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Objective:To explore the clinical characteristics and prognostic factors of patients with special types of esophageal ulcer.Methods:The data of 53 cases of esophageal ulcer in Xiangya Hospital of Central South University from October 2014 to October 2019 were analyzed retrospectively, and the prognosis was followed up by telephone.Results:The average age of onset was (51.2±13.4)years old. 84.91% of the patients (45/53) had unknown causes. 66.67% (34/51) had symptoms of discomfort or pain in the esophageal region. 67.92% (36/53) of the ulcers involved the lower esophageal segment and 52.83% (28/53) involved the middle thoracic segment of the esophagus. The common pathological changes were chronic inflammation and squamous cell hyperplasia. Nearly 1/3 of the patients had no improvement, deterioration or recurrence after treatment. All 7 patients with T cell spot test of tuberculosis infection (TSPOT) positive and other tuberculosis infection were treated effectively.Conclusions:Special types of esophageal ulcer are common in middle-aged men, most of the patients have unknown etiology. The most common clinical symptom is the discomfort or pain in the area of esophagus. The common involved part is the lower part of esophagus. The curative effect is not good or easy to recur. Antituberculosis therapy may be effective in patients with TSPOT positive and other TB infection bases.
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Objective To compare the effects of different doses of propofol on cardiac pump function in morbidly obese patients. Methods Forty morbidly obese patients undergoing laparoscopic Roux-en-Y gastric by-pass were randomly divided into lean body weight(LBW)group and total body weight(TBW)group,with 20 cases in each group.In LBW group,patients were induced by propofol with a dose according to LBW(kg)×2.0 mg/kg but in TBW group,patients were induced by propofol depending on TBW of the patients.We monitored the changes of left ventricular ejection fraction(LVEF)and stroke volume(SV)in patients before anesthetic induction(T1)and at 1 min(T2)after propofol administration.At the same time,we monitored invasive arterial pressure,noninvasive arterial pressure,BIS,and SpO2.Results Compared with those measured at T1,LVEF and SV were decreased af-ter the induction of anesthesia in the 2 groups(P < 0.05);compared with LBW,TBW had greater influence on LVEF and SV after the induction of anesthesia(P<0.05);compared with those at T1,non invasive arterial blood pressure,invasive arterial blood pressure and mean arterial pressure decreased after theinduction of anesthesia (P<0.05);compared with LBW,TBW had no significant effect on noninvasive arterial blood pressure,invasive arterial blood pressure and mean arterial pressure after the induction of anesthesia(P < 0.05);BIS was less than 50 after the induction of anesthesia in 2 groups. Conclusion Propofol induction with a LBW-dependent dose has less influence on cardiac pump function in morbidly obese patients while ensuring the depth of anesthesia.
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AIM:To explore the safety of anesthesia for neonates by studying the effects of general anesthesia (GA) and spinal-epidural anesthesia (SA) on the levels of lactic acid, S100B, superoxide dismutase (SOD) and malond-ialdehyde ( MDA) in the umbilical cord blood and placental stereological changes .METHODS:The singleton , term preg-nancy of 50 patients for elective cesarean section were assigned to 2 groups:GA group and SA group , with 25 patients in each group.Blood pressure (BP) and heart rate (HR) of the parturient women were monitored and recorded at 6 time points.The Apgar score was calculated at 1 min and 5 min after birth.The gas analysis of the umbilical artery blood , S100B protein concentration, blood lactic acid, SOD and MDA were also measured .Stereological evaluation of the vascular adaptations in the human placental villous capillary was performed .RESULTS:BP, HR, Apgar scores, gas analysis, the pH value of the umbilical artery blood , the serum concentrations of S 100B protein and the length density of villous capillar-ies had no significant change between the 2 groups (P>0.05).The levels of blood lactic acid and SOD in GA group were significantly lower than those in SA group (P<0.01).MDA content and volume density of villous capillaries in GA group were significantly higher than those in SA group ( P<0.01 ) .CONCLUSION: General anesthesia for cesarean section was safety for neonates .However, as indicated by the oxidation index , general anesthesia may have some harmful effect on the neonates by oxygen free radicals .
