Increasing evidences show that a gradual trend away from deep hypothermia toward moderate hypothermic circulatory arrest, which has been proved to be safe and effective in clinic. By summarizing and analyzing the research progress and applying status of the moderate hypothermia circulatory arrest with selective antegrade cerebral perfusion, the article aims at promoting the application of this tenique as a cerebral protection strategy in aortic arch surgery for adults in China.
【摘要】 目的 探討辣椒素對不同年齡SD大鼠內臟感覺神經元上辣椒素受體（TRPV1）介導的離子通道的影響。 方法 急性分離7~9 d和21~23 d大鼠迷走神經結狀神經節神經元，利用全細胞膜片鉗技術在分離的神經元上記錄辣椒素激活TRPV1受體后通道電流的變化。 結果 ①7~9 d和21~23 d大鼠內臟感覺神經元的膜電容分別為（18.57±8.60）和（19.85±9.47） pF，（Pgt;0.05）；②辣椒素能夠激活7~9 d和21~23 d大鼠內臟感覺神經元上TRPV1并產生相似的內向電流，兩組產生的峰電流密度分別為（48.59±18.87）、（55.91±20.52） pA/pF（Pgt;0.05）；③反復應用辣椒素使TRPV1受體發生失敏現象。 結論 大鼠內臟感覺神經元的TRPV1受體通道在出生后已經發育成熟，且對辣椒素激活的通道電流有相似的變化。【Abstract】 Objective To investigate the effects of capsaicin on transient receptor potential vanilloid 1 (TRPV1) receptor-mediated ion channel currents of visceral sensory neurons in different-aged Sprague-Dawley rats. Methods We isolated the vagal nodose ganglion neurons of rats at an age of 7-9 days or 21-23 days acutely. With the whole cell patch clamp technique, we recorded the current changes of TRPV1 channels activated by capsaicin. Results ① Membrane capacitances of the visceral sensory neurons were (18.57±8.60) and (19.85±9.47) pF in rats of 7-9 and 21-23 days, respectively (Pgt;0.05). ② Capsaicin activated the TRPV1 channels and generated inward currents in all the rats; and the peak current densities of the rats of 7-9 days and 21-23 days were respectively (48.59±18.87) and (55.91±20.52) pA/pF (Pgt;0.05). ③ Repeated applications of capsaicin produced a phenomenon of desensitization in TRPV1 channels. Conclusion TRPV1 receptor channels of visceral sensory neurons in rats have matured after birth, and the current changes of TRPV1 channels activated by capsaicin are similar.
Gastrointestinal complications after cardiac surgery are rare, but they are associated with significant morbidity and mortality. The mechanisms of gastrointestinal complications after cardiac surgery may be unique, as the abdominal cavity is not involved. This review summarizes the current evidence of the pathophysiology, clinical manifestations, risk factors, and management of gastrointestinal complications after cardiac surgery, aiming to improve the recognition of gastrointestinal complications after cardiac surgery.
【摘要】 目的 研究雙側迷走神經切斷對肺缺血再灌注引起的氧化應激反應的影響。 方法 將24只健康雄性新西蘭大白兔隨機分為:假手術組（S組）、缺血再灌注組（IR組）、雙側迷走神經切斷合并缺血再灌注組（NIR組）。缺血前和再灌注末抽取動脈血進行血氣分析，觀察動脈血氧分壓PaO2及肺泡動脈氧分壓差（A-aDO2）的變化。再灌注末取肺組織檢測肺的濕干重比值（W/D）和氧化應激指標，包括丙二醛（MDA）、超氧化物歧化酶（SOD）及過氧化氫酶（CAT）。 結果 與S組比較，缺血再灌注明顯降低了PaO2，增加了A-aDO2和W/D值，增加了肺組織MDA含量并降低了SOD、CAT活性；雙側迷走神經切斷進一步降低了SOD活性。 結論 切斷實驗兔的雙側迷走神經，降低了肺組織抗氧化酶-超氧化物歧化酶的活性，提示迷走神經在降低肺缺血再灌注引起的氧化應激反應中發揮了重要的調節作用。【Abstract】 Objective To evaluate the effect of bilateral vagal nerves transection on lung ischemia-reperfusion induced oxidative stress. Methods A total of 24 New Zealand male rabbits were randomly divided into 3 groups: sham group (S group), ischemia-reperfusion group (IR group), and bilateral vagal nerves transection with ischemia-reperfusion group (NIR group). Before ischemia and at the end of reperfusion, arterial blood samples were collected for blood gas analysis. Arterial partial pressure of oxygen (PaO2) and alveolo-arterial oxygen tension difference (A-aDO2) were detected. At the end of reperfusion, lung tissues were obtained to measure wet/dry weight ratio (W/D). Evaluation of oxidative stress indicators, including content of lung malondialdehyde (MDA), superoxide dismutase enzyme (SOD) and catalase (CAT) activities was also performed. Results Compared with the S group, lung ischemia-reperfusion significantly decreased the PaO2, elevated A-aDO2 and lung W/D weight ratio. At the same time, MDA level in the lung tissue was elevated and SOD and CAT activities were decreased. After bilateral vagal nerves transection, SOD activity was further decreased. Conclusion Transection of bilateral vagal nerves reduced the activity of antioxidant enzyme, especially superoxide dismutase in lung tissue, suggesting that the integrity of the vagal nerves plays an important regulatory role in ischemia-reperfusion mediated oxidative stress in the lung.
