冬凌草甲素诱导胃癌SGC-7901细胞凋亡及机制

目的 探讨冬凌草甲素体外诱导胃癌SGC-7901细胞凋亡和细胞周期阻滞的作用及其机制.方法 10～80 μmol/L冬凌草甲素分别处理SGC-7901细胞后,CCK8法检测冬凌草甲素体外对SGC-7901细胞抑制生长的作用;用流式细胞仪分别观察冬凌草甲素诱导凋亡及细胞周期阻滞.Western blot测定凋亡相关蛋白的表达.结果 冬凌草甲素对SGC-7901细胞有明显的生长抑制作用,并随着药物浓度的增加(10～80 μmol/L)而逐渐增强,呈浓度、时间依赖关系.此外,流式细胞术检测发现,冬凌草甲素浓度为0、10、40、60、80 μmol/L,作用24 h后,G_2/M期细胞数分别是(9.90±1.17)%、(9.94±0.27)%、(11.76±0.16)%、(15.64±1.48)%和(22.59±1.01)%;而S期细胞比例分别为(31.79±1.03)%、(30.90±0.47)%、(29.25±0.80)%、(21.46±1.61)%、(18.81±0.61)%,冬凌草甲素能够使得SGC-7901细胞周期呈剂量依赖性阻滞于G_2/M期;冬凌草甲素浓度为80 μmol/L,作用12、24 h后,凋亡率分别为(12.78±1.54)%、(20.62±2.39)%,明显高于对照组的(9.92±0.56)%,其能使SGC-7901细胞发生凋亡.随着冬凌草甲素作用时间延长,SGC-7901细胞的bel-2蛋白表达逐渐减弱,前体Caapase-3被激活.结论 冬凌草甲素能够诱导SGC-7901细胞产生凋亡,并使细胞周期阻滞在G_2/M期.其凋亡机制可能与下调bcl-2蛋白表达及Caspase-3的激活相关.     

鱼藤素对胃癌细胞MKN-45增殖及凋亡的影响

目的:研究鱼藤素对胃癌细胞增殖及凋亡的影响。方法:利用CCK8检测不同浓度(0、1、10和25μmol/L)鱼藤素作用于胃癌细胞MKN-45 24、48、72和96 h后对其增殖的影响;AnnexinⅤ-FITC/PI检测细胞凋亡;流式细胞仪检测细胞周期;利用倒置相差显微镜观察鱼藤素作用后细胞形态的变化;DAPI及Hoechst染色观察细胞核变化。结果:1μmol/L鱼藤素作用于MKN-45细胞24 h后抑制率为(28.82±0.002)%。随着鱼藤素浓度(10、25μmol/L)增加,作用时间(48、72、96 h)延长,其抑制作用增加,表明其抑制作用呈时间-剂量依赖关系。不同浓度(1、10和25μmol/L)鱼藤素作用于细胞48 h后,早期凋亡率、晚期凋亡率和总凋亡率显示鱼藤素显著促进细胞凋亡。细胞周期检测发现,与对照组比较,1μmol/L鱼藤素作用于细胞48 h后,S期细胞比例升高,G_0/G_1期及G_2/M期细胞比例下降;10μmol/L鱼藤素作用于细胞48 h后,G_2/M期细胞比例升高,G_0/G_1期细胞比例下降(P     

木脂素1对人胃癌细胞株SGC-7901体外抗肿瘤作用

目的研究木脂素1抑制人胃癌细胞株SGC-7901增殖的机理。方法使用倒置显微镜观察不同浓度的木脂素1对人胃癌细胞株SGC-7901细胞形态学变化的影响;采用四甲基偶氮唑盐比色法(MTT法)检测木脂素1在不同浓度范围内对人胃癌细胞株SGC-7901细胞存活率的影响,计算半数抑制浓度(IC50);通过流式细胞仪分析木脂素1对SGC-7901细胞凋亡以及细胞周期的影响;通过Western blot法分析木脂素1对SGC-7901细胞凋亡相关蛋白Caspase3、Bcl-2及Bax表达的影响。结果形态学结果显示,木脂素1对SGC-7901细胞有不同程度的杀伤作用,其作用随浓度的增加而增强;在不同浓度范围内(2.5~20μg/m L),木脂素1对SGC-7901细胞存活率表现出不同程度的抑制作用,且呈现出时间和浓度依赖关系(P0.05),其IC50为4.19μg/m L;木脂素1干预SGC-7901细胞48 h后,随着药物浓度增加,凋亡细胞比率、G2/M期细胞比率以及Caspase3和Bax的表达增高(P0.05),而G0/G1期细胞比率和Bcl-2的表达降低(P0.05)。结论木脂素1显著抑制SGC-7901细胞增殖并通过阻滞其于细胞周期的G2/M期而诱导细胞凋亡,其机理可能与活化该细胞中的Caspase3及Bax蛋白以及抑制Bcl-2蛋白表达有关。     

