1.Bispectral index in monitoring and evaluating induction of anesthesia with TCI propofol in general anesthesia without tracheal intubation
Chinese Journal of Primary Medicine and Pharmacy 2011;18(12):1614-1616
Objective To investigate the utility of anesthesia depth monitoring of BIS during general anesthesia without tracheal intubation.Methods Sixty patients underwent surgery with local anesthesia were randomly divided into three groups of Ⅰ ,Ⅱand Ⅲ,who were sedated with propofol by TCI propofol 1.0,1.5,2.0μg/ml,respectively.HR,MAP,SpO2 BIS and MOAA/S score were recorded at l0min before operation(T0) .during local anesthesia ( T1) , at 30min after incision (T2) , at 60min after incision (T3) , and the end of operation (T4).Results BIS values declined with the decrease of MOAA/S.MOAA/S score was lower in group Ⅲ than that in group Ⅰ (all P < 0.05).Respiratory depression was seen in 3 cases in group Ⅲ.The difference of MAP had statistical significance between level 3 and level 2 of MOAA/S in group Ⅱ and group Ⅲ (P < 0.05).Conclusion Propofol 1.0 ~ 1.5 μg/ml given by TCI could produce optimal depth of sedation with less side effects in surgery during local anesthesia.
2.Risk factors for airway management after tracheal extubation in old patients
Chinese Journal of Primary Medicine and Pharmacy 2011;18(18):2469-2470
ObjectiveTo investigate the risk factors for airway management after tracheal extubation in old patients. Methods280 patients underwent general anesthesia were enrolled in the study. The procedure of anesthesia induction and maintenance were in the routine method. The patients were with tracheal extubation under clinical standards after operation. Dyspnea was recorded after tracheal extubation. They were divided into dyspnea group and general group. Twelve perioperative variables, ten variables in operation and six post-operative variables of two groups were compared respectively. ResultsThe incidence of dyspnea after tracheal extubation was 8.6%. Analysis identified that obesity( BMI ≥25kg/m2 ), preoperative lung disease and without postoperative neostigmine were the significant risk factors for dyspnea. ConclusionBMI≥25kg/m2 ,preoperative lung disease and without antagonist muscular relaxant were the main risk factors for dyspnea after tracheal extubation in old patients.
3.Application of Deliberated Hypotension Combined with Acute Hypervolemic Hemodilution on Patients Undergoing Endoscopic Nose Surgery
Sanqiang DING ; Danna YANG ; Zhongqun CHEN
Journal of Chinese Physician 2001;0(10):-
Objective To evaluate the effects of deliberated hypotension combined with acute hypervolemic hemodilution (AHH) on safety,operation time, blood loss,postoperative hemoglobin (Hb) and hematocrit (Hct) of the patients undergoing endoscopic nose surgery.Methods Twenty ASA grade I to II patients undergoing selective endoscopic nose surgery were divided randomly into two groups: control group (n=10) and hypotensive group (n=10). All patients received general anesthesia. In the hypotensive group, AHH was accomplished with infusion of HAES and lactated Ringer's solution after endotracheal intubation and before operation. Deliberated hypotension was induced and maintained with nitroprusside 0 5~3 0?g?kg -1 ?min -1 iv. Operation time, intraoperative blood loss, postoperative hemoglobin (Hb) and hematocrit (Hct) and hemodynamics during operation were recorded and compared between the both groups.Results Operation time was about 44% shorter in the hypotensive group than that in the control group. Blood loss was significantly lower in the hypotensive group than that in the control group (P
4.The effect of implementing regional cooperative rescue on patients with acute coronary syndrome
Jinchuan YAN ; Yi LIANG ; Zhongqun WANG ; Liangjie XU ; Peijing LIU ; Wei YUAN ; Xiaojie CHEN
Chinese Journal of Emergency Medicine 2015;24(6):648-652
Objective To evaluated the effect of the regional cooperative rescue model implemented on the length of time from first medical contact (FMC) to balloon dilation (B),economic expense and prognosis in patients with acute coronary syndrome (ACS).Methods Patients with ACS (including ST-segment elevation and non-ST-segment elevation) selected from other hospitals within 24 hours after onset were treated with emergency percutaneous coronary intervention.Patients were divided into two groups, regional cooperative rescue group and control group without the regional cooperative rescue model approved.The lengths of FMC-to-B time and Door-to-B time (from arrival at emergency department or OPD to balloon dilation),time required for patients referred to our hospital,cardiac function,averaged hospital costs,average hospital stay,percentage of medication used and a major adverse cardiac event (MACE) were analyzed.Results Mean FMC-to-B time,Door-to-B time,referral time and time consumed to obtain informed consent were significantly shorter [(106±33) min,(31 ±8) min,(62 ±18,8 ±3) min] vs.[(231 ±35) min,(109 ±26) min,(98 ±31) min,(28 ±11) min,respectively] by implementing the regional cooperative rescue compared with control group,and LVEF was increased,and LVED was deceased inregional cooperative rescue group.The mean costs [(44 123.0 ±3 427.0) yuan vs.(51 587.0 ±5 621.0)] yuan,days of hospital stay [(8.7 ±4.1) vs.(13.2 ±6.4)] and percentage of medication used were significantly decreased in the regional cooperative rescue group.The incidence of MACE inregional cooperative rescue group was 6.2%,whereas the incidence in control group was 16.8%.Conclusions The regional cooperative rescue model can improve the prognosis and decrease the FMC-to-B time,the rate of MACE and financial burden in patients with ACS.
