中华麻醉学杂志最新文献

{"title":"Effect of sevoflurane on phosphorylation of connexin 43 at ser368 in ventricular myocardium in isolated hearts of diabetic rats","authors":"Zijun Wang, Hong Gao, Guilong Wang, Ying Cao, Jing Yi, Yanqiu Liu","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.09.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.09.011","url":null,"abstract":"Objective \u0000To evaluate the effect of sevoflurane on phosphorylation of connexin 43 (Cx43) at Ser368 (Cx43 Ser368) in ventricular myocardium in isolated hearts of diabetic rats. \u0000 \u0000 \u0000Methods \u0000Twenty-four clean-grade healthy adult male Sprague-Dawley rats, aged 3 months, weighing 180-220 g, were used in this study.The diabetic model was established by intraperitoneally injecting streptozotocin 60 mg/kg.The hearts were rapidly excised and retrogradely perfused with K-H solution saturated with 95% O2-5% CO2 at 37 ℃ in a Langendorff apparatus.Sixteen Langendorff-perfused diabetic hearts were divided into 3 groups (n=8 each) using a random number table method: diabetes mellitus group (group D) and sevoflurane group (group DS). Another 8 Langendorff-perfused normal hearts of rats were selected and served as control group (group C). After 15 min equilibration with K-H solution, the hearts were continuously perfused for 30 min with K-H solution in group C and group D and with K-H solution saturated with 2.5% sevoflurane in group DS.S1S2 program-controlled stimulation was performed at the end of perfusion, the occurrence of induced ventricular arrhythmia (VA) and the maximal pacing cycle length (PCL) of induced VA were recorded, and conduction velocity (CV) was calculated.The expression of phosphorylated Cx43 at Ser368 (p-Cx43 Ser368) in ventricular myocytes was determined by Western blot. \u0000 \u0000 \u0000Results \u0000Compared with group C, the incidence of induced VA was significantly increased, the maximal PCL of induced VA was prolonged, the CV was decreased, and the expression of p-Cx43 Ser368 was up-regulated in group D (P<0.05). Compared with the incidence of induced VA was significantly decreased, the maximal PCL of induced VA was shortened, the CV was increased, and the expression of p-Cx43 Ser368 was down-regulated in group DS (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000The mechanism by which sevoflurane stabilizes the ventricular electrical conduction is associated with decreasing the phosphorylation of Cx43 at Ser368 in diabetic rats. \u0000 \u0000 \u0000Key words: \u0000Anesthetics, inhalation; Diabetes mellitus; Connexins","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1067-1070"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46183254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of dexmedetomidine on mitochondrial dynamics in mice with endotoxin-induced acute lung injury","authors":"Jia Shi, Li-li Wu, Yanfang Zhang, Shi-Han Du, Li-rong Gong","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.09.029","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.09.029","url":null,"abstract":"Objective \u0000To evaluate the effect of dexmedetomidine on mitochondrial dynamics in mice with endotoxin-induced acute lung injury (ALI). \u0000 \u0000 \u0000Methods \u0000Thirty clean-grade healthy adult male C57BL/6 mice, weighing 20-25 g, aged 2 months, were divided into 3 groups (n=10 each) using a random number table method: control group (group C), endotoxin-induced ALI group (group LPS) and endotoxin-induced ALI plus dexmedetomidine group (group LPS+ DEX). In LPS and LPS+ DEX groups, lipopolysaccharide (LPS) 10 mg/kg was injected via the caudal vein to establish the model of endotoxin-induced ALI.In group LPS+ DEX, dexmedetomidine 50 μg/kg was intraperitoneally injected at 30 min before injection of LPS, while the equal volume of normal saline was given instead in C and LPS groups.The mice were sacrificed at 6 h after LPS administration, and lung tissues were obtained for examination of the pathological changes (with a light microscope) which were scored and for determination of the level of reactive oxygen species (ROS) and expression of mitochondrial fusion proteins mitofusin 1 (Mfn1), Mfn2, optic atrophy 1 (OPA1), dynamin-related protein 1 (Drp1) and fission protein 1 (Fis1)(using Western blot). \u0000 \u0000 \u0000Results \u0000Compared with group C, the lung injury scores and ROS level in lung tissues were significantly increased, the expression of Mfn1, Mfn2 and OPA1 was down-regulated, and the expression of Drp1 and Fis1 was up-regulated in LPS and LPS+ DEX groups (P<0.05). Compared with group LPS, the lung injury scores and ROS level in lung tissues were significantly decreased, the expression of Mfn1, Mfn2 and OPA1 was up-regulated, and the expression of Drp1 and Fis1 was down-regulated in group LPS+ DEX (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Dexmedetomidine can reduce endotoxin-induced ALI through maintaining the mitochondrial fusion-fission balance in mice. \u0000 \u0000 \u0000Key words: \u0000Dexmedetomidine; Acute lung injury; Endotoxemia; Mitochondria","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1139-1142"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44832378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal dose of neostigmine to reverse residual neuromuscular blockade during recovery from anesthesia in patients undergoing hepatectomy","authors":"Hao Wang, L. Yun, Fang Zhang, Yanlin Zhang, M. Duan, Wanyou Yu","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.09.031","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.09.031","url":null,"abstract":"","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1147-1148"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46231589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of thoracic paravertebral nerve block at different time points on postoperativelong-term quality of life in patients undergoing thoracoscopic radical resection of lung cancer","authors":"Yao Liu, Bing Li, Xing Meng, Jiaqiang Zhang, Wei Zhang","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.09.