1.Effects of Dexmedetomidine Hydrochloride Injection on Elderly Patients Underwent Thoracic Surgery dur-ing Anesthesia Recovery Period
China Pharmacy 2017;28(11):1523-1525
OBJECTIVE:To investigate the effects of Dexmedetomidine hydrochloride injection on elderly patients underwent thoracic surgery during anesthesia recovery period. METHODS:Totally 60 elderly patients underwent thoracic surgery in our hospi-tal during Jun. 2014-Feb. 2016 were selected as research objects and then divided into control group and observation group ac-cording to even and odd-numbered admission order,with 30 cases in each group. Control group was given Propofol injection 0.5-1 mg/kg intravenously 5 min after mask oxygen inhalation. Observation group was given Dexmedetomidine hydrochloride injec-tion 0.5-1.0 μg/kg intravenously. Both group were successively given Etomidate emulsion injection 0.1-0.2 mg/kg,Sufentanil citrate injection 0.3 μg/kg and Cisatracurium besilate for injection 0.2 mg/kg intravenously for anesthesia induction;tracheal intubation was performed and ventilator was used to assist ventilation after anesthesia induction. And then control group was given continuous intravenous dripping of propofol 3-6 mg/kg·h;observation group was given continuous intravenous dripping of Dexmedetomidine hydrochloride injection 0.2-0.5 μg/(kg·h). At the same time,both group were given continuous intravenous dripping of sufentanil 0.1-0.2 μg/(kg·min)and cis-atracurium 1.5-2 μg/(kg·min),and continuously inhaled 1%-2% sevoflurane for anesthesia mainte-nance. Hemodynamic index(HR,MAP,SpO2),postoperative recovery,the occurrence of delirium,restlessness,cough and involun-tary movement were observed in 2 groups before surgery (T0),after anesthesia induction (T1),at the moment of sputum suction and extubation(T2),5 min after extubation(T3),30 min after extubation(T4). RESULTS:At T2 and T3,HR and MAP of control group were increased significantly compared to at T0,T1,and higher than those of observation group,with statistical significance (P<0.05). At T0,T1,T4,there was no statistical significance in HR and MAP between 2 groups (P>0.05). At T0,T1,T2,T3, T4,there was no statistical significance in SpO2 level between 2 groups(P>0.05). The breathing recovery time,eye openning time and extubation time of observation group were significantly shorter than those of control group,with statistical significance (P<0.05). The incidence of postoperative restlessness,delirium,cough and involuntary movement in observation group were signifi-cantly lower than control group,with statistical significance (P<0.05). CONCLUSIONS:Dexmedetomidine hydrochloride injec-tion can keep hemodynamics stable in elderly patients underwent thoracic surgery during anesthesia recovery period.,shorten recov-ery time and reduce the occurrence of stress response as postoperative delirium,restlessness,cough,involuntary movement.
2.Influence of intra-colonic infusion of acetic acid irritation combined with chronic external bondage stress on the visceral sensitivity and mast cell state in the colon of rats
Zhaomeng ZHUANG ; Xiaoteng WANG ; Bin LV
Chinese Journal of Comparative Medicine 2014;(10):73-77
Objective The aim of this study was to explore the establishment method of an animal model of irritable bowel syndrome ( IBS) and the evaluation of this animal model.Methods 30 adult SD rats were randomly divided into two groups: acetic acid irritation and bondage stress group ( n=10 ) , bondage stress group ( n =10 ) , and normal control group ( n=10 ) .The rats of the intervention group received an intra-colonic infusion of 0.4% acetic acid irritation combined with bondage stress to establish an animal model of IBS.The colonic sensitivity of the intervention group rats was assessed by stool test and colorectal distension ( CRD) test.Hydrochloric acid toluidine blue staining was used to observe the number degranulation phenomenon of mast cells in the ileocecum.Results On the 7th day, the number of soft feces was 8 and loose stool was 4 in the model group, significantly higher than that in the bondage stress group(0 and 0) (P<0.05),and normal control group (1 and 0) (P<0.05).On the 10th day, when the AWR=2, the average rectal distension volume was 1.2 mL, significantly lower than that in the bondage stress group(1.37mL) (P <0.05),also significantly lower than in the normal control group (1.49 mL) (P<0.05), and when the AWR=4, the average rectal distension volume was 1.49 mL, significantly lower than that in the bondage stress group(1.74mL) (P<0.05),and the normal control group (1.77 mL) (P<0.05).These results indicated that the visceral sensitivity of the model group was significantly higher than that in the bondage stress group and normal control group.Histological analysis showed that the rats of all groups had no obvious inflammatory changes.Conclusions Chronic bondage stress combined with intra-colonic infusion of 0.4%acetic acid irritation can be used to increase the visceral sensitivity and amount and degranulation of mast cells in the intestinal tissue in rats.This established rat model shows pathogenetic changes resembling the pathogenesis of human irritable bowel syndrome, and provides a useful animal model for further studies of the pathogenesis of this disease.
