1.Effect of dexmedetomidine on median effective target effect-sire concentration of remifentanil required for preventing body movement in response to skin incision
Zheng CHEN ; Donghua SHAO ; Lihua HANG
Chinese Journal of Anesthesiology 2011;31(7):799-801
ObjectiveTo investigate the effect of dexmedetomidine on the median effectivetarget effectsite concentration (EC50) of remifentanil required for preventing body movement in response to skin incision made under propofol sedation.MethodsForty ASA Ⅰ or Ⅱ patients aged 20-50 yr weighing 45-58 kg scheduled for elective breast tumor excision were randomly allocated into 2 groups ( n =20 each):group remifentanil (group R) and group remifentanil + demedetomidine ( group RD).Sedation was induced with propofol TCI at target plasma concentration of 3.0 mg/L in both groups.In group RD dexmedetomidine 1.0 μg/kg was infused iv over 10 min before start of propofol TCI,while in group R equal volume of normal saline was infused instead of dexmedetomidine.Remifentanil TCI was started with target effect-site concentration set at 3.0 and 2.5 μg/L in groups R and RD respective at 13 min after beginning of propofol TCI.Skin incision (3 cm in length) was made when the target concentrations of propofol and remifentanil TCI were reached.Body movement was assessed by a nurse not involved in this study.EC50 and 95% confidence interval (CI) of remifentanil were determined by up-and-down technique.The target effect-site concentration was increased or decreased by 20% depending on the response of the previous patient to skin-incision.ResultsThe EC50 of remifentanil for preventing body movement in response to skin incision performed under propofol sedation was 1.7 μg/L (95% CI 1.5-1.9 μg/L) and 2.5 μg/L (95% CI 2.2-2.7μg/L) in groups RD and R respectively.The EC50 of remifentanil was significantly lower in group RD than in group R.ConclusionDexmedetomidine 1.0 μg/kg can decrease EC50 of remifentanil for preventing body movement in response to skin incision made under propofol sedation.
2.Effect of dexmedetomidine on bispectral index value at loss of consciousness caused by propofol given by target-controlled infusion
Zheng CHEN ; Donghua SHAO ; Lihua HANG
Chinese Journal of Anesthesiology 2012;32(4):460-462
Objective To investigate the effect of dexmedetomidine on bispectral index (BIS) value at loss of consciousness (LOC) caused by propofol given by target-controlled infusion (TCI).Methods One hundred and twenty ASA Ⅰ or Ⅱ patients,aged 20-50 yr,weighing 41-68 kg,scheduled for general surgery were randomly divided into 3 groups (n =40 each):propofol group (group P),dexmedetomidine 0.5 μg/kg + propofol group (group D1P) and dexmedetomidine 1.0 μg/kg + propofol group (group D2P).The patients in each group were randomly assigned into 5 subgroups ( n =8 each):groups P0-4 receiving TCI of propofol with the target effect-site concentration (Ce) set at0,1,2,3 and 4 mg/L respectively.Groups D1P0-4 received iv infusion of dexmedetomidine 0.5 μg/kg at a rate of0.05μg·kg-1 ·min-1 and TCI of propofol with the target Ce set at 0,1,2,3 and 4 mg/L respectively at 5 min after the end of dexmedetomidine infusion.Groups D2 P0-4 received iv infusion of dexmedetomidine 1.0 μg/kg at a rate of 0.1μg· kg- 1· min- 1 and TCI of propofol with the target Ce set at 0,1,2,3 and 4 mg/L respectively at 5 min after the end of dexmedetomidine infusion.Three minutes after TCI of propofol was started,OAA/S score and BIS value were recorded.The OAMS score ≤ 2 was defined as LOC.The EC50 and 95% confidence interval of propofol for LOC and BIS50 and 95% confidence interval at LOC were calculated by Probit analysis.Prediction probability (Pk) of BIS value at LOC was calculated using Smith method.Results Compared with group P,EC50 was significantly decreased,BIS50 was significantly increased ( P < 0.05 or 0.01 ),and no significant change was found in Pk in groups D2 P and D1 P ( P > 0.05).There were no significant differences in EC50,BIS50 and Pk between groups D2 P and D1P ( P > 0.05).Conclusion BIS value can accurately predict the level of consciousness during anesthesia with dexmedetomidine and TCI of propofol,but BIS value is increased at LOC.