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.09.006","url":null,"abstract":"Objective \u0000To evaluate the effect of thoracic paravertebral nerve block (TPVB) at different time points on postoperative long-term quality of life in the patients undergoing thoracoscopic radical resection of lung cancer. \u0000 \u0000 \u0000Methods \u0000One hundred and fifty patients of both sexes, aged 25-64 yr, with body mass index of 18-24 kg/m2, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, scheduled for elective radical resection of lung cancer, were divided into 3 groups (n=50 each) by a random number table method: preoperative TPVB group (P1 group), TPVB at the end of operation group (P2 group) and preoperative TPVB combined with TPVB at the end of operation group (P3 group). In group P1, TPVB was performed at T4, 6 points on the affected side under ultrasound guidance before anesthesia induction, and 0.5% ropivacaine 10 ml was injected in total.In group P2, TPVB was performed at T4, 6 points on the affected side under ultrasound guidance at the end of operation, and 0.5% ropivacaine 10 ml was injected in total.In group P3, TPVB was performed at T4, 6 points on the affected side under ultrasound guidance before anesthesia induction and at the end of operation, and 0.5% ropivacaine 10 ml was injected each time.The analgesia pump was connected at the end of operation in three groups.The patients were followed up after operation, and 5 ml solution extracted from the analgesic pump was intravenously injected when VAS score was greater than or equal to 4.The occurrence of postoperative chronic pain in the 3 groups was recorded though telephone follow-up at 6 and 12 months after surgery, and the effect of pain on daily life and treatment measures were scored.A concise health-related quality of life scale was used to evaluate patients′ quality of life, and the physical and mental health scores were calculated. \u0000 \u0000 \u0000Results \u0000There was no significant difference in the incidence of chronic pain at 6 and 12 months after surgery among the three groups (P>0.05). The physical and mental health scores were significantly decreased at 12 months after surgery than at 6 months after surgery in the three groups (P<0.05). Compared with P1 and P2 groups, the scores of effect of pain on daily life and treatment measures were significantly decreased, and the physical and mental health scores were increased at 12 months after surgery in group P3 (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000The combination of preoperative TPVB and TPVB at the end of operation can effectively improve postoperative long-term quality of life in the patients undergoing thoracoscopic radical resection of lung cancer. \u0000 \u0000 \u0000Key words: \u0000Nerve block; Thoracoscopes; Lung neoplasms; Quality of life","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1047-1050"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45303350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A survey of the ten-year implementation of WHO surgical safety checklist in China","authors":"Bin Zhu, Huan Gao, Xiangyong Zhou, Yu Liu, Yuguang Huang, Jeffrey J Huang","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.09.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.09.005","url":null,"abstract":"Objective \u0000To investigate the current status of the ten-year implementation of the World Health Organization (WHO) surgical safety checklist (SSC) in China. \u0000 \u0000 \u0000Methods \u0000A questionnaire was designed based on the three phases described by the checklist — the period before induction of anaesthesia, the period before skin incision, and the period before patient leaves operating room, taking into account some hotspots and disputes.The questionnaire was sent to the members of the Chinese-based online New Youth Anesthesia Forum through the WeChat platform.Answers were completed by mobile phones or desktop computers.Each WeChat ID number allowed only one answer for each individual participant. \u0000 \u0000 \u0000Results \u0000A total of 3 943 members red the questionnaire invitation, of which 2 121 members completed the questionnaire with an overall completion rate of 53.79%.For checks completed before induction of anesthesia, the percentage of members who routinely practiced checks before induction of anesthesia was 93.35%, the percentage of members who completed each and every element of the checklist was 60.16%, and the percentage of members who selected the element of the checklist the surgeon was not involved in the check was 14.05%.For checks practiced