1.Evaluation of the effects of intravenous anesthesia with propofol and fentanyl on flexible fiberoptic bronchoscopy
Chinese Journal of Postgraduates of Medicine 2010;33(9):27-29
Objective To evaluate the effects of intravenous anesthesia with propofol and fentanyl on flexible fiberoptic bronchoscopy (FFB).Methods Forty ASA Ⅰ - Ⅱ patients undergoing elective FFB were randomly divided into two groups (20 cases in each group): control group and intravenous anesthesia group.All patients received airway local topical anesthesia with 2% lidocaine before the procedure.The patients in intravenous anesthesia group received propofol 1.5 mg/kg and fentanyl 1 μ g/kg intravenous injection for induction while in control group normal saline was given instead.Supplemental oxygen was administered by the endoscopy face mask.The mean arterial pressure (MAP),heart rate (HR)and pulse oxygen saturation (SpO_2) were continuously monitored and recorded before induction of anesthesia (T_1, baseline), 1 min after intravenous injection (T_2) ,immediately and 3 min after intubation (T_3,T_4),after FFB (T_5).The persistence time of the procedure was noted.When the patients responded to commands exactly, the recovery time was recorded.All patients were interviewed for the global tolerance to the procedure, the acceptance of another fiberoptic bronchoscopy and the degree of amnesia.Results All of the 40 patients finished FFB successfully.VAS postoperation and dependence scores were lower in intravenous anesthesia group than those in contrel group[(1±2),(2±3) scores and (7±1),(7±3) scores](P< 0.05).MAP and HR at T_3, T_4 and T_5 were significantly increased compared with baseline values at T_1 in control group (P <0.05).MAP and HR at T_2 was lower than those at T_1,HR at T_3 was higher than that at T_1 in intravenous anesthesia group (P < 0.05 ).Compared with control group, MAP and HR at T_3, T_4 and Ts were lower, HB at T_2 was lower in intravenous anesthesia group (P < 0.05).There was no awareness during the FFB in intravenous anesthesia group.Conclusion Intravenous anesthesia with propofol and fentanyl is safe and effective for FFB.
2.Effects of ropivacaine combined with sulfentanyl in epidural anesthesia for caesarean section
Chinese Journal of Postgraduates of Medicine 2009;32(24):13-15
Objective To assess the effects and side effects of ropivacaine combined with sulfentanyl in epidural anesthesia for caesarean section. Methods Two hundred ASA Ⅰ- Ⅱ patients scheduled for elective caesarean section were randomly divided into 2 groups (100 cases each):group S received 0.75% ropivacaine and 0.75 μg/ml sulfentanyl; and group R received 0.75 % ropivacaine. Epidural space L2-3 was punctured and the catheter was put upward 3 cm in all patients. Local anesthetic agents were administered until a complete sensory block was established extending upper T4-T6. In the operation, Bp, HR,SpO2, ECG were observed and the onset time, the upper spread and duration of sensory block were recorded.Assessed anesthetic efficacy and side-effects on newborn. Results The onset time [(4.5±1.2) min], the time needed to reach the highest sensory level [ ( 13±5) min ] were significantly shorter and the duration of sensory block [ (402±150 ) min ] was significantly longer in group S than those in group R (P < 0.05 ). There was no significant difference in the side effects such as tachycardia, nausea, vomiting, and shivering. Apgar score in newborn was not affected. Conclusion The anesthetic efficacy of epidural 0.75% ropivacaine is significantly enhanced which also has smaller local anesthetic requirements and low incidence of side-effects,in epidural anesthesia for caesarean section when sulfentanyl is added.
3.The role of nuclear factor kappa B in neural stem cells
Journal of Medical Postgraduates 2004;0(01):-
Nuclear factor kappa B(NF-?B) is a pleiotropic nuclear transcriptive factor widely expressed in the nervous system.Recently,studies have demonstrated that NF-?B is also expressed in neural stem cells and may play an important role in their proliferation,migration and differentiation.This article reviews the recent advances in this new research field.
4.Oxygenation and pulmonary hemodynamics during one-lung with Bain circuit ventilation in canine
Chuanhan ZHANG ; Peng WANG ; Xianwei ZHANG
Chinese Journal of Anesthesiology 1995;0(02):-
To observe the oxygenation and pulmonary hemodynamic variation of one-lung ventilation (OLV) with Bain circuit in canine. Method:To use oxygen insufflation into the upper nonventilated lung with or with out Bain circuit during OLV fifteen dogs was studied in comparison with two-lung ventilation (TLV). Result: In the OLV dog without Bain circuit PaO_2 and SaO_2 significantly decreased, A-aDO_2, CcO_2- CaO_2 and Qs/Qt increased markedly(P
5.The Effect of Fentanyl on Proliferation and Cell Cycle of Human Breast Carcinoma Cell Line MCF-7
Xianwei ZHANG ; Hanlin DING ; Chuanhan ZHANG
Journal of Chinese Physician 2001;0(01):-
Objective To study the effects and its mechanism of fentanyl(Fen) on the proliferation and cell cycle of human breast carcinoma line MCF-7. Methods MCF-7 cells were cultured in the medium with Fen, naloxone(Nx) or both the medicines at different concentration for different time. MTT method was employed to evaluate the level of the cell proliferation. The distribution of the cell cycle was detected with the flow cytometry (FCM). The expression levels of p53 and p21/WAF1 in the cells were determined by SP immunocytochemical staining method. Results Fen at≥0.1?mol/L concentration inhibited MCF-7 cells proliferation in dose- and time-dependent manners, and its IC 50 for 72h was 0.81?0.02 ?mol/L. However, the antiprolifeative effect of Fen was not antagonized by Nx. Fen significantly enhanced the ratio of G 0/G 1 phase MCF-7 cells, and decreased the proliferation index of MCF-7 cells in dose-dependent manner. Fen also upregulated the expression of p53 and p21/WAF1 in MCF-7 cells. Conclusion The data suggested that the inhibitory effect of Fen on MCF-7 cell growth might be mediated by blocking cell cycle progression from G 1 to S phase, and upregulating the expression of p53 and p21/WAF1.
