莪术醇对人脑胶质瘤U251细胞增生与凋亡影响的实验研究

目的 本研究观察中药活性成分莪术醇对人脑胶质瘤细胞株U251增生与凋亡的影响,检测其对胶质瘤细胞凋亡相关基因表达的影响,初步探讨其抗胶质瘤的可能机制,为脑胶质瘤的中草药治疗积累实验数据.方法 以体外培养的人脑胶质瘤细胞株U251为模型,以培养基稀释莪术醇成不同浓度,观察与检测以下内容:MTT法检测不同时间、不同浓度莪术醇对U251细胞增生的影响;显微镜观察不同浓度莪术醇对U251细胞形态学的影响;流式细胞仪检测不同浓度莪术醇对U251细胞凋亡的影响;RT-PCR法检测不同浓度莪术醇对U251细胞中凋亡相关基因bcl-2与COX-2表达水平的影响.结果 莪术醇对人脑胶质瘤U251细胞增生有抑制效应,且表现出浓度依赖性与时间依赖性(P＜0.05).结论 莪术醇对人脑胶质瘤U251细胞有明确的增生抑制作用.诱导凋亡、抑制增生可能为莪术醇抑制胶质瘤增生效应的重要机制.莪术醇下调人脑胶质瘤U251细胞中bcl-2与COX-2的基因表达水平可能为其诱导凋亡、抑制增生的重要机制之一.     

RNA编辑酶ADAR2在人胶质瘤细胞株中的表达

目的 观察人胶质瘤细胞株SHG44、BT325、U251和正常人脑星形细胞(NHA)中ADAR2mRNA表达水平及苯乙酸(PA)对U251细胞中ADAR2表达的影响.方法 实时荧光定量聚合酶链反应( Real-time fluorescent quantitative PCR)方法检测胶质瘤细胞中ADAR2mRNA表达水平,检测PA处理前后U251细胞中ADAR2mRNA表达水平的变化;噻唑蓝(MTT)比色法检测PA作用24、48和72 h后U251细胞增殖.Western印迹法检测PA作用前后U251细胞中ADAR2蛋白表达.结果 Real-time PCR检测显示:ADAR2 mRNA在NHA中表达极弱(19.9±2.2),在SHG44和BT325细胞中明显表达(35.6±2.8、78.8±3.2),在U251细胞中表达水平最高(101.3±3.5).PA3.0和5.0 mmol/L作用U251细胞24h后,ADAR2mRNA分别为60.3±1.5和50.5±l.2(P＜0.01);MTT法检测显示PA对U251细胞的增殖呈时间和剂量依赖性抑制(P＜0.01);Western印迹法显示PA可降低ADAR2蛋白表达水平.结论 在不同的胶质瘤细胞中,ADAR2mRNA表达水平不同;PA可抑制U251细胞中ADAR2mRNA和蛋白水平的表达.     

RNA干扰抑制Cyr61表达对人脑胶质瘤细胞生物学行为的影响

目的 观察RNA干扰技术沉默Cyr61基因表达对人脑胶质瘤U251细胞生物学行为的影响.方法 针对Cyr61 mRNA的序列设计合成小干扰RNA(siRNA)的DNA模板,构建pRNAT-Cyr61重组质粒,转染人脑胶质瘤U251细胞;RT-PCR和Western blot检测其对U251细胞内源性Cyr61表达的影响;用噻唑蓝(MTT)比色法观察U251细胞体外增殖活性的变化;用Transwell 小室法检测U251细胞体外侵袭能力的改变;流式细胞仪检测U251细胞凋亡并用透射电镜观察凋亡后的细胞形态学变化.结果 pRNAT-Cyr61重组质粒在mRNA及蛋白水平分别显著抑制Cyi61基因表达,抑制率分别最高达到74.87%和78.23%;U251细胞的体外生长抑制率最高达68.15%,侵袭细胞数下降至(46.00±2.82)个;U251细胞凋亡率最高达53.16%.结论 pRNAT-Cyt61可抑制Cyr61在人脑胶质瘤U251细胞中的表达,并抑制细胞的增殖活性和侵袭能力,促进细胞凋亡.     

