Objective To explore the long-term effects of dexmedetomidine on the brain development in propofol-induced neonatal rats.Methods Thirty-five seven-day-old Sprague-Dawley rats of both genders,weighing 10-15 g,were randomly divided into seven groups (n =5) using a random number table:normal saline group (group N),intralipid group (group F),propofol 100 mg/kg group (group P),dexmedetomidine 75 μg/kg (group D),dexmedetomidine 25 μg/kg,50 μg/kg and 75μg/kg+propofol 100 mg/kg groups (groups PD25,PD50 and PD75),neonatal rats in each group were treated according to the corresponding dosing regimen.After fully awake,the rats were allowed to mature until postnatal week 9 and the spatial learning and memory capacities were tested by Morris water maze.The rats were sacrificed after the tests.Brain was sliced for determination of hippocampal apoptosis by TUNEL assays and the expression of postsynaptic density protein 95 (PSD95) by immunohistochemistry.Results Compared with group N,the escape latency was significantly prolonged,the times of platform crossing were significantly decreased,the hippocampal apoptosis ratio was significantly increased and the expression of PSD95 was significantly down-regulated in groups P,PD25 and PD50 (P＜0.05).Compared with group P,the escape latency was significantly shortened,the times of platform crossing were significantly increased and the hippocampal apoptosis were significantly decreased in groups PD50 and PD75 (P＜0.05),the expression of PSD95 was up-regulated in group PD75 (P＜0.05).Compared with group PD25,the escape latency was significantly shortened,the number of platform crossing was significantly increased and the hippocampal apoptosis were significantly decreased in groups PD50 and PD75 (P＜0.05),the expression of PSD95 was significantly up-regulated in group PD75 (P＜0.05).Compared with group PD50,the hippocampal apoptosis were significantly decreased,the expression of PSD95 was significantly up-regulated in group PD75 (P＜ 0.05).Conclusion The addition of dexmedetomidine 50,75 μg/kg attenuates propofol-induced neurocognitive impairment in neonatal rats after aducthood,partially by attenuating hippocampal apoptosis and upregulating the expression of PSD95.Dexmedetomidine alone was not neurotoxic to the developing brain.
Objective To investigate the optimal dose of dexmedetomidine （DEX） combined with sufentanil 0.3μg·kg-1 for anesthesia of radio frequency ablation（RFA）for liver cancer geriatrics.Methods Our study was a random,single blind one.Sixty patients of both sexes,males 53 and females 7,aged 65-84 years,BMI 18.1-35.4 kg/m2,falling into ASA physical statusⅡ orⅢ and Child-Pugh class A or B,scheduled for elective RFA for liver cancer,were randomly assigned into 3 groups（n =20 each）.All groups received different dose of DEX and 0.3μg/kg sufentanil infused 20 minutes before RFA surgery:group D1 (DEX 0.3μg·kg-1·h-1),group D2(DEX 0.5μg·kg-1·h-1),and group D3(DEX 0.7μg·kg-1·h-1).Ramsay sedation score were recorded at the following time points:patients entered into the operating room （T0）,20 minutes after DEX infused （T1）,ablation beginning（T2）,10 minutes after ablation beginning （T3） and the end of operation （T4）.Visual analogue scale（VAS）was recorded at T4,and 2,4,8,12 hours after the ablation respectively.The dosages of etomidate,nitroglycerin,urapidil,and naloxone were noted.The complications and side effects were also noted.The complications of intraoperative awareness,respiratory obstruction,puncture needle displacement,and submembrane hematoma of the liver,and the adverse reaction of hypertention,hypotension and tachycardia were recorded.Results Compare to T0,Ramsay sedation score of groups D2 and D3 at T2-T3 was increased significantly （P <0.05）.Compare to group D1,VAS of groups D2 and D3 at 2,4,8 hours after the ablation were decreased significantly （P < 0.05）.The dosage of etomidate,nitroglycerin,and urapidil in groups D2 and D3 were decreased significantly compare to group D1 （P <0.05）.Compare to group D2,the incidence of intraoperative awareness of group D1 were increased significantly（P < 0.05）,the dose of naloxone of group D3 （70.48±21.38μg）was increased significantly （P < 0.05）,the incidence of transient hypertension,bradycardia and respiratory depression of group D3 were increased significantly （P <0.05）.Conclusion The combination dexmedetomidine 0.5μg·kg-1·h-1 with sufentanil 0.3μg/kg can provide good conscious analgesia,reduce respiratory depression and adverse reactions is a reasonable clinical use for elderly patients under going RFA.
