1.Comparison of the effect of different methods of anesthesia on cerebral autoregulation in patients undergoing neurosurgery
Chinese Journal of Anesthesiology 2011;31(2):144-146
Objective To compare the effect of different methods of anesthesia on cerebral autoregulation in patients undergoing neurosurgery.Methods Sixty-nine ASA Ⅱ orⅢ patients with brain tumor, aged 23-62 yr, scheduled for neurosurgery under general anesthesia, were randomly divided into 3 groups ( n = 23 each) : propofol-remifentanil group (group PR), sevoflurane-remifentanil group (group SR) and propofol-sevoflurane-remifentanil group (group PSR) . Anesthesia was induced with target-controlled infusion (TCI) of propofol (target plasma concentration3 μg/ml, PR and PSR groups) or inhalation of 8% sevoflurane (group SR) and iv injection of remifentanil 1 mg/kg and atracurium 0.5 mg/kg. The patients were mechanically ventilated after tracheal intubation. PETCO2 was maintained at 32-35 mm Hg. Anesthesia was maintained with TCI of propofol (target plasma concentration 2.0-3.5 μg/ml) in group PR, with inhalation of 1.5%-2.5% sevoflurane in group SR, with TCI of propofol (target plasma concentration 1.5-3.0 μg/ml) and inhalation of 1% sevoflurane in group PSR, and with TCI of remifentanil (target plasma concentration 2.0-4.5 ng/ml) and iv infusion of atracurium at 6 μg · kg-1 · min-1 in all groups. Auditory evoked potential index was maintained between 40-45. The middle cerebral artery time-average peak flow velocity was recorded before induction (baseline) , immediately after intubation, immediately before craniotomy and at the beginning of skin suture. The unilateral carotid artery was compressed for 7 s at the corresponding time points mentioned above. The transient hyperemic response ratio (THRR) was calculated to reflect cerebral autoregulation. Results Compared with the baseline value at T0, THRR was significantly increased at T2in group PR and decreased at T2,3 in group SR (P <0.05) ,while no significant change was found in THRR at T1-3in group PSR (P >0.05). The THRR was significantly lower in SR and PSR groups than in group PR, and higher in group PSR than in group SR ( P < 0.05). Conclusion Propofol-remifentanil anesthesia can improve cerebral autoregulation, sevoflurane-remifentanil anesthesia can reduce cerebral autoregulation, and propofol-sevofluraneremifentanil anesthesia exerts no effect on cerebral autoregulation in patients undergoing neurosurgery.
2.Comparison of effects of sedation induced with propofol versus midazolam on anterior pituitary hormone in mechanically ventilated patients with traumatic brain injury
Chun MENG ; Yan ZHANG ; Yaxin WANG
Chinese Journal of Anesthesiology 2012;32(7):863-865
Objective To compare the effects of sedation induced with propofol and midazolam on anterior pituitary hormone in mechanically ventilated patients with traumatic brain injury.Methods Eighty-four patients with acute traumatic brain injury,aged 20-60 yr,weighing 50-70 kg,undergoing mechanical ventilation during sedation induced with propofol or midazolam,were randomly divided into 2 groups ( n =42 each):propofol group (group P) and midasolam group (group M).Ramsay sedation score was maintained at 2-4.In group P,propofol was continuously infused at the initial infusion rate of 1.5-6.0 mg·kg-1 ·h-1 and propofol 50 mg was injected intravenously to increase the depth of sedation when needed.In group M,midazolam was continuously infused at the initial infusion rate of 0.10-0.35 mg· kg-1· h-1 and midazolam 7.5 mg was injected intravenously to increase the depth of sedation when needed.The patients were ventilated for 70-120 h.Glasgow Coma Scale scores were assessed before sedation and Glasgow Outcome Scale scores were assessed 4 weeks after admission to the intensive care unit.Venous blood samples were collected at 24 and 72 h of sedation and 4 weeks after admission to the intensive care unit for determination of the levels of serum cortisol,thyroid-stimulating hormone,prolactin,and growth hormone by ELLSA.Results Compared with group M,the levels of serum cortisol and growth hormone were significantly decreased and the level of thyroid-stimulating hormone was significantly increased at 24 and 72 h of sedation in group P ( P < 0.05 or 0.01 ),and the parameters mentioned above were in the normal range.There was no significant difference in the serum prolactin level and outcome between the two groups (P > 0.05).Conclusion The effects of sedation induced with propofol and midazolam on anterior pituitary hormone are comparable in mechanically ventilated patients with traumatic brain injury.
