1.Effects of different analgesics combined with propofol of intravenous anesthesia on postoperative analgesia and emotion in patients of artificial abortion
Xingmei ZHANG ; Guilong WANG ; Junli CAO ; Zhiping WANG
Chinese Journal of Postgraduates of Medicine 2017;40(5):433-437
Objective To evaluate the effects of different analgesics combined with propofol of intravenous anesthesia on postoperative analgesia and emotion in patients of artificial abortion. Methods One hundred and twenty-two patients who had underwent painless artificial abortion were selected. The patients were divided into 4 groups by random digits table method: simple propofol group (C group, 29 cases), fentanyl combined with propofol group (F group, 30 cases), oxycodone combined with propofol group (Q group, 30 cases) and sufentanil combined with propofol group (S group, 33 cases). The induced dose of propofol was 2.5 mg/kg. When patients had limb movement during operation, a single addition of propofol 0.5 mg/kg was added until the body movement disappeared. The changes of mean arterial pressure (MAP), heart rate and respiratory rate before and after operation were compared among the 4 groups. The emotional status was assessed with affective scale before operation and 1 h after operation. The visual analog scale (VAS) was used to evaluate the degree of abdominal pain at 10, 30 and 60 min after palinesthesia. The propofol dose, operation time, recovery time and adverse reaction were recorded. Results No obvious adverse reactions were found during the operation. There was no statistical difference in operation time among 4 groups (P>0.05). The propofol dose, recovery time, body movement and the VAS score at 10, 30, 60 min after palinesthesia in F group, Q group and S group were significantly lower than those in C group, and there were statistical differences (P<0.05);but there were no statistical difference among F group, Q group and S group (P>0.05). The MAP, heart rate and respiratory rate at beginning of the surgery and during the surgery were significantly lower than that before anesthesia in the 4 groups, and there were statistical differences (P<0.05); but there were no statistical differences in MAP, heart rate and respiratory rate among 4 groups (P>0.05). The positive affective score after operation in C group, F group, Q group and S group was significantly higher than that before operation: (24.6 ± 5.6) scores vs. (21.7 ± 6.2) scores, (24.6 ± 3.1) scores vs. (20.6 ± 4.6) scores, (28.3 ± 6.3) scores vs. (20.8 ± 5.3) scores and (25.2 ± 5.4) scores vs. (19.9 ± 4.8) scores, and the negative affective score after operation in C group, F group, Q group and S group was significantly lower than that before operation: (17.0 ± 5.3) scores vs. (29.7 ± 7.4) scores, (17.2 ± 3.0) scores vs. (30.8 ± 5.0) scores, (16.1 ± 5.1) scores vs. (30.4 ± 4.9) scores and (17.9 ± 4.0) scores vs. (32.1 ± 5.5) scores, and there were statistical differences (P<0.05). The positive affective score after operation in Q group was significantly higher than that in C group, F group and S group, and there was statistical difference (P<0.05). There was no statistical difference in negative affective score after operation among 4 groups (P>0.05). Conclusions The fentanyl, sufentanil and oxycodone combined with propofol of intravenous anesthesia in patients underwent artificial abortion can reduce propofol dose, shorten recovery time, improve positive affective score, decrease negative affective score and strengthen the analgesic effect, and doesn't increase the adverse reaction. The respiratory and circulatory inhibition effects of different analgesics combined with propofol of intravenous anesthesia were similar, but oxycodone can increase positive affective score.
