Adolescent ; Adult ; Anesthesia, Intravenous ; Anesthetics, Intravenous ; Cardiopulmonary Bypass ; Female ; Fentanyl ; Heart Valve Prosthesis Implantation ; Humans ; Male ; Middle Aged ; Sufentanil

Adult ; Anesthetics, Inhalation ; administration & dosage ; Desflurane ; Electroencephalography ; methods ; Female ; Humans ; Isoflurane ; administration & dosage ; analogs & derivatives ; Male ; Middle Aged ; Monitoring, Intraoperative ; Nitrous Oxide ; administration & dosage

Objective:To construct the lentiviral-vector encoding human interleukin-10 protein(LV-hIL-10) and to observe the effect of LV-hIL-10 on controlling neuropathic pain via intrathecal administration in CCI rats. Methods:hIL-10 gene fragment was isolated and amplified from pCYIL-10 plasmid by PCR, and was cloned into pWPXL. The recombinant plasmid pWPXL-IL-10,envelope plasmid pMD2.G and packaging plasmid psPAX2 were cotransfected into 293T cells, LV-hIL-10 is prepared by concentrating the collected supernatant .At the same time, the empty plasmid pWPXL-GFP,pMD2.G and psPAX2 were cotransfected into 293T cells, LV-GFP is prepared for contrast.135 sheer breed pathogen-free adult male Sprague-Dawley rats divided into 9 arrays at random: CCI models 4 arrays (C0,C1,C2,C3), sham operatived rats 4 arrays (S0,S1,S2,S3) and a normal contrast array (N), each respectively intrathecal injection LV-hIL-10 (C1,S1)、LV-GFP (C2, S2),isotonic Nachloride (C3,S3) and control (no implanted catheters and no administration, C0,S0), the pain threshold of each array and the expression of mRNA and protein of IL-10 in spinal cord,pallium and hippocampus on different time were observed after intrathecal administration LV-hIL-10 in successful CCI model rats . Results:The hIL-10 gene fragment was obtained from pCYIL-10 plasmid, pWPXL-hIL-10 was recombinated successfully. the cloned gene segment was validated by DNA sequencing .High titer(2?1010)and highly purified LV-hIL-10 particles were obtained by three plasmids were cotransfected into 293T cells. The mechanical allodynia and thermal hyperalgesia were alleviated via intrathecal injection LV-hIL-10 in CCI rats. The overexpression of IL-10 were detected in spinal cord,pallium and hippocampus , especially in the spinal cord .Conclusions:The mechanical allodynia and thermal hyperalgesia can be relieved by intrathecal injection LV-hIL-10 in CCI rats.

Objective To investigate the effectivity of bispectral index(BIS)and auditory -evoked potentials index(AEP index)in monitoring the depth of desflurane anesthesia in the elderly. Methods Sixty patients(ASA gradeⅠ～Ⅱ)without obvious auditory and psychiatric dysfunction undergoing general anesthesia were enrolled in this study,and they were devided into the elderly group (n=30)and the non-elderly group(n=30)according to the age.After the endotracheal intubation,the lungs were ventilated with desflurane in oxygen.End-tidal concentrations of desflurane were maintained at 0.6,1.0 minimum alveolar concentrations(MAC)and 1.3 MAC for 20 minutes, respectively.The changes of BIS,AEP index,mean arterial blood pressure(MAP)and heart rate (HR)were recorded simultaneously.Results In the elderly and non-elderly groups,BIS were 94.14?6.5 and 94.5?4.6(P＞0.05),and AEP index at pre-anesthesia were 87.2?11.7 and 89.2?6.9(P＞0.05)respectively,which showed no statistic difference between two groups.BIS and AEP index decreased significantly in each time point at pre-anesthesia compared with those during anesthesia in two groups (P＜0.05).In the periods of increasing concentration of desflurane,BIS decreased gradually in two groups(P＞0.05),but BIS in the elderly group were higher than in the non-elderly group at the same end-tidal desflurane concentration(P＞0.05),and BIS negatively correlated with the end-tidal desflurane concentration in two groups.In the elderly group,AEP index decreased significantly at the concentration of 1.0 MAC and 1.3 MAC of desflurane compared with that of 0.6 MAC(P＜0.05),but there was no difference in AEP index with increasing end-tidal desflurane concentration from 1.0 MAC to 1.3 MAC(P＞0.05).At every concentration of desflurane,AEPindexintheelderlygroupwaslessthaninthenon-elderlygroup(P＜0.05).Conclusions BIS and AEP indexes correlate well with the end-tidal desflurane concentration,and are valuable for monitoring the depth of desflurane anesthesia in the elderly.AEP index can predict the difference in depth of anesthesia at the same end-tidal desflurane concentration between the elderly and the non-elderly.

