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Objective:To identify the effective concentrations of Ropivacaine in the modified fascial iliac compartment block(FICB)that would not affect the movement of the affected limb but would offer effective pain relief after total knee arthroplasty(TKA)in elderly patients.In addition, adverse reactions within 24 hours of FICB were examined.Methods:This study was a prospective, single-arm sequential trial.Forty-five elderly patients treated with TKA at the First Affiliated Hospital of Soochow University between September 2021 and March 2022 were selected, with an American Society of Anesthesiologists(ASA)score of Ⅰ or Ⅱ.All patients were given ultrasound-guided FICB on the surgical side under general anesthesia and 10 minutes before the operation, and the injection volume was 30 ml.According to preliminary experiments and relevant literature, the initial concentration of Ropivacaine was 0.1%, and the concentration for the next patient was determined using a modified Dixon sequential method.If the quadriceps femoris muscle strength score of the first patient was ≥4, there was no resting pain[visual analogue scale(VAS)score ≤1], and the VAS score during activity was ≤3, the concentration for the next patient would be reduced.Conversely, the concentration would be increased.The Ropivacaine concentration was increased or decreased by 0.01% each time and the trial would be stopped after 12 reentries.The median effective concentration(ED50), 95% effective concentration(ED95)and corresponding 95% confidence interval(CI)of ropivacaine were calculated using the probit model.Meanwhile, adverse reactions within 24 hours of FICB were monitored.Results:Of 43 elderly patients who completed the trial, the intervention was effective in 23 and ineffective in 20.While ensuring that postoperative limb movement in elderly patients was not affected, a single injection of 30 ml ropivacaine through FICB was able to effectively inhibit postoperative pain, and the ED50 and ED95 of ropivacaine were 0.072%(95% CI: 0.065%-0.078%)and 0.093%(95% CI: 0.084%-0.124%), respectively.Within 24 hours of FICB, 2 patients had lower limb weakness and could not get out of bed and walk, and 5 patients had severe pain and needed additional analgesics.No other adverse reactions were found. Conclusions:The effective ED50 and ED95 of Ropivacaine for postoperative pain relief in elderly patients after TKA are 0.072% and 0.093%, respectively.And the incidence of adverse reactions is low.
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Objective:To construct a Soochow University model of comfortable medical procedures during peri-anesthesia period for patients undergoing radical resection of lung cancer through thoracoscope.Methods:In this prospective study, eight hundreds and sixty patients undergoing radical resection of lung cancer through thoracoscope were enrolled in our hospital in 2018.During peri-anesthesia period, the 860 patients were randomly(by the random number table method)divided into the control group(the group C receiving routine medical procedures, n=430)and the comfort group(the group S receiving the comfortable medical procedures of Soochow University model, n=430). The scores of Visual Analogue Scale(VAS), Richmond Agitation-Sedation Scale(RASS), and Thirsty Analogue Scale(TAS)were recorded at 5 min after extubation(T1), at out of the post-anesthesia care unit(T2), at 1 h(T3), 6 h(T4), 12 h(T5), 24 h(T6), 2 d(T7)and 3 d after surgery(T8)in two groups.The incidences of postoperative sore throat(POST), nausea and vomiting(PONV), catheter-related bladder discomfort(CRBD), thirst and hypothermia were recorded at T2, T6 and T8, respectively.Meanwhile, the peri-anesthesia comfort questionnaire(PCQ)and peri-anesthesia satisfaction questionnaire(PSO)were completed at T6 and T8.Results:The incidences of POST(48.6% vs.16.2%), PONV(24.9% vs.13.0%), CRBD(78.8% vs.20.9%)and thirst(74.9% vs.20.0%)were higher in the group C than in the group S at T2( P<0.05). The comfort score and satisfaction score were lower in the group C than in the group S at T6(3.14±1.04 vs.4.92±1.42, 2.67±0.89 vs.3.30±1.01)and at T8(3.84±1.83 vs.5.05±1.77, 2.74±0.84 vs.3.26±1.06)( P<0.05). Conclusions:The Soochow University model of comfortable medical procedures during peri-anesthesia period for patients undergoing radical resection of lung cancer through thoracoscope has been successfully constructed, and this model can reduce the incidence of complications, and improve the comfort and satisfaction during peri-anesthesia period.
