Pub Date : 2020-03-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.03.016
Z. Gou
The treatment of paclitaxel-induced neuropathic pain has been a research hotspot. Also, some progress has been made in the field of targeted therapy. In this article, we introduced paclitaxel, summarized the receptors or pathways that involved in pa-clitaxel-induced neuropathic pain, the characteristics of neuropathic pain that induced by paclitaxel, targeted treatment methods of pa-clitaxel-induced neuropathic pain and the progress of other treatment methods. By reviewing the targeted treatment methods of paclitax-el-induced neuropathic pain, we proposed and predicted other possible treatment methods in the future, explored the effective treatment methods of paclitaxel-induced neuropathic pain and provided possible basis for clinical treatment. Key words: Paclitaxel; Neuropathic pain; Targeted therapy
{"title":"Research advances in targeted therapy of paclitaxel-induced neuropathic pain","authors":"Z. Gou","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.03.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.03.016","url":null,"abstract":"The treatment of paclitaxel-induced neuropathic pain has been a research hotspot. Also, some progress has been made in the field of targeted therapy. In this article, we introduced paclitaxel, summarized the receptors or pathways that involved in pa-clitaxel-induced neuropathic pain, the characteristics of neuropathic pain that induced by paclitaxel, targeted treatment methods of pa-clitaxel-induced neuropathic pain and the progress of other treatment methods. By reviewing the targeted treatment methods of paclitax-el-induced neuropathic pain, we proposed and predicted other possible treatment methods in the future, explored the effective treatment methods of paclitaxel-induced neuropathic pain and provided possible basis for clinical treatment. \u0000 \u0000 \u0000Key words: \u0000Paclitaxel; Neuropathic pain; Targeted therapy","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"305-310"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45818893","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}
Pub Date : 2020-03-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.03.012
Yongqiang Shi, Ruyue Mu
As a visual technology, ultrasound has made great progress in the application of spinal anesthesia. Spinal anesthesia is a common anesthesia method for lower abdomen and lower limb surgery. Ultrasound can clearly show the spinal canal and its sur-rounding anatomy, which makes great significance to the precision of spinal anesthesia. Scanning before spinal anesthesia with ultra-sound can predict the difficulty of puncture, locate the puncture point and measure the depth of puncture, thereby improving the suc-cess rate of spinal anesthesia, real-time ultrasound guided spinal anesthesia can observe the angle and depth of the needle in real time , which makes the whole process of anesthesia visible, the application of ultrasound to difficult and pediatric spinal puncture can reduce the complications and risks caused by multiple puncture, which has far-reaching significance. Key words: Ultrasound; Spinal anesthesia; Position; Puncture
{"title":"Application of ultrasound in spinal anesthesia puncture","authors":"Yongqiang Shi, Ruyue Mu","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.03.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.03.012","url":null,"abstract":"As a visual technology, ultrasound has made great progress in the application of spinal anesthesia. Spinal anesthesia is a common anesthesia method for lower abdomen and lower limb surgery. Ultrasound can clearly show the spinal canal and its sur-rounding anatomy, which makes great significance to the precision of spinal anesthesia. Scanning before spinal anesthesia with ultra-sound can predict the difficulty of puncture, locate the puncture point and measure the depth of puncture, thereby improving the suc-cess rate of spinal anesthesia, real-time ultrasound guided spinal anesthesia can observe the angle and depth of the needle in real time , which makes the whole process of anesthesia visible, the application of ultrasound to difficult and pediatric spinal puncture can reduce the complications and risks caused by multiple puncture, which has far-reaching significance. \u0000 \u0000 \u0000Key words: \u0000Ultrasound; Spinal anesthesia; Position; Puncture","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"289-292"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47670080","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}
Pub Date : 2020-03-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.03.005
Mamtili Ilyar, L. Wang, Chun-lin Ge
Objective To evaluate the effectiveness and safety of low tidal volume protective lung ventilation (PLV) and pressure controlled ventilation (PCV) in patients undergoing gynecologic laparoscopic surgery. Methods A total of 144 patients who were scheduled for gynecologic laparoscopic surgery in our hospital were enrolled. According to the random number table method, they were divided into two groups (n=72): a PLV group and a PCV group. The PLV group used a tidal volume of 6 ml/kg, an inspiration and expiration ratio of 1∶2, a respiratory rate of 16 breaths per minute, and a positive end expiratory pressure of 5 cmH2O (1 cmH2O=0.098 kPa). In the PCV group, the ventilation pressure was maintained at a tidal volume of 8 ml/kg, with an inspiration and expiration ratio of 1∶2, and a respiratory rate of 12-16 breaths per minute. Their airway peak pressure (Ppeak) and