1.Influence of different target concentrations of sufentanil TCI on BIS during propofol anesthesia
Chinese Journal of Anesthesiology 2008;28(10):869-872
Objective To investigate the changes in BIS values induced by TCI of sufentanil at different target concentrations (Cr) during propofol anesthesia. Methods Fifty ASA Ⅰ or Ⅱ patients aged 18-57 yr undergoing elective surgery under general anesthesia were randomly divided into 5 groups (n = 10 each) based on CTof sufentanil: 0.07, 0.10, 0.14, 0.20 and 0.28 ng/ml. BIS, ECG, HR, MAP, SpO2, PET CO2 were continuously monitored. Anesthesia was induced with propofol TCI. The initial target plasma concentration (Cp) was set at 3.0 μg/ml. If the patient remained conscious 5 rain after the equilibrium between Cp and target effect-site concentration (Ce) was achieved, the Cp of propofol was increasing in increments of 0.3 μg/ml until consciousness was lost (LOC). Propofoi TCI was maintained at this level and Cp and Ce were recorded. TCI of safentanil was then started at the different Cp set in the 5 groups. When the equilibrium between Cp and Ce of safentanil was achieved, tracheal intubation was facilitated with succinyl choline 1.5 mg/kg and the patients were mechanically ventilated (VT= 8-10 mi/kg, RR = 8-12 bpm, PETCO2 = 30-35 mm Hg). BIS value, HR, MAP, SP and DP were recorded before induction of anesthesia at LOC (T0) and 1,2, 3, 4, 5 and 6 min after sufentanil TCI was started. Results There was no significant difference in Cp and Ce of propofol at LOC (T0) among the 5 groups. BIS value was decreasing after the beginning of TCI of sufentanil and was significantly lower than the BIS value at T0. The changes in BIS value was negatively correlated with the Cp and Ce of sufentanil. Conclusion TCI of sufentanil can decrease BIS value further during propofol anesthesia.
2.Influence of combined administration of lactobacilli and clostridium butyricum on acute mice ulcerative colitis
International Journal of Laboratory Medicine 2009;30(1):33-35
Objective To investigate the therapeutic effect of combined administration of lactobacilli and clostridium butyricum on acute mice ulcerative colitis, and explore its therapeutic mechanism.Methods Dextran sulfate sodium (DSS)-induced mice model of acute ulcerative colitis was established. After administration of lactobacilli and clostridium butyricum, the pathological change of tunica mucosa coli was observed and the expression levels of tumor necorisis factor (TNF-α) and tissue factor (TF) were measured.Results Lactobacilli and clostridium butyricum significantly alleviated the damage of tunica mucosa coli and suppressed the expression of TNF-αand TF. By comparison, there were the lightest histological damage and the lowest expression of TNF-αand TF when lactobacilli and clostridium butyricum were administrated combined.Conclusion Both lactobacilli and clostridium butyricum show therapeutic effect on DSS-induced mice ulcerative colitis. The coordinate repression on expression of TNF-αand TF may be the molecular mechanism of the co-effect on mice UC.
4.Analysis of failure-related issues of young patients with endometrial carcinoma who undergo the conservative treatment
Journal of Chinese Physician 2015;17(8):1140-1143,1146
An increasing number of young patients who suffer from endometrial carcinoma (atypical hyperplasia of endometrium) succeed in childbirth.However,some young patients have to receive surgery due to resistance and prognosis and so on.Here we make a brief revicw of the failure-related issues and subsequent treatment of young patients of endometrial carcinomas (atypical hyperplasia of endometrium) who fail in conservative treatments.
6.Blindness causes analysis of 1854 hospitalized patients in Xinjiang
International Eye Science 2015;(1):178-181
Abstract?AlM:To analyze the blindness causes of 1854 cases in our hospital hospitalized patients, and explore the strategy and direction of blindness prevention according to the different treatment efficacy.?METHODS: Cluster sampling was used to select from September 2010 to August 2013 in our hospital department of ophthalmology patients 5 473 cases, in which total of 1 854 cases of blind patients, accounting for 33. 88% of hospitalized patients. According to the WHO's criteria of blindness. The BCVA enacted <0. 05 or vision radius less than 10 degrees are for the blind, and the exclusion of less than 3 years old children don't cope with visual inspection of the inclusion criteria for age and cause of blindness blind patients were analyzed. To the blind to patient age and etiology were analyzed, the main cause of blindness and statistics of all ages, records of the blind patients after treatment eye sight;and calculating the blindness of the literacy rate, on the blindness through analysis of the causes of the risk treatment.?RESULTS:ln 1 854 cases of blind patients, including 728 people right-eye blinding, 767 people left-eyes blinding, 359 people total blinding, adding up to 2 213 eyes, aged from 60~80 years old were in the majority. The top three diseases resulting blindness were cataract, diabetic retinopathy and glaucoma. ln 2 213 blind eyes, the eyes treated were 2 172, of which 1 762 eyes ( 81. 12%) were succeeded, 410 eyes ( 18. 88%) failed. ln the failed cases, the first three diseases were diabetic retinopathy, glaucoma and retinal detachment.?CONCLUSlON: ln recent years, disease etiology of blinding eye has changed, but cataracts, diabetic retinopathy and glaucoma are still high incidence of blindness due, so the treatment of diabetic retinopathy, glaucoma and retinal detachment should be the emphasis for blindness prevention and treatment in the future.