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Objective To observe the effect of small doses of dexmedetomidine on postoperative analgesia and comfort after colorectal cancer radical operation in elderly patients .Methods 60 cases of elderly patients for elective colorectal cancer resection ,ASAⅠ~Ⅱgrade anesthesia were selected .According to randomly digital table , they were divided into the dexmedetomidine given group ( group D) and control group ( group C),30 cases in each group.The patients of group D was given to 0.5μg/kg dexmedetomidine for induction of anesthesia infusion , 15minutes bolus injection was completed ,intraoperative maintain 0.2μg· kg-1 · h-1 dexmedetomidine fixed to the front end of surgery 10 min.And group C was given to infusion of 0.9%sodium chloride injection in the same capacity . The operation time, amount of fentanyl using , comfort and VAS scores were recorded within 24h, maintain VAS score≤3 points.When VAS score>3 points,the pressing PCA was given ,and the number of times of pressing the PCIA was recorded.The adverse reactions occurred within 24h such as nausea and vomiting were also recorded . Results In the two groups,the results of postoperative analgesia were good ,but the VAS score of group D at each time of PCA point were less than those of group C (tend of surgery =5.99,tafter operation 2h =4.76,tafter operation 4h =4.08,all P<0.01).The Bruggrmann comfort score of group D were greater than those of group C (tend of surgery =9.86,tafter operation 2h =4.91,tafter operation 4h =6.84,all P<0.01).The incidence of adverse reactions of group D was 13.30%,which was less than 26.67%of group C(χ2 =4.32,P<0.05).Conclusion Small doses of dexmedetomidine given to improve the analgesic effect in elderly patients with colorectal cancer cure can improve comfort and reduce the incidence of adverse reactions ,and has a role in reducing postoperative nausea and vomiting .
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Effects of carbon sources (Na2CO3, NaHCO3 and glucose) and concentration of NaHCO3 on the growth density and lipid contents of Nannochloropsis oculata were studied. N. oculata preferred inorganic carbon to glucose, the growth density and lipid content of algae cultured with NaHCO3 were higher than that with glucose. The effects of concentration of NaHCO3 on growth density and lipid content were related to inoculation density and nitrogen level. In high nitrogen level, the concentration of NaHCO3 had little effect on the growth density, but in low nitrogen level, the growth density increased at first, and then decreased with the increase of concentration of NaHCO3. Based on the results we suggest that an optimum ratio of carbon to nitrogen was existed. Furthermore, we found the optimum ratio was changed with inoculation density. The optimum ratio of carbon to nitrogen was 3 when inoculation density was OD440 of 0.10, the optimum ratio increased to 5 with OD440 of 0.70. Concentration of NaHCO3 and ratio of carbon to nitrogen had significant effects on the lipid content and productivity. Lipid content reached the highest value when the ratio of carbon to nitrogen was 1 with experimental range of nitrogen level and inoculation density. The lipid productivity was 56.7 mg/(L.d) , and the EPA productivity was 6.5 mg/(L.d) at optimum cultivation condition with NaHCO3 as carbon source, the ratio of carbon to nitrogen at 1, the concentration of NaNO3 at 0.225 g/L, and the inoculation density with OD440 of 0.70.