Objective To investigate the effect of human cytomegalovirus (HCMV) on proliferation of colony forming unit T-lymphocyte (CFU -TL)and its interference methods. Methods Normal CFU - TL culture was used as blank control. Normal CFU- TL culture system plus inactivated HCMV fluid as inactivated HCMV control. The dilution of 1:10,1:100,1:1000 were added into CFU -TL colonies culture system directly as infected group. Astragalus (AMI) and ganciclovir(GCV) were added into culture system with HCMV dilution of 1:10 as experimental group. By methylcellulose semi-solid culture, different concentrations of HCMV - AD1699 affect CFU-TL and interfered by astragalus AMI, GCV. CFU - TL were surveyed. The effect of HCMV on CFU-TL proliferation was measured by MTT; HCMV-AD169 DNA in CFU-TL was found by PCR. Results 1. Compared with control group, the numbers of CFU -TL in the HCMV infection groups decreased significantly(P

OBJECTIVE: To examine the characteristics of drug-induced fatal adverse effects in the United States from 1999 to 2004 and put forward suggestions for China's control of drug-induced adverse effects. METHODS: The data came from the compressed mortality file of Centers for Disease Control and Prevention (CDC) of the United States. Drug-induced mortality was used to analyze the effects of gender, race, age, and drug on drug-induced fatal adverse effects. RESULTS: During 1999-2004, 1 700 persons died of drug-induced adverse effects (mortality, 0.10/100,000). No difference was found in mortality between males and females. The drug-induced mortalities of whites, blacks and Native Americans, and other racial groups were respectively 0.10, 0.12, and 0.04 per 100,000 persons. The mortality increased quickly with the increase of age since the age group of 5-9. In this period, the 5 most common drugs that led to deaths were: (1) agents primarily affecting blood constituents; (2) analgesics, antipyretics, and anti-inflammatory drugs; (3) primarily systemic agents; (4) systemic antibiotics; and (5) hormones and their synthetic substitutes and antagonists, not elsewhere classified. At the age group of 20-84, 3 most common drugs leading to deaths for whites were: anticoagulants,opioids and related analgesics, and insulin and oral hypoglycaemic drugs. For blacks and Native Americans, they were: hydantoin derivatives, anticoagulants, and anaesthetic, unspecified. For people ages older than 84, anticoagulants, opioids and related analgesics, and drug or medicament, unspecified, were the 3 most common drugs resulting in deaths. For the rest of racial groups, the number of deaths caused by all kinds of drugs was less than 3. CONCLUSION Obvious differences on race, gender, age, and drug were found for drug-induced fatal adverse effects in the United States during 1999-2004, and these differences should be considered by the government when interventions are developed. China can learn something from the United States in controlling drug adverse effects, and improve its surveillance system of drug adverse effects as soon as possible.
Adolescent ; Adult ; Adverse Drug Reaction Reporting Systems ; organization & administration ; Aged ; Aged, 80 and over ; Analgesia ; adverse effects ; Anticoagulants ; adverse effects ; Child ; Child, Preschool ; Drug-Related Side Effects and Adverse Reactions ; epidemiology ; etiology ; mortality ; Female ; Humans ; Male ; Middle Aged ; United States ; epidemiology ; Young Adult

