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1.
Cancer Research and Clinic ; (6): 6-10, 2024.
Artigo em Chinês | WPRIM | ID: wpr-1030405

RESUMO

Objective:To investigate the efficacy of sintilimab combined with paclitaxel and docetaxel in the treatment of advanced non-small cell lung cancer (NSCLC).Methods:Prospective cohort study was performed. A total of 90 patients with advanced NSCLC receiving second-line treatment in Baotou Cancer Hospital from October 2019 to October 2022 were prospectively selected. All patients were divided into the study group (sintilimab combined with paclitaxel and docetaxel as second-line treatment, 45 cases) and the control group (paclitaxel or docetaxel alone, 45 cases) according to random number table method. The short-term efficacy, serum cytokine levels, quality of life and T-cell subsets of the two groups were compared. The survival of patients within 6 months was followed up. Kaplan-Meier method was used to analyze the overall survival (OS) of both groups, and log-rank test was used to make comparison among groups.Results:There were 25 males (55.56%) in the study group with the age of (63±5) years and 28 males (62.22%) in the control group with the age of (65±6) years. There were no statistically significant differences in the gender, age, Eastern Cooperative Oncology Group scores, the body mass (all P>0.05). The total effective rate was 88.89% (40/45) in the study group and 71.11% (32/45) in the control group, and the difference was statistically significant ( χ2 = 4.44, P = 0.035). The levels of serum vascular endothelial growth factor (VEGF) and carbohydrate antigen 125 (CA125) of both groups after treatment were lower than those before treatment (all P<0.001); the levels of VEGF and CA125 in the study group after treatment were lower than those in the control group [VEGF: (223±15) pg/ml vs. (289±15) pg/ml, t=20.82, P<0.001;CA125: (23±6) ng/ml vs. (75±4) ng/ml, t=51.28, P<0.001].Quality of life scale score, Karnofsky score of both groups after treatment were higher than those before treatment (all P<0.05); quality of life scale score and Karnofsky score in the study group after treatment were higher than those in the control group [quality of life scale score: (63±6) scores vs. (51±5) scores, t=10.29, P<0.001; Karnofsky score: (80.5±5.7) scores vs.(78.8±3.7) scores, t=1.70, P=0.041]. T-cell subsets indicators of both groups after treatment were higher than those before treatment (all P<0.001). T-cell subsets indicators in the study group after treatment were higher than those in the control group [CD3 + cell proportion: (68±5)% vs. (65±5)%, t=2.52, P = 0.014; CD4 + cell proportion:(42.5±1.7)% vs. (36.5±3.7)%, t=9.91, P<0.001;CD4 +/CD8 +: 1.78±0.54 vs. 1.46±0.27, t=3.56, P<0.001]. There was no significant difference in the incidence of adverse reactions between the two groups [11.11% (5/45) vs. 15.55% (7/45), χ2=0.39, P=0.534]. The follow-up time was 6 months. The OS in the study group was better than that in the control group ( χ2=3.86, P = 0.044). Conclusions:Sintilimab combined with taxoid chemotherapy drugs is effective in the second-line treatment of advanced NSCLC, and it improves immune function and shows a favorable safety.

2.
Artigo em Chinês | WPRIM | ID: wpr-1028531

RESUMO

Objective:To evaluate the interaction between remimazolam and propofol for sedation during hysteroscopy.Methods:American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients, aged 20-45 yr, with body mass index of 18-28 kg/m 2, scheduled for elective hysteroscopy, were included. The test was conducted in two steps. Up-and-down sequential allocation was used to determine the median effective dose (ED 50) of remimazolam (group A) and propofol (group B). The ED 50 obtained in A and B groups were then used as the standard to determine the combination regimen in group C (0.25×ED 50 of remimazolam+ 0.75×ED 50 of propofol as the initial dose), in group D (0.5×ED 50 of remimazolam+ 0.5×ED 50 of propofol as the initial dose), and in group E (0.75×ED 50 of remimazolam+ 0.25×ED 50 of propofol as the initial dose). Up-and-down sequential allocation was used to determine the ED 50 of propofol when propofol and remimazolam were combined in C, D and E groups. The interaction between the sedative effects of two drugs was analyzed using the isobolographic analysis method, and the interaction coefficient and synergistic dose ratio of two drugs were calculated. Results:The ED 50 of remimazolam was 0.180 mg/kg in group A, and the ED 50 of propofol was 1.167 mg/kg in group B. The results of isobolographic analysis showed that remimazolam and propofol had a synergistic effect. When remimazolam 0.045, 0.090 and 0.135 mg/kg were combined with propofol 0.546, 0.288 and 0.160 mg/kg, the interaction coefficients were 1.393, 1.339 and 1.127 respectively. The synergistic dosage ratio of remimazolam and propofol was 1.0∶(3.2 to 12.0). Conclusions:Remimazolam and propofol have a synergistic effect on sedation when used for hysteroscopy, and the dose ratio is 1.0∶(3.2-12.0).