Objective To explore the effect of dexmedetomidine on phosphoinositide 3-kinase/protein kinase B (PI3K/Akt ) pathway in hippocampus of propofol anesthetized neonatal rats. Methods Eighty Sprague-Dawley male rats,aged 7 days,weighing 10-1 5 g,were randomly divided into 8 groups (n= 10 each):normal saline group (group N),DMSO group (group D),intralipid group (group I),propofol group (group P),dexmedetomidine 25 μg/kg,50 μg/kg and 75 μg/kg +propofol 100 mg/kg groups (groups PD25 ,PD50 and PD7 5 ),LY294002 25 μg + dexmedetomidine 75μg/kg + propofol 100 mg/kg group (group LYPD).The hippocampus of rats in all groups were taken 2 h after the animals fully awake.The ultrastructure of hippocampal neurons was observed by transmission electron microscope.The pAkt-(ser473 )protein and Akt protein in the hippocampus were evaluated by Western blot analysis.Results There was no significant difference in the expression of Akt protein among the eight groups.Compared with group N,the expression of pAkt (ser473)protein was significantly down-regulated in groups P,PD25 ,PD50 ,PD7 5 and LYPD (P <0.05).Compared with group P,the expression of pAkt (ser473)protein was increased significantly in groups PD7 5 and LYPD (P <0.05).Compared with group PD7 5 ,the expression of pAkt (ser473) protein was significantly down-regulated in group LYPD (P <0.05 ).The structure of hippocampal neurons was normal in groups N,I and D.Nuclear nuclei swelling,chromatin decreasing and mito-chondrion vacuolar degeneration were observed in group P while improved gradually with dexmedeto-midine in a dose-dependent manner in groups PD25 ,PD50 and PD7 5 .Neurons karyopyknosis,partial dissolution of nuclear membrane,chromatin condensation,mitochondria vacuolar degeneration were observed in group LYPD.Conclusion Dexmedetomidine pretreatment provides neuroprotection against propofol-induced hippocampal destruction by preserving PI3K/Akt pathway activity in the de-veloping brains.
Objective To investigate the effect of thoracic paravertebral nerve block on the treatment of refractory angina pectoris.Methods Sixty patients with definite diagnosis of refractory angina pectoris were recruited.They were divided into two groups in order of clinic time:blind paravertebral nerve block group(blind exploration group)and ultrasonic-guided paravertebral nerve block group(ultrasound guidance group),and 15 ml 0.375%ropivacaine was given by single-dose injection respectively at the treatment site in both groups.The effects of treatment were evaluated.The state of angina pectoris,SBP,HR before and 1,24 and 48hafter treatment were recorded.And the myocardial oxygen consumption index(SBP×HR)were calculated.Results Compared with the blind exploration group,the effective rate and total effective rate were significantly higher in ultrasound guidance group(P0.05).Compared with the treatment before,scores of number of angina pectoris attacks and duration,myocardial oxygen consumption index at 24 hafter treatment of the two groups were significantly lower,and that in ultrasound guidance group was significantly lower than that in the blind exploration group(P0.05).Conclusion The effects of thoracic paravertebral nerve block in the treatment of refractory angina pectoris were satisfying,and the outcome was better under ultrasonic guidance.
Objective To determine the Cp50 of propofol by target controlled infusion(TCI)combined with fentanyl in patients with obesity receiving painless colonoscopy.Methods Twentyseven male and twenty-eight female patients who undergoing painless colonoscopy under propofol TCI for sedation were assigned to group N(18.5kg/m2≤BMI24.0kg/m2)or group O(BMI≥28.0kg/m2).In both of the groups,the target plasma concentration of propofol was initially set at 3.0μg/ml and it could be adjusted with a level of 0.5μg/ml(sequential up-and-down methods)based on the physical responses to propofol in the previous patient receiving the same procedure.The Cp50 of propofol and its 95% confidence interval in both of groups were computed.Results When combined with fentanyl(1.0μg/kg),the Cp50 of propofol was 2.95μg/ml in group N and 2.83μg/ml in group O,with a 95% confidence interval of 2.68-3.24μg/ml and 2.62-3.05μg/ml,respectively.Conclusion TCI of propofol combined with 1.0μg/kg fentanyl during colonoscopy in patients with obesity is safe and effective,with the Cp50 of 2.83μg/ml.The Cp50 of propofol in obesity is reduced.