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<p><b>OBJECTIVE</b>To observe the anesthetic efficacy and safety of bilateral ultrasound-guided supraclavicular brachial plexus block in patients undergoing arthrolysis for shoulder periarthritis.</p><p><b>METHODS</b>Twenty-seven patients (ASA class I-II) undergoing bilateral shoulder joint release surgery and 24 ml received bilateral ultrasound-guided supraclavicular brachial plexus block anesthesia with 0.4% ropivacaine and 0.8% lidocaine. The visual analogue scale (VAS) scores for shoulder joint pain were recorded before and after anesthesia. The efficacy of axillary nerve, dorsal scapular nerve and suprascapular nerve block was evaluated, and the anesthetic effect and complications was assessed during surgery. Before and after anesthesia, the range of left and right diaphragmatic muscle movement was measured when the patient took a quiet breath and a deep breath.</p><p><b>RESULTS</b>The patients showed no significant variations in MAP, HR, or SpO₂after anesthesia. The VAS scores of shoulder joint pain during anteflexion, abduction, posterior extension, rotation, posterior extension and medial rotation were significantly lowered after anesthesia (P<0.05), but the left and the right diaphragm movement range showed no significant difference between quiet breath and deep breath (P>0.05). The rates of complete block of the axillary nerve and dorsal scapular nerve was 100%, and that of suprascapular nerve was 92.6%. Partial phrenic nerve block occurred in 1 case with mild local anesthetic toxicity in another.</p><p><b>CONCLUSIONS</b>Bilateral ultrasound-guided supraclavicular brachial plexus block in patients has excellent analgesic effect in should joint release surgery with good safely.</p>
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Humans , Amides , Anesthetics, Local , Brachial Plexus Block , Diaphragm , Lidocaine , Orthopedic Procedures , Pain Measurement , Periarthritis , Diagnostic Imaging , General Surgery , Shoulder Joint , Diagnostic Imaging , UltrasonographyABSTRACT
<p><b>OBJECTIVE</b>To investigate the correlation between arterial partial pressure of CO2 (PaCO2) and end expiratory tidal partial pressure of CO2 (Pet-CO2) in morbidly obese patients during anesthesia for laparoscopic gastric bypass surgery.</p><p><b>METHODS</b>Forty morbidly obese patients with a body mass index (BMI) between 35 and 50 kg/m(2) underwent laparoscopic gastric bypass surgery under general anesthesia. PaCO2 and Pet-CO2 were measured after intubation and before induction of pneumoperitoneum (T0), at 30 min (T1), 60 min (T2), and 120 min (T3) during pneumoperitoneum, and at 30 min (T4) and 60 min (T5) after deflation.</p><p><b>RESULTS</b>At each time point of measurement, Pet-CO2 was lower than PaCO2 in all the patients. PaCO2 and Pet-CO2 were positively correlated before, during, and after pneumoperitoneum (P<0.05). At a moderate pressure of CO2 pneumoperitoneum (16 mmHg), the level of correlation between PaCO2 and Pet-CO2 at T1, T2, and T3 differed from that before and after post-pneumoperitoneum.</p><p><b>CONCLUSIONS</b>PaCO2 and Pet-CO2 are closely correlated during a moderate CO2 pneumoperitoneum in morbidly obese patients undergoing laparoscopic gastric bypass surgery.</p>
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Adult , Female , Humans , Male , Middle Aged , Anesthesia , Arterial Pressure , Blood Gas Analysis , Carbon Dioxide , Blood , Gastric Bypass , Laparoscopy , Obesity, Morbid , Blood , General Surgery , Pneumoperitoneum, ArtificialABSTRACT
Objective To understand and explore the personality characteristic of patients with migraine .To prevent and solve the health problems and provide scientific basis .Methods 100 patients with migraineurs were examined by self -edited question-naier and the Chinese version of the Minnesota Multiphasic Personality Inventory .86 effective questionnaiers which made up by 30 males and 56 females(aged from 18 to 65 ,46 years in average) were collected and analyzed .The subjects were grouped according to the gender ,and compared with the Chinese normal .Results In the male patients ,the measured scales of L ,HS ,D ,Hy ,Pd ,Pt and Ma appeared significantly higher than those in the normal males (P<0 .05) ,while in the female ,the measured scales of F ,Hs ,D , Hy ,Pa ,Pt and Ma appeared significantly higher than those in the normal females (P<0 .05) .Conclusion Patients with migraine have some changes in personality .Male patients and female patients were different .Eealy screening and intervention in the treatment of personality will help to improve the treatment of migraine effect .
