胰腺癌PC-3细胞株外源性p14ARF抑癌基因表达与内源性p53表达水平的关系

目的　探讨外源性 p1 4ARF基因表达于胰腺癌PC 3细胞后与另一重要细胞周期调控蛋白 p53表达水平的相互关系。 方法　将含人 p1 4ARFcDNA的重组质粒通过脂质体介导转染入胰腺癌PC 3细胞中 ,并筛选出阳性克隆 ,逆转录 聚合酶链反应 (RT PCR)、Westernblot法检测PC 3细胞转染前后p1 4ARF的mRNA及蛋白的表达 ,同时用Westernblot分析其内源性 p53蛋白表达水平的变化。噻唑蓝 (MTT)比色法测定PC 3细胞在转染前、后的生长曲线变化。结果　胰腺癌PC 3细胞中p1 4ARF基因缺失。外源性 p1 4ARF基因成功转染入PC 3细胞并获得 1 4× 1 0 3大小的p1 4蛋白表达 ,且内源性 p53蛋白表达水平在转染后明显增高。PC 3细胞在导入 p1 4ARF基因后第 1天及第 5天的生长抑制率分别为 2 2 %及 2 6 % ,两者差异有显著性 (P <0 .0 5)。结论　p1 4ARF基因可上调胰腺癌PC 3细胞的内源性p53蛋白表达水平 ,从而发挥其细胞周期阻滞功能。     

p14ARF基因对胰腺癌细胞侵袭力的影响

目的探讨外源性p14ARF基因导入人胰腺癌PC-3细胞株后,细胞侵袭力的变化。方法用脂质体介导法将外源性p14ARF基因导入人胰腺癌PC-3细胞株后,用细胞穿透Matrigel 胶法比较转染前后细胞侵袭力的改变,并用逆转录-聚合酶链反应(RT-PCR)法检测与侵袭转移相关基质金属蛋白酶(MMP)2和MMP9表达。结果转染p14ARF基因后的PC-3细胞穿过Ma- trigel胶的能力减弱,48 h后平均穿膜细胞数从(92±12)个减少到(28±5)个,而且MMP9 mRNA 表达下降。结论 p14ARF基因能抑制胰腺癌PC-3细胞的侵袭能力。     

p21waf1基因真核表达载体的构建和对人胆管癌细胞生长的影响

目的　探讨p2 1waf1基因过表达在人胆管癌细胞增殖和凋亡中的作用。方法　包含 2 .1kb的 p2 1waf1cDNA片段经阳离子脂质体DOTAP包裹转染人胆管癌细胞QBC939中 ,并得到稳定表达 ,通过聚合酶链反应 (PCR)、逆转录 PCR(RT PCR)、流式细胞仪及免疫组织化学等方法检测p2 1waf1基因表达、细胞生长和细胞凋亡等情况。结果　p2 1waf1基因转染后 ,细胞生长明显受抑制 ,细胞周期停滞于G1期 ,表现为与对照组相比 ,细胞周期G1期比例明显增加 ,S和G2 /M期比例明显减少(G1期 :5 7.32 %→ 73 .6 9% ;S期 :2 1.81%→ 15 .85 % ;G2 /M期 :19.35 %→ 11.76 % ) ,细胞凋亡率增加(3 .47%→ 15 .81% ) ,裸鼠致瘤性降低。结论　p2 1waf1基因能够抑制人胆管癌细胞增殖和诱导细胞凋亡。     

p14ARF基因转染治疗胰腺癌的研究

目的 探讨p14ARF抑癌基因转染对胰腺癌（PC－3细胞）生长抑制的影响。方法 用脂质介导方法将p14ARF基因转导到人胰腺癌细胞株PC－3,应用逆转录酶链反应（RT－PCR）检测p14ARFmRNA 表达;应用免疫印迹方法分析p14ARF转基因蛋白表达,并观察p14ARF基因转染的胰腺癌细胞生长情况。结果 p14ARFmRNA基因转染的PC－3细胞能够表达p14ARF,并通过免疫组化和免疫印迹证实外源性p14ARF基因已转入细胞并结合于细胞基因组中。结论 p14ARF基因转染后的PC－3细胞明显受到抑制,提示p14ARF基因转染治疗胰腺癌具有潜在的临床应用价值。     

