Ribs were obtained from 110 individuals undergoing thoracostomy. Bone marrow from these ribswas cultured on agar plates. The average number of cell colonies formed on the agar plates was 164?10.4/2?105 nucleated cells (33.4+-571.6/2?105 nucleated cells). Factors which might affect theculture were counting method for the mono-nucleated cells, the method of cell separation, and the use of horse serum.

Objective To explore the two different anesthesia methods on hemodynamics and inflammatory cytokines in elderly patients during peroperative period.MethodsFifty elderly patients with Knee Replacement( ASA Ⅰ,Ⅱ )were randomly divided into general anesthesia group( group A,n =25 ) and combined general and epidural anesthesia group( group B,n =25 ).The changes of mean arterial pressure(MAP) and heart rate ( HR ) were monitored before induction of anesthesia ( T1 ),at intubation ( T2 ),during skin incision ( T3 ) and at the time of extubation ( T4 ),at 30 min after extubation ( T5 ).Blood samples were taken from artery for determination of plasma TNF-α,IL-6,IL-10 concentrations before tourniquet inflation ( T5 ),10 min after tourniquet deflation(T6),30 min after tourniquet deflation (T7)and 30 min after operation (T8)by enzymelinked immunosorbent assay(ELISA).ResultsThe MAP and HR of patients in two groups at T2,T3,T4 were all increased when compared with T1 [ group A:HR:( 94.3 ± 10.4 ) bpm,( 96.4 ± 12.7 ) bpm,(93.3 ± 11.1 )bpm vs(62.6 ±7.3)bpm;MAP:( 18.8 ±3.4)kPa,( 19.6 ±3.4)kPa,( 17.8 ±2.0)kPa vs ( 14.5 ± 1.5)kPa,P＜0.05;group B:HR(76.2 ±6.5)bpm,(70.1 ± 9.7) bpm,(71.5 ± 8.3) bpm vs(64.6 ± 8.4) bpm;MAP:( 16.3 ± 2.5 ) kPa,( 15.3 ± 1.2) kPa,( 14.8 ± 1.4) kPa vs ( 14.1 ± 1.3 ) kPa,P ＜ 0.05 ].There was significant difference on MAP and H R between group A and group B( F =11.957,9.745;P ＜ 0.05 ).The level of plasma TNF-α,IL-6 and IL-10 were significantly increased at T6 to T8 compared with T5 in both groups[ groupA:TNF-α:(4.36 ±0.18) ng/L,(7.54 ± 1.23) ng/L,(10.35 ±2.21 )ng/L vs (2.26 ±0.16) ng/L; groupA:IL-6:(4.32 ±0.21 ) ng/L,( 8.35 ± 1.26 ) ng/L,( 10.23 ± 2.23 ) ng/L vs ( 1.36 ± 0.08 ) ng/L; groupA:IL-10:(5.32±1.10) ng/L,(7.56 ± 1.36) ng/L,(8.63 ± 2.21) ng/L vs (1.25 ± 0.03) ng/L; groupB:TNF-α:(3.43 ±0.06)ng/L,(5.24 ±2.10) ng/L,(7.68 ± 1.43) ng/L vs(2.22 ±0.15) ng/L;groupB:IL-6:(3.41 ±0.08 ) ng/L,(5.34 ± 1.34 ) ng/L,( 8.54 ± 2.03 ) ng/L vs ( 1.28 ± 0.04 ) ng/L; groupB:IL-10:( 7.28 ± 1.22 )ng/L,( 10.53 ± 2.14)ng/L,( 12.45 ± 2.03 )ng/L vs( 1.31 ± 0.04)ng/L,P ＜ 0.05 ].And there was significant difference on TNF-α,IL-6 and IL-10 between group A and group B( F =7.889,3.554,5.443,respectively,P ＜0.05).ConclusionCompared with general anesthesia group,combined general and epidural anesthesia group can ensure hemodynamic stability of elderly patients during peroperative period very well and can reduce the releasing of inflammatory cytokins,it is a viable and an ideal method.