6.Change in the expression of excitatory amino acid transporter 3 in the spinal cord neurons in a rat model of chronic morphine-tolerance
Lingli GUI ; Li WAN ; Chuanhan ZHANG
Chinese Journal of Anesthesiology 2010;30(1):60-63
Objective To investigate the change in the expression of excitatory amino acid transporter 3 (EAAT3) in the spinal cord neurons in a rat model of chronic morphine tolerance. Methods Forty-five male SD rats were randomly divided into 5 groups ( n = 9 each) : group I sham operation (group S); group II normal saline (group NS); group Ⅰ morphine (group M); group Ⅳ ketamine (group K) and groupV M + K. In group II - V a catheter was placed in the subarachnoid space at L_(3-5) interspace. The animals were observed for 3 days. The animals with motor or sensory paralysis of the hindlimbs were excluded. NS 40 μl,morphine 20 μg, ketamine 30μg,morphine 20μg + ketamine 30μg were injected via intrathecal catheter twice a day for 7 consecutive days. 50% paw withdrawal threshold and latency (PWT, PWL) of the hindpaw to radiant heat were measured before (T_0, baseline) , on day 1, 3, 5, 7 of (T_(1-4)) and 1 day after (T_5 ) IT drug administration. The rats were sacrificed after last pain threshold measurement. The expression of EAAT3 protein in the spinal cord was determined by Western blotting and immuno-histochemistry. Results The sensitivity of the hindpaw to noxious heat stimulation was significantly decreased during (T_(1,2)) and increased after IT administration (T_(4,5)) in group M and was significantly decreased during and after FT administration (T_(1-5)) in group M + K as compared with the baseline values at T_0 and group S and was significant lower in group M + K than in group M. The expression of EAAT3 protein in the spinal cord was significantly decreased in group M and M + K as compared with group S and was significantly lower in group M than in group M + K. Conclusion The down-regulation of the expression of EAAT3 in the spinal dorsal horn neurons is involved in the development of chronic morphine tolerance and the expression of EAAT3 is down-regulated by morphine partly through the activation of NMDA receptor.
7.Effect of hemodilution with different plasma substitutes on expression of tumor necrosis factor-? and interteuldnL-1 in brain after global cerebral ischemia-reperfusion in rats
Zhen WU ; Yuke TIAN ; Chuanhan ZHANG
Chinese Journal of Anesthesiology 1995;0(02):-
Objective To investigate the effect of hemodilution with different plasma substitutes on the expression of tumor necrosis factor-? (TNF-?) and interleukin-1 (IL-1 ) in brain tissue after global cerebral ischemia-reperfusion (I/R) in rats.Methods 116 male Wistar rats weighing 230-280 g were randomly divided into 4 groups: group S ( n = 20) sham operation; group Ⅰ ( n = 32) I/R; group H (n = 32) I/R + hemodilution with 6% hydroxyethyl starch (HAES, 200/0.5) and group G ( n = 32) I/R + hemodilution with gelatine solution. Group Ⅰ, H and G were further divided into 4 equal subgroups with 8 animals in each subgroup according to the duration of reperfusion: 1, 3, 6, 12 h. Global cerebral ischemia was produced by permanent occlusion of bilateral vertebral arteries and cross-clamping of bilateral common carotid arteries for 10 min. The clamping was then released for reperfusion. Global cerebral ischemia was confirmed by coma, loss of righting reflex, bilateral pupil dilation and loss of pain sensation. In group H and G acute hemodilution was performed at 10 min after the beginning of reperfusion. 1 ml? 100 g-1 of blood was removed from the right femoral artery and equal volume of plasma substitute was infused into left femoral vein simultaneously within 5 min. Hematocrit was checked before and after hemodilution. The animals were decapitated after being reperfused for different periods of time as planned and the brains were immediately removed. MTT bioassay and radioimmunoassay techniques were used to determine the IL-1 activity and TNF-? content of the brain tissue respectively. Results The IL-1 and TNF-? levels of brain tissue at 1, 3, 6, 12 h after reperfusion was started were significantly higher in group Ⅰ, H and G than in group S (P
8.Effect of lobe bronchus blockade on intrapulmonary shunt during radical esophagus cancer resection
Chuanhan ZHANG ; Zhaojun CHEN ; Peng WANG
Chinese Journal of Anesthesiology 1995;0(02):-