Objective To evaluate the effect of physostigmine on isflurane induced cognition deficit and inflammatory response as well as the expression of caspase-3in hippocampus in rats.Methods Eighty 2-month-old male Sprague-Dawley rats,weighing 280-320 g,were randomly assigned into 4groups(n=20):control group(group C),isoflurane group(group I),physostigmine plus isoflurane group(group PI),and physostigmine group(group P).Rats in group C inhaled a gas mixture of oxygen and air for 6hand rats in group I inhaled 1.4%isoflurane for 6h.Physostigmine100μg/kg was injected intraperitoneally every 8h,totally 3times in the group PI and group P.After the first injection,1.4%isoflurane was given to the rats in group PI,while same concentration of oxygen and air was given to the rats in group P for 6h.Blood samples were taken immediately after the end of anesthesia for blood gas analysis.The hippocampus was isolated 12 hafter the end anesthesia for determining the expression of TNF-α,IL-1β,IL-6and caspase-3mRNA.The pathological change in the pyramid cells of hippocampus was also examined.The cognitive function was assessed on the2 nd to 7th day after the end of anesthesia.Results There were no significant differences in arterial blood gas analysis,blood glucose level and the expression of TNF-αbetween four groups.When compared with group C and group P,the expression of IL-1β,and IL-6in group I and PI were increased,and the expression of caspase-3in group I and PI were up-regulated(P0.05).The escape latency on day 4-6in group I and group PI were prolonged,and the probe time was shortened(P0.05).The number of apoptosis cells was increased in group I and PT.When compared with group I,the expression of IL-1β,IL-6in group PI were decreased,while the expression of caspase-3was down-regulated(P0.05).The escape latency in group PI was shortened,and the probe time was prolonged(P0.05).The number of apoptosis cells in group PI was also decreased as compared with group I(P0.05).Conclusion Physostigmine can improve isoflurane induced cognitive function in adult rats,which may be related to inhibition of inflammatory response and neuron apoptosis in the hippocampus.
Objective To measure the dose requirement of propofol and the changes of Narcotrend index(NI)for loss of consciousness(LOC)in different age groups and to observe the correlation between age and propofol dose,and age and NI.Methods Patients of 3-70 years,scheduled for general surgery were divided into seven groups according to age,group G1(3-10yr),group G2(11-20yr),group G3(21-30yr),group G4(31-40yr),group G5(41-50yr),group G6(51-60yr)and group G7(61-70yr).20patients(10 male,10female)with normal BMI were enrolled in each group.Induction of anesthesia was done with a continuous intravenous infusion of propofol at 20mg·kg-1·h-1 and this infusion was stopped when the patients became unconscious.The time and dose of propofol required for LOC and changes in HR,MAP and NI before the infusion of propofol and after the LOC were recorded.Results The propofol requirement in group G1 was more than those in groups G2-G7 at LOC(P0.01),and groups G2-G4 were more than those groups G6 and G7(P0.05).The correlation coefficient between age and propofol dose required for LOC was negative(r=-0.566,P0.001).The time required for LOC was gradually shortened with increasing age.MAP and NI were significantly decreased at LOC than those before propofol infusion(P0.05),and NI in group G1 was higher than those in groups G2-G6(P0.05).The NI was different in different age groups at LOC and there was no significant correlation between age and NI(r=-0.082,P=0.289).Conclusion The time and dose of propofol required for LOC were decreased along with the increase of age.The changes of the NI were different in different age groups;the NI of LOC was higher in younger patients.