before skin incision, the percentage of members who routinely completed checks before skin incision was 78.22%, the percentage of members who completed each and every element of the checklist was 51.91%, and the percentage of members who selected the element of the checklist surgeons and anesthesiologists routinely stated their own professional key information was 18.24% and 18.81%, respectively.For checks practiced before the patient leaved the operating room, the percentage of members who routinely completed checks before removing the patient from the operating room was 64.26%, and the percentage of members who completed each and every element of the checklist was 44.18%.The percentage of members who was really serious about practicing the checklist was 56.20%.The percentage of members who believed that surgeons should participated in checks practiced before induction of anesthesia was 81.47%.If the member himself or a member of his family needed a surgery, the percentage of members who hoped to implement the checklist was 98.35%.The percentage of members who believed that practicing WHO SSC could reduce the complications of surgery and improve the anesthetic safety of patients was 94.34%. \u0000 \u0000 \u0000Conclusion \u0000The implementing rate of checks practiced before induction of anesthesia is high, while the implementing rates of checks completed before skin incision and before patient leaves operating room are sequentially reduced in China.Although there are some problems with the implementation of WHO SSC, most respondents believe that implementing SSC can improve the anesthetic safety of patients undergoing surgery. \u0000 \u0000 \u0000Key words: \u0000Anesthesia; Surgical safety checklist","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1041-1046"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42523180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of penehyclidine hydrochloride on TLR4/NF-κВ signaling pathway in non-ventilated lung injury in patients undergoing radical operation for lung cancer","authors":"Xiuxia Wu, Gang Xu, Xihua Lu","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.09.023","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.09.023","url":null,"abstract":"Objective \u0000To evaluate the effect of penehyclidine hydrochloride (PHC) on Toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB) signaling pathway in non-ventilated lung injury in the patients undergoing radical operation for lung cancer. \u0000 \u0000 \u0000Methods \u0000A total of 100 patients, aged 40-64 yr, with body mass index 18-27 kg/m2, of American Society of Anesthesiology physical status Ⅱ or Ⅲ, undergoing radical operation for lung cancer, were divided into 2 groups (n=50 each) according to the random number table method: control group (group C) and PHC group.PHC 0.01 mg/kg was intravenously injected at 10 min before anesthesia induction in group PHC, while the equal volume of normal saline was given instead in group C. The peripheral tissues of the removed lung tissues were obtained for determination of wet/dry weight ratio (W/D ratio). The pathological changes and ultrastructure of lung tissues were observed under light microscope, and lung injury was assessed and scored.The expression of TLR4 and NF-κB protein and mRNA was detected by Western blot and real-time polymerase chain reaction, respectively.Before administration (T0), at the onset of one-lung ventilation (T1), at 60 min of one-lung ventilation (T2), immediately after the end of one-lung ventilation (T3), at the end of operation (T4) and at 24 h after operation (T5), blood samples were collected from the internal jugular vein for determination of serum tumor necrosis factor-alpha, interleukin-6 (IL-6) and IL-8 concentrations by enzyme-linked immunosorbent assay. \u0000 \u0000 \u0000Results \u0000Compared with group C, the W/D ratio and lung injury scores were significantly decreased, the expression of TLR4 and NF-κВ protein and mRNA was down-regulated, and the concentrations of tumor necrosis factor-alpha, IL-6 and IL-8 were decreased at T2-T5 in group PHC (P<0.05). The pathological changes and damage to ultrastructure of lung tissues were significantly attenuated in group PHC as compared with group C. \u0000 \u0000 \u0000Conclusion \u0000The mechanism by which PHC attenuates non-ventilated lung injury is related to blocking TLR4/NF-κВ signaling pathway and reducing inflammatory responses in the patients undergoing radical operation for lung cancer. \u0000 \u0000 \u0000Key words: \u0000Cholinergic antagonists; Lung neoplasms; Lung injury; NF-kappa B; Toll-like receptor 4","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1117-1120"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44505803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of ABCB1 C3435T genetic polymorphism on efficacy of postoperative analgesia","authors":"Xueying Zhang, Yongxin Liang, Cuili Wen, Jing Xia, Haichen Chu","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.09.