3.
Chinese Journal of Anesthesiology ; (12): 1445-1450, 2023.
Artigo em Chinês | WPRIM | ID: wpr-1028483

RESUMO

Objective:To compare the efficacy of different drugs in reducing incidence of emergence agitation after tonsillectomy and adenoidectomy in the pediatric patients.Methods:Cochrane Library, PubMed, Web of Science, EMBASE, China National Knowledge Infrastructure, Wanfang and Chinese Biomedical Literature Databases were searched from inception to July 2023 for the randomized controlled trials involving interventions to reduce the incidence of emergence agitation after tonsillectomy and adenoidectomy in pediatric patients. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias in the included studies. STATA 17.0 software was used to conduct a network meta-analysis according to the frequency-ology framework.Results:Twenty randomized controlled trials were finally included, involving 1 687 patients. Compared with placebo, 10 interventions could reduce the incidence of emergence agitation in pediatric patients after tonsillectomy and adenoidectomy, and the order of probability was as follows: dexmedetomidine ( OR and 95% confidence interval [ CI] 0.13 [0.09-0.20]), ketamine ( OR and 95% CI 0.15 [0.08-0.26]), clonidine ( OR and 95% CI 0.15 [0.05-0.50]), tramadol ( OR and 95% CI 0.16 [0.04-0.61]), remazolam ( OR and 95% CI 0.17 [0.06-0.47]), afentanil ( OR and 95% CI 0.22 [0.08-0.62]), remifentanil ( OR and 95% CI 0.24 [0.12-0.48]), desocine ( OR and 95% CI 0.29 [0.12-0.69]), fentanyl ( OR and 95% CI 0.31 [0.19-0.52]) and propofol ( OR and 95% CI 0.46 [0.24-0.86]). Four interventions cloud reduce the usage rate of postoperative rescue drugs, and the probability was ranked as follows: dexmedetomidine ( OR and 95% CI 0.19 [0.11-0.32]), tramadol ( OR and 95% CI 0.20 [0.10-0.42]), ketamine ( OR and 95% CI 0.49 [0.28-0.86]) and fentanyl ( OR and 95% CI 0.49 [0.32-0.77]). One intervention cloud reduce the incidence of postoperative nausea and vomiting: dexmedetomidine ( OR and 95% CI 0.54 [0.31-0.94]). Conclusions:Dexmedetomidine provides the best effect in reducing the incidence of emergence agitation after pediatric tonsillectomy and adenoidectomy.

4.
Artigo em Chinês | WPRIM | ID: wpr-994220

RESUMO

Objective:To evaluate the role of α7 nicotinic acetylcholine receptor (α7nAChR) in penehyclidine hydrochloride-induced reduction of endotoxin-induced acute lung injury (ALI) in mice.Methods:Forty SPF healthy male C57BL/6 mice, aged 6-8 weeks, weighing 18-25 g, were divided into 4 groups ( n=10 each) using a random number table method: control group (group C), ALI group, penehyclidine hydrochloride group (PHC group), and α7nAChR inhibitor MLA group (MLA group). ALI was induced by intraperitoneal injection of lipopolysaccharide 15 mg/kg in anesthetized animals, while normal saline was given instead in group C. In PHC group, penehyclidine hydrochloride 2 mg/kg was intraperitoneally injected at 30 min before developing the model. MLA 10 mg/kg was intraperitoneally injected at 10 min before administration of penehyclidine hydrochloride in MLA group. Mice were sacrificed at 6 h after lipopolysaccharide administration, and lung tissues were collected for microscopic examination of the pathological changes (by HE staining) and for determination of the wet/dry weight ratio (W/D ratio), content of tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β) and IL-10 (by enzyme-linked immunosorbent assay) and expression of α7nAChR (by Western blot). Results:Compared with C group, the W/D ratio and contents of TNF-α and IL-1β were significantly increased, the content of IL-10 was decreased, and the expression of α7nAChR was up-regulated in ALI, PHC and MLA groups ( P<0.05). Compared with ALI group, the W/D ratio and contents of TNF-α and IL-1β were significantly decreased, the content of IL-10 was increased, and the expression of α7nAChR was up-regulated in PHC group ( P<0.05). Compared with PHC group, the W/D ratio and contents of TNF-α and IL-1β were significantly increased, the content of IL-10 was decreased, and the expression of α7nAChR was down-regulated in MLA group ( P<0.05). Compared with ALI group, the pathological changes of lung tissues were significantly mitigated in PHC group, while this effect of PHC was partially reversed by α7nAChR inhibitor MLA. Conclusions:α7nAChR is involved in penehyclidine hydrochloride-induced reduction of endotoxin-induced ALI in mice.