3.Application of critical-care pain observation tool for the evaluation of pain in elderly patients with mechanical ventilation
Meng CHUN ; Zhang YAN ; Liang YU
Chinese Journal of Geriatrics 2011;30(12):1008-1011
ObjectiveTo assess the degree of pain in elderly patients with mechanical ventilation in ICU using critical-care pain observation tool(CPOT) and to choose the correct sedative and analgesic method.Methods 110 elderly patients in ICU after neurosurgery were divided into three assessment stages,every stage had two record points and total six points (T1-T6):the first stage (intubation and unconsciousness,T1-T2),the second stage (intubation and consciousness,T3T4 ) and the third stage(extubation and consciousness,T5-T6 ).Among them T1,T3and T5were nonnocuity assessment points of every stage,while T2,T4 and T6 were nocuity assessment points of every stage.The assessment time was one minute at every point.After recorded at every point in second and third stages,patients were asked to use the pain intensity descriptive scale (PIDS) themselves.CPOT,heart rate and mean arterial pressure (MAP) from T1 to T6 were recorded as well as PIDS from T3 to T6 in second and third stages.Results In the three stages,CPOT〔(26.8 vs.0.54,3.36 vs.1.20,2.78 vs.0.68) scores〕,HR〔(95 vs.85,94 vs.82,94 vs.84)beat/min〕 and MAP〔(95 vs.85,95 vs.87,94 vs.87)mm Hg〕 at T2,T4and T6 were higher than T1 (t=-42.89,-55.95,-55.38),T3 (t =- 5.52,- 11.33,- 11.78) and T5 ( t =- 5.54,- 9.95,- 11.33 ) ( P< 0.05 ).The PIDS at T4 and T6were higher than at T3and T5in the second and third stages 〔(2.52 vs.1.69,2.12 vs.1.44)scores〕 (P<0.05).The correlation coefficient between CPOT and PIDS at T3 and T4 in the second stage were 0.49 and 0.58,respectively (P<0.05),and between CPOT and PIDS at T5 and T6 were 0.52 and 0.59 in the third stage,respectively (P < 0.05),and they both reached moderate correlation.ConclusionsCPOT may be an effective way to assess the degree of pain in elderly patients with mechanical ventilation at present.