mean airway pressure (Pmean) were recorded 5 min after tracheal intubation (T1), 10 min after pneumoperitoneum (T2), 20 min af-ter pneumoperitoneum (T3), and 10 min after pneumonectomy (T4), while dynamic lung compliance (Cdyn) was calculated. Blood gas analysis was performed at T3 and T4 to record arterial oxygen partial pressure (PaO2), arterial CO2 partial pressure (PaCO2), and alveolar-arterial oxygen partial pressure difference (A-aDO2), while oxygenation index (OI) was calculated. Results At T3, the PLV group presented remarkably increased Ppeak and Pmean and decreased Cdyn, compared with the PCV group (P 0.05). There was no significant differ-ence in the incidence of respiratory complications and the length of hospitalization stay between the two groups (P>0.05). Conclusions For patients undergoing gynecologic laparoscopic surgery, PCV is helpful to maintain stable respiratory dynamics, while low tidal volume PLV is helpful to maintain oxygenation function during surgery. There is no significant difference in safety be-tween the two types of treatment. Key words: Gynaecology; Laparoscopy; Protective lung ventilation mode; Pressure controlled ventilation; Oxygenation function
{"title":"Effects of low tidal volume protective lung ventilation versus pressure controlled ventilation on oxygenation in patients un-dergoing gynecologic laparoscopic surgery","authors":"Mamtili Ilyar, L. Wang, Chun-lin Ge","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.03.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.03.005","url":null,"abstract":"Objective \u0000To evaluate the effectiveness and safety of low tidal volume protective lung ventilation (PLV) and pressure controlled ventilation (PCV) in patients undergoing gynecologic laparoscopic surgery. \u0000 \u0000 \u0000Methods \u0000A total of 144 patients who were scheduled for gynecologic laparoscopic surgery in our hospital were enrolled. According to the random number table method, they were divided into two groups (n=72): a PLV group and a PCV group. The PLV group used a tidal volume of 6 ml/kg, an inspiration and expiration ratio of 1∶2, a respiratory rate of 16 breaths per minute, and a positive end expiratory pressure of 5 cmH2O (1 cmH2O=0.098 kPa). In the PCV group, the ventilation pressure was maintained at a tidal volume of 8 ml/kg, with an inspiration and expiration ratio of 1∶2, and a respiratory rate of 12-16 breaths per minute. Their airway peak pressure (Ppeak) and mean airway pressure (Pmean) were recorded 5 min after tracheal intubation (T1), 10 min after pneumoperitoneum (T2), 20 min af-ter pneumoperitoneum (T3), and 10 min after pneumonectomy (T4), while dynamic lung compliance (Cdyn) was calculated. Blood gas analysis was performed at T3 and T4 to record arterial oxygen partial pressure (PaO2), arterial CO2 partial pressure (PaCO2), and alveolar-arterial oxygen partial pressure difference (A-aDO2), while oxygenation index (OI) was calculated. \u0000 \u0000 \u0000Results \u0000At T3, the PLV group presented remarkably increased Ppeak and Pmean and decreased Cdyn, compared with the PCV group (P 0.05). There was no significant differ-ence in the incidence of respiratory complications and the length of hospitalization stay between the two groups (P>0.05). \u0000 \u0000 \u0000Conclusions \u0000For patients undergoing gynecologic laparoscopic surgery, PCV is helpful to maintain stable respiratory dynamics, while low tidal volume PLV is helpful to maintain oxygenation function during surgery. There is no significant difference in safety be-tween the two types of treatment. \u0000 \u0000 \u0000Key words: \u0000Gynaecology; Laparoscopy; Protective lung ventilation mode; Pressure controlled ventilation; Oxygenation function","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"249-254"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44956752","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}
Pub Date : 2020-03-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.03.001
Haiying Ji, B. He
Objective To prepare proprotein convertase subtilisin/kexin type 9 (PCSK9) nanovaccine and preliminarily discuss its in vitro uptake efficiency by dendritic cells (DC 2.4). Methods PCSK9207-223was selected as antigen peptide, with bovine serum albumin (BSA) as carrier pro-tein, so as to transform BSA molecules into BSA nanoparticles (BNs) by the "reduction-heating-oxidation" method. PCSK9 peptide was linked to the sur-face of BNs to synthesize BSA-PCSK9 nanoparticles (BPNs). PCSK9 peptide was directly linked with BSA molecules to synthesize molecular vaccine BSA-PCSK 9 (BP). The particle size and potential of BNs and BPNs were determined by dynamic light scattering and the morphology was observed un-der a transmission electron microscope. Antigen loading was analyzed by sodium dodecyl sulfate-poyacrylamide gel electrophoresis (SDS-PAGE). The particle size changes of BPNs at different time points were measured to assess its stability under the physiological environment. BPNs were incubated with DC 2.4 for 24 h, and DC 2.4 viability was tested by enhanced cell counting kit-8 (CCK8) to reflect BPN biocompatibility. The uptake of DC 2.4 to-wards nanovaccine was assessed by flow cytometry. Results The synthesized BPNs had a particle size of (68.2±3.1) nm and a potential of(−14.8± 0.6) mV, with an almost spherical shape under a transmission electron microscope. SDS-PAGE results showed an increase in the relative molecular weight of BPNs, which suggested the successful linkage of the short peptide. The particle size of BPNs remained stable under the mimic physiological en-vironment over 144 h. Enhanced CCK8 results indicated that the viability of DC 2.4 was over 100%. According to flow cytometry, DC 2.4 exhibited high-er uptake efficiency towards BPNs than BPs. Conclusions BPNs have good in vitro stability and biocompatibility and are easily to be uptaken by DC. Key words: Proprotein convertase subtilisin/kexin type 9; Nanovaccine; Dendritic cell; Phagocytosis
{"title":"Establishment of proprotein convertase subtilisin/kexin type 9 nanovaccine and in vitro study on cellular uptake efficiency","authors":"Haiying Ji, B. He","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.03.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.03.001","url":null,"abstract":"Objective \u0000To prepare proprotein convertase subtilisin/kexin type 9 (PCSK9) nanovaccine and preliminarily discuss its in vitro uptake efficiency by dendritic cells (DC 2.4). \u0000 \u0000 \u0000Methods \u0000PCSK9207-223was selected as antigen peptide, with bovine serum albumin (BSA) as carrier pro-tein, so as to transform BSA molecules into BSA nanoparticles (BNs) by the \"reduction-heating-oxidation\" method. PCSK9 peptide was linked to the sur-face of BNs to synthesize BSA-PCSK9 nanoparticles (BPNs). PCSK9 peptide was directly linked with BSA molecules to synthesize molecular vaccine BSA-PCSK 9 (BP). The particle size and potential of BNs and BPNs were determined by dynamic light scattering and the morphology was observed un-der a transmission electron microscope. Antigen loading was analyzed by sodium dodecyl sulfate-poyacrylamide gel electrophoresis (SDS-PAGE). The particle size changes of BPNs at different time points were measured to assess its stability under the physiological environment. BPNs were incubated with DC 2.4 for 24 h, and DC 2.4 viability was tested by enhanced cell counting kit-8 (CCK8) to reflect BPN biocompatibility. The uptake of DC 2.4 to-wards nanovaccine was assessed by flow cytometry. \u0000 \u0000 \u0000Results \u0000The synthesized BPNs had a particle size of (68.2±3.1) nm and a potential of(−14.8± 0.6) mV, with an almost spherical shape under a transmission electron microscope. SDS-PAGE results showed an increase in the relative molecular weight of BPNs, which suggested the successful linkage of the short peptide. The particle size of BPNs remained stable under the mimic physiological en-vironment over 144 h. Enhanced CCK8 results indicated that the viability of DC 2.4 was over 100%. According to flow cytometry, DC 2.4 exhibited high-er uptake efficiency towards BPNs than BPs. \u0000 \u0000 \u0000Conclusions \u0000BPNs have good in vitro stability and biocompatibility and are easily to be uptaken by DC. \u0000 \u0000 \u0000Key words: \u0000Proprotein convertase subtilisin/kexin type 9; Nanovaccine; Dendritic cell; Phagocytosis","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"225-229"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41374659","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}
Objective To observe the effects of lipopolysaccharide (LPS) on the expression of a key enzyme during aerobic glycolysis, 6-phosphofructo-2-kinase/fructose-2, 6-biphosphatase 3 (PFKFB3), and its relationship with aerobic glycolysis, so as to explore the potential mechanism of aerobic glycolysis in lung fibroblasts and lung tissue during LPS-induced pulmonary fibrosis. Methods Human embryonic lung fibroblasts (MRC-5 cell line) were divided into two groups according to the random number table method (n=3): a PBS control (PBS) group and an LPS group. After LPS stimulation for 6 h, the expression of PFKFB3 was detected by Western blot, while the intracellular localization of PFKFB3 was determined by immunofluorescence. The oxygen consumption rate (OCR) and the extracellular acidification rate (ECAR) were mea-sured by the Seahorse Extracellular Flux Analyzer, and the colorimetric method was used to detect the production of lactic acid, a product of aer-obic glycolysis. Meanwhile, the synthesis of collagenⅠwas detected by Western blot after LPS stimulation for 48 h. Twenty-four C57BL/6 mice were divided into two groups according to the random number table method (n=12): a normal saline control group (group C), and an LPS group(group L). Groups L and C were intraperitoneally injected with 5 mg/kg LPS or an equal volume of normal saline for five consecutive days. Six mice of each group were sacrificed on Day 7 after modeling to obtain the plasma and lung tissue. The expression of PFKFB3 in lung tissue of each group was detected by Western blot and immunofluorescence, and the colorimetric method was used to detect the content of lactic acid in the plasma of mice in each group. Lung tissues were collected from the remaining mice on Day 28 after modeling, where a lung was collected to detect collagen Ⅰ synthesis by Western blot, while the other lung were taken to prepare paraffin sections for pathological examination. Results Compared with the PBS group, the expression of PFKFB3 in lung fibroblasts significantly increased after LPS stimulation for 6 h (P< 0.05). After LPS stimulation for 48 h, compared with the PBS group, the LPS group presented a decreased OCR, an increased ECAR, and a re-markably increased amount of lactic acid (P<0.05), with significantly increased synthesis of collagen Ⅰin the cells (P<0.05). Compared with group C, the expression of PFKFB3 in lung tissue significantly increased after intraperitoneal injection of LPS into the mice of group L for seven days (P<0.05), with a significantly increased content of lactic acid in the plasma (P<0.05). After LPS injection for 28 days, the mice in group L presented significantly increased expression of collagenⅠ (P<0.05), with obvious fibrosis in lung tissue. Conclusions LPS can induce the ex-pression of PFKFB3 in lung fibroblasts and lung tissue during LPS-induced pulmonary fibrosis, which is related to aerobic glycolysis. The upreg-ulated expression of PFKFB3 may be a key step