Objective To evaluate the effect of lobe bronchus blockade with a branchial blocker on intrapulmonary shunt during radical esophagus cancer resection. Methods Twenty four ASA Ⅰ-Ⅲ patients with normal lung function aged 18-69 yrs undergoing elective radical esophagus cancer resection were randomized into 2 groups ( n = 12 each): group A one-lung ventilation (OLV) and group B lobe bronchus blockode. Radial artery and right internal jugular vein were cannulated for BP and CVP monitoring and blood sampling. Anesthesia was induced with midazolam 50 ?g?kg-1, fentanyl 4 ?g?kg-1, propofol 2 mg?kg-1 and vecuronium 0.1 mg?kg-1. In group A double-lumen tube (DLT) was used while in group B a single lumen endotracheal tube was placed first, then a bronchial blocker was inserted fiberoptically into the bronchus of lower lobe of the operated side. The patients were mechanically ventilated (FiO2= 100%, VT = 8 ml?kg-1 , RR = 10-15 bpm, I: E = 1:2). PaCO2 was maintained at 30-35 mm Hg. Anesthesia was maintained with 1.5%-2.0% isoflurane and intermittent Ⅳ boluses of fentanyl and vecuronium. BP, HR, CVP, SpO2, PETCO2 and airway pressure were monitored during operation. Blood samples were taken simultaneously from radial artery and central vein for blood gas analysis before induction of anesthesia when the patients were lying supine and breathing spontaneously (T0), after the lungs on both sides were ventilated for 30 min in lateral position (T1) and 30 min after OLV (group A) or lower lobe bronchus was blocked off (group B) in lateral position (T2). Qs/Qt was calculated (blood from central vein was used instead of mixed venous blood from pulmonary artery) . Blood concentrations of TXB2 and 6-k-PGF1 were determined by radioimmunoassay at T0, T1 and T2. Results There was no significant difference in demographic data between the two groups. At T2 the airway pressure in group A was significantly higher than that in group B. At T2 PaO2 was significantly higher in group B than in group A. Qs/Qt was significantly increased at T1 and T2 as compared to the baselines in both groups. Qs/Qt was significantly increased at T2 compared to that at T1 in group A only, while there was no significant difference between Qs/Qt at T1 and T2 in group B. The TXB2 concentration at T2 was significantly increased as compared to that at T0 and T1 in group A and was significantly higher than that at T2 in group B. Conclusion Lower lobe bronchus blockade was superior to OLV in terms of Qs/Qt and PaO2 during esophagus cancer resection.
9.Effects of desflurane and propofol on systemic oxygenation in patients undergoing one-lung ventilation during video-assisted thoracoscopic surgery
Cheng LIU ; Chuanhan ZHANG ; Biyun ZHOU
Chinese Journal of Anesthesiology 1994;0(06):-
Objective To compare the effects of desflurane and propofol on systemic hemodynamics and arterial oxygenation undergoing one-lung ventilation (OLV) during video-assisted thoracoscopic surgery (VATS)Methods Twenty patients,ASA physical status Ⅱ or Ⅲ, scheduled for elective VATS undergoing OLV , were prospectively randomized into two groups : desflurane group(group D,n=10) and propofol group (group P,n=10) Anesthesia was induced with intravenous propofol 2mg?kg -1(group P) or thiopental 5 mg?kg -1( group D) combined with intravenous fentanyl 4?g?kg -1 ,vecuronium 01mg?kg -1 and succinylcholine 100mg , and was maintained with infusion of propofol at rate of 2-8 mg? kg -1?h -1 (group P) or inhalation of desflurane 2%-4% (group D) The Carlen double-lumen endobronchial tube was intubated to ventilated mechanically with 100% oxygen MAP and HR were monitored during the entire procedures, and blood gas analysis was made before operation, 30 min following two-lung ventilation, 30 min and 60 min following OLV in both groups,respectively Results PaO 2 were decreased significantly following OLV in both groups(P005)Conclusions Desflurane can be used as safely as propofol with one-lung ventilation during video-assisted thoracoscopic surgery
10.Effects of on-pump and off-pump coronary revascularization on renal function
Dongji HAN ; Ailin LUO ; Yi ZHANG ; Chuanhan ZHANG
Chinese Journal of Postgraduates of Medicine 2006;0(20):-
Objective To investigate the effects of on-pump and off-pump coronary revascularization on renal function.Methods Twenty four patients underwent elective coronary revascularization were divided into 2 groups: group A with cardiopulmonary bypass(CPB)(n=12) and group B without CPB(n=12).Markers of glomerular and tubular function were evaluated before anesthesia(T_0),at the end of operation(T_1),2 hours after operation(T_2) and 24 hours after operation(T_3).Results The ratio of urinary microalbumin to creatinine and NAG levels increased significantly at T_1 as compared with that at T_0 in on-pump coronary revascularization(P