1.Changes of cerebral blood flow and cerebral autoregulation during propofol or sevoflurane anaesthesia in patients undergoing gynecologic laparoscopic surgery
Fubo TIAN ; Shaoqiang HUANG ; Weimin LIANG
Fudan University Journal of Medical Sciences 2009;36(6):715-718
Objective To observe the effects of propofol or sevoflurane combined with remifentanil on cerebral blood flow (CBF) and cerebral autoregulation in patients undergoing gynecologic laparoscopic surgery. Methods Forty patients were randomly divided into two groups: the propofol group (group P, n=20) and the sevoflurane group (group S, n=20). Anaesthesia was induced with target-controlled infusion (TCI) of propofol and remifentanil in group P, with an inhaled induction of sevoflurane and TCI of remifentanil in group S, respectively. The depth of anesthesia was regulated according to bispectral index (BIS). The pressure of end-tidal carbon dioxide (P_(ET)CO_2) was kept at 35-40 mmHg by mechanical ventilation. The mean arterial pressure (MAP), heart rate (HR), pressure of arterial carbon dioxide (PaCO_2), P_(ET)CO_2, time-averaged peak flow velocity (TAP) and the transient hyperaemic response ratio (THRR) were recorded at 7 different time points: supine position (T_1) and supine lithotomy position before induction (T_2), the instant and 5 min after tracheal intubation (T_3,T_4), the instant and 15 min after abdominal CO_2 insufflation and trendelenburg-lithotomy position (T_5,T_6), and 10 min after the deflation abdomen (T_7), respectively. Results Compared with the baseline values at T_1, TAP was not significantly changed at T_2, T_5, or T_6 in group P, but was markedly decreased at T_3, T_4 and T_7. TAP in group S only decreased at T_4 and T_7, while it was much higher than that in group P at T_3. In group S, THRR was markedly lowered at T_3 compared with that at T_1; but in group P, it showed a significant increase at T_3. Conclusions Combined with remifentanil, propofol decreased CBF, but has no effect on the brain self-regulation. When inhaled in high concentrations, sevoflurane significantly reduces the brain self-regulation. Intraoperation pneumoperitoneum and postural factor significantly increase CBF, playing a stronger role than the narcotic drugs in clinical dosage (propofol, sevoflurane), without any influence on the brain self-regulation.
3.Design of digital video acquisition card based on TMS320C6201
Na WEI ; Zheng WANG ; Liang CUI ; Dianzhong HUANG ; Yue TIAN
Chinese Medical Equipment Journal 2004;0(07):-
Conventional digital video acquisition card can only collect but not process video frequency.This paper introduces the design of a digital video acquisition card based on C6000 DSP chip of TI company,which can process digital video automatically and communicate with mainframe through PCI interface.
4.Progress of multi-drug resistant bacteria and clinical treatment strategies
Qi HUANG ; Lixing TIAN ; Xiaoying ZHOU ; Tao CHEN ; Huaping LIANG
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2017;24(3):328-332
Over the past two decades, multiple drug-resistant infections have escalated globally with the significantly increased morbidity and mortality due to the unreasonable uses of antimicrobial agents in areas such as animal husbandry, industry and medicine. As the situation of drug resistance has been progressively serious, anti-drug-resistant clinical strategies have attracted widely social concerns. This review will report the current status of antibiotic resistance and the mechanism of antibiotic-resistance all over the world. The anti-drug resistance strategies are the emphasis of our report, including the new indication of old antibiotics, the combination of existing antibiotics, the development of new antibiotics, nano-antibiotics, and non-infection treatment with immunomodulators and phage. This review aims to further understand the current situation of drug resistance, which optimizes the strategies of drug-resistant bacteria and clinical services.
5.Pharmacodynamics of different local anesthetics administered intrathecally for caesarean section
Jianying HU ; Shaoqiang HUANG ; Weimin LIANG ; Fubo TIAN
Chinese Journal of Anesthesiology 2010;30(7):796-798
Objective To investigate tbe pharmacodynamics of different local anesthetics administered intrathecally for caesarean section. Methods Ninety-six parturients with singleton term pregnancies undergoing caesarean section under combined spinal-epidural anesthesia were enrolled in this study. The patients were randomly divided into 3 groups ( n = 32 each ) and received intrathecal (IT) 0.5 % bupivacaine, 0.5 %levobupivacaine and 0.5% ropivacaine respectively. The initial doses was 9 mg in all 3 groups. The ratio of two successive doses was 0.9. If the upper sensory block reached T7 or above and there was no need for additional dose in the 45 min after the initial dose, the IT analgesia was considered to be effective. The median effective dose ( ED50 ), the 95 % effective dose( ED95) and 95 % confidence interval (95 % CI )were calculated by Dixon. Results The ED50 and ED95 and 95%CI of bupivacaine were 6.15 (95%CI 5.48-6.68) mg and 7.62 (95%CI 6.91-11.82) mg; of levobupivacaine were 8.06 (95%CI 7.46-8.62) mg and 9.59 (95%CI 8.86-13.42) mg;of ropivacaine were 10.55 (95%CI 9.73-11.49) mg and 12.80 (95%CI 11.66-21.42) mg. The relative potency potency ratio between bupivacaine, levobupivacaine and rupivacaine is 1.00:0.76:0.58.
