1.Pharmacokinetics of different concentration of ropivacaine following lumbar plexus combined with sciatic nerve block
Huaqing SHU ; Xiaoming ZHANG ; Shanglong YAO
Chinese Journal of Anesthesiology 1997;0(11):-
Objective To evaluate the pharmacokinetics of ropivacaine following lumbar plexus combined with sciatic nerve block for knee arthroscopy. Methods After obtaining written informed consent 16 ASAⅠorⅡpatients of both sexes (8 males ,8 females) scheduled for unilateral knee arthroscopy under lumbar plexus combined with sciatic nerve block with ropivacaine were randomly divided into 2 groups (n = 8 each) : group A received 0.5% ropivacaine 30 ml (15.0 mg) and group B received 0.75% ropivacaine 30 ml (22.5 mg) . Blood samples were taken from radial artery immediately after and at 5, 10, 15, 30, 45, 60, 120 and 180 min after drug administration for determination of plasma ropivacaine concentration by HPLC. The pharmacokinetic parameters were calculated using 3p97 computer program. Results The two groups were comparable with respect to sex ratio (M/F), age, body weight, height, duration of operation and amount of fluid infused. The main pharmacokinetic parameters in group A and B were: Cmax(1.4?0.3) mg?L-1 and (2.7?0.9) mg?L-1;AUC (3.88?0.28) mg?L-1?h-1 and (7.13?0.65) mg?L-1?h-1;t1/2?(0.44?0.19)h and (0.60?0.34)h; t1/2?(3.4?0.4)h and (2.4?0.5)h. The Cmax in group B was significantly higher than that in group A. The Cmax of ropivacaine reached 3.57 mg?L-1 in group B. No patient developed central nervous system or cardiac toxicity.Conclusion The plasma concentration versus time curve is fitted to two-compartment pharmacokinetic model. Lumbar plexus combined with sciatic nerve block with 0.5% ropivacaine 30 ml is safer.
3.Relationship Between High-sensitivity C-reactive Protein and P Wave Dispersion in Patients With Lone Paroxysmal Atrial Fibrillation
Lihui ZHENG ; Yan YAO ; Lingmin WU ; Kuijun ZHANG ; Shu ZHANG
Chinese Circulation Journal 2014;(12):983-986
Objective: To analyze the relationship between high-sensitivity C-reactive protein (hs-CRP) and P wave dispersion (Pd) in patients with lone atrial ifbrillation (AF), and to explore the effect of inlfammation on atrial electrophysiological remodeling.
Methods: Our research included 2 groups. AF group, containing 71 consecutive paroxysmal lone AF patients, and Control group, containing 71 paroxysmal supra ventricular tachycardia patients with the matched age and gender. The clinical characteristics, electrocardiographic Pd assessment and plasma hs-CRP levels were compared between 2 groups. The relationship between hs-CRP and Pd was studied by linear and multi linear regression analysis.
Results: Compared with Control group, AF group showed increased left atrial diameter, Pd and hs-CRP, all P<0.05. multilinear regression analysis indicated that hs-CRP was positively related to Pd in both groups, P<0.01. Multiple logistic regression analysis revealed that hs-CRP was an independent risk factor for AF occurrence (HR=15.430, 95%CI 6.031-39.476, P<0.001), with adjusted Pd, multiple logistic regression analysis presented that both Pd and hs-CRP were the independent risk factors for AF occurrence, both P<0.001, while the HR for hs-CRP predicting AF occurrence was attenuated from 15.430 to 6.246.
Conclusion: Plasma hs-CRP level and electrocardiographic Pd were the important risk factors for paroxysmal lone AF, the interaction between hs-CRP and AF occurrence could be mediated by Pd, suggesting that inlfammation might be involved in atrial electrophysiological remodeling.
7.High-density micropulse photocoagulation combined with intravitreal injection of ranibizumab for diabetic macular edema
Guangli SUN ; Jing JIANG ; Chenghu WANG ; Shu ZHANG ; Jin YAO
Recent Advances in Ophthalmology 2017;37(3):279-281
Objective To investigate the clinical effects of high-density micropulse photocoagulation (HD-SDM) combined with intravitreal injection of ranibizumab for diabetic macular edema (DME).Methods Thirty-one patients (31 eyes) with DME were randomly divided into two groups.Group A (15 eyes) received HD-SDM combined with intravitreal injection of ranibizumab.Group B (16 eyes) only received intravitreal injection of ranibizumab.The best corrected visual acuity (BCVA) and central macular thickness (CMT) of the two groups before and after treatment were analyzed,and the annual injection times of the two groups were compared.Results The average annual injection times was 3.67 ± 1.11 in group A,and 9.12 ±2.63 in group B.The difference was significant between the two groups (t =2.05,P < 0.05).There were significant differences in CMT before and after treatment in both groups (all P < 0.05).There was no significant difference in CMT between the two groups(t =1.19,P > 0.05).There were significant differences in BCVA before and after treatment in both groups (all P < 0.05),but there was no significant difference before and after treatment between the two groups(all P > 0.05).Conclusion Both HD-SDM combined with intravitreal injection of ranibizumab and single intravitreal injection of ranlbizumab are effective for DME,but the combining treatment can remarkably decrease the annual injection times and had a good compliance of patients,is a good choice for DME patients.