3.A study on the relationship between serum cytokine levels and clinical manifestation in colorectal cancer patients
Aiguo LU ; Minhua ZHENG ; Donghua LI
Chinese Journal of General Surgery 2001;0(10):-
Objective To investigate the Th1/Th2 imbalance, defective cell medicated anti tumor response and the relationship between cytokine levels and clinicopathologic findings in colorectal cancer patients.Methods 62 colorectal cancer patients and 15 volunteers were recruited for the study. Peripheral blood samples were collected to detect IL 2, IL 6, IL 10, IL 12, TNF levels and NK activity, proportions of CD3 + , CD4 + ,CD8 + T cells.Results Patients with colorectal cancer had decreased levels of IL 2, IL 12 and elevated levels of IL 6, IL 10 compared to controls( P
4.Imbalance of Th_1/Th_2 Cytokines in the Rats with Spleen Deficiency Syndrome and Effect of Decoction of SiJunZi on It
Donghua YANG ; Jiabang LI ; Aihua ZHENG
Journal of Chinese Physician 2001;0(02):-
Objective To investigate change of Th 1/Th 2 Cytokines in the rats with spleen deficiency syndrome and effect of decoction of SiJunZi on it. Methods The contents of IL-4 and IFN-? in the T cells of the rats with spleen deficiency syndrome before and after treatment of decoction of SiJunZi and powder of ChaiHuShuGan were detected by ELISA. Results Compared with normal group, the content of IFN-? decreased (P0 05). After treated with powder of ChaiHuShuGan, the levels of IL-4 and IFN-? did not obviously change compared with normal group (P
5.Overexpression of caveolin-1 inhibits the growth of human cervical squamous cell Hela cell line in vitro
Qingling ZHENG ; Donghua GU ; Jinliang PING ; Rong ZHU ; Qi CHEN
Journal of Chinese Physician 2010;12(10):1304-1308
Objective To investigate the effects of caveolin-1 overexpressing on the growth of cervical squamous cell cancer Hela cell line. Methods Eukaryotic expression vector of human caveolin-1 gene was introduced into Hela cells by Lipofectamine. The clones stably overexpressed caveolin-1 were identiffed by RT-PCR, immunofluorescence cell staining techniques and Westernblotting. Cells proliferation viabihty was tested by MTT assay, and flow cytometry was used to assay the cell cycle and apoptosis, and the relative phosphorylation level of extracellular regulated protein kinases (Erk1/2) were detected by Westernblotting. Results The clones stably overexpressed caveolin-1 were obtained. Compared with the parental Hela cells, the tranfected cells exhibited a slower rate of growth. FAGS analysis results revealed that overexpression of caveolin-1 resulted in the cell cycle arrest in the G0/G1 [ ( 68. 04 ± 2. 57 ) % vs ( 53.41 ±1.01)%] phase and increased the apoptotic cell fraction[ (19. 18 ±2.20)% vs (5.63 ±0.55)%, P <0. 05 ]. Western blotting results showed that overexpression of caveolin-1 reduced the phosphorylation of Erk1/2(0.28 ±0.05 vs 0.81 ±0.07, P <0.05). Conclusions Overexpression of caveolin-1 suppressed the growth of Hela cells and induced apoptosis, down-regulation of Erk1/2 phosphorylation might be involved in its mechanism.