4.Effect of sevoflurane versus propofol on cerebral energy metabolism in patients undergoing intracranial aneurysm clipping
Yan ZHANG ; Chun MENG ; Yaxin WANG
Chinese Journal of Anesthesiology 2011;31(10):1206-1209
Objective To compare the effect of sevoflurane and propofol on cerebral metabolism in patients undergoing intracranial aneurysm clipping.Methods Sixty-eight ASA Ⅱ or Ⅲ patients aged 22-62 yr weighing 52-81 kg with Hunt-Hess Ⅱ or Ⅲ undergoing intracranial aneurysm clipping were randomly divided into 2 groups( n =34 each): group propofol(group P) and group sevoflurane (group S).Anesthesia was induced with target-controlled infusion(TCI) of propofol (target plasma concretration 2.0 μg/ml,group P) or inhalation of 8%sevoflurane (group S) and iv injection of remifentanil 0.8 mg/kg and atracurium 0.5 mg/kg.Anesthesia was maintained with TCI of propofol(target plasma concretration 1.5 μg/ml,group P) or inhalation of 2% sevoflurane (group S) and TCI of remifentanil (target plasma concretration 2.0-3.5 ng/ml) and infusion of atracurium (4μg· kg- 1 · min- 1 ).Samples of dialysate in brain were collected at 5 min before temporary arterial occlusion (T0 ),5 min (T1),10 min (T2 ),15 min (T3) of temporary arterial occlusion,and 10 min (T4),20 min (T5),40 min (T6 ) after cerebral aneurysm clipping for determination of glucose,lactate and pyruvate concentrations.Lactate/pyruvate(L/P) ratio was calculated.Results Compared with group P,the concentrations of glucose,lactate and pyruvate were significantly increased at T1 -06,and L/P ratio was decreased at T2-T4 in group S( P < 0.05).The glucose concentration was significantly lower,and lactate concentration higher at T1 -T6,pyruvate concentration was lower at T1 -T4,and higher at T5 and T6,and L/P ratio was higher at T1 -T5 in both groups than that at T0 ( P <0.05).The concentrations of glucose and pyruvate were higher and L/P ratio was lower at T4-T6,and lactate concentration was lower at T5,T6 in both groups than that at T3 ( P < 0.05).Conclusion Compared with propofol,sevoflurane can better improve cerebral metabolites in patients undergoing intracranial aneurysm clipping.
5.Comparison of the effects of propofol versus midazolam on serum level of hydrocortisone in the elderly craniocerebral trauma
Chun MENG ; Gang LIU ; Yan ZHANG ; Yaxin WANG
Chinese Journal of Geriatrics 2012;31(3):208-210
Objective To compare the effects of propofol versus midazolam on serum hydrocortisone in the aged traumatic brain injury. Methods 64 patients (aged 65-72 years) with traumatic brain injury during mechanical ventilation were divided into propofol group (n=32) and midazolam group(n=32).The hemodynamics data,intracranial pressure(ICP) and the calculated cerebral perfusion pressure(CPP) were recorded.The serum hydrocortisone of patients was detectedby enzyme linked immunosorbent assay (ELISA) at 24 h,72 h and 4 weeks in intensive care unit(ICU). Results There was no differences in partial pressure of carbon dioxide,heart rate,meanartery pressure,pulse biood oxygen saturation (SpO2 ),armpit temperature,endexpiratory gas(PEr CO2),intraeranial pressure (ICP) and cerebral pertusion pressure (CPP) between the two groups (P>0.05).The serum hydrocortisone in propofol group at 24 h and 72 h [(269.7±43.2) nmol/L and (235.0±67.0) nmol/L] were lower than in midazolam group [(278.0±75.5) nmol/L and (243.2±42.4) nmol/L] (t=5.312 and 5.919,both P=0.000).The serum hydrocortisone in propofol and midazolam group at 4 weeks were (209.1±73.9) nmol/L and (210.8±66.6) nmol/L,respectively,no significant difference was found(t=0.075,P =0.938). Conclusions There is a significant difference in the effects of propofol and midazolam on the early level of hydrocortisone in the aged patients with traumatic brain injury.