5.
Artigo em Chinês | WPRIM | ID: wpr-1019808

RESUMO

Objective To investigate the correlation between TCM syndrome types and solar term of onset in patients with gastric cancer.Methods A total of 359 patients with gastric cancer admitted to the Cancer Center of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2020 to August 2023 were included in this study,and the frequency distribution method was used to analyze their information such as sex,age,solar term of onset,differentiation,metastasis and TCM syndrome type.The solar term of onset corresponding to the onset date was calculated,and then the association between solar term of onset and TCM syndrome type in gastric cancer was analyzed.The circular distribution method was used to explore the peak of solar term of onset and TCM syndrome type.Results Among the 359 patients with gastric cancer included in this study,male patients were more than female patients(1.69∶1).The age of onset was mainly between 60 and 70 years old(117 cases,32.6%),and male patients(85 cases,72.6%)were more than female patients(32 cases,27.3%)in this age group.The most common TCM syndromes were qi and blood deficiency syndrome(160 cases,44.6%)and phlegm damp condensation syndrome(94 cases,26.2%).The onset of the disease mainly occurred in winter(132 cases,36.8%),and the peaks were light snow(31 cases,23.5%),major cold(25 cases,18.9%),heavy snow(23 cases,17.4%)and the start of winter(22 cases,16.7%).Qi and blood deficiency syndrome and phlegm damp condensation syndrome in patients with gastric cancer were correlated with solar terms and seasons(P<0.05).The 285 patients with gastric cancer were mainly poorly differentiated gastric cancer(175 cases,61.4%),mainly concentrated in winter(66 cases,37.7%).The main route of gastric cancer metastasis is lymph node metastasis,followed by liver and abdominal cavity metastasis.Conclusion Qi and blood deficiency syndrome and phlegm dampness condensation syndrome are common in patients with gastric cancer.The onset time of gastric cancer is mostly in winter,and the syndrome type is significantly correlated with the onset solar term and differentiation degree.

6.
Chinese Journal of Anesthesiology ; (12): 1108-1111, 2022.
Artigo em Chinês | WPRIM | ID: wpr-957575

RESUMO

Objective:To evaluate the role of Toll-like receptor 4 (TLR4) in the mechanism by penehyclidine hydrochloride alleviating lipopolysaccharide (LPS)-induced acute lung injury(ALI)in rats.Methods:Twenty-four healthy male Sprague-Dawley rats, aged 10 weeks, weighing 220-250 g, were divided into 4 groups ( n=6 each) according to the random number table method: normal saline group (NS group), endotoxin-induced ALI group (ALI group), penehyclidine hydrochloride + normal saline group (PHC+ NS group) and penehyclidine hydrochloride + endotoxin-induced ALI group (PHC+ ALI group). ALI was induced by intratracheal instillation of LPS 5 mg/kg in anesthetized animals. In group PHC+ ALI, penehyclidine hydrochloride 2 mg/kg was intraperitoneally injected immediately after intratracheal instillation of LPS. The equal volume of normal saline was injected into the airway in group NS, and penehyclidine hydrochloride 2 mg/kg was intraperitoneally injected immediately after intratracheal instillation of normal saline in group PHC+ NS. The rats were sacrificed at 6 h after intratracheal instillation of LPS or normal saline, and lungs were removed. The lung was lavaged and broncho-alveolar lavage fluid (BALF) was collected for determination of concentrations of tumor necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1β) by enzyme-linked immunosorbent assay. Lung tissues were obtained for microscopic examination of the pathological changes (with a light microscope) and for determination of wet to dry lung weight ratio (W/D ratio) and TLR4 protein and mRNA expression (by immuno-histochemistry or real-time polymerase chain reaction). Results:Compared with group NS and group PHC+ NS, the W/D ratio and concentrations of TNF-α and IL-1β in BALF were significantly increased, the expression of TLR4 protein and mRNA in lung tissues was up-regulated ( P<0.01), and the pathological changes of lung tissues were aggravated in group ALI . Compared with group ALI, the W/D ratio and concentrations of TNF-α and IL-1β in BALF were significantly decreased, the expression of TLR4 protein and mRNA in lung tissues was down-regulated ( P<0.01), and the pathological changes of lung tissues were significantly mitigated in group PHC+ ALI. Conclusions:The mechanism by which penehyclidine hydrochloride reduces endotoxin-induced lung injury may be related to reduction of TLR4 activity and thus inhibition of pulmonary inflammatory responses in rats.

7.
Artigo em Chinês | WPRIM | ID: wpr-911211

RESUMO

Objective:To systematically compare the efficacy of different drugs in alleviating remifentanil-induced hyperalgesia.Methods:Databases such as PubMed, Cochrane Library, EMBASE, Web of Science, CNKI, Wanfang Data and CBM were searched using computers from inception to May 2020.The randomized controlled trials comparing the efficacy of different intervention measures for alleviating remifentanil-induced hyperalgesia were searched.After independently identifying the literature, the two reviewers conducted data extraction and evaluated the bias of the included studies, and Stata 14.0, ADDIS 1.16.5 and R4.0.2 softwares were used to analyze the data.Results:Thirty randomized controlled trials were included in our study.Compared with placebo, 3 out of 6 drugs could alleviate remifentanil-induced hyperalgesia, and the probability order for the effect was as follows: butorphanol with MD value (95% CI)-1.50 (-2.80, -0.24), dexmedetomidine with MD value (95% CI)-1.20 (-2.40, -0.09) and ketamine with MD value (95% CI) -0.88 (-1.60, -0.16). After sensitivity analysis, the efficacy of butorphanol remained to be verified.Two drugs could decrease the dosage of opioids within 24 h after operation, and the probability order for the effect was as follows: dexmedetomidine with MD value (95% CI) -14.00 (-28.00, -0.19) and ketamine with MD value (95% CI) -9.20 (-18.00, -0.08). One drug could decrease the incidence of postoperative nausea and vomiting within 24 h after operation: dexmedetomidine with RR value (95%CI) 0.28 (0.16, 0.22). Conclusion:The results of network meta-analyses show that dexmedetomidine has the best efficacy in alleviating remifentanil-induced hyperalgesia.

