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Objective:To make a new simple respirator and observe the oxygen therapy effect of the respirator on patients with severe and critical coronavirus disease 2019 (COVID-19).Methods:Based on the infectivity and hospital requirements of COVID-19, a new simple respirator was designed by the medical staff of the Department of Anesthesiology of the Second Affiliated Hospital of Nanchang University, which was applied on the 22 patients with severe and critical COVID-19 who needed oxygen therapy admitted to the Cancer Center of Tongji Medical College of Huazhong University of Science and Technology from February 15th to March 15th in 2020. The new simple respirator contained two National Utility Model Patents (a respirator: ZL 2015 2 0410623.6, a fluid switch and oxygen suction device: ZL 2017 2 0873509.6), which was mainly composed of anesthesia mask and filter, L-shaped connecting tube, soft breathing bladder, connecting tube and elastic fixing belt. When in use, the anesthesia mask was fixed to the patient's mouth and nose with elastic straps, the connecting tube was inserted into the oxygen meter interface, the oxygen flow was adjusted to 6-10 L/min, and the L-shaped connecting tube was opened immediately after the soft breathing bag was full. The carbon dioxide and excess oxygen in the body was discharged from exhaust port. The oxygen flow was lowered to 2-3 L/min, the patient's respiratory rate (RR) was observed through the soft breathing bag fluctuations, and the oxygen flow was adjusted at any time. The changes of pulse oxygen saturation (SpO 2), RR and heart rate (HR) before and after application of new simple respirator were observed, and the blood gas test results of part of the patients were collected. Results:Twenty-two patients with severe and critical COVID-19 had significantly higher SpO 2 at 10 minutes after application of the new simple ventilator than before application (0.994±0.007 vs. 0.952±0.017, P < 0.01), and RR was significantly lower than that before application (times/min: 27.59±3.63 vs. 29.64±3.81, P < 0.01); after 1 day of application, each index was further improved. All 13 patients who received blood gas analysis indicated no carbon dioxide accumulation. Conclusions:The new simple respirator can significantly improve the oxygen therapy effect of patients with severe and critical COVID-19. At the same time, 2019 novel coronavirus (2019-nCoV) can be filtered through the filter to reduce the formation of aerosol and protect the medical staff and patients.
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Objective To evaluate the effect of preoperative sleep deprivation on hippocampal Tolllike receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB) signaling pathway in aged mice with postoperative cognitive dysfunction.Methods Sixty clean-grade healthy male C57BL/6J mice,aged 16 months,weighing 28-36 g,were divided into 4 groups (n=15 each) using a random number table method:control group (group C),surgery group (group S),sleep deprivation group (group SD) and sleep deprivation plus surgery group (group SD+S).Mice were fed a common diet in group C.Mice were sleep-deprived for 24 h in group SD.Tibial fracture internal fixation was performed in group S.Tibial fracture internal fixation was performed after 24-h sleep deprivation in group SD+S.Cognitive function was assessed using the contextual fear conditioning test at days 3 and 7 after operation.The animals were sacrificed at day 7 after operation,brains were removed and hippocampi were isolated for determination of tumor necrosis factor-alpha (TNF-α) content (by enzyme-linked immunosorbent assay) and expression of TLR4 and p-NF-κB p65 (by Western blot).Results Compared with group C,the percentage of time spent freezing induced by condition and percentage of time spent freezing induced by context were significantly decreased at days 3 and 7 after operation,the content of TNF-α was increased,and the expression of TLR4 and p-NF-κB p65 was up-regulated in S,SD and SD+S groups (P＜0.05).Compared with group S and group SD,the percentage of time spent freezing induced by condition and percentage of time spent freezing induced by context were significantly decreased at days 3 and 7 after operation,the content of TNF-α was increased,and the expression of TLR4 and p-NF-κB p65 was up-regulated in group SD+S (P＜0.05).Conclusion Preoperative sleep deprivation further accentuates postoperative cognitive dysfunction,and the mechanism is related to activating TLR4/NF-κB signaling pathway and inducing inflammatory responses of aged mice.
