蛙皮素对PC-3细胞骨架及细胞内游离Ca~(2+)的影响

目的:观察蛙皮素(BBS)对前列腺癌PC-3细胞骨架形态及细胞内游离Ca2+([Ca2+]i)浓度的影响。方法:①利用免疫荧光法(IH),结合激光扫描共聚焦显微镜(LSCM)检测10-5mol/L浓度BBS处理的PC-3细胞角蛋白(CK)的表达,以反映其对细胞骨架形态的影响;②应用Fluo-3/AM荧光标记技术和LSCM检测不同浓度BBS(10-9、10-7、10-5mol/L)处理的PC-3细胞[Ca2+]i浓度。结果:①10-5mol/L浓度的BBS可促进PC-3细胞CK表达及伪足形成;②BBS可提高PC-3细胞[Ca2+]i浓度,并具有浓度依赖性。结论:实验证明一定浓度的BBS可明显提高PC-3细胞[Ca2+]i浓度及CK表达,进而影响PC-3细胞骨架形态。本研究为探索BBS应用于肿瘤研究以及BBS作用后细胞内信息传递途径提供了基础。     

蛙皮素对雄激素非依赖型前列腺癌细胞增殖、粘附、迁移的影响

目的 观察蛙皮素（Bombesin，BBS）及其受体拮抗剂对雄激素非依赖型前列腺癌细胞系（PC-3、DU-145）增殖、粘附、播散的影响。方法 ①四甲基偶氮唑盐微量酶反应比色法（MTT法）检测BBS及其受体拮抗剂对细胞增殖的影响；②通过计算细胞贴壁率检测BBS及其受体拮抗剂对细胞粘附能力的影响；③细胞划痕试验及Millicell小室检测BBS对细胞播散能力的影响。结果①不同浓度（10^10—10`-5mol／L）的BBS可促进细胞增殖，并呈现一定浓度依赖性，而其受体拈抗剂具有相反作用；②终末浓度10`-6—10`-5mol／L的BBS提高细胞贴壁率效果最佳，其受体拮抗剂则降低细胞贴壁率；③不同浓度的BBS可提高细胞播散能力。结论实验证明BBS可通过特异性受体介导致PC-3、DU-145细胞系增殖、粘附、播散，其拮抗剂具有相反作用。此为探索BBS及其受体拮抗剂应用于肿瘤生物学特性研究提供了基础。     

选择性COX-2抑制剂NS398对前列腺癌PC-3细胞增殖与凋亡的影响

目的观察环氧化酶-2(COX-2)抑制剂NS398对前列腺癌细胞PC-3增殖和凋亡的影响。方法采用四甲基偶氮唑蓝法(MTT法)检测不同浓度和不同时间NS398对PC-3细胞增殖的影响;RT-PCR法检测不同浓度NS398作用PC-3细胞24h后COX-2 mRNA的表达;酶联免疫测定法(ELISA)检测不同浓度NS398作用PC-3细胞24h后PGE2释放水平;流式细胞仪检测不同浓度NS398作用PC-3细胞24h后细胞凋亡情况。结果NS398可以抑制PC-3细胞的增殖,呈时间和剂量依赖性;RT-PCR和ELISA法检测结果显示,随着NS398浓度增高,PC-3细胞COX-2 mRNA表达和PGE2释放水平呈下调趋势;细胞凋亡检测结果显示100、200μmol/LNS398对PC-3细胞具有诱导凋亡的作用。结论NS398可能通过COX-2依赖性途径抑制前列腺癌PC-3细胞增殖,促进肿瘤细胞凋亡。     

白藜芦醇对硝普钠诱导的软骨细胞凋亡bax及bcl-2表达的影响

[目的]探讨白藜芦醇对硝普钠诱导的软骨细胞凋亡及凋亡调控基因bax及bcl-2表达的影响。[方法]常规培养关节软骨细胞后,按不同浓度白藜芦醇(分别为25μmol/L、50μmol/L、100μmol/L)处理后分组并用硝普钠(SNP)(2.5 mmol/L)诱导细胞凋亡。采用MTT法检测各组软骨细胞活性、DAPI染色和流式细胞术检测各组细胞凋亡,采用western-blot技术检测各组细胞sirt1、bax、bcl-2的表达,RT-PCR法检测各组细胞sirt1mRNA的表达。[结果]随着白藜芦醇浓度的升高,MTT法结果显示处理后细胞活性依次增高;DAPI染色、流式细胞术检测显示处理后细胞凋亡相对较少;western-blot检测显示随着白藜芦醇浓度的升高,处理后细胞sirt1、bcl-2依次增高,而bax逐渐降低;RT-PCR法检测显示白藜芦醇处理后细胞sirt1 mRNA表达随浓度逐渐增高。[结论]白藜芦醇激活sirt1,使bcl-2/bax表达增高,是白藜芦醇抑制软骨细胞凋亡、预防骨关节炎的机制之一。     

