Bibliometric study of diabetic retinopathy during 2000-2010 by ISI

AIM: To analyze the progress in diabetic retinopathy (DR) researches between 2000 and 2010 through bibliometric study. METHODS: Using ISI Web of Science database for statistical sources, we retrieved DR literatures during 2000-2010, analyzed 'the number of published articles per year, authors, source publications, subject category, document type, document language, institution and country/region' by bibliometric statistical methods. RESULTS: The total number of published articles that were retrieved for the years during 2000-2010 was 8590. DR researches changed as a linear upward trend, the main researches focused on ophthalmology, endocrine and metabolic diseases. Article was the main document type. Harvard University was the major research institution. CONCLUSION: There has achieved a significant increase in the number of ISI publications and collaborations in DR literatures from 2000 to 2010. With the rising of the number of diabetes in the world, diabetic retinopathy has become a focus of scientific researches.

Continuous versus bolus cardiac output monitoring during orthotopic liver transplantation

BACKGROUND: Cardiac output monitoring is important for critical patients. This study aimed to determine the delayed response of continuous cardiac output (CCO) thermodilution measurement, whether CCO and bolus cardiac output (BCO) thermodilution agree sufficiently to be used interchangeably, and whether CCO monitoring is reliable for patients undergoing liver transplantation. METHODS: Thirteen patients undergoing liver transplantation without veno-venous bypass were studied (37-66 years old, weight 46-75 kg). Continuous and bolus thermodilution measurements were performed at predefined time points using an 'Opti-Q' SvO(2)/CCO monitor (Abbott Laboratories, North Chicago, IL, USA). Bias and 95% limits of agreement were calculated according to Bland and Altman analysis. The limits of agreement by which two methods are judged to be interchangeable were defined in advance as +/-(13%X BCO(mean)) L/min. The repeatability and relative error of CCO, and the differences between CCO and the mean of the two measurements were calculated. RESULTS: Cardiac output measurements yielded 196 data pairs with ranges of 1.9 to 17.9 L/min for CCO and 2.1 to 18.3 L/min for BCO. The response time of CCO was delayed in the early phases after caval clamping and after reperfusion. At most of the measurement points, bias and 95% limits of agreement were -0.18 +/- 1.91 L/min. 95% limits of agreement did not fall within the predetermined limits of agreement of +/- 1.14 L/min. The repeatability coefficient of CCO was 0.36 L/min and the relative error was 4.6 +/- 4.7%. The mean difference between CCO and the average of the two methods was -0.09 L/min (0.49 L/min). CONCLUSIONS: In patients undergoing liver transplantation, the delayed response of CCO limits its application during the early phases after caval clamping and after reperfusion of the graft. The two methods are not interchangeable even in hemodynamic stability. Continuous thermodilution monitoring, however, is reliable or acceptable for clinical purposes.

Comparison of PCIA with tramadol and combined spinal-epidural analgesia

Objective To evaluate the analgesic efficacy and safety of patient controlled intravenous analgesia (PCIA) with tramadol for labor analgesia as compared with combined spinal-epidural analgesia (CSEA) + patient controlled analgesia ( PCEA) with ropivacaine and fentanyl. Methods Eighty ASA Ⅰ - Ⅱ full term primigravidae in active labor (at 2 cm cervical dilation) who had a single fetus with vertex presentation and were expected to have a vaginal delivery were randomly divided into 3 groups: Ⅰ control group received no analgesia (n = 30), Ⅱ group A received CSEA + PCEA with ropivacaine and fentanyl (n = 30) and Ⅲ group B received PCIA with tramadol ( n = 20). In group A CSEA was performed at L2-3. Ropivacaine 2. 5 mg and fentanyl 5 mg were injected intrathecally. A catheter was then advanced 4 cm into epidural space cephalad for PCEA with a mixture of 0.1% ropivacaine with fentanyl 5 μg· μλ-1 (backgroud infusion 4 ml · h-1, demand bolus 4 ml with a 15 min lockout interval). In group B the