ObjectiveTo observe the changes of the respiratory dynamics during expand thymectomy,and to explore the protection of ulinastatin on pulmonary function.MethodsSixty patients with myasthenia gravis( Ossermann Ⅰ,Ⅱ b)undergoing expand thymectomy were randomly divided into control group( group C,n =30)and ulinastatin group( group U,n =30).Patients in ulinastatin group received intravenous injection of ulinastatin 4000 U/kg in 20 ml physiological saline immediately after entering operating room and pumped ulinastatin 2000 U/( kg · h)to the end of the operation continuously.Patients in control group received the same volume of normal saline.Heart rate ( HR ),mean arterial pressure ( MAP ),lung compliance,airway peak pressure,plateau airway pressure,inspiratory and expiratory resistance were monitored before induction of anesthesia( T1 ),during skin incision ( T2),at 30 min after operation ( T3 ) and at 60 min after operation (T4),at the end of operation before extubation(T5).ResultsCompared with T1,HR and MAP at T2 in two groups were increased obviously [ group U HR:( 90.2 ± 13.5 ) bpm vs ( 78.6 ± 10.4 ) bpm,MAP:( 15.5 ± 2.3 ) kPa vs ( 12.1 ± 1.5)kPa;group C HR:(94.3 ± 15.4)bpm vs(81.6 ± 12.2)bpm,MAP:( 16.8 ± 2.6) kPa vs( 12.6 ±1.8)kPa,P ＜ 0.05 )].There was no significant difference on HR,MAP at each time between the two groups (P ＞0.05).At T3,T4,T5,the lung compliance was significantly decreased when compared with T1 [ group U:T3,T4,TS(51.23 ± 12.33) ml/cm H2O,(50.35 ± 13.29) ml/cm H2O and(50.65 ± 13.16) ml/cm H2O vs T1 (53.69 ± 14.34) ml/cm H2O;group C:T3,T4,T5(41.56 ± 11.20)ml/cm H2O,(42.02 ± 10.12) ml/cm H2O and(39.85 ± 10.31 ) ml/cm H2O vs T1 ( 53.45 ± 15.21 ) ml/cm H2O; P ＜ 0.05 ) ].Airway peak pressure,plateau airway pressure,inspiratory and expiratory resistance at T3,T4,T5 were obviously increased compared with T1 in two groups [ airway peak pressure:group U:( 13.04 ± 2.14 ) cm H2O,( 13.12 ± 2.42 ) cm H2O,(13.22±2.48)cm H2O,vs(12.04 ±2.12)cm H2O;group C:(16.25 ±3.27)cm H2O,(15.56 ±4.34)cm H2 O,( 16.64 ± 3.45 ) cm H2O,vs ( 13.12 ± 2.32 ) cm H2O; plateau airway pressure:group U:( 10.54 ±2.46) cm H2O,( 11.76 ± 3.11 ) cm H2O,( 12.02 ± 3.25 ) cm H2 O,vs ( 9.48 ± 2.13 ) cm H2O; group C:(15.02 ±3.87)cm H2O,( 15.51 ± 3.13) cm H2O,( 15.67 ± 3.02) cm H2O,vs (9.25 ± 1.26) cm H2O;inspiratory resistance:group U:( 8.56 ± 2.52 ) cm H2O,( 9.31 ± 3.06 ) cm H2O,( 8.44 ± 2.45 ) cm H2O,vs (8.25 ±2.20)cm H2O;group C:(11.52 ±3.06)cm H2O,(12.16 ±3.02)cm H2O,(12.83 ±3.14)vs ( 8.31 ± 2.24 ) cm H2O ; expiratory resistance:group U:( 10.22 ± 2.24 ) cm H2O,( 10.34 ± 2.66 ) cm H2O,(10.27 ± 2.22) cm H2O,vs(8.46 ± 2.37) cm H2O; group C:(14.43 ±3.18)cm H2O,(14.56 ±3.32)cm H2O,( 14.46 ± 3.52 ) cm H2O,vs ( 8.55 ± 2.18 ) cm H2O; P ＜ 0.05 ) ].The increased degree of lung compliance and the decreased degree of airway peak pressure,plateau airway pressure,inspiratory and expiratory resistance at the time of T3,T4,T5 and T1 in ulinastatin group were all significantly higher than those in control group(F=6.167,3.138,4.137,5.217,4.361,respectively,P ＜0.05).ConclusionUlinastatin can improve respiratory dynamics,reduce lung injury,and play a protective role in patients with myasthenia gravis.