6.Intraoperative opioid-sparing effect of different frequency transcutaneous electrical acupoint stimulation in patients undergoing video-assisted thoracoscopic pneumonectomy
Shun HUANG ; Wenping PENG ; Xue TIAN ; Hansheng LIANG ; Yi FENG
Chinese Journal of Anesthesiology 2015;35(3):340-343
Objective To evaluate the intraoperative opioid-sparing effect of different frequency transcutaneous electrical acupoint stimulation (TEAS) in the patients undergoing video-assisted thoracoscopic pneumonectomy.Methods Eighty patients,aged 40-64 yr,weighing 50-90 kg,of ASA physical status Ⅰ-Ⅲ,scheduled for elective thoracoscopic pneumonectomy under general anesthesia,were randomly divided into 4 groups (n =20 each) using a random number table:control group (group Con),stimulation on Lieque (LU7)-Quchi (LI11)-Neiguan (PC6)-Hegu (LI4) at 2/100 Hz group (group 2/100 Hz),stimulation on LU7-LI11-PC6-LI4 at 2 Hz group (group 2 Hz),and stimulation on LU7-LI1 1-PC6-LI4 at 100 Hz group (group 100 Hz).The patients in group Con had the electrodes applied,but received no stimulation.In 2/100 Hz,2 Hz and 100 Hz groups,the patients received 2/100,2 and 100 Hz TEAS on LU7-LI11-PC6-LI4 acupoints ipsilateral to the surgery site,respectively,starting from 30 min before induction of anesthesia until the end of surgery,and the intensity was the maximum current that could be tolerated.Anesthesia was induced with iv midazolam,propofol,sufentanil and cisatracurim,and maintained with target-controlled infusion of remifentanil and propofol,continuous infusion of cisatracurim,and iv boluses of sufentanil when necessary.The target plasma concentration of propofol was adjusted to maintain BIS value at 40-60 during operation.The initial target effect-site concentration of remifentanil was 1 ng/ml,and adjusted to 4 ng/ml at skin incision.The concentration of remifentanil and consumption of sufentanil were adjusted to maintain Analgesia Nociception Index (ANI) at 50-70.When the concentration of remifentanil was increased to 4 ng/ml,ANI was still less than 50,and then 0.1 μg/kg sufentanil was given.The duration of operation and intraoperative consumption of remifentanil and sufentanil (the consumption of sufentanil was converted to the consumption of remifentanil producing the equivalent effect by 1:10) were recorded.Results The intraoperative consumption of remifentanil was significantly reduced in 2/100 Hz group as compared with Con,2 Hz and 100 Hz groups.There was no significant difference in the intraoperative consumption of remifentanil between Con group,2 Hz group and 100 Hz group.Conclusion The use of 2/100 Hz but not 2 and 100 Hz TEAS on LU7-LI11-PC6-LI4 significantly reduces intraoperative opioid consumption in the patients undergoing video-assisted thoracoscopic pneumonectomy.
7.Comparison of non-steroidal anti-inflammatory drugs after posterior lumbar fusion surgery
Shuaihao HUANG ; Qiujian ZHENG ; Yisheng WANG ; Changxiang LIANG ; Mengmeng TIAN
The Journal of Practical Medicine 2014;(20):3321-3323
Objective To compare the analgesia effect and the safety of Flurbiprofen Axetil (FA) and Parecoxib Sodium (PS) after posterior lumbar fusion surgery. Methods 90 patients undergoing internal fixation of lumbar spine randomly assigned to 3 groups:those in Group A(n = 30) received 100 mg of FA; those in Group B (n=30) received 40 mg of PS and those in Group C received saline.The VAS scores of 2, 6, 12, 24, 48, 72 h after operation and the dose of tramadol hydrochloride (TH) used and the side effect was recorded respectively. Results Group A and B had significantly better analgesic effect than Group C(P<0.05). Group A and B had lower average dose of TH than Group C (P<0.05). The VAS scores in Group A was lower than that in Group B in 2 h after the surgery. The VAS scores after the surgery showed no significant difference between Group A and B in 6 , 12, 24 h after the surgery. The VAS scores in Group A was higer than that in Group B in 48,72 h after the surgery. Conclusion Both PS and FA can alleviate postoperative pain and have fewer adverse reactions.
