三氧化二砷对激素非依赖性前列腺癌PC-3细胞株Bcl-2、Bax表达的影响

目的了解三氧化二砷对激素非依赖性前列腺癌PC-3细胞株细胞增殖、细胞凋亡及bcl-2、bax基因表达的影响。方法分别以1、2、3、6、10μmol/L的三氧化二砷作用于PC-3细胞,48h后对细胞增殖活性、细胞凋亡及细胞bcl-2、bax基因表达的变化进行检测。结果各浓度的三氧化二砷均可抑制PC-3细胞增殖,并具有剂量依赖性。3、6、10μmol/L的三氧化二砷还可诱导PC-3细胞凋亡,计算细胞凋亡率分别为11．8%、12．7%、29．6%。逆转录聚合酶链反应(RT-PCR)检测PC-3细胞中bcl-2、bax表达的相对强度,发现bcl-2的表达强度随三氧化二砷浓度的升高而逐渐降低(P＜0．01),而bax表达强度变化不明显(P＞0．05)。结论三氧化二砷可有效抑制PC-3细胞增殖,诱导PC-3细胞凋亡,这一过程与三氧化二砷抑制PC- 3细胞中bcl-2的表达有关。     

米非司酮诱导雄激素非依赖性前列腺癌细胞凋亡的实验研究

目的探讨米非司酮在体外诱导雄激素非依赖性前列腺癌DU-145、PC-3细胞凋亡的作用。方法采用四甲基偶氮唑蓝法检测1,10,50和100μmol／L米非司酮作用于前列腺癌DU-145、PC-3细胞24～120h的吸光度（A）值,用流式细胞仪检测10μmol／L米非司酮作用24和48h后DU．145、PC-3细胞凋亡率的变化;采用免疫组化法检测米非司酮作用DU-145、PC．3细胞后bax、bcl-2、血管内皮生长因子（VEGF）蛋白表达的变化。结果1μmol／L米非司酮组的A值与对照组相比,差异无统计学意义（P〉0．05）;10,50和100μmol／L米非司酮组的A值与对照组比较,差异有统计学意义（P〈0．01）;米非司酮对前列腺癌DU-145、PC-3细胞的抑制作用呈时间-剂量依赖性。10μmol／L米非司酮作用前列腺癌DU-145细胞24和48h的凋亡率分别为15．3％和30．4％,PC-3细胞的凋亡率分别为22．2％和32．0％。经10μmol／L米非司酮作用后,DU-145、PC-3细胞中VEGF和bcl-2蛋白的表达明显减少,而bax的表达显著增加（P〈0．05）。结论米非司酮以时间．剂量依赖性方式抑制激素非依赖性前列腺癌DU-145和Pc-3细胞的增殖,其作用可能是通过降低VEGF蛋白的表达。从而下调bcl-2、激活bax蛋白的表达来实现。     

bcl-2 mRNA、baX mRNA表达在三氧化二砷诱导肝癌细胞凋亡中的意义

目的 分析三氧化二砷(As2O3)诱导肝癌细胞凋亡中凋亡相关基因bcl—2 mRNA、bax mRNA表达的意义。方法 采用电镜、流式细胞仪、电泳及半定量RT—PCR方法检测不同剂量三氧化二砷诱导人肝癌细胞株bel—7402后凋亡的出现及bcl-2mRNA、bax mRNA的表达。结果 0．5にmol/L As2O3处理肝癌细胞未见凋亡，8μmol/L As2O3诱导肝癌细胞出现明显凋亡。对照组和药物组未检测到bcl-2 mRNA的表达，随浓度增加，bax mRNA的表达上调。结论 As2O3通过诱导凋亡抑制肝癌细胞株bel-7402的增殖，凋亡诱导基因bax mRNA的表达上调与此过程有关。bcl—2mR—NA表达与此过程无关。     

米非司酮对前列腺癌PC-3细胞周期及其蛋白的影响

目的 探讨米非司酮（MIF）对前列腺癌PC-3细胞周期及其调控蛋白的影响及其作用机制。方法 MTT法检测1、10、50、100μmol／LMIF作用于PC-3细胞24～120h的吸光度（A）值，流式细胞仪检测10、50μmol／LMIF作用PC-3细胞48h后细胞周期的变化，免疫组化法和Western blot法检测10、50μmol／LMIF处理48h后PC-3细胞cyclinD1、bax、bcl-2蛋白表达的变化情况。结果 1μmol／LMIF作用24～120h的A值与对照组相比差异无统计学意义（P〉0．05）；10、50、100μmol／L组A值与对照组比较差异有统计学意义（P〈0．01）；MIF对PC-3细胞的抑制作用呈时间-剂量依赖性。MIF作用48h后使PC-3细胞停滞于G1／G0期，并使此期细胞比例从对照组的27．4％增加到10μmol／L组的50．4％和50μmol／L组的59．2％，差异有统计学意义（P〈0．05）。处理后PC-3细胞中bcl-2蛋白和cyclinD1蛋白表达量，与对照组比较差异有统计学意义（P〈0．05）；而bax表达量显著增加。结论 MIF以时间．剂量依赖性方式抑制前列腺癌PC-3细胞的增殖，可能通过下调cyclinD1蛋白表达，阻止PC-3细胞G1期向S期的转换，使其停留于G1／G0期；同时降低bcl-2蛋白的表达及激活bax蛋白的表达等抑制前列腺癌PC-3细胞增殖。     