SUMO-1对p53基因诱导HepG2细胞凋亡的增强作用

目的研究小分子泛素样修饰体1(smallubiquitin likemodifier1,SUMO1)在野生型p53基因诱导HepG2细胞凋亡中的作用。方法用含人野生型p53基因质粒pcDNA3wtp53(pwtp53)、含人双微粒体基因2〔(humandoubleminutegene2(HDM2);鼠同源基因为MDM2〕质粒pCMV HDM1B(pMDM2)、含人SUMO1基因质粒pcDNA3His6SUMO1(pSUMO1)和空质粒pcDNA3分别或同时转染HepG2细胞,获得各转染细胞系,应用Westernblot检测转染后细胞中质粒蛋白的表达及流式细胞技术检测细胞凋亡比例。结果转染pwtp53和pMDM2质粒的HepG2细胞均可见p53及MDM2蛋白条带,同时转染pSUMO1质粒的细胞分别可见被SUMO1修饰的相对分子量较大的p53和MDM2蛋白条带,在未转染任何质粒、仅转染空质粒和pSUMO1质粒的细胞中只检测到少量p53蛋白表达。转染pwtp53及pwtp53+pSUMO1质粒的HepG2细胞凋亡比例分别为(16.79±1.62)%和(18.15±1.36)%,转染pwtp53+pMDM2+pSUMO1质粒的细胞凋亡比例为(14.06±1.84)%,转染pwtp53+pMDM2质粒的细胞凋亡比例则下降至(5.17±1.23)%,与前三者比较差异有显著性意义(P<0.01);其他转染系细胞中的细胞凋亡比例均≤2%,差异无显著性意义。结论SUMO1通过与p53蛋白的结合或翻译后修饰,抑制MDM2等癌基因蛋白对p53蛋白的降解,可增强p53抑癌基因诱导的细胞凋亡。     

丙型肝炎病毒p7蛋白上调去唾液酸糖蛋白受体1基因的表达

目的探讨HCVp7对去唾液酸糖蛋白受体1(ASGPR1)启动子转录的调节作用。方法据生物信息学确定ASGPR1的启动子区域,聚合酶链反应(PCR)扩增ASGPR1p,克隆至真核报告载体pCAT3-Basic中,构建pCAT3-ASG-PR1p报告载体;以该质粒转染肝癌细胞系HepG2,用酶联免疫吸附试验(ELISA)检测氯霉素乙酰转移酶(CAT)的表达活性;并与pcDNA3.1(-)-HCVp7共转染HepG2细胞系,用ELISA检测CAT的表达活性。结果成功获得ASGPR1p启动子的正确克隆。pCAT3-ASGPR1p和pcDNA3.1(-)-HCVp7共转染HepG2细胞的CAT表达活性是pCAT3-Basic空载体的7.7倍,是pCAT3-ASGPR1p的2.4倍。结论 ASGPR1启动子有顺式激活下游基因的活性,HCVp7对ASGPR1基因的表达有上调作用。     

外源野生型p53基因对人胆囊癌GBC-SD细胞生长的作用

目的观察外源野生型p53(wtp53)基因对人胆囊癌GBC-SD细胞生长的抑制作用。方法用脂质体介导的转染技术,将含有wtp53的真核表达质粒pCMV-p53导入GBC—SD细胞。用聚合酶链反应(PCR)和逆转录-聚合酶链反应(RT—PCR)证实外源p53基因的整合与表达;用细胞计数和克隆形成实验反映细胞增殖状况;用流式细胞仪检测细胞周期的改变。结果转化细胞系中存在外源p53基因的整合与表达。稳定转染wtp53基因的GBC-SD-wtp53细胞,体外生长速率明显减慢;克隆形成率仅为3．2％,显著低于对照组GBC-SD-mutp53(28％)和亲本GBC-SD细胞 (29％,P<0．01);G0／G1期、S期、G2／M期比例(％)分别为(66．12±4．2、32．87±2．15、1．01± 0．37),与对照组(46．20±5．1、30．78±2．92、23．02±1．87)及亲本细胞(41．25±3．2、40．03±2．09、 18．72±1．05)相比,G0／G1期细胞比例明显增加,G2／M期细胞比例显著减少(P<0．01)。结论外源野生型p53基因的表达能有效抑制人胆囊癌GBC-SD细胞的体外生长。     