8.The efficacy of calcined natural bovine bone(CBB)in the treatment of bone defects in animal
Yue HE ; Zhiquan TIAN ; Liang WANG ; Yang YAO ; Lu YANG ; Wentao HUANG ; Xinhui HUANG
Journal of Practical Stomatology 2015;(2):167-170
Objective:To observe the efficacy of calcined bovine bone(CBB)in the repair of animal bone defects.Methods:Ca-nine alveolar bone defect model,rat and rabbit calvarial critical size defect models were established respectively.All animals were randomly divided into 2 groups(n=6).The defects in the experimental group were repaire with CBB,those in the control group were not treated.The effects were observed by HE staining,Micro CT and Masson trichrome staining.Results:Canin alveolar bone de-fects were well repaired 8 week after operation.The skull defects in rabbits and SD rats were replaced by new bone 1 2 and 8 weeks after operation respectively.In all the control groups bone defects were not healed or not completely repaired.Conclusion:CBB is ef-fective in the repair of bone defects.
9.Screening of 10 types of Chinese herbal compounds inhibiting Abeta and their possible related mechanism in vitro.
Ran ZHU ; Tian-Xi HUANG ; Xue-Mei ZHAO ; Ji-Min ZHANG ; Ping LIANG
Acta Pharmaceutica Sinica 2014;49(6):800-806
This study is to screen the Chinese herbal compounds which could inhibit the production of Abeta and investigate the underlying mechanism. Ten types of compounds which have potential value in the treatment of AD were selected as initial screening trial. The cell models which used could overexpress Abeta and beta-secretases or Abeta and gamma-secretases. Extracellular Abeta was determined by ELISA after the cell models treated with different concentrations of compounds (0.5-100 micromol x L(-1)), separately. Then the compounds were selected which could inhibit extracellular Abeta and their best concentration ranges were decided, too. Furthermore, the cell viability and apoptosis rate, the level of intracellular Abeta, beta and gamma-secretases were determined after the cell models treated with different concentrations of selected compounds. The results showed that 4 of the 10 compounds could reduce the level of extracellular Abeta; they were cryptotanshinone, astragalosides, gastrodin and paeoniflorin, and their best concentration ranges were 0.5-5.0, 0.5-5.0, 5.0-50, 1.0-25 micromol x L(-1), respectively. Further study indicated that the 4 selected compounds were nontoxic to the cellular models and lowering intracellular Abeta were more effective compared with extracellular; of which astragalosides and gastrodin showed dose-dependent inhibition to the activities of beta and gamma-secretases, with the maximum inhibiting rates of 78.2% and 80.3%, respectively. In conclusion, cryptotanshinone, astragalosides, gastrodin and paeoniflorin could inhibit the expression and secretion of Abeta, and the underlying inhibiting mechanism of astragalosides and gastrodin were related with the reduction of the beta and gamma-secretase activities, respectively.
Amyloid Precursor Protein Secretases
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metabolism
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Amyloid beta-Peptides
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antagonists & inhibitors
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Apoptosis
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Benzyl Alcohols
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pharmacology
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Cell Line
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Dose-Response Relationship, Drug
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Drug Evaluation, Preclinical
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Drugs, Chinese Herbal
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pharmacology
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Glucosides
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pharmacology
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Humans
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Monoterpenes
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pharmacology
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Phenanthrenes
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pharmacology
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Saponins
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pharmacology
10.Levels of interleukin-6,interleukin-10 and T cell subsets in bronchoalveolar lavage fluid of children with refractory mycoplasma pneumonia
Kun LIANG ; Ling TIAN ; Xiaolei WU ; Guangju HUANG ; Xiuhua DAI ; Huiyu ZHANG
Chinese Pediatric Emergency Medicine 2014;21(11):689-692
Objective To explore the interleukin (IL)-6,IL-10 and T cell subsets levels in bronchoalveolar lavage fluid(BALF) of children with refractory mycoplasma pneumonia.Methods A total of 53 children with refractory mycoplasma pneumonia were selected as the observation group,30 children with bronchial foreign body in our hospital were chosen as controls during the same period.ABC-double antibody sandwich ELISA method was used to detect IL-6,IL-10 levels and the CD3 +,CD4 + and CD8 + T levels were measured by means of flow cytometry in BALF.Results The IL-6 and IL-10 levels in BALF of children in the observation group were (63.25 ± 18.61) ng/ml,(31.83 ± 8.33) ng/ml respectively,and they were significantly higher than those of the controls[(30.51 ± 1.34) ng/ml,(11.01 ± 2.91) ng/ml] (P < 0.05,respectively).The percentage of CD3 +,CD4 +,CD8 + T cells and the ratio of CD4 +/CD8 + T cells in BALF of the observation group were (48.47 ± 2.88)%,(21.16 ± 6.29)%,(23.04 ± 4.63)%,0.94 ± 0.33,respectively,and they were significantly lower than those of the controls [(64.24 ± 3.06) %,(34.34 ± 7.59) %,(26.71 ±5.29)%,1.56-±0.67] (P<0.05,respectively).Conclusion The IL-6,IL-10 levels in BALF of children with refractory mycoplasma pneumonia significantly increased,suggesting that cell-mediated immunity play an important role in the pathogenesis of refractory mycoplasma pneumonia.