尼美舒利对胆管癌QBC939细胞增殖与凋亡的调节

目的研究选择性环氧合酶-2（cyclooxygenase-2,COX-2）抑制剂尼美舒利对人胆管癌细胞系QBC939增殖和凋亡的影响.方法应用MTT比色法观察尼美舒利对人胆管癌细胞系QBC939增殖的影响,细胞凋亡采用透射电镜及流式细胞仪检测,应用免疫组化、RT-PCR检测尼美舒利对凋亡相关基因表达的影响.结果尼美舒利呈时间、剂量依赖性抑制胆管癌细胞增殖,高浓度（200 μmol/L）尼美舒利不仅抑制胆管癌细胞增殖,而且诱导其凋亡,流式细胞仪研究显示,随药物浓度增加,细胞凋亡率显著增加,透射电镜下可见典型的细胞凋亡形态学改变：细胞核染色质致密浓缩,凋亡小体形成等,免疫组化和RT-PCR测定显示尼美舒利显著下调bcl-2、survivin表达,而bax表达上调.结论尼美舒利显著抑制QBC939细胞增殖,诱导其凋亡,且呈时间、剂量依赖性,bcl-2、bax、survivin等凋亡相关基因可能参与了尼美舒利诱导的QBC939细胞凋亡过程.     

小檗胺诱导前列腺癌PC-3细胞凋亡及其机制

目的探讨小檗胺体外诱导雄激素非依赖性前列腺癌PC-3细胞凋亡的作用及其机制。方法噻唑蓝（MTT）法检测10、20、30和40mg／L小檗胺作用于PC-3细胞24、48、72h的吸光度（A）值；流式细胞仪检测小檗胺作用后细胞凋亡率及细胞周期的变化；透射电镜观察细胞凋亡形态；免疫细胞化学法检测小檗胺作用后bcl-2、bax和Survivin表达变化。结果各浓度组小檗胺作用48h。细胞抑制率分别为（13．60±1．49）％、（31．79±2．31）％、（54．16±3．09）％和（63．72±2．46）％，与对照组比较差异均有统计学意义（P〈0．05）。小檗胺对PC-3细胞的抑制作用呈时间-浓度依赖性；40mg／L小檗胺作用24、48、72h，细胞凋亡率分别为（31．44±3．27）％、（50．32±4．03）％和（63．46±3．75）％，与对照组比较差异有统计学意义（P〈0．05）。随小檗胺浓度的增高，凋亡率随之升高，细胞周期呈现G0／G1期、S期细胞比例增多，G2／M期细胞比例减少趋势；电镜扫描可见典型的“凋亡小体”；40mg／L小檗胺作用72h，PC-3细胞中bax的表达增加、Survivin表达减少（P〈0．05），而bcl-2的表达差异无统计学意义（P〉0．05）。结论小檗胺通过诱导细胞凋亡和影响细胞周期的方式抑制PC-3细胞的增殖，并具有时间和浓度依赖性；诱导凋亡的机制可能是通过下调Survivin、上调bax蛋白的表达来实现。     

胡椒碱对人膀胱癌 T24细胞增殖及侵袭作用的研究

目的：探讨不同浓度胡椒碱对膀胱癌 T24细胞增殖和侵袭作用的影响。方法用不同浓度的胡椒碱（5、10、20、40、80、160μmol／L）处理体外培养的膀胱癌 T24细胞,然后通过 MTT实验、Transwell 实验、Western blot 等方法检测 bax 和 bcl-2的表达以及 T24细胞的增殖和凋亡情况。结果胡椒碱作用于 T24细胞24 h 后,IC50值为38．73μmol／L,并且呈剂量依赖性。随着胡椒碱浓度的增加,T24细胞活性被抑制作用明显增加,且抑凋亡蛋白 bcl-2的表达量减少,促凋亡蛋白 bax 的表达量增加。结论胡椒碱对膀胱癌 T24细胞具有抑制增殖及促进其凋亡的作用。     