{"title":"An observational study on the involvement of 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase 3 in aerobic glycolysis in lung fibroblasts and lung tissue induced by lipopolysaccharide","authors":"Xiaoting Hu, Hanxi Wan, Tingting Xie, Qiaoyi Xu, Shunpeng Xing, Yuan Gao","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.03.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.03.002","url":null,"abstract":"Objective \u0000To observe the effects of lipopolysaccharide (LPS) on the expression of a key enzyme during aerobic glycolysis, 6-phosphofructo-2-kinase/fructose-2, 6-biphosphatase 3 (PFKFB3), and its relationship with aerobic glycolysis, so as to explore the potential mechanism of aerobic glycolysis in lung fibroblasts and lung tissue during LPS-induced pulmonary fibrosis. \u0000 \u0000 \u0000Methods \u0000Human embryonic lung fibroblasts (MRC-5 cell line) were divided into two groups according to the random number table method (n=3): a PBS control (PBS) group and an LPS group. After LPS stimulation for 6 h, the expression of PFKFB3 was detected by Western blot, while the intracellular localization of PFKFB3 was determined by immunofluorescence. The oxygen consumption rate (OCR) and the extracellular acidification rate (ECAR) were mea-sured by the Seahorse Extracellular Flux Analyzer, and the colorimetric method was used to detect the production of lactic acid, a product of aer-obic glycolysis. Meanwhile, the synthesis of collagenⅠwas detected by Western blot after LPS stimulation for 48 h. Twenty-four C57BL/6 mice were divided into two groups according to the random number table method (n=12): a normal saline control group (group C), and an LPS group(group L). Groups L and C were intraperitoneally injected with 5 mg/kg LPS or an equal volume of normal saline for five consecutive days. Six mice of each group were sacrificed on Day 7 after modeling to obtain the plasma and lung tissue. The expression of PFKFB3 in lung tissue of each group was detected by Western blot and immunofluorescence, and the colorimetric method was used to detect the content of lactic acid in the plasma of mice in each group. Lung tissues were collected from the remaining mice on Day 28 after modeling, where a lung was collected to detect collagen Ⅰ synthesis by Western blot, while the other lung were taken to prepare paraffin sections for pathological examination. \u0000 \u0000 \u0000Results \u0000Compared with the PBS group, the expression of PFKFB3 in lung fibroblasts significantly increased after LPS stimulation for 6 h (P< 0.05). After LPS stimulation for 48 h, compared with the PBS group, the LPS group presented a decreased OCR, an increased ECAR, and a re-markably increased amount of lactic acid (P<0.05), with significantly increased synthesis of collagen Ⅰin the cells (P<0.05). Compared with group C, the expression of PFKFB3 in lung tissue significantly increased after intraperitoneal injection of LPS into the mice of group L for seven days (P<0.05), with a significantly increased content of lactic acid in the plasma (P<0.05). After LPS injection for 28 days, the mice in group L presented significantly increased expression of collagenⅠ (P<0.05), with obvious fibrosis in lung tissue. \u0000 \u0000 \u0000Conclusions \u0000LPS can induce the ex-pression of PFKFB3 in lung fibroblasts and lung tissue during LPS-induced pulmonary fibrosis, which is related to aerobic glycolysis. The upreg-ulated expression of PFKFB3 may be a key step ","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"230-237"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41581567","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}
Pub Date : 2020-03-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.03.006
Huili Li, D. Ma
Objective To determine the effects of ropivacaine at different concentrations in the same volume on the analgesic effect and diaphragmatic motor function in elderly patients with intermuscular sulcus brachial plexus block. Methods A total of 46 patients who were scheduled for shoulder arthroscopy were selected. According to the random number table method, they were divided a 0.5% ropivacaine 20 ml group (group A, n=24) and a 0.3% ropivacaine 20 ml group (group B, n=22) and received ultrasound-guided intermuscular sulcus brachial plexus block before induction of general anesthesia. Their hemodynamics, Visual Analogue Scale (VAS) scores, diaphragmatic movement and other adverse reactions were recorded at different time points. Results There was no statistical difference between the two groups in hemodynamics within 30 min after block (P>0.05), as well as in VAS scores at resting and during movement and other adverse reaction rate within 20 h after block (P>0.05). Patients in group A presented significant differences in bi-lateral diaphragmatic movement on quiet breathing and maximal expiration 5 min, 3 h, 6 h and 20 h after block, compared with those before block (P<0.05). Patients in group B also demonstrated significant differences in bilateral diaphragmatic movement on quiet breathing and maximal expiration 5 min, 3 h and 6 h after block, compared with those before block (P<0.05). The incidence of diaphrag-matic palsy in group A