Objective:To study the effects of Dexmedetomidine combined with Sufentanil on hemodynamics, stress state, helper T cytokines and pain degree during the waking period of general anesthesia in elderly patients with lowe...Objective:To study the effects of Dexmedetomidine combined with Sufentanil on hemodynamics, stress state, helper T cytokines and pain degree during the waking period of general anesthesia in elderly patients with lower limb fracture surgery were studied.Methods:From June 2017 to July 2018, 95 elderly patients with lower limb fracture who visited First Affiliated Hospital of Xi 'an Jiaotong University and received fracture surgery and general anesthesia were collected. According to their different anesthesia methods, 46 patients were divided into the sufentanil maintenance anesthesia group (Sufentanil group), and 49 patients were divided into the metopidine combined with sufentanil maintenance anesthesia group (Joint group). Changes in hemodynamics (HR, SpO2, MAP) of the two groups were monitored at different times throughout the operation. Using enzyme-linked immunoassay detection of two groups of patients in maintain anesthesia and anesthesia to stress index (Cor, E, FIns and HOMA-IR). The the changes of pain mediators (NO,β-EP, SP) and helper T cytokines (IFN-γ, TNF-α) were compared between the two groups before and 24 hours after surgery. Results:In the combined group, HR, SpO2, MAP and sufentanil groups showed little change in SpO2 during anesthesia, with no significant difference. The HR and MAP of T2 and T3 in the sufentanil group were significantly higher than those in the combined group at T2 and T3. The stress indicators Cor, E, FIns and HOMA-IR in the anesthesia of the two groups were significantly higher than those in the anesthesia maintenance. The serum stress indexes of Cor, E, FIns and HOMA-IR were significantly lower in the combined group than in the sufentanil group. The IFN-γ level of the combined group was significantly higher than that of the sufentanil group, and the TNF-α level was significantly lower than that of the control group. Serum levels of NO,β-EP and SP were significantly higher in the two groups 24 h after surgery. Serum pain mediators NO,β-EP and SP in the combined group were significantly lower than those in the sufentanil group before and 24 h after surgery.Conclusion: Combined anesthesia with Remifentanil and Propofol can stabilize the hemodynamic state of patients undergoing craniotomy, reduce cardiovascular stress response and inflammatory response, reduce nerve damage, and play a role in brain protection.展开更多
A novel and efficient[3+2]annulation of 2-substituted aziridines and N-tosyl cyanamides via a dominoregioselective ring-opening/5-exo-dig cyclization procedure has been developed,allowing the directpreparation of N_(2...A novel and efficient[3+2]annulation of 2-substituted aziridines and N-tosyl cyanamides via a dominoregioselective ring-opening/5-exo-dig cyclization procedure has been developed,allowing the directpreparation of N_(2)-unprotected five-membered cyclic guanidines in good to excellent yields under mildconditions without metals and strong bases.Moreover,the highly biologically interesting urea analoguescould also be conveniently obtained via hydrolysis of the produced guanidines.展开更多
文摘Objective:To study the effects of Dexmedetomidine combined with Sufentanil on hemodynamics, stress state, helper T cytokines and pain degree during the waking period of general anesthesia in elderly patients with lower limb fracture surgery were studied.Methods:From June 2017 to July 2018, 95 elderly patients with lower limb fracture who visited First Affiliated Hospital of Xi 'an Jiaotong University and received fracture surgery and general anesthesia were collected. According to their different anesthesia methods, 46 patients were divided into the sufentanil maintenance anesthesia group (Sufentanil group), and 49 patients were divided into the metopidine combined with sufentanil maintenance anesthesia group (Joint group). Changes in hemodynamics (HR, SpO2, MAP) of the two groups were monitored at different times throughout the operation. Using enzyme-linked immunoassay detection of two groups of patients in maintain anesthesia and anesthesia to stress index (Cor, E, FIns and HOMA-IR). The the changes of pain mediators (NO,β-EP, SP) and helper T cytokines (IFN-γ, TNF-α) were compared between the two groups before and 24 hours after surgery. Results:In the combined group, HR, SpO2, MAP and sufentanil groups showed little change in SpO2 during anesthesia, with no significant difference. The HR and MAP of T2 and T3 in the sufentanil group were significantly higher than those in the combined group at T2 and T3. The stress indicators Cor, E, FIns and HOMA-IR in the anesthesia of the two groups were significantly higher than those in the anesthesia maintenance. The serum stress indexes of Cor, E, FIns and HOMA-IR were significantly lower in the combined group than in the sufentanil group. The IFN-γ level of the combined group was significantly higher than that of the sufentanil group, and the TNF-α level was significantly lower than that of the control group. Serum levels of NO,β-EP and SP were significantly higher in the two groups 24 h after surgery. Serum pain mediators NO,β-EP and SP in the combined group were significantly lower than those in the sufentanil group before and 24 h after surgery.Conclusion: Combined anesthesia with Remifentanil and Propofol can stabilize the hemodynamic state of patients undergoing craniotomy, reduce cardiovascular stress response and inflammatory response, reduce nerve damage, and play a role in brain protection.
基金support from the Natural Science Foundation of Henan Province(grant no.212300410152)the Key Scientific and Technological Project of Henan Province(grant no.212102110439)+1 种基金Henan University of Animal Husbandry and Economy(grant no.2019HNUAHEDF011 and XKYCXJJ2020006)the Key Scientific Research Project for Colleges and Universities of Henan Province(grant no.22B150005)。
文摘A novel and efficient[3+2]annulation of 2-substituted aziridines and N-tosyl cyanamides via a dominoregioselective ring-opening/5-exo-dig cyclization procedure has been developed,allowing the directpreparation of N_(2)-unprotected five-membered cyclic guanidines in good to excellent yields under mildconditions without metals and strong bases.Moreover,the highly biologically interesting urea analoguescould also be conveniently obtained via hydrolysis of the produced guanidines.