5. CD137 signaling promotes the formation of plaque calcification via inhibiting the fusion of autophagy and lysosomal in Apo E-/- mice
Xiaoyang LI ; Rui CHEN ; Wei ZHONG ; Bo LI ; Chen SHAO ; Zhongqun WANG ; Jinchuan YAN
Chinese Journal of Cardiology 2017;45(12):1078-1085
Objective:
To investigate whether CD137 signaling promoted the formation of atherosclerotic plaque calcification by inhibiting the fusion of autophagosome and lysosome.
Methods:
(1) In vivo, CD137 agonist antibody and anti-CD137 antibody were used to stimulate and inhibit the CD137 signaling, respectively. Fifteen Apo E-/- mice were randomly divided into three groups: control group (intraperitoneal injection of IgG2b 200 µg) , CD137 agonist group (intraperitoneal injection of CD137 agonist antibody 200 µg) , anti-CD137 group (pretreatment with 200 µg anti-CD137 antibody for 24 hours, then injection of CD137 agonist antibody) . (2) In vitro, primary culture of mouse aortic VSMCs obtained through adherence methods for tissues explants. The cells was divided into three groups: control group, agonist-CD137 group (CD137 agonist antibody 10 μg/ml) , and anti-CD137 group (pretreatment with 10 μg/ml anti-CD137 antibody for 60 minutes, then incubated with 10 μg/ml CD137 agonist antibody) . Von kossa staining was used to detect the calcification in the cell and plaque. Immunohistochemical staining was used to observe the expression of LC3B, Beclin 1 and p62 which are associated with autophagy. The levels of autophagy related protein (LC3) , Beclin 1, p62, and the expression of Runx2 and bone morphogenetic protein 2, which is associated with osteogenic differentiation in the VSMCs, were determined by Western blot. The autophagy flow of each group was detected by fluorescence microscopy. The autophagy was observed by transmission electron microscope in vivo and in vitro.
Results:
(1) In vivo, the calcified plaque area in CD137 agonist group was significantly larger than that in the control group (3.01%±0.45% vs. 0.27%±0.06%,
6. CD137-CD137L signaling influences the autophagy via JNK pathway in mouse vascular smooth muscle cells
Yao XU ; Rui CHEN ; Liang DING ; Wei ZHONG ; Ping YANG ; Bo LI ; Chen SHAO ; Zhongqun WANG ; Jinchuan YAN
Chinese Journal of Cardiology 2018;46(5):370-375
Objective:
To investigate whether CD137-CD137L signaling can affect the autophagy of mouse vascular smooth muscle cells(VSMCs) through JNK signal pathway.
Methods:
Primary culture of C57BL/6J mouse thoracic aorta VSMCs was performed by tissue block adherence method. VSMCs between the third to fifth passages were isolated and cultured. VSMCs were divided into 4 groups: control group, CD137 agonist group, JNK inhibition group, and DMSO group. VSMCs in CD137 agonist group were treated with recombinant protein of CD137L (10 μg/ml), VSMCs in JNK inhibition group were treated with JNK inhibitor SP600125 (10 μmol/L) for 30 minutes followed by recombinant protein of CD137L (10 μg/ml) and DMSO group was treated with the same amount of DMSO in JNK inhibition group for 30 minutes, then added recombinant protein of CD137L (10 μg/ml). Western blot was used to detect the protein expression of p-JNK, LCⅡ and p62 in each group. Fluorescence microscopy was used to track the changes of autophagy in cells which was infected with adenovirus expressing tandem mRFP-GFP-LC3. Transmission electron microscope (TEM) was used to observe intracellular autophagosomes and autolysosomes.
Results:
(1) Compared with the control group, stimulating CD137-CD137L axis by recombinant protein of CD137L significantly upregulated the expression of p-JNK, LCⅡ and p62 (1.15±0.19 vs. 0.72±0.21,
7. CD137-CD137L interaction induced the calcification of mouse smooth muscle cells via P38 MAPK signaling
Liang DING ; Yao XU ; Ping YANG ; Rui CHEN ; Bo LI ; Chen SHAO ; Wei ZHONG ; Zhongqun WANG ; Jinchuan YAN
Chinese Journal of Cardiology 2018;46(11):892-900
Objective:
To explore whether CD137-CD137L interaction could induce mouse vascular smooth muscle cells(VSMCs) calcification via P38 MAPK signaling.
