Effect of dexmedetomidine on cognition, immune inflammatory reaction and oxidative stress in lung cancer patients with VATS / 中国基层医药

Objective@#To investigate the effect of dexmedetomidine on cognition (MMSE score), immune inflammatory reaction and oxidative stress in lung cancer patients with VATS.@*Methods@#From January 2016 to December 2017, 89 lung cancer patients underwent VATS in the Second Hospital of Qinhuangdao were randomly divided into the control group (n=46) and the dexmedetomidine group (n=43) according to the digital table.The MMES, CD4 and CD8 lymphocytes, inflammatory factors and oxidative stress factors were compared between the two groups before operation (T0) and at 3 hours (T1), 12 hours (T2), 24 hours (T3) after operation.@*Results@#There were no statistically significant differences in MMSE, CD4 and CD8 lymphocytes, inflammatory factors and oxidative stress factors between the two groups (P>0.05). At the time points of T1, T2 and T3, MMSE scores decreased in both two groups, but the MMSE score in the dexmedetomidine group was higher than those in the control group [(27.67±1.97)points vs.(25.61±1.81)points, (26.47±1.92)points vs.(24.70±2.26)points, (26.16±1.90)pouints vs.(23.41±2.33)points, t=-2.122, -2.553, -2.528, P=0.037, 0.012, 0.013]. The CD8 lymphocyte, inflammatory factors and oxidative stress factors increased after operation in both two groups, and dexmedetomidine could inhibit the increase of immune inflammatory factors and oxidative response factors(IL-6: t=3.038, 2.489, 3.291, P=0.003, 0.015, 0.001; hsCRP: t=2.147, 2.164, 2.752, P=0.035, 0.033, 0.007; TNF-α: t=2.119, 2.323, 2.485, P=0.037, 0.023, 0.015; MDA: t=2.499, 2.116, 2.094, P=0.014, 0.037, 0.039; MPO: t=2.190, 2.166, 2.849, P=0.031, 0.033, 0.005; SOD: t=-2.551, -2.598, -3.141, P=0.012, 0.011, 0.002). The incidence rate of adverse reactions in dexmedetomidine group was lower than that in control group(6/43 vs.18/46, P=0.011).@*Conclusion@#Dexmedetomidine can improve cognition, reduce immune inflammatory reaction and oxidative stress, and alleviate adverse effects in lung cancer patients with VATS.

Effect of dexmedetomidine on cognition,immune inflammatory reaction and oxidative stress in lung cancer patients with VATS / 中国基层医药

To investigate the effect of dexmedetomidine on cognition ( MMSE score),immune inflammatory reaction and oxidative stress in lung cancer patients with VATS.Methods From January 2016 to December 2017,89 lung cancer patients underwent VATS in the Second Hospital of Qinhuangdao were randomly divided into the control group (n＝46) and the dexmedetomidine group (n＝43) according to the digital table.The MMES,CD4 and CD8 lymphocytes,inflammatory factors and oxidative stress factors were compared between the two groups before operation (T0) and at 3 hours (T1),12 hours (T2),24 hours (T3) after operation.Results There were no statistically significant differences in MMSE ,CD4 and CD8 lymphocytes,inflammatory factors and oxidative stress factors between the two groups (P＞0.05).At the time points of T1,T2 and T3,MMSE scores decreased in both two groups, but the MMSE score in the dexmedetomidine group was higher than those in the control group [(27.67 ±1.97) points vs.(25.61 ±1.81) points,(26.47 ±1.92) points vs.(24.70 ±2.26) points,(26.16 ± 1.90)pouints vs.(23.41 ±2.33) points,t ＝-2.122,-2.553,-2.528,P ＝0.037,0.012,0.013].The CD8 lymphocyte,inflammatory factors and oxidative stress factors increased after operation in both two groups , and dexmedetomidine could inhibit the increase of immune inflammatory factors and oxidative response factors (IL-6:t＝ 3.038,2.489,3.291,P＝0.003,0.015,0.001;hsCRP:t＝2.147,2.164,2.752,P＝0.035,0.033,0.007;TNF-α:t＝2.119,2.323,2.485,P＝0.037,0.023,0.015;MDA:t＝2.499,2.116,2.094,P＝0.014,0.037,0.039;MPO:t＝2.190,2.166,2.849,P＝0.031,0.033,0.005;SOD:t＝-2.551,-2.598,-3.141,P＝0.012,0.011,0.002). The incidence rate of adverse reactions in dexmedetomidine group was lower than that in control group (6／43 vs. 18／46,P＝0.011).Conclusion Dexmedetomidine can improve cognition ,reduce immune inflammatory reaction and oxidative stress,and alleviate adverse effects in lung cancer patients with VATS.

