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BACKGROUND@#Atopic dermatitis (AD) affects approximately 10% of adults worldwide. CM310 is a humanized monoclonal antibody targeting interleukin-4 receptor alpha that blocks interleukin-4 and interleukin-13 signaling. This trial aimed to evaluate the efficacy and safety of CM310 in Chinese adults with moderate-to-severe AD.@*METHODS@#This multicenter, randomized, double-blind, placebo-controlled, phase 2b trial was conducted in 21 medical institutions in China from February to November 2021. Totally 120 eligible patients were enrolled and randomized (1:1:1) to receive subcutaneous injections of 300 mg CM310, 150 mg CM310, or placebo every 2 weeks for 16 weeks, followed by an 8-week follow-up period. The primary endpoint was the proportion of patients achieving ≥75% improvement in the Eczema Area and Severity Index (EASI-75) score from baseline at week 16. Safety and pharmacodynamics were also studied.@*RESULTS@#At week 16, the proportion of EASI-75 responders from baseline was significantly higher in the CM310 groups (70% [28/40] for high-dose and 65% [26/40] for low-dose) than that in the placebo group (20%[8/40]). The differences in EASI-75 response rate were 50% (high vs . placebo, 95% CI 31%-69%) and 45% (low vs . placebo, 95% CI 26%-64%), with both P values <0.0001. CM310 at both doses also significantly improved the EASI score, Investigator's Global Assessment score, daily peak pruritus Numerical Rating Scale, AD-affected body surface area, and Dermatology Life Quality Index compared with placebo. CM310 treatment reduced levels of thymus and activation-regulated chemokine, total immunoglobulin E, lactate dehydrogenase, and blood eosinophils. The incidence of treatment-emergent adverse events (TEAEs) was similar among all three groups, with the most common TEAEs reported being upper respiratory tract infection, atopic dermatitis, hyperlipidemia, and hyperuricemia. No severe adverse events were deemed to be attributed to CM310.@*CONCLUSION@#CM310 at 150 mg and 300 mg every 2 weeks demonstrated significant efficacy and was well-tolerated in adults with moderate-to-severe AD.
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Adulto , Humanos , Dermatite Atópica/tratamento farmacológico , Resultado do Tratamento , Índice de Gravidade de Doença , Anticorpos Monoclonais Humanizados/uso terapêutico , Injeções Subcutâneas , Método Duplo-CegoRESUMO
Background@#Postoperative pain management is crucial for patients undergoing total knee arthroplasty (TKA). There have been many recent clinical trials on post-TKA peripheral nerve block; however, they have reported inconsistent findings. In this meta-analysis, we aimed to comprehensively analyze studies on post-TKA analgesia to provide evidence-based clinical suggestions. @*Methods@#We performed a computer-based query of PubMed, Embase, the Cochrane Library, and the Web of Science to retrieve related articles using neurothe following search terms: nerve block, nerve blockade, chemodenervation, chemical neurolysis, peridural block, epidural anesthesia, extradural anesthesia, total knee arthroplasty, total knee replacement, partial knee replacement, and others. After quality evaluation and data extraction, we analyzed the complications, visual analogue scale (VAS) score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. Evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach. @*Results@#We included 16 randomized controlled trials involving 981 patients (511 receiving peripheral nerve block and 470 receiving epidural block) in the final analysis. Compared with an epidural block, a peripheral nerve block significantly reduced complications. There were no significant between-group differences in the postoperative VAS score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. @*Conclusions@#Our findings demonstrate that the peripheral nerve block is superior to the epidural block in reducing complications without compromising the analgesic effect and patient satisfaction. Therefore, a peripheral nerve block is a safe and effective postoperative analgesic method with encouraging clinical prospects.