阻断信号传导和转录活化因子3对胶质瘤细胞侵袭性特征的影响

目的 观察用AG490阻断人胶质瘤细胞株中信号传导和转录活化因子3(STAT3)信号通路对肿瘤细胞侵袭性特征的影响.方法 体外培养的人胶质瘤U251、U87细胞株,应用AG490阻断STAT3信号通路;以Western blot检测STAT3和其激活状态p-STAT3蛋白在AG490作用前后的表达情况;通过Transwell细胞侵袭实验了解肿瘤细胞体外侵袭能力的变化;用明胶酶谱法检测肿瘤细胞基质金属蛋白酶(MMP-2、MMP-9的表达;用逆转录一聚合酶链反应(RT-PCR)了解血管内皮生长因子(VEGF)mRNA表达的变化.结果 AC490作用后胶质瘤细胞内p-STAT3表达下降,其程度随AG490浓度升高而增强,差异有统计学意义(P<0.01).而STAT3蛋白的表达不受AG490影响,与对照组比较差异无统计意义(P>0.05),说明AG490的作用机制是通过抑制STAT3蛋白的磷酸化激活过程从而阻断STAT3信号通路.AG490作用后,U251细胞的体外侵袭力下降,差异有统计学意义(P<0.01).STAT3信号通路阻断后,胶质瘤细胞MMP-2、MMP-9的表达下调,差异有统计学意义(P<0.01).VEGF mRNA表达也相应下降(P<0.05).结论 应用AG490阻断STAT3信号通路能够抑制胶质瘤细胞的体外侵袭能力,STAT3信号通路有可能成为控制胶质瘤侵袭性生长的有效靶点.     

肝细胞生长因子受体反义寡核苷酸影响胶质瘤细胞对丝裂霉素C敏感性的研究

目的探讨肝细胞生长因子受体(c-Met)反义寡核苷酸(ASODN)增强胶质瘤细胞系 U251细胞对丝裂霉素C(MMC)敏感性的作用。方法用5 μmol／L c-Met ASODN封闭U251细胞 c-Met mRNA,将50μg/L的MMC与其共培养,采用逆转录-聚合酶链反应(RT-PCR)技术检测c- Met mRNA表达,噻唑蓝(MTT)试验检测U251细胞的生长情况,免疫组织化学法检测细胞PCNA 蛋白的表达,体外检测细胞黏附率。以无义寡核苷酸处理及未处理U251细胞为对照。结果经 c-Met ASODN处理的U251细胞 ,c-Met mRNA的表达(吸光度值为62±21)明显低于经无义寡核苷酸处理U251细胞(吸光度值为150±25,P<0．05);对MMC的敏感性,细胞生长抑制率、细胞黏附率及PCNA指数分别为(53．84±12．21)％、(14．61±3．82)％和(0．35±0．02)％,明显高于相应的无义[(9．86±3．42)％、(24．84±5．90)％和(0．55±0．04)％,P<0．05]。结论 c-Met ASODN能增强胶质瘤细胞系U251细胞对MMC的敏感性,其分子机制可能与c-Met反义寡核苷酸下调了c- Met基因和PCNA蛋白的表达有关。     

榄香烯体外增强人脑胶质瘤U251细胞对γ射线敏感性的研究

目的 探讨榄香烯体外增强人脑胶质瘤U251细胞对γ射线敏感性的机制研究。方法 人脑胶质瘤U251细胞分为4组：空白组、加药组（榄香烯治疗）、放射组（单独γ射线照射）和联合组（榄香烯联合γ射线照射），应用克隆形成计数法，绘制细胞放射生存曲线，计算增敏比，流式细胞仪（FCM）检测细胞周期，电镜观察不同方法处理的U251细胞超微结构的改变，逆转录．聚合酶链反应（RT-PCR）检测c-myc和bcl-2基因的表达。结果 榄香烯增强γ射线对U251细胞株抑制率，呈剂量的依赖性，榄香烯增强U251细胞对γ射线敏感的比值为1．38，FCM检测榄香烯增强γ射线对U251细胞的阻滞作用，导致G2／M期细胞比例明显升高，联合组细胞电镜下见细胞核分裂；RT-PCR证实榄香烯增强γ射线对U251细胞c-myc和bcl-2基因表达的抑制作用。结论 榄香烯对U251细胞有放射增敏作用，其作用机制可能与下调bcl-2和c-myc基因表达有关，诱导U251细胞凋亡和对细胞G2／M期阻滞有关。     

