Objective To evaluate the efficacy of laryngeal mask airway (LMA) Guardian for airway management in the patients requiring insertion of nasogastric tube before laparoscopic cholecystectomy.Methods Sixty patients of both sexes,aged 26-64 yr,weighing 48-95 kg,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,with Mallampati grade Ⅰ-Ⅲ,scheduled for elective laparoscopic cholecystectomy under general anesthesia,were divided into group Ⅰ and group Ⅱ (n =30 each) using a random number table.In group Ⅰ,the nasogastric tube was inserted through the drain tube of LMA Guardian.In group],the nasogastric tube was inserted through the nostril before operation,and after successful LMA Guardian placement,another nasogastric tube was inserted through the drain tube of LMA Guardian.The hemodynamic parameters,SpO2,end-tidal pressure of carbon dioxide and peak airway pressure (Ppeak) were monitored during operation.The fiberoptic laryngoscopy scores were assessed after successful LMA placement,and the nasogastric tube displacement was recorded.The LMA placement time,success rate of LMA placement at first attempt,airway sealing pressure,occurrence of air leakage of LMA and nasogastric tube drainage were recorded.The bloodstains and gastroesophageal reflux were observed after removal of the LMA.The pH values were tested at the tip of LMA and on the dorsal and ventral sides of the body of LMA using pH test papers.The development of adverse reactions in the oropharynx was recorded within 24 h after operation.Results The hemodynamics was stable,the SpO2 and Ppeak were within the normal range during operation,and Ppeak was lower than airway sealing pressure in the two groups (P＞0.05),and there was no significant difference between the two groups.There was no significant difference between the two groups in the LMA placement time,success rate of LMA placement at first attempt,airway sealing pressure,score for exposure of oropharynx,development of adverse reactions in the oropharynx,consumption of anesthetics,development of bloodstains within the body of LMA and gastroesophageal reflux,and pH values at the tip of LMA and on the dorsal and ventral sides of the body of LMA (P＞0.05).Nasogastric tube drainage:the rate of nasogastric tube drainage through the LMA Guardian was 67％ in group Ⅰ;the rate of nasogastric tube drainage through the nostril was 40％,and the rate of nasogastric tube drainage though the LMA Guardian was 50％ in group Ⅱ.No nasogastric tube displacement was found after operation in group Ⅱ.Conclusion For the patients requiring insertion of nasogastric tube before laparoscopic cholecystectomy,insertion of LMA Guardian is easy,and LMA Guardian can assure good airway sealing and adequate ventilation and can be safely and effectively used for airway management in this type of patients.

Objective To evaluate the efficacy of laryngeal mask airway (LMA) Ⅰ-gel for airway management in the patients requiring insertion of nasogastric tube before laparoscopic cholecystectomy.Methods Sixty patients,aged 26-64 yr,weighing 54-90 kg,of ASA physical status Ⅰ-Ⅲ (Mallampati Ⅰ-Ⅲ),scheduled for elective laparoscopic surgery,were randomly divided into Ⅰ,Ⅱ and Ⅲ groups (n =20 each) using a random number table.In group Ⅰ,the nasogastric tube was inserted through the drain tube of LMA I-gel.In group Ⅱ,the nasogastric tube was inserted through the nostril before surgery.In group Ⅲ,the nasogastric tube was inserted through the nostril before surgery,and another nasogastric tube was inserted through the drain tube of LMA I-gel after induction of anesthesia.The hemodynamic parameters,SpO2,PET CO2 and peak airway pressure were monitored during surgery.The fiberoptic laryngoscopy scores were assessed and the development of nasogastric tube displacement was recorded after successful LMA placement.The LMA placement time,success rate of LMA placement at the first attempt,depth of placement,airway sealing pressure,and occurrence of air leakage of LMA and nasogastric tube drainage were recoded.The bloodstains and gastroesophageal reflux were observed after removal of LMA Ⅰ-gel.The pH values were tested at the tip of LMA and on the dorsal and ventral sides of the body of LMA by using pH test papers.The development of adverse reactions in the oropharynx was recorded within 24 h after surgery.Results The hemodynamics was stable and SpO2,peak airway pressure and PETCO2 were all within the normal range during surgery,and Ppeak was lower than airway sealing pressure in the three groups.There were no significant differences between the three groups in LMA placement time,success rate of LMA placement at the first attempt,depth of placement,airway sealing pressure,incidence of air leakage of LMA,fiberoptic laryngoscopy scores,time for removal of LMA I-gel,incidences of adverse reactions in the oropharynx,bloodstains within the body of LMA and gastroesophageal reflux,and pH values at the tip of LMA and on the dorsal and ventral sides of the body of LMA.There was no nasogastric tube displacement in Ⅱ and Ⅲ groups.There were 7 patients developing gastric juice outflow from drainage tube of the LMA I-gel and 2 patients developing gastric juice outflow from the nostril gastrictubes in group Ⅱ.Conclusion For the patients requiring insertion of nasogastric tube before laparoscopic cholecystectomy,insertion of LMA I-gel is easy,and I-gel LMA can assure good airway sealing and adequate ventilation.