6.Changes in the expression of neuromedin U receptor 2 in spinal dorsal horn in a rat model of bone cancer pain
Lihua HANG ; Donghua SHAO ; Zheng CHEN ; Hong WANG
Chinese Journal of Anesthesiology 2013;33(6):701-703
Objective To investigate the changes in the expression of neuromedin U receptor 2 (NMUR2) in spinal dorsal horn in a rat model of bone cancer pain (BCP).Methods Thirty-two female Sprague-Dawley rats,weighing 150-180 g,were randomly divided into 2 groups (n =16 each):sham operation group (group S) and BCP group.BCP was induced by inoculating Walker 256 mammary gland carcinoma cells (1 × 105) into the medullary cavity of left tibia.Heat-killed Walker 256 cells (1 × 105) were injected into the medullary cavity of left tibia in S group.Eight rats were chosen from each group and the paw withdrawal threshold (PWT) to yon Frey filaments was measured at 1 day before operation (baseline) and 1,3,6,9,12 and 15 days after operation.Bone destruction was shown by X-ray at 15 days after operation.At 1 day before operation and 15 days after operation,4 rats in each were chosen and sacrificed,and L4,5 segments of the spinal cord were removed for measurement of the expression of NMUR2 mRNA (by real-time PCR) and protein (using Western blot analysis) in the spinal dorsal horn.Results Compared with S group,the PWT was significantly decreased at day 6-15 after operation and the expression of NMUR2 mRNA and protein in the spinal dorsal horn was up-regulated at 15 days after operation in BCP group (P < 0.05 or 0.01).Compared with the baseline value,the PWT was significantly decreased at day 6-15 after operation and the expression of NMUR2 mRNA and protein in the spinal dorsal horn was up-regulated at 15 days after operation in BCP group (P < 0.05 or 0.01).X-ray showed defect of bone trabecula and cortical bone destruction in BCP group.Conclusion The expression of spinal NMUR2 is up-regulated in rats with BCP and this change may be involved in the development and maintenance of BCP.
7.High risk factors of blood infection in voluntary donors in China: A single-centre retrospective study
Li TONG ; Donghua ZHENG ; Yanping ZHU ; Xiaoguang HU ; Changjie CAI
Chinese Journal of Organ Transplantation 2016;37(12):753-757
Objective To analyze the high risk factors of blood infection in Chinese citizens' organ donation,provide the basic evidence for early protection,increase the success rate of donor distribution,and expand the Chinese organ donation pool.Methods A retrospective study was performed on 70 cases of donation recruited during October 2014 to January 2016.The incidence of blood infection in these donors was analyzed.The univariate analysis and multivariate logistic regression analysis were used to find out the high risk factors influencing the donor blood infection.Finally,the donor blood infection assessment model and the receiver operating characteristic (ROC) curve were established to assess the sensitivity and specificity.Results The overall infection rate was 64.3% (45/70).The pulmonary,blood,and urinary tract infection rate was 42.9%,31.4% and 1.4% respectively.The total length of hospital stay (>10 days) (P =0.017),oxygenation index (< 233.5 ± 107.0) (P =0.046),aspartate aminotransferase (>196.9 ± 329.1 U/L) (P =0.044),and valley alanine aminotransferase (>95.0 ± 78.1 U/L) (P =0.026) were four risk factors for predicting the donor blood infection.The multivariate logistic regression analysis revealed that the total length of stay >10 days along with the donors' oxygenation index (<233.5 ± 107.0) was independent risk factor for predicting the blood infection.The donor blood infection model was:0.193 + 1.753 hospital stay (>10 days)-0.007 oxygenation index.The sensitivity and specificity were 0.682 and 0.75 (P <0.001) respectively.Conclusion For a long-term stay in ICU,the rate of blood infection for donors was much higher,at this time,the most effective antibiotics should be chosen.Besides,improving donor oxygenation index and liver function can reduce the incidence of infection.