塞来昔布对SGC-7901人胃癌细胞NHE1表达及细胞内pH的影响

目的探讨选择性COX-2抑制剂塞来昔布对SGC-7901人胃癌细胞钠氢交换体1(NHE1)表达及细胞内pH的影响。方法以SGC-7901人胃癌细胞为研究对象,不同浓度的塞来昔布(5、12.5、25、50、75和100μmol/L)作用于SGC-7901细胞不同时间后,采用MTT法检测塞来昔布对胃癌细胞生长的抑制作用;采用Western blot技术检测不同浓度塞来昔布对SGC-7901细胞NHE1表达的影响;在此基础上,采用BCECF-AM免疫荧光测定不同浓度塞来昔布对SGC-7901细胞内pH的影响。结果塞来昔布能抑制SGC-7901细胞的生长,在一定范围内,其抑制作用随着塞来昔布浓度的增加而增强;同一浓度条件下,其抑制作用随着作用时间的延长也相应增强(P0.05)。不同浓度塞来昔布(除5μmol/L组外)作用于SGC-7901细胞后,NHE1表达均有下调,并呈浓度依赖性(P0.05)。SGC-7901细胞内pH为碱性,不同浓度(除5μmol/L组外)塞来昔布干预24 h后,SGC-7901细胞内pH较对照组细胞明显下降(P0.05),并且下降情况呈浓度依赖关系(P0.05)。结论塞来昔布对SGC-7901细胞生长抑制作用可能通过下调NHE1表达和降低细胞内pH实现。     

胃泌素促进胃癌细胞增殖和血管生成拟态形成

目的 探讨胃泌素对胃癌细胞血管生成拟态(VM)的作用及其分子机制.方法 应用免疫细胞化学检测SGC-7901、AGS细胞中胃泌素受体(CCK-BR);用终质量浓度为10、100 nmol/L胃泌素处理SGC-7901和AGS 72 h,噻唑蓝(MTT)比色法检测细胞增殖率、实时定量聚合酶链反应(Real-time PCR)检测缺氧诱导因子-1α(HIF-1α)的表达、酶联免疫吸附实验检测血管内皮细胞生长因子(VEGF)的分泌水平;三维培养SGC-7901和AGS,用10、100 nmol/L胃泌素处理,显微镜下观察24、48、72 h VM形成,计数72 h VM形成数;软琼脂克隆形成实验检测细胞培养3周的克隆形成率.结果 SGC-7901和AGS细胞表达CCK-BR;经10、100 nmol/L的胃泌素处理后,SGC-7901和AGS的细胞增殖率和克隆形成率高于对照组,细胞的环形、半环形VM形成数也高于对照组(P＜0.01);细胞中HIF-1α的表达量比对照组上调了5.39、11.00(SGC-7901)、4.12和6.06倍(AGS);分泌性VEGF的浓度也比对照组增高[298、339 μg/mg蛋白(SGC-7901)及168和281 μg/mg蛋白(AGS),p＜0.01].结论 通过胃泌素-CCK-BR-HIF-1 α-VEGF构成的信号传递链,胃泌素促进胃癌细胞的体外增殖及VM的形成.     

木犀草素基于JAK/STAT信号通路对SGC7901胃癌细胞的作用

目的:研究木犀草素基于JAK/STAT信号通路对SGC7901胃癌细胞的作用.方法:体外培养SGC7901细胞,以1、5、10μmol/L的木犀草素作用24 h,空白对照组不做任何处理,溶剂对照组加入0.5％DMSO,MTT法检测木犀草素对SGC7901细胞增殖的影响,流式细胞技术检测木犀草素对SGC7901细胞凋亡的...     

吡格列酮及全反式维甲酸对胃癌SGC-7901细胞株PPARγ基因的影响

目的 观察吡格列酮(PGZ)及全反式维甲酸(ATRA)对胃癌SGC-7901细胞生长以及对PPARγ mRNA表达的影响,探讨其作用机制.方法 不同浓度的PGZ(25、50、100 μmol/L)、ATRA(0.1、1、10 μg/L)及两者合用(PGZ 50 μmol/L+ATRA 10 μg/L)处理胃癌SGC-7901细胞,CCK-8法观察细胞增殖抑制作用;逆转录-聚合酶链反应(RT-PCR)法检测胃癌SGC-7901细胞PPARγ mRNA表达的变化.结果 PGZ及ATRA均能抑制SGC-7901细胞增殖,呈浓度和时间依赖性;两者合用效应比单独使用更显著(P＜0.05).PGZ(50 μmol/L)及ATRA(10 μg/L)作用72 h后均明显抑制胃癌SGC-7901细胞PPARγ基因表达,且两者合用效果更显著,差异有统计学意义(P＜0.05).结论 PGZ及ATRA可能通过下调PPARγ mRNA表达抑制胃癌SGC-7901细胞增殖.     

