1.Effects of Transcutaneous Acupoint Electrical Stimulation and Dexmedetomidine on Postoperative Cognitive Dysfunction in Patients Underwent Laparoscopic Surgery
Junchao ZHU ; Xiufei TENG ; Yanchao YANG ; Yuxiao WAN ; Yang LI
Journal of China Medical University 2016;45(4):345-348
Objective To observe the effect of transcutanous acupoint electrical stimulation(TAES)and dexmedetomidine on postoperative cogni?tive dysfunction in female patients underwent laparoscopic surgery. Methods Nighty patients scheduled for laparoscopic surgery were recruited in this study and randomly divided into control group(group C,n=30),TAES group(group T,n=30)and dexmedetomidine group(group D,n=30). In group T,patients received TAES treatment 30 min before the anesthesia until the end of the surgery at Neiguan(PC 6)and Zusanli(ST 36). The frequency was 2/100 Hz. In group D,patients were intravenously administrated with dexmedetomidine(0.5μg/kg)before the induction. All the patients were given routine general anesthesia. Drugs induced were sulfentanyl,etomidate and cisatracurium. Sevoflurane was given to main?tain the bispectral index(BIS)between 40 and 55. The time of extubation and in PACU was recorded. The serum S100βlevel was assessed at pre?operation(T0),the end of operation(T1)and 24 h after operation(T2). Mini?mental state examination(MMSE)was adopted to evaluate and re?cord the changes in cognitive function 1 day before operation and 24 h after operation. Results The incidence rate of POCD in group T and group D were lower than that in group C(all P<0.05). The level of S100βin group T and group D was lower than those in group C at T1 and T2 separately (all P<0.05). The time of extubation and time in PACU in group D were longer than those in group C and group T(all P<0.05),and the incidence of bradycadia in group D was higher than that in the other groups(all P<0.05). Conclusion TAES and dexmedetomidine reduce the incidence of cognitive dysfunction,decrease the release of S100βprotein. However,dexmedetomidine increases bradycadia,and prolongs extubation time and stay time in PACU. Hence,TAES deserve to be recommended practically.
2.Effects of Dexmedetomidine Combined with Sufentanil in the Treatment of Postoperative Analgesia after Laparoscopic Surgery
Huanhuan ZHANG ; Yang LI ; Xiufei TENG ; Yanchao YANG ; Yuxiao WAN ; Jingjie WAN ; Junchao ZHU
Journal of China Medical University 2016;45(4):333-336
Objective To observe the clinical efficacy of dexmedetomidine combined with sufentanil in the treatment of self?control intravenous an?algesia after laparoscopic surgery. Methods Sixty patients,who underwent laparoscopic sugery and general anaesthesia,American Society of Anes?thesiologistsⅠtoⅡ,were randomly divided into dexmedetomidine(DS)group and sufentanil(S)group,with thirty cases in each group. Group S received sufentanil 2μg·kg-1 and ramosetron hydrochloride 0.3 mg;group DS received sufentanil 2μg·kg-1,dexmedetomidine 200μg and ramose?tron hydrochloride 0.3 mg. Drugs of both groups were dissolved in saline 100 mL,with a loading dose of 4 mL,background infusion of 2 mL·h-1,con?trolled dose of 0.5 mL·h-1,and the lockout time was 15 min. Visual analog scale(VAS)score,Ramsay sedation scale(RSS)score,sufentanil cu?mulative consumption after surgery at 2 h,4 h,6 h,12 h,24 h were recorded,as well as the adverse reactions such as nausea,the occurrence of vomiting and chills within 24 h after surgery,and the satisfaction of patients with postoperative analgesia. Results Six hours post operation,VAS score of group DS was significantly lower than the group S(P<0.05);2 hours post operation,RSS score of group DS was significantly higher than the group S(P<0.05);the cumulative consumption within 6 hours after sufentanil was significantly lower in group DS than group S(P<0.05). The incidence of nausea,vomiting,chills and other adverse reactions were significantly higher in group S than group DS(P<0.05). Conclusion Compared with the simple application of sufentanil,dexmedetomidine combined with sufentanil for postoperative analgesia achieve better analgesic effect,reducing the amount of sufentanil,while reducing the associated sufentanil adverse reactions,improve patient comfort and satisfaction of post?operative analgesia.