OBJECTIVE: To determine the effect of lung protection mechanical ventilation on respiratory function in the elderly undergoing spinal fusion. METHODS: Sixty 70-85 year old patients, ASA class II or III, undergoing spinal fusion were randomly assigned into 2 groups (30 in each group): a protection mechanical ventilation group (group P) and a conventional mechanical ventilation group (group C). Low VT and low level positive end expiratory pressure (PEEP) mechanical ventilation were applied in group P (VT=6mL/kg, RR=12-18 b/min, I:E=1:2, PEEP=10 cmH2O, alveolar recruitment performed once every 15 min), while traditional ventilation was used in group C ( VT=10-12 mL/kg, RR=12 b/min, I:E=1:2). Arterial blood samples were taken and pH, PaO2, PaCO2, PaO2/FiO2, A-aDO2, HR, SBP, DBP and CVP were recorded before the operation (T0), 1 h after tracheal intubation (T1), tracheal extubation immediately (T2), 1 h after tracheal extubation (T3), 1 d, 2 d, and 3 d after the operation (T4, T5, and T6). The pulmonary complication was also examined 1 d after the operation. RESULTS: At T1, T2, T3, T4 and T5, PaO2 and PaO2/FiO2 in group P were higher than those in group C, but A-aDO2 in group P was lower than that in group C. Five patients had bronchitis, 5 had hyoxemia, and 3 had atelectasis in group C, but 2 bronchitis in group P. The incidence of pulmonary complication was 43.3% in group C and 6.6% in group P. There was no significant difference in HR, SBP, DBP and CVP between the 2 groups. CONCLUSION Lung protection mechanical ventilation improves the arterial oxygenation and accelerates the recovery of respiratory functions in elderly patients after spinal fusion operation, with no influence on hemodynamics.
Aged ; Aged, 80 and over ; Anesthesia, General ; Female ; Humans ; Hypoxia ; prevention & control ; Male ; Positive-Pressure Respiration ; methods ; Postoperative Complications ; prevention & control ; Pulmonary Ventilation ; Respiration, Artificial ; methods ; Respiratory Function Tests ; Spinal Fusion ; methods

Objective To investigated the effects of patient controlled intravenous analgesia and ultrasound guided patient?controlled paravertebral block on pulmonary function in patients with multiple fractured ribs? Methods From May 2015 to March 2016,60 patients with multiple rib fractures in Ningbo NO?6 Hospital with American Society of Anesthesiologists Ⅱ-Ⅲ underwent internal fixation, including 30 males and 30 females aged from 16 to 70 years ( mean age ( 54?6 ± 15?2 ) years ) . All patients were randomly divided into 2 groups (n=30 each):patient controlled intravenous analgesia(PCIA) group and patient controlled thoracic paravertebral block(PCPB) group.PCIA solution contained sufentanil 2 μg/kg in 100 ml of normal saline. The PCIA pump was set up to deliver a 2 ml bolus dose with 15 minutes lockout interval and background infusion at 2 ml/hour.In PCPB group,the patients received paravertebral injection of 0?2% ropivocaine 15 ml on the corresponding area of fractured side under ultrasound guidance at the end of operation,and then received PCPB.PCPB solution contained 0?75% ropivacaine 67 ml in 250 ml of normal saline,and the pump was set up to deliver a 5 ml bolus dose, with 15 minutes lock out interval and background infusion at 5 ml/hour? Both analgesia lasted to 72 hours after operation.Before the operation,at 30 minutes,60 minutes,1 day,2 days,3 days after analgesia,arterial blood samples were collected to test the levels of pH,PaO2 ,PaCO2 ,PaO2/FiO2 and PA?aDO2 . The pulmonary function was also examined before and 3 days after the operation through FEV1 and FEV1%? Results Compared with PCIA group at 30 minutes, 60 minutes, 1 day, 2 days, 3 days after analgesia, the level of PaO2 ( ( 85?1 ± 9?7 ) mmHg vs? ( 72?4 ± 12?3)mmHg,(90?3±12?4)mmHg vs? (73?5±7?8)mmHg,(94?2±8?2)mmHg vs? (86?1±5?6)mmHg, (98?5±7?0)mmHg vs? (88?8±7?5)mmHg,(99?6±9?8)mmHg vs? (91?3±8?6)mmHg,P<0?05)) and PaO2/FiO2 were significantly increased ( ( 405?1 ± 46?0 ) mmHg vs? ( 340?1 ± 58?9 ) mmHg, ( 430?5 ± 59?1) mmHg vs? ( 344?0 ± 65?4 ) mmHg, ( 448?3 ± 39?1 ) mmHg vs? ( 410?1 ± 26?7 ) mmHg, ( 460?1 ± 33?5)mmHg vs? (423?2±36?5)mmHg,(465?1±28?2)mmHg vs? (435?1±40?8)mmHg,P<0?05)), the level of PA?aDO2 was decreased ((22?9±4?6)mmHg vs? (36?6±5?1)mmHg,(17?7±4?7)mmHg vs?(34?5±2?9)mmHg,(13?8±4?1)mmHg vs? (21?9±3?2)mmHg,(13?5±4?6)mmHg vs? (19?2± 3?8)mmHg,(12?4±2?0)mmHg vs? (17?7±2?4)mmHg,P<0?05)), and FEV1,FEV1% were significantly increased at 3 days after operation in PCPB group ((2?9±0?4)mmHg vs? (2?2±0?5)mmHg, (78?1± 4?7) mmHg vs? ( 64?8 ± 4?3 ) mmHg; P<0?01 ) ) . Conclusion Ultrasound guided patient?controlled paravertebral block improves the arterial oxygenation function and accelerates the recovery of pulmonary function in patients with multiple?fractured ribs after internal fixation operation.