6.Expression of hypoxia inducible factor-1a and vascular endothelial growth factor in retina during rat embryon development
Chun-yan, YUAN ; Xu-xia, MENG ; Li-li, XIN
Chinese Journal of Experimental Ophthalmology 2011;29(3):230-234
Background Research determined that hypoxia inducible factor-1(HIF-1)is associated with the hypoxia response in normal organ,and it plays an important role during the embryon development.It is also proved that the expression of vascular endothelial growth factor(VEGF)is upregulated in embryon retina.But,whether the action of HIF-1 and VEGF is correlated is unclear. Objective The aim of this study was to investigate the dynamic change of expression of HIF-1α and VEGF in retina during embryonic development and explore the role of HIF-1α and VEGF along with retinal evolvement.Methods The different embryon ages of SD rats were obtained from 30 clean pregnant SD rats by cesarean surgery.The retinas were isolated from embryon 10一day,12一day,14-day,16-day and 20-day rats respectively.The expressions of HIF-1 α and VEGF protein in retina were semi-quantitatively and qualitatively determined by immunochemistry,and the expressions of HIF-l α and VEGF mRNA in retina with different-embryon-phase and adult rats were detected by RT-PCR. Results The hishly level of expression of HIF-1 α and VEGF protein were found in the cellular nuclei and cytoplasm of retina in embryon 10一and 12-day rats.With the increase of embryon age.the expression of HIF-1α and VEGF protein in retina lowed(F=56.70,P<0.01;F=60.78.P<0.01).Compared with the adult rats,the expressions of HIF-1α and VEGF protein in retina were higher from embryon 0-day through 20-day rats(all P<0.01).The significantly positive correlation was found in the expression level between HIF-1α and VEGF protein throughout the experimental duration(r=0.96,P=0.00).Followed the same pattern,the expression levels of HIF-1α and VEGF mRNA in retinas were also enhanced in the embryon 10- and 12-day rats.Identically,a gradually weakened trend was seen in the expressions of HIF-1 α and VEGF mRNA in retinas as the increase of gestational age of rats(F=68.84,P<0.01;F=96.49,P<0.01),and the exDressions of HIF-1 α and VEGF mRNA decreased in the adult rats compared with different embryon-phase rats,showing a statistically significant difference between them(all P<0.01). Conclusion The expressions of HIF-1 αand VEGF in retina appear a dynamic alteration from hish to low during the embryonic development of rat retina,indicating that HIF-1α/VEGF pathway might participate in the process of embryo development of rat retina.
7.Changes of erythropoietin expression during the embryonic deveiopment period of rat retina
Chun-yan, YUAN ; Xu-xia, MENG ; Ying-jun, NIU
Chinese Journal of Experimental Ophthalmology 2011;29(11):998-1001
Background Erythropoietin (EPO) was proved to be express in hematopoietic tissue and nervous system and play the effects of stimulating blood cell production and protecting nervous tissue.Researches showed that EPO is expressed in the embryon brain of animal.However,whether EPO exist in nervous-derived retina and its action on retina with the development is concerned. Objective This research was to investigate the expression of EPO during the embryonic development period of rat retina and explore the role of EPO in retina development process.Methods Clean Wistar rats with pregnancy for 12 days,16 days and 20 days were collected,and the embryonic 12-day rats (E12 d,5 rats),embryonic 16-day rats (E16 d,5 rats) and embryonic 20-day rats ( E20 d,5 rats) were obtained by caesarean operation,and 5 12-month W istar rats were used as controls.The rats were sacrificed by cervical dislocation and the retinal sections were prepared in the different-embryo-phase (12 d,16 d,20d) and growth phase.The expression of EPO protein and mRNA in rat retina was detected by immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR),respectively.The feed and use of the animals followed the Regulation for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results EPO was positively expressed in the cytoplasm and nuclei in the neuroepithelial layer and pigment epithelium of every-embryo-phase rats but only in retinal ganglion cell layer in 12-month-old rats.The gray scale values of EPO expression in retina were 105.55±10.35,99.35± 8.71,83.27± 7.84and 30.30± 3.80 in E12 d rats,E16 d rats,E20 d rats and 12-month-old rats respectively with a statistically significant difference (F=76.13,P<0.01 ).RT-PCR revealed that the relative values of EPO mRNA expression in retina were 0.876±0.10,0.861 ±0.09 and 0.256±0.03 in E16 d rats,E20 d rats and 12-month-old rats respectively,presenting a elevated value in embryonic rats compared with adult rats ( P =0.00).Gel imaging deletion showed that the A value of EPO amplification products was highest in E16 d rats and lowest in adult rats.Conclusions The expression of EPO appears a high to low fashion during the embryonic development of Wistar rats,which is closely associated with the developing procedure of retina.