8.Early identification of potential brain death organ donors based upon prediction of spontaneous respiratory arrest
Guixing XU ; Donghua ZHENG ; Hua LIU ; Yuan LIAO
Chinese Journal of Organ Transplantation 2021;42(2):87-90
Objective:To construct a nomogram model for spontaneous respiratory arrest prediction in nerocritical patients within 72 hours after brain injury for early identification of potential brain death organ donors.Methods:From October 2017 to May 2019, 127 hospitalized neurocritical patients (including traumatic brain injury and spontaneous cerebral hemorrhage) were prospectively enrolled and the parameters related to brain injury were dynamically recorded. Among them, the data from October 1, 2017 to May 31, 2018 were used for constructing the training set and the data from June 1, 2018 to January 31, 2019 for constructing the validation set. The occurrence of spontaneous respiratory arrest within 72 h after brain injury was regarded as the time interest point and grouping factor. The factors associated with spontaneous respiratory arrest were screened by univariate and multivariate analyses. Then the Nomogarm prediction model was developed and tested in the validation set.Results:Sixty-five patients entered the training set and another 62 cases were enrolled into the validation set. In training set, univariate and multivariate analyses indicated that midline shift ( OR=4.56, 95%CI: 1.87~19.21), absent of ambient cistern ( OR=4.83, 95%CI: 1.35~16.34), cough reflex ( OR=3.82, 95%CI: 1.15~12.42), intraventricular hemorrhage ( OR=3.16, 95%CI: 1.53~14.52) and serum Na + <125 mmol/L ( OR=3.06, 95%CI: 1.53~13.44) were associated with spontaneous respiratory within 72 h. In both sets, the predicted C index of spontaneous respiratory arrest rate within 72 h was 0.81 (95%CI: 0.76~0.85) and 0.80 (95%CI 0.75~0.83) respectively. Further statistical analysis implied that 140, 160 and 170 points were the dangerous dividing points and these three points were 30.1%, 65.6% and 93.4% associated with spontaneous respiratory arrest within 72 h respectively. Conclusions:Nomogram model based upon assessment parameters of brain injury may predict the time of spontaneous respiratory arrest in neurocritical patients. It can be used for early identification of potential brain death organ donors. The results require further external data validation.
9.Detection of epileptic spike wave in EEG signals based on morphological component analysis.
Donghua MA ; Xuyuan ZHENG ; Zhen WANG
Journal of Biomedical Engineering 2013;30(4):710-723
This paper proposed a morphological component analysis (MCA) method, which is based on sparse representation, to detect the spike wave in electroencephalogram (EEG) signals. It takes the advantage of MCA being able to extract the background waves and the spike waves from the EEG signals, respectively,as the dictionaries and chooses the discrete cosine transform (DCT) and the daubechies order 4 wavelet (db4) transformation as the dictionaries of MCA to detect the spike waves from the epileptic EEG. The experiment results showed that the MCA could detect epileptic spike waves in EEG signals very effectively, and it yielded high selectivity of 89.01% and sensitivity of 90.71%. As a feature extraction/decomposition algorithm, MCA can be used to extract the spike waves from EEG signals.
Algorithms
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Electroencephalography
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methods
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Epilepsy
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classification
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diagnosis
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physiopathology
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Humans
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Principal Component Analysis
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methods
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Signal Processing, Computer-Assisted
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Wavelet Analysis
10.The clinical efficacy of body weight supported treadmill training for the recovery of walking ability and comprehensive function after thoracolumbar spinal cord injury
Chaoyang WANG ; Jirong ZHANG ; Shuang WU ; Yu HUANG ; Yan LONG ; Donghua ZHENG ; Qiang PEI
Chinese Journal of Physical Medicine and Rehabilitation 2013;(3):181-184
Objective To investigate the clinical efficacy of body weight supported treadmill training (BWSTT) for the recovery of walking ability and comprehensive function after thoracolumbar spinal cord injury (SCI).Methods Sixty patients with SCIs in a thoracolumbar segment were assigned to a treatment group or a control group with 30 in each.Both groups received similar conventional rehabilitation training,but the patients in the treatment group were additionally treated with BWSTT (30 to 40 min,once daily,5 d/week,30 days for a course,a total 3 courses).The American Spinal Injury Association lower-extremity motor function assessment (ASIA),a functional comprehensive assessment (FCA),the walking ability assessment from the FCA (WA) and the modified Barthel index (MB1) were used in the assessment of the two groups before and after treatment.Results There were no significant differences in the two groups' average ASIA,FCA,WA or MBI results before treatment.After treatment ASIA,FCA,WA and MBI scores had all increased significantly in the treatment group compared with before treatment,and were significantly higher than in the control group.Conclusion As a supplement to conventional rehabilitation,BWSTT can improve walking ability and comprehensive function significantly after thoracolumbar spinal cord injury.