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.09.015","url":null,"abstract":"Objective \u0000To evaluate the effect of ATP-binding cassette B subfamily member 1 transporter (ABCB1) C3435T genetic polymorphism on the efficacy of postoperative analgesia. \u0000 \u0000 \u0000Methods \u0000One hundred American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients, aged 18-60 yr, scheduled for elective thoracoscopic lobectomy under general anesthesia, were enrolled in this study.The gene mutation of ABCB1 C3435T was detected, and the patients were divided into 3 groups according to the genotypes: wild homozygote group (CC group), mutation heterozygote (CT group) and mutation homozygote group (TT group). Patient-controlled intravenous analgesia was performed with sufentanil after operation.Visual analogue scale (VAS) scores at 24 and 48 h after operation, postoperative consumption of sufentanil, sleep quality score at 24 h after operation and state-trait anxiety score were recorded. \u0000 \u0000 \u0000Results \u0000Compared with CC group, VAS scores at 24 h after operation and postoperative consumption of sufentanil were significantly decreased in TT and CT groups, and the state-trait anxiety score was significantly decreased in TT group and increased in CT group (P 0.05). \u0000 \u0000 \u0000Conclusion \u0000ABCB1 C3435T genetic polymorphism may be one of the mechanisms of the individual variation in the efficacy of postoperative analgesia. \u0000 \u0000 \u0000Key words: \u0000Polymorphism, single nucleotide; Analgesia; Pain, postoperative","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1085-1087"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49453648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of microRNA-125b in ventilator-induced lung injury in mice","authors":"Tianfeng Huang, Ju Gao, Luo-jing Zhou, Ya-li Ge","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.09.024","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.09.024","url":null,"abstract":"Objective \u0000To evaluate the role of microRNA-125b (miR-125b) on ventilator-induced lung injury (VILI) in mice. \u0000 \u0000 \u0000Methods \u0000Forty healthy male C57BL/6 male mice, weighing 25-30 g, aged 2-3 months, were divided into 4 groups (n=10 each) using a random number table method: sham operation group (group Sham), group VILI, VILI plus miR-125b negative control group (group VILI+ NC), and VILI plus miR-125b overexpression group (group VILI+ miR-125b agomir). In VILI+ NC and VILI+ miR-125b agomir groups, miR-125b negative control and miR-125b agomir transfection complex 50 μl were intratracheally instilled, respectively, and 48 h later VILI model was established.The animals were mechanically ventilated for 4 h with high tidal volume (40 ml/kg) to induce VILI.Blood samples were obtained from the femoral artery at 4 h of mechanical ventilation for detection of PaO2, then animals were sacrificed, lungs were removed for determination of wet to dry weight ratio (W/D ratio) and for examination of pathological changes (with a light microscope), and lung injury was scored.In VILI+ NC and VILI+ miR-125b agomir groups, bronchoalveolar lavage fluid (BALF) was collected to measure the concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) by enzyme-linked immunosorbent assay.The cell apoptosis of lung tissues was measured using TUNEL, apoptosis index was calculated, the caspase-3 expression was detected by Western blot, and the miR-125b expression was detected by real-time polymerase chain reaction. \u0000 \u0000 \u0000Results \u0000Compared with Sham group, PaO2 was significantly decreased, and W/D ratio and lung injury score were increased in VILI, VILI+ NC and VILI+ miR-125b agomir groups, and the expression of miR-125b was down-regulated in VILI and VILI+ NC groups (P<0.05). Compared with VILI group, PaO2 was significantly increased, W/D ratio and lung injury score were decreased, the expression of miR-125b was up-regulated (P<0.05), the pathological changes of lung tissues were significantly attenuated in group VILI+ miR-125b agomir, and no significant change was found in the parameters mentioned above in group VILI+ NC (P<0.05). Compared with group VILI+ NC, the concentrations of TNF-α and IL-6 in BALF and apoptotic index were significantly decreased, and the expression of caspase-3 was down regulated in group VILI+ miR-125b agomir (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000MiR-125b is involved in the endogenous protective mechanism of VILI in mice. \u0000 \u0000 \u0000Key words: \u0000MicroRNAs; Ventilator-induced lung injury","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1121-1124"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45177533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of enhanced recovery after surgery for robot-assisted laparoscopic pyeloplasty in pediatric patients","authors":"Ting-ting Wu, Han Guo, Bi-yu Wei, Huixia Zhou, Xuemei Hao, Yaqun Ma","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.09.021","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.09.021","url":null,"abstract":"Objective \u0000To evaluate the safety and efficacy of enhanced recovery after surgery (ERAS) in robot-assisted laparoscopic pyeloplasty in pediatric patients. \u0000 \u0000 \u0000Methods \u0000Sixty pediatric patients of both sexes with hydronephrosis, aged 3-12 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing robot-assisted laparoscopic pyeloplasty from March 2018 to April 2019, were divided into 2 groups using a random number table method: control group (group C, n=28) and ERAS group (n=32). In ERAS group, preoperative ERAS education was carried out, the time of preoperative food