BMS-345541通过抑制IκB激酶/核因子-κB信号通路诱导人脑胶质瘤细胞凋亡

目的 观察IκB激酶(IKK)高度选择性抑制剂BMS-345541对胶质瘤细胞凋亡的影响及其机制.方法 不同浓度BMS-345541作用于人脑胶质瘤细胞株U87MG后,采用Annexin V-FITC/PI双标记法检测细胞凋亡,荧光素酶核因子-κB(NF-κB)报告基因法检测NF-κB活性,免疫印迹法检测bcl-2、Caspase-3和NF-κB胞核定位.结果 终质量浓度1、10、20 μmol/L BMS-345541作用U87MG细胞24 h后,细胞凋亡率分别为(18.2±2.2)%、(49.3±3.6)%、(73.3±8.9)%,与对照组比较差异有统计学意义(P＜0.01).BMS-345541处理U87MG细胞后,bcl-2蛋白表达减少、Caspase-3被激活;NF-κB转录启动子的活性下降(66.2±5.1)%(P＜0.01),NF-κB p65亚单位核移位被抑制.结论 BMS-345541可通过抑制IKK/NF-κB信号通路诱导人胶质瘤细胞凋亡.     

PDIA4基因沉默对胶质瘤细胞凋亡的影响

目的 探讨蛋白二硫键异构酶家族成员4(PDIA4)基因在胶质瘤细胞中的表达及对细胞凋亡的影响.方法 下载并分析CGGA数据库RNAseq数据;收集人脑胶质瘤细胞系U251、U87和星形胶质细胞HA1800,用RT-qPCR法检测细胞系中的PDIA4表达水平;用siRNA转染U251细胞,沉默PDIA4的细胞株为si#7...     

中华眼镜蛇毒C组分诱导U251细胞凋亡及bcl-2/bax相关基因表达的研究

目的以人神经胶质瘤细胞系U251为实验对象，研究中华眼镜蛇毒C组分诱导细胞凋亡的的机制。方法将中华眼镜蛇毒C组分分为1．5mg／L（A组），3．0mg／L（B组），4．5mg／L（C组），15．0mg／L（D组）和30．0mg／L（E组）5个浓度组，以顺铂（DDP）40．0mg／L为阳性对照组，另设一阴性对照组。采用DNA凝胶电泳检测法，观察FC诱导细胞凋亡的情况；采用免疫组织化学法（SP）和逆转录一聚合酶链反应（RT-PCR）法检查bcl-2／bax基因的表达。结果中华眼镜蛇毒C组分对U251细胞具有诱导凋亡的作用，FC诱导U251细胞凋亡率与药物浓度密切相关（P〈0．01），使用FC前后，bcl-2／bax表达无显著变化。结论FC有诱导U251细胞凋亡的作用，但其诱导凋亡不依赖于bcl-2／bax基因的改变。     

LRIG1对人脑胶质瘤放疗敏感性的作用及其机制

目的 探讨多亮氨酸重复区免疫球蛋白样蛋白1( LRIG1)对人脑胶质瘤细胞株U251放疗敏感性的影响及其机制.方法 应用脂质体介导的基因转染技术将PEGFP-N1、PEGFP-LRIG1 质粒分别转染人人脑胶质瘤U251细胞,G418( 1000 mg/L)筛选,建立稳定细胞株,采用克隆形成实验测定N1-U251及LRIG1-U251两组细胞的放射敏感性,Western blot法测定两组细胞中LRIG1及RAD51蛋白的表达差异,彗星分析法测定两组细胞双链DNA断裂的修复.结果 成功建立高表达LRIG1的U251稳定细胞株,LRIG1-U251组(0.352±0.011)较N1-U251组(0.071±0.003) LRIG1基因表达明显上调(P＜0.01).LRIG1基因表达上调后U251细胞的放射敏感性增加,放射增敏比为1.448.上调LRIG1基因明显抑制了RAD51基因的表达(P＜0.01)及照射后的高表达(P＜0.01).彗星分析表明LRIG1基因的过表达将照射8h后U251细胞的Olive彗尾力矩由21.14±3.42增加至32.81±5.61 (P ＜0.05).结论 LRIG1可以增加人脑胶质瘤U251细胞的放射敏感性.机制可能是通过降低RAD51蛋白表达,进而抑制双链DNA损伤的修复.     

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.