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<p><b>OBJECTIVE</b>To determine the optimal dose of colloid preload, which is both safe and effective, for preventing hypotension in parturients undergoing cesarean section under spinal anesthesia.</p><p><b>METHODS</b>Forty-five healthy, termed parturients scheduled for cesarean delivery under spinal anesthesia were randomly assigned to 3 colloid preload groups to receive gelofusine infusion at the rates of 5, 10, or 15 ml·kg(-1)·h(-1) (groups I, II, and III, respectively). Colloid preload was administered 10 min before spinal anesthesia and maintained until the delivery. Blood pressure (BP) and heart rate (HR) of the parturients were monitored during the operation, and Apgar scores at 1 and 5 min after birth were recorded. S100β protein concentration and blood gas values of the umbilical artery were also measured. The vascular adaptation in the placental villous capillary was evaluated stereologically.</p><p><b>RESULTS</b>At each time point of measurement, BP and HR showed no significant differences among the 3 groups during the operation (P>0.05), but within the same group, BP and HR underwent significant variations during the operation; groups II and III maintained more stable hemodynamics compared to group I. Apgar scores and blood gas analysis, pH value, and S100β protein in the umbilical artery showed no significant differences among the 3 groups (P>0.05). The 3 groups exhibited no significant differences in the length and volume density of the placental villous capillaries (P>0.05).</p><p><b>CONCLUSION</b>Colloid preload with gelofusine administered at the rate of 10 ml·kg(-1)·h(-1) can reduce the incidence and severity of hypotension in cesarean section under spinal anesthesia with the least adverse maternal and fetal effects.</p>
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Adult , Female , Humans , Pregnancy , Anesthesia, Obstetrical , Anesthesia, Spinal , Cesarean Section , Methods , Colloids , Fetal Blood , Metabolism , Hypotension , Nerve Growth Factors , Blood , Placenta , Polygeline , S100 Proteins , BloodABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of dexmedetomidine on oxygenation function in adult patients with balanced anesthesia by propofol-fentanyl under one-lung ventilation (OLV).</p><p><b>METHODS</b>Twenty-two patients undergoing thoracic operation were randomly divided into the study group and control group, both receiving propofol and fentanyl balanced anesthesia. In the study group, additional infusion of dexmedetomidine (0.3 µg/kg loading dose, 0.3 µg·kg(-1)·h(-1) maintenance dose) was administered, and the patients in the control group received only normal saline. Arterial blood samples were obtained at 4 time points from each patient during anesthesia for blood gas analysis.</p><p><b>RESULTS</b>In the study group, the pH values remained stable, the oxygenation index tended to decline progressively, but the incidence of hypoxemia was low; in the control group, the pH value and oxygenation index both declined progressively with a higher incidence of hypoxemia.</p><p><b>CONCLUSION</b>Dexmedetomidine can better maintain the oxygenation function of OLV patients in balanced anesthesia by propofol and fentanyl, and its mechanism may be related to the decreased dose of propofol used.</p>
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Adult , Female , Humans , Male , Middle Aged , Balanced Anesthesia , Blood Gas Analysis , Dexmedetomidine , Pharmacology , Fentanyl , One-Lung Ventilation , PropofolABSTRACT
Objective To evaluate the protective effect of perfluorocarbon emulsions (FCE) on donor lung of rats during storage.Methods Twenty-four healthy male Sprague-Dawley rats,weighing 350-400 g,were equally and randomly divided into 2 groups using a random number table:University of Wisconsin (UW) solution group (UW group) and FCE group (FCE group).After the model of lung perfusion was established according to the method described by Fischer et al,the lung and heart were removed and perfused with 4 ℃ UW or FCE preservation solutions.The lung was taken out when stored for 6 h for determination of SOD activity (by WST assay),malondialdehyde (MDA) content (by TBA assay),and activity of myeloperoxidase (MPO) and content of interleukin1 β (IL-1β),IL-6,tumor necrosis factor-apha (TNF-α) (using ELISA) in lung tissues and for microscopic examination of pathologic changes.Results MPO activity was significantly lower in UW group than in FCE group (P <0.05).There were no significant differences in the SOD activity and content of MDA,IL-1β,IL-6,TNF-α between the two groups (P > 0.05).Conclusion FCE can reduce the neutrophil infiltration in lung tissues,indicating that FCE is more superior to UW solution in reduction of injury to the donor lung of rats.