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Background@#Postoperative pain management is crucial for patients undergoing total knee arthroplasty (TKA). There have been many recent clinical trials on post-TKA peripheral nerve block; however, they have reported inconsistent findings. In this meta-analysis, we aimed to comprehensively analyze studies on post-TKA analgesia to provide evidence-based clinical suggestions. @*Methods@#We performed a computer-based query of PubMed, Embase, the Cochrane Library, and the Web of Science to retrieve related articles using neurothe following search terms: nerve block, nerve blockade, chemodenervation, chemical neurolysis, peridural block, epidural anesthesia, extradural anesthesia, total knee arthroplasty, total knee replacement, partial knee replacement, and others. After quality evaluation and data extraction, we analyzed the complications, visual analogue scale (VAS) score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. Evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach. @*Results@#We included 16 randomized controlled trials involving 981 patients (511 receiving peripheral nerve block and 470 receiving epidural block) in the final analysis. Compared with an epidural block, a peripheral nerve block significantly reduced complications. There were no significant between-group differences in the postoperative VAS score, patient satisfaction, perioperative opioid dosage, and rehabilitation indices. @*Conclusions@#Our findings demonstrate that the peripheral nerve block is superior to the epidural block in reducing complications without compromising the analgesic effect and patient satisfaction. Therefore, a peripheral nerve block is a safe and effective postoperative analgesic method with encouraging clinical prospects.
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Objective:To observe the clinical efficiency, duration of action and adverse reactions of lip contour after local injection of type A botulinum toxin into the orbicularis oculi muscle.Methods:From March 2019 to June 2019, a total of 11 patients (6 males and 5 females, mean age 42.2 years) received superficial injection of botulinum toxin A in the orbicular muscle in our hospital. The change of lip thickness was assessed by Medicis lip fullness scale (MLFS) and the 3D structured light camera was used to collect and analyze the facial data. Pre- and post-treatment effects, duration of action and complications were evaluated.Results:Improvement of upper lip thickness was noted in 11 cases (100%). The average onset time after injection was 14.6 days and average effect maintenance time was 124.1 days. The height of the red lips ( Z=-2.940, P<0.05), the distance from the upper lip to the Ricketts line ( Z=-2.137, P<0.05) and nasolabial angle ( Z=-2.137, P<0.05) were significantly changed one month after the injection. No allergic reaction was observed, and the adverse reactions were mild and reversible. Conclusion:Local injection of botulinum toxin type A can achieve mild lip augmentation.
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Objective To evaluate the efficacy of anterior cutaneous branch of the intercostal nerve block combined with pectoral nerves (Pecs) block type Ⅱ for early postoperative analgesia by comparing with Pecs block type Ⅱ in the patients undergoing modified radical mastectomy.Methods Sixty-eight patients,aged 18-64 yr,with American Society of Anesthesiologists physical status Ⅰ-Ⅲ,scheduled for elective modified radical mastectomy under general anesthesia,were divided into 2 groups (n=34 each) using a random number table method:Pecs block type Ⅱ plus anterior cutaneous branch of intercostal nerve block group (P+A group) and Pecs block type Ⅱ group (P group).Anesthesia was induced with fentanyl,propofol and cisatracurium besilate,the patients were then tracheally intubated,and anesthesia was maintained with sevoflurane combined with nitrous oxide in both groups.In both groups,0.25% levobupivacaine 10 ml was injected into the space between pectoralis major and pectoralis minor under ultrasound guidance,and then 0.25% levobupivacaine 10 ml was injected into the surface of the serratus anterior muscle at the level of 3rd rib for Pecs block type Ⅱ before operation.In group P+A,0.25% ropivacaine 10 ml (20 ml in total) was injected into the interspace between the transverse thoracic and intercostal muscles in the junction area at the level of 4th and 5th ribs to perform anterior cutaneous branch of the intercostal nerve block.The equal volume of normal saline was given instead in group P.Morphine was given for analgesia when visual analogue scale score>3 or when the patients required.The cumulative amount of morphine administered at 24 h after surgery was recorded.The development of postoperative nausea and vomiting was observed.Results Compared with group P,the cumulative amount of morphine administered at 24 h after surgery was significantly decreased,and the postoperative analgesia time was prolonged in group P+A (P<0.05).There was no significant difference in the incidence of postoperative nausea and vomiting between the two groups (P>0.05).Conclusion Combination of anterior cutaneous branch of the intercostal nerve block and Pecs block type Ⅱ provides better analgesic efficacy for early postoperative analgesia than Pecs block type Ⅱ alone in the patients undergoing modified radical mastectomy.
