Determination of the median effective dose (ED50) of bupivacaine and ropivacaine unilateral spinal anesthesia

Background

Unilateral spinal anesthesia (USpA) has been reported to potentiate spinal anaesthesia and is used in geriatric patients. The purpose of this study was to determine the median effective dose (ED₅₀) of 0.5% hypobaric bupivacaine and 0.5% hypobaric ropivacaine USpA for geriatric patients (age ≥ 70 years) undergoing elective hip replacement surgery.

Methods

A total of 60 geriatric patients (age ≥ 70 years) undergoing elective hip replacement surgery were enrolled in this study. The patients were randomized into 2 groups to receive either intrathecal 0.5% hypobaric bupivacaine USpA (group B) or 0.5% hypobaric ropivacaine USpA (group R). Effective anesthesia was defined as a T10 sensory blockade level maintained for more than 60 min, and a Bromage score of 3 on the operation side within 10 min after injection with no additional epidural anesthetic required during surgery. The ED₅₀ of 0.5% hypobaric bupivacaine and 0.5% hypobaric ropivacaine was calculated using the Dixon and Massey formula.

Results

No significant differences were found between the two groups in terms of demographic data. The ED₅₀ of 0.5% hypobaric bupivacaine USpA was 4.66 mg (95% confidence interval CI 4.69–4.63 mg) mg and that of 0.5% hypobaric ropivacaine USpA was 6.43 mg (95% CI 6.47–6.39 mg) for geriatric patients undergoing hip replacement surgery.

Conclusion

We find the ED₅₀ were lower, and the ED50 of 0.5% hypobaric bupivacaine and ropivacaine was 4.66 mg (95% CI 4.69–4.63 mg) and 6.43 mg (95% CI 6.47–6.39 mg), respectively, for USpA in geriatric patients (age ≥ 70 years) undergoing elective hip replacement surgery.

     

错配修复系统MLH1基因rs1800734多态性与肝细胞癌的关联研究

目的研究错配修复系统MLH1基因rs1800734多态性与肝细胞癌遗传易感性的关系。方法采用以医院为基础的病例对照研究方法,运用荧光定量聚合酶链反应(polymerase chain reaction,PCR)和非条件Logistic回归分析MLH1基因型在两组中分布频率的差异,以及基因多态性和环境因素的交互作用。结果病例组MLH1基因位点AA、AG和GG各基因型频率分别为37.09%、48.57%和14.35%,对照组中基因型频率分别为32.89%、47.46%和19.65%,差异无统计学意义(P=0.085)。多因素Logistic回归分析表明,与AA基因型相比,AG或者GG基因型的个体罹患HCC的风险OR值分别为1.102和1.544。病例组等位基因(A)频率(61.37%)较对照组(56.62%)增高(2=4.22,P=0.040),A等位基因携带者患肝细胞癌的危险性是G等位基因携带者的1.217倍。交互作用分析结果表明MLH1基因多态性与肿瘤家族史、乙型肝炎病毒表面抗原(epatitis B surface antigen,HBsAg)阳性之间均存在交互作用(P<0....     

周围神经损伤的早期显微外科修复

目的探索周围神经损伤早期显微外科修复的临床效果及预后。方法根据神经损伤的部位及程度应用不同的显微外科方法进行修复。具体方法为神经探查、神经松解、神经外膜修补、神经外膜端端吻合、神经束膜端端吻合、神经移植、神经移位、神经植入等。结果共修复周围神经118例12条166处，获随访72例12条98处，运动功能恢复达M3以上31．82％，感觉功能恢复达S3以上67．74％，其中前臂内外侧皮神经、股外侧皮神经、腓肠神经损伤修复后感觉恢复均达到S3，28处指神经损伤修复后感觉恢复达s3以上占82．14％，尺神经、腓总神经的运动功能无一例恢复，桡神经及股神经的运动功能恢复最理想。结论应用显微外科技术早期修复周围神经损伤效果良好，但应注意修复时机及方式。     

Fibroblast growth factor-18 is a trophic factor for mature chondrocytes and their progenitors

OBJECTIVE: The aim of this study was to examine the effects of recombinant human Fgf18 on chondrocyte proliferation and matrix production in vivo and in vitro. In addition, the expressions of Fgf18 and Fgf receptors (Fgfr) in adult human articular cartilage were examined. METHODS: Adenovirus-mediated transfer of Fgf18 into murine pinnae and addition of FGF18 to primary cultures of adult articular chondrocytes were used to assess the effects of FGF18 on chondrocytes. In situ hybridization was used to examine the expression of Fgf18 and Fgfr s in adult human articular cartilage. RESULTS: Expression of Fgf18 by adenovirus-mediated gene transfer in murine pinnae resulted in a significant increase in chondrocyte number. Chondrocytes were identified by staining with toluidine blue and a monoclonal antibody directed against type II collagen. Fgf18, Fgfr 2-(IIIc), Fgfr 3-(IIIc), and Fgfr 4 mRNAs were detected within these cells by in situ hybridization. The nuclei of the chondrocytes stained with antibodies to PCNA and FGF receptor (FGFR) 2. Addition of FGF18 to the culture media of primary articular chondrocytes increased the proliferation of these cells and increased their production of extracellular matrix. To assess the receptor selectivity of FGF18, BaF3 cells stably expressing the genes for the major splice variants of Fgfr1-3 were used. Proliferation of cells expressing Fgfr 3-(IIIc) or Fgfr 2-(IIIc) was increased by incubation with FGF18. Using FGFR-Fc fusion proteins and BaF3 cells expressing Fgfr 3-(IIIc), only FGFR 3-(IIIc)-Fc, FGFR 2-(IIIc)-Fc or FGFR 4-Fc reduced FGF18-mediated cell proliferation. Expression of Fgf18, Fgfr 3-(IIIc) and Fgfr 2-(IIIc) mRNAs was localized to chondrocytes of human articular cartilage by in situ hybridization. CONCLUSION: These data demonstrate that Fgf18 can act as a trophic factor for elastic chondrocytes and their progenitors in vivo and articular chondrocytes cultured in vitro. Expression of Fgf18 and the genes for two of its receptors in chondrocytes suggests that Fgf18 may play an autocrine role in the biology of normal articular cartilage.     

单纯性肥胖儿童社会适应能力和行为问题研究

为探讨单纯性肥胖儿童心理行为的特征,应用Achenbach儿童行为量表,采取1：1配对病例对照方法,研究120对单纯性肥胖儿童的社会适应能力及行为问题。结果：单纯性肥胖儿童的社会适应能力较体重正常儿童差;他们的焦虑、社交退缩、抑郁、躯体诉述等行为因子评分显著高于体重正常儿童,性格内向者亦较多。结论：单纯性肥胖儿童的心理行为发育有一定程度的偏倚,应根据他们的心身发育特点,制定相应的心理干预措施,对他们进行心理干预。