Effect of thoracic epidural anesthesia combined with general anesthesia on cytokine production and gut mucosal perfusion

Objective To investigate the changes in plasma concentrations of IL - 6 and IL - 10, pHi and the difference between tissue and arterial PCO2[P(t - a)CO2] during pulmonary surgery and the effects of thoracic epidural anesthesia on cytokine production and gut mucosal perfusion. Methods Twenty ASA class Ⅰ - Ⅱ patients undergoing elective pulmonary surgery, were randomly assigned to be operated upon under general anesthesia (group GA, n = 10) or under general anesthesia combined with thoracic epidural anesthesia (group GEA, n = 10 ). Premedication in both groups consisted of pethidine 50 mg and scopolamine 0. 3 mg im 30 min prior to surgery and oral ranitidine 150 mg the night and 1 h before operation. Anesthesia was induced with fentanyl 2 pg · kg -1, droperidol 1 mg, propofol 1.5-2. 5 mg · kg-1 and succinylcholine 1-2 mg · kg-1 and mainatained with inhalation of 1 % - 2.5 % isoflurane and 50% N2O in oxygen and intermittent iv boluses of fentanyl and vecuronium. In GEA group epidural catheter was

Effect of clonidine added to ropivacaine for epidural anesthesia

Objective To evaluate the effect of clonidine added to ropivacaine for epidural anesthesia. Methods Sixty ASA Ⅰ - Ⅱ patients aged 24 - 62 yr, weighing 50 - 76 kg, scheduled for elective gynecological surgery under epidural anesthesia were randomly assigned to one of four equal groups of 15 patients each, according to the dose of clonidine added to ropivacaine solution: group 1 (R) received no clonidine and served as control;group 2 - 4 in which clonidine 50,100 or 150 μg was added to 0. 75% ropivacaine 25 ml (R - C 50, R - C 100, R - C 150). Epidural anesthesia was performed at L2-3. Epidural catheter was inserted into epidural space and advanced in cephalad direction for 3 : 5 cm. Ropivacaine solution was prepared and provided by a specially designated person. A test dose of 5 ml of ropivacaine was given. 5 min later when epidural placement of catheter was confirmed, the rest 20 ml of ropivacaine was given in fractions of 5 ml every 2-3 min. At the beginning of operation midazolam 2.5-3.5 mg was

Effect-site concentration of remifentanil blunting cardiovascular responses to tracheal intubation and skin incision during propofol anesthesia

Objective To determine the effect-site concentration of remifentanil blunting sympathetic responses to tracheal intubation and skin incision during propofol anesthesia. Methods Sixty ASA Ⅰ or Ⅱ patients aged 20-65 yrs weighing 40-75 kg undergoing elective surgery under general anesthesia were enrolled in this study. The patients were premedicated with intramuscular atropine 0.5 mg.

Effect of propofol infusion at different rate on liver blood flow and oxygen metabolism in rabbit

To evaluate the effect of propofol infusion on hepatic blood flow(HBF) and oxygen delivery and consumption in rabbit.Methods Thirty adult male rabbits weighing 1.6～2.4 kg were randomly allocated into 3 groups:group Ⅰ high dose propofol (HP) (n=11);group Ⅱ low dose propofol(HP) (n=10) and group Ⅲ control group (C)(n=9).The rabbits were anesthetized with intravenous 3% pentobarbital 45 mg·kg -1 and mechanically ventilated (VT=10 ml·kg -1 RR=40 bpm,I∶E=1∶2) after tracheal intubation.ECG,urinary output and rectal temperature were continuously monitored.Portal vein and hepatic artery were dissected and exposed for measurement of blood flow using electromagnetic flowmeter.Catheters were inserted into carotied artery,portal vein and hepatic vein via the mesenteric vein and right femoral vein for collection of blood samples.After the circulation was stabilized for 30 min,propofol infusion was started at a rate of 1.2 mg·kg -1 ·min -1 (HP) or 0.4 mg·kg -1 ·min -1 (LP).In control group normal saline was infused instead of propofol.Portal venous and hepatic arterial blood flow were continuously measured.Blood samples were obtained from carotid artery,portal vein and hepatic vein before (baseline )and at 30,50,70 and 90 min of propofol infusion for determination of Hb,SO2,PO2 and PCO2.The hepatic O2 delivery (DO2) and consumption (VO2) were calculated.Results The three groups were comparable with respect to body weight,duration of operation,the volume of fluid infused and blood loss and urinary output.HBF was significantly higher at 30～90 min of propofol infusion in HP group than in C group,meanwhile DO2 and VO2 in HP group were significantly higher during propofol infusion than the baseline value before infusion and those in C group.However,there was no significant difference in DO2/VO2 ratio between HP and C group.Conclusion High dose propofol infusion improves liver blood flow and O2 delivery but it also increases hepatic O2 comsumption.However the balance between hepatic O2 supply/demand remains unchanged.9 refs,2 tabs.