鱼藤素诱导人前列腺癌细胞凋亡及其机制研究

目的 观察鱼藤素对于激素抵抗型前列腺癌(HRPC)细胞PC3和DU145增殖、细胞周期和凋亡的影响并探讨其机制.方法 设阴性对照组(有细胞但不加药),空白对照组(无细胞仅有培养液),阳性对照组(渥曼青霉素100 nmoL/L),及鱼藤素分别10、100、1 ìmol/L共6组.CCK-8法进行细胞毒性实验,检测细胞生长抑制率.流式细胞术检测细胞周期和凋亡,Westem-blot检测Akt、MAPK及其磷酸化蛋白表达,探讨药物作用机制.结果 10 nmol/L～1 ìmol/L鱼藤素对PC3细胞均有生长抑制作用,呈现明显的时间、浓度依赖性,对DU145细胞则无此作用.鱼藤素使PC3细胞出现G2/M期阻滞现象并引起浓度依赖性的凋亡,而未改变DU145细胞的周期分布也不能诱导其凋亡.鱼藤素能够阻断P13K/AKT通路而对MAPK通路无影响.结论 鱼藤素通过阻断PI3K/AKT通路实现抑制PC3细胞增殖、诱导凋亡的作用.两株细胞间实验结果 的差异是因为其PI3K/AKT通路活化状态的差异造成的.     

塞来昔布对胃癌SGC-7901细胞凋亡与Fas/FasL表达的影响

目的 观察选择性环氧合酶2抑制剂塞来昔布体外诱导胃癌SGC-7901细胞凋亡的作用及其机制.方法 用吖啶橙/溴化乙啶染色结合荧光显微镜、流式细胞仪(FCM)技术观察不同浓度的塞来昔布对胃癌SGC-7901细胞凋亡的影响,用流式细胞仪技术榆测Fas和FasL.蛋白表达.结果 荧光染色法显示塞来昔布在15～120 μmol/L时诱导胃癌SGC-7901细胞凋亡,且呈浓度和时间依赖性.FCM显示不同浓度的塞来昔布作用SGC-7901细胞48 h后.凋亡率分别为8.02%～50.81%,呈浓度依赖性.塞来昔布上凋胃癌SGC-7901细胞Fas蛋白的表达,下调FasL蛋白的表达.结论 塞来昔布可诱导胃癌SGC-7901细胞凋亡;Fas/FasL表达的改变可能是塞来昔布诱导胃癌SGC-7901细胞凋亡的机制之一.     

Akt特异性抑制剂鱼藤素对前列腺癌PC-3细胞生长的影响

目的:观察Akt抑制剂鱼藤素对前列腺癌PC-3细胞株的抑制作用并探讨其可能的作用机制。方法:用MTT法检测鱼藤素对PC-3细胞的增殖抑制率;流式细胞术(FCM)检测鱼藤素对细胞周期的影响;RT-PCR检测细胞中小鼠双微体2(MDM2)、糖元合成酶激酶3β(GSK3β)mRNA表达的变化;Western印迹法检测MDM2、GSK3β蛋白表达的变化。结果:MTT法显示,10、100、500、1 000 nmol/L的鱼藤素作用于前列腺癌PC-3细胞24、48、72 h后,对前列腺癌PC-3细胞增殖抑制率分别为(91.10±3.75)%、(86.39±1.16)%、(79.51±2.63)%;(82.46±3.65)%、(76.84±0.97)%、(69.69±2.30)%;(81.46±0.41)%、(75.56±1.12)%、(54.07±3.21)%;(66.77±2.82)%、(58.22±0.35)%、(39.34±2.40)%,均能显著抑制其增殖(P均<0.01);FCM检测显示各浓度的鱼藤素使前列腺癌PC-3细胞周期阻滞在G0/G1期比例增加[(53.4±2.3)%、(62.4±2.2)%、(63.6±1.1)%、(65.0±0.3)%、(66.5±1.9)%,P均<0.01],S期细胞比例减少[(26.9±1.7)%、(14.7±2.4)%、(11.1±5.2)%、(5.8±1.1)%、(7.0±0.6)%,P均<0.01];RT-PCR和Western印迹法结果显示鱼藤素上调了GSK3βmRNA和蛋白的表达水平,而下调了MDM2 mRNA和蛋白的表达水平。结论:Akt抑制剂鱼藤素能抑制前列腺癌PC-3细胞的增殖,其机制可能与影响Akt信号通路下游分子GSK3β、MDM2的表达相关。     

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.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

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.