8.
Chinese Journal of Endemiology ; (12): 805-809, 2020.
Artigo em Chinês | WPRIM | ID: wpr-866208

RESUMO

Objective:To investigate the status of removing iodized salt, water iodine, and iodine nutrition of children in water source high iodine areas in Taiyuan City, Shanxi Province, so as to provide basis for the implementation of prevention and control measures in high iodine areas according to local conditions.Methods:From 2012 to 2017, four administrative villages were selected from each of the high iodine townships in the water source high iodine areas (Qingxu County and Xiaodian District) in Taiyuan City, and 15 households in each administrative village were sampled for salt iodine detection by semi quantitative method. According to the "National Monitoring Program for Water Source High Iodine Areas (Trial)" (2012 edition), 1-2 high iodine villages were selected respectively in Qingxu County and Xiaodian District every year as monitoring sites, and grouped by water iodine of 150-300 μg/L and > 300 μg/L. If the monitoring site had been implemented the water improvement project, one tap water sample shall be collected. Whereas, if the monitoring site had not been implemented the water improvement project, two drinking water samples shall be collected from each household in the five directions of east, west, south, north and middle, and the water iodine shall be detected using the "Research on Methods for Water Iodine Testing in Iodine Deficiency and High Iodine Areas" recommended by the National Iodine Deficiency Disorders Reference Laboratory of the Chinese Center for Disease Control and Prevention. A total of 100 children aged 8-10 years old were selected from village primary schools or central primary schools in townships where the monitoring sites were located, and their thyroid volume was detected by B-ultrasound; urine samples were taken from more than 30 children and urinary iodine was detected by arsenic-cerium catalytic spectrophotometry.Results:From 2012 to 2017, the rate of non-iodized salt in Qingxu County ranged from 91.7% (165/180) to 96.1% (173/180); the rate of non-iodized salt in Xiaodian District were all 100.0% (120/120). A total of 52 water samples were tested, and the median water iodine was 282.3 μg/L, ranged from 121.1 to 546.3 μg/L. A total of 1 401 children's thyroid were examined, and the goiter rate was 7.5% (105/1 401). A total of 597 children's urine samples were tested, and the median urinary iodine was 458.1 μg/L, ranged from 21.0 to 1 778.7 μg/L. The median urinary iodine (327.1 μg/L) and goiter rate (4.9%, 34/697) of children in the 150-300 μg/L water iodine group were compared with those in the > 300 μg/L water iodine group (552.9 μg/L; 10.1%, 71/704), the differences were statistically significant ( Z = - 8.934, χ 2 = 13.698, P < 0.01). Conclusions:From 2012 to 2017, the median water iodine is 282.3 μg/L in water source high iodine areas in Taiyuan City, the status of removing iodized salt is good (the rate of non-iodized salt > 90%). However, children have excessive iodine (median urinary iodine ≥300 μg/L) and goiter rate (> 5%). It is suggested that the main measures should be taken to improve water quality and reduce iodine content in drinking water in water source high iodine areas, continuously monitor water iodine, and timely adjust the prevention and control measures according to the change of water iodine.

9.
Artigo em Chinês | WPRIM | ID: wpr-869977

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Objective:To evaluate the optimized efficacy of sevoflurane inhalation combined with caudal ropivacaine for abdominal surgery in low birth weight neonates.Methods:Eighty low birth weight neonates of either sex, with gestational age<37 weeks, weighing 1.5-2.5 kg, of American Society of Anesthesiologists physical statusⅡorⅢ, scheduled for elective laparotomy, were divided into 2 groups ( n=40 each) using a random number table method: sevoflurane combined with caudal block with ropivacaine group (SCB group) and sevoflurane plus remifentanil group (SR group). Anesthesia was induced and maintained with sevoflurane inhalation in the two groups.Caudal anesthesia was performed with 0.2% ropivacaine 1 ml/kg in the left lateral position after successful intubation in group SCB.Cis-atracurium 0.1 mg/kg was given, and remifentanil was infused at 0.5 μg·kg -1·min -1 in group SR.Inhaling sevoflurane was stopped at the end of operation in the two groups, and rescue analgesia was performed when the FLACC score was greater than 3 within 6 h after operation.The operation time, emergence time, extubation time, and duration of postanesthesia care unit (PACU) stay were recorded.The occurrence of adverse reactions during the emergence period and PACU stay and requirement for rescue analgesia within 6 h after surgery were recorded.The complications of caudal block were recorded in group SCB. Results:There was no significant difference in the operation time between the two groups ( P>0.05). Compared with group SR, the emergence time, extubation time, and duration of PACU stay were significantly shortened, and the incidence of adverse reactions during the emergence period and PACU stay and requirement for rescue analgesia within 6 h after surgery were decreased in group SCB ( P<0.05). The caudal block-related complications were not found in group SCB. Conclusion:Sevoflurane combined with caudal ropivacaine can be used as an optimized strategy helpful for the quality of anesthesia recovery in low birth weight newborns undergoing abdominal surgery.