三氧化二砷抑制肾癌细胞系786-0增殖及诱导凋亡的研究

目的探讨三氧化二砷(As2O3)对人肾癌细胞系786-0的增殖抑制和诱导凋亡的作用及可能机制。方法采用细胞增殖检测、形态学观察、琼脂糖凝胶电泳和肿瘤克隆形成等方法观察As2O3对786-0细胞的增殖抑制和诱导凋亡的作用,以免疫组织化学和逆转录-聚合酶链反应(RT-PCR)技术等探讨As2O3的作用机制。结果2μmol/L以上浓度As2O3可显著抑制786-0细胞的增殖、降低细胞核分裂指数并出现凋亡的形态学改变和DNA片段化,经2.0μmol/LAs2O3处理72h后,其抑制786-0细胞增殖率为69.13%(P<0.01),使其核分裂指数由6.00降低至1.80(P<0.01),肿瘤细胞克隆形成抑制率达到100.00%。As2O3使786-0细胞内bcl-2、PCNA和Ki-67基因表达降低(P<0.01),其作用随药物浓度升高和时间延长而增加。结论As2O3对786-0细胞具有显著的增殖抑制作用,并具有浓度和时间依赖性特点,可能通过下调其PCNA和Ki-67基因表达抑制增殖,抑制bcl-2基因的表达诱导细胞凋亡。     

雷帕霉素抑制人前列腺癌细胞增殖及其作用机制

目的 观察雷帕霉素(Rapamycin)对体外培养的人前列腺癌PC-3M-2B4细胞增殖及凋亡的影响,探讨其机制.方法 分别用不同浓度的雷帕霉素(100、200、400、800μg/L)对细胞进行干预后,采用噻唑蓝(MTT)比色法检测细胞增殖变化,流式细胞术检测细胞凋亡变化,Western blot 法检测凋亡相关蛋白bcl-2及bax表达的变化.结果 雷帕霉素能明显抑制PC-3M-2B4细胞的增殖活性,此作用呈现量-效、时-效关系.雷帕霉素呈浓度依赖性诱导细胞凋亡.雷帕霉素作用PC-3M-2B4细胞后,细胞内凋亡抑制蛋白bcl-2的表达明显降低,bax蛋白的表达明显增加.结论 雷帕霉素能够通过调节凋亡相关蛋白bcl-2和bax的表达比例,诱导前列腺癌细胞凋亡,从而抑制肿瘤生长.

Abstract：

Objective To investigate the effects of Rapamycin on the growth and apoptosis of human prostate carcinoma cell line PC-3M-2B4. Methods The inhibitory effect of Rapamycin was observed at 100,200,400,800μg/L on the growth of human prostate carcinoma cell line PC-3M-2B4 in serum-free medium for different concentrations by methyl thiazol tetrazolium (MTF) assays. Flow cytometry (FCM)analysis was used to study the changes of cell apoptosis. The expression level of bcl-2 and bax was determined by Western blotting. Results Rapamycin caused dose-dependent inhibition on the growth of human prostate carcinoma cell line PC-3M-2B4 in a concentration-and time dependent manner. Rapamycin induced the apoptosis of PC-3M-2B4 cells in a concentration-dependent manner. The levels of bcl-2 protein were reduced gradually with the increase of concentration or action time. Conclusion Rapamycin, a mTOR inhibitor, inhibits the growth of human prostate cancer cell and induces apoptosis of human prostate cancer cell. mTOR might be a potential target for anti-prostate cancer.     

三氧化二砷对激素非依赖性前列腺癌PC-3细胞Caspase-3活性及Survivin基因表达的影响

目的　探讨三氧化二砷对激素非依赖性前列腺癌PC 3细胞株细胞增殖、细胞凋亡、Caspase 3活性及Survivin基因表达的影响。方法　以 1、2、3、6、10 μmol/L的三氧化二砷作用于体外培养的PC 3细胞 ,48h后对细胞增殖、细胞凋亡、Caspase 3活性 ,SurvivinmRNA表达进行检测。结果　 48h后各浓度的三氧化二砷均可抑制PC 3细胞增殖 ,3、6、10 μmol/L处理组可检测到细胞凋亡 ,凋亡率分别为 11.8%、12 .7%、2 9.6% (P <0 .0 0 1)。1、2、3、6、10 μmol/L三氧化二砷组Cas pase 3活性较对照组升高10 .5、2 7.5、3 1.5、3 4.5及 42倍。对照组及 1、2、3、6、10 μmol/L组的Sur vivin基因表达强度分别为 1.11± 0 .2 4、0 .99± 0 .0 6、0 .89± 0 .12、0 .78± 0 .0 4、0 .5 1± 0 .0 6、0 .4±0 .0 5 ,差异具有统计学意义意义 (P <0 .0 1)。结论　三氧化二砷可抑制PC 3细胞的增殖 ,诱导凋亡 ,与三氧化二砷的浓度相关 ,这一作用与三氧化二砷抑制PC 3细胞中Survivin基因表达及增加Caspase 3的活性有关。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

Systemic analgesia adapted to the children's condition

A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions.