Comparison of Propofol and Fentanyl for Preventing Emergence Agitation Following Sevoflurane Anesthesia in Pediatric Patients: A Single-Center Study in Bangladesh

Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare their associated complications or side effects. Methods: This prospective randomized observational comparative study was conducted at Dhaka Medical College Hospital from July 2013 to June 2014. The study aimed to evaluate the effects of propofol and fentanyl on EA in children aged 18 to 72 months undergoing circumcision, herniotomy, and polypectomy operations. Ninety children were included in the study, with 45 in each group. Patients with psychological or neurological disorders were excluded. Various parameters including age, sex, weight, American Society of Anesthesiologists (ASA) class, duration of anesthesia, Saturation of Peripheral Oxygen (SPO2), heart rate (HR), respiratory rate (RR), Pediatric Anesthesia Emergence Delirium (PAED) score, duration of post-anesthesia care unit (PACU) stay, incidence of laryngospasm, nausea, vomiting, and rescue drug requirement were compared between the two groups. Results: Age, sex, weight, ASA class, and duration of anesthesia were comparable between the two groups. Perioperative SpO2 and HR were similar in both groups. However, the PAED score was significantly higher in the fentanyl group during all follow-ups except at 30 minutes postoperatively. The mean duration of PACU stay was significantly longer in the fentanyl group. Although the incidence of laryngospasm was higher in the fentanyl group, it was not statistically significant. Conversely, nausea or vomiting was significantly higher in the fentanyl group. The requirement for rescue drugs was significantly higher in the fentanyl group compared to the propofol group. Conclusion: Both propofol and fentanyl were effective in preventing emergence agitation in pediatric patients undergoing various surgical procedures under sevoflurane anesthesia. However, propofol demonstrated a better safety profile with fewer incidences of nausea, vomiting, and rescue drug requirements compared to fentanyl.

Effects of Morphine,Fentanyl and Tramadol on Human Immune Response

Summary： Morphine has been reported to suppress human immune response. We aimed to observe the effects of morphine, fentanyl and tramadol on NF- K B and IL-2 from both laboratory and clinical perspective. Jurkat cells were incubated with ten times clinically relevant concentrations of morphine, fentanyl and tramadol before being stimulated with PMA. NF- κB binding activity and IL-2 levels were measured, In the clinical study, 150 consenting patients were randomized into 3 groups according to the analgesics used in them, namely, group morphine （M）, group fentanyl （F） and group tramadol （T）. IL-2 was measured preoperatively and 1, 3 and 24 h after operation. Consequently, NF-κB activation was suppressed by morphine and fentanyl but not by tramadol. IL-2 was significantly decreased by morphine and fentanyl but not by tramadol in vitro. In the PCA patients, IL-2 was decreased in group M and increased in group F postoperatively. Whereas in group T, IL-2 was unchanged 1 h after operation but was significantly elevated 3 and 24 h after operation. Our results showed that the inhibition of morphine on IL-2 was most probably related to its suppression on NF-κB, Fentanyl had different effects on human immune response in vitro and in vivo. Tramadol may have immune enhancing effect.

基于ADE优化的IPMSM全速域无传感器控制

为了实现内置式永磁同步电机(IPMSM)全速域的无传感器控制和切换速域的平滑过渡,提出了一种基于自适应差分进化(ADE)算法优化的复合控制方法。分别在零低速域、中高速域采用旋转高频电压注入法和滑模观测器法来对电机转速和转子位置进行估算,并在切换速域采用基于ADE算法的权重系数优化法来实现上述两种控制方法的平滑切换,从而实现IPMSM全速域无传感器控制。仿真结果表明:提出的复合控制方法能够实现电机全速域的无感控制和切换速域的平滑过渡,且具有良好的稳定性。

儿童维生素AD滴剂,这样吃才对

众所周知,维生素A、D对孩子的生长发育至关重要。而补充维生素A、D,最好选择专门的维生素AD制剂,比如维生素AD滴剂。但许多家长对其又不甚了解,有诸多疑问。以下,笔者将一一进行解答。