Background: The CD38/cyclic ADP?ribose (cADPR) pathway plays a role in various central nervous system diseases and in morphine tolerance, but its role in local anesthetic intoxication is unknown. The aim of this study was to determine the role of the CD38/cADPR pathway in ropivacaine?induced convulsion. Methods: Forty male Sprague?Dawley rats were randomly divided into five groups (n = 8 per group): sham group, ropivacaine group, ropivacaine+8?Br?cADPR (5 nmol) group, ropivacaine+8?Br?cADPR (10 nmol) group, and ropivacaine+8?Br?cADPR (20 nmol) group (no rats died). Rats were intracerebroventricularly injected with normal saline or 8?Br?cADPR 30 min before receiving an intraperitoneal injection of ropivacaine. Electroencephalography and convulsion behavior scores were recorded. The hippocampus was harvested from each group and subjected to nicotinamide adenine dinucleotide and cADPR assays, Western blotting analysis, and malondialdehyde (MDA) and superoxide dismutase (SOD) assays. Results: Intraperitoneal injection of ropivacaine (33.8 mg/kg) induced convulsions in rats. CD38 and cADPR levels increased significantly following ropivacaine?induced convulsion (P = 0.031 and 0.020, respectively, compared with the sham group). Intraventricular injection of 8?Br?cADPR (5, 10, and 20 nmol) significantly prolonged convulsion latency (P = 0.037, 0.034, and 0.000, respectively), reduced convulsion duration (P = 0.005, 0.005, and 0.005, respectively), and reduced convulsion behavior scores (P = 0.015, 0.015, and 0.000, respectively). Intraventricular injection of 8?Br?cADPR (10 nmol) also increased the B?cell lymphoma?2 (Bcl?2)/Bcl?2?associated X protein ratio (P = 0.044) and reduced cleaved Caspase 3/Caspase 3 ratio, inducible nitric oxide synthase, MDAand SOD levels (P = 0.014, 0.044, 0.001, and 0.010, respectively) compared with the ropivacaine group. Conclusions: The CD38/cADPR pathway is activated in ropivacaine?induced convulsion. Inhibiting this pathway alleviates ropivacaine?induced convulsion and protects the brain from apoptosis and oxidative stress.

Objective To evaluate the safety and short-term efficacy of transrectal ultrasound-guided transperineal cryosurgical ablation(TRUSCSA) for localized prostate cancer. Methods The data of 26 patients who were diagnosed with clinically localized prostate cancer (T_(1a)N_0M_0 - T_(2x)N_0M_0) by biopsy were reviewed. The data of serum prostate-specific antigen (PSA) level, clinical stage and Gleason score were collected. The Gleason score of all cases was ≤7; among them 6 cases were 2 - 4 and 20 cases were 5 - 7. The average pretreatment value of PSA was 11. 9 ng/ml (4. 7 - 19. 2 ng/ml). All the patients were treated with TRUSCSA, with a dual freeze-thaw cycle by using ultrathin 17-gauge cryoneedles. Immediate and delayed morbidities were evaluated. The PSA level was obtained every 3 months for the first 2 years and then every 6 months thereafter, and failure was defined as the inability to reach a nadir of 0. 5 ng/ml or less. All patients were strongly encouraged to undergo routine biopsies despite a stable PSA level. Results The operative time was (102±32)min. The postoperative hospital stay was (6±2)d. After withdrawal of the catheter, 22 cases had good continence) 4 had temporary incontinence for 3 - 7 d. Before operation 9 cases had normal sex life, and among them 5 cases had erectile dysfunction after operation. No one developed urinary retention or urethro-rectal fistula. The follow-up ranged from 6 to 30 months (mean 22). The PSA level at the last follow up visit was less than 0. 5 ng/ml in 23 patients (88%) and 0. 5 ng/ml or more in 3(12%). Postoperative biopsies were taken in 20 cases and the results were negative at the 6th month. Conclusions Transrectal ultrasound-guided percutaneous cryosurgical ablation for clinically localized prostate cancer could be effective and safe. Additional studies with longer follow-up are necessary to determine the sustained efficacy of this procedure.