Morphine-sparing effect and safety of parecoxib for postoperative analgesia

Objective To evaluate the morphine-sparing effect and side effects of intravenous parecoxib sodium for pain relief following gynecological or orthopedic surgery. Methotis This was a prospective, randomized, double-blind, placebo-controlled multi-center study. After obtaining ethic committee approval and written informed consent, 223 ASA Ⅰ or Ⅱ patients aged 18-64 yr undergoing abdominal hysterectomy or operation on lower limb under epidural anesthesia were randomly allocated to one of 2 groups：

Effect of ifenprodil pretreatment on the expression of NR2B subunit protein of NMDA receptor in the dorsal horn of spinal cord in a rat model of neuropathic pain

Objective To investigate the effect of ifenprodil pretreatment on the expression of NR2B subunit protein of NMDA receptor in the dorsal horn of spinal cord in a rat model of neuropathic pain. Methods Fifty male SD rats weighing 180-200 g were used in this study. Neuropathic pain was produced by chronic constrietive injury （CCI）. The left sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1-2 mm intervals with 4-0 chromic catgut under pentobarbital anesthesia.

Hemodynamic changes and oxygen metabolism daring off-pump coronary artery bypass grafting

Objective To examine the hemodynamic changes and oxygen metabolism during off-pump coronary artery bypass grafting (OPCABG). Methods Twenty patients (18 male,2 female) aged (60 ±8)yr, weighing (71 ± 9) kg undergoing OPCABG were studied. The patients were premedicated with diazepam 10 mg PO 2h before operation and morphine 10 mg and scopolamine 0. 3 mg im 30 min before operation. Anesthesia were induced with midazolam 0.1 -0.2 mg·kg-1,fentanyl 5 - 10 μg·kg-1 and vecuronium 0. 12 - 0. 15 mg · kg-1 and maintained with 0. 5% - 2% isoflurane inhalation, fentanyl 10 - 20 μg·kg-1 and intermittent iv boluses of vecuronium and in some patients propofol infusion. Radial artery was cannulated. Swan-Ganz catheter was placed via internal jugular vein into pulmonary artery. Hemodynamic parameters including MAP, HR, cardiac index ( CI), stroke volume (SV), MPAP, PCWP, SVR, left ventricle stroke work index (LVSWI) and PVSWI; oxygen metabolism including oxygen delivery (DO2 ), oxygen consumption (VO2) and

Total calcium is not suitable for diagnosis of hyper-and hypo-calcemia in liver transplantation

Objective To evaluate whether total calcium can be used to monitor calcium hemostasis in orthotopic liver transplantation （OLT） patients. Methods Twenty ASA Ⅱ-Ⅴ patients with end-stage liver diseases undirwent OLT,Anesthesia was induced with midazolam 0. 1 mg/kg, fentanyl 3μg/ kg, propofol 0.5-1.5mg/kg, vecoronium 0. 1mg/kg and maintained with isoflurance inhalation and intermittent i. v. boluses of fentanyl,

EC50 of ropivacaine when combined with different concentrations of sufentanil for epidural labor analgesia