ADS-B信号在对流层大气波导中的传播性能

对流层大气环境存在特殊大气结构“大气波导”,可形成电波超视距传播或产生雷达盲区等。目前,通过雷达、GNSS信号等可以对大气波导进行一定程度的反演探测,但均存在一定的不足。ADS-B信号具有应用范围广、信号密度大、实时性高等特点,为此提出利用ADS-B信号受到不同大气环境影响后能量损耗不同的特点对ADS-B信号与对流层大气环境关联性进行分析研究。以武汉地区ADS-B信号数据为例,基于抛物方程传播理论对路径损耗进行仿真分析,并进行了实验验证。结果表明:ADS-B接收信号与仿真结果存在线性相关性并给出线性表述,为后续利用ADS-B信号反演大气波导提供参考依据。

Effect of pretreatment with different concertrations of morphine, fentanyl and tramadol on the differentiation of human helper T cells in vitro

Objective： To investigate and compare the .effects of different concentrations of morphine, fentanyl and tramadol on the differentiation of human adult helper T cells in vitro. Methods： Twenty out-patients without immune disease were selected and their peripheral blood was collected. Then the Whole blood of peripheral blood mononuclear cells （PBMCs） were pretreated with different concentration of morphine, fentanyl and tramadol for 24 h. The level of CD4^＋ IFN-γ^＋ IL-2^＋/CD4^＋ IL-4^＋ IL-10^＋ was analyzed by three-color flow cytometry, and the CD4^＋ CCR5^＋ and CD4^＋ CCR3 ^＋ cells were counted to observe the imbalance of Th2/Th2. Results： The number of Th2 increased significantly and the ratio of Th2/Th2 decreased dramatically compared with the control group, and there was a dose-dependent fashion in all drugs. Conclusion： Morphine, fentanyl and tramadol can direct Th0 cells toward Th2 differentiation, especially morphine and fentanyl.

Effects of Dexamethasone, Clonidine, Tramadol and Nalbuphine on Fentanyl-Induced Hyperalgesia in Rats

Opioids are drugs used to alleviate pain. However, studies have demonstrated that these drugs can cause an increase in pain sensitivity, which is called opioid-induced hyperalgesia. The objective of this study was to describe the effects of dexamethasone, clonidine, tramadol and nalbuphine on fentanyl-induced hyperalgesia in rats. After obtaining approval from the Committee for the Ethical Use of Animals (CEUA), 36 male Wistar rats were divided into 6 groups: Group 1 (GCSSL) wherein the rats received 1 ml 0.9% saline solution in two injections;Group 2 (GFTSL), received fentanyl at a dose of 100 ug·kg-1 followed by 1 ml 0.9% saline solution via intraperitoneal;the remaining groups (3, 4, 5, 6) received fentanyl at a dose of 100 ug·kg-1 following doses via intraperitoneal: Group 3 (GFTDX), dexamethasone at a dose of 1.0 mg·kg-1;Group 4 (GFTCL), clonidine at a dose of 20 mg·kg-1;Group 5 (GFTTR), tramadol at a dose of 50 mg·kg-1, and Group 6 (GFTNB), nalbuphine at a dose of 5 mg·kg-1. Under general anestesia using isoflurane, the animals were submitted to a surgical incision. Hyperalgesia was evaluated by applying Von Frey filaments at 2 hours after the incision and on the 1st, 3rd and 5th days afterward. At 2 hours after the surgical procedure, there was lower intensity of pain in the fentanyl group (GFTSL) compared to the other groups, and on the fifth day there were no significant differences for pain intensity between groups. The results suggest the presence of fentanyl-induced hyperalgesia and efficacy in its reduction by dexamethasone, clonidine, tramadol and nalbuphine.