七氟烷对大鼠离体海马神经元程序性坏死的影响：与兰尼碱受体的关系

目的评价七氟烷对大鼠离体海马神经元程序性坏死的影响及其与兰尼碱受体的关系。方法原代培养SD大鼠胎鼠的海马神经元,培养7 d时,以5×105个/ml细胞密度接种于培养孔(100 μl/孔)或培养瓶(3 ml/瓶)中,采用随机数字表法分为3组(n=24):对照组(C组)、七氟烷组(S组)和兰尼碱受体拮抗剂组(R组)。C组常规培养,R组加入兰尼碱受体拮抗剂丹曲林,终浓度为3 μmol/L,30 min后将S组和R组细胞放置于含2%七氟烷的培养箱中,37 ℃培养5 h。收集细胞,倒置显微镜下观察神经元形态,采用流式细胞术检测细胞胞浆游离钙离子浓度([Ca2+]i),采用Western blot法检测兰尼碱受体和磷酸化人混合系列蛋白激酶样结构域(p-MLKL)的表达,采用免疫荧光法检测受体相互作用蛋白激酶3的表达,计算程序性坏死率。结果与C组比较,S组和R组神经元[Ca2+]i升高,兰尼碱受体和p-MLKL表达上调,程序性坏死率升高(P<0.05);与S组比较,R组神经元[Ca2+]i降低,兰尼碱受体和p-MLKL表达下调,程序性坏死率降低(P<0.05)。C组神经元形态未见明显异常...     

沙利度胺对前列腺癌PC3细胞的体外作用及机制研究

目的 研究沙利度胺对激素非依赖性前列腺癌(AIPC)细胞株PC-3体外生长的抑制作用及其可能的机制.方法 将不同浓度的沙利度胺作用于AIPC细胞株PC-3,采用CCK-8法检测沙利度胺对PC-3细胞的增殖抑制作用;流式细胞仪检测凋亡率;通过RT-PCR法检测沙利度胺处理前后PC-3细胞中低氧诱导因子-1(HIF-1α)和血管内皮生长因子(VEGF) mRNA的表达水平;Western blot检测沙利度胺作用后HIF-1α、VEGF、Bcl-2、Bax蛋白的表达水平.结果 不同浓度的沙利度胺作用于PC-3细胞后,细胞增殖水平明显下降(P＜0.05),且沙利度胺对PC-3细胞增殖的抑制作用呈浓度-时间依赖性.流式细胞仪检测结果表明不同浓度的沙利度胺诱导PC-3细胞发生凋亡,和对照组相比差异有统计学意义(P＜0.05).随着沙利度胺浓度的增加,PC-3细胞中HIF-1 α、VEGF mRNA的表达逐渐下调;HIF-1α、VEGF和Bcl-2蛋白的含量逐渐下降,而Bax蛋白的含量逐渐增加.结论 沙利度胺可能通过诱导AIPC细胞的凋亡和抑制肿瘤血管的生成而发挥双重抗肿瘤生长的作用.     

表皮生长因子对PC-3细胞内皮素-1及其受体mRNA表达的影响

目的:探讨表皮生长因子(EGF)对激素非依赖性前列腺癌(HRPC)PC-3细胞中内皮素1(ET-1)及其受体mRNA表达的影响。方法:EGF作用不同时间(0、8、16、24、32、48h)后,RT-PCR法测定PC-3细胞中ET-1及其受体ETAR mRNA、ETBR mRNA表达;EGF干预24h后,RT-PCR法测定ET-1及其受体ETAR mRNA、ETBR mRNA表达变化。结果:在PC-3细胞中可检测到ET-1及ETAR mRNA表达,但无ETBR mRNA表达;EGF可上调ET-1及ETAR mRNA表达,与对照组比较,差异具有显著性;ET-1及ETAR mRNA表达随EGF干预时间增加而增加,EGF作用不同时间对PC-3细胞ET-1、ETAR mRNA表达的影响不同,差异具有显著性(P<0.05)。结论:EGF可上调PC-3细胞中ET-1及ETAR mRNA表达,为HRPC的治疗提供了分子生物学基础。     