and water deprivation was shortened, pediatric patients drank glucose water at 2 h before surgery, anesthetic regimen was optimized, lung protective ventilation and target-directed fluid therapy were performed, and intraoperative warming and multi-mode antiemetic measures were carried out during operation, and multi-mode analgesic measures were taken after operation, and pediatric patients received water and food intake early through the mouth and got out of bed as soon as possible after operation.In group C, the traditional concept was adopted for perioperative management.Immediately after tracheal intubation, at 30 min and 1 and 2 h after establishing pneumoperitoneum, at 5 min after the end of pneumoperitoneum and at 5 min after extubation, the airway peak pressure and tidal volume were recorded, and blood gas analysis was performed.The occurrence of cardiovascular events was recorded during surgery.The postoperative time of extubation, time of first intake, the first postoperative off-bed time, the first flatus time, time of pulling out the ureter and drainage tube, and length of hospital stay were recorded.The Pediatric Anesthesia Emergence Delirium scale was used to assess the agitation during the recovery period.The Faces Pain Scale-Revised scale was used to assess the degree of pain within 72 h after surgery.When Faces Pain Scale-Revised scale score ≥4, fentanyl 0.25 μg/kg was intravenously injected as rescue analgesic.The requirement for rescue analgesia was recorded.The overall complications were evaluated by using Clavin-Dindo grading, and postoperative complications included nausea and vomiting, abdominal distension, abdominal pain, incision infection, abdominal infection, anastomotic leakage, fever, etc. \u0000 \u0000 \u0000Results \u0000Compared with group C, the preoperative food and water deprivation time was significantly shortened, the time of postoperative extubation was prolonged, the postoperative length of hospital stay, time of first intake, the first postoperative off-bed time, the first flatus time, and time of pulling out the ureter were shortened, airway peak pressure was decreased at 1 and 2 h of pneumoperitoneum, arterial blood lactate concentrations were decreased at each time point of pneumoperitoneum (P 0.05). No intraoperative adverse cardiovascular events were found, and no pediatric patients required rescue analgesia after operation in two groups.","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1108-1113"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46221590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of hydrogen on mitochondrial biosynthesis in hippocampus of mice with sepsis-associated encephalopathy","authors":"Yaoqi Wang, Yuzun Wang, Yi Jiang, Man Yang, X. Mao, Hongguang Chen, Yonghao Yu","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.09.025","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.09.025","url":null,"abstract":"Objective \u0000To evaluate the effect of hydrogen on mitochondrial biosynthesis in the hippocampus of mice with sepsis-associated encephalopathy (SAE). \u0000 \u0000 \u0000Method \u0000Two hundred and twenty-four healthy clean-grade male C57BL/6J mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups (n=56 each) using a random number table method: sham operation group (group SH), sham operation plus hydrogen group (group SH+ H2), group SAE, and SAE plus hydrogen group (group SAE+ H2). The model of SAE was established by cecal ligation and puncture in anesthetized mice.Group SH+ H2 and group SAE+ H2 inhaled 2% hydrogen for 1 h starting from 1 and 6 h after operation, respectively.Twenty mice were selectde to record the postoperative 7-day survival rate.The remaining animals were sacrificed at 24 h after operation, and brain tissues were taken for examination of the pathological changes in hippocampal CA1 region (with a light microscope) and for determination of neuronal apoptosis (by TUNEL), mitochondrial membrane potential (MMP) (by fluorescence spectrophotometry) and ATP content (by a bioluminescence assay). The apoptosis rate was calculated.The expression of peroxisome proliferator-activated receptor gamma coactivator 1α (PGC-1α) in hippocampus was determined by Western blot at 6, 12 and 24 h after operation. \u0000 \u0000 \u0000Results \u0000Compared with group SH, the postoperative 7-day survival rate was significantly decreased, the apoptosis rate of hippocampal neurons was increased, the contents of MMP and ATP were decreased, and the expression of PGC-1α was up-regulated in SAE and SAE+ H2groups (P 0.05). Compared with group SAE, the postoperative 7-day survival rate was significantly increased, and the apoptosis rate of hippocampal neurons was decreased, the contents of MMP and ATP were increased, and the expression of PGC-1α was up-regulated (P<0.05), and the pathological changes of hippocampal tissues were significantly attenuated in group SAE+ H2. \u0000 \u0000 \u0000Conclusion \u0000The mechanism by which hydrogen mitigates SAE may be related to promoting mitochondrial biosynthesis in mice. \u0000 \u0000 \u0000Key words: \u0000Hydrogen; Sepsis-associated encephalopathy; Mitochondria; Biosynthesis","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1125-1128"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45686970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}