7.Ameliorative effects of 99Tc-methylene diphosphonate on the articular gall symptoms in patients with rheumatoid arthritis
Chuan ZUO ; Nanping YANG ; Yongtao CHEN
Chinese Journal of Tissue Engineering Research 2005;9(11):200-201
BACKGROUND: It is always the key issue of rheumatoid arthritis(RA) to treat articular gall. A kind of medicine with favorable therapeutic effects and safety is urgently needed in the clinics. 99Tc-methylene diphosphonate 99(Tc-MDP) receives generalized attentions on its therapeutic effects and safety since its application into RA therapy.OBJECTIVE: To explore the characters of 99Tc-MDP in the amelioration of articular dysfunction in RA patients.DESIGN: A before-and-after controlled study by employing patients as subjects.SETTING: Department of rheumatism and immunology of an affiliated hospital of a university.PARTICIPANTS: Totally 67 patients with RA at active phase including 11males and 56 females aged between 29 and 71 years old with the course of disease between 9 and 78 months and admitted by the Department of Rheumatism of Huaxi Hospital Affiliated to Sichuan University were in accordance with the RA diagnostic criteria established by American Rheumatism Association(ARA) in 1987. Serious heart,liver or kidney dysfunction,active gastrointestinal pathological changes, hematology and endocrinology diseases,allergic complexion,and women during pregnancy or breast-feeding period were eliminated.METHODS: Clinical indicators including articular edema index, articular pain,grip,morning stiffness duration,rest pain,erythrocyte sedimentation rate (ESR) and C reactive protein(CRP) were compared before and after therapy in 67 cases received 99Tc-MDP treatment. Integrated evaluation was performed after the completion of therapy. Effective meant 30% of improvement in symptoms and physical signs,and reduction in ESR and CRP. Side effects were observed and recorded simultaneously. Data were statistically analyzed.RESULTS: After 99Tc-MDP treatment,RA condition significantly improved,as well as each clinical indicator including articular edema index,articular pain index,morning stiffness duration,rest pain,ESR and CRP(P<0.05) . The total clinical effective rate of this medicine was 81% and the incidence of side effects was small and mild.CONCLUSION: 99Tc-MDP can ameliorate the articular dysfunction of RApatients,which is a safe medicine with strong effect.
8.Pharmacodynamics of propofol-remifentanil target-controlled infusion in elderly patients
Ning YANG ; Mingzhang ZUO ; Yu SHI
Chinese Journal of Geriatrics 2013;(3):312-314
Objective To compare the EC50 ~ EC95 for propofol and remifentanil targetcontrolled infusion(TCI)at loss of consciousness (LOC) and without response to a standard Hoxious painful stimulus in elderly and young adult patients.Methods A total of 102 (American society of anesthesiologists) ASA Ⅰ-Ⅱ patients undergoing elective surgery under general anesthesia were enrolled in this study and divided into control group (aged 18-64 years,n=52) and elderly group (aged≥65 yrs,n=52).Propofol TCI was started at target plasma concentration (Cp) of 1.2 mg/L and the Cp increased by 0.3 mg/L every 30s until loss of consciousness (LOC),kept the target effectsite concentration (Ce) of propofol at LOC.Remifentani TCI was started at Cp of 2.0 μg/L,increased by 0.3 μg/Levery 30s until loss of somatic response to a tetanic stimulus (50Hz,80mA,0.25ms,4s) Cp,Ce,systolic blood pressure (SBP),diastolic blood pressure (DBP),mean artery pressure (MAP) and heart rate(HR) were recorded.The Ce of propofol at LOC,the Ce of remifentanil at loss of somatic response to noxious stimulus in 50%-95% of the patients (EC50-EC95),and 95% confidence interval were determined by probit method.The adjustment required for TCI propofol with remifentanil in elderly patients was explored.Results In elderly group,the propofol Ce at LOC was (2.0±0.3) mg/L,significantly lower than that in control group (2.9±0.2) mg/L (t=6.168,P<0.01) and EC50-EC95 of remifentanil at loss of somatic response to noxious stimulus in elderly group (3.5-5.4) μg/L was similar to that in control group (3.7-5.9) μg/L.Conclusions For TCI propofol and remifentanil in elderly patients,the requirement of Ce of propofol is significantly decreased and Ce of remifentanil required in elderly patients is similar to adult patients.