10.
Chinese Journal of Anesthesiology ; (12): 1002-1005, 2020.
Artigo em Chinês | WPRIM | ID: wpr-869987

RESUMO

Objective:To evaluate the efficacy of ultrasound-guided sacral canal block for anesthesia in neonatal anoplasty.Methods:Sixty neonats with anal atresia, of American Society of Anesthesiology physical status ⅠorⅡ, were divided into 2 groups ( n=30 each) by a random number table method: traditional positioning method for sacral canal block group (group T) and ultrasound-guided sacral canal block group (group U). After successful puncture, 0.2% ropivacaine 1 ml/kg was injected in both groups.The success of puncture at first attempt, puncture time, successful sacral canal block and occurrence of adverse reactions were recorded. Results:Compared with group T, the success rate of puncture at first attempt was significantly increased, the puncture time was shortened ( P<0.05), and no significant change was found in the success rate of sacral canal block in group U ( P>0.05). Neonatal sacrococcygeal contents and the termination of the neonatal dural sac were observed under ultrasound in group U. Blood return in the puncture needle was observed in one case in group T, and no adverse reactions were found in group U. Conclusion:Ultrasound-guided sacral canal block provides better efficacy than the traditional sacral canal block when used for anesthesia in neonatal anoplasty.

11.
Artigo em Chinês | WPRIM | ID: wpr-869901

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Objective:To evaluate the role of microRNA-21 (miR-21) in sepsis-induced lung injury and the relationship with transient receptor potential melastatin 2 (TRPM2) expression in rats.Methods:Forty-eight clean-grade Wistar rats, half male and half female, weighing 250-300 g, were divided into 4 groups ( n=12 each) by a random number table method: sham operation group (SH group), sepsis group (S group), miR-21 inhibitor group (group MI), and miR-21 inhibitor plus TRPM2 blocker Gd3 + group.Sepsis was induced by cecal ligation and puncture (CLP) in anesthetized rats.In MI group and MIG group, miR-21 inhibitor and miR-21 inhibitor plus TRPM2 blocker Gd3 + were injected through the tail vein, respectively, at 12 h before CLP.Carotid artery blood samples were collected at 24 h after CLP for blood gas analysis, PaO 2 was recorded, and oxygenation index was calculated.Animals were sacrificed, and lung tissues were removed for microscopic examination of the pathological changes which were scored and for determination of wet to dry weight ratio (W/D ratio), expression of miR-21 and TRPM2 mRNA (quantitative real-time polymerase chain reaction), levels of malondialdehyde (MDA) and superoxide dismutase (SOD) (by spectrophotometer colorimetry) and levels of interleukin-6 (IL-6), IL-8 and tumor necrosis factor-alpha (TNF-α) in serum (by enzyme-linked immunosorbent assay). Results:Compared with group SH, the oxygenation index and SOD activity were significantly decreased, and W/D ratio, lung injury score, MDA content, serum IL-6, IL-8 and TNF-α concentrations were increased in the other three groups, and the expression of miR-21 mRNA was up-regulated, and the expression of TRPM2 mRNA was down-regulated in group S ( P<0.05). Compared with group S, the oxygenation index, SOD activity and serum IL-6, IL-8 and TNF-α concentrations were significantly increased, and W/D ratio, lung injury score and MDA content were decreased in group MI, and the expression of miR-21 mRNA was down-regulated, and the expression of TRPM2 mRNA was up-regulated in MI and MIG groups ( P<0.05). Compared with group MI, the oxygenation index and SOD activity were significantly decreased, W/D ratio, lung injury score, MDA content, serum IL-6, IL-8 and TNF-α concentrations were increased, and the expression of TRPM2 mRNA was down-regulated in group MIG ( P<0.05). Conclusion:Up-regulated expression of miR-21 and down-regulated expression of TRPM2 are involved in the process of sepsis-induced lung injury in rats.