星基ADS-B系统空天链路的建模与仿真

星基广播式自动相关监视(ADS-B,automatic dependent surveillance-broadcast)系统是一种新型的航空器监视技术,在未来空中交通管理系统中具有广阔的应用前景。为了深入研究星基ADS-B系统中航空器到卫星的空天链路通信性能,将专业软件Matlab和STK(system tool kit)有效联合,构建符合国际标准的星基ADS-B空天链路完整模型;通过离散事件动态交互模拟ADS-B消息的发送与接收全过程,最后统计得出体现星基ADS-B空天链路通信性能的消息识别概率(POI,possibility of identify)、消息检测概率(POD,possibility of detective)、信号接收功率、信号冲突概率、卫星覆盖范围等指标。仿真结果表明,随着区域内航空器数量上升,POI、POD下降,消息冲突概率上升。

基于迁移学习-元学习的ADS-B攻击分类研究

准确分类通航领域ADS-B攻击类型,采取预防攻击措施,对保障通航运行安全性具有重要意义。针对通航领域ADS-B攻击数据样本少,提出一种基于迁移学习-元学习的ADS-B攻击分类模型。该模型将迁移学习与深度卷积自编码器相结合,建立ADS-B攻击特征提取模型,提取数据样本的攻击有效特征表示,并运用元学习策略在特征空间中实现ADS-B攻击准确分类。实例研究表明,基于迁移学习-元学习的攻击分类模型可有效分类小样本ADS-B攻击,且正确率在95%以上。

A Comparative Study of Uses of Ephedrine by Different Doses on Prevention of Hemodynamic Changes Accompanied with Induction of General Anesthesia through Propofol and Fentanyl without Adverse Effects

Background: Propofol and fentanyl combination are common with general anesthesia. However, hypotension and bradycardia are common during induction of anesthetic. This study aimed to compare the response of different doses of ephedrine for attenuation of the hemodynamic changes after anesthetic induction without adverse effects. Materials and Methods: This was a randomized, double-blinded, case-controlled clinical trial. One hundred and twenty adult patients were allocated into one of the four groups: receiving IV saline, ephedrine 0.05 mg/kg, 0.1 mg/kg, or 0.2 mg/kg respectively. Induction of anesthesia was done with propofol 3 mg/kg and fentanyl 1 mg/kg. Alterations in systolic and diastolic blood pressures (SBP, DBP), mean arterial pressure (MAP), and heart rate (HR) were calculated every 1 min after induction, and 2, 3, 4 and 5 min. Then, intubation was made. Results: Baseline hemodynamic variables were comparable between groups. Patients received 0.1 mg/kg, and 0.2 mg/kg had less drop in blood pressure both systolic and diastolic, MAP, and HR with no significant rise in side effects. The numbers of patients with hypotension were significantly lower in the group receiving ephedrine 0.2 mg/kg compared to other groups (P-value 0.05). Use of IV ephedrine at a dose of 0.1 mg/kg was shown to be useful for reduction of hemodynamic changes but did not eliminate the risk of blood pressure drop. Ephedrine 0.2 mg/kg was better without causing any adverse effects. We can conclude that ephedrine 0.1 mg/kg was suitable for minimizing or decreasing changes in hemodynamic at propofol-fentanyl induction but ephedrine 0.2 mg/kg was better without causing more adverse effects.

基于多时间特征融合网络的ADS-B实采信号分离

不同于以往单天线广播式自动相关监视(Automatic Dependent Surveillance-Broadcast,ADS-B)信号分离中利用仿真的ADS-B信号制作数据集,将单天线接收的真实飞机发射的ADS-B原始信号通过调整信号起始时间以及功率并人为增加噪声来制作数据集。为了提高信号分离的时域波形精度,提出一种多分辨率多时间特征融合重采样(Multi-Temporal fusion Resampling of Multi-Resolution Features,MTRM-RF)网络,通过卷积将信号转化成不同采样率的信号并分别使用多层堆叠逐渐膨胀的一维卷积提取不同时间间隔的特征,以获得更多的时间信息。对多种基于深度学习的语音分离网络进行比较发现,MTRM-RF网络能够有效地融合ADS-B信号的不同采样率、不同时间间隔采样点的特征进行训练。并且随着训练集数据量的增加,分离信号的平均解码正确率达到88.39%,证明该网络可有效分离单天线实采的ADS-B交织信号。