9.Pharmacodynamics of sufentanil required to inhibit body movement induced by tetanic stimulation and skin incision when combined with propofol in patients undergoing thoracic or abdominal surgery
Ning YANG ; Mingzhang ZUO ; Yu SHI
Chinese Journal of Anesthesiology 2010;30(11):1301-1303
Objective To investigate the pharmacodynamics of sufentanil required to inhibit the body movement induced by tetanic stimulation and skin incision when combined with propofol in patients undergoing thoracic or abdominal surgery. Methods Fifty ASA Ⅰ or Ⅱ patients aged 18-57 yr undergoing elective thoracic or abdominal surgery were randomized into 5 groups sufentanil target effect-site concentration (Ce) (n = 10 each):0.07, 0.10, 0.14, 0.20 and 0.28 ng/ml groups. Anesthesia was induced with TCI of propofol at the target plasma concentration of 3.0-3.2 μg/ml. As soon as the patients lost consciousness, infusion of sufentanil with the corresponding Ce was started in the each group. One tetanic stimulus (frequency 50 Hz, intensity 80 mA, wave length 0.25 ms) was given after the target effect-site and plasma concentrations were balanced. Tracheal intubation was facilitated with succinylcholine 1.5 mg/kg. The concentrations of propofol and sufentanil were maintained until 4 min after skin incision. The body movement was observed during tetanic stimulation and skin incision. The effective effect-site concentration (EC50, EC94) of sufentanil and 95% confidence interval (CI) were calculated using probit regression analysis. Results The EC50 and EC95 of sufentanil required to inhibit the body movement induced by tetanic stimulation when combined with propofol were 0.12 (95% CI 0.09-0.14) ng/ml and 0.20 (95% CI 0.17-0.31) ng/ml respectively. The EC50 and EC95 of sufentanil required to inhibit the body movement induced by skin incision when combined with propofol were 0.13 (95% CI 0.11-0.16) ng/ml and 0.21 (95% CI 0.17-0.29) ng/ml respectively. There was no significant difference in the EC50 and EC95 of sufentanil between the two different stimuli (P > 0.05). Conclusion The EC50 and EC95 of sufentanil required to inhibit the body movement induced by tetanic stimulation (frequency 50 Hz, intensity 80 mA, wave length 0.25 ms) when combined with propofol were 0.12 and 0.20 ng/ml respectively, the EC50 and EC95 of sufentanil required to inhibit the body movement induced by skin incision when combined with propofol were 0.13 and 0.21 ng/ml respectively and there was no significant difference in the pharmacodynamics between the two different stimuli, indicating that tetanic stimulation as an alternative to skin incision can be used to evaluate the pharmacodynamics of anesthetics.
10.Effects of inhalation of different concentrations of sevoflurane on pulmonary inflammatory response in rats
Ruifang JIA ; Baxian YANG ; Mingzhang ZUO ; Haiyan AN
Chinese Journal of Anesthesiology 2010;30(9):1078-1080
Objective To investigate the effects of inhalation of different concentrations of sevoflurane on pulmonary inflammatory response in rats. Methods One hundred and twenty adult Wistar rats of both sexes weighing 200-250 g were randomly divided into 4 groups: Ⅰ control group breathing room air (group C, n = 12);Ⅱ oxygen group breathing 40% O2(group O, n = 36);Ⅲ and Ⅳ sevoflurane groups breathing 1.5% and 3.0% sevoflurane in 40% O2 respectively (group S1, S2, n = 36). Group Ⅱ was further divided into 3 subgroups according to the duration of 40% O2 inhalation 4 h, 8 h and 10 h. Group Ⅲ and Ⅳ were further divided into 3 subgroups ( n = 12 each) breathing sevoflurane for 4 h, 8 h and 8 h followed by 2 h O2 (40%) inhalation. The animals were sacrificed at the end of O2 or/and sevoflurane inhalation. Broncho-alveolar lavage was performed in 6 animals in each subgroup. The TNF-α concentration in broncho-alveolar lavage fluid was determined. The TNF-α mRNA expression and MPO activity in the lung tissue were measured in the other 6 animals in each subgroup. Results Inhalation of 1.5% or 3.0% sevoflurane for 4 or 8 h did not induce inflammatory response in the lung as compared with animals breathing room air or 40% O2 . Conclusion Exposure to sevoflurane does not induce pulmonary inflammatory response in rats breathing spontaneously.