3.Changes on degranulation of mast cells and neurogenic inflammation-related factors in the dura mater of the rat model of migraine
Wu XU ; Zhaochun SHI ; Junchao WEI ; Yuezhou CAO ; Ting WU ; Qi WAN
Chinese Journal of Neurology 2011;44(8):563-567
Objective To observe the changes on the neurogenic inflammation-related factors in the dura mater of the rat model of migraine and investigate the possible mechanism of the pain of migraine.Methods SD rats were randomly divided into stimulation group ( n = 32 ) and sham group ( n = 32 ).Unilateral trigeminal ganglion was stimulated to induce migraine for rats in the stimulation group. Rats in the sham group were subjected to sham surgery. The levels of calcitonin gene-related peptide (CGRP) in the blood of jugular vein in the stimulation side were measured by radioimmunoassay. The levels of histamine in peripheral blood and prostaglandin E2 (PGE2 ) in the dura mater were determined by enzyme-linked immunosorbent assay (ELISA). The number of mast cells and percentage of their degranulation in the dura mater were determined under a microscope after toluidine blue staining. Cyclooxygenase 2 (COX-2)expression in the dura mater was evaluated by immunohistochemical staining and western blot analysis. Results In the stimulation group, the level of CGRP in the ipsilateral jugular vein was (82. 84 ± 16. 24)pg/ml and in the sham group was (59. 20 ±11.66) pg/ml (t = -3.34, P < 0. 05 ). The level of histamine in the ipsilateral jugular vein was ( 11.59 ± 1.20) ng/ml and in the sham group was (9. 87 ±0. 88) ng/ml (t = - 3. 27, P < 0. 05). The number of mast cells in the dura mater decreased from 15.46 ± 2. 40 in the stimulation group to 11.63 ± 1.67 in the sham group ( t = 3.71, P < 0. 05 ). Degranulation of mast cells in the dura mater significantly increased from 14. 09% ±4. 53% in the sham group to 29. 10% ±9. 39% in the stimulation group (t = - 4. 07, P < 0. 05 ). The level of PGE2 in the stimulation group was ( 382. 30 ±20. 90) pg/ml and in the sham group was (80. 70 ± 10. 60) pg/ml (t = - 16. 674, P <0. 05). The number of COX-2 positive cells significantly increased from 42. 00 ± 18.40 in the sham group to 139.00 ±20. 50 in the stimulation group (t = -7. 994, P <0. 05). Also the COX-2 protein level was elevated from 19. 50 ±9. 20 in the sham group to 359. 20 ±21.90 in the stimulation group (t = -5. 190, P <0. 05). Conclusions Electrical stimulation on the unilateral trigeminal ganglion induces neurogenic inflammation in the dura mater. Changes on the neurogenic inflammation-related factors are probably the essential pathophysiological mechanism underlying the pain in migraine.
4.Application of Propfol Closed-loop Anesthesia System in Pediatric Otorhinolaryngologic Surgery
Ning JIN ; Zhen LI ; Xin HUANG ; Jingjie WAN ; Xiufei TENG ; Junchao ZHU
Journal of China Medical University 2015;(10):873-876
Objective To evaluate the application of propfol?remifentanil closed?loop and opened?loop anesthesia in children otorhinolaryngologic operation under BIS monitoring. Methods Fourty children underwent elective children tonsillectomy and adenoidectomy were recruited for the study and randomly divided into two groups:closed?loop group(group T)and opened?loop group(group C),with 20 children each. The two groups all received total intravenous induction,then the subjects of closed?loop group were administrated with a method of system automatic regulation of plasma target control and the opened?group cases underwent manual adjustment of plasma target control method according to the BIS value during op?eration. The variables of non?invasive blood pressure(BP),heart rate(HR),pulse oxygen saturation(SpO2),electrocardiogram(ECG),bispec?tral index(BIS),the number of times the manual adjustment of propfol target control applied,and recovery time,were recorded respectively at the time points of before anesthesia(T0),immediately after intubation(T1),5 min after intubation(T2),10 min after(T3),15 min after(T4),30 min after(T5)and the removal of endotracheal intubation(T6). Results The total dosage of propfol in group T was less than the dosage in group C with dosage decrease of 9.83%;there was no significant statistical difference of the total dosage of remifentanil. Conclusion The use of propfol?remi?fentanil closed?loop anesthesia in children otorhinolaryngologic operation is safe,easy,and of strong controllability,which should be widely promoted.