8.Antioxidant response element activator protects motor neurons from selected death
Hui BU ; Chun-Yan LI ; Xiao-Yun LIU ; Zhe LI ; Bin LI ; Meng-Meng SUN
Chinese Journal of Neurology 2001;0(01):-
Objective To investigate the effects of antioxidant response element (ARE) activator- 5,6-dihydrocyclopenta[ C ]-1,2-dithiole-3-thione (CPDT) on organotypic spinal cord cultures and to study whether this activation can protect motor neurons from oxidative stress.Methods Organotypic spinal cord cultures were prepared using lumbar spinal cord slices from 8-day-old rat.Threo-hydroxyaspartate (THA) was continuously added into the culture medium for 3 weeks,which caused selective motor neuron death. Thus,the in vitro model of amyotrophic Lateral sclerosis (ALS) was established.15,30 ?mol/L of CPDT were added into the culture medium respectively.Ventral motor neurons survival was evaluated by immunohistochemical staining with monoclonal antibody SMI-32,a nonphosphorylated neurofilament marker. Ultrastructure was observed with electronic microscope.Results The pretreatment of organotypic spinal cord cultures with different concentrations of CPDT significantly increase the total number of ventral motor neurons (15?mol/L:(15.81?6.97) perexplant;30?mol/L:(16.25?6.74) perexplant respectively) compared with THA group ((5.31?5.76) perexplant) and the former had plentiful neurite extensions (n= 15,P
9.Structure and function of 3'- untranslated region in picornavirus.
Rui-Ying LIANG ; Chuan-Feng LI ; Chun-Chun MENG ; Zong-Yan CHEN ; Guang-Qing LIU
Chinese Journal of Virology 2014;30(4):463-469
Both sides of the picornavirus genome have 5'-untranslated region (5'UTR) and 3'- untranslated region (3'UTR). This study demontrated that both the 5'-and 3'-UTR can form complex structures, such as stem-loop, clover and pseudoknot structure, These structures play an important role in the regulaton of the replication and translation of the viruses. This article reviewed the progress of research on the structure and function of picornavirus' 3'-UTR over recent years.
3' Untranslated Regions
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Animals
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Humans
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Nucleic Acid Conformation
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Picornaviridae
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chemistry
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genetics
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metabolism
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Picornaviridae Infections
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virology
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RNA, Viral
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chemistry
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genetics
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metabolism
10.Optimization on alcohol precipitation techniques of Liuwei Dihuang decoction by response surface methodology.
Ming YAN ; Ying-chun WEI ; Xue-feng LI ; Jin MENG ; Yun WU ; Wei XIAO
China Journal of Chinese Materia Medica 2015;40(19):3794-3799
The theoretical basis of the alcohol precipitation process control was provided, the alcohol precipitation was optimized and the relationship equation was got. The monod glycoside, loganin and paeoniflorin were used as the evaluation indexes to determine the impact factors of alcohol precipitation techniques of Liuwei Dihuang decoction by the Plackett-Burman experimental design and the levels of non-significant factors were identified. Then, Box-Behnken response surface methodology was used to research and discuss the critical process parameters influence the effect of alcohol precipitation and draw interaction between key process parameters and the correlation equation with index components. Through the establishment and solving the quadratic regression model of composite score, the optimum preparation conditions of alcohol precipitation techniques of liuwei were as follows: stirring speed was 580 r x min(-1), standing time was 17 hours, alcohol concentration was 34%, the density of Liuwei Dihuang decoction was 1.13. The response surface methodology for optimized alcohol precipitation techniques of Liuwei Dihuang decoction is. reasonable and feasible.
Chemical Precipitation
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Chemistry, Pharmaceutical
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methods
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Drugs, Chinese Herbal
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chemistry
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Ethanol
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chemistry