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There is accumulating evidence that microRNAs are emerging as pivotal regulators in the development and progression of neuropathic pain. MicroRNA-15a/16 (miR-15a/16) have been reported to play an important role in various diseases and inflammation response processes. However, whether miR-15a/16 participates in the regulation of neuroinflammation and neuropathic pain development remains unknown. In this study, we established a mouse model of neuropathic pain by chronic constriction injury (CCI) of the sciatic nerves. Our results showed that both miR-15a and miR-16 expression was significantly upregulated in the spinal cord of CCI rats. Downregulation of the expression of miR-15a and miR-16 by intrathecal injection of a specific inhibitor significantly attenuated the mechanical allodynia and thermal hyperalgesia of CCI rats. Furthermore, inhibition of miR-15a and miR-16 downregulated the expression of interleukin-1β and tumor-necrosis factor-α in the spinal cord of CCI rats. Bioinformatic analysis predicted that G protein-coupled receptor kinase 2 (GRK2), an important regulator in neuropathic pain and inflammation, was a potential target gene of miR-15a and miR-16. Inhibition of miR-15a and miR-16 markedly increased the expression of GRK2 while downregulating the activation of p38 mitogen-activated protein kinase and NF-κB in CCI rats. Notably, the silencing of GRK2 significantly reversed the inhibitory effects of miR-15a/16 inhibition in neuropathic pain. In conclusion, our results suggest that inhibition of miR-15a/16 expression alleviates neuropathic pain development by targeting GRK2. These findings provide novel insights into the molecular pathogenesis of neuropathic pain and suggest potential therapeutic targets for preventing neuropathic pain development.
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Animais , Camundongos , Ratos , Biologia Computacional , Constrição , Regulação para Baixo , Hiperalgesia , Inflamação , Injeções Espinhais , MicroRNAs , Neuralgia , Proteínas Quinases p38 Ativadas por Mitógeno , Fosfotransferases , Proteínas Quinases , Nervo Isquiático , Medula Espinal , Regulação para CimaRESUMO
Objective·To compare the clinical features between different subtype bipolar patients with first mania episode, and to contribute to early identification of bipolar disorder. Methods·This study was based on the database named as National Bipolar Mania Pathway Survey (BIPAS). From November 2012 to January 2013, bipolar patients from 26 mental health facilities in China were enrolled in current study. The clinical features were compared between mania patients of different subtypes, including hypomania (groupⅠ), mania without psychotic symptoms (groupⅡ), mania with psychotic symptoms (group Ⅲ) and mixed state (group Ⅳ). Results·There was significant difference in the percentage of clinical symptoms between different subtype bipolar patients with first mania episode, especially the mania and anxiety related symptoms. Group Ⅰ, Ⅲ , Ⅳ were further compared with groupⅡ, which was considered as the typical bipolar disorder. The results showed that the mania related symptoms was significantly higher in group Ⅱ, but anxiety related symptoms was significantly higher in group Ⅰ, Ⅲ, Ⅳ. Moreover, Logistic regression analysis revealed that more eloquent or humor and unusually restless could be in favor of the diagnosis of hypomania; younger and mania or hypomania as first episode might be in favor of the diagnosis of mania with psychotic symptoms; older, national minorities and unusually restless could be in favor of the diagnosis of mixed state. Conclusion·The clinical features between different subtype bipolar patients with first mania episode are various, and analysis of the clinical features can contribute to early identification of bipolar disorder.
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Bipolar disorder (BD) is a chronic mental illness with high recurrence rate and disability. As one of the core symptoms, cognitive impairment may occurs at every stage of the disease. Evidence from the neuroimaging studies revealed that the abnormal brain volumes, the blood flow and oxygen saturation of key brain areas are related to executive impairment in patients with bipolar disorder. This article reviews current structural and functional neuroimaging studies about the executive impairment of patients with euthymic bipolar disorder and research progresses.