4.A systematic review of medial and lateral pinning versus lateral entry pinning for supracondylar fractures of the humerus in children
Hanbin OUYANG ; Bin YU ; Jun XIONG ; Peng XIANG ; Zhuang CUI
Chinese Journal of Trauma 2011;27(11):979-985
Objective To systematically review the existing evidence about the effect of medial and lateral (crossed) entry pins versus only lateral entry pin fixation on the supracondylar fractures of the humerus in children.Methods Eligible studies were identified in Cochrane library,the Cochrane Bone,Joint and Muscle Trauma Group (till March 2011 ),Medline (from 1966 to March 2011 ),EMbase (from 1966 to 2011 ),CBM (from January 1979 to March 2011 ),PubMed,Wanfang Data (from 2000 to March 2011 ) and CNKI and the references of the included studies and several Chinese orthopedic journals were manually searched.Then,the randomized controlled trials (RCTs) and quasi-randomized controlled trials (CCTs) about two entries (crossed and only lateral pinning) for supracondylar fractures of humerus in children were collected.After evaluation of methodology with the enrolled studies,available data was extracted and systematic review was conducted via the method recommended by the Cochrane Collaboration.Results In total,five RCTs involving 311 patients were involved.Compared with the preoperative data,the meta-analysis results showed no significant difference in reduction stability in terms of change in Baumann angle and Carrying angle between the two groups.For the postoperative function outcome including complete reduction,Flynn grade and full return to function,no significant difference was found between the two groups.For the postoperative complications,there was no difference in the infection of pin tract,though lateral entry resulted in a significant lower incidence of the iatrogenic nerve injury compared with the medial and lateral entry.Conclusions With the Kirschner wire fixation for supracondylar fractures of humerus in children,current existing evidences indicate that the lateral entry of pinning has similar results in reduction stability,function outcome and incidence of pin tract infection compared with medial and lateral entry.Nevertheless,lateral entry,as a safe pinning technique,may effectively decrease the risk of iatrogenic nerve injury
6.Expressions of associated proteins in vascular smooth muscle cells and infiltration of macrophages in elderly abdominal aortic aneurysms
Shihong ZHUANG ; Honglian ZHOU ; Min HUANG ; Bin NIE
Chinese Journal of Geriatrics 2008;27(10):750-752
ObjectiveTo investigate the pathological characteristics of the expressions of associated proteins in vascular smooth muscle cells and infiltration of macrophages in elderly abdominal aortic aneurysms. MethodsHE stained slices, Van Gieson' s stained slices and immunohistochemical staining were applied to detect protein expression in the tissue sections of 15 cases of elderly abdominal aortic aneurysms and 6 cases of normal abdominal aorta. The protein expressions of α-smooth muscle actin, cathepsin B and CD68 were detected by immunohistochemical staining. ResultsCompared with normal abdominal aorta, the collagen content was higher in elderly abdominal aortic aneurysms [(9.3 ± 1.9) % vs. (5.3±1.8) %, P < 0.05]. The levels ofexpression of cathepsin B and CD68 were higher in elderly abdominal aortic aneurysms than those in normal abdominal aorta , but the level of expression of α-SMA was lower in elderly abdominal aorticaneurysms than that in normal abdominal aorta[(0.38±0.07) vs. (0.135=0.06), (0.51±0.12) vs.(0.01±0.01), (0.23±0.05) vs. (0.335±0.05) ,respectively, all P<0.05]. ConclusionsChanges in the expression of associated proteins in vascular smooth muscle cells and infiltration of macrophages may participate in the vascular walls destruction in elderly abdominal aortic aneurysms.
