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Objective To compare the safety and efficacy of the different doses of sufentanil combined with propofol target controlled infusion for modified electronic convulsive therapy ( MECT ) .Methods A total of 100 patients with mental disorders were randomly divided into four groups:control group (group C), sufentanil 1 group (S1), sufentanil 2 group ( S2 ) and sufentanil 3 group ( S3 ) , 25 cases in each group.In sufentanil groups, patients were respectively intravenously injected with 0.1, 0.2 and 0.3 μg? kg -1 sufentanil 10 mL, and those in control group were given 0.9%NaCl solution.Propofol was given through target controlled infusion, and the initial target density of 3.0 μg? mL-1 was set, and increased by 0.5μg? mL-1.When eyelash reflex disappeared, succinylcholine 1.0 mg? kg -1 was injected by intravenous injection.The vital signs of patients before anesthesia ( T1 ) , target control infusion stop immediately ( T2 ) , immediately after MECT finished ( T3 ) and consciousness recovery ( T4 ) , clinical effects,the seizure energy index, the seizure duration, awakening time, assisted ventilation time and adverse reactions were recorded.Results The difference had no statistical significance in vital signs, the seizure energy index, the seizure duration of all patients ( P >0.05 ) .Compared with group C, assisted ventilation in group S2 and S3 was prolonged, and the waking time was extended in group S3, total effective rate was increased in group S1 to S3 ( P<0.05 ) .Compared with group S1 , assisted ventilation time and waking time were extended, myalgia was decreased, and the total effective rate was increased in group S3(P<0.05).Compared with group S2 , the assisted ventilation was prolonged in group S3 ( P<0.05 ) .The incidences of nausea and vomiting and sleepiness were increased, while muscle pain and headache incidence were decreased as sufentanil dose increased. Conclusion Sufentanil combined with anesthesia of propofol target controlled infusion can be safe and effective for MECT, and 0.2 μg? kg-1 sufentanil is preferred.

6.Analysis of clinicopathologic features and morphogenesis of carcinoid tumorlets in the lung with bronchiectasis.

Jun-chen WANG ; Da-ren SHI ; Xue-lian FU ; Wan-ping LU ; Feng-juan SHI ; Chang-li LU

Chinese Journal of Pathology 2003;32(4):350-353

OBJECTIVETo describe the clinicopathologic features and immunophenotypes of carcinoid tumorlets in the lung with bronchiectasis, and to study the morphogenesis of these tiny tumors.

METHODSThe histopathologic characteristics of 3 bronchiectasis cases with carcinoid tumorlets, 11 bronchiectasis and 2 normal lungs were studied. Specific markers of the tiny tumors and the number of neuroendocrine cells (NECs) in the airway mucosa were immunohistochemically detected by EnVision method.

RESULTSThe tumorlets in the lungs presented as multi-focal nodules and most were displayed only under microscopy. These cells were arranged in clusters and foci of fascicles which were situated in the surrounding bronchial wall and bronchioles adjacent to bronchiectatic lesion, or in the scar tissues. The tiny tumors were consisted of short fusiform cells and small ovoid cells. Their nuclei were circular, oval or long fusiform and the cells were strongly argyrophilic on Grimelius staining. Intensive positive immunostaining for calcitonin, chromogranin A, NSE and gastrin were detected. Weak positive for CK, EMA, S-100 and focal positive for HC, ACTH, 5-HT were also observed. Proliferative NECs in airway mucosa adjacent to the tiny tumors increased significantly in number, compared with those in the airway mucosa of bronchiectasis without tumorlets and normal lungs (P < 0.001, respectively).

CONCLUSIONSThe clinicopathologic features and immunophenotypes of carcinoid tumorlets resemble carcinoid tumors. They are the early stage of carcinoid development. Their development may be related to the chronic pulmonary damage resulting in hypoxia and stimulating the proliferation of NECs. These pulmonary carcinoid tumorlets can be used as a model to study the tumorigenesis of carcinoid carcinoma of the lung.

Adult ; Aged ; Bronchiectasis ; pathology ; Carcinoid Tumor ; chemistry ; pathology ; Female ; Humans ; Immunohistochemistry ; Lung Neoplasms ; chemistry ; pathology ; Middle Aged ; Morphogenesis ; Neurosecretory Systems ; pathology