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The perfluorocarbon (PFC) nanoparticle is a sort of new drug carrier in recent years, and it has lots of unique properties such as chemical stability, favourable biocompatibility, high aerobic capacity, targeting action to tissues or cells and so on. In this paper, we summarize the physico-chemical properties of the PFC nanoparticles. We also show the research progress of the PFC nanoparticles as a kind of drug carrier for targeted therapy of cardiovascular system, nervous system diseases and tumor. Further more, its characteristics of being selectively in target cells, tissues, and rapid release of drugs are expounded. PFC nanoparticles, as drug carriers for targeted diagnosis and treatment, have good prospect and clinical application value.
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Animals , Humans , Biocompatible Materials , Pharmacology , Chemical Phenomena , Drug Carriers , Pharmacology , Drug Delivery Systems , Fluorocarbons , Pharmacology , NanoparticlesABSTRACT
AIM:To investigate the effects of perfluorocarbon and ligustrazine on lung injury during liver transplantation in pigs with hepatopulmonary syndrome. METHODS:A hepatopulmonary syndrome (HPS) model of pig was established by chronic bile duct ligation. The animals were assigned randomly to 2 groups:(1) Perfluorocarbon in combination with ligustrazine treatment groups (PFCL group):the pigs were treated with intratracheal instillation of perfluorocarbon and ligustrazine; (2) The conventional mechanical ventilation group (MV group):all animals were subjected to mechanical ventilation and orthotopic liver transplantation. After 5 h the lungs were harvested for further analysis. RESULTS:The lung wet to dry weight radio,pulmonary permeation index and leukocyte count in bronchoalveolar lavage fluids (BALF) in PFCL group significantly decreased compared to MV group (P<0.05). Contents of tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) in the lung tissue,plasma and BALF of pigs in PFCL group were significantly lower than those in MV group (P<0.05). Moreover,the activation of NF-κB was inhibited markedly by PFCL. CONCLUSION:Perfluorocarbon in combination with ligustrazine effectively reduces the PMN accumulation in the lungs,inhibits TNF-α and IFN-γ production and protects against lung injury during liver transplantation in pigs with hepatopulmonary syndrome.
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AIM To elucidate the structure of the glycan of SPPA-1, a glycoconjugate isolated from Spirulina platensis. METHODS Methylation analysis, GC/MS, and 1D, 2DNMR techniques were used to determine the structures of the glycoconjugate (SPPA-1). RESULTS SPPA-1 was only composed of α-D-glucose and shown to be a (1→4) linked α-D-glucan to which a few glucosyl side chains are attached at O-6 of the glucosyl residues of the main chain. CONCLUSION The glycan of SPPA-1 is a new glucan.
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Objective To report a case of disseminated cryptococcosis with cutaneous manifestations and osteomyelitis. Methods and Results A 33 year old female was admitted due to multiple nodules and ulcers on the upper arms, shoulders, buttocks and thighs for one year. The patient was pregnant when admitted, and gave birth to a premature baby during her illness. The nodules increased half a month after delivery, which was suspected to be hematogenously disseminated pulmonary tuberculosis and was given anti tuberculous therapy for three months but failed. Physical examination showed there were 39 nodules or ulcers on the face, gum, trunk, buttocks and extre mities. The bone structure of the left tibia and fibula destroyed and a sinus developed on the left fibula. Microbiologic examination showed that lots of spores were seen in the smear of pus and necrotic tissues, which produced yeast like colonies in culture with positive urease and caffeic acid test. Cryptococcus neoformans, serotype A was identified by API yeast reaction band and serology. Inoculation with mice and rats showed that their brains, lungs and livers were involved easily. Further identification as C.neoformans var.neoformans was obtained based on sequence analysis of ribosomal internal transcribed spacer region 2. The anti tuberculous therapy was stopped and anti fungal therapy was initiated at once. Intravenous and topical amphotericin B in combination with fluconazole were chosen in the initial therapy and itraconazole for maintenance. The nodules disappeared after 30 days and the last ulcer in the left tibia healed completely after 200 days. The anti fungal therapy was discontinued after 277 days and the patient was completely cured.