Objective To determine the median effective concentration （EC50） of ropivacaine when combined with different concentrations of sufentanil for epidural labor analgesia. Methods One hundred ASA Ⅰ or Ⅱ nulliparous parturients at 37-42 weeks of gestation with 2-3 cm cervical dilation, requesting epidural analgesia were randomly assigned into 2 groups：

Shock——Effect of dopamine combined with norepinephrine on the renal function in patients with septic shock

Objective To investigate the effects of dopamine and norepinephrine on the renal function in the patients with septic shock. Methods Eighty-seven patients with septic shock were divided into three groups （group A,B, C） according to the biggest infusing rate of norepinephrine, with the infusing rate of 0. 5 -0. 9, 1.0 1.5,1.6-2.0 μg·kg^-1·min^-1, respectively. Mean arterial blood pressure （MAP）, heart rate （HR）, urine output, blood urea nitrogen （BUN）, creatinine （ CRE ）, urine albumin （UALB） and urine β2-microglubulin （Uβ2-MG） as well as APACHE m score in all the patients were detected. Results Before anti-shock therapy was given,hypotension, tachycardia and oliguria occurred in all the 87 patients,and CRE,BUN, U-ALB, Uβ2-MG and APACHE Ⅲ score were abnormal in most eases. With the anti-shock therapy, MAP, FIR, urine output and BUN, CRE in all patients returned to normal levels gradually, and U-ALB, Uβ2-MG levels and APACHE Ⅲ score also restored but still remained abnormal. Conclusion The first aim of treating septic shock should be restoring the organ blood supply, and based on volume resuscitation, dopamine, noradrenaline and other vasoactive drugs could be combined to maintain circulatory stability. 15 refs,2 tabs.

Effect of midazolam and propofol on cytokine balance in patients undergoing cardiac valve replacement

Objective To compare the effect of midazolam and propofol on cytokine balance in patients undergoing cardiac June 2003 Vol12 No2 valve replacement under CPB. Methods Twenty NYHA class II - 333 patients with rheumatic heart disease scheduled for elective cardiac valve replacement under CPB were randomy divided into 2 groups: midazolam group (M, n = 10) and propofol group (P, n = 10). Patients with preoperative hepatic and renal dysfunctions were premedicated intramuscular morphine 0. 1 mg · kg-1 and oral diazepam 0.1 mg·kg-1 . Anesthesia was induced withmidazolam 0. 06 -0.1 mg· kg-1 (group M) or propofol1.0-1.5 mg·kg-1 (gropu P) and scopolamine 0.6 mg, fentanyl 4-10 μg · kg-1, vecuronium 0. 1 mg · kg-1 and lidocaine 1. 5 mg·kg-1,and maintained with intermittent iv boluses of midazolam 0. 04 - 0.1 mg· kg-1(group M) or propofol intravenous infusion at a rate of 3 - 5 mg· kg-1 · h-1 supplemented with intermittent boluses of fentanyl and vecuronium. PETCO2 was maintained at 30 -40 mmHg during

The use of continuous spinal anesthesia in high risk elderly patients undergoing lower abdominal or lower extremity surgery