Objective To evaluate the effect of wire-reinforced polyurethane epidural catheters on the success rate of epidural catheterization in the patients undergoing caesarean section.Methods A total of 182 pregnant patients,aged 25-43 yr,with body height of 145-178 cm,weighing 51-100 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective caesarean section under combined spinal-epidural anesthesia,were divided into 2 groups using a random number table:polyvinyl chloride epidural catheter group (group Ⅰ,n =94) and wire-reinfnrced polyurethane epidural catheter group (group 11,n=88).Spinal or epidural puncture was performed at L2,3 or L3,4 interspace,and the corresponding epidural catheter was inserted in each group aficr succcssful puncturc.Thc dcvclopment of difficult insertion,intravascular catheter insertion or paresthesia during puncture or insertion was defined as a failure of epidural catheterization.The occurrence of failed epidural catheterization was recorded.Results The failure rate of epidural catheterization was significantly lower in group 1Ⅱ than in gronp Ⅰ (P＜0.05).Conclusion Wire-reinforced polyurethane epidural catheters can raise the success rate of epidural catheterization in the patients undergoing caesarean section.

Objective To evaluate the changes of left ventricular(LV) 3-dimension peak displacement (3D-D) during different cardiac pacing patterns. To provide a reliable mechanical data base for the optimization cardiac pacing. Methods Cardiac pacings in open-chest Beagle canine models( n = 10) were performed using three patterns[I, e. , right ventricular apical pacing (RVA-P), LV lateral pacing (LVL-P)and LV apical pacing(LVA-P)],3D full volumetric real-time imaging were acquired in a completed cardiac cycle. The 3D-D,3D-D peak time (3D-DTc) and the standard deviation of TC(3D-DTSD) were calculated and analyzed in different pacing patterns for difference and spatial correlationship. Results ① The 3D-D of LVL-P and LVA-P state decreased compared with BASE and RVA-P state, there were significant 3D-D difference of mid anterior,mid anteriorspetal, mid interior,mid posterior, mid lateral between LVL-P and BASE, RVA-P patterns( P ＜0.05). There were significant 3D-D difference of mid anterior,mid lateral,mid posterior between LVA-P and RVA-P patterns groups( P ＜0.05). There were significant 3D-D difference of all segments in apical level between LVL-P,LVA-P and BASE, RVA-P states( P ＜0.05). ② Corrected by the heart rate,the 3D-DTC of different cardiac pacing patterns were shorter than BASE state. ③ There were no significant 3D-DTSD difference between different cardiac pacings and BASE patterns. There were significant 3D-DTSD difference between RVA-P and LVA-P patterns (P ＜ 0.05). Conclusions LV mechanical activation and synchronization could be maintained during RVA-P rather than LVA-P and LVL-P. Echocardiographic study of left ventricular 3D-D can actually reveal myocardial mechanical state during different cardiac pacings and BASE patterns.

OBJECTIVETo explore whether there exists coincidence of the most appearing time of clinical features of liver cancer at different longitude and latitude, according to the law of field equation and the theory of warpage of space time by Einstein.

METHODSThree regions with different longitude and latitude were selected randomly and sampled. There were 36 items altogether, including 12 clinical items, which were used to imitate the yearly cycle cosine curve. The acorphases and the ratioes of amplitudes and means were compared to justifying whether they were in the same range.

RESULTSAll the acorphases of 36 items appeared between -90.1degrees to -207.5 degrees (from april to july), existing in one third of the same range, in which 13 items occurred rhythmly (P<0.05). The image acorphases of liver cancer at the early and middle stage and gamma-glutamyl transpeptidase acorphase appeared between -98.5 degrees to -148.2 degrees (from april to may), in which 5 items occurred rhythmly (P<0.05).