地氟烷预处理对幼鼠心肌细胞血管紧张素受体Ⅰ型表达的影响

目的 观察地氟烷预处理对缺氧,复氧心肌细胞血管紧张素受体Ⅰ型(AT1受体)表达的影响。方法无菌取新生2—3 d的SD幼鼠心室,采用胰蛋白酶消化成散在的单个细胞。加入DMEM培养液培养至第7天。随机分为四组,组1:细胞不经任何处理;组2:缺氧2 h,复氧1 h;组3:1.5 MAC地氟烷预处理20 min,清洗10 min,其余处理同组2;组4:地氟烷预处理前5 min,培养液中加入AT1受体阻断剂洛沙坦(Losartan),终浓度为10-6mol/L。比色法测培养液中肌酸激酶(CK)、乳酸脱氢酶(LDH)活性;Rt-PCR测各组细胞AT1受体的基因表达(mRNA)。结果 组2CK、LDH活性及AT1受体mRNA的相对含量均高于组1(P<0.01);组3 CK、LDH活性及AT1受体mRNA均降低(与组2和组1比较,P<0.01);组4与组3比较CK、LDH活性及AT1受体mRNA的相对含量上升(P<0.05或0.01),但仍低于组2(P<0.01)。结论 地氟烷预处理可部分逆转缺氧/复氧所致的心肌细胞损伤,其保护效应的发生机制部分由AT1受体介导。     

多西紫杉醇对PC-3细胞livin基因表达的影响

目的 研究DT对PC-3细胞livin基因表达的影响.方法 予10～7mol/L浓度DT体外作用PC-3细胞48h,RT-PCR及westerm-blot检测处理组与对照组PC-3细胞livin基因mRNA及蛋白表达水平变化.结果 处理组与对照组PC-3细胞livin基因mRNA及蛋白表达水平分别为(55.17 ± 0.87)%、(8.23±0.68)%;(87.32±9.13)%、(51.12±2.01)%;经t检验处理组与对照组差别有统计学意义.结论 DT处理PC-3细胞后livin基因表达增强,livin基因可能在PC-3细胞对DT化疗耐药中起重要作用.     

异氟醚对转染APPsw基因SH-SY5Y细胞凋亡的影响和IP3受体在其中的作用

目的 评价异氟醚对转染APPsw基因SH-SY5Y细胞凋亡的影响和1,4,5-三磷酸肌醇(IP3)受体在其中的作用.方法 将转染APPsw基因的SH-SY5Y细胞以1.2×104个/cm2密度接种于培养瓶中,采用随机数字表法,将其分为4组(n=6):对照组(C组)、IP3受体拮抗剂组(Ⅹ组)、异氟醚组(Ⅰ组)和异氟醚+ IP3受体拮抗剂组(Ⅰ+Ⅹ组).继续培养24h细胞贴壁后,C组常规培养;Ⅹ组和Ⅰ+Ⅹ组加入IP3受体拮抗剂Xestospongin C 100 nmol/L; 30 min后Ⅰ组和Ⅰ+Ⅹ组给予1.2％异氟醚处理8h.收集细胞,电镜下观察超微结构,采用流式细胞术检测细胞凋亡率和胞浆内游离钙离子浓度([Ca2+]i),采用Western blot法测定IP3受体蛋白表达.结果 与C组比较,Ⅹ组细胞凋亡率、[Ca2+]i和IP3受体蛋白表达差异无统计学意义(P＞0.05),Ⅰ组和Ⅰ+Ⅹ组细胞凋亡率增加,[Ca2+]i升高,IP3受体蛋白表达上调(P ＜0.05或0.01);与Ⅰ组比较,Ⅰ+Ⅹ组细胞凋亡率和[Ca2+]i降低,IP3受体蛋白表达下调(P＜0.01).Ⅰ组和Ⅰ+Ⅹ组细胞出现病理学损伤,Ⅰ组损伤重于Ⅰ+Ⅹ组.结论 异氟醚可通过升高胞浆内游离Ca2+浓度、上调IP3受体蛋白表达,引起转染APPsw基因的SH-SY5Y细胞凋亡.     

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.