Vasopressin-Mediated Modulation of Trigeminal Reflexes in Rats

In experiments on rats under urethane anesthesia, we studied how microinjections of vasopressin into the spinal trigeminal nucleus influence jaw-opening reflexes (JOR): nociceptive JOR, induced by stimulation of the tooth pulp, and non-nociceptive JOR, evoked by stimulation of A fibers of the infraorbital nerve. It was shown that injection of 10 M vasopressin resulted in a pronounced decrease (by 45-50%) in the nociceptive JOR amplitude for 25-30 min, whereas the non-nociceptive JOR dropped only by 8-10% for 11-13 min. It is concluded that vasopressin predominantly affects the nociceptive JOR; this fact is obviously related to a central analgesic effect of this peptide.     

Transient Spinal Cord Ischemia in Rat: The Time Course of Spinal FOS Protein Expression and the Effect of Intraischemic Hypothermia (27°C)

1. In the present study, we characterize the time course of spinal FOS protein expression after transient noninjurious (6-min) or injurious (12-min) spinal ischemia induced by inflation of a balloon catheter placed into the descending thoracic aorta. In addition, this work examined the effects of spinal hypothermia on FOS expression induced either by ischemia or by potassium-evoked depolarization (intrathecal KCl).2. Short-lasting (6-min) spinal ischemia evoked a transient FOS protein expression. The peak expression was seen 2 hr after reperfusion in all laminar levels in lumbosacral segments. At 4 hr of reperfusion, more selective FOS expression in spinal interneurons localized in the central part of laminae V–VII was seen. At 24 hr no significant increase in FOS protein was detected.3. After 12 min of ischemia and 2 hr of reflow, nonspecific FOS expression was seen in both white and gray matter, predominantly in nonneuronal elements. Intrathecal KCl-induced FOS expression in spinal neurons in the dorsal horn and in the intermediate zone. Spinal hypothermia (27°C) significantly suppressed FOS expression after 6 or 12 min of ischemia but not after KCl-evoked depolarization.4. Data from the present study show that an injurious (but not noninjurious) interval of spinal ischemia evokes spinal FOS protein expression in glial cells 2 hr after reflow. The lack of neuronal FOS expression corresponds with extensive neuronal degeneration seen in this region 24 hr after reflow. Noninjurious (6-min) ischemia induced a transient, but typically neuronal FOS expression. The significant blocking effect of hypothermia (27°C) on the FOS induction after ischemia but not after potassium-evoked depolarization also suggests that simple neuronal depolarization is a key trigger in FOS induction.     

Increase of anti-inflammatory cytokines in patients with esophageal cancer after perioperative treatment with G-CSF

Granulocyte colony-stimulating factor (G-CSF) has been shown to effectively stimulate granulopoiesis, in both neutropenic and in non-neutropenic patients. Recently, other effects of G-CSF on the immune system have attracted interest in treating non-neutropenic patients with a high risk of severe infection. In this phase II trial, we measured the effects of G-CSF on the serum cytokine levels in patients with esophageal cancer undergoing esophagectomy. Twenty subsequent patients (study group, 19 evaluable) received G-CSF (rhG-CSF, Filgrastim) at standard doses (300 microg or 480 microg) subcutaneously 2 days before and up to 7 days after surgery. G-CSF was well tolerated. Leukocytes increased from 7600/microl at study entry (day -2) to a maximum of 45 100/microl (day 6). In the study patients, we found a highly significant (P<0.001) postoperative increase of G-CSF, IL-1ra, sTNFRp55 and sTNFRp75 as compared with the baseline level. In contrast, IL-8 levels were decreased by a factor of 6.8; there were no changes in the very low TNF-alpha levels. The comparison of the study group with a control group of 21 cancer patients undergoing major surgery who were not treated with G-CSF showed significant differences in the serum levels of G-CSF, sTNFRp55, sTNFRp75, and IL-1ra, respectively. There was no infection in the study group up to 10 days after surgery as compared with 29.9% in a historical control group (P=0.008). Thus, the induction of anti-inflammatory cytokines and the downregulation of pro-inflammatory cytokines by G-CSF might be a promising adjuvant treatment of infectious complications in patients undergoing esophagectomy.     