12.
Artigo em Chinês | WPRIM | ID: wpr-709743

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Objective To investigate the efficacy of dexmedetomidine in preventing postoperative delirium in elderly patients undergoing laparoscopic radical resection for cervical cancer. Methods Eighty American Society of Anesthesiologists physical status Ⅱor Ⅲ patients, aged 65-75 yr, weighing 45-80 kg, scheduled for elective laparoscopic radical resection for cervical cancer, were divided into 2 groups (n= 40 each) using a random number table: dexmedetomidine group (group D) and routine group (group R). Dexmedetomidine was infused at a rate of 0. 5 μg·kg-1 ·h-1 after anesthesia induction until the end of operation in group D, while the equal volume of normal saline was given instead in group R. Delirium rating scale was used to assess the development of delirium within 3 days after operation. Blood samples were collected from the jugular bulb before anesthesia induction (T0 ), at the end of operation (T1 ) and at 1, 6 and 24 h after operation (T2-4 ) to determine the serum concentrations of S100β protein, neuron-spe-cific enolase, tumor necrosis factor-alpha and interleukin-1beta (IL-1β) by enzyme-linked immunosorbent assay. Results Compared with group R, the incidence of postoperative delirium was significantly de-creased (38%∕2%), the serum concentrations of S100β protein, neuron-specific enolase, tumor necrosis factor-alpha and IL-1β were decreased at T1-4 , and the serum concentrations of IL-1β protein were de-creased at T2-4 in group D (P<0. 05). Conclusion Infusing dexmedetomidine at 0. 5 μg·kg-1 ·h-1 from the end of anesthesia induction until the end of operation can effectively prevent the development of delirium following laparoscopic radical resection for cervical cancer, and the mechanism is related to inhibiting in-flammatory responses and reducing brain injury in elderly patients.

13.
Artigo em Chinês | WPRIM | ID: wpr-607847

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Objective To investigate the application value of Calot triangle hollowing-out maneuver in laparoscopic cholecystectomy (LC) for preventing bile duct injury.Methods The retrospective cross-sectional study was conducted.The clinical data of 537 patients who underwent LC in the Dexing People's Hospital between January 2011 and December 2015 were collected.The tissues in Calot triangle were hollowed out,and cystic ducts were cut off and then gall bladders were resected.Observation indicators:(1) operation situations:anatomy of the Calot triangle and operation time;(2) postoperative recovery situations:postoperative complications and bile duct injury;(3) follow-up situation.The follow-up using outpatient examination and telephone interview was performed to detect the survival of patients and occurrence of cholangitis up to May 2016.Results (1) Operation situations:of 537 patients with LC,anatomical relation among cystic duct,common hepatic duct and common bile duct (three-duct relation for short) could be seen in 165 patients without dissection,and three-duct relation cannot be seen in other 372 patients.Of 372 patients,16 were operated on with the gallbladder open due to the difficult dissection of Calot triangle,7 were converted to open surgery due to local severe adhesion and unclear structure,1 was converted to open surgery due to intraoperative varices induced bleeding in Calot triangle,and other 348 patients underwent successful LC using Calot triangle hollowing-out maneuver.Operation time was 15-190 minutes,with an average time of 28 minutes.(2) Postoperative situations:2 patients were complicated with biliary colic pain,showing stones in the distal common bile duct via magnetic resonance imaging scans,and then received endoscopic sphincterotomy (EST);3 had subxyphoid puncture hole infection,1 had a small amount of postoperative bleeding due to hepatocirrhosis,3 had pulmonary infection,and they were improved by symptomatic treatment;1 had chylous fistula and were improved through drainage and low fat diet intake for 1 week;2 with mild bile leakage was improved through peritoneal drainage.No bile duct injury was detected.(3) Follow-up situation:348 patients were followed up for 12-18 months,with a median time of 16 months.During the followup,348 patients with follow-up had survival without manifestation of cholangitis.Conclusion Calot triangle hollowing-out maneuver could effectively prevent bile duct injury in LC.

14.
Artigo em Chinês | WPRIM | ID: wpr-465276

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BACKGROUND:Pulsed laser deposition synthesis technology has been used to prepare new nano-hydroxyapatite thin film coating by colagen deposition on artificial mechanical heart valve. OBJECTIVE: To investigate the toxicity of new nano-hydroxyapatite thin film on human umbilical vein endothelial cels. METHODS: Human umbilical vein endothelial cels were cultured with nano-hydroxyapatite film room-temperature leaching solution, nano-hydroxyapatite film high-temperature leaching solution, high-density polyethylene and phenol solution. Within 72 hours, cel growth was observed under the inverted phase contrast microscope. At 7 days after culture, cel proliferation and toxicity grading were detected using Cel Counting Kit-8. RESULTS AND CONCLUSION:At 24 hours after culture, cels grew wel, showed fusiform shape, and had strongrefraction in the nano-hydroxyapatite film room-temperature leaching solution, nano-hydroxyapatite film high-temperature leaching solution, high-density polyethylene groups, and no significant differences in cel morphology and number were detected among above groups. Cels in the phenol solution group were suspended, round, pyknotic and dead. At 48 hours, except phenol solution group, cel number increased significantly, and cel grew densely in other three groups. At 72 hours, cels grew strongly, and the gap became smal obviously. Within 7 days after culture, cel proliferation activity was not significant in the nano-hydroxyapatite film room-temperature leaching solution, nano-hydroxyapatite film high-temperature leaching solution, and high-density polyethylene groups, which was significantly higher than in the phenol solution group (P < 0.05). The toxicity of nano-hydroxyapatite film graded 0 to 1. These results suggested that nano-hydroxyapatite artificial mechanical heart valve has good histocompatibility, but no toxicity.