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Objective To investigate the effect of vecuronium at different doses for induction of anesthesia on monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery.Methods One hundred and seventeen patients,ASA Ⅰ or Ⅱ,aged 20-64 yr,weighing 50-85 kg,scheduled for thyroid surgery,were randomly divided into three groups:group Ⅰ (n =39),group Ⅱ (n =40) and group Ⅲ(n =38).Anesthesia was induced with midazolam 2 mg,propofol 2 mg/kg,sulfentanil 0.5 μg/kg.Following BIS value at 40-50,vecuronium 0.05(ED95) or 0.10 mg/kg (2 × ED95)was intravenously injected in group Ⅰ or Ⅱ respectively,and the electromyographic (EMG) endotracheal tube was intubated under glidescope at 5 min after vecuronium administration.Group Ⅲ received sevoflurane inhalation and the EMG endotracheal tube was intubated following end-tidal sevoflurane concentration at 4%.Anesthesia was maintained with inhalation of sevoflurane in three groups.Cooper' s score and the success of attempt at endotracheal intubation were recorded.The recurrent laryngeal nerve-evoked EMG response was monitored to record the amplitude at 5 min intervals from 30 min to 70 min following surgery.Results The success rates of endotracheal intubation were 100% in three groups,but the Cooper' s score of groups Ⅰ and Ⅱ was significantly higher than that of group Ⅲ (P < 0.05),while there was no significant difference between groups Ⅰ and Ⅱ.In spite of the EMG amplitude being significantly decreased as compared with group Ⅲ,the EMG response was adequate for monitoring of recurrent laryngeal nerve in group Ⅰ.The EMG response was lost 30 min following surgery,and inadequate for neuromonitoring of recurrent laryngeal nerve 35-45 min following surgery in group Ⅱ.Conclusion Vecuronium 0.05 mg/kg (ED95)for induction of anesthesia may be helpful to provide satisfactory endotracheal intubation conditions,also not affect the monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery,which can be recommended as the optimal dosage.
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Objective To study the sedative and analgesic effects of different drugs on patients under-going endoscopic variceal ligation( EVL). Methods Sixty patients undergoing selective EVL were randomly assigned to three groups:pethidine group( A),propofol-fentanyl group( B)and dexmedetomidine-fentanyl group(C). Data concerning blood pressure,heart rate,peripheral oxygen saturation,Ramsay score,endo-scopic operation and anesthesia time,surgeons' satisfaction and adverse reactions were recorded. Follow-up was done 24 hours later to confirm the patients' satisfaction and incidence of intraoperative awareness. Results The Ramsay scores of group B(5. 2 ± 0. 3)and C(3. 5 ± 0. 4)were significantly higher than group A (1. 6 ± 0. 4)(P<0. 05). There was no cough,body movement and high blood pressure during the EVL in group B or C,while the incidences of these symptoms in group A(40%,40% and 30%)were obviously higher (P<0. 05). The surgeons'satisfaction of group B(9. 2 ± 0. 3)and C(9. 6 ± 0. 4)were significantly higher than that of group A(5. 0 ± 0. 4)(P<0. 05). The patients' satisfaction scores of group B(9. 6 ± 0. 3)and C (9. 6 ± 0. 4)were also markedly higher than that of group A(5. 4 ± 0. 3)(P<0. 05). There was no difference of operation time among the three groups. The anesthesia time of group A(44 ± 6)was obviously longer than those of group B(35 ± 4)and C(36 ± 5)(P<0. 05). There was no difference in patients'or surgeons'satis-faction,or anesthesia time between group B and C. But the incidences of bradycardia( 40%),hypotension(30%)and hyoxemia(30%)in group B were obviously higher than those of group C(5%,0,0)(P<0. 05). There was no intraoperative awareness in group B or C. Conclusion Both dexmedetomidine and propofol com-bined with fentanyl are superior to pethidine for patients undergoing EVL,while dexmedetomidine provides bet-ter hemodynamics and respiratory conditions compared with propofol.
