Application effect of sevoflurane combined with remifentanil intravenous inhalation anesthesia in patients undergoing laparoscopic radical resection of cervical cancer.

OBJECTIVE: To determine the application effect of sevoflurane combined with remifentanil intravenous inhalation anesthesia in patients undergoing laparoscopic radical resection of cervical cancer (LRHCC). METHODS: The clinical data of 127 patients with cervical cancer (CC) who received LRHCC in Henan Provincial People's Hospital during January 2017 and June 2021 were retrospectively analyzed. Among them, 60 patients anesthetized by propofol combined with remifentanil were assigned to the control group (Con group), while the rest 67 anesthetized by sevoflurane combined with remifentanil to the research group (Res group). The following items of the two groups were compared: the changes of heart rate and blood pressure before anesthesia (T0), at 30 min after anesthesia (T1) and 10 min after surgery (T2), anesthetic effect, stress substance contents, anesthesia recovery, changes in brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF), Mini-Mental State Examination (MMSE) scores, and adverse reactions. RESULTS: The heart rate and blood pressure at T1 and T2 were notably different between the two groups (P<0.05). In contrast to the Con group, the Res group showed a greatly better recovery effect of anesthesia and presented notably lower levels of adrenaline and GLU (all P<0.05). 10 min after surgery, the Con group showed lower levels of BDNF and NGF than the Con group. After surgery, the MMSE scores in the Res group were higher than that of the Con group, and the two groups had no significant difference in the incidence of adverse reactions (P>0.05). CONCLUSION: In contrast to propofol combined with remifentanil anesthesia, intravenous inhalational anesthesia with sevoflurane combined with remifentanil can exert a stronger anesthetic effect in patients receiving LRHCC, with a high safety.

Acquired infection after intubating patients with COVID-19: Datasets.

Thirty-six anesthesia departments in 36 hospitals in four provinces of China where an outbreak of COVID-19 occurred were surveyed. We found that there were ten anesthesiologists (5 male and 5 female) who contracted the infection after performing intubation, as well as 4 nurses (1 male and 3 female) who contracted the infection after assisting with the intubation. This is a retrospective investigation and no intervention was applied. The numbers are presented as mean ± Standard Deviation (SD). We used Graphpad Prism (version 8.2.1 Windows version, GraphPad Software, San Diego). Fisher's exact test at a two-sided significance level of 0.05 was used to identify potential risk factor (s) for intubation providers. A P value less than 0.05 is considered statistically significant. A total of 211 anesthesiologists from four provinces were involved in the intubation of 664 patients with confirmed or potential COVID-19. Of these 644 patients, 640 cases were eventually confirmed with a diagnosis of COVID-19. Among the 211 anesthesiologists who performed intubation, 10 of them had a confirmed diagnosis of COVID-19 afterwards. Coughing is a risk factor for provider infection (P = 0.0001). The number of intubation attempts (within three attempts) did not increase the risk of the infection. All of the affected anesthesiologists had symptoms 2-12 days after the intubation encounter (average 6 ±â€¯3 days). All had radiological image evidence of bilateral pneumonia and all reported relatively mild symptoms. The affected doctors were out of clinical service for 20-60 days (average 46 ±â€¯12 days). Seven of the doctors have been discharged from the hospital, but three of them remain hospitalized. Four nurses who assisted with intubations contracted COVID-19. One of these nurses was in critical condition but was eventually discharged with a loss of 50 days of clinical service. The remaining three nurses have had mild symptoms so far, but one is still hospitalized.

The effects of stimulation at acupoint ST36 points against hemorrhagic shock in dogs.

The aim of this study is to investigate the effects of electroacupuncturing (EA) zusanli points on levels of basic hemodynamics, lactate, and cytokines in dogs with hemorrhagic shock. Thirty healthy dogs were randomly divided into 5 groups: sham hemorrhagic shocked group, hemorrhagic shocked group, EA group, nonacupuncturing group, and EA after vagotomy group. Zusanli points were electroacupunctured with constant voltage (10-15 V, 30 Hz) for 30 minutes immediately after the shock models were established. Before the stimulation, a blood pressure transducer was implanted into the right femoral artery for continuous recording of mean arterial pressure (MAP), and a 5F Swan-Ganz pediatric catheter was implanted into the pulmonary artery. The levels of serum tumor necrosis factor α (TNF-α) in the femoral artery were detected at 0, 120, and 180 minutes after hemorrhage. The levels of serum lactate in the femoral artery were detected before hemorrhage (-45 minutes), at 0 minute, and at 180 minutes. In the hemorrhagic shocked group, the levels of MAP, cardiac output, cardiac index, central venous pressure, and pulmonary arterial wedge pressure decreased significantly; at the same time, the levels of serum TNF-α and serum lactate increased significantly. There were no differences between these groups and the hemorrhagic group, but they were different from the sham hemorrhagic shocked group. In the EA group, the levels of MAP, cardiac output, cardiac index, central venous pressure, and pulmonary arterial wedge pressure gradually increased, but the content of serum TNF-α and lactate obviously decreased. The results suggested that EA zusanli points produce a protective effect on hemorrhagic shock in dogs.