Objective To present the technique and short-term results of retroperitoneal laparoscopic renal cryoablation for small renal tumors. Methods Ten selected patients cases with 11 renal tumors were included in present study. There were 3 cases of left renal tumor, 6 cases of right renal tumor and 1 case of bilateral renal tumors. Tumors were located at the upper pole (2), middle (6), or lower pole (3). All tumors were located distant from the collecting system, without evidence of metastatic disease. Mean tumor size was 2. 8 cm (range: 1.5-4.0). All the patients were managed with a double freeze-thaw cycle of retroperitoneal laparoscopic renal cryoablation. The preoperative Hb was (137± 21)g/L, ESR was (27±12)mm/1 h, SCr was (92±41)μmol/L, GFR was (42±10)ml/min.All the patients were taken routine biopsies. Results Cryoablation was technically successful in all 10 patients (11 tumors). The mean time of the operations was (101 ± 31) min, and the mean blood loss was (42±21) ml. None of the cases received blood transfusion post-operation. No operative complication was seen. The postoperative hospital stay was (4±2) d. The postoperative Hb was (129 ±18)g/L,ESR was (31±14)mm/1 h,SCr was (95±39)μmol/L,GFR was (40±11)ml/min. There was no statistic change of Hb, ESR, SCr and ECT-GFR after operations(P＞0. 05). The biopsy results revealed that 8 tumors were renal clear cell carcinomas, and 2 tumors were papillary renal cell carcinomas, and 1 tumor was renal angiomyolipoma. All the patients had a minimum follow-up of 6 months (mean 16, range 6 to 21). Follow-up magnetic resonance imaging at 1, 3, and 6 months identified the punched-out, nonenhancing, spontaneously resorbing, renal cryolesions. Follow-up biopsie of the cryoablated tumor site was negative in the only patient who have undergone the biopsy. No evidence of local or port-site recurrence was found, and no metastatic disease. ConclusionsRetroperitoneal laparoscopic renal cryoablation for small renal tumors could be an accurate and effective intervention with a relatively low incidence of complications. Critical long-term data regarding laparoscopic renal cryoablation are awaited.

OBJECTIVETo investigate the effect of controlled hypotension using different drugs on gastrointestinal perfusion and bleeding volume in nasal endoscopic surgery.

METHODSThirty ASA class I or II patients scheduled for nasal endoscopic surgery were randomized into three groups, including a routine general anesthesia group (group A) and two controlled hypotension groups (groups B and C). After anesthesia induction, anesthesia was maintained with 1%-2% isoflurane and vecuronium. ECG, mean arterial blood pressure (MAP), heart rate (HR), SpO(2) and PETCO(2) were continuously monitored. TRIP tonometry catheter 14 F was inserted into the stomach and connected to Tonocap (Datex-Ohmeda, Finland ). In groups B and C, hypotension was induced with isoflurane (1%-2%) and sodium nitroprusside (0.3-3 microg.kg(-1).min(-1)), and with isoflurane (1%-2%) and glonoine (0.5-5 microg.kg(-1).min(-1)), respectively, and the MAP was reduced to 50-55 mmHg in 10-15 min. In groups B and C, blood samples were taken for blood gas analysis after anesthesia (T(0)), after acute hypervolemic hemodilution (T(1)), at 30 and 60 min after controlled hypotension (T(2) and T(3)), and 30 min after recovery from hypotension (T(4)). In group A, blood samples were taken at different time points in the perioperative period.

RESULTSThe patients in groups B and C had smaller bleeding volume than those in group A. HR was decreased after moderate acute hypervolemic hemodilution, and increased after controlled hypotension (T(2) and T(3)) in comparison with that at T(1) to a level similar to that at T(0). No significant changes were found in pHi at T(2) and T(3) in comparison with that at T(1) in the three groups.

CONCLUSIONWhen appropriate measures are taken, induced hypotension at 50-55 mmHg does not necessarily produce disturbance in gastrointestinal perfusion. Induced hypotension with glonoin can decrease the bleeding volume better than sodium nitroprusside in nasal endoscopic surgery.

Adolescent ; Adult ; Blood Loss, Surgical ; prevention & control ; Endoscopy ; Female ; Hemodilution ; methods ; Humans ; Hypotension, Controlled ; methods ; Intestines ; blood supply ; Male ; Middle Aged ; Nitroglycerin ; therapeutic use ; Nitroprusside ; therapeutic use ; Paranasal Sinuses ; surgery ; Young Adult