Expression of tachykinin receptors in Xenopus oocytes injected with poly(A)~+RNA from cat dorsal root ganglion

ＴａｃｈｙｋｉｎｉｎｆａｍｉｌｙｉｓａｇｒｏｕｐｏｆｎｅｕｒｏｐｅｐｔｉｄｅｓｗｉｔｈｓｉｍｉｌａｒＣｔｅｒｍｉｎａｌｓｅｑｕｅｎｃｅｓａｎｄｒｅｌａｔｅｄｂｉｏａｃｔｉｖｉｔｉｅｓ.ＴｈｅｍａｊｏｒｔａｃｈｙｋｉｎｉｎｓｉｎｍａｍｍａｌｉａｎａｒｅｓｕｂｓｔａｎｃｅＰ(ＳＰ),ｎｅｕｒｏｋｉｎｉｎＡ(ＮＫＡ)ａｎｄｎｅｕｒｏｋｉｎｉｎＢ(ＮＫＢ).Ｃｏｒｒｅｓｐｏｎｄｉｎｇｔｏｔｈｅｓｅｐｅｐｔｉｄｅｓ,ｔｈｒｅｅｄｉｓｔｉｎｃｔｔａｃｈｙｋｉｎｉｎｒｅｃｅｐｔｏｒｓｗｅｒｅｄｉｓｃｏｖｅｒｅｄａｎｄｎ…     

Reversal of Ketamine/Xylazine combination anesthesia by Atipamezole in olive baboons (Papio anubis)

Background  The potential of Atipamezole (ATI) to reverse Ketamine/Xylazine (KET/XYL) anesthesia in the Olive baboon ( Papio anubis ) was studied.
Methods  Anesthesia was induced with 10 mg/kg KET and 0.5 mg/kg XYL intramuscularly. Mean arousal time (MAT), heart rate (HR), systolic arterial blood pressure (SAP), rectal temperature, respiratory rate (RR), and hemoglobin oxygen saturation (SpO₂) were monitored. Baboons were treated with: KET/XYL only, KET/XYL followed by 100 μg/kg ATI or by 200 μg/kg ATI administered 25 minutes after KET/XYL.
Results  Atipamezole rapidly reversed depressed HR and SAP (10 ± 5.2 minutes), RR (5 ± 2 minutes) and SpO₂ (3 ± 6 minutes) and significantly decreased MAT (13 ± 2.2 minutes) vs. KET/XYL alone (35 ± 5 minutes). Emesis was absent and salivation was observed after administration of 200 μg/kg ATI only.
Conclusions  Atipamezole at 100 μg/kg is sufficient for rapid and smooth reversal of KET/XYL anesthesia in the Olive baboon with minimal side effects.     

右美托咪定联合舒芬太尼术后镇痛对卵巢癌根治术患者细胞免疫功能和炎症应激反应的影响

摘要 目的：探讨右美托咪定联合舒芬太尼术后镇痛对卵巢癌根治术患者细胞免疫功能和炎症应激反应的影响。方法：根据随机数字表法将2020年2月至2023年2月期间陕西省肿瘤医院120例择期行卵巢癌根治术的患者分为对照组（n=60，术后镇痛药物选用舒芬太尼）和研究组（n=60，术后镇痛药物选用右美托咪定联合舒芬太尼）。对比两组镇静（Ramsay镇静评分）、细胞免疫功能[CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺]、镇痛情况[视觉模拟评分法（VAS）]、不良反应、炎症应激反应[白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、皮质醇（Cor）和去甲肾上腺素（NE）]变化情况。结果：与对照组术后6 h、12 h、24 h、48 h 相比，研究组同时间点VAS评分更低，Ramsay镇静评分更高（P<0.05）。与对照组术后24 h相比，研究组同时间点CD3⁺、CD4⁺、CD4⁺/CD8⁺更高，CD8⁺更低（P<0.05）。两组不良反应发生率组间对比未见差异（P>0.05）。与对照组术后24 h相比，研究组同时间点IL-6、TNF-α、Cor、NE更低（P<0.05）。结论：右美托咪定联合舒芬太尼用于卵巢癌根治术患者术后镇痛，镇静、镇痛效果显著，同时还可减轻机体炎症应激反应，缓解免疫抑制。     