Methods:
(1) Mouse VSMCs obtained from 8-week old male C57 mice were cultured by using method of tissue piece inoculation.The cells from 3 to 8 passage were divided into 4 groups: control group, agonist-CD137 group(recombinant CD137L protein), anti-P38 group(agonist-CD137 group+P38 inhibitor), single anti-P38 group(P38 inhibitor). The calcification was induced by adding a mixture of 10 mmol/L β-glycerophosphate+10-8 mol/L dexamethasone+10-7 mol/L insulin in the culture medium.Immunofluorescence was used to observe the changes of VSMCs markers(α-SMA and OPN).Real time-PCR was used to observe the mRNA expression of OPN and RUNX-2. Western blot was used to observe the protein expression of p-P38, OPN and RUNX-2. The level of cell calcification was observed by detecting alkaline phosphatase activity and calcium concentration. (2) The degeree of local calcium deposition was also tested on Von Kossa staining and Alizarin red staining methods in following 5 mouse VSMCs groups: control group, agonist-CD137 group(recombinant CD137L protein), anti-P38 group (agonist-CD137 group+P38 inhibitor), anti-CD137 group (agonist-CD137 group+CD137 inhibitor),agonist-P38 group(anti-CD137 group+P38 agonist).
Results:
(1) Compared with the control group, the fluorescence intensity of α-SMA was lower in the agonist-CD137 group(2.79±0.25 vs. 5.42±0.47,
8. CD137 induces vascular muscle cells phenotype transformation through activating nuclear factor of activated T-cells 1 signaling
Wei ZHONG ; Bo LI ; Jun LIU ; Yuan XU ; Rui CHEN ; Chen SHAO ; Zhongqun WANG ; Jinchuan YAN
Chinese Journal of Cardiology 2017;45(9):799-804
Objective:
To investigate whether CD137 induces primary vascular muscle cells (VSMCs) phenotype transformation through activating nuclear factor of activated T-cells 1(NFATc1) signaling.
Methods:
VSMCs were obtained from aorta of C57BL/6J mice (8 weeks, male) through tissue-piece inoculating. Cells were divided into control group, CD137 agonist group (treated with CD137L recombinant protein) and anti-CD137 group (treated with anti-CD137 antibody). In si-RNA transfection assay, cells were divided into si-control group and si-NFATc1 group which were transfected with control or si-NFATc1 sequence respectively. The levels of NFATc1 and other phenotype related protein such as α-smooth muscle actin (α-SMA), smooth muscle myosin heavy chain (SM-MHC), vimentin were detected by Q-PCR and Western blot. Nuclear protein expression and activity of NFATc1 were detected by immunofluorescence and Western blot. Transwell assay was performed to measure the migration of VSMCs.
Results:
According to Western blot, the expression of NFATc1 and vimentin was significantly upregulated (5.07±0.36 vs. 1.00±0.00,
9. Impact of CD137-CD137L signaling mediated exocytosis of autophagosome within vascular smooth muscle cells on the formation of atherosclerotic calcification
Bo LI ; Xiaoyang LI ; Wei ZHONG ; Chen SHAO ; Zhongqun WANG ; Wei YUAN ; Jinchuan YAN
Chinese Journal of Cardiology 2017;45(1):49-56
Objective:
To explore whether CD137-CD137L signaling mediated exocytosis of autophagosome within vascular smooth muscle cells (VSMCs) could influence the formation of atherosclerotic calcification.
Methods:
Fifteen 8-week-old male ApoE-/-(C57BL/6J-KO) mice fed with high fat diet for 5 weeks were randomly divided into three groups by using stochastic indicator method as follows: control group,
10.Attention deficit hyperactivity disorder in children with congenital heart diseases
International Journal of Pediatrics 2021;48(11):723-726
Congenital heart disease is the most common congenital defect.With the advancement of surgical techniques, the survival rate of children with congenital heart disease is gradually increasing.However, the neurodevelopmental defects in children with congenital heart disease have gradually increased, which elicits increasing scholars′ attention.Attention deficit hyperactivity disorder(ADHD)is one of the most prominent neurodevelopmental behavior disorders in children.In previous studies, the prevelance of ADHD in cyanotic congenital heart disease was obviously higher than that of the general population, and however, research of congenital heart disease was in its infancy.This paper intends to review the incidence, etiology, pathogenesis, treatment and prognosis of ADHD in congenital heart disease in order to provide references for clinical work.