Objective To compare the effects of different doses of dexmedetomidine on the hemodynamic response of ephedrine on general anesthesia patients.Methods Sixty-six cases of patients undergoing elective orthopedics operations under general anesthesia(20-60 years old,50-75 kg,ASA grade:Ⅰ-Ⅱ)were randomly divided into three groups(n=22in each group):normal saline group(group C),low dose of dexmedetomidine group(group D1)and high dose dexmedetomidine group(group D2).Before induction of anesthesia,patients received continuous intravenous pumping of dexmedetomidine 0.4μg/kg in group D1 or 0.8μg/kg in group D2 for ten minutes and then 0.4μg·kg-1·h-1 prior to anesthesia induction.Group C was injected with equivalent normal saline.5min after laryngeal mask insertion,ephedrine 0.1 mg/kg were intravenous administered in all three groups.The heart rate,blood pressure of the patients after entering the operation room(T0),anesthesia before induction(T1),after induction(T2),after laryngeal mask insertion(T3),administration of ephedrine(T4)and the maximum(Tmax)value and time of heart rate and blood pressure in 10 minutes.The difference between Tmax and T4 values were expressed asΔSBP,ΔDBP and ΔHR.Results The TBPof groups D1 and D2 was significantly shorter than that in group C(P0.05).there was no statistical significance between the The THRof three groups of patients.The SBP,DBP,HR in groups D1 and D2was significantly lower than that in group C(P0.05),And the changes of the group D2 was significantly lower than that in the group D1(P 0.05).Conclusion Dexmedetomidine can enhance the pressor response of ephedrine and accelerate the onset time in general anesthiesa patients,and the pressor response of ephedrine with 0.8μg/kg loading dose of dexmedetomidine was stronger than that of 0.4μg/kg loading dose.
Objective To compare the effects of ultrasound-guided fascia iliaca compartment block of the single and multiple injection.Methods One hundred and twenty five patients undergoing hip replacement,ASA Ⅰ orⅡ,67 patients were male and 58 patients were female.Patients were randomized to receive ultrasound-guided fascia iliaca compartment block by single injection(control group,n=63)or multiple injection(experimental group,n=62).Local anesthetics using 150 mg ropivacaine combined with 7.5mg dexamethasone.Consumption of local anesthetics was 30 ml.We evaluated the onset time of sensory block and the success rate for block of the femoral nerve,the obturator nerve and the lateral femoral cutaneous nerve.Results The onset time of sensory block for the lateral femoral cutaneous nerve(9.1±3.6)min and the obturator nerve(9.2±3.6)min were shorter in experimental group than that in control group [(11.2±4.7)min (13.8±5.3)min](P0.05).The success rate for the lateral femoral cutaneous nerve block(87.3%)and the obturator nerve block(82.5%)in control group was significantly lower than that of experimental group(98.4% 95.2%)(P0.05).However,there was no significant difference on the success rate of femoral nerve block between two groups.Conclusion Ultrasound-guided fascia iliaca compartment block using multiple injection is more effective than single injection.
Objective To observe the effect of fascia iliaca compartment nerve block(FICB)combined with the ilioinguinal/iliohypogastric nerve block(IINB)to early analgesia of children with development dislocation of the hip(DDH).Methods Forty cases of children with one-sided DDH for the first time,ASA physical statusⅠ orⅡ,aged 2to 6years pediatric patients were divided into two groups randomly:group F(FICB and IINB),group C(FICB only).Nerve block has been undertaken by ultrasound guided.The time of the operation,FLACC pain scores at PACU 0h(T0),1h(T1),2h(T2),4h(T3),6h(T4)were recorded.Number of PACU additional fentanyl cases,the duration in PACU and postoperatively side effects were also recorded.Results FLACC pain scores of the each point were always lower in the group F when it compared with group C(P0.05).The duration in PACU of group F was shorter than group C(P0.05).There was no difference in number of PACU additional fentanyl cases(3vs.8)and postoperative complications(4vs.2)between group F and group C.Conclusion Compared with FICB only,the methods of FICB combined with IINB performed to pediatric DDH can reduce the pain scores significantly at the early time and provide more stable early pain management postoperatively.
