Increasing evidences show that a gradual trend away from deep hypothermia toward moderate hypothermic circulatory arrest, which has been proved to be safe and effective in clinic. By summarizing and analyzing the research progress and applying status of the moderate hypothermia circulatory arrest with selective antegrade cerebral perfusion, the article aims at promoting the application of this tenique as a cerebral protection strategy in aortic arch surgery for adults in China.
【摘要】 目的 探讨辣椒素对不同年龄SD大鼠内脏感觉神经元上辣椒素受体(TRPV1)介导的离子通道的影响。 方法 急性分离7~9 d和21~23 d大鼠迷走神经结状神经节神经元,利用全细胞膜片钳技术在分离的神经元上记录辣椒素激活TRPV1受体后通道电流的变化。 结果 ①7~9 d和21~23 d大鼠内脏感觉神经元的膜电容分别为(18.57±8.60)和(19.85±9.47) pF,(Pgt;0.05);②辣椒素能够激活7~9 d和21~23 d大鼠内脏感觉神经元上TRPV1并产生相似的内向电流,两组产生的峰电流密度分别为(48.59±18.87)、(55.91±20.52) pA/pF(Pgt;0.05);③反复应用辣椒素使TRPV1受体发生失敏现象。 结论 大鼠内脏感觉神经元的TRPV1受体通道在出生后已经发育成熟,且对辣椒素激活的通道电流有相似的变化。【Abstract】 Objective To investigate the effects of capsaicin on transient receptor potential vanilloid 1 (TRPV1) receptor-mediated ion channel currents of visceral sensory neurons in different-aged Sprague-Dawley rats. Methods We isolated the vagal nodose ganglion neurons of rats at an age of 7-9 days or 21-23 days acutely. With the whole cell patch clamp technique, we recorded the current changes of TRPV1 channels activated by capsaicin. Results ① Membrane capacitances of the visceral sensory neurons were (18.57±8.60) and (19.85±9.47) pF in rats of 7-9 and 21-23 days, respectively (Pgt;0.05). ② Capsaicin activated the TRPV1 channels and generated inward currents in all the rats; and the peak current densities of the rats of 7-9 days and 21-23 days were respectively (48.59±18.87) and (55.91±20.52) pA/pF (Pgt;0.05). ③ Repeated applications of capsaicin produced a phenomenon of desensitization in TRPV1 channels. Conclusion TRPV1 receptor channels of visceral sensory neurons in rats have matured after birth, and the current changes of TRPV1 channels activated by capsaicin are similar.
Gastrointestinal complications after cardiac surgery are rare, but they are associated with significant morbidity and mortality. The mechanisms of gastrointestinal complications after cardiac surgery may be unique, as the abdominal cavity is not involved. This review summarizes the current evidence of the pathophysiology, clinical manifestations, risk factors, and management of gastrointestinal complications after cardiac surgery, aiming to improve the recognition of gastrointestinal complications after cardiac surgery.
目的:探讨在不同年龄SD大鼠右心房注射前列腺素E2(PGE2)对呼吸的影响。方法:7~9 d和21~23 d大鼠在迷走神经完整和迷走神经切断的情况下从右心房注射PGE-2,观察呼吸指标的变化。结果:①右心房注射PGE2在7~9 d和21~23 d大鼠中均引起呼吸暂停,呼气延长时间分别为基础呼气时间的9.5和7.5倍(Plt;0.05);②切断迷走神经后,右心房注射PGE-2在7~9 d和21~23 d大鼠均不再产生呼吸暂停,仅出现轻微呼吸抑制。结论:右心房注射PGE2在7~9 d和21~23 d大鼠均产生呼吸暂停,且依赖于迷走神经的完整性。
This study aims to investigate the effect of lung ischemia reperfusion injury (LIRI) on expression of transient receptor potential vanilloid 1 (TRPV1) in the lung and brainstem of rats. Sixteen adult male Sprague Dawley rats weighing 250-320 g were randomly divided into Sham group and ischemia reperfusion group (IR group). Before ischemia, 0.5 hour and 4 hours after the reperfusion, respectively, arterial partial pressure of oxygen (PaO2) and arterial-alveolar oxygen pressure gradient (A-aDO2) were recorded and calculated, respectively. Left lung tissues and the brainstems were obtained at the end of the experiment. Lung tissue malondialdehyde (MDA), myeloperoxidase (MPO) activities, calcitonin gene related peptide (CGRP) and substance P (SP) levels were assessed. The mRNA and protein expressions of TRPV1 in the lung and brainstem were measured by qRT-PCR and Western blot. Compared with in the Sham group, rats in the IR group had a poorer blood gas exchange (P<0.05) and the MPO activity and MDA level of lung tissues in the IR group were significantly higher than those in the Sham group (P<0.05). CGRP level in the IR group increased remarkably (P<0.05), while SP level did not differ statistically between the two groups (P>0.05). The mRNA and protein expressions of TRPV1 in the lung tissue were upregulated in the IR group (P<0.05), but there were no differences of those in the brainstem between the two groups (P>0.05). The results suggest that LIRI could upregulate the expressions of TRPV1 and evoke CGRP release in the lung.
目的 探讨在丙泊酚诱导麻醉的改良电休克治疗中脑双频谱指数(BIS)与动作发作时间的关系,以及其他因素对电休克动作发作时间的影响。 方法 2012年4月-5月,记录28名患者的107次治疗中的不同时刻脑双频谱指数(BIS)值诱导前、睫毛反射消失时、治疗前即刻、动作发作结束即刻、动作发作结束后60 s)、麻醉药物剂量、动作发作时间及治疗不良反应,并根据动作发作时间将治疗分为A组(治疗无效组,动作发作时间<17 s)和B组(治疗有效组,动作发作时间≥17 s)。探讨不同时刻BIS值与癫痫发作时间的关系并比较A、B组之间BIS值、麻醉药物剂量差异。 结果 两组间睫毛反射消失时及治疗前即刻BIS值差异有统计学意义(P<0.05)。动作发作时间与治疗前即刻BIS值呈正相关(r=0.245,P=0.012),与治疗次数呈负相关(r=−0.283,P=0.004)。 结论 治疗前即刻BIS值与动作发作时间呈正相关,因此,此时的BIS值也许可以作为预测动作发作时间长短的指标。
Left ventricular outflow tract obstruction (LVOTO) in Ebstein's anomaly is a rare complication, and LVOTO related to surgery is rarer. We present a 46 years old female patient who was dignosed with Ebstein's anomaly, then suffered from cardiac arrest because of LVOTO secondary to cone reconstruction in ICU.