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Objective To investigate the alexithymia, mental health condition and their relationship in female rheumatoid arthritis patients. Methods Fifty-four female patients with rheumatoid arthritis and 50 healthy women were enrolled and assessed with Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20) and the symptom checklist-90(SCL-90). Disease duration and DAS28 of the patients were also recorded and calculated. The data were statistical analyzed by t test between the two groups and other block groups. The association between TAS-20, SCL-90, duration and DAS28 was assessed using Spearman corre-lations. Results ① The TAS-20 total score and Tf1, Tf2, Tf3 factors score of female rheumatoid arthritis patients were significantly higher than those of the control group (57±9, 51±7, t=4.15, P DAS28 and anxiety and paranoid factors (P <0.05). Conclusion There is obvious alexithymia and psychological problems in female rheumatoid arthritis patients; the Tf1 and Tf3 factors of TAS-20, duration and DAS28 are all major factors related to the psychological state.
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Objective To investigate the effect of rocuronium 0.3 mg/kg(ED95)for anesthesia induclion on monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery.Methods Seventy-five patients,ASA Ⅰ or Ⅱ,aged 20-70 yr,weighing 50-85 kg,scheduled for thyroid surgery,were randomly divided into two groups:rocuronium group(groupⅠ,n=38)and sevoflurane group(group Ⅱ,n =37).Anesthesia was induced with midazolam 2 mg,propofol 2 mg/kg,sulfentanil 0.5 ug/kg.After loss of eyelash reflex,group Ⅰ received rocuronium 0.3 mg/kg(ED95)and was intubated with the electromyographic(EMG)endotracheal tube under glidescope al 2 min after rocuronium administration.Group Ⅱ received sevoflurane inhalation and was endotracheal intubated with EMG tube until end-tidal sevoflurane concentration achieved 4%.Anesthesia was maintained with inhalation of sevoflurane in both groups.SP,DP,and HR were monitored continuously through the surgery.Cooper's score and the success of attempt at endotracheal intubation were recorded.Recurrent laryngeal nerve evoked EMG was recorded by neuromonitoring and the amplitude of EMG responses was recorded at 5 min intervals from 30 min to 70 min of surgery duration.Results SP,DP and HR remained within normal range in both groups.The success rates of endotracheal intubation were 100% in both groups,but the Cooper' s score of group Ⅰ was significantly higher than that of group Ⅱ(P < 0.05).Compared with group Ⅱ,the amplitude of EMG respouses was significantly decreased in group Ⅰ(P < 0.05).However,the EMG response in group Ⅰ was adequate for neuromonitoring of recurrent laryngeal nerve.Conclusion Rocuronium 0.3 mg/kg(ED95)for anesthesia induction can not only provide satisfied endotracheal intubation conditions,but also be adequate for monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery.
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Objective To investigate the effects of sevoflurane on renal ischemia-reperfusion (I/R) injury in rats and the role of Na+-2Cl--K+ cotransporter 1 (BSC1) and aquaporin 2 (AQP2) in it.Methods Twentyfour male Sprague-Dawley rats,aged 8-12 weeks,weighing 125-145 g,were randomly divided into 3 groups (n =8 each) ∶ sham operation group (S group),I/R group and sevoflurane group (Sev group).Renal ischemia was induced by occlusion of the renal artery for 45 min with atraumatic microclips followed by 24 h reperfusion.In group Sev,the rats inhaled 1 MAC (2.2%) sevoflurane,renal ischemia was induced after loss of consciousness and 1 MAC (2.2%) sevoflurane was inhaled for 1 h.The urine were collected at 24 h before I/R (T1) and 24 h of reperfusion (T2) for detection of urine specific gravity and creatinine (Cr) level.The urine volume was recorded.The endogenous creatinine clearance rate (Ccr) was calculated.Blood samples were taken from the irferior vena cava at T2 for determination of concentrations of serum blood urea nitrogen (BUN) and Cr and activities of superoxide dismutase (SOD) and myeloperoxidase (MPO),malondialdehyde (MDA) concentration.The left kidney was removed for determination of MPO and SOD activities and MDA content and for microscopic examination and the pathological changes of the renal tubule were scored.The expression of AQP2 and BSC1 was detected by immunohistochemistry and Western blot.Results Compared with group S,the urine volume was enlarged,concentrations of serum BUN and Cr were significantly increased,urine specific gravity and Ccr were significantly decreased,MPO and MDA levels were significantly increased,SOD activity was significantly decreased,the pathological score was significantly increased,and the expression of AQP2 and BSC1 was down-regulated in groups I/R and Sev (P < 0.05).Cer was significantly higher,conceutratious of serum BUN and Cr and MPO and MDA levels were lower,SOD activity was higher,the pathological score was lower,and the expression of AQP2 and BSC1 was higher in group Sev than in group I/R (P < 0.05).Sevoflurane inhalation significantly attenuated the pathological changes.Conclusion Sevoflurane can attenuate renal I/R injury in rats through up-regulating the expression of BSC1 and AQP2.