3.Perioperative clinical effect of extracorporeal membrane oxygenation for lung transplantation in idiopathic pulmonary hypertension patients
Chunxiao HU ; Bo XU ; Zhiping WANG ; Jingyu CHEN ; Guilong WANG ; Zhong QIN ; Yonggang YANG
Chinese Journal of Organ Transplantation 2017;38(5):267-271
Objective To summarize the perioperative clinical effect of extracorporeal membrane oxygenation (ECMO) technique in bilateral lung transplantation of patients with idiopathic pulmonary arterial hypertension.Methods Of 18 recipients with idiopathic pulmonary arterial hypertension receiving double lung transplantation,there were 11 cases of 11 grade Ⅲ (WHO cardiac function ratings) and 7 cases of grade Ⅳ.All patients were given ECMO technique after anesthetic induction,and the speed and volume of ECMO were adjusted according to oxygenation and cardiac function.At the end of the operation,the ECMO flow rate was decreased to 1 L·min-1 ·m-2.If the hemodynamics was stable and the oxygenation index was above 300,the ECMO could be removed.All data were Collected at 7 time points (preoperation,30 min after two lung ventilation,15 min after ECMO,the establishment of one lung ventilation,30 min after pulmonary artery occlusion,30 min after pulmonary artery open and at the end of the operation).The prognosis of the recipients was observed postoperatively.Results All patients successfully completed operation under the support of ECMO technique.As compared with preoperation,PaO2 and PaCO2 were significantly increased at 30 min after two lung ventilation (P<0.05).As compared with 30 min after two lung ventilation,PaO2 was significantly elevated (P<0.05),PaCO2 and PAP were reduced at 15 min after ECMO (P<0.05).As compared with 15 min after ECMO,PAP was significantly increased at 30 min after pulmonary artery occlusion (P<0.05).As compared with 30 min after pulmonary artery occlusion,PAP was significantly reduced at 30 min after pulmonary artery open (P < 0.05).ECMO of 3 patients was removed after operation at once and of 15 patients were not removed until 3.3 ± 2.5 days in ICU.Tencases suffered from left cardiac insufficiency to varying degrees after removing ECMO (including 3cases whose ECMO was removed at once after operation),3 of them received ECMO bypass again and 7 of them were relieved after administration of cardiotonic,diuretics and vasodilators.Two cases sufferred from wound fat liquefaction and infection and 2 cases had moderate femoral artery thrombosis after postoperative ECMO.One case had renal failure 5 days after operation and thereafter died of multiple organ failure 2 weeks later after treatment with the continuous ECMO pipelines of hemofiltration,then 17 cases were cured.The pulmonary arterial pressure of all recipients was (30.79 ± 6.18) mmHg 2 months after operation and the cardiac function rating was significantly increased (P <0.01).Conclusion The application of ECMO technique in the lung transplantation patients with idiopathic pulmonary hypertension can reduce the pulmonary arterial pressure,improve the safety of operation and has obvious auxiliary effect on the perioperative cardiac function.
4.Induction of apoptosis by c-myc antisense oligonucleotide in osteosarcoma cell MG-63
Jun HU ; Guilong WANG ; Yang XIANG ; Yi LIU ; Yisheng CHEN ; Ruhu DING
Chinese Journal of Pathophysiology 2000;0(07):-
AIM:To study the induction of apoptosis by c-myc antisense oligonucleotide in osteosarcoma cell(MG-63).METHODS:The designed c-myc antisense oligonucleotide fragment was transfected into human osteosarcoma MG-63 cells.The cell growth and apoptosis were measured by the methods of MTT,FCM,HE staining and transmission electron microscopy.RESULTS:The results showed that the proliferation of human osteosarcoma MG-63 cells was inhibited and apoptotic rate was 37.92% when treated with c-myc antisense oligonucleotide at the does of 10.0 ?mol/L for 48 h.c-myc antisense oligonucleotide(10.0 ?mol/L) also inhibited the expression of c-myc protein.CONCLUSION:c-myc antisense oligonucleotide is able to induce apoptosis in human osteosarcoma MG-63 cells.
5.Diagnostic value of cardiovascular magnetic resonance in children with myocarditis
Binghua CHEN ; Yumin ZHONG ; Aimin SUN ; Qian WANG ; Ming ZHU ; Jinglei WANG ; Wei GAO ; Meirong HUANG ; Guilong WANG
Chinese Journal of Radiology 2015;(6):435-439
Objective To determine the diagnostic value of cardiovascular magnetic resonance (CMR) in children with myocarditis. Methods A total of 27 children with myocarditis were examined with cardiac MRI, including 16 new?onset cases and 11 chronic cases, as well as 14 cases with non?myocarditis. Sequences included SSFP in axial, two chamber, four chamber and short axis, T2?weighted triple inversion recovery, T1?weighted spin echo before and after gadolinium injection, and inversion recovery?gradient echo after gadolinium injection(late gadolinium enhancement, LGE) in axial and short axis. Qualitative and quantitative image analysis was performed to obtain focal T2 signal intensity and early enhancement signal intensity(SI) ratio of myocardium to skeletal muscleon EGE and LGE.The sensitivity, specificity and accuracy were calculated. Mann?Whitney and χ2 test were used for statistical comparison. Results The median value of EF was 60.20%(44.40%,70.20%), median value of T2W SI ratio was 2.50(2.04, 3.79),and there were 13 cases with LGE positive findings in myocarditis group. The median value of EF was 73.60%(65.40%,75.85%), the median value of T2WI SI ratio was 1.85(1.77, 2.15), and one case presented LGE positive sign in non?myocarditis group. There were significant statistical differences between the two groups (Z=-2.94,-2.52 ,χ2=5.19 ,P<0.05). The sensitivities for T2WI, EGE, LGE were 81.5%(22/27), 14.8%(4/27) and 48.1%(13/27) respectively. The specificities for T2WI, EGE, LGE were 57.1%(8/14), 100.0%(14/14)and 92.9%(13/14) respectively. The diagnostic accuracies for T2WI, EGE, LGE were 73.2%(30/41), 43.9%(18/41) and 63.4%(26/41) respectively. The best diagnostic performance was obtained when“any?two”of the three sequences were positive in the same patient, yielding a 51.9%(14/27)sensitivity, 92.9%(13/14) specificity, and 65.9%(27/41) diagnostic accuracy.Conclusions The combined CMR approach using T2?weighted imaging, early and late gadolinium enhancement, provides a high diagnostic accuracy and is a useful tool in the diagnosis and assessment of children with myocarditis.