Objective To retrospectively assess the clinical use of Cookgas,Fastrach and CTrach Intubating Laryngeal Mask Airway(ILMA)in the management of predicted severe difficult airways.Methods Twenty-one patients with severe difficult airways(Mallampati score Ⅲ or Ⅳ,thyromental distance60mm,and mouth opening between 10-20mm)undergoing selective plastic surgery and requiring orotracheal intubation were enrolled in the study.The types of the ILMA were chosen by the anesthesiologists according to their favorite tools,however,the patients were intubated via Cookgas ILMA that whose mouth opening less then 15 mm,and/or with severe cervical scar contracture,or with the large expanders implanted in cervical area.The whole information of intubating procedures were collected and analyzed.Results All ILMA were inserted successfully,except one failure case in group Fastrach.7cases were intubated using Cookgas ILMA with fibreoptic bronchoscope(FOB)in group Cookgas.In group Fastrach,the intubations were finished at the first attempt in 6cases,one failed.The intubations were all successful at the first attempt in group CTrach.The degree of intubations successful at first attempt had no significant differences between the three groups.The time of intubating ILMA in group Fastrach(33.3±15.5)s and group CTrach(41.7±22.3)s was prolonged significantly than that in group Cookgas(23.9±16.2)s(P 0.05).Conclusion All three types of ILMA are safe and effective tools for predicted severe difficult airways,but Cookgas ILMA has obvious advantages for patients with at least one of these presences,such as mouth opening less then 15 mm,severe cervical scar contracture malformations,or large skin soft-tissue expanders implanted in cervical area.
Objective To explore the effects of blood reservoirs height on erythrocytes injuries due to vacuum suction.Methods Concentrated red blood cells which were identified to be infected with hepatitis virus and stored for 30-40 days were mixed with fresh frozen plasma of the same blood cell type(1U∶100ml).Each time withdrawn 50 ml aliquots of blood,totally 60 samples.All the 60 samples of blood were randomly divided equally into three groups:group H,group N and group L.Each 50 ml aliquot of blood were withdrawn by syringe and serially placed on a bent metal tray with flat base,the blood were collected into a blood reservoir with a continuous negative pressure of 200 mm Hg.The reservoirs were placed at different height in different groups:In group N,it was placed at the same level with the metal tray,while in group H and group L,it was respectively placed 30 cm higher and lower than the metal tray.Erythrocyte deformity rate(EDR),plasma free hemoglobin(FHb)before and after vacuum suction as well as the blood volume(Vcollect)collected in 60 swere compared among three groups.Results Compared with blood before vacuum suction,the EDR and FHb of the blood after vacuum suction were increased(P0.05 or P0.01).Compared with group H,the Vcollectin group N and group L were increased,while the EDR and FHb of the blood after vacuum suction in these two groups were decreased(P0.05).Conclusion Malformation and hemolysis of the stored concentrated red blood cells mixed with fresh frozen plasma may happened due to vacuum suction.The damage is related to reservoirs height.Reservoirs placed 30 cm below or equal to the vacuum level is superior to above the vacuum level.
Objective To evaluate the effect of edaravone on serum the adiponectin(ADP),S-100βand postoperative cognitive function in elderly patient after artificial hip replacement.Methods Ninety ASA Ⅰ orⅡ patients,aged 65-93 years,scheduled for artificial hip replacement,were randomized into edaravone group(group E,n=45)and control group(group C,n=45).In group E edaravone 60 mg was intravenous injected preoperative 30min(dissolved in 100 ml saline infusion,rate 200ml/h),in group C,received same volume of saline.Cognitive function was assessed by Mini-Mental State Examination(MMSE),at 24 hbefore operation and 6,24,48 and 72hafter operation,and venous blood samples were collected for determination of serum ADP and S-100βproptein levels.Results MMSE scores in group E were higher than in group C at postoperative 6-48h(P0.05).Compared with preoperative 24 h,the serum levels of S-100βprotein in two groups were increased significantly,whereas ADP levels were decreased significantly at postoperative 6-72h(P0.05).At postoperative 6-72 h,the serum levels of S-100βprotein in group E were lower,ADP levels were higher than in group C(P0.05).Conclusion Edaravone could decrease early postoperative cognitive dysfunction,and declined the serum levels of proptein S-100βthrough increased the serum ADP levels in elderly patient after artificial hip replacement.
