Objective To assess the possibility of using arterial pressure waveform or pulse oximetry plethysmographic waveform variation to estimate the pulmonary arterial wedge pressure (PAWP) Methods Fourteen ASA Ⅰ Ⅱ patients aged 33 69 years and weighing (62 0?9 5)kg scheduled for elective abdominal tumor surgery were studied Their Hb exceeded 120g/L and Hct 35% Anesthesia was induced with midazolam 0 04mg/kg atropine 8?g/kg,fentanyl 2?g/kg,propofol 2mg/kg and vecuronium 0 1mg/kg and maintained with isoflurane The patients were intubated and mechanically ventilated and P ET CO 2 was maintained at 4 67 5 33 kPa Radial artery was connulated for arterial pressure waveform monitoring and Swan Ganz catheter was inserted via right internal jugular vein and connected to continuous cardiac output monitor (VGS2,Baxter,USA) for hemodynamic monitoring Hypervolumic hemodilution was performed after induction of anesthesia and intubation with crystalloid and colloid (1:1) infused at a rate of 0 7ml?kg -1 ?min -1 PAWP, systolic pressure variation (SPV), delta down (dDown), SPV plet and dDown plet and other hemodynamic parameters were measured and recorded when total fluid volume (crystalloid and colloid) infused reached 10ml/kg and 20 ml/kg and at the end of operation, CVP was maintained at 10 12mm/kg during operation Systolic blood pressure at the end of Valsalva maneuver (airway pressure was kept at 30 cmH 2O) and the systolic pressure before the Valsalva maneuver during apnea were used to calculate arterial pressure ratio (APR) Results APR,SPV,dDown,SPV plet and dDown plet all correlated well with PAWP (r=o 7174,-0 6951,-0 680-0 5216 and 0 6237 respectively P

Animals ; Hypertension ; metabolism ; physiopathology ; Male ; Myocardium ; metabolism ; Peptidyl-Dipeptidase A ; genetics ; metabolism ; Proto-Oncogene Proteins ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Inbred SHR ; Rats, Inbred WKY ; Receptor, Angiotensin, Type 1 ; genetics ; metabolism ; Receptors, G-Protein-Coupled ; genetics ; metabolism

Adolescent ; Adult ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Injections, Intravenous ; Male ; Middle Aged ; Phytotherapy ; RNA ; administration & dosage ; Salvia miltiorrhiza ; chemistry

Objective To prepare and characterize ginkgolide K-loaded mPEG-PLGA [poly (D,L-lactide-co-gly-colide)-block-poly (ethylene glycol)] polymer nanoparticles (GK-mPEG-PLGA-NPs) and to evaluate its neuroprotective effect on the H2O2-induced PC12 cells injury in vitro. Methods The PLGA-PEG-COOH polymer was selected as carrier and double emulsion solvent evaporation technique was employed to prepare the stealth nanoparticles. The encapsulation efficiency (EE) and drug load (DL) of GK-mPEG-PLGA-NPs were investigated by HPLC. The size distribution, zeta potential, and surface morphology of GK-mPEG-PLGA-NPs were characterized by dynamic light scattering (DLS) and transmission electron microscopy (TEM), respectively. The in vitro release of GK-mPEG-PLGA-NPs was examined using phosphate buffer solution (pH 7.4) as the releasing medium for 24 h. The H2O2-induced PC12 cells injury models was established for the investigation of the protective effect of GK-mPEG-PLGA-NPs on nerve cells in vitro. Results EE and DL of GK-mPEG-PLGA-NPs was (83.40 ± 2.85)% and (3.26 ± 0.24) mg/g, respectively. The average diameter of GK-mPEG-PLGA-NPs was (93.19 ± 2.77) nm and zeta potential was (-11.93 ± 1.71) mV. The cumulative rate of drug release was (90.5 ± 4.0)% after 60 h in phosphate buffer solution. GK-mPEG-PLGA-NPs significantly inhibited the apoptosis of PC12 cells and the release of lactic dehydrogenase induced by H2O2. However, the protective action of GK-mPEG-PLGA-NPs on the H2O2-iduced PC12 cells injury was significantly weaker than that of GK. Conclusion Our results proved that GK-mPEG-PLGA-NPs had a sustained release behavior in vitro and the neuroprotective effect of GK-mPEG-PLGA-NPs on H2O2-induced PC12 cells, which indicates that GK-mPEG-PLGA-NPs has the prospect of application and deserves further research. Key words: ginkgolide K; mPEG-PLGA; in vitro release; in vitro neuroprotection; d