was higher than that in group B 3 h and 20 h after block (P<0.05). Patients in group A presented a decreased di-aphragmatic thickness fraction at the blocked side 5 min, 3 h, 6 h and 20 h after block (P<0.05), as well as an increased diaphragmatic thickness fraction at the opposite side 3 h, 6 h and 20 h after block, compared with those before block (P<0.05). Patients in group B pre-sented a decreased diaphragmatic thickness fraction at the blocked side 5 min, 3 h and 6 h after block (P<0.05), as well as an increased diaphragmatic thickness fraction at the opposite side 3 h and 6 h after block, compared with those before block (P<0.05). Conclusions Similar analgesic effects are found between 20 ml of 0.5% and 0.3% ropivacaine in elderly patients within 20 h after shoulder arthroscopy, but the incidence and duration of diaphragmatic paralysis in patients of the high concentration group significantly increase. Key words: Brachial plexus block; Diaphragm; Pain
{"title":"Effects of different concentrations of ropivacaine on the diaphragmatic motor function in elderly patients after intermuscu-lar sulcus brachial plexus block","authors":"Huili Li, D. Ma","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.03.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.03.006","url":null,"abstract":"Objective \u0000To determine the effects of ropivacaine at different concentrations in the same volume on the analgesic effect and diaphragmatic motor function in elderly patients with intermuscular sulcus brachial plexus block. \u0000 \u0000 \u0000Methods \u0000A total of 46 patients who were scheduled for shoulder arthroscopy were selected. According to the random number table method, they were divided a 0.5% ropivacaine 20 ml group (group A, n=24) and a 0.3% ropivacaine 20 ml group (group B, n=22) and received ultrasound-guided intermuscular sulcus brachial plexus block before induction of general anesthesia. Their hemodynamics, Visual Analogue Scale (VAS) scores, diaphragmatic movement and other adverse reactions were recorded at different time points. \u0000 \u0000 \u0000Results \u0000There was no statistical difference between the two groups in hemodynamics within 30 min after block (P>0.05), as well as in VAS scores at resting and during movement and other adverse reaction rate within 20 h after block (P>0.05). Patients in group A presented significant differences in bi-lateral diaphragmatic movement on quiet breathing and maximal expiration 5 min, 3 h, 6 h and 20 h after block, compared with those before block (P<0.05). Patients in group B also demonstrated significant differences in bilateral diaphragmatic movement on quiet breathing and maximal expiration 5 min, 3 h and 6 h after block, compared with those before block (P<0.05). The incidence of diaphrag-matic palsy in group A was higher than that in group B 3 h and 20 h after block (P<0.05). Patients in group A presented a decreased di-aphragmatic thickness fraction at the blocked side 5 min, 3 h, 6 h and 20 h after block (P<0.05), as well as an increased diaphragmatic thickness fraction at the opposite side 3 h, 6 h and 20 h after block, compared with those before block (P<0.05). Patients in group B pre-sented a decreased diaphragmatic thickness fraction at the blocked side 5 min, 3 h and 6 h after block (P<0.05), as well as an increased diaphragmatic thickness fraction at the opposite side 3 h and 6 h after block, compared with those before block (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Similar analgesic effects are found between 20 ml of 0.5% and 0.3% ropivacaine in elderly patients within 20 h after shoulder arthroscopy, but the incidence and duration of diaphragmatic paralysis in patients of the high concentration group significantly increase. \u0000 \u0000 \u0000Key words: \u0000Brachial plexus block; Diaphragm; Pain","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"255-259"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43361275","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}
Pub Date : 2020-03-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.03.017
Shi-you Wei
At present, since the mechanism of occurrence and development of bone cancer pain (BCP) is sophisticated, it is still perplexing in the clinical practice. MicroRNA (miRNA), which plays a regulatory role at the post-transcriptional level, may be in-volved in the BCP process. Therefore, the search for unique miRNA and biomarkers involved in the occurrence and development of BCP will be helpful for the treatment, clinical detection and diagnosis. In this paper, we reviewed recent researches and described how miRNA regulate osteoclast activation, promoted bone resorption and led to the formation of BCP. We also described how miRNA regu-late different signaling pathways [chemokine C-X-C motif ligand 12 (CXCL12)/chemokine C-X-C motif receptor 4 (CXCR4) signaling pathway, protein kinase A/cAMP-response element binding protein (CREB) signaling pathway, et al] that involved in the formation and development of BCP and how miRNA plays a role in BCP regulation by regulating neuronal plasticity and changing the expression of neuronal ion channels. Subsequently, This review summarizes the occurrence and development mechanism of BCP and provides help for clinical transformation. Key words: MicroRNA; Bone cancer pain; Osteoclast