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Objective To investigate the effects of ulinastatin with parecoxib sodium on early cellular immunology function and cognitive function in elderly patients undergoing total hip replacement.Methods One hundred patients (aged 65-80 years,ASA grade Ⅱ) undergoing elective total hip replacement were randomly assigned into 4 groups: group W(n=25),group P(n=25),group WP(n=25) and group C(n=25).The patients in group W received intravenous injection of ulinastatin with a dose of 5 000 U/kg before skin incision and at the moment of the end of operation.Patients in group P accepted intravenous injection of parecoxib sodium of 40 mg before anesthesia and at a 12 h intervals for six times.Patients in group WP accepted intravenous injection of ulinastatin with a dose of 5 000 U/kg before skin incision and at the moment of the end of operation,and accepted intravenous injection of parecoxib sodium with a dose of 40 mg before anesthesia and at a 12 h interval for six times.Patients in group C were given normal saline at the same time as placebo.The operation time,the volume of bleeding and autologous blood receiving and the intraoperative fentanyl consumption were recorded in four groups.Blood samples were obtained before induction (T0),at the end of operation (T1),on 6 h (T2),24 h (T3),72 h (T4) after operation for determination of plasma concentration of S100β protein,neuron-specific enolase(NSE),IL-6,TNF-α.The percentages of T lymphocyte subsets (CD3+,CD4+,CD8+) and CD4+/CD8+ ratio were detected with flow cytometry.The Mini-Mental State Examination (MMSE) was used to test the cognitive function of the patients at T0,T4 and 7 d after operation (T5).Results Compared with T0,the percentages of CD3+,CD4+ cells and CD4+/CD8+ in groups C,W and P were significantly decreased,the plasma concentrations of IL-6 and TNF-α significantly increased at T1-T4,concentration of NSE and S100 protein were significantly increased at T2 and T3 (P<0.05).the percentages of CD3+,CD4+T lymphocyte and CD4+/CD8+ ratio in groups W and P at T2,T3 and group WP at T1-T4 was significantly higher than that of group C,the concentration of IL-6,TNF-α,NSE and S100β protein content was significantly lower than in group C (P<0.05);the percentages of CD3+,CD4+T lymphocyte and CD4+/CD8+ ratio in group WP was significantly higher than those of groups W and P,the concentrations of TNF-α,IL-6,NSE and S100β protein content was significantly lower than those of group W and P at T2,T3 (P<0.05).Compared with T0,MMSE score in group C was significantly lower at T4,T5 (P<0.05).MMSE score of groups W,P and WP was significantly higher than that of group C at T4 (P<0.05).MMSE score of group WP was significantly higher than those of groups W and P at T4 (P<0.05).Conclusion Ulinastatin combined with parecoxib sodium ameliorates early cellular immunology function and cognitive function in elderly patients undergoing total hip replacement,and it is more effective than using ulinastatin or parecoxib sodium alone.
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Objective To compare the effectiveness of postoperative analgesia and early rehabil-itation between the wound infiltration combined with intravenous analgesia and epidural analgesia after hepatectomy.Methods Forty-eight patients with liver carcinoma,37 males and 1 1 females,aged 40-65 years,ASA physical status Ⅰ or Ⅱ,were randomly divided into two groups.Patients in group T were given 0.375% ropivacaine 30 ml for incision infiltration before closing the abdomen and intrave-nous analgesia.Patients in group E were given 0.2% ropivacaine 100 ml for epidural analgesia. Pareoxib sodium 40 mg was injected intravenously 30 min toward the end of the operation.Pain scores were assessed by VAS at postoperative 2,6,12,24 and 48 h.Postoperative activity distance was re-corded on 1st,2nd,3th day after surgery;the time first getting off bed and hospital stay were recor-ded.Finally,the complications were also recorded.Results Compared with group T,VAS scores at rest and in activity 12,24 and 48 h postoperatively were significantly lower (P <0.05 ).Compared with group E,postoperative activity distance on 1st,2nd and 3th day after surgery in group T were shorter.Furthermore,the time first getting off bed and the hospital stay in group T were shorter than those in group E (P <0.05).The incidence of adverse reactions between the two groups had no sta-tistical significance.Conclusion The wound infiltration combined with intravenous analgesia is benefi-cial to early recovery and shorter hospital stay.
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Objective To investigate the effects of different duration hypotension thresholds on p-Tau-181 and Aβ-42 protein expression and cognition in rats. Methods Thirty-nine healthy male SD rats were randomly di-vided into 4 groups:the control group(group C,n=9),the hypotension group(groupA1、A2、A3 ,n=10). The blood pressure of groupA1、A2、A3 was measured in different time of 2 h、4 h、6 h ,for 5 days. The antihyperten-sive group of mean arterial pressure(MAP)were maintained in the 50~55 mmHg safe range. Morris water maze was used to detect the spatial learning and memory ability of rats. The levels of Aβ42 and p-Tau-181 were detected by ELISA. Results There was no significant difference in mortality of rats in each group (P > 0.05). Compared with the group C,the escape latency and swimming distance of A2 group and A3 group were increased(P<0.05). In 3~7 days after operation,the cerebrospinal fluid P-Tau-181 and Aβ42 protein expression increased in the A2 group and A3 group compared with the A1 group(P<0.05). The escape latency and swimming distance of the A2 group and the A3 group were significantly longer than those in the control group. Aβ42 and p-Tau-181 were signifi-cantly increased in A3 group(P < 0.05). Compared with the A2 group,the increase of Aβ42 and p-Tau-181 in the A3 group was not significant(P<0.05). Conclusion Long-term controlled hypotension may lead to postoper-ative cognitive dysfunction which may relate to the increase of Aβ42 and p-Tau-181 protein expression.