【摘要】 目的 評價α2受體激動劑是否可以降低七氟烷引起的小兒術后躁動的發生率。 方法 通過檢索Medline、荷蘭醫學文摘、Cochrane臨床試驗數據庫、中國生物醫學文獻數據庫和中國期刊網全文數據庫等數據庫，收集可樂定或右美托咪啶對七氟烷引起的小兒術后躁動的預防作用的隨機對照試驗（randomized controlled trial，RCT），提取資料和評估方法學質量，采用Cochrane協作網RevMan 5.0軟件進行Meta分析。 結果 最終納入11個RCT，其中104例患兒預防性使用右美托咪啶，268例患兒使用可樂定，365例患兒使用安慰劑。Meta分析顯示，可樂定組小兒術后躁動發生率的比值比（OR）為0.31，95%CI為（0.15，0.61）（P=0.000 8）；右美托咪啶組小兒術后躁動發生率的OR為0.16，95%CI為（0.08，0.31）（Plt;0.000 01）。 結論 α2受體激動劑可以顯著降低七氟烷引起的小兒術后躁動的發生率。【Abstract】 Objective To determine whether alpha2-adrenoceptor agonists can decrease emergence agitation (EA) in pediatric patients after sevoflurane anesthesia. Methods The Medline, Embase, Cochrane Library, CBM and CNKI were searched. All randomized controlled trials comparing clonidine or dexmedetomidine with other interventions in preventing emergence agitation after sevoflurane anesthesia were retrieved. Study selection and assessment, data collection and analyses were undertaken. Meta-analysis was done using the Cochrane Collaboration RevMan 5.0 software. Results Eleven articles reached our inclusion criteria and were included in the Meta-analysis. A total of 104 children treated with dexmedetomidine, 268 children treated with clonidine, and 365 children treated with placebo were evaluated for the incidence of emergence agitation. The pooled odds ratio for the clonidine subgroup was 0.31, with a 95% confidence interval of 0.15-0.61 (P=0.000 8). The pooled odds ratio for the dexmedetomidine subgroup was 0.16, with a 95% confidence interval of 0.08-0.31 (Plt;0.000 01). Conclusion Alpha2-adrenoceptor agonists can significantly decrease the incidence of emergence agitation in pediatric patients after sevoflurane anesthesia.
目的 探討在丙泊酚誘導麻醉的改良電休克治療中腦雙頻譜指數(BIS)與動作發作時間的關系，以及其他因素對電休克動作發作時間的影響。 方法 2012年4月－5月，記錄28名患者的107次治療中的不同時刻腦雙頻譜指數（BIS）值誘導前、睫毛反射消失時、治療前即刻、動作發作結束即刻、動作發作結束后60 s）、麻醉藥物劑量、動作發作時間及治療不良反應，并根據動作發作時間將治療分為A組（治療無效組，動作發作時間＜17 s）和B組（治療有效組，動作發作時間≥17 s）。探討不同時刻BIS值與癲癇發作時間的關系并比較A、B組之間BIS值、麻醉藥物劑量差異。 結果 兩組間睫毛反射消失時及治療前即刻BIS值差異有統計學意義（P＜0.05）。動作發作時間與治療前即刻BIS值呈正相關（r=0.245，P=0.012），與治療次數呈負相關（r=?0.283，P=0.004）。 結論 治療前即刻BIS值與動作發作時間呈正相關，因此，此時的BIS值也許可以作為預測動作發作時間長短的指標。