p15、p16对人胆管癌细胞增殖影响的实验研究

目的 研究抑癌基因p15、p16对人胆管癌细胞的生长抑制作用。方法 将抑癌基因p15、p16的cDNA构建到真核表达的质粒载体pcDNA3-neo中形成p15真核表达质粒pcDNA3 p15及p16真核表达质粒pcDNA3 p16。通过脂质体法将重组质粒pcDNA3 p15,pcDNA3 p16质粒分别转染人胆管癌细胞系QBC939，获得稳定高表达p15或p16的人胆管癌细胞模型。用MTT法测定细胞生长曲线，流式细胞光度术测定细胞生长周期。结果 p15、p16高表达的人胆管癌细胞QBC939的增殖受到抑制，p15、p16均明显阻遏细胞由G1期向S期的转换。结论 抑癌基因p15、p16均参与了细胞周期的阻抑作用。     

野生型p16基因对人瘢痕疙瘩成纤维细胞生长及代谢影响的实验研究

目的　探讨野生型 p16基因对人瘢痕疙瘩成纤维细胞 (keloidfibroblasts,KFb)生长增殖及DNA合成代谢的影响。　方法　构建含p16cDNA片段的真核表达载体 pcDNA3 p16 ,采用脂质体介导的基因转染法 ,将其导入体外培养的KFb中 ,并用G4 18筛选阳性克隆。随后对已转染及未转染的KFb进行免疫细胞化学染色 ,观察p16蛋白的表达 ,并通过绘制细胞生长曲线及采用氚标记胸腺嘧啶脱氧核苷 (3 H TdR)掺入法 ,比较转染前后细胞在生长增殖及DNA合成代谢方面的变化。结果　经酶切鉴定证实 ,pcDNA3 p16构建成功。已转染的KFb经G4 18筛选 ,出现阳性克隆 ,并有 p16蛋白表达 ;与正常KFb比较 ,其生长增殖速度明显减缓 ,DNA合成代谢能力明显减弱 (P <0 .0 5 )。　结论　p16基因对KFb的生长增殖及DNA合成代谢有明显的抑制作用。     

导入野生型p53基因对人胶质瘤细胞生长及放疗敏感性的影响

目的　研究野生型p5 3基因对人胶质瘤细胞生长及放疗敏感性的影响。方法　将野生型 p5 3基因导入U 2 5 1细胞 ,通过逆转录 聚合酶链反应 (RT PCR)检测 p5 3基因的表达。U2 5 1细胞分为 4组 :对照组、转染组、放疗组、转染联合放疗组。用四甲基偶氮唑盐微量酶反应比色法(MTT法 )和流式细胞仪检测p5 3基因或 /和放疗 (3、6、9Gy)对U 2 5 1细胞生长抑制及凋亡的影响。结果　通过RT PCR证实了 p5 3基因在U 2 5 1细胞中的表达。MTT检测发现 p5 3基因对U2 5 1细胞的生长抑制率为 (79.60± 5 .69) %。当放射剂量为 3、6、9Gy时 ,U2 5 1细胞的生长抑制率分别为(17.0 6± 4.3 5 ) % ,(17.3 9± 1.67) % ,(18.73± 4.68) %。当 p5 3基因与放疗 (3、6、9Gy)联合作用时 ,抑制率分别为 (80 .60± 5 .3 5 ) % ,(90 .3 0± 1.67) % ,(91.3 0± 2 .0 1) %。p5 3基因转染所产生的U 2 5 1细胞凋亡率为 17.3 8%。放疗 (3、6、9Gy)引起的细胞凋亡率分别为 4.61% ,4.84% ,5 .40 %。当p5 3基因与放疗 (3、6、9Gy)联合作用时 ,凋亡率分别为17.80 % ,2 0 .0 3 % ,2 2 .3 4%。结论　野生型p5 3基因与放疗对人胶质瘤细胞生长有协同抑制作用     

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.     

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.     

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.