Subject(s)
Carbon , Chemistry , Metabolism , Culture Media , Culture Techniques , Methods , Fatty Acids , Metabolism , Fermentation , Glucose , Metabolism , Lipid Metabolism , Microalgae , Metabolism , Population Density , Stramenopiles , MetabolismABSTRACT
Nitrogen source is one of the important factors that affect the microalgae growth and lipid accumulation. We studied the effects of various nitrogen sources (i.e. NaNO3, CO(NH2)2, NH4Cl and CH3COONH4) and amount on the growth density, lipid yield, and eicosapentaenoic acid (EPA) content of Nannochloropsis oculata by single factor experimental method. The results show that N. oculata preferred NH4+ as nitrogen source rather than NO3- and CO(NH2)2. NH4+ could promote the growth and lipid accumulation of N. oculata. With the increase of nitrogen concentration, the biomass and the content of polyunsaturated fatty acid (PUFA) increased, but the content of lipid decreased. CH3COONH4 was the most suitable for growth, accumulation of lipid and EPA of N. oculata among the four investigated nitrogen sources. The optimal concentration was 5.29 mmol/L.
Subject(s)
Eicosapentaenoic Acid , Metabolism , Lipids , Microalgae , Metabolism , Nitrogen , Metabolism , Stramenopiles , MetabolismABSTRACT
Objective To investigate the effect of sevoflurane on adriamycin-induced damage to primary neonatal rat cardiomyocytes.Methods Primary neonatal rat cardiomyocytes were isolated from Sprague-Dawley rats (within 24 h after birth) and cultured in DMEM liquid culture medium.The cells were seeded in 96-well plates (200μl/hole) or 6-well plates (2 ml/hole) with a density of 5 × 104/ml and randomly divided into 4 groups (n =24 each):control group (group C),adriamycin group (group A),sevoflurane group (group S) and adriamycin + sevoflurane group (group AS).In groups A and AS,adriamycin 1 μmol/L was added to the cultured medium,the equal volume of PBS was added instead in groups C and S,and the cells were then incubated for 24 h.The cells were exposed to 2.4％ sevoflurane for 2 h starting from 24 h of incubation in groups A and AS.The cell viability,concentrations of cTnI and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the culture medium,and expression of Bax and Bcl-2 were detected 2 h after the end of exposure to sevoflurane.The Bax/Bcl-2 ratio was calculated.Results Compared with group C,the cell viability and expression of Bcl-2 were significantly decreased,while the concentrations of cTnI and NT-proBNP in the culture medium,expression of Bax and Bax/Bcl-2 ratio were significantly increased in group A,and the cell viability was decreased in group AS (P ＜ 0.05).The expression of Bcl-2 was significantly higher and the concentrations of cTnI and NT-proBNP in the culture medium,expression of Bax and Bax/Bcl-2 ratio were significantly lower in group AS than in group A (P ＜ 0.05).Conclusion Sevoflurane can reduce adriamycin-induced damage to primary neonatal rat cardiomyocytes and inhibition of cell apoptosis is involved in the mechanism.
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Objective To investigate the effects of ulinastatin on the expression of NF-κB in lung tissues during limb ischemia-reperfusion(I/R) in rats.Methods Forty-eight male SD rats weighing 230-260 g were randomly divided into 3 groups (n=16 each):sham operation group (group S);I/R group; ulinastatin group (group U).A rat model of lung injury induced by I/R of hind limbs which was produced by occlusion of the bilateral femoral arteries for 2 h followed by reperfusion was established.The rats were sacrificed at 2 and 4 h of reperfusion(8 rats at each time point) and the lung tissues removed for determination of NF-κB expression (by immuno-histochemistry) and microscopic examination.W/D lung weight ratio was calculated.Results W/D lung weight ratio was significantly increased and NF-κB expression was up-regulated in group I/R compared with group S(P＜ 0.05). W/D lung weight ratio was significantly decreased and NF-κB expression was down-regulated in group U compared with group I/R (P＜0.05). The lung injury induced by I/R was reduced in group U compared with group I/R. Conclusion Ulinastatin can reduce the lung injury induced by limb I/R by down-regulating the expression of NF-κB in rat lung tissues.