Objective To investigate the effects of dexmedetomidine on cell apoptosis and CCAAT/enhancer binding protein homologous protein(CHOP)in lung injury following one-lung ventilation(OLV)in rats.Methods Forty adult male Sprague-Dawley rats were randomly divided into four groups:group control,group OLV,group OLV+saline and group OLV+dexmedetomidine,with 10 rats per each group.The rats of group control received two-lung ventilation for 2h.The rats of group OLV,group OLV+saline and group OLV+dexmedetomidine all received one-lung ventilation for 1.5hand two-lung ventilation for 0.5h.Animals of group OLV+dexmedetomidine received intravenous dexmedetomidine at a rate of 5μg·kg-1·h-1 for 60 min prior to OLV.Animals of group OLV+saline received same volume of normal saline.Rats were euthanized and the left lung tissue was excised.Wet lung weight to dry lung weight(W/D)was determined.Pathological changes of lung tissue were analyzed by light microscope,and changes of ultrastructure of lung tissue were evaluated by transmission electron microscope.Apoptosis index(AI)of lung tissue was determined by TdT-mediated dUTP nick end labeling(TUNEL)assay.The expression levels of mRNA and protein of glucose regulated protein 78kD(GRP78)and CHOP were detected respectively by RT-PCR and Western blot.Results Compared with group control and group OLV+dexmedetomidine,W/D and AI in group OLV and group OLV+saline were higher(P0.01).Compared with group control and group OLV+ dexmedetomidine,the expression levels of mRNA and protein of GRP78 and CHOP in group OLV and group OLV+saline were significantly higher(P0.01).In group OLV and group OLV+saline,morphological structure and ultrastructure of lung tissue were obviously injured,but the injury of lung tissue in group OLV+dexmedetomidine was notably alleviated.Conclusion Pretreatment of dexmedetomidine could alleviate lung injury induced by OLV,and the mechanism may involve inhibition of pneumocyte apoptosis and suppression of CHOP expression.
Objective To compare the effects and possible mechanisms of oxycodone and morphine on the proliferation,apoptosis,and migration of A549 lung cancer cells in vitro.Methods A549 human lung cancer cells were cultured in vitro and treated with oxycodone(group C)and morphine in different concentrations[10μg/ml(group Q1 and M1),20μg/ml(groups Q2 and M2),40μg/ml(groups Q3 and M3)],respectively.The morphological change of A549 cells was observed under the microscope.The proliferation of cells was measured by methyl thiazolyltetrazolium(MTT)method.The cell apoptosis rate was detected by flow cytometry.Cell scratch assay was used to evaluate the transfer ability of cells.Moreover,RT-PCR was performed to assess the mRNA expression of apoptosis-related protein,including P53,Bax and Bcl-2.The levels of VEGF and uPA were detected by ELISA.Results A549 cell apoptosis occurred after the treatment of oxycodone and morphine under the microscope observation.According to the MTT result,both oxycodone and morphine could dose-dependently inhibit the proliferation of cells.And oxycodone was more effective than morphine(P0.05).The apoptosis rate of cells increased dose-dependently 48 hours after the administration of these two drugs,but there was no significant difference between the effects of these two drugs.Compared with morphine,which elevated the cell migration ability,oxycodone inhibited the cell migration ability effectively(P0.05).Meanwhile,both morphine and oxycodone significantly elevated the expression of P53 and Bax mRNA(P0.05),but inhibited the expression of Bcl-2mRNA(P0.05).Moreover,both morphine and oxycodone inhibited the expression of VEGF,and the inhibitory effect of oxycodone was more than morphine(P0.05).Oxycodone inhibited the expression of uPA significantly,whereas morphine improved the expression of uPA significantly(P0.05).Conclusion Compared with morphine,oxycodone may induce the apoptosis of A549 lung cancer cells and inhibit the proliferation and migration of these cells more effectively.These effects of oxycodone are probably related with the regulation of apoptotic proteins and related growth factors or adhesion molecules.
