Methods Twenty-four female Sprague-Dawley rats,aged 3-4 weeks,weighing 180-220 g,were randomized into 2 groups:sham operation group (group S,n =8) and bone cancer pain group (group P,n =16).Bone cancer pain was induced by inoculating Walker 256 carcinoma cells into the medullary cavity of the left tibia,while group S received normal saline instead.The pain threshold was measured after determination of body weight on the day of inoculation (T0) and on 1,3,5,7,9,11 and 14 days after inoculation (T1-7).The tibia was removed for microscopic examination of the inoculated tibia and X-ray examination.The growth of tumor cells and damage to the tibia were observed.The expression of ASIC3 in the DRG was detected using immunofluorescence.Results The tumor cell infiltration occurred in the medullary cavity and bone destruction was observed in P group.Compared with S group,the body weight was decreased at T3-T7,and the pain threshold was decreased at T4-T7,and the expression of ASIC3 in the DRG was upregulated at T7 in P group (P < 0.05).Conclusion ASIC3 protein expression in DRG is significantly up-regulated in the rats with bone cancer pain,suggesting that the pathway may be involved in the mechanism of bone cancer pain.
6.Changes in expression of acid-sensing ion channel 3 in dorsal root ganglion in a rat model of bone cancer
Fang QIU ; Weixiu YUAN ; Weidong MI ; Xiaoli WEI ; Yanhong LIU
Chinese Journal of Anesthesiology 2012;32(5):566-568
Objective To investigate the changes in the expression of acid-sensing ion channel 3(ASIC3)in the dorsal root ganglion(DRG)in a rat model of bone cancer pain.Methods Twenty-four female SD rats,aged 3-4 yr,weighing 180-220 g,were randomly divided into 2 groups:sham operation group(group S,n =8)and bone cancer pain group(group P,n =16).Bone cancer pain was induced by intra-tibial inoculation of 10 μl Walker 256 cancer cell suspension in group P,while group S received intra-tibial inoculation of 5 μl normal saline.Body weight and paw withdrawal threshold to mechanical stimulation with yon Frey filaments(MWT)were measured at 0,1,3,5,7,9,1 1 and 14 d after cancer cell inoculation.The tibia was removed at 14 d after cancer cell inoculation in group S and at 7 and 14 d after cancer cell inoculation in group P for pathological and imaging examinations.The tumor cell growth and bony destruction were observed.The expression of ASIC3 in the DRG was determined by immunolluorescence.Results Pathological damage occurred at 14 d after cancer cell inoculation,bony destruction was observed obviously,ant cortical bone was missing in many places.Compared with group S,body weight at T3-7 and MWT al T2-7:were significantly decreaed,and the expression of ASIC3 was up-regulated at 14 d after cancer cell inoculation in group P(P < 0.05).Conclusion Up-regulation of the expression of ASIC3 in the DRG is involved in the developntent and maiutenence ot bone cancer pain in rars.
7.Efficacy of gabapentin for prevention of post-thoracotomy pain syndrome
Shuang FU ; Jun FANG ; Huidan ZHOU ; Yanhong LIAN ; Pisheng QU
Chinese Journal of Anesthesiology 2014;34(2):161-163
Objective To evaluate the efficacy of gabapentin for prevention of post-thoracotomy pain syndrome (PTPS).Methods Sixty-nine ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 46-69 yr,weighing 47-78 kg,scheduled for elective resection for lung cancer under general anesthesia combined with epidural block,were randomly divided into 2 groups using a random number table:group A (n =36) and group B (n =33).In group A,gabapentin 300 mg was given orally at 2 h before operation and gabapentin 100 mg was given orally three times a day from 1st day after operation until 10th day after operation.Group B received placebo instead of gabapentin.Epidural blockade with ropivacaine and sufentanil was performed before induction of anesthesia and the level of block was controlled at T4-10.Patient-controlled epidural analgesia (PCEA) was performed within 3 days after operation and VAS scores were maintained ≤ 3.The development of pain (numeric rating scale score > 4) within 6 months after operation and the duration were recorded.The consumption of propofol and remifentanil during operation and the number of attempts for PCEA after operation were recorded.The adverse reactions such as postoperative drowsiness,dizziness,fatigue were also recorded.Results Compared with B group,the incidence of pain within 6 months after operation was significantly decreased,the duration of pain was shortened (P < 0.05),and no significant changes were found in the consumption of propofol and remifentanil during operation and the number of attempts for PCEA after operation in A group (P > 0.05).No adverse reactions developed in group B.Mild dizziness and fatigue occurred in 2 patients in group A.Conclusion Gabapentin (continuous application at 2 h before operation and 10 days after operation) can reduce the development of PTPS in patients with no obvious adverse reactions.