OBJECTIVE: To explore whether the protective mechanism of ginkgolide K on cerebral focal ischemia reperfusion injury in rats induced by middle cerebral artery occlusion (MCAO) was associated with the amelioration of mitochondrial calcium uniporter ( MCU) or not. METHODS: Sprague Dawley (SD) rats were divided into 5 big groups randomly: sham operation group, MCAO group, GK added into RR group, GK group and GK added into SM group. The MCAO rat model were established after cerebral artery ischemia for 2 h and reperfusion for 22 h. Zea Longa 5 score system was used to evaluate neurological deficit score; Determination of brain water content and cerebral infarction areas were determined using gravimetric method and by triphenyltetrazolium chloride(TTC) staining method, respectively. In addition, malondialdehyde (MDA) and superoxide dismutase (SOD), nitric oxide synthase (NOS), nitric oxide (NO) were detected by Elisa. Additionally, mitochondrial[Ca2+] i concentration was estimated with the fluorescence spectrophotomete. The morphological change of the injured brains were observed by HE staining. The expression of caspase-3/8/9 protein were detected by Western blot. RESULTS: Compared with GK group, GK + RR group relieved obviously the neurological deficit score and reduced the cerebral infarction areas, brain water content, mitochondrial[Ca2+]i concentration and MDA, caspase-3/8/9 protein expression while enhance SOD activity. However, the effect of SM on the GK protective activity in MCAO rat injury was the opposite in comparison to GK + RR group. CONCLUSION: The stimulative effect of RR and the inhibitory effect of SM on the GK protection in MCAO rat had proves that the protective mechanism of GK on MCAO rat injury is associate with its down-regulation of the transport capacity of MCU, leading the attenuation of mitochondrial[Ca2+]i influx.

Objective To study the effects of sample digestion conditions on measurement results of urinary iodine determined by As(Ⅲ)-Ce4+ catalytic spectrophotometry with ammonium persulfate digestion,and to promote the application of newly revised (the 2012 edition) national standard method for determination of urinary iodine.Methods According to the newly revised national standard method,various digestion conditions,such as ammonium persulfate concentration (0.8-1.3 mol/L,group interval 0.1),digestion instruments (heating block and drying oven) and standing time after digestion(0.5,1.0,2.0,4.0 and 22.0 h),were studied.The samples included 3 standard materials,which were GWB09108k,GWB09109f and GWB09110m containing iodine of (68.2 ± 9.0),(138.0 ± 10.0) and (221.0 ± 10.0) μg/L,and 5 urine samples with iodine concentration of 100-300 μg/L.Results Measurement results among the three groups of 0.9,1.0 and 1.1 mol/L ammonium persulfate digestion fluid showed no significant difference(P ＞ 0.05).The digestive effect showed no significant difference between heating block and drying oven (P ＞ 0.05) except one standard material in low concentration (GBW09108k).After digestion,samples were placed 0.5-22.0 h,the measurement results between groups showed no significant difference (P ＞ 0.05).Conclusions Appropriate concentrations of ammonium persulfate are from 0.9 mol/L to 1.1 mol/L.Heating block is recommended for the digestion,however,when absent,drying oven can be used alternatively.The standing times from 0.5 h to 22 h after digestion have not affected the measurement results.

The leukocytic phagocytosis rate and the index of phagocytosis of rats on cross-linked agar beads entrapped attapulgite clay (CAA) hemoperfusion were studied. The results revealed that the leukocytic phagocytosis rate and the index of phagocytosis descended significantly after 1 hour and rose gradually after 6 hours. Finally it reached the normal level after 48 hours. Hemoperfusion repeated two times gave similar results. In conclusion, the function of leukocytic phagocytosis declined temporarily during CAA hemoperfusion. Many times hemoperfusion will not notably affect the body's defense system of rats.
Agar ; Animals ; Biocompatible Materials ; Hemoperfusion ; methods ; Leukocytes ; drug effects ; physiology ; Magnesium Compounds ; Male ; Materials Testing ; Microspheres ; Phagocytosis ; drug effects ; Rats ; Rats, Wistar ; Silicon Compounds