Objective To investigated the effects of patient controlled intravenous analgesia and ultrasound guided patient?controlled paravertebral block on pulmonary function in patients with multiple fractured ribs? Methods From May 2015 to March 2016,60 patients with multiple rib fractures in Ningbo NO?6 Hospital with American Society of Anesthesiologists Ⅱ-Ⅲ underwent internal fixation, including 30 males and 30 females aged from 16 to 70 years ( mean age ( 54?6 ± 15?2 ) years ) . All patients were randomly divided into 2 groups (n=30 each):patient controlled intravenous analgesia(PCIA) group and patient controlled thoracic paravertebral block(PCPB) group.PCIA solution contained sufentanil 2 μg/kg in 100 ml of normal saline. The PCIA pump was set up to deliver a 2 ml bolus dose with 15 minutes lockout interval and background infusion at 2 ml/hour.In PCPB group,the patients received paravertebral injection of 0?2% ropivocaine 15 ml on the corresponding area of fractured side under ultrasound guidance at the end of operation,and then received PCPB.PCPB solution contained 0?75% ropivacaine 67 ml in 250 ml of normal saline,and the pump was set up to deliver a 5 ml bolus dose, with 15 minutes lock out interval and background infusion at 5 ml/hour? Both analgesia lasted to 72 hours after operation.Before the operation,at 30 minutes,60 minutes,1 day,2 days,3 days after analgesia,arterial blood samples were collected to test the levels of pH,PaO2 ,PaCO2 ,PaO2/FiO2 and PA?aDO2 . The pulmonary function was also examined before and 3 days after the operation through FEV1 and FEV1%? Results Compared with PCIA group at 30 minutes, 60 minutes, 1 day, 2 days, 3 days after analgesia, the level of PaO2 ( ( 85?1 ± 9?7 ) mmHg vs? ( 72?4 ± 12?3)mmHg,(90?3±12?4)mmHg vs? (73?5±7?8)mmHg,(94?2±8?2)mmHg vs? (86?1±5?6)mmHg, (98?5±7?0)mmHg vs? (88?8±7?5)mmHg,(99?6±9?8)mmHg vs? (91?3±8?6)mmHg,P<0?05)) and PaO2/FiO2 were significantly increased ( ( 405?1 ± 46?0 ) mmHg vs? ( 340?1 ± 58?9 ) mmHg, ( 430?5 ± 59?1) mmHg vs? ( 344?0 ± 65?4 ) mmHg, ( 448?3 ± 39?1 ) mmHg vs? ( 410?1 ± 26?7 ) mmHg, ( 460?1 ± 33?5)mmHg vs? (423?2±36?5)mmHg,(465?1±28?2)mmHg vs? (435?1±40?8)mmHg,P<0?05)), the level of PA?aDO2 was decreased ((22?9±4?6)mmHg vs? (36?6±5?1)mmHg,(17?7±4?7)mmHg vs?(34?5±2?9)mmHg,(13?8±4?1)mmHg vs? (21?9±3?2)mmHg,(13?5±4?6)mmHg vs? (19?2± 3?8)mmHg,(12?4±2?0)mmHg vs? (17?7±2?4)mmHg,P<0?05)), and FEV1,FEV1% were significantly increased at 3 days after operation in PCPB group ((2?9±0?4)mmHg vs? (2?2±0?5)mmHg, (78?1± 4?7) mmHg vs? ( 64?8 ± 4?3 ) mmHg; P<0?01 ) ) . Conclusion Ultrasound guided patient?controlled paravertebral block improves the arterial oxygenation function and accelerates the recovery of pulmonary function in patients with multiple?fractured ribs after internal fixation operation.

To investigate the expression and significance of cell surface receptor signaling lymphocyte activation molecule family member 7 (SLAMF7) in normal intestinal tissues and intestinal inflammatory tissues of mice.