6.Correlation Between Plasma Homocysteine Concentration and Transient Ischemic Attack
Peirong XIAO ; Jianguo ZHONG ; Haicun SHI ; Yao WANG ; Weigeng SONG ; Guilong ZHOU ; Yuan SHEN ; Sheng SUN ; Gendi WANG
International Journal of Cerebrovascular Diseases 2008;16(9):690-693
Objective:To investigate the correlation between plasma homocysteine (Hcy) concentration and transient ischemic attack (TIA) and traditional vascular risk factors.Methods:The plasma Hcy concentrations of 112 patients with TIA and 62 controls were measured by fluorescenee polarization immunoassay.Hcy concentrations and related risk factors were analyzed.Results:The risk of TIA was increased significantly in plasma Hcy concentration 10.0 to 14.9 μmol/L group(OR=2.450,95% CI 1.091 to 5.502) and≥15.0 μmol/L group(OR=5.169,95% CI 2.096 to 12.746) compared with plasma Hcy concentration<10.0 μmol/L group.Using TIA as the dependent wariable,various vascular risk factors (including plasma Hcy concentration) as the independent variable,logistic regression was analyzed.The result showed that the risk of TIA was increased significantly in plasma Hcy concentration>10.0 μmol/L group compared with plasma Hcy concentration<10.0 μmol/L group(OR=3.150,95% CI 1.380 to 7.192).Conclusions:Plasma Hcy concentration is an independent risk factor for TIA.
7.Application of high time-resolved contrast-enhanced MR angiography in postoperative follow-up study of children with congenital heart diseases
Aimin SUN ; Yumin ZHONG ; Qian WANG ; Wei GAO ; Xiaohong GU ; Rongzhen OUYANG ; Yi LIN ; Guilong WANG ; Ming ZHU
Chinese Journal of Radiology 2015;(9):685-689
Objective To assess the application value of high time-resolved MR angiography (TR-MRA) in postoperative follow-up study of children with congenital heart diseases. Methods Seventy-three patients (median age 6 years, range 1-20 years) with congenital heart diseases who underwent TR-MRA scan after operation were retrospectively analyzed. Twenty-nine cases also were performed conventional contrast-enhanced MRA and forty-four cases were performed phase-contrast MRA. A 3D T1-weighted fast gradient-echo sequence was used for time-resolved three-dimensional MRA (10-20 dynamic data sets, less than three seconds per dynamic data set). The flow dynamics and morphology of pulmonary circulations, lung perfusion and collaterals flow direction were noted. All imaging quality was evaluated by using 5 scales. Left and right pulmonary artery flow volumes were measured and left and right pulmonary artery ratio was noted. SPSS22.0 was used in statistic analysis. The statistical analysis of comparing imaging quality was performed by using paired t-test. The intermodality agreement between TR-MRA and phase contrast in assessing left and right pulmonary perfusion was tested by Kappa coefficient. Results In 73 cases, imaging scores were over 3 and imaging quality was good enough for diagnosis. In 29 cases, there was no statistic difference between TR-MRA and conventional CE-MRA in demonstrating great vessels (P>0.05) except that CE-MRA scores(3.77 ± 0.39)was higher than TR-MRA scores(3.44 ± 0.55)of
inferior vena cava (IVC). There was statistic difference(t=3.68,P=0.01)between two sequences. TR-MRA could qualitatively demonstrate the pulmonary perfusion comparing to the results of PC. In PC sequence, there were 8 cases with symmetric and 36 cases with asymmetric left and right pulmonary perfusion. In TR-MRA sequence, there were 6 cases with symmetric and 38 cases with asymmetric left and right pulmonary perfusion. There was an excellent agreement between PC and TR-MRA (Kappa=0.83,P=0.01). Conclusions TR-MRA not only supplies with high spatial resolution imaging which demonstrates postoperative great arteries anatomy and also with high temporal resolution imaging which can demonstrate the preferential or balanced pulmonary blood flow and collaterals flow direction. TR-MRA is a very important sequence in follow-up study of congenital heart disease.