To evaluate the feasibility and safety of using continuous spinal anesthesia (CSA) in high risk elderly patients undergoing lower abdominal or lower extremity surgery.Methods Sixty-four ASA Ⅲ or Ⅳ patients aged 70～101 yr weighing 38～55 kg undergoing lower abdominal or lower extremity surgery were randomized to receive epidural anesthesia (EA) (n=32) or CSA (n=32).The patients were complicated with cerebral embolism and/or hypertension,coronary artery disease and/or COPD and/or diabetes mellitus.The patients were unpremedicated.EA was performed at L 2,3 or L 1,2 .A test dose of 2 ml of 2% lidocaine was given.When no signs of spinal block was observed,1 % ropivacaine was given in small increments until the block height reached T 6-8 .CSA was performed at L 3,4 using Spinocath (B.Braun).A 2-cm catheter segment was left in subarachnoid space.0.5% bupivacaine was given in 0.5 ml increments every 3 min until satisfactory block level was reached.The onset time of anesthesia was recorded.The degree of motor block was assessed using modified Bromage scale.Arterial blood samples were obtained before anesthesia (T0,baseline),when satisfactory block level was reached (T1),1 h after skin incision (T2) and at the end of operation (T3) for determination of lactate concentration.The amount of ephedrine and innovar (droperidol-fentanyl mixture) used during operation and the recovery of motor function of lower extremities were also recorded.Results The demographic data including sex,age,height,body weight,ASA physical status and types of operation were not significantly different between the two groups.BP and HR were significantly decreased after anesthesia as compared to the baseline values at T0 in group EA,whereas in CSA group there were no significant changes in BP and HR after anesthesia.Significantly more patients received ephedrine in EA group (98%) than in CSA group (15%) and the mean dose of ephedrine was significantly higher in EA group [(34.5±3.1)mg] than in CSA group [(4.3±0.5)mg].The onset of block was significantly faster in CSA group than in EA group.Motor blockade was less intense in EA group as assessed by modified Bromage scale.Analgesia was more satisfactory in CSA group and less patients received innovar during operation in CSA group (20%) than in EA group (51%).The recovery of motor function of lower extremities was faster in CSA group than in EA group.Blood lactate was significantly higher at T1,T2,T3 in EA group than in CSA group.No late complications related to CSA was observed.Conclusion CSA in safe and effective and provides better analgesia with better hemodynamic stability and faster onset of block than EA in elderly patients.8 refs,4 tabs.

Effects of hemodilution on neurological injury and cerebral amino acid content after circulatory arrest during profound hypothermia in rats

To investigate the effects of different degrees of hemodilution on neurological injury and amino acid content in different brain areas after deep hypothermic circulatory arrest (DHCA).Methods Forty-eight male adult SD rats weighing 400～450 g were randomly divided into 4 groups (n=12 each):group Ⅰ Hct 10%(H1);group Ⅱ Hct 20% (H2);group Ⅲ Hct 30%(H3) and control group (C).All animals except those in control group underwent DHCA at 18℃ for 90 min (includinhg cooling and rewarming) under general anesthesia with fentanyl,ketamine and droperidol.Different degrees of hemodilution were accomplised by changing the composition and volume of priming solution used in cardiopulmonary bypass (CPB).Hct was determined before,at the initiation of CPB and beginning of rewarming.PaO2,pH and blood lactate of arterial blood and SO2 of venous blood from internal jugular vein (SjvO2) were determined at the beginning and end of cooling and rewarming.The animals were killed and brains removed after recovery of circulatory function for the count of injured neurons and detemination of glutamate (Glu),aspartate (Asp),glycine (Gly),γ-aminobutyric acid (GABA) and taurine (Tau) contents in cortex,hippocampus and thalamus.Results The number of injured neurons in hippocampus and parietal cortex were significantly smaller in Hct 30% group than in the other two groups (P<0.05).The contents of the five amino acids in hippocampus and parietal cortex were all increased after DHCA.The Glu,Asp and Gly contents in hippocampus and parietal cortex were significantly lower in Hct 30% group than in the other 2 groups (P<0.05).There was no significant difference in GABA and Tau contents among the 3 groups.Conclusion Hemodilution at Hct 30% attenuates the neuronal injury after DHCA.The inhibition of the release of the excitatory amino acids in the brain may be involved in the mechanism of neuronal protection.13 refs,1 fig,3 tabs.

Esophageal nasopharyngeal catheter in the wake-up anesthesia of the brain function area operations

Objective To evaluate the feasibility and safety of the self developed sound outside the ventilation device-esophageal nasopharynx catheter in brain functional areas surgery applications. Methods 13 patients involved functional areas of brain surgery were chosed. After induction of general anesthesia,the catheters were placed in the esophagus,then connected to anesthesia machines to an external