Outcome Values of Adding Sodium Bicarbonate, Dexamethasone and Fentanyl to Local Anesthetic in Peribulbar Block during Vitreoretinal Surgeries. A Randomized Prospective Study

Background and aims: we aimed to detect the outcome values of adding fentanyl, dexamethasone and sodium bicarbonate to mixture of local anesthetic in peribulbar block for vitreoretinal surgery. Methods: 120 adult ASA I & II patients, admitted for vitreoretinal surgery under peribulbar block were included in this comparative study. This study included 4 groups: Group I: (30) patients using a mixture of 1 ml normal saline, 4 ml lidocaine 2% plus 4 ml from bupivacaine 0.5% 20 ml vial containing hyaluronidase 1500 IU. Group II: (30) patients using a mixture of 1 ml of sodium bicarbonate (from 1 ml sodium bicarbonate 8.4% diluted in 10 ml normal saline), 4 ml lidocaine 2% plus 4 ml from bupivacaine 0.5% 20 ml vial containing hyaluronidase 1500 IU. Group III: (30) patients using a mixture of 1 ml fentanyl 20 μg (from a mixture of fentanyl 100 μg diluted in 5 ml normal saline), 4 ml lidocaine 2% plus 4 ml from bupivacaine 0.5% 20 ml vial containing hyaluronidase 1500 IU. Group IV: (30) patients using a mixture of 1 ml of 4 mg dexamethasone (1 ampoule = 8 mg/2 ml), 4 ml lidocaine 2% plus 4 ml from bupivacaine 0.5% 20 ml vial containing hyaluronidase 1500 IU. We measured the onset and duration of anesthesia, IOP, eyelid and global akinesia, postoperative pain by numerical pain rating scale, first analgesic requirement and postoperative side effects. Results: No significant differences were detected among the four groups as respect to age, sex and the intraocular pressure (IOP) before the anesthesia block. While the intraocular pressure (IOP) after the anesthesia block there was a significant difference, as IOP was markedly decreased postoperatively in group II compared with other groups. As regard to the onset & duration of anesthesia there was significant difference among all groups, there was rapid onset and prolonged duration of anesthesia in group III compared with other groups (1.77 ± 0.63 & 5.03 ± 0.89) respectively. As regard the onset of lid akinesia there was significant difference among the four groups with better outcome in group III, as in group III represented the most rapid onset of lid akinesia. As respecting to the onset of global akinesia there was significant difference among the four groups. There was better outcome in group III as it represented more rapid onset of global akinesia compared with other groups. There were significant differences among the four groups as regard postoperative pain all over 6 hours, better results were in group III (0.27 ± 0.69) compared with group I (2.23 ± 1.17), group II (2.00 ± 1.70), group IV (0.67 ± 0.71). As regarding to the first time for analgesic requirement there were significant differences among groups, there was no request for analgesia with better outcome in group III with increasing need to the analgesic medication in group I compared to group II and group IV. As regard side effects postoperatively there were few side effects in all groups with few numbers of cases in groups III only one patient. Although these differences in number of patients are not significant among the four groups. Conclusion: Addition of sodium bicarbonate to local anesthetic mixture was the best way in lowering the IOP other than other groups and addition of fentanyl to local anesthesia provided more rapid onset and duration of anesthesia, more rapid onset and duration for lid and global akinesia, less pain, less analgesic requirement and minimal side effects than the other groups.