Role of aminophylline in COPD patients undergoing abdominal surgery under general anesthesia / 中国基层医药

Objective To study the role of aminophylline in COPD patients undergoing abdominal surgery under general anesthesia.Methods A total of 60 COPD patients who received the upper abdominal surgery under general anesthesia were randomly assigned as regular treatment group (control,n=30) and aminophylline group (aminophylline,n=30).The aminophylline group was intravenously injected aminophylline (2mg/kg) after intubation,and the same volume of saline was injected for the control group.The respiratory mechanics,serum cytokines including tumor necrosis factor-α(TNF-α),interleukin-8 (IL-8) and interleukin-10(IL-10),recovery time and adverse cardiovascular events were measured.Results The general conditions,including gender,age,weight,smoking status,lung function,GOLD standard,surgical site,operation time and anesthetic time had no statistically significant differences between the two groups.During general anesthesia,aminophylline decreased the peak airway pressure(15 minutes,t=9.220,P=0.047),the plate airway pressure(15 minutes,t=5.906,P=0.025) and the airway resistance(15 minutes,t=10.438,P=0.04).Aminophylline increased the respiratory compliance(15 minutes,t=-7.431,P=0.001).Aminophylline attenuated the increase of inflammatory cytokines,such as TNF-α(8 hours,t=6.374,P=0.000),IL-8(8 hours,t=7.716,P=0.000) and hsCRP(8 hours,t=6.665,P=0.000).Aminophylline shortened the time to spontaneous ventilation(t=3.439,P=0.001),opening eyes(t=3.516,P=0.001),limb movement(t=6.249,P=0.000) and extubation (t=3.159,P=0.003).Administration of aminophylline had no obvious adverse effects on blood pressure and heart rate.Conclusion Administration of aminophylline for COPD patients undergoing abdominal surgery under general anesthesia can improve respiratory mechanics,downregulate inflammatory cytokines,accelerate recovery after general anesthesia and possess no obvious adverse cardiovascular effects,which is worthy of popularization.

The clinical relevance of abnormal upper trunk posture for predicting shoulder impingement syndrome among stroke survivors / 中华物理医学与康复杂志

Objective To explore the relevance of abnormal posture to the development of shoulder pain among stroke survivors.Methods A total of 102 stroke survivors were studied.Those with shoulder impingement syndrome or shoulder pain formed a shoulder pain group,while those without shoulder pain served as controls.The upper trunk sagittal sitting postures of all of the subjects were quantified using the thoracic and craniovertebral angles measured from photographs.Results The average craniovertebral angle of the shoulder pain group was significantly smaller than that of the control group,while the average thoracic angle of the former was significantly larger.The craniovertebral angles were negatively correlated with shoulder pain,while a large thoracic angle was positively correlated.Conclusion Thoracic and craniovertebral angles can be used as a predictor of shoulder impingement syndrome among stroke survivors.Stroke patients with thoracic kyphosis and forward head posture should undergo active rehabilitation.

The clinical relevance of abnormal upper trunk posture for predicting shoulder impingement syndrome among stroke survivors / 中华物理医学与康复杂志

Objective To explore the relevance of abnormal posture to the development of shoulder pain among stroke survivors.Methods A total of 102 stroke survivors were studied.Those with shoulder impingement syndrome or shoulder pain formed a shoulder pain group,while those without shoulder pain served as controls.The upper trunk sagittal sitting postures of all of the subjects were quantified using the thoracic and craniovertebral angles measured from photographs.Results The average craniovertebral angle of the shoulder pain group was significantly smaller than that of the control group,while the average thoracic angle of the former was significantly larger.The craniovertebral angles were negatively correlated with shoulder pain,while a large thoracic angle was positively correlated.Conclusion Thoracic and craniovertebral angles can be used as a predictor of shoulder impingement syndrome among stroke survivors.Stroke patients with thoracic kyphosis and forward head posture should undergo active rehabilitation.

Effect of epidural analgesia with different methods on intestinal peristalsis / 中国基层医药

Objective To explore the effect of PCEA on intestinal peristalsis.Methods 120 patients with ASA Ⅰ～Ⅱ lower abdominal or lower limbs surgery were randomly divided into four groups with 30 cases each and received PCEA at the end of operation sespectively.Group A were given 0.0002% fentanyl,0.2% Ropivacaine and 0.005 % Droperidol;0.01% morphine,0.2% Ropivacaine and 0.005% droperidol in group B;0.2% Ropivacaine in group C;0.9% saline in group D.Postoperative analgesia was provided by PCA pump with LCP model.Results Satisfactory analgesia in group A was 93%,97% in group B 47% in group C and 13% in group D.Both group A and B did not show any significant difference in the analgesic effects(P＞ 0.05).Satisfactory analgesia in group A and B were significantly better than in group C and D(P＜0.05).The renewal of intestinal peristalsis were significantly faster in lower limbs surgery patients than lower abdominal patients(P＜ 0.01),but it did not show any significant difference in the same kinds of surgery in four groups (P＞0.05).Conclusion Both group A and B can get a satisfied analgesia effect;intestinal peristalsis of lower limbs surgery patients renewed were shorter than in lower abdominal patients.

Effect of volume preloading to prevent hypotension associated with epidural block combined general anesthesia / 中国基层医药

Objective To compare the effects of volume preloading with crystalloid and colloid fluid to prevent hypotension associated with thoracic epidural block combined general anesthesia.Methods Ninety ASA Ⅰ～Ⅱ grade patients,scheduled for elective upper abdominal surgery,were randomly allocated to three groups(30 patients in each group).A,B and C group respectively received 1000ml lactated Ringer's solution,500ml and 1000ml polygeline injection for volume preloading in 40min before general anesthesia induction.During volume preloading,epidural catheter was placed at T_ 8～9 and blocked with mixed solution of 1.6% lidocaine and 0.2% dicaine.Results Systolic blood pressure(SBP) and diastolic blood pressure(DBP) were significantly lower in group A and B than those in group C after epidural block,general anesthesia induction and intubation(P