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Objective:To evaluate the efficacy of combination of dexmedetomidine and compound lidocaine cream for the prevention and treatment of the stress responses during recovery from general anesthesia in the patients undergoing transnasal transphenoidal pituitary adenoma resection.Methods:A total of 90 patients, aged 18-64 yr, with body mass index of 18-25 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing elective pituitary tumor resection by transsphenoidal approach with general anesthesia, were divided into 3 groups ( n=30 each) by the random number table method: combination of dexmedetomidine and compound lidocaine cream group (D-L group), dexmedetomidine group (D group) and compound lidocaine cream group (L group). Compound lidocaine cream 2 g was applied to the anterior 1/3 of the tracheal tube and surface of the cuff in D-L and L groups, and paraffin oil was applied to the surface of the tracheal tube in group D. In D-L and D groups, dexmedetomidine 0.5 μg/kg was intravenously infused for 10 min at 30 min before the end of surgery, while the equal volume of normal saline was given in group L. Heart rate and mean arterial pressure were continuously monitored during peritracheal extubation, and the occurrence of responses to extubation was recorded.The optic nerve sheath diameter (ONSD) was measured by ultrasound after entering the operating room(t 0), after anesthesia induction(t 1), and at 5 min after extubation (t 2). The bucking and agitation scores were recorded during recovery from anesthesia. Results:Compared with group D and group L, the incidence of bucking and responses to extubation was significantly decreased in group D-L (27%, 37%, 6%; 23%, 27%, 3%, respectively, P<0.05). Compared with group L, the incidence of agitation was significantly decreased in D-L and D groups (37%, 10%, 13%, respectively, P<0.05). No severe bucking and agitation occurred in group D-L.There was no significant difference in ONSD at each time point among three groups ( P>0.05). Conclusion:Combination of dexmedetomidine and compound lidocaine cream performs better than either alone and can prevent and treat stress responses during recovery from general anesthesia in the patients undergoing transnasal transsphenoidal pituitary adenoma resection.
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Objective The purpose of this research is to use modern statistical methods,to analyze the rules of cointment by Prof.Yang Zhimin treating yang deficiency and fatigue state patients,to increase the pertinence and to improve the clinical efficacy.Methods This paper analyzed 62 cases of Prof.Yang Zhimin in the treatment of the patients with yang deficiency and fatigue state from October 2010 to January 2013.The analyses were frequency analysis and association rules.Results Among the patients with yang-deficiency and fatigue,193 Chinese medicine were used.The monkshood was the highest frequency.Dampness-transforming medicine accounts for about 22.2％ in the top 36 frequency of medicine.Based on analyzing association rules,we found that the compatibility of medicine which were used more frequently came from Sini decoction,Danggui Sini decoction and Jinkui Shenqi pills,such as "monkshood and dried ginger","monkshood and roasted liquorice","dried ginger and roasted liquorice","monkshood and angelica","monkshood and comel","monkshood and prepared rehmannia root" and "monkshood and yam".Futhermore,we found two new core prescription.One was Qian Yang Dan combined with Sini decoction consist of "monkshood,roasted liquorice,dried ginger,fructus amomi".The other one was Tu Si Jian consist of "yam,semen cuscutae,angelica,roasted liquorice".Conclusions "Invigorating spleen and kidney","warming yang and dissipating dampness" and "hiding yang and Seeking Yang in Yin" are the habits and rules of the ointment medication by Prof.Yang Zhimin treatingyang deficiency and fatigue state patients.