Objective To investigate the effect of tramadol combined with cisplatin on invasionon and migration of human lung adenocarcinoma cell A549.Methods Human lung adenocarcinoma A549 cells were inoculated on cultured for 24 h,then were randomly divided into 5groups:control group(group CON),cisplatin group(group CIS),tramadol 3μg/ml+cisplatin group(group TT1),tramadol 30μg/ml+cisplatin group(group TT2),tramadol 300μg/ml+cisplatin group(group TT3).Concentration of cisplatin was 4μg/ml.Each group were medicated immediately after 48 hincubation,invasion detection cells by Transwell assay,cell scratch assay cell migration ability,Westernblot detection of matrix metalloproteinase-2(MMP-2),the expression of MMP-9,Ezrin protein and Fascin protein.Results Compared with group CON,group CIS and tramadol cmbined with cisplatin group redueced tumor cell invasion and migration ability,group TT3 and CIS up-regulated MMP-2,MMP-9,Ezrin and Fascin expression(P0.05).Compared with group CIS,tramadol combined with cisplatin group reduced tumor cell migration and invasion.Group TT3down-regulated MMP-2,MMP-9,Ezrin and Fascin expression(P0.05).Conclusion Tramadol could dose-dependently enhance cisplatin on invasion and migration of human lung adenocarcinoma cell A549,down-regulation MMP-2,MMP-9,Ezrin and Fascin expression is one of its possible mechanisms.
Objective To evaluate the effects of different puncture positions on cross-sectional area of the right internal jugular vein(RIJV),overlap of the RIJV and carotid artery(CA)and safe puncture range by ultrasound imaging assessment.The optimal positions of the RIJV catheterization were recommended.Methods One hundred elective surgical patients including male 62 and female 38 were enrolled,aged 21-79 years old,ASA Ⅰ-Ⅲ.The patients were placed in the shoulder-padded position with a pillow,the supine position or the 15-30°Trendelenburg position.An ultrasound probe was placed on the right neck at the apex of the triangle formed by the head of the sternocleidomastoid muscle and the clavicle.For each simulated puncture position,two-dimensional ultrasound images of the RIJV and CA were repeatly obtained and saved at four different degrees of head rotation to the left from midline:0°,30°,45°,60°.The cross-sectional area of the RIJV,the overlap degree of the RIJV and CA and the secure puncture range were measured.Results Compared with the 15°-30°Trendelenburg position,the cross-sectional area of RIJV was significantly decreased in the supine position and the shoulder-padded position(P0.05),and shoulder-padded position was more less than the supine position(P0.05).The cross-sectional area of the RIJV was largest in 15-30°Trendelenburg position(P0.05).Compared with head rotation to the left 0°,the cross-sectional area of the RIJV increased significantly at head rotation to the left 30°,45°,60°(P0.05).Compared with the 15-30°Trendelenburg position,the safe puncture range was decreased significantly in the shoulder-padded position or the supine position(P0.05).Compared with the 15-30°Trendelenburg position,the overlap score of the RIJV and CA decreased significantly in the supine position and the shoulder-padded position(P0.05).When the head was rotated to the left from 0°to 60°,the safe puncture range decreased significantly(P0.05)and the CA-RIJV overlap degree increased significantly(P 0.05).Conclusion The 15-30°Trendelenburg position may be the most ideal posture for RIJV catheterization.Head rotated to the left increased the RIJV distension.To decrease the risk of punture of the carotid artery,the head should be kept30°rotation to the left during RIJV catheterization.
Objective To observe the effect of intravenous infusion lidocaine intraoperatively on serum interleukin(IL)-10 and the blood micrometastasis after radical laparoscopic colorectectomy.Methods Sixty hospitalized patients,aged 30-70 years,ASA I or II grade,Dukes stage A to C,scheduled to elective radical laparoscopic colorectectomy were equally randomized into two groups:lidocaine group(group L)and control group(group C).Group L received intravenous injection lidocaine 1 mg/kg at the beginning of anesthesia induction,then intravenous infusion lidocaine 1.5mg·kg-1·h-1 intraoperatively;group C received an equal volume of saline.Blood samples were taken from the peripheral venous at 5min before anesthesia induction(T1),the end of surgery(T2),postoperative 24hours(T3)and 48hours(T4).The concentration of serum IL-10 was determined with an enzyme-linked immunosorbent assay(ELISA).The positive expression rate of CK20 mRNA was determined with reverse transcriptase polymerase chain reaction.Results Compared with T1,the concentrations of serum IL-10 at T2-T4 in the two groups were significantly increased(P0.05).Compared with group C,the concentration of serum IL-10 in group L was lower at T3(P0.05).There was no significant difference of CK20 mRNA positive expression rate between the two groups at T1 and T3.Conclusion Intravenous injection lidocaine intraoperatively could reduce the postoperative immunosuppression after radical laparoscopic colorectectomy,and had no impact on the hematogenous micrometastasis at postoperative 24 hours.