8.Physical development monitoring of primary school students in the Oroqen Inhabited Area from 2013 to 2018
SUN Guilong, HU Mei, DING Rujia,WANG Aibo
Chinese Journal of School Health 2021;42(7):1077-1079
Objective:
To understand physical development of children aged 7 to 12 in the oroqen autonomous banner experimental primary school in the oroqen settlement area from 2013 to 2018, and to provide scientific basis for their physical fitness and health.
Methods:
According to the standards of "National Student Physical Health Standards (2014 Revised Edition)" and the standards of "Overweight and Obesity Screening for School age Children and Adolescents" issued by the National Health and Family Planning Commission in 2018, the Oroqen Autonomous Banner Experimental Primary School was 7-12 years old. The average value and growth rate of children s height, weight and BMI in the past 6 years.
Results:
From 2013 to 2018, the height and weight of boys and girls aged 7 to 12 showed an increasing trend, with height growth values of boys were 1.8,1.7,1.9,2.6,5.7,5.9 cm,girls were 2.8,4.5,1.9,1.8,3.6,2.9 cm.And the weight groups values of boys were 2.2,2.5,5.1,6.3,6.4,7.2 kg,girls were 2.4,3.6,3.1,1.3,4.6,3.0 kg. The growth rate of girls aged 7 to 8 was higher than that of boys, and the growth rate of boys aged 9 to 12 was higher than that of girls. With the increase of age, the average BMI of boys and girls aged 7 to 12 showed an upward trend, and the BMI of boys of the same age was always higher than that of girls. Among them, the average BMI of boys aged 7 to 12 in 2018 exceeded the critical value of overweight BMI.
Conclusion
The physical shape of children aged 7-12 years increases with age, but the development tends to be overweight and obese, which is related to the natural environment of life, lifestyle, and reduction in physical activity.
9.Role of sarcolemmal KATP channel in sevoflurane-induced maintenance of electrophysiological stabili-ty of ventricular myocardium in diabetic rats
Zijun WANG ; Hong GAO ; Weichao LI ; Guilong WANG ; Ying CAO ; Huayu LI ; Yuqi SHE
Chinese Journal of Anesthesiology 2019;39(6):742-745
Objective To evaluate the role of sarcolemmal ATP-sensitive potassium ( sarcKATP ) channel in sevoflurane-induced maintenance of electrophysiological stability of ventricular myocardium in di-abetic rats. Methods Clean-grade healthy male Sprague-Dawley rats, aged 3 months, weighing 280-320 g, in which diabetes mellitus ( DM) was induced by intraperitoneal streptozotocin 60 mg/kg and confirmed by blood glucose ≥16. 7 mmol/L, were used in this study. Their hearts were excised after anesthesia and retrogradely perfused in a Langendorff apparatus at 4 weeks after establishing the DM model. Twenty-four Langendorff-perfused hearts were divided into 3 groups ( n=8 each) using a random number table method:DM group ( group D) , DM plus sevoflurane group ( group DS) and DM plus sevoflurane plus HMR-1098 group (group DSH). Another 8 Langendorff-perfused hearts of normal rats were selected as control group ( group C) . Hearts were perfused with 37℃ K-H solution via the aorta in each group, 15 min of equilibra-tion later hearts were continuously perfused for 30 min with K-H solution in C and D groups, with K-H solu-tion saturated with 2. 5% sevoflurane in group DS, or with K-H solution saturated with 10 μmol/L HMR-1098 and 2. 5% sevoflurane in group DSH. Monophasic action potential (MAP) duration at 50% and 90%repolarization ( MAPD50 and MAPD90 ) in the endocardium and epicardium of the left ventricular anterior wall were recorded at 15 min of equilibration ( T0 ) and 15 and 30 min of reperfusion ( T1,2 ) , transmural dispersion of repolarization ( TDR) was calculated. S1S2 program-controlled stimulation was performed at the end of perfusion to record the effective refractory period (ERP), ventricular arrhythmia (VA) induced and the longest pacing cycle length ( PCL) of ventricular fibrillation threshold ( VFT) induced. ERP/MAPD90 ratio was calculated. Results Compared with group C, TDR was significantly increased at T0 , ERP/MADP90 ratio was decreased, the incidence of VA induced was increased, and the longest PCL of VFT induced was prolonged in group D ( P<0. 