5."Survey and analyses on the satisfaction degree of the postgraduate in professional degree in ""The Joining Together of Double-Track""education model"
Wenya BAI ; Xiufei TENG ; Yanchao YANG ; Yang LI ; Yuxiao WAN ; Xin HUANG ; Zhen LI ; Junchao ZHU
Chinese Journal of Medical Education Research 2017;16(4):325-329
Objective To survey the satisfaction degree of the postgraduates in professional degree with The Joining Together of Double-Track education model in the current stage of professional degree graduate education and standardized training of residents in China. Methods According to various factors, such as the current situation of postgraduates in medical universities, we sought the opinions of relevant experts to design questionnaire. Meanwhile, to enhance the reliability of the questionnaire and the survey, we chose the postgraduates of Shengjing Hospital of China Medical University first to do the pre-survey, and according to the feedback, we adjusted part of the aspects, thus formed a formal questionnaire, which included the satisfaction with training of clinical practice ability, training of research ability, and tutors' assessment etc. Finally, the Chinese New Youth Forum online released the questionnaires, selecting the postgraduates in professional degree who were participating in, or had participated in the completion of the standardized training as the participants, which took place between March 2016 and May 2016. SPSS 16.0 was used for statistical analysis. The evaluation results of different majors were tested by Kruskal-Wallis rank sum test. Results According to the results of the survey, the aspects in the clinical resident standard-ized training that the 1000 postgraduates were more satisfied with were as follows: training time [42.8%(n=428)], training center [41.8% (n=418)], training of clinical practice ability [41.6% (n=416)], tutors [40.2%(n=402)], economic income [38.8%(n=388)], department arrangements [38.4% (n=384)], training of research ability [37.5%(n=375)]. There is a significant difference in the satisfaction degree of different pro-fessional graduate students in theJoining Together of Double-Trackeducation model (P<0.05). ConclusionThe Joining Together of Double-Track education model should be compatible with the training objectives of postgraduates in professional degree. Much more attention should be paid to the post-graduates, satisfac-tion degree with the clinical resident standardized training, as well as the requirements during the training period, improve the evaluation of graduate students' ability of scientific research, econo-mic income and so on, so as to improve the training system for the postgraduates.
6.The design of all solid-state tunable pulsed Ti:sapphire laser system.
Zhe CHEN ; Geng KU ; Junchao WAN ; Wei WANG ; Chuanqing ZHOU
Chinese Journal of Medical Instrumentation 2013;37(3):185-188
This paper presented a design of broadly all solid-state tunable pulsed Ti:sapphire laser with high power and stable performance. The laser was pumped by custom-made Nd:YAG laser which had water cooling system and amplified by two stage amplifier. The method accomplished tunable output of all solid-state tunable pulsed Ti:sapphire laser by modifying the reflection angle of the back mirror. We investigated the relationship between the power of the pumping laser and the all solid-state tunable pulsed Ti: sapphire laser by changing the power of the pumping source.
Aluminum Oxide
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Equipment Design
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Laser Therapy
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instrumentation
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Lasers, Solid-State
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Titanium
7.A study on effect of Shenfu injection on early postoperative cognitive function and brain derived neurotrophic factor in patients with burns
Junchao DAI ; Xiang LONG ; Yunqiang WAN ; Hongjun LIU
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2018;25(2):149-152
Objective To investigate the effects of Shenfu injection on early post-operative cognitive dysfunction (POCD) and brain derived neurotrophic factor (BDNF) in patients with burns. Methods Fifty-six patients with burns and ready to receive surgical treatment of scars admitted to Affiliated Hospital of Southwest Medical University from July 2015 to January 2017 were enrolled, and they were divided into a control group and a Shenfu group by random number table, 28 cases in each group. The regimen of anesthesia induction before operation and anesthesia maintenance in the operation in two groups was the same, and the patients in Shenfu group received intravenous drip of Shenfu injection 40 mL at 0.5 hour before surgery. The Mini-mental State Examination Scale (MMSE) was used to evaluate the cognitive function after surgery, and MMSE score reduction of > 2 scores was recognized as cognitive impairment after operation;patient's pain degree was evaluated by using visual analogue scale (VAS); the levels of serum BDNF were detected by the enzyme-linked immunosorbent assay (ELISA) at 0.5 hour before operation, immediately after operation, and 12 hours, 1 day, 3 days after operation. Results The MMSE scores were significantly decreased in the two groups after surgery, but decreasing degree of the MMSE scores in Shenfu group were significantly slower than those of the control group (1 day after surgery was 22.8±2.9 vs. 20.5±3.2, 3 days after surgery was 25.6±3.1 vs. 23.2±3.0, both P < 0.05). The incidence of POCD in the Shenfu group was significantly lower than that of the control group [7.1% (2/28) vs. 42.9% (12/28), P < 0.05]. The VAS scores were significantly higher in the two groups after surgery, but there was no significant difference between the two groups at each time point (all P > 0.05). The serum BDNF levels were significantly increased in two groups at immediate post-operation and 12 hours after surgery compared with those 1 day before operation, in addition, the BDNF level in Shenfu group was obviously higher than that in the control group (mg/L: 13.5±4.2 vs. 9.9±3.3, 11.4±3.5 vs. 9.1±3.2, both P < 0.05), the serum BDNF levels in two groups returned to their preoperative levels on 1 day and 3 days after surgery (all P > 0.05). Conclusion The Shenfu injection can reduce the incidence of early POCD in patients with large area burns and its mechanism may be related to the increase of BNDF expression.