15.
Artigo em Chinês | WPRIM | ID: wpr-465639

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BACKGROUND:A new type of nano-hydroxyapatite artificial mechanical heart valve has been developed using pulsed laser deposition technology at the Department of Materials, Hefei University and Anhui Institute of Optics and Fine Mechanics, Chinese Academy of Sciences, China. OBJECTIVE:To investigate the compatibility of nano-hydroxyapatite artificial mechanical heart valve with human umbilical vein endothelial cels. METHODS:Human umbilical vein endothelial cels were in vitroisolated, cultured and passaged to the 2-4 generations, and then the cel suspension was inoculated onto the nano-hydroxyapatite artificial mechanical heart valve. After 3, 7, 12 days of culture, the cel growth on the artificial mechanical heart valve was observed under scanning electron microscope. In addition, the human umbilical vein endothelial cels were respectively cultured in room-temperature and high-temperature extract liquids of nano-hydroxyapatite artificial mechanical heart valve, high-density polyethylene and phenol solution extracts for 72 hours, and then, the proliferation of cels was detected by MTT method. RESULTS AND CONCLUSION:Under the scanning electron microscope, the human umbilical vein endothelial cels were fusiform- or polygon-shaped with protuberances adhered to the artificial mechanical heart value at 3 days of culture; the cels were stretched thoroughly and fused at 7 days of culture; and the cels were confluent to pieces that tightly overlaid the heart valve surface and the extracelular matrix was formed localy at 21 days of culture. Results from MTT test displayed that the nano-hydroxyapatite artificial mechanical heart valve had no cytotoxicity to the human umbilical vein endothelial cels, indicating a good cytocompatibility.

16.
Artigo em Chinês | WPRIM | ID: wpr-470731

RESUMO

Objective To investigate the effect of penehyclidine hydrochloride on endotoxemiainduced intestinal injury in neonatal rats.Methods Ninety healthy neonatal Sprague-Dawley rats,aged 7days,weighing 16-20 g,were randomly divided into 3 groups (n =30 each) using a random number table:control group (group C),lipopolysaccharide (LPS) group,and penehyclidine hydrochloride group (group P).Endotoxemia was induced by intraperitoneal LPS 5 mg/kg in LPS and P groups.In group P,penehyclidine 2 mg/kg was injected intraperitoneally at 30 min before and after LPS injection.The equal volume of normal saline was given in group C.At 2,6 and 12 h after LPS or normal saline administration,10 rats in each group were randomly chosen and sacrificed.The ileum was removed to detect wet/dry lung weight ratio (W/D ratio) and contents of tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),hypoxia-inducible factor 1 alpha (HIF-1α) and glutamine (Gln),and for examination of the pathologic changes of the ileum with light microscope.Results Compared with group C,the W/D ratio and contents of TNF-α,IL-6 and HIF-1α were significantly increased,and the content of Gln was decreased at each time point in LPS and P groups.Compared with group LPS,the W/D ratio and contents of TNF-α,IL-6 and HIF-1α were significantly decreased,the content of Gin was increased at each time point,and the pathologic changes of the ileum were mitigated in group P.Conclusion Penehyclidine hydrochloride can reduce endotoxemia-induced intestinal injury in the neonatal rats,and down-regulated expression of HIF-1α,up-regulated expression of Gln and attenuated inflammatory responses may be involved in the mechanism.

17.
Artigo em Chinês | WPRIM | ID: wpr-455708

RESUMO

Objective To evaluate the effects of sevoflurane pretreatment on the expression of interleukin-17 (IL-17) in rats with lipopolysaccharide (LPS)-induced acute lung injury.Methods Thirty-two adult male Sprague-Dawley rats,weighing 220-260 g,aged 2 months,were randomly divided into 4 groups (n =8 each):control group (group C),sevoflurane group (group S),LPS group (group L) and sevoflurane + LPS group (group SL).ALI was induced by slow intra-tracheal instillation of LPS 5 mg/kg in L and SL groups,while the equal volume of normal saline was administered in the same way in the other two groups.The rats inhaled 2.4 % sevoflurane for 30 min,and then normal saline and LPS were given in S and SL groups,respectively.The rats were sacrificed at 12 h after administration of LPS.The left main bronchus was lavaged and broncho-alveolar lavage fluid (BALF) was collected for determination of white blood cell (WBC) and polymorphonuclear leukocyte (PMN) counts.The right lung was removed for microscopic examination by using light microscope and for determination of -L-17 mRNA and protein expression in the right lung tissues.Results Compared with group C,WBC and PMN counts were significantly increased,and IL-17 mRNA and protein expression was up-regulated in L and SL groups.Compared with group L,WBC and PMN counts were significantly decreased,and IL-17 mRNA and protein expression was down-regulated in group SL.The pathological changes of lungs were significantly mitigated in group SL as compared with group L.Conclusion Sevoflurane pretreatment can reduce inflammatory reponses in rats with LPS-induced acute lung injury,and down-regulation of IL-17 expression in lung tissues is involved in the mechanism.