{"title":"Research advances of microRNA involved in bone cancer pain","authors":"Shi-you Wei","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.03.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.03.017","url":null,"abstract":"At present, since the mechanism of occurrence and development of bone cancer pain (BCP) is sophisticated, it is still perplexing in the clinical practice. MicroRNA (miRNA), which plays a regulatory role at the post-transcriptional level, may be in-volved in the BCP process. Therefore, the search for unique miRNA and biomarkers involved in the occurrence and development of BCP will be helpful for the treatment, clinical detection and diagnosis. In this paper, we reviewed recent researches and described how miRNA regulate osteoclast activation, promoted bone resorption and led to the formation of BCP. We also described how miRNA regu-late different signaling pathways [chemokine C-X-C motif ligand 12 (CXCL12)/chemokine C-X-C motif receptor 4 (CXCR4) signaling pathway, protein kinase A/cAMP-response element binding protein (CREB) signaling pathway, et al] that involved in the formation and development of BCP and how miRNA plays a role in BCP regulation by regulating neuronal plasticity and changing the expression of neuronal ion channels. Subsequently, This review summarizes the occurrence and development mechanism of BCP and provides help for clinical transformation. \u0000 \u0000 \u0000Key words: \u0000MicroRNA; Bone cancer pain; Osteoclast","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"311-314"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46130405","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}
Pub Date : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.02.009
Jinbing Lin, Cheng-xiang Yang, H. Liang, Xingqing Liu, Xianjie Wen
Objective To evaluate the clinical application of general anesthesia with tracheal intubation combined with quadratus lumborum block (QLB) in lumbar spine surgery. Methods Fifty patients with American Society of Anesthesiologists (ASA) Ⅰ‒Ⅲ who were scheduled for lumbar spine surgery were divided into two groups according to the random number table method (n=25): a control group (group C) and a QLB (group N). Before the induction of general anesthesia, patients in group N received bilateral QLB under the guidance of ultrasound, and were injected with 15 ml of 0.5% ropivacaine hydrochloride between the quadratus lumborum and psoas major muscle on each side. Group C did not undergo QLB, but completed operation under general anesthesia with tracheal intubation. The mean blood pressure (MAP), heart rate, pulse oxygen saturation (SpO2) were recorded before surgery (T0), immediately after anesthesia induction with endotracheal intubation (T1), before the starting of surgery (T2), at the end of surgery (T3), and immediately after extubation (T4). The operation time, blood loss, fluid intake and the score of surgeon’s satisfaction towards muscle relaxation were recorded. The Visual Analogue Scale (VAS) scores at resting were recorded at T4, 4 h after surgery (T5), 8 h after surgery (T6), 12 h after surgery (T7), 24 h after surgery (T8) and 48 h after surgery (T9). The VAS scores during movement were recorded from T7 to T9. The perioperative doses of propofol, remifentanil and cisatracurium besylate were recorded. The dose of sufentanil within 24 h after surgery, the pressing times of patient-controlled intravenous analgesia (PCIA) and the number of additional use of intravenous anesthetics for remediation were recorded. Postoperative complications such as nausea, vomiting and respiratory depression were recorded. Results There was no statistical difference in general information between the two groups (P>0.05). The VAS score of group N was lower than that of group C at each time point (P<0.05). The doses of propofol, remifentanil, cisatracurium besylate and sufentanil used in group N were significantly lower than those in group C (P<0.05). The number of postoperative analgesic remediation cases and the incidence of adverse reactions in group N were significantly lower than those in group C (P<0.05). Meanwhile, the surgeons presented better muscle relaxation satisfaction towards group N than group C (P<0.05). Conclusions The application of general anesthesia with tracheal intubation combined with QLB in patients for lumbar spine surgery can reduce the doses of general anesthetics, decrease the incidence of adverse reactions, and decline the VAS score after surgery, which is a feasible method of anesthesia. Key words: Lumbar spine surgery; Anesthesia, general; Quadratus lumborum block; Postoperative analgesia
目的探讨气管插管全麻联合腰方肌阻滞(QLB)在腰椎手术中的临床应用。方法50例与美国麻醉医师协会(ASA)Ⅰ~Ⅲ病人安排腰椎手术分为两组根据随机数字表法(n = 25):对照组(C组)和QLB (n组)。在全身麻醉诱导前,病人在n组的指导下获得双边QLB超声波,并被注射15毫升的0.5%盐酸ropivacaine肌和腰大肌肌两侧。C组未行QLB，全麻下气管插管完成手术。记录两组患者术前(T0)、气管插管诱导麻醉后立即(T1)、手术开始前(T2)、手术结束时(T3)、拔管后立即(T4)的平均血压(MAP)、心率、脉搏血氧饱和度(SpO2)。记录手术时间、出血量、饮水量及外科医生对肌肉放松的满意度评分。分别于术后T4、4 h (T5)、8 h (T6)、12 h (T7)、24 h (T8)、48 h (T9)记录静息时视觉模拟评分(VAS)。从T7到T9记录运动时的VAS评分。记录围手术期丙泊酚、瑞芬太尼、顺阿曲库铵的剂量。记录术后24 h内舒芬太尼给药剂量、患者自控静脉镇痛按压次数及静脉补药次数。术后出现恶心、呕吐、呼吸抑制等并发症。结果两组一般资料比较，差异无统计学意义(P < 0.05)。N组各时间点VAS评分均低于C组(P<0.05)。N组丙泊酚、瑞芬太尼、顺阿曲库铵、舒芬太尼用量均显著低于C组(P<0.05)。N组术后镇痛补救例数及不良反应发生率均显著低于C组(P<0.05)。同时，N组患者肌肉松弛满意度优于C组(P<0.05)。结论在腰椎手术患者中应用气管插管全麻联合QLB可减少全麻剂量，降低不良反应发生率，降低术后VAS评分，是一种可行的麻醉方法。关键词:腰椎外科;麻醉,一般;腰方肌阻滞;术后镇痛