Changes in auditory evoked potential index during endotracheal intubation

To investigate the changes in auditory evoked potential index (AEPI) during endotracheal intubation and the effects of intravenous lidocaine or topical anesthesia of larynx and vocal cords with tetracaine on intubation response.Methods Thirty-six patients classified as ASA physical status and Mallampati intubation status Ⅰ or Ⅱ,aged 19～55 yr scheduled for elective surgery under general anesthesia were randomly divided into 3 groups with 12 patients in each group:(1) control group (C);(2) intravenous lidocaine group (L) and (3) topical tetracaine group (T).The patients were premedicated with intramuscular atropine 0.01 mg·kg -1 and phenobarbital 0.1 g.Anesthesia was induced with midazolam 30 μg·kg -1 ,fentanyl 3 μg·kg -1 and propofol 1.5～2.0 mg·kg -1 .Direct vision tracheal intubation was performed at 3 min after vecuronium 0.1 mg·kg -1 .In group L 1% lidocaine 1 mg·kg -1 was given i.v. after propofol injection.In group T the suproglottic area and vocal cords were sprayed with 1% tetracaine 3～5 ml before intubation.All intubations were performed by the same anesthesiologist.BP,HR,SpO2 and AAI value were recorded 1 min before and 1 min after intubation.The time between vecuronium injection and tracheal intubation was also recorded.Results AAI value,MAP and HR significantly increased after endotracheal intubation in all 3 groups.The increase in AAI value in group T was significantly larger than that in group C and L.The increase in MAP and HR in group L after intubation was significantly smaller in group L than in group C and T.There was no significant difference in MAP and HR between group C and T after intubation.Conclusion AAI is more sensitive than MAP and HR in terms of detecting the increase in AAI value induced by responses to tracheal intubation.Neither intravenous lidocaine nor tetracaine topical anesthesia of vocal cords inhibits the intubation.Intravenous lidocaine can attenuate the cardiovascular response to intubation.10 refs,2 tabs.

The effect of different doses of vecuronium on respiratoty function and mechanics during laparoscopic cholecystectomy

Objective To investigate the effects of different doses of vecuronium on ventilatory function and mechanics of breathing during elective laparoscopic cholecystectomy. Methods Sixty - three ASA Ⅰ - Ⅱ patients aged 29 -57 yr were randomly divided into 3 groups of twenty-one: group Ⅰ received vecuronium 1 ± ED95 , group Ⅱ 2 ± ED95 and group Ⅲ ± ED95. Patients with respiratory disease were excluded. The patients were premedicated with intramuscular scopolamine 0 . 3 mg and oral diazepam 0 . 1 mg· kg-1 . Anesthesia was induced with fentanyl 2 μg ·kg-1 ,propofol 2 mg·kg-1 and succinylcholine 1. 5 mg· kg-1 and maintained with 1.0% -1.5% isoflurance and intermittent iv boluses of propofol 1 mg·kg when needed. Vecuronium 1 ± ED95 ( group Ⅰ ) or 2 ± ED95 (group Ⅱ ) or 3 ± ED95 (group Ⅲ ) was given iv after succinylcholine when TOF showed that T1 】 70 % . The patients were mechanically ventilated. VT was set at 10 ml ·kg-1 and respiratory rate at 12 bpm. End-tidal PCO2 was maintained at 30 -

Comparison of the effects of autotransfusion and homologous transfusion on milieu interieur and secretion of erythropoietin

Objective To compare the effects of autotransfusion and homologous transfusion on milieu interieur and secretion of erythropoietin (EPO). Methods Thirty patients aged 8-21 yr, undergoing surgical correction of kyphoscoliosis were randomly divided into two groups of fifteen:group A and group B. In group A patients received homologous transfusion during operation, while in group B shed blood was collected from operative field and after filtration RBCs were separated by a differential centrifugation and washed in normal saline and reinfused. Anesthesia was induced with fentanyl 2 μg· kg-1 ,propofol 1 mg·kg-1 and vecuronium 0.1 mg·kg-1 and maintained with inhalation of isoflurane and 50 % N2O in oxygen and intermittent iv boluses of vecuronium and fentanyl. Blood routine, blood gases, electrolytes, plasma osmotic pressure and activated clotting time (ACT) were measured before operation, 2 h after skin incision and at the end of surgery. Blood EPO concentration was measured before operation,at the end