CONCLUSIONIt is the same mode of the yearly biologcal cycle for liver cancer malignant growth within the most appearing time (from april to july). It will increase the detecting rate of liver cancer at the early and middle stage during this time (especially from april to may).

Carcinoma, Hepatocellular ; pathology ; Cell Cycle ; physiology ; Chronobiology Phenomena ; Hepatocytes ; physiology ; Humans ; Liver Neoplasms ; pathology ; Mathematical Computing ; Periodicity

OBJECTIVETo observe the effects of Relinqing granules (powder of Polygonum capitatum extract) on the bacterial pyelonephritis model in rats.

METHODThe rat bacterial pyelonephritis model was induced by injecting the escherichia coli ATCC-25922 into kidney parenchyma. The rats were divided ramdamly into Relinqing groups(52.32, 26.16 g x kg(-1)), norflorin group (0.03 g x kg(-1)), model group and normal control group, and were given experimental drugs by gastrogavage. The contents of leucocytes (WBC), occult bloo (BLD), glucose (GLU), protein (PRO), ketones, bilirubin and urobilinagen in urine were determined.

RESULTAs compared with the model group, Relinqing granules 6.0 g x kg(-1) (crude drug 52.32 g x kg(-1)) could decrease significantly the contents of WBC and BLD in urine and, however, had no markedly effects on the other biochemical parameters of urine.

CONCLUSIONRelinqqing granule has significant effects of decreasing urine WBC and BLD on the bacterial pyolonephritis in rats.

Animals ; Anti-Infective Agents, Urinary ; isolation & purification ; pharmacology ; Bilirubin ; urine ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Escherichia coli Infections ; urine ; Female ; Glycosuria ; urine ; Ketones ; urine ; Leukocyte Count ; Male ; Occult Blood ; Plants, Medicinal ; chemistry ; Polygonum ; chemistry ; Proteinuria ; urine ; Pyelonephritis ; urine ; Rats ; Rats, Sprague-Dawley

Objective To evaluate the effects of different anesthetic methods on postoperative acute pain in patients with myasthenia gravis undergoing video-assisted thoracoscopic thymectomy.Methods Fifty-four patients of both sexes,aged 18-64 yr,with body mass index of 20-28 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective video-assisted thoracoscopic thymectomy,were allocated into 2 groups (n =27 each) using a random number table method:sevoflurane-based anesthesia group (group S) and propofol-based anesthesia group (group P).After routine anesthesia induction in two groups,anesthesia was maintained by inhaling sevoflurane and target-controlled infusion of remifentanil in group S and by target-controlled infusion of propofol and remifentanil in group P.Heart rate and mean arterial pressure were recorded before operation and at 5 and 10 min after extubation (T1.2).The intensity of pain at T2 and visual analog scale (VAS) score and consumption of morphine at 1,2,4,24 and 48 h after operation (T3-7) were recorded.The pressing times of analgesia pump,requirement for rescue analgesia and development of nausea and vomiting were recorded at T7.Results There were no significant differences in heart rate or mean arterial pressure at each time point between two groups (P＞0.05).Compared with group S,the intensity of pain was significantly alleviated at T2,and VAS scores and morphine consumption were decreased at T3,4 in group P (P＜0.05).There were no significant differences between group P and group S in VAS scores or consumption of morphine at T5-7,or pressing times of analgesia pump,requirement for rescue analgesia or incidence of nausea and vomiting at T7 (P＞0.05).Conclusion Propofol-based anesthesia provides better efficacy in alleviating postoperative acute pain in patients with myasthenia gravis undergoing video-assisted thoracoscopic thymectomy.

OBJECTIVETo investigate the clinical and pathologic characteristics of anti-glomerular basement membrane(GBM) disease with normal renal function.

METHODSThe clinical and pathologic data of 6 patients with anti-GBM disease and normal renal function in Peking Union Medical College Hospital were reviewed retrospectively. Furthermore, 29 patients with anti-GBM disease and impaired renal function in the same period in the same hospital were enrolled as the control group. Factors that may influence the prognosis were analyzed.