{"title":"Evaluation of the application of general anesthesia with tracheal intubation combined with quadratus lumborum block in lumbar spine surgery","authors":"Jinbing Lin, Cheng-xiang Yang, H. Liang, Xingqing Liu, Xianjie Wen","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.009","url":null,"abstract":"Objective \u0000To evaluate the clinical application of general anesthesia with tracheal intubation combined with quadratus lumborum block (QLB) in lumbar spine surgery. \u0000 \u0000 \u0000Methods \u0000Fifty patients with American Society of Anesthesiologists (ASA) Ⅰ‒Ⅲ who were scheduled for lumbar spine surgery were divided into two groups according to the random number table method (n=25): a control group (group C) and a QLB (group N). Before the induction of general anesthesia, patients in group N received bilateral QLB under the guidance of ultrasound, and were injected with 15 ml of 0.5% ropivacaine hydrochloride between the quadratus lumborum and psoas major muscle on each side. Group C did not undergo QLB, but completed operation under general anesthesia with tracheal intubation. The mean blood pressure (MAP), heart rate, pulse oxygen saturation (SpO2) were recorded before surgery (T0), immediately after anesthesia induction with endotracheal intubation (T1), before the starting of surgery (T2), at the end of surgery (T3), and immediately after extubation (T4). The operation time, blood loss, fluid intake and the score of surgeon’s satisfaction towards muscle relaxation were recorded. The Visual Analogue Scale (VAS) scores at resting were recorded at T4, 4 h after surgery (T5), 8 h after surgery (T6), 12 h after surgery (T7), 24 h after surgery (T8) and 48 h after surgery (T9). The VAS scores during movement were recorded from T7 to T9. The perioperative doses of propofol, remifentanil and cisatracurium besylate were recorded. The dose of sufentanil within 24 h after surgery, the pressing times of patient-controlled intravenous analgesia (PCIA) and the number of additional use of intravenous anesthetics for remediation were recorded. Postoperative complications such as nausea, vomiting and respiratory depression were recorded. \u0000 \u0000 \u0000Results \u0000There was no statistical difference in general information between the two groups (P>0.05). The VAS score of group N was lower than that of group C at each time point (P<0.05). The doses of propofol, remifentanil, cisatracurium besylate and sufentanil used in group N were significantly lower than those in group C (P<0.05). The number of postoperative analgesic remediation cases and the incidence of adverse reactions in group N were significantly lower than those in group C (P<0.05). Meanwhile, the surgeons presented better muscle relaxation satisfaction towards group N than group C (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000The application of general anesthesia with tracheal intubation combined with QLB in patients for lumbar spine surgery can reduce the doses of general anesthetics, decrease the incidence of adverse reactions, and decline the VAS score after surgery, which is a feasible method of anesthesia. \u0000 \u0000 \u0000Key words: \u0000Lumbar spine surgery; Anesthesia, general; Quadratus lumborum block; Postoperative analgesia","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"169-172"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41346786","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}
Pub Date : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.02.008
Yongying Pan, Qingning Wang, Xinxu Ou, Pin Li, Xing-rong Song
Objective To investigate the effects of a low concentration of ropivacaine on the contraction of the uterine and abdominal muscles during labor analgesia. Methods One hundred and fifty primiparous women who expected to have a natural birth were selected. Then, 100 primiparous women were divided into two groups according to the random number table method: a 0.062 5% ropivacaine group (group ropivacaine, n=50) and a 0.062 5% levobupivacaine group (group levobupivacaine, n=50). Meanwhile, 50 primiparous women who did not take analgesic measures during vaginal delivery were set as a control group. Their age, body mass index(BMI), gestational age, cesarean section rate, forceps delivery rate, the duration of the first and second stages of labor, the rate of oxytocin use, and blood loss 2 h after delivery were recorded. The maternal pain was evaluated on the basis of Visual Analogue Scale (VAS) scores at the beginning of labor analgesia (T1), 15 min after labor analgesia (T2), 30 min after labor analgesia (T3) and 45 min after labor analgesia (T4). Then, the parameters of electromyography (EMG) burst wave energy were recorded, including the number and duration of burst waves, root mean square (RMS), and power and peak frequency, so as to comprehensively evaluate the contraction of the uterine and abdominal muscles. Results There was no significant difference in age, BMI, gestational age, cesarean section rate, forceps delivery rate, and blood loss 2 h after delivery among the three groups (P>0.05). Compared with groups control and ropivacaine, group levobupivacaine presented significantly extended duration of the first and second stages of labor, and marked increases in the rate of oxytocin use (P<0.05). Compared with group control, groups ropivacaine and levobupivacaine showed obviously decreased maternal VAS scores at T2, T3, and T4 (P<0.05). In the first stage of labor, compared with group control, the RMS of uterine muscle EMG in groups ropivacaine and levobupivacaine significantly reduced (P<0.05), compared with groups control and ropivacaine, the maternal power of group levobupivacaine significantly reduced (P<0.05). In the second stage of labor, compared with groups control and ropivacaine, group levobupivacaine presented significantly extended duration of EMG burst wave in the uterine muscle (P<0.05), compared with group control, groups ropivacaine and levobupivacaine showed significantly reduced RMS (P<0.05). Conclusions The use of 0.062 5% ropivacaine for epidural analgesia can achieve good effects, without significant impacts on maternal labor force, and does not prolong labor stage. Key words: Ropivacaine; Levobupivacaine; Labor analgesia; Electromyography; Labor stage