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Objective To evaluate the role of Wnt/β-catenin signaling pathway in lithium chloride preconditioning-induced improvement in postoperative cognitive function of aged rats.Methods A total of 100 pathogen-free healthy male Sprague-Dawley rats,aged 18 months,weighing 540-650 g,were divided into 5 groups (n =20 each) using a random number table:control group (group C),surgery group (group S),lithium chloride preconditioning group (group L),secreted frizzled-related protein 1 (sFRP-1) group (group F) and lithium chloride preconditioning plus sFRP-1 group (group L+F).Lithium chloride 2 mmol/kg was intraperitoneally injected once a day for 5 consecutive days before operation in L and L+ F groups.In F and L + F groups,sFRP-1 10 μl (concentration 10 μg/ml) was injected into the ventricle at 1 day before operation.Ten rats in each group were randomly sacrificed at 1 day after operation,and the hippocampi were removed for determination of the expression of phosphorylated glycogen synthase kinase-3 beta (p-GSK-3β),3-catenin and Wnt in hippocampal tissues (by Western blot).The rest rats underwent Morris water maze test at day 3-7 after operation,and the concentrations of amyloid beta 42 (A3-42) and phosphorylated tau-181 protein (p-tau-181) in cerebrospinal fluid (CSF) were detected by enzyme-linked immunosorbent assay at day 7 after operation.Results Compared with group C,the escape latency was significantly prolonged at 3-7 days after operation,and the concentration of Aβ-42 in CSF was increased in the other four groups,and the expression of Wnt,p-GSK-3β and β-catenin in hippocampal tissues was down-regulated in group S,the expression of Wnt,p-GSK-3β and β-catenin in hippocampal tissues was significantly up-regulated in L and L+F groups,and the concentration of p-tau-181 in CSF was significantly increased in S and L+F groups (P＜0.05).Compared with group S,the escape latency was significantly shortened at 3-7 days after operation in group L and at 5-7 days after operation in group L+F,and the expression of Wnt,p-GSK-3β and β-catenin was significantly up-regulated,and the concentrations of Aβ-42 and p-tau-181 in CSF were decreased in L and L+F groups (P＜0.05).Compared with group L,the escape latency was significantly prolonged at 3-6 days after operation,the expression of Wnt,p-GSK-3β and β-catenin was down-regulated,and the concentration of p-tau-181 in CSF was increased in group L+F (P＜ 0.05).Compared with group F,the escape latency was significantly shortened at 3-7 days after operation,the expression of Wnt,p-GSK-3β and β-catenin was up-regulated,and the concentrations of Aβ-42 and ptau-181 in CSF were decreased in group L+F (P＜0.05).Conclusion The mechanism by which lithium chloride preconditioning improves in postoperative cognitive function is partially related to activating Wnt/β-catenin signaling pathway in aged rats.
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<p><b>OBJECTIVE</b>To evaluate and select excellent germplasm resources of Artemisia annua L., providing basic data for data base and breeding of A. annua.</p><p><b>METHOD</b>Seventy-two germplasms of A. annua, which were collected from main production areas, were planted in germplasm resources garden in Jingxi and Nanning under the same conditions. The samples were gathered in the squaring stage. Artemisinin was extracted by supersonic wave and determined by ultraviolet spectrophotometry.</p><p><b>RESULT</b>The leaf's yield and the content of artemisinin in the samples of different germplasms were varied significantly. Effect of environment on artemisinin content was more than that of hereditary factors. The content of artemisinin was different when the same material of A. annua grew in different place. The content of artemisinin in next year's plant was decreasing.</p><p><b>CONCLUSIONS</b>Seven germplasms from south of China have been selected, their content of artemisinin was above 0.9% and calculated yield was more than 2250 kg x hm(-2). The content of artemisinin has been affected by hereditary factors and variation of the growth environment.</p>