RESULTSSix (17.1%) of all 35 patients maintained normal renal function for 12-133 months during follow-up. Five patients had microhematuria and proteinuria, one had pulmonary hemorrhage only, and three manifested as Goodpasture syndrome. Renal biopsies from 4 patients revealed linear deposition of IgG 2+-3+ along the glomerular capillary walls by immunofluorescence. As shown by normal light microscopy, mild mesangial proliferation and crescentic glomerulonephritis with a large amount of fibrinoid necrosis of glomerular capillary walls were observed in different patients; however, most pathological changes were mild. Five of these six patients were treated with immunosuppressive drugs and/or plasma exchange. Compared with the control group, the 6 patients with normal renal function had significantly higher hemoglobin[(77.97±20.62 vs.(99.67±19.80 g/L P=0.024], lower titers of anti-GBM antibody[(224.34 ± 145.79 vs.(80.23 ± 85.73 EU/ml P=0.027], and lower ratio of glomeruli with crescents[(0.58±0.29 vs.(0.17±0.27 ,P=0.005]. These 6 patients with normal renal function were followed up for 12-133 months, among whom 4 patients achieved complete remission and 2 had mild proteinuria and microhematuria.

CONCLUSIONAnti-GBM disease with normal renal function is not uncommon. Most patients have mild pathologic changes and good prognosis.

Adult ; Anti-Glomerular Basement Membrane Disease ; pathology ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Kidney ; physiopathology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

OBJECTIVETo evaluate the femoral head perfusion and to predict the traumatic avascular necrosis (AVN) of the femoral head by single photon emission computerized tomography and computerized tomography (SPECT/CT).

METHODSTotally 18 adult beagle dogs were divided randomly into three equal-sized (n equal to 6) groups. Subsequently different degrees of ischemia model were developed by destroying blood vessels of the femoral head. The left hip received sham operation as normal control and the right hip underwent blood interruption. In Group A, the ligamentum teres was cut off. In Group B, the marrow cavity of the right femoral neck was destroyed while in Group C, the soft tissues at the base of the femoral neck were stripped in addition to the resection of the ligamentum teres and destruction of the marrow cavity. Three hours after surgery, SPECT/CT was performed. Laser Doppler Flowmetry (LDF) measurements were also obtained at three different time points (before operation, immediately and three hours after operation) in order to assess the change process of blood supply to the femoral head.

RESULTSSPECT/CT showed no significant difference in the radionuclide uptake between the right and left femoral heads in Group A (t equal to -0.09, P equal to 0.94) and Group B (t equal to 0.52, P equal to 0.62). However, in Group C, it was 261+/-62 for the right femoral head, only 12% of that in the left femoral head. LDF measurements indicated that the femoral head perfusion was decreased from (45.0+/-3.3) PU to (39.1+/-3.7) PU in Group A,from (44.0+/-2.7) PU to (34.3+/-2.6) PU in Group B, and from (47.3+/-2.1) PU to (4.96+/-0.6) PU in Group C immediately after operation. However, the perfusion was restored and returned to normal values three hours after operation except in Group C.

CONCLUSIONSPECT/CT could assess the perfusion of the femoral head semiquantitatively, which might be useful in predicting the development of traumatic AVN.

Animals ; Dogs ; Femur Head ; Femur Head Necrosis ; Tomography, Emission-Computed, Single-Photon

OBJECTIVETo study the reverse effect of ligustrazine (TMP) on HepG2/ADM, a herd of hepatocellular carcinoma cell, multidrug resistance (MDR) and the influence of P-gp170 expression.

METHODThe reverse effect of ligustrazine on HepG2/ADM cell was observed, with the methods of cell culture, MTT's analyze, RT-PCR and Flow cytometric, etc.

RESULTLigustrazine could make MDR of cell line of HepG2/ADM reduce the expression of P-gp170, enhance the density of adriamycin in cell and increase the adriamycin's cytotoxicity. With the Flow cytometric, the results of RT-PCR showed the transcriptional activity of the MDR1 decreased.

CONCLUSIONLigustrazine can reverse MDR of HCC cell line of HepG2/ADM and has prospect in clinical use.

Calcium Channel Blockers ; pharmacology ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Cell Line, Tumor ; Cytotoxicity, Immunologic ; drug effects ; Doxorubicin ; metabolism ; pharmacology ; Drug Resistance, Multiple ; drug effects ; Drug Resistance, Neoplasm ; drug effects ; Genes, MDR ; Glycoproteins ; metabolism ; Humans ; Liver Neoplasms ; metabolism ; pathology ; Pyrazines ; pharmacology