Objective To evaluate the effects of reserved jejunal feeding tube during postoperative chemotherapy of gastric cancer. Methods Forty-two patients with gastric cancer underwent radical gastrectomy and going to adjuvant chemotherapy,conventional placed jejunal feeding tube. All of the patients weredivided into group A and group B randomly by pathological staging and tumor site, group A reserved jejunal feeding tube and received enteral nutrition through the tube during chemotherapy, and group B non-reservedjejunal feeding tube and been given daily diet,compared nutrition and immune indicators of two groups beforeand after chemotherapy ,compared the rate of vomiting,and observed complications long-term reserved jejunal feeding tube. Results In post-chemotherapy,nutrition and immune indicators of group A were betterthan those of group B, the difference was statistically significant (P＜0.05) ,the rate of vomiting in group Awas significantly lower than that of in group B (X2= 9.75, P＜0.01 ), no serious complieations occurred forlong-term reserved jejunal feeding tube. Conclusions Reserved jejunal feeding tube and received enteralnutrition through the tube during postoperative chemotherapy of gastric cancer can significantly improve the nutritional and immune status. It is safe and reliable, worth promoting.

Objective To make a reasonable evidence-based nursing scheme for the oxygen non-humidified of continuing nasal cannula oxygen therapy. Method Adopting the JBI clinical evidence application system, make sure the evidence baseline investigated before application, used during clinical application, and reviewed after application. Based on the now available best evidence, making examination standard and apply it to clinical care. During the application of evidence, 81 continuing low-flow (oxygen flow≤4L/min) nasal cannula oxygen patients were taken. Making assessment on the experiment group(oxygen non-humidified) and control group (oxygen humidified) in three aspects: the comfort level and effect of oxygen therapy, and humidification bottles contamination. Results During the application of evidence, the difference between experiment group and control group shows no statistical significance (P>0.05);the experiment group in oxygen therapy operating time was (162.93±40.18) s, the control group operating time was (258.60 ± 56.97) s, the difference of two groups in shows statistical significance (t=8.752, P<0.01). Conclusion The continuing low-flow (oxygen flow≤4L/min) nasal cannula oxygen therapy do not need humidification. And the clinical application of this best evidence standardizes the clinical nurses oxygen nursing behavior, reduces the nursing cost and enhances the quality of clinical nursing.

OBJECTIVETo assess the possibility of using arterial pressure waveform or pulse oximetry plethysmographic waveform variation to estimate the pulmonary arterial wedge pressure (PAWP).

METHODSFourteen American Society of Anesthesiologists grade I - II patients aged 33 - 69 years and weighing 62.0 +/- 9.5 kg scheduled for elective abdominal tumor surgery were studied. Their hemoglobin exceeded 120 g/L and hematocrit exceeded 35 percent. Pre-operative acute hypervolemic hemodilution was applied immediately after general anesthestic induction and tracheal intubation. PAWP, systolic pressure variation (SPV), delta down (dDown), SPV(plet), dDown(plet) and other hemodynamic parameters were measured and recorded when total fluid volume (crystalloid and colloid) infused reached 10 ml/kg and 20 ml/kg and again at the end of the operation. Central venous pressure was maintained at 10 - 12 mm Hg during operation. Systolic blood pressure at the end of Valsalva maneuver (airway pressure was kept at 22 mm Hg) and the systolic pressure before the Valsalva manoeuvre during apnea were used to calculate arterial pressure ratio (APR).

RESULTSAPR, SPV, dDown, SPV(plet) and dDown(plet) all correlated well with PAWP (r = 0.717, -0.695, -0.680, -0.522 and -0.624 respectively, P < 0.01). There was a closer linear correlation between APR and PAWP than between the other parameters. The regression equation was PAWP (mm Hg) = 0.207 x APR (%) - 0.382.

CONCLUSIONDuring positive pressure mechanical ventilation, APR, SPV, dDown, SPV(plet) and dDown(plet) can be used to estimate PAWP effectively.

Adult ; Aged ; Blood Pressure Determination ; methods ; Humans ; Middle Aged ; Oximetry ; Plethysmography ; Positive-Pressure Respiration ; Pulmonary Wedge Pressure