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AIM: To observe the effect of partial liquid ventilation with perfluorocarbon on gas exchange, hemodynamics and lung histological change in the piglets with surfactant depletion-induced acute lung injury. METHODS: 12 piglets were treated by lung lavage to a partial pressure of oxygen in arterial blood (PaO 2) below 100 mmHg for one hour and randomly divided into gas ventilation group (control group) and partial liquid ventilation (PLV) group, in PLV group, piglets received PFC (FC3280) intratracheally at doses of 15 mL/kg. The parameters of gas exchange and hemodynamics were measured before lung lavage, after lung lavage when the acute lung injury (ALI) was established, and 1 hour, 2 hours after ALI. Animals underwent euthanasia at the end of the study, lung histologic analysis followed. RESULTS: Surfactant depletion by lung lavage induced a stable acute lung injury.Gas exchange increased markedly in the animals that underwent PLV, less hemodynamic damage was observed in PLV group compared with the animals in GV group. Lung histologic analysis demonstrated a less lung damage, including atelectasis, neutrophil excudation, intra-alveolar hemorrhage and interstitial edema in PLV group compared with control group. CONCLUSION: In piglets with surfactant depletion-induced acute lung injury, partial liquid ventilation with perfluorocarbon can improve the gas exchange with less adverse hemodynamic effect and less lung injury compared with conventional gas ventilation.
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AIM: To investigate the anti-inflammatory effect of partial liquid ventilation in the piglets with lung lavage-induced acute lung injury. METHODS: 16 piglets were treated by lung lavage to a partial pressure of oxygen in arterial blood (PaO_2) below 100 mmHg for one hour and randomly divided into mechanical ventilation group (MV group) and partial liquid ventilation group (PLV group). Blood-gas analysis, hemodynamics, the contents of TNF-?, MDA, SOD, and MPO activity in lung tissue were measured. RESULTS: (1) Lung W/D, PPI and the count of WBC in the BALF in PLV group were significantly lower than those in MV group. The contents of MDA and MPO in lung tissue in PLV group were significantly lower than those in MV group. However, no evident difference in SOD activity in lung tissue between two groups was observed. (2) The contents of TNF-? in lung tissue in PLV group were significantly lower than those in MV group. CONCLUSION: Partial liquid ventilation with perfluorocarbon has anti-inflammatory effect on lung lavage-induced acute lung injury in the piglets.
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AIM: To evaluate the influence of anesthesia and different means of postoperative pain control on the T-lymphocyte during the perioperative period in patients with rectal cancer.METHODS: 40 adult patients, aged 65 or older, of American Society of Anesthesiologists (ASA) class 2-3 were divided into two groups according to the type and means of postoperative pain managements. Group Ⅰ (n=20) received intravenous anesthesia and patient controlled analgesia(PCA), fentanyl (13 ?g/kg) for post pain; group Ⅱ (n=20) received intravenous anesthesia plus lumber epidural anesthesia and epidural PCA of morphine 5 mg plus ropivacaine 100 mg for post operative pain. Blood samples from internal jugular vein were obtained before surgery, at the completion of surgery and 24, 48, and 120 h post surgery for detecting CD3+, CD4+, CD4/CD8 counts of peripheral T-lymphocytes. In addition, blood cortisol level and pain intensity were assessed by visual analogue score (VAS)at each time point. RESULTS: Baseline(before anesthesia) values of CD3+,CD4+, CD4/CD8 in patients were messured and there was a significant decrease of all these values from completion of surgery to 48 h after surgery in both groups (P
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Fourty wistar rats were used for experimental study of myocardial infarction (MI )induced by ligation of the left coronary artery. The results showed that the AF and HBFP stalng as well as Ao fluorescence were sensitive in demonstrating the early MI changes occuced 1 ~ 2 hour after coronary arteryligation. The TTC stamg method was reliable for demonstrating the MI margin. Both HBFP and AOfluorescence were under no influeence of the post-mortem autolysis, but the AF reaction were undeithe influence of the early post-mortem autolysis. Four hours were required for complete developemenof MI. The early stage of MI demonstrated by SEM was conslstant with that bv TEM. Both resuhwere influenced by the post-mortem autolysis.
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AIM: To observe the effect of partial liquid ventilation on gas exchange and histopathological changes of lung in acute lung injury. METHODS: After acute lung injury (ALI) was induced by saline lavage,twenty piglets were assigned randomly to 2 groups: partial liquid ventilation with perfluorocarbon (PFC) group (PLV) and conventional gas ventilation group (CV). The changes of gas exchange were examined before ALI, during ALI and at 1,2,3,4 h after ALI, and histological sections taken from 8 different parts of lung were stained by H & E. RESULTS: The PaO_2 significantly increased and alveolar-aterial oxygen gradient (AaDO_2) markedly decreased in PLV group compare with CV group (P