4.Efficacy of anesthesia with different doses of dexmedetomidine combined with propofol and remifentanil in patients undergoing abdominal surgery
Kunhe LI ; Yi LI ; Haihua SHU ; Nan JIANG ; Zhen CHEN ; Liangchan XIAO
Chinese Journal of Anesthesiology 2012;32(7):799-801
Objective To evaluate the efficacy of anesthesia with different doses of dexmedetomidine combined with propofol and remifentanil in patients undergoing abdominal surgery.Methods Ninety ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,weighing 45-80 kg,undergoing abdominal surgery,were randomly assigned into 3 groups ( n =30 each):control group (group C ),dexmedetomidine 0.25 μg· kg-1 · h-1 group ( group D1 ) and dexmedetomidine 0.50 μg· kg-1·h-1 group (group D2 ).Dexmedetomidine was infused at a rate of 0.25 μg·kg-1 ·h-1 and 0.50 μg·kg-1 ·h-1 in groups D1 and D2 respectively until extubation after a loading dose of 0.5 μg/kg over 15 min.In group C,normal saline was infused intravenously at a rate of 10 ml/h.Anesthesia was induced with TCI of propofol with the target plasma concentration (Cp) of 1.0 μg/ml,iv injection of cisatracurium 0.2 mg/kg and TCI of remifentanil with Cp of 3 ng/ml.The patients were tracheal intubated and mechanically ventilated.PETCO2 was maintained 35-40 mm Hg and SpO2 was maintained ≥95%.Anesthesia was maintained with TCI of remifentanil with the target Cp of 5 ng/ml,iv infusion of cisatracurium 0.1 mg· kg-1 · h-1 and TCI of propofol.The target Cp of propofol was increased to maintain Narcotrend index of 37-46.The amount of remifentanil,cisatracurium and propofol consumed,extubation time and eye-opening time,complications during operation and during recovery from anesthesia were recorded.Results There was no significant difference in the amount of remifentanil and cisatracurium consumed and extubation time among the three groups ( P > 0.05).Compared with group C,the eye-opening time was significantly prolonged,the incidence of hypertension and tachycardia during operation,and restlessness,vomitting,hypertension,and tachycardia during recovery from anesthesia was significantly decreased in groups D1 and D2,and the amount of propofol consumed was significantly decreased in group D2 (P < 0.05).Compared with group D1,the eye-opening time was significantly prolonged,the incidence of hypertension during operation,and restlessness,hypertension,and tachycardia during recovery from anesthesia was significantly decreased in group D2 ( P < 0.05).Conclusion When combined with propofol and remifentanil,dexmedetomidine infused at a rate of 0.50 μg·kg-1 · h-1 can provide satisfactory efficacy for abdominal surgery.
5.Therapy progress of spinal cord compression by metastatic spinal tumor.
Yao-sheng LIU ; Qi-zhen HE ; Shu-bin LIU ; Wei-gang JIANG ; Ming-xing LEI
China Journal of Orthopaedics and Traumatology 2016;29(1):94-98
Metastatic epidural compression of the spinal cord is a significant source of morbidity in patients with systemic cancer. With improvment of oncotheray, survival period in the patients is improving and metastatic cord compression is en- countered increasingly often. Surgical management performed for early circumferential decompression for the spinal cord com- pression with spine instability, and spine reconstruction performed. Patients with radiosensitive tumours without spine instabili- ty, radiotherapy is an effective therapy. Spinal stereotactic radiosurgery and minimally invasive techniques, such as vertebro- plasty and kyphoplasty, percutaneous pedicle screw fixation, radiofrequency ablation are promising options for treatment of cer- tain selected patients with spinal metastases.
Decompression, Surgical
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Humans
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Minimally Invasive Surgical Procedures
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Spinal Cord Compression
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therapy
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Spinal Neoplasms
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secondary
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therapy
7.Case Report of Peliosis Hepatic in Child and Its Literature Review
zhao-yuan, QIN ; shu-mei, CHEN ; rui-de, HU ; xiao-yun, JIANG ; mei-na, LIU ; zhen-yu, SHEN
Journal of Applied Clinical Pediatrics 2006;0(19):-
Objective To report a peliosis hepatic in child and review literature and discuss.Methods Case history was inquired.Physical,labtoratory,imagement and histopathology of liver biopsy(HE staining) were examed.Results A 4-year old girl appeared dermatitis with erythema and herpes at local skin where was bit by insect before onset.The girl appeared fever,cough,then abdominal pain,hepatomegaly,pleural effusion and ascites.Lab examination revealed slight elevation of aspartate transaminase,?-glutamyltranspeptidase and alkaline phosphatase.The liver B-mode ultrasonography and CT scan revealed hepatomegaly with density heterogeneity of the parenchyma.The liver biopsy revealed many small capsule filled with blood cells.Conclusions Clinical characteristics of the disease are fever,upper abdomen pain,janundice,ascites and hepatomegaly.The diagnosis shall be combined with the pathologic biopsy of liver.
8.An experimental study on the effects of postburn dietary supplementation of enhanced nutrients.
Shu-liang LU ; Shu-wen JIN ; Jian ZHANG ; Ikeda SHIGEO ; Saito HIDEAKI ; Zhen-jiang LIAO ; Ji-xiang SHI
Chinese Journal of Burns 2003;19(4):197-201
OBJECTIVETo evaluate the effects of postburn dietary supplementation of arginine (Arg), omega-3 polyunsaturated fatty acid (omega-3PUFA) and glutamine (Glu) on the metabolism, immunology and wound healing in scalded rats.