8.The expression of macrophage phenotype in kidney injury caused by severe acute pancreatitis
Shengchun DANG ; Shu FENG ; Pingjiang WANG ; Yao SHEN ; Jianxin ZHANG
Chinese Journal of Emergency Medicine 2014;23(7):765-769
Objective To investigate the macrophages (Mφ) phenotype mechanism in acute kidney injury caused by severe acute pancreatitis (SAP).Methods Sixty-four male Wistar rats were randomly divided into control group (SO) and SAP group (n =32 in each group).SAP rat model was made by retrograde cholangiopancreatic injection of 5% sodium taurocholate.At 2,6,12 and 24 h after modeling,the samples of blood and kidney tissue were collected.The levels of blood urea nitrogen (BUN) and creatinine (Cr) were detected by using automatic biochemical analyzer.The expressions of IL-12,TNF-α,IL-10 and TGF-β mRNA of kidney tissue were detected by fluorescence quantitative polymerase chain reaction (QRT-PCR).The levels of CD68,iNOS and Arg-1 were measured by Western blot.Results In the SAP group at each interval,BUN and Cr concentrations were significantly higher than those of the control group (P < 0.01,P < 0.05) ; Compared with the control group,the expressions of IL-12,TNF-α,IL-10 and TGF-β mRNA in renal tissue of SAP group were significantly higher (P < 0.01,P < 0.05).In the SAP group,the levels of CD68,iNOS and Arg-1 were higher than those in the control group.Conclusions Inflammation and inflammatory imbalances may be pathological factors of acute kidney injury following SAP.
9.Clinical analysis of laparoscopic sungery treatment of tubal obstruction infertility combined with endometriosis
Yao ZHANG ; Changqing PAN ; Xiaofang SHU ; Wei HE ; Lisa HUANG
Clinical Medicine of China 2011;27(11):1222-1224
Objective To investigate the diagnosis and treatment value of laparoscopic surgery in tubal obstruction infertility patients with endometriosis.Methods Retrospective analysis was done in 381 cases underwent laparoscopic treatment for tubal obstruction from May 2005 to May 2010,,of which 119 cases were combined with endometriosis.The treatment results were analyzed,including the decomposition of the umbrella side tubal obstruction adhesions,lesions of endometriosis electrocoagulation,endometriosis cystectomy and pregnancy and so on.Results Hysterosalpingography(HSG)showed tubal occlusion in both side or one side in the distal end in 381 cases,and these patients were treated with laparoscopic surgery.There were 262 cases showed distal tubal occlusion not companied with endometriosis,of which 82 cases clinically pregnanced,accounting for 31.3%.Surgical treatment of endometriosis found in 119 cases,accounting for 31.2% ; and 29 cases pregnaced,which accounted 24.4%.We found 42 cases of tubal adhesions grade Ⅰ-Ⅱ and endometriosis stage Ⅰ-Ⅱ,16 cases of clinical pregnancy,accounting for 38.1% ;Twenty-six cases of tubal adhesions grade Ⅰ-Ⅱ and endometriosis stage Ⅰ-Ⅱ,7 cases of clinical pregnancy,accounting for 26.9% ;Twenty-eitht cases of tubal adhesions grade Ⅲ-Ⅳ and endometriosis stage Ⅰ-Ⅱ,4 cases of clinical pregnancy,accounting for 14.3% ;Twenty-three cases of tubal adhesions grade Ⅲ-Ⅳ and endometriosis stage Ⅲ-Ⅳ,2 cases of clinical pregnancy,accounting for 8.7%.The clinical pregnancy rate in the first group was significantly higher than the other groups,chnical pregnancy rate of the last group was the lowest.Conclusion Laparoscopic surgery is an effective treatment of tubal obstruction infertility combined with endometriosis.After laparoscopic surgery,the clinical pregnancy rate is significantly higher in Tubal obstruction without endometriosis than patients with endometriosis.After surgery,the clinical pregnancy rate in patients with the light stage tubal adhesions and endometriosis is better than those severely.
10.The levels and clinical significance of serum B cell activating factor in Chinese patients with polymyositis or dermatomyositis
Qinglin PENG ; Yao XIE ; Rongfu ZHANG ; Xiaoming SHU ; Guochun WANG
Chinese Journal of Internal Medicine 2012;51(3):210-213
Objectives To investigate serum levels of B cell activating factor(BAFF)in Chinese patients with polymyositis(PM)or dermatomyositis(DM),and analyze the correlation of BAFF with autoantibodies and clinical phenotypes.Methods Serum BAFF levels of 28 PM patients and 30 DM patients(study group),and 25 matched healthy controls(control group)were measured by ELISA.Serum anti-Jo-1 antibody levels were also measured by ELISA in all the subjects.The results of the two groups were compared by unpaired t test and the relevance was analyzed by Pearson's correlation analysis.Results Serum levels of BAFF in PM/DM patients were significantly higher compared to healthy controls(P =0.000),but there was no statistically significant difference between the PM and DM patients(P > 0.05).Patients with interstitial lung disease(ILD)had significantly higher serum BAFF level than the patients without ILD(P =0.000)or the controls(P =0.000).Serum BAFF levels of patients with positive antinuclear antibody(ANA)were significantly higher than those with negative ANA(P =0.003).For patients with anti-Jo-1 antibodies,the serum BAFF levels were correlated with the serum concentration of anti-Jo-1 antibodies(r =0.799,P =0.006).Conclusions Serum levels of BAFF are increased in Chinese PM/DM patients.These findings indicate that BAFF may be possibly enrolled in the pathogenesis of PM/DM.Detecting serum BAFF levels could have some implication for the diagnosis and treatment of PM/DM.