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ObjectiveTo evaluate the efficacy of preemptive analgesia with parecoxib for acute postoperative pain after pulmenary lobectomy.MethodsSixty ASA Ⅱ or Ⅲ patients of both sexes aged 20-64 yr weighing 50-80 kg undergoing elective pulmonary lobectomy were randomly divided into 3 groups ( n =20 each): control group (group C); group A (parecoxib 40 mg was injected iv at 20 min before surgery) and group B (parecoxib 40 mg was injected iv when skin was sutured).Patient controlled intravenous analgesia (PCIA) with sufentanil and ramosetron (continuous background dose 2 ml/h,bolus dose 0.5 ml,lockout time 15 min) was used after surgery.When VAS score > 3,iv bolus of tramadol 1-2 mg/kg was injected as rescue medicine.Agitation condition was observed after operation.The number of successfully delivered doses and the number of attempt were recorded.The consumption sufentanil and the number of rescue medicine were recorded during 24 h after surgery.ResultsThe incidence of postoperation agitation,number of successfully delivered doses and number of attempt,consumption sufentanil and number of rescue medicine were significantly lower in groups A and B than in group C.The consumption sufentanil and number of rescue medicine were significantly lower in group A than in group B ( P <0.05).ConclusionParecoxib can use for preemptive analgesia in patients after thoracic surgery,reduce the complication during anesthesia recovery and the opioid analgesics consupmtion.
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BACKGROUND: Human adipose tissue-derived stromal cells (ADSCs) possess exert proliferation and multi-directional ability. As a novel stem cell, it has been widely utilized in tissue engineering and plays an important role in biological and potential therapeutic applications.OBJECTIVE: To review the research progress, applications and existing problems of human ADSCs in tissue engineering and cell therapy by retrieving relevant publications. METHODS: PubMed and CNKI databases were undertaken to identify the relevant articles published from January 1960 to January 2009 with the key words of "human adipose tissue-derived mesenchymal cells, isolation, differentiation, immune phenotype, application" both in English and Chinese. The articles relate to biological characteristics and applications of ADSCs were selected. In the same field, the documents published earlier or in the authoritative journals were preferred, and the repetitive studies were excluded. RESULTS AND CONCLUSION: A total of 81 documents were searched by computer, and 57 references were included in the final analysis. The results demonstrated that, human ADSCs share many characteristics, including the high proliferative potential and exhibiting the exert ability to undergo multilineage differentiation under appropriate conditions. Human ADSCs can not only utilize for tissue repairing, but also for cell immune modulation and gene therapy. However, there are still problems in its application. With the development of research on human ADSCs, their biological characteristics will be revealed, and their application in tissue repairing, cell therapy, transplantation, as well as gene therapy must be hold a great promise.
