1.Comparison of respiratory depression effect of equal analgesic plasma concentration of sufentanil and remifentanil
Chinese Journal of Postgraduates of Medicine 2010;33(33):6-9
Objective To observe the respiratory depression of sufentanil and remifentanil with target-controlled infusion under propofol sedation or not, and compare the effect of respiratory depression of the two drugs. Methods Eighty patients scheduled for elective neurosurgery were allocated into four groups by random digits table: the sufentanil group (group S), the remifentanil group (group R), the combination of sufentanil and propofol group (group SP) and the combination of remifentanil and propofol group (group RP),each group was 20 cases. The respiratory rate (RR), minute ventilation (MV),partial pressure of end-tidal carbondioxide ( PETCO2), pulse oxygen saturation (SpO2), mean arterial pressure ( MAP ), heart rate (HR), observer's assessment of alertness/sedation (OAA/S) were measured and respiratory depression was defined as one of the following end points were achieved: muscle rigidity, RR < 6 beats/min, MV < 3 L/min,PETCO2 > 55 mm Hg ( 1 mm Hg = 0.133 kPa), SpO2 < 0.90 or apnea > 15 s. Results The calculated effect concentration (Ce) of sufentanil for respiratory depression were (0.46 ± 0.14) μ g/L in group S and (0.23 ±0.06) μ g/L in group SP, and Ce of remifentanil for respiratory depression were (5.22 ± 2.11 ) μ g/L in group R and (2.22 ± 1.02) μ g/L in group PP. Some respiratory parameters,such as RR,MV were decreased and PETCO2 was increased significantly as the increase of Ce. Conclusions Target-controlled infusion of equal analgesic plasma concentration of sufentanil and remifentanil can suppress spontaneous respiration significantly with the increase of plasma concentration. There will be a synergetic effect after combining with propofol, and respiratory depression will appear at lower concentration. But equal analgesic plasma concentration of the two drugs have no significant difference in the effect of respiratory depression.
2.Respiratory depression effect-site concentration of remifentanil used in combination with different target concentrations of propofol in patients undergoing neurosurgical surgery
Chinese Journal of Anesthesiology 2009;29(9):796-799
Objective To determine the respiratory depression effect-site concentration (Ce) of remifentanil when used in combination with different target concentrations of propofol in patients undergoing neurosurgical surgery. Method Eighty patients aged 18-64 yr weighing 45-90 kg scheduled for elective neurosurgical surgery were randomly divided into 4 groups (n = 20 each): remifentanil group (group R), remifentanil combined with propefol 1, 1.5, 2 μg/ml group (group RP1, RP1.5, RP2). In group R, RP1, RP1.5 or RP2, the patients received propofol by TCI at target plasma concentration (Cp) of 0, 1, 1.5 or 2 μg/ml respectively, when the preset concentration was reached, received remifentanil via TCI at the initial target Cp of 2 ng/ml, and the concentration was then increased in the increment of 2 ng/ml at 3 min intervals until respiratory depression was achieved. Respiratory depression was defined as one of the following end points: muscle rigidity, RR<6 bpm, MV < 3 L/min, PETCO_2> 55 mm Hg, SpO_2 < 90% or apnea > 15 s. The Ce of remifentanil, amount of remifentanil used and side effects were recorded during respiratory depression. Result The respiratory depression Ce of remifentanil were (5.2±2.1), (3.2±1.0), (2.9 ±1.3) and (2.2±1.0) ng/ml in group R, RP1, RP1,5 and RP2 respectively. Compared with group R, the respiratory depression Ce of remifentanil were significantly decreased in group RP1, RP1.5 and RP2 (P<0.01). Compared with group RP1 and RP1.5, the respiratory depression Ce of remifentanil was significantly decreased in group RP2(P<0.01). There was no significant difference in respiratory depression Ce of remifentanil between group RP1 and RP1.5 (P > 0.05). Conclusion The respiratory depression Ce of remifentanil is (5.2±2.1) μg/ml in patients without sedation. The respiratory depression Ces of remifentanil are (3.2 ±1.0), (2.9 ± 1.3) and (2.2 ±1.0) ng/ml in patients under sedation with propofoi at target Cps of 1, 1.5, 2 μg/ml during neurosurgical surgery.
9.The clinical significance of C-12 multiple tumor marker protein chip detective system in diagnosis of lung cancer
Jia WANG ; Dong WANG ; Debing XIANG
Medical Journal of Chinese People's Liberation Army 1981;0(04):-
Objective To evaluate the diagnosis value of C-12 multiple tumor marker protein chip detective system for lung cancer. Methods The serum levels of 12 tumor makers were measured in 172 lung cancer patiens,52 pulmonary benign diseases patients. All lung cancer patients were definitly diagnosised by cytology or histology, including 89 squamous cell carcinoma patients, 72 bronchogenic adenocarcinoma patients, 11 small cell lung cancer patients; 12 patients in stage I, 28 patients in stageII, 65 patients in stage III, 67 patients in stage IV. The 12 common tumor markers in serum included CA199, NSE, CEA, CA242, CA125, CA153, AFP, Ferrtin, free-PSA, PSA, HGH, ?-HCG. Results At least one kind of tumor maker was found higher in 128 of the 172 lung cancer patients, the positive rate was 74.42%, and in 5 of the 52 pulmonary benign diseases patients, the positive rate was 9.62%,it is statistical significance between two the groups (P0.05) in different pathological types lung cancer patients .The positive rate was statistical significance in different stage lung cancer patients , the highest positive rate which in stage IV patients was 79.2% (P
10.Exploring the effects of Chinese medicine in improving uterine endometrial blood flow for increasing the successful rate of in vitro fertilization and embryo transfer.
Journal of Integrative Medicine 2011;9(12):1301-6
Endometrial blood flow is directly related to endometrial receptivity thereby affecting in vitro fertilization and embryo transfer (IVF-ET) outcomes. In recent years a growing number of studies have shown that traditional Chinese medicine (TCM) can play a role to improve endometrial blood flow and embryo transfer. Studies have confirmed that formulas based on reinforcing kidney and activating blood can promote the formation of uterine endometrial blood vessels by adjusting expressions of a variety of vessel growth factors, and regulating nitric oxide level for inhibition of vascular smooth muscle contraction of the uterus. Treatments based on differentiation of syndromes are key to the theory of TCM. Differentiation of syndromes should be combined with biomedical disease diagnosis. It is also necessary to further clarify other endometrial blood flow disorders using TCM diagnostic methods. In these cases, drugs for reinforcing kidney and activating blood are relevant, but other medicines for smoothing liver qi and nourishing blood, as well as tonifying the spleen and generating blood may also be effective. Future clinical studies should focus on the observation of different types of TCM syndromes and the research on compatibility ratio and dose-dependent relationship of Chinese medicines. Acupuncture has been used during IVF-ET for more than 10 years. Electro-acupuncture can control the expansion of the uterine arteries by inhibiting the sympathetic nerves. However, acupuncture has not been proved to regulate endometrial arteries. To sum up, TCM can be applied to improve endometrial blood flow so as to increase birth rates in IVF-ET. The combination of Chinese and Western medicines and acupuncture application will increase their combined effect, thereby obtaining greater clinical benefits.