METHODSThirty Sprague-Dawley (SD) rats inflicted with 30% total body surface area deep partial thickness scald on the back after the gastrostomy catheter was placed were employed as the model. The rats were randomly divided into A and B groups, and all of them received continuous isonitrogenous (25% protein, 12% fat, 63% carbohydrate), isocaloric (175 kcal/kg/day), and isovolemic intragastric tube feedings. The contents of Arg, omega-3PUFA, Glu in the dietary of B group were enriched. The parameters were measured on the 10th day after injury, including the response of spleen cells to ConA, the plasma levels of PGE(2), IL-2, albumin, transferrin, glucagons, cortisol in blood, the urinary content of vanillylmandelic acid (VAM) in 24-hour urine, the content of hydroxyproline, the ratio of type I to type III collagen in burn wounds, and the nitrogen content in the liver and in the jejunal mucosa, as well as the weight changes, skin delayed hypersensitivity test, and wound healing time.
RESULTSIt was revealed that the serum level of albumin, the nitrogen content in the liver and in the jejunal mucosa were obviously higher in B than those in A group. At the same time, there was no statistical difference in the plasma levels of cortisol and glucagons and urinary content of VAM between the two groups, nor in body weight changes. Meanwhile, the response of spleen cells to ConA and the skin delayed hypersensitivity induced by DNFB 14 days after injury in group B were also enhanced compared with those in group A. Although the expression of PGE2 from peritoneal macrophages was lower, the content of hydroxyproline from burn wounds in group B was significantly higher than that in group A, and the ratio of type l to type III collagen in group B was significantly lower than that in group A. Compared with group A, the wound healing time in group B was significantly shortened (P < 0.05).
CONCLUSIONThe low-fat and high-protein feeding diet with enriched arginine, omega-3 PUFA, glutamine could benefit the nutritional status after burn injury, thus improve the immunological function and promote wound healing.
Animals ; Arginine ; therapeutic use ; Burns ; drug therapy ; immunology ; metabolism ; Dietary Supplements ; Enteral Nutrition ; Female ; Glutamine ; therapeutic use ; Linolenic Acids ; therapeutic use ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Wound Healing
9.Effect of small interfering RNA targeting Rac1 gene on colony formation of SW480 cells in vitro.
Qing-zhen NAN ; Lei GAO ; Bing XIAO ; Zhen-shu ZHANG ; Bo JIANG
Journal of Southern Medical University 2010;30(6):1339-1342
OBJECTIVETo construct a vector expressing small interfering RNA (siRNA) against Rac1 gene and observe its effect on soft agar colony formation of SW480 cells in vitro.
METHODSOligos of 64 base pairs for hairpin RNA targeting Rac1 were chemically synthesized and annealed. The siRNA constructs for Rac1, produced by inserting the annealed oligos into the downstream of H1 promoter of linearized pSUPER, were confirmed by restriction digestion and DNA sequencing. The constructed Rac1-siRNA was transfected into SW480 cells and Western blotting was performed to assess the expression and interference efficiency of siRNAs against Rac1.The soft agar colony formation assay was used to study the effect of Rac1 gene silencing on SW480 cells.
RESULTSRestriction digestion and DNA sequencing showed that the siRNA targeting Rac1 gene was successfully constructed. The siRNA could effectively down-regulate the expression of Rac1 in SW480 cells. Soft agar colony formation assay showed that the colony number and diameter of SW480 cells was reduced after siRNA transfection.
CONCLUSIONA vector expressing hairpin RNA against Rac1 gene are successfully produced, which significantly reduces the colony numbers and size of SW480 cells in vitro, suggesting that Rac1 plays an important role in the growth of colorectal cancer in vitro.
Base Sequence ; Cell Line, Tumor ; Cell Proliferation ; Colonic Neoplasms ; pathology ; Down-Regulation ; Humans ; Molecular Sequence Data ; RNA Interference ; RNA, Small Interfering ; genetics ; Transfection ; rac1 GTP-Binding Protein ; genetics
10.Assessment of lymph node metastasis in gastric cancer: status quo, recent advances and new perspectives.
Min TU ; Zhen-shu ZHU ; Lin-sen SHI ; Xi-qun JIANG ; Hao WANG ; Wen-xian GUAN
Chinese Journal of Gastrointestinal Surgery 2012;15(2):197-200
The precondition of accurate gastric cancer surgery is precise assessment of lymph node metastasis. To date, no imaging modality achieves both high sensitivity and high specificity in detecting lymph node metastasis in gastric cancer. Intraoperative sentinel node tracing and biopsy are the most popular method to identify the localization of tumor cell, but is limited to early gastric cancer. Nano-composite materials, designed for tumor imaging and tracing, show us a newly emerging domain for tumor detection in gastric cancer. The function of these nano-composite materials to detect lymph node metastasis in gastric cancer relies on the effective backflow of lymph system. However, the lymph vessels can be obstructed by tumor cells in advanced gastric cancer, which may restrain the application of these nanoparticles. Therefore, more methods to detect lymph node metastasis in gastric cancer should be explored. This review summarizes the characteristic of the targeted nanosphere. Based on the reported studies, a novel idea is conceived that targeted multifunctional nanosphere may be a potential method to achieve precise assessment of lymph node metastasis in gastric cancer.
Humans
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Lymph Nodes
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pathology
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Lymphatic Metastasis
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pathology
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Stomach Neoplasms
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pathology