8.Molecular cloning and alternative splicing analysis of hepatoma associated gene HTA
Yanhong LIU ; Yanjie ZHAO ; Shujuan FANG ; Yuehui LI ; Guancheng LI
Journal of Central South University(Medical Sciences) 2013;38(9):869-875
Objective:To obtain the full length cDNA sequences of hepatoma associated gene HTA, analyze its alternative splicing, detect the expression pattern of 2 HTA gene transcripts in different hepatic cell lines, and to establish a base for further study of HTA gene function in hepatocellular carcinoma (HCC) occurence and development. Methods:The full length cDNA of HTA gene was cloned by rapid amplification of cDNA 3' ends (3'-RACE), rapid ampliifcation of cDNA 5' ends (5'-RACE) and DNA sequencing. The gene structure and alternative splicing were analysed. Northern blot assay was performed to detect the expression pattern of 2 HTA gene transcripts in different hepatic cell lines. Results:The full length of HTA gene was 1414 bp, composed of 3 exons and 2 introns, and the second intron could be retained in mRNA. Northern blot assay showed that 2 transcripts of HTA mRNA(1.4 kb and 1.7 kb) could express in the HCC cell lines HepG2 and QGY-7703, but not in the non-malignant cell line L-02 and HUVEC. The expression level of 1.4 kb transcript was much higher than 1.7 kb one. Conclusion:This study successfully has obtained the full length cDNA of HTA gene, and analysed the gene sequence and alternative splicing, 2 transcripts of HTA mRNA specifically expressed in HCC cell lines. As a hepatoma associated gene, HTA deserves further investigation.
9.Effect of hypercapnia on cerebral oxygen metabolism under propofol anesthesia during one-lung ventilation
Huifang JIANG ; Jun FANG ; Yanhong LIAN ; Huidan ZHOU
Chinese Journal of Anesthesiology 2013;33(9):1059-1061
Objective To investigate the effect of hypercapnia on cerebral oxygen metabolism under propofol anesthesia during one-lung ventilation (OLV) in patients.Methods Forty ASA physical status [or Ⅱ patients,aged 53-63 yr,scheduled for elective lobectomy performed via video-assisted thoracoscope,were enrolled in the study.Anesthesia was induced with iv injection of midazolam,fentanyl and vecuronium and target-controlled infusion of propofol and maintained with target-controlled infusion of propofol and intermittent iv boluses of fentanyl and vecuronium.BIS value was maintained at 40-60 during surgery.At 15 min of OLV,hypercapnia was performed and PaCO2 was maintained at 50-55 mm Hg lasting for 15 min,and then respiratory rate was adjusted to maintain PaCO2 at 40-45 mm Hg.Immediately before OLV (T0),at 15 min of OLV and hypercapnia (T1,2),and at 15 min after the end of hypercapnia (T3),arterial and jugular bulb venous blood samples were obtained for determination of arterial partial pressure of oxygen (PaO2),arterial oxygen saturation (SaO2),jugular bulb venous oxygen partial pressure (PjO2) and hemoglobin saturation (SjO2).The arterial to venous oxygen content difference (Da-jO2) and cerebral extraction rate of oxygen (CERO2) were calculated.Results SaO2 and PaO2 at T1-3,SjO2 and PjO2 at T1 and T3 and Da-jO2 at T2 were significantly lower and CERO2 at T1 and T3 was higher than those at T0 (P < 0.05).SjO2 and PjO2 were significantly increased and Da-jO2 and CERO2 were significantly decreased at T2(P <0.05) and no significant changes were found in the parameters of cerebral oxygen metabolism at T3 as compared with those at T1 (P > 0.05).Conclusion Hypercapnia can improve cerebral oxygen metabolism under propofol anesthesia during OLV in patients.
10.The role of iterative reconstruction in CT angiography of carotid artery into cranial segment
Fang WANF ; Lili YANG ; Ruoshui HA ; Yanhong ZHAO ; Jinhua WU
Chinese Journal of Radiology 2013;47(11):975-979
Objective To explore the role of 256 CT iterative reconstruction in improving image quality and reducing radiation dose of carotid artery into cranial segment.Methods Sixty patients underwent head and neck CTA on a 256 CT scanner.Conventional dose scanning was performed in 30 patients using a filtered back projection (FBP) reconstruction (group A) and iterative iDose4 reconstruction (group B).Low dose scanning was performed in the other 30 patients using FBP reconstruction (group C) and iDose4 reconstruction (group D).The noise,SNR,CNR,score of image quality and effective radiation dose were evaluated in four groups.One-way ANOVA was used to analyze the image quality index between groups.Independent sample of Kruskal-Wallis test of ranked data was used to compare image quality score between groups.Paired t test was used to compare the effective radiation doses between the low dose group and conventional dose group.Results The image noise of four groups were 8.21 ±0.88,7.31 ± 0.33,11.17 ± 2.02 and 6.50 ± 0.49 respectively.SNR were 43.21 ± 4.49,5 1.83 ± 3.64,42.88 ± 9.19 and 53.47 ± 4.88,respectively.CNR were 37.88 ± 4.02,61.21 ± 6.31,36.63 ± 8.20 and 62.99 ±5.90,respectively.There were statistic differences (F =112.786,97.041 and 86.098,P <0.01).The differences of image noise between group A and B had no statistic significance,which was statistic different between group A and C (P < 0.01).Except that the differences of SNR and CNR between group A and C,B and D had no statistic significance,the differences between other two groups had statistic significance (P < 0.01).In case of image quality score of 1,2 and 3,there were 2,13 and 15 patients in group A; 0,7 and 23 patients in group B; 5,15 and 10 patients in group C; and 0,5 and 25 patients in group D.There was statistic differences of image quality score between each group (H =22.575,P <0.01).The effective radiation dose was (2.31 ±0.13) mSv in conventional dose group and (0.84 ±0.04) mSv in low dose group.There was statistic difference between the two groups (t =60.682,P < 0.05).Conclusion Compared with conventional dose,iDose4 iterative reconstruction algorithms can obtain excellent images of CTA for carotid artery into the cranial segment with more than 50% radiation dose decrease.