Solid phase pegylation of hemoglobin.

A solid phase conjugation process was developed for attachment of polyethylene glycol to hemoglobin molecule. Bovine hemoglobin was loaded onto an ion exchange chromatography column and adsorbed by the solid medium. Succinimidyl carbonate mPEG was introduced in the mobile phase after the adsorption. Pegylation took place between the hemoglobin on the solid phase, and the pegylation reagent in the liquid phase. A further elution was carried out to separate the pegylated and the unpegylated protein. Analysis by HPSEC, SDS-PAGE, and MALLS demonstrated that the fractions eluted from the solid phase contained well-defined components. Pegylated hemoglobin with one PEG chain was obtained with the yield of 75%, in comparison to the yield of 30% in the liquid phase pegylation. The P(50) values of the mono-pegylated hemoglobin, prepared with SC-mPEG 5 kDa, 10 kDa and 20 kDa, were 19.97, 20.23 and 20.54 mmHg, which were much closer to the value of red blood cells than that of pegylated hemoglobin prepared with the conventional method.

A solid-phase adsorption method for PEGylation of human serum albumin and staphylokinase: preparation, purification and biochemical characterization.

A solid-phase adsorption method was developed to circumvent the disadvantage of the conventional liquid-phase PEGylation, i.e. the heterogeneity of the PEGylated products. The model proteins, human serum albumin (HSA) and staphylokinase (SAK), were adsorbed on the ion exchange chromatography media, followed by PEGylation with succinimidyl carbonate (SC)-mPEG5K and salt elution. Since PEGylation with SC-PEG5K alters the positive charge of the proteins, Q-Sepharose Big Beads and DEAE Sepharose Fast Flow were used for adsorption of HSA and SAK, respectively. Size exclusion chromatography and SDS-PAGE studies demonstrated that solid-phase PEGylation of proteins generate monoPEGylated proteins with the yield of 35-47%. Circular dichroism and intrinsic fluorescence studies showed that solid-phase PEGylation led to little conformational change of the proteins. Solid-phase PEGylation resulted in 35% loss in the biological activity of SAK, which is lower than the liquid-phase PEGylation (70%).

Investigation on PEGylation strategy of recombinant human interleukin-1 receptor antagonist.

Although PEGylation is a potential approach to prolong the half-lives and reduce the dosing frequency of therapeutic proteins, conjugation behaviors of polymer have pivotal effects on the remaining bioactivities of the derivatives. In this study, the PEGylation strategy of recombinant human interleukin-1 receptor antagonist was investigated. The random conjugation of polyethylene glycol to amino groups on the protein resulted in a severe loss of activity and only retained 9.8% of the activity. In contrast, the PEGylation at the thiol groups had moderate effects on the bioactivity of protein and 40% of activity was conserved. The results suggested that the thiol-target PEGylation was more beneficial for IL-1ra.

Conjugate of bovine hemoglobin and human serum albumin as a candidate for blood substitute: characteristics and effects on rats.

Conjugate of bovine hemoglobin (bHb) and human serum albumin (HSA) was prepared. The product was simply composed of 89.7% one-to-one Hb-HSA conjugate, 6.0% oligomer of Hb and HSA, 3.5% unconjugated HSA and 0.8% unconjugated Hb, with an average molecular weight of 157 kD. The physicochemical characteristics were determined. Effects of single replacement on blood pressure and long-term survival of rats with 30% and 60% acute blood loss were studied, in comparison with Ringer-lactate solution, stroma-free hemoglobin (SFHb), 5% HSA in Ringer-lactate, whole blood and no resuscitation fluid. Results showed that Hb-HSA conjugate maintained the mean arterial pressure of rats to initial level with no pressor effect. Long-term effects of the replacement fluids on 30% bleeding rats showed that, for the group infused with Hb-HSA conjugate, histology of five major organs, heart, kidney, liver, spleen and lung, were essentially normal, similar to that of whole blood, while obviously renal side-effects appeared in other groups. The efficacy of the conjugate was further demonstrated by the resuscitation of lethal hemorrhagic shock rats (60% acute blood loss) with 100% survival rate (followed for 14 days), the same result as whole blood. The Hb-HSA conjugate can thus be another candidate for blood substitute in emergency.