05) . Compared with group D, TDR was significantly decreased at T2 in group DS (P<0. 05), and ERP/MADP90 ratio was significantly increased, the incidence of VA in-duced was decreased, and the longest PCL of VFT induced was shortened in DS and DSH groups ( P<0. 05). TDR was significantly smaller at T2 in group DSH than in group DS (P<0. 05). Conclusion sarcKATP channel is involved in sevoflurane-induced maintenance of electrophysiological stability of ventricu-lar myocardium in diabetic rats.
10.Electrophysiological characteristics of myocardium after hypothermic ischemia-reperfusion in rats with different degrees of arrhythmia: an in vitro experiment
Yurong FENG ; Hong GAO ; Guilong WANG ; Yanqiu LIU ; Youqin HE ; Zijun WANG
Chinese Journal of Anesthesiology 2019;39(7):826-830
Objective To investigate the electrophysiological characteristics of myocardium after hypothermic ischemia-reperfusion (I/R) in rats with different degrees of arrhythmia using an in vitro experiment.Methods Healthy clean-grade male Sprague-Dawley rats,aged 2-3 months,weighing 300-400 g,were used in this study.The rats were sacrificed after anesthesia,and their hearts were rapidly excised.Sixteen Langendorff-perfused hearts were prepared and divided into 2 groups (n=8 each) by a random number table method:control group (group C) and hypothermic I/R group (group I/R).The hearts were made globally ischemic for 60 min followed by 30-min hypothermic (4 ℃) reperfusion to establish the model of hypothermic I/R injury.The occurrence and duration of arrhythmia and time of recovery of spontaneous heartbeat were recorded during reperfusion.The rats in group I/R were further divided into low-risk group (I/R-L group,ventricular arrhythmia score≤3 points) and high-risk group (I/R-H group,ventricular arrhythmia score>3 points) according to the arrhythmia score.Monophasic action potential amplitude (MAPA),monophasic action potential (MAP) duration at 50% and 90% repolarization (MAPDs0 and MAPD90) and maximum ascending velocity (Vmax) of phase 0 in the endocardium,myocardium and epicardium of the left ventricular anterior wall were recorded at 30 min of equilibration (T0) and 15 and 30 min of reperfusion (T1,2).The effective refractory period (ERP) and ventricular fibrillation threshold (VFT) of the left ventricle were measured by programmed electrical stimulation,and the ERP/MAPD90 ratio was calculated.Results Compared with the baseline at T0,MAPA in the three layers was significantly decreased,and MAPD50 and MAPD90 were prolonged at T1,2 in I/R-L and I/R-H groups,and V in the three layers was decreased at T1,2 in I/R-H group (P<0.05).MAPD50 and MAPD90 in the three layers were significantly shorter at T2 than at T1 in I/R-L and I/R-H groups (P<0.05).Compared with group C,MAPDs0,MAPDg0 and ERP in the three layers were significantly prolonged at T1,2,the ERP/MAPDg0 ratio was decreased,and VFT was increased in I/R-L and I/R-H groups (P < 0.05).Compared with I/R-L group,the duration of arrhythmia and MAPD90 and ERP in the three layers were significantly prolonged at T2,the ERP/MAPDg0 ratio was decreased,and VFT was increased in group I/R-H (P<0.05).Conclusion Myocardial depolarization is inhibited,repolarization duration is prolonged,and electrophysiological stability is decreased after hypothermic I/R in the rats with arrhythmia,and the prolongation of myocardial repolarization and decrease in electrophysiological stability are more obvious in the rats at high risk of arrhythmia.