{"title":"Effects of a low concentration of ropivacaine on maternal labor force during labor analgesia","authors":"Yongying Pan, Qingning Wang, Xinxu Ou, Pin Li, Xing-rong Song","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.008","url":null,"abstract":"Objective \u0000To investigate the effects of a low concentration of ropivacaine on the contraction of the uterine and abdominal muscles during labor analgesia. \u0000 \u0000 \u0000Methods \u0000One hundred and fifty primiparous women who expected to have a natural birth were selected. Then, 100 primiparous women were divided into two groups according to the random number table method: a 0.062 5% ropivacaine group (group ropivacaine, n=50) and a 0.062 5% levobupivacaine group (group levobupivacaine, n=50). Meanwhile, 50 primiparous women who did not take analgesic measures during vaginal delivery were set as a control group. Their age, body mass index(BMI), gestational age, cesarean section rate, forceps delivery rate, the duration of the first and second stages of labor, the rate of oxytocin use, and blood loss 2 h after delivery were recorded. The maternal pain was evaluated on the basis of Visual Analogue Scale (VAS) scores at the beginning of labor analgesia (T1), 15 min after labor analgesia (T2), 30 min after labor analgesia (T3) and 45 min after labor analgesia (T4). Then, the parameters of electromyography (EMG) burst wave energy were recorded, including the number and duration of burst waves, root mean square (RMS), and power and peak frequency, so as to comprehensively evaluate the contraction of the uterine and abdominal muscles. \u0000 \u0000 \u0000Results \u0000There was no significant difference in age, BMI, gestational age, cesarean section rate, forceps delivery rate, and blood loss 2 h after delivery among the three groups (P>0.05). Compared with groups control and ropivacaine, group levobupivacaine presented significantly extended duration of the first and second stages of labor, and marked increases in the rate of oxytocin use (P<0.05). Compared with group control, groups ropivacaine and levobupivacaine showed obviously decreased maternal VAS scores at T2, T3, and T4 (P<0.05). In the first stage of labor, compared with group control, the RMS of uterine muscle EMG in groups ropivacaine and levobupivacaine significantly reduced (P<0.05), compared with groups control and ropivacaine, the maternal power of group levobupivacaine significantly reduced (P<0.05). In the second stage of labor, compared with groups control and ropivacaine, group levobupivacaine presented significantly extended duration of EMG burst wave in the uterine muscle (P<0.05), compared with group control, groups ropivacaine and levobupivacaine showed significantly reduced RMS (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000The use of 0.062 5% ropivacaine for epidural analgesia can achieve good effects, without significant impacts on maternal labor force, and does not prolong labor stage. \u0000 \u0000 \u0000Key words: \u0000Ropivacaine; Levobupivacaine; Labor analgesia; Electromyography; Labor stage","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"164-168"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43028181","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}
Pub Date : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.02.019
Pinhao Guo, Lulong Bo
Aberrant activation of innate immune cells and immunosuppression are part of the pathogenesis of sepsis. The loss of CD4+ T cells, CD8+ T cells, Th17 cells, γδT cells, upregulation of regulatory T cells (Tregs) and aberrant immune cell metabolism can be detected in the stage of immunosuppression. Summarizing and analyzing the influence of immunometabolism of immune cells (CD4+ T cells, CD8+ T cells, Th17, Tregs and γδT) during sepsis-induced immunosuppression on regulating the function of T cells are helpful to investigate potential target of the immunometabolism of T cells. This review is benefit to explore novel immunometabolism therapeutic method to treat sepsis. Key words: Sepsis; Immunosuppression; Immunometabolism; T cells
{"title":"Immunometabolism of different T cell subsets during sepsis","authors":"Pinhao Guo, Lulong Bo","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.02.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.02.019","url":null,"abstract":"Aberrant activation of innate immune cells and immunosuppression are part of the pathogenesis of sepsis. The loss of CD4+ T cells, CD8+ T cells, Th17 cells, γδT cells, upregulation of regulatory T cells (Tregs) and aberrant immune cell metabolism can be detected in the stage of immunosuppression. Summarizing and analyzing the influence of immunometabolism of immune cells (CD4+ T cells, CD8+ T cells, Th17, Tregs and γδT) during sepsis-induced immunosuppression on regulating the function of T cells are helpful to investigate potential target of the immunometabolism of T cells. This review is benefit to explore novel immunometabolism therapeutic method to treat sepsis. \u0000 \u0000 \u0000Key words: \u0000Sepsis; Immunosuppression; Immunometabolism; T cells","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"212-216"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43086724","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}
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