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Objective To observe the effect of acute hypervolemic hemodilution(AHH) combined with nicardipine controlled hypotension on hemodynamics changes in revision operation of total hip replacement.Methods Forty patients were divided into two groups according to the sequence of the surgery(odd number came into group A,even number came into group B,20 in each group).In group A,AHH was carried out with nicardipine controlled hypotension;group B was control group.AHH was carried out in both groups before anesthesia induction.6%voluven was transfused in group A at 15 mL?kg-1 and 30 mL?min-1 and nicardipine was transfused at 0.3-0.5 mL?kg-1?h-1 with MAP altering between 60 and 65 mmHg;Same quantity of physiological saline was transfused in group B.HR,MAP,CVP,Hb,Hct and Plt were recorded and observed at preoperation,1 h after AHH and 24 h after the operation.Results In group A after AHH with nicardipine controlled hypotension,MAP was obviously lower than pre-operation(P
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95mmHg) were randomly divided into 3 equal groups of 20 each : thiopental group, etomidate group and propofol group. All patients were prmedicated with intramuscular phenobarbital 0. 1g and atropine 0.5mg. Anesthesia was induced with thiopental 4mg?kg-1 or etomidate 0.3mg?kg-1 or propofol 2mg?kg-1, midazolam 0.1mg?kg-1, fentanyl 5?g?kg-1 and vecuronium 0.1mg?kg-1 and maintained with isoflurane inhalation and intermittent boluses of fentanyl and vecuronium. Blood samples were taken before anesthesia(To), 2min after induction(T1) and 2 and 10 min after tracheal intubation (T2, T3) for determination of plasma levels of endothelin(ET), calcitonin gene-related peptide(CGRP), neuropeptide Y (NPY) and neurotensin (NT). Results The three groups were compared with regard to age, sex and weight. BP significantly decreased after induction with thiopental or propofol but increased significantly after intubation in thiopental group and etomidate group. ET and NPY decreased but CGRP and NT increased significantly after induction in thiopental and propofol group. The plasma levels of all four neuropeptides increased significantly after tracheal intubation in thiopental and etomidata group but remained unchanged in propofol group. Conclusions Propofol is the intravenous anesthetic of choice for induction of anesthesia in patients with hypertension.
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Objective To investigate the etiology of papular urticaria: is it caused only by arthropod-like insects-bite allergy, or by multiple factors such as food allergy, disturbance of gastrointestinal function and infection? Methods We searched, by computer and manually, the foreign and domestic literature related to the etiology of papular urticaria published since 1950s, and according to the methods of evidence-based medicine, systematically evaluated the evidence supporting either the insect-bite theory or the multiple factor theory. Results Twenty-nine articles ( 22 English and 7 Chinese ) supported the theory of hypersensitivity to bites from certain insects such as mosquitoes, gnats, fleas, mites, bedbugs etc. Two articles in Chinese mentioned the possibilities other than insect-bite, but the reliability was unconvincing, because the authors did not present the source of data or statistical methods used in the articles. The evidence from epidemiology, histopathology, laboratory and clinical researches all supported the insects-bite theory. No proven evidence was found supporting other aetiological hypotheses. Conclusion Our results suggest that papular urticaria is caused only by the allergy to stings or bites of arthropods, and other hypotheses still lack convincing evidence.
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The characteristics of ductal adenocarcinoma of colon under eieciror: microscopy were stout and dense microvill, with small roots buried in the top of cytoplasm. The ullrarnorphological changes of carcinomatous infiltration was similar to the picture observed in vitro cultivation of cancer cells.In 104 cases out of 159, there was an over expression of ras oncogenes P21, indicating that carcinoma of colon was related to activation of ras oncogenes. Examination with monoclonal antibodies yielded a positive rate of 83.4%- 95.7%, indicating that most of the carcinomas had colon related antigens. This phenomenon should play an important role in raising the diagnostic accuracy, and it also should serve as an indicator of effective treatment. In 62 cases of mucoid adenocarcinoma and 30 cases of signet ring cell carcinoma, there was a marked reduction of mueoitin sulfate with an increase in sialic acid mucus. The letter was a glycoprotein containing hydroxyl mucus, and it facilitated the separation of cancer cells to infiltrate and metastasize.in 134 cases, AgNOR was quantified, and there were 13.05? 1.48 granules in each mucleas. There was more abundant AgNOR in undifferentiated cancer, while the number of AgNOR fluctuated between 10.56 to 11.83 in papillary adenocarcinoma, ductal adenocarcinoma, and mucoid adenocarcinoma. indicating the qunantity of AgNOR was related to degree of malignancy in colonic carcinoma.