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Objective To study the inhibitory effect of the Chinese medicine on S180 tumor-bearing mice and the effect on the immune function of the mice by respiratory drug administration. Methods The S180 cells were inoculated into the abdominal cavity of Kunming mice. After the ascites was formed, the left anterior limb of mice was inoculated with ascites to establish the subcutaneous transplantation tumor model. Drug was administrated when the tumor volume reached 0.06cm3. The experimental grouping and intervention measures are as follows (n=6): mice in control group received no intervention, and fed normally. Mice in experiment group were treated with respiratory tract inhalation of Chinese medicine gas, daily administration 6h, once a day, continuous administration of 21 days. Mice in adriamycin (ADM) group were intraperitoneally injected 1mg/kg of ADM, once a week, a total of 3 times. General signs of the mice including activity and eating status were observed daily. The body weight of mice was measured every other day. Blood samples were taken 2 days after stopping drug inhalation by inner canthus vein bleeding for detection of CD3+, CD4+ and CD8+ T lymphocyte ratio by flow cytometry. The subcutaneous nodule was dissected and weighed, and some tumor tissues were pathologically observed. Part of tumor tissues was prepared into single cell suspension to detect the cell apoptosis by flow cytometry. Results The CD3+, CD4+ T lymphocytes ratio and the ratio CD4+/CD8+ were significantly higher in experiment group than in control group (P0.05). The apoptotic rate increased significantly in experiment group than in control group (P<0.05). Histopathological observation showed that, in control group, the transplanted tumor tissue had rich cells arranged closely with necrosis limited; while in the experiment group the necrosis of tumor tissue distributed widely without obvious regional, the fibrous tissue proliferated, the tumor cells scattered in the arrangement with peritumoral lymphocytic infiltration. More necrotic tissues were also observed in ADM group. Conclusion Respiratory tract inhalation of Chinese medicine may inhibit the growth of S180 subcutaneous transplanted tumor in mice to a certain extent.
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Objective: To investigate the effects of common peneration enhancers on the transdermal permeation of total flavones and six flavonoid components from Scutellariae Radix Gel-unguentum (SRGU), thus to provide the experimental evidence for the selection of optimal penetration enhancers. Methods: In vitro diffusion cell method was used to evaluate the changes of the transdermal pemeation parameters by azone (AZ), menthol (MT), and propylene glycol (PG), separately or in combination. Results: When applied individually, AZ and MT showed the best enhancing effect on the transdermal permeability and cumulative permeation of flavonoids and their aglycons, respectively. PG, in contrast, produced poor enhancement. When applied in combination, the permeation enhancing effects were generally more remarkable than those of single enhancer. In particular, 3% AZ + 5% PG could achieve the most effective enhancement effect on the transdermal permeation of flavonoids. Conclusion: Penetration enhancers could significantly affect the transdermal permeation of total flavones and flavonoid components from SRGU in vitro, and 3% AZ + 5% PG may serve as the most effective enhancer.
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Objective To evaluate the effect of topical anesthesia with compound lidocaine cream coated on the tracheal tube on extubation response in patients undergoing Han-uvulopharyngoplasty (H-UPPP).Methods Eighty-four patients,aged 28-48 yr,weighing 91-108 kg,scheduled for elective H-UPPP,requiring tracheal intubation under general anesthesia,were equally and randomly divided into 2 groups:compound lidocaine cream group (group L) and control group (group C).The compound lidocaine cream 2-3 g were coated on the tracheal tube cuff and exterior before induction of anesthesia in group L,while the paraffin oil was coated in group C.Mean arterial pressure (MAP),HR and pulse oxygen saturation were recorded before induction of anesthesia,at the end of infusion of anesthetics,during extubation and 5 min after extubation (T1-4).Blood samples were taken from the forearm veins on the noninfusion side at T1-4 for detection of plasma adrenergic and norepinephrine concentrations.Cardiovascular events during extubation were recorded.Results Compared with group C,MAP and HR were significantly decreased at T3,4,the incidences of hypotension and tachycardia were decreased,the plasma adrenergic and norepinephrine concentrations were significantly decreased at T2-4 in group L (P ＜ 0.05).Conclusion Topical anesthesia with compound lidocaine cream coated on the tracheal tube can effectively reduce the extubation response in the patients undergoing H-UPPP.
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Objective: To establish the determination method of geniposide in Xiaobanlifu Unguentum. Methods: HPLC was performed to determine the content of geniposide on Inertsil ODS-3 column, using methanol-potassium dihydrogen phosphate-acetic acid-isopropyl alcohol (67∶173∶4∶4,v/v) as a mobile phase and detection wavelength at 238nm. Results: The linearity of this method was good, and the averge recovery was 97.3%, RSD=1.94%. Conclusion: This method was relatively simple and accurate, and available for the quality control in Xiaobanlifu Unguentum.