Adverse Effects of Morphine and Fentanyl for Stomatitis in Patients Receiving Allogeneic Hematopoietic Cell Transplantation—A Single Center Retrospective Analysis

Opioids are widely used as analgesics for oral mucositis in allogeneic hematopoietic cell transplantation (allo-HCT). Their main adverse events are nausea, vomiting, constipation, psychological symptoms, and respiratory depression. In our institute, continuous intravenous morphine was generally used until 2007, followed by intravenous fentanyl as the first-line agent because of its potential fewer adverse events. We retrospectively analyzed 99 patients who underwent allo-HCT in the University of Tsukuba Hospital from 2004 to 2009. Out of 99 patients, 64 were treated with opioids (morphine, 32 and fentanyl, 32). The attending physicians were in charge of providing stable pain control. Median age, sex, stem cell source, preparative regimen, and GVHD prophylaxis were similar in the two groups. There were no significant differences in psychological symptoms, drowsiness, nausea, and vomiting in both groups. Defecation ratio (the days having a bowel movement/the days taking opioids) was 63% and 94% in the morphine and fentanyl group, respectively (P < 0.0001). The percentage of patients who needed to use purgative drugs was 25% and 6% in the morphine and fentanyl group, respectively (P = 0.04). It is suggested that fentanyl has less adverse effects on gastrointestinal movement and is safer than morphine when used for oral mucositis in allo-HCT.

Comparison of impact of adjuvant treatment of midazolam, fentanyl, and magnesium sulfate with intrathecal bupivacaine on block characteristics and postoperative analgesia in knee arthroplasty: A randomized clinical trial

Objective:To compare the efficacy of midazolam,fentanyl,and magnesium sulfate as adjuvants to intrathecal bupivacaine on both block characteristics and postoperative analgesia in knee arthroplasty.Methods:This randomized double-blind clinical trial recruited spinal anesthesia patients of the American Society of Anesthesiologists classⅠorⅡ,who needed knee arthroplasty.Patients were stratified into three intervention groups,including the midazolam group,the fentanyl group,and the magnesium sulfate group,and the patients were administered with midazolam,fentanyl,and magnesium sulfate,respectively.Hemodynamic parameters,sensory and motor block,and pain score(Visual Analogue Scale)were measured and compared among the three groups.Results:A total of 105 patients were included in this study with 35 patients in each group.There was no statistically significant difference in terms of oxygen saturation,mean blood pressure,duration of surgery,and postoperative complications,including nausea,vomiting,bradycardia,dizziness,and hypotension,as well as the time of opioid administration among the three groups(P>0.05).Statistically significant differences were found in terms of heart rate at 15,30,45,60,75,and 105 min after beginning of operation among the three groups,which was lower in the midazolam group(P<0.05).The midazolam group showed a shorter time to achieve sensory block after spinal anesthesia,sensory block to T8 or higher and sensory block to T12 and L1(P<0.05).Besides,the three groups showed significantly differences in terms of onset of motor block after spinal anesthesia and time to achieve motor block to T8 or higher or Bromage score 3(P=0.001).No significant difference was noted in pain scores among the three groups(P>0.05).Conclusion:Midazolam resulted in a shorter time to achieve sensory and motor block to T8 or higher,the onset of motor block and sensory block after spinal anesthesia,and time to achieve sensory block to T12 and L1,and the pain scores were not significantly different among the groups.Thus,midazolam can be highly underlined,if a shorter onset of sensory and motor blocks is targeted.[Funded by the research deputy of Arak University of Medical Sciences(No.99258);fa.irct.ir number,IRCT20141209020258N164].

基于AD与TRIZ的加工中心主轴松拉刀机构优化设计

数控加工中心在加工过程中常出现主轴松刀力不足或无法松刀的现象。针对此问题,通过TRIZ系统组件分析明确现有松拉刀机构各组件间作用关系,利用因果链分析得出影响松刀的根本原因,最终应用TRIZ理论中的物场模型分析方法和AD独立性原理提出优化设计方案。根据新方案计算出实际工况下的主轴松刀力和螺杆强度,并对松刀杆进行建模和仿真。结果表明:最大位移量为6.995μm,最大应力为45.24 MPa,符合结构设计要求。最后,经过现场实物测试,当液压力为5 MPa时,松刀行程、松刀力以及打刀量均符合生产要求,验证了优化设计方案的合理性。

白菜型冬油菜BrADS2基因的克隆、表达分析与亚细胞定位

【目的】探究白菜型冬油菜(Brassica rapa L.)脂