【摘要】 目的 评价α2受体激动剂是否可以降低七氟烷引起的小儿术后躁动的发生率。 方法 通过检索Medline、荷兰医学文摘、Cochrane临床试验数据库、中国生物医学文献数据库和中国期刊网全文数据库等数据库，收集可乐定或右美托咪啶对七氟烷引起的小儿术后躁动的预防作用的随机对照试验（randomized controlled trial，RCT），提取资料和评估方法学质量，采用Cochrane协作网RevMan 5.0软件进行Meta分析。 结果 最终纳入11个RCT，其中104例患儿预防性使用右美托咪啶，268例患儿使用可乐定，365例患儿使用安慰剂。Meta分析显示，可乐定组小儿术后躁动发生率的比值比（OR）为0.31，95%CI为（0.15，0.61）（P=0.000 8）；右美托咪啶组小儿术后躁动发生率的OR为0.16，95%CI为（0.08，0.31）（Plt;0.000 01）。 结论 α2受体激动剂可以显著降低七氟烷引起的小儿术后躁动的发生率。【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 观察电压依赖性钙通道是否作用于大鼠脊髓背角胶状质层（SG）神经元大振幅微小兴奋性突触后电流的形成。 方法 选用成年雄性Sprague-Dawley（SD）大鼠，2%～3%异氟烷麻醉后，分离其腰骶部的脊髓，然后切片。采用全细胞电压钳技术，玻璃微电极的电阻为4~6 MΩ，钳制电压为?70 mV，记录胶状质层神经元微小兴奋性突触后电流（mEPSC）电流。将电流信号用Axopatch 200来放大并储存于电脑。对照组和用药结束后，持续采样mEPSC电流30 s。mEPSC电流的频率和振幅用Clampfit 8.1进行分析。 结果 钳制电压为?70 mV时，所有SG神经元均有自发性的EPSC。辣椒素增加mEPSC发生的频率和波幅。钴离子抑制辣椒素诱导的大振幅mEPSC。钴离子抑制辣椒素诱导的mEPSC的平均振幅，而不抑制其发生频率。 结论 电压依赖性钙离子通道参与了辣椒素引起的痛觉形成。
【摘要】 目的 研究双侧迷走神经切断对肺缺血再灌注引起的氧化应激反应的影响。 方法 将24只健康雄性新西兰大白兔随机分为:假手术组（S组）、缺血再灌注组（IR组）、双侧迷走神经切断合并缺血再灌注组（NIR组）。缺血前和再灌注末抽取动脉血进行血气分析，观察动脉血氧分压PaO2及肺泡动脉氧分压差（A-aDO2）的变化。再灌注末取肺组织检测肺的湿干重比值（W/D）和氧化应激指标，包括丙二醛（MDA）、超氧化物歧化酶（SOD）及过氧化氢酶（CAT）。 结果 与S组比较，缺血再灌注明显降低了PaO2，增加了A-aDO2和W/D值，增加了肺组织MDA含量并降低了SOD、CAT活性；双侧迷走神经切断进一步降低了SOD活性。 结论 切断实验兔的双侧迷走神经，降低了肺组织抗氧化酶-超氧化物歧化酶的活性，提示迷走神经在降低肺缺血再灌注引起的氧化应激反应中发挥了重要的调节作用。【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 探讨辣椒素对不同年龄SD大鼠内脏感觉神经元上辣椒素受体（TRPV1）介导的离子通道的影响。 方法 急性分离7~9 d和21~23 d大鼠迷走神经结状神经节神经元，利用全细胞膜片钳技术在分离的神经元上记录辣椒素激活TRPV1受体后通道电流的变化。 结果 ①7~9 d和21~23 d大鼠内脏感觉神经元的膜电容分别为（18.57±8.60）和（19.85±9.47） pF，（Pgt;0.05）；②辣椒素能够激活7~9 d和21~23 d大鼠内脏感觉神经元上TRPV1并产生相似的内向电流，两组产生的峰电流密度分别为（48.59±18.87）、（55.91±20.52） pA/pF（Pgt;0.05）；③反复应用辣椒素使TRPV1受体发生失敏现象。 结论 大鼠内脏感觉神经元的TRPV1受体通道在出生后已经发育成熟，且对辣椒素激活的通道电流有相似的变化。【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.
This study aims to investigate the effect of lung ischemia reperfusion injury (LIRI) on expression of transient receptor potential vanilloid 1 (TRPV1) in the lung and brainstem of rats. Sixteen adult male Sprague Dawley rats weighing 250-320 g were randomly divided into Sham group and ischemia reperfusion group (IR group). Before ischemia, 0.5 hour and 4 hours after the reperfusion, respectively, arterial partial pressure of oxygen (PaO2) and arterial-alveolar oxygen pressure gradient (A-aDO2) were recorded and calculated, respectively. Left lung tissues and the brainstems were obtained at the end of the experiment. Lung tissue malondialdehyde (MDA), myeloperoxidase (MPO) activities, calcitonin gene related peptide (CGRP) and substance P (SP) levels were assessed. The mRNA and protein expressions of TRPV1 in the lung and brainstem were measured by qRT-PCR and Western blot. Compared with in the Sham group, rats in the IR group had a poorer blood gas exchange (P<0.05) and the MPO activity and MDA level of lung tissues in the IR group were significantly higher than those in the Sham group (P<0.05). CGRP level in the IR group increased remarkably (P<0.05), while SP level did not differ statistically between the two groups (P>0.05). The mRNA and protein expressions of TRPV1 in the lung tissue were upregulated in the IR group (P<0.05), but there were no differences of those in the brainstem between the two groups (P>0.05). The results suggest that LIRI could upregulate the expressions of TRPV1 and evoke CGRP release in the lung.
Left ventricular outflow tract obstruction (LVOTO) in Ebstein's anomaly is a rare complication, and LVOTO related to surgery is rarer. We present a 46 years old female patient who was dignosed with Ebstein's anomaly, then suffered from cardiac arrest because of LVOTO secondary to cone reconstruction in ICU.
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.
目的 探讨在Sprague-Dawley大鼠右心房注射缓激肽对呼吸的影响。 方法 7～9 d和21～23 d大鼠在迷走神经完整和迷走神经切断的情况下从右心房注射缓激肽，观察呼吸指标的变化。 结果 ① 右心房注射缓激肽后，7～9 d大鼠出现呼吸暂停，而在21～23 d大鼠仅出现呼吸抑制（P＜0.05）；② 切断迷走神经后，右心房注射缓激肽在两组大鼠均不再出现呼吸暂停。 结论 右心房注射缓激肽在7～9 d大鼠产生呼吸暂停，且依赖于迷走神经的完整性。