18.
Artigo em Chinês | WPRIM | ID: wpr-435621

RESUMO

Objective To evaluate the effect of dexmedetomidine on myocardial injury in infants undergoing repair of ventricular septal defect.Methods Forty ASA grade Ⅱ or Ⅲ infants,aged 3-6 months,weighing 4-6 kg,scheduled for elective repair of ventricular septal defect,were randomly divided into 2 groups (n =20each):control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with midazolam,etomidate,cisatracurium and sufenanil.The infants were mechanically ventilated after nasotracheal intubation.PET CO2 was maintained at 30-40 mm Hg,Anesthesia was maintained with cisatracurium,sufenanil and sevoflurane.In group D,dexmedetomidine was infused at 0.5 μg· kg-1 · h-1 until the end of operation.While in group C normal saline was given at the same rate until the end of operation.BP and HR were recorded at 10 min before operation (T1),skin incision (T2),chest opening (T3),10 min after aortic unclamping (T4) and the end of operation (T5).Blood samples were taken from the right internal jugular vein for determination of plasma creatine kinase MB (CK-MB) activity and cardiac troponin T (cTnT) concentrations at T1,T5 and 24 h after operation (T6).Results Compared with the baseline value at T1,no significant changes were found in HR and BP at different time points in group D,HR and BP were significanfly increased at T2-T5 in group C,and the plasma CK-MB ctivity and cTnT concentration were significantly increased at T5 and T6 in the two groups (P < 0.05).HR and BP at T2-5 and plasma CK-MB activity and cTnT concentration at T5 and T6 were significantly lower in group D than in group C (P <0.05).Conclusion Dexmedetomidine infused at 0.5 μg· kg-1 · h-1 after induction can reduce myocardial injury in infants undergoing repair of ventricular septal defect.

19.
Artigo em Chinês | WPRIM | ID: wpr-263913

RESUMO

<p><b>OBJECTIVE</b>To study the anti-cataract effect of gigantol combined with syringic acid and their action mechanism.</p><p><b>METHOD</b>H202-induced lens oxidative injury in vitro rat model was establish to observe the impact of gigantol combined with syringic acid on lens transparency under a dissecting microscope. D-galactose-induced cataract rat model was established to observe the impact of gigantol combined with syringic acid on lens transparency under a slit-lamp. UV spectrophotometry was adopted to detect the inhibitory activity of gigantol combined with syringic acid against AR. Molecular docking method was used to detect binding sites, binding types and pharmacophores of gigantol combined with syringic acid in prohibiting aldose reductase.</p><p><b>RESULT</b>Both in vitro and in vivo experiments showed a good anti-sugar cataract activity in the combination of gigantol and syringic acid and a better collaborative effect than single component-gigantol and syringic acid and positive control drug Catalin. Molecular docking and dynamic simulation showed their collaborative AR-inhibiting amino acid residue was Asn160 and the major acting force was Van der Waals' force, which formed common pharmacophores.</p><p><b>CONCLUSION</b>Gigantol combined with syringic acid shows good anti-cataract, their action mechanism is reflected in their good collaborative inhibitory effect on AR.</p>


Assuntos
Animais , Feminino , Humanos , Masculino , Ratos , Aldeído Redutase , Bibenzilas , Catarata , Tratamento Farmacológico , Sinergismo Farmacológico , Ácido Gálico , Farmacologia , Guaiacol , Farmacologia , Técnicas In Vitro , Cristalino , Ratos Wistar
20.
Chinese Journal of Neurology ; (12): 15-19, 2011.
Artigo em Chinês | WPRIM | ID: wpr-384813

RESUMO

Objective To observe the efficacy and the side-effects of sodium valproate (VPA) in patients with epilepsy in rural China. Methods Epilepsy patients were selected from rural areas of Tianmen in Hubei province and Tiandong county in Guangxi province according to the inclusion and exclusion criteria.Efficacy evaluation standard depending on the change of seizure frequency compared with the situation prior to entering the treatment group. Among the treated patients, no seizures, seizure reduced > 75%, seizure reduced 50%-75% sums for the total effective rate. Results All 607 patients with epilepsy were treated and followed up, the male were 395 (65. 1% ) female 212 (34. 9% ), and 579 patients were treated for 12 months. Patients with generalized tonic-clonic seizures were 517 (85.2%), absence seizures 20 (3. 3% )and the other types of seizures 70 (11.5% ) including simple partial seizures, tonic, clonic, myoclonic or atonic seizures etc. The completed control of seizures ( without any seizures) during the period after taking 3 months, 6 months, 12 months were 270 (45.5%), 249 (42. 3% ) and 238 (41.1%) respectively. The total effective rates in the three periods were 65.2% , 75.4% and 85.5% respectively. The 58 patients in the total group showed side-effects during the follow-up period, mainly including drowsiness, lethargy,fatigue, dizziness, headache and tremor. Nineteen patients (3. 1% ) quitted the treatment group.Conclusions The VPA is an effective antiepileptic drug and no more severe side-effects. It is the same as Phenobarbital and suitable to be used in rural areas of China.

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