CBL联合PBL教学方法在创伤外科学教学中的初步探究

目的:研究以案例为中心教学法(CBL)联合以问题为中心教学法(PBL)的教学方法与传统的基于课堂的教学法(LBL)在临床医学五年制本科生创伤外科学教学中的应用效果。方法:随机选取我校临床医学五年制四年级的学员80人,随机分为CBL联合PBL教学组及LBL教学组各40人。在课程结束以后,采用记名试卷考核联合不记名问卷调查的方式,进行教学方法、教学模式、教学内容掌握程度评价。结果:实验组学员理论考核成绩优于对照组学员,有统计学差异。CBL联合PBL教学法支持率高于传统LBL教学法,并且在激发学员兴趣,提高学员学习兴趣,合作能力方面均优于对照组。结论:CBL联合PBL教学法可以在创伤外科学中实施,能取得较好的教学效果。     

早期胃癌的治疗现状与进展

胃癌是常见的消化道肿瘤之一,是我国死亡率最高的恶性肿瘤之一。与日本韩国等发达国家相比,我国胃癌患者多数在就诊时已处于进展期,早期胃癌所占比例不足10%。传统的开腹胃癌手术仍是治疗早期胃癌的主要手段。相较于传统开腹手术,腹腔镜手术对于早期胃癌的治疗优势是显而易见的。早期胃癌患者行腹腔镜手术,具有术后恢复快,生活质量好,近期疗效佳等优势。内镜黏膜下剥离术(ESD,endoscopic submucosal dissection)是近年来出现的一项新的治疗早期胃癌的手段。本文就传统开腹手术、腹腔镜手术及ESD分别在早期胃癌治疗中的应用进行了综述。微创手术治疗早期胃癌将逐渐代替开腹手术,成为早期胃癌治疗的主要手段。     

硬膜外复合全麻对老年高血压患者腹部手术后并发症的影响

目的：探讨硬膜外复合全麻对老年高血压患者腹部手术后并发生的影响。方法：收集2013 年6 月-2015 年6 月在两家医院 接受腹部手术的老年高血压患者100 例,根据麻醉方法不同分为研究组和对照组。研究组患者给予硬膜外复合麻醉,对照组给予 全凭静脉麻醉。观察并比较两组患者的麻醉时间、药物用量以及术后并发症的发生率。结果：两组麻醉时间比较,差异无统计学意 义（P>0.05）;研究组麻醉药物用量低于对照组,差异具有统计学意义（P<0.05）;两组患者手术时间比较,差异无统计学意义（P>0. 05）;研究组患者术后苏醒时间、拔管时间以及住院时间均短于对照组,差异具有统计学意义（P<0.05）;研究组术后并发症的发生 率低于对照组,差异具有统计学意义（P<0.05）。结论：硬膜外复合全麻用于老年高血压患者腹部手术能够减少麻醉药物用量,降低 术后并发症的发生率,安全性较高。     

Real‐time monitoring of incision profile during laser surgery using shock wave detection

Lack of sensory feedback during laser surgery prevents surgeons from discerning the exact location of the incision, which increases duration and complexity of the treatment. In this study we demonstrate a new method for monitoring of laser ablation procedures. Real‐time tracking of the exact three dimensional (3D) lesion profile is accomplished by detection of shock waves emanating from the ablation spot and subsequent reconstruction of the incision location using time‐of‐flight data obtained from multiple acoustic detectors. Here, incisions of up to 9 mm in depth, created by pulsed laser ablation of fresh bovine tissue samples, were successfully monitored in real time. It was further observed that, by utilizing as little as 12 detection elements, the incision profile can be characterized with accuracy below 0.5 mm in all three dimensions and in good agreement with histological examinations. The proposed method holds therefore promise for delivering high precision real‐time feedback during laser surgeries. (© 2013 WILEY‐VCH Verlag GmbH &Co. KGaA, Weinheim)