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.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.
3.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.
4.Optimum dose of oxycodone inhibiting responses to tracheal intubation with a double-lumen endobronchial tube in patients undergoing one-lung ventilation
Huifang JIANG ; Yanhong LIAN ; Huidan ZHOU ; Jun FANG
Chinese Journal of Anesthesiology 2015;35(9):1104-1106
Objective To determine the optimum dose of oxycodone inhibiting responses to tracheal intubation with a double-lumen endobronchial tube in patients undergoing one-lung ventilation (OLV).Methods Sixty adult patients aged 55-64 yr, weighing 60-80 kg, with American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective thoracic surgery requiring OLV, were randomly divided into 3 different doses of oxycodone groups (O1-3 groups, n =20 each).Anesthesia was induced with iv midazolam 0.05 mg/kg, oxycodone 0.30, 0.35 and 0.40 mg/kg (O1.3 groups, respectively) , propofol 1.5 mg/kg and rocuronium 0.9 mg/kg.The patients were tracheally intubated using a double-lumen endobronchial tube and mechanically ventilated.Before anesthesia induction (T0) , immediately before and after intubation (T1,2) , and 1 and 5 min after intubation (T3.4) , arterial blood samples were taken to determine the concentrations of serum norepinephrine (NE) and epinephrine (E) using high-performance liquid chromatography.The occurrence of bucking, body movement, hypertension, and tachycardia were observed.Results The concentrations of serum NE and E were significantly increased at T2,3 than at T1 in group O1 (P<0.05).Compared with group O1 , the concentrations of serum NE and E were significantly decreased at T2,3 , and the incidence of bucking, body movement, hypertension, and tachycardia was decreased in O2 and O3 groups (P<0.05).There was no significant difference in the parameters mentioned above between O2 and O3 groups (P > 0.05).Conclusion The optimum dose of oxycodone inhibiting responses to tracheal intubation with a double-lumen endobronchial tube is 0.35 mg/kg in patients undergoing OLV.
5.Ameliorating effect of tannic acid on high glucose or AGEs induced oxidative stress and micro-inflammatory state in glomerular mesangial cells
Haifeng WEI ; Cai LI ; Yanqiu FANG ; Yanhong WEI ; Yan TAN
Journal of Jilin University(Medicine Edition) 2014;(5):1007-1012
Objective To investigate the effect of tannic acid on glomerular mesangial cells (GMC),and to clarify the mechanism of tannic acid in improving the pathological changes of diabetic nephropathy (DN)from the aspect of oxidative stress and micro-inflammation. Methods The glomerular mesangial cells were treated with glucose (30 mmol·L-1 )or advanced glycosylation end-products (AGEs)bovine serum albumin(BSA)(250 mg·L-1 )and then different concentrations of tannic acid (10,20,40 and 80μmol·L-1 )were added into the GMC.The cells cultured by normal glucose or treated with BSA were used as control groups and then the level of malonic dialdehyde (MDA), glutathione peroxidase (GSH-Px ), superoxide Dismutase (SOD ), CAT (Catalase ) activities and 8-hydroxy-2′-deoxyguanosine(8-OHdG)levels in the culture supernatant 48 h after culture were determined by colorimetry and ELISA method. The expressions of intercellular cell adhesion molecule-1 (ICAM-1 ) protein, monocyte chemotactic protein 1 (MCP-1 ) and ICAM-1 mRNA in GMC were detected by immunohistochemical staining and RT-PCR method.Results Compared with high glucose and AGEs groups,the MDA levels in tannic acid groups were reduced significantly(P<0.05);the activities of GSH-Px,SOD and CAT were increased significantly(P<0.05 or P<0.01);the 8-OHdG levels in annic acid groups were significantly reduced (P<0.05). Compared with high glucose and AGEs groups,the expressions levels of ICAM-1 protein in 40 and 80μmol· L-1 tannic acid groups were decreased (P<0.05 ). The mRNA expressions levels of MCP-1 and ICAM-1 were significantly lower than those in high glucose group (P<0.01 ).Conclusion Tannic acid could protect GMC against the damage of oxidative and inflammatory mediators,thereby delaying and improving the glomerular lesions of DN.