7.Clinical study of LigaSure vessel sealing system for surgery in gastroenteric cancer
Shutong ZHUANG ; Min XU ; Kai ZHENG ; Yuanzhi TANG ; Bin CHEN
Chinese Journal of Postgraduates of Medicine 2010;33(14):28-29
Objective To investigate the value of LigaSure vessel sealing system for surgery in gastroenteric cancer. Methods From January to September 2009,44 cases of gastroenteric cancer were operated by using LigaSure vessel sealing system,including 13 cases of gastric cancer, 14 cases of colon cancer, 17 cases of rectum cancer. Laparoscopy was employed in 10 cases. Results All the cases were performed successfully. The operation time was 130-250 min, the blood loss was 50-250 ml, and the number of lymph nodes resected was 4-20. None of the cases had serious complications. Conclusion As an optimal hemostatic tool, LigaSure vessel sealing system is safe and feasible for gastroenteric cancer.
8.The Clinical Application Status and Development Trends of Hydrogen Peroxide Low Temperature Plasma Sterilizers.
Min ZHUANG ; Yunxin ZHENG ; Ying CHEN ; Bin HOU ; Zitian XU
Chinese Journal of Medical Instrumentation 2016;40(1):55-57
The hydrogen peroxide low temperature plasma sterilization technology solved the problems of thermo-sensitive materials' disinfection and sterilization based on its development and unique characteristics. This paper introduced the researches of clinical application quality control, and showed the hydrogen peroxide low temperature plasma sterilizers were being widely used in hospitals and highly recognized. According to the clinical data and the literatures of the domestic equipment in preliminary application, it could be concluded that the technology maturity of domestic hydrogen peroxide low temperature plasma sterilizers was in a high level. The advantages of using domestic hydrogen peroxide low temperature plasma sterilizers to do disinfection and sterilization included lower cost, safer, faster and non-toxic, etc. Also the management system should be improved and the clinical staff should master the technical essentials, obey the procedures strictly, verify periodically and offer full monitoring to upgrade the quality of sterilization.
Cold Temperature
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instrumentation
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Hydrogen Peroxide
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chemistry
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Plasma Gases
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chemistry
9.Clinical risk factor analysis of childhood refractory Mycoplasma pneumoniae pneumonia
Yuxia MEI ; Jinjin JIANG ; Bin CAI ; Cheng ZHUANG ; Ruohua CHEN
Journal of Clinical Pediatrics 2014;(12):1138-1140
Objective To identify the clinical risk factors of refractory Mycoplasma pneumoniae pneumonia (RMPP) and their values in early diagnosis. Methods The retrospective analysis of clinical data was conducted in 142 children with Myco-plasma pneumoniae pneumonia (MPP) admitted to Changhai Hospital of Second Military Medical University from Jan. 2012 to Jan. 2014. All children were divided into two groups, RMPP group (n=112) and MPP group (n=30). The comparison was made between two groups in clinical data. The factors were analyzed by the multifactor logistic regression. Results As compared to MPP, RMPP had longer fever duration, the higher ratios of large consolidation shadows, extrapulmonary complications and in-creased CRP level (P<0.05). The results of logistic regression indicated that the clinical risk factors included large consolidation shadows (OR=6.57, 95%CI:2.10-20.56), extrapulmonary complications (OR=11.66, 95%CI:2.42-56.08) and CRP (OR=14.87, 95%CI:2.67-82.79) (P<0.01). Conclusions Large consolidation shadows, extrapulmonary complications and CRP are clinical risk factors of RMPP. CRP elevation and lung imaging changes are valuable in early diagnosis of RMPP.