6.The expression of protection of telomeres 1 in acute myeloid leukemia and its significance
Fang YE ; Ruixia MA ; Zhenhua QIAO ; Yanhong TAN ; Jie WANG
Journal of Leukemia & Lymphoma 2016;25(3):169-173
Objective To analyze the relationship between the expression of protection of telomeres 1 (POT1) and the pathogenesis of acute myeloid leukemia (AML). Methods 62 patients with de novo AML (case group) and 10 patients with iron deficiency anemia (control group) were enrolled in this study. The quantitative real-time polymerase chain reaction (PCR) and Western blot were used to detect the expression of POT1 in AML patients. Results There were 62 de novo AML patients, including 2 cases M1, 14 cases M2, 12 cases M3, 14 cases M4, 17 cases M5, 2 cases M6 and 1 case AML without classification. According to the risk stratification, high risk group (24 cases), medium risk group (22 cases) and low risk group (16 cases) were divided. Compared with that in the controls, POT1 expression levels in patients with AML were significantly decreased both in mRNA and protein level (P< 0.05). The relative expression levels of POT1 mRNA and protein in patients with M2, M4 and M5 were significantly lower than those in the controls (P< 0.05). The expression levels of POT1 in high risk group, medium risk group and low risk group were significantly decreased than those in the controls (P<0.05). Compared with that in the controls, The relative POT1 mRNA expression was significantly decreased in M3 patients (P< 0.05), but not in protein level. POT1 protein expression was showed both in the cytoplasm and nucleus. There was no significant difference of the expression of POT1 protein between cytoplasm and nucleus (P> 0.05). Conclusions POT1 may be involved in the pathogenesis of AML. POT1 protein expresses in both cytoplasm and nucleus, and the regulatory mechanism may be related to the telomere length.
7.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.
8.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.
9.Relationship between apolipoprotein E gene polymorphism and cerebral infarction patients with different gender and etiological typing
Yanhong ZHANG ; Lei ZHU ; Dejun ZHENG ; Jinyao PAN ; Jianzhi FANG
Chinese Journal of Cerebrovascular Diseases 2014;(6):305-310
Objective To investigate the relationship between apolipoprotein E ( ApoE ) gene polymorphism and cerebral infarction patients with different gender and etiological typing. Methods A total of 91 patients with cerebral infarction aged≥60 years ( cerebral infarction group) were enrolled. They were divided into either a large artery atherosclerotic (LAA) stroke group (n=37) or a small artery occlusion (SAO) stroke group (n=54) according to the Trial of Org 10172 in acute stroke treatment (TOAST) classification. A total of 105 age-,sex-,and residence-matched healthy subjects were enrolled as controls. A Nested Allele-Specific Multiplex Polymerase Chain Reaction Method was used to detect the ApoE gene polymorphism. The ApoE gene polymorphism of cerebral infarction of different gender and etiological typing were compared. Results ( 1 ) ApoE Genotypes of E2/2, E2/3, E2/4, E3/3, and E3/4 were detected,but the ApoE E4/4 was not detected. (2) There were no significant differences in the frequencies of ApoE genotypes and each gene carrier frequency between the cerebral infarction group and the control group (all P>0. 05). There was significant difference in ApoE genotype frequencies and each gene carrier frequency of the males between the cerebral infarction group and the control group (P<0. 01,P<0. 05). Both the E3/3 genotype frequency (56. 1%) and ε3 carrier frequency (78. 0%) of the cerebral infarction group were lower than the males of the control group ( 79. 2% and 89. 6% respectively );both the E3/4 genotype frequency (31. 7%) and ε4 carrier frequency (15. 9%) were higher than the control group (7. 5% and 3. 8%respectively). There was no significant differences in the ApoE genotype frequency and gene carrier frequency in female participants between the two groups (all P>0. 05). (3) There were no significant differences in the ApoE genotype frequency and gene carrier frequency among the LAA,SAO,and control groups. There was significant difference in the ApoE genotype frequency and gene carrier frequency in males between the LAA group and the control group (P>0. 01);the genotype frequencies of E2/3 and E3/E3 (6. 7% and 46. 7%),ε2,as well as theε3 carrier frequency (3. 3% and 73. 3%) of LAA were lower than those of the control group (13. 2%,79. 2%,6. 6%,and 89. 6%,respectively);the E3/4 genotype frequency andε4 carrier frequency of the LAA subtype were 46. 7% and 23. 3% respectively. They were all higher than 7. 5% and 3. 8% in the control group. However,there were no significant differences in males among the SAO group,the control group,and the 3 groups of females ( the LAA subtype,SAO subtypes,and the control group) (P>0. 05). Conclusion ε4 gene may be a risk factor for LAA in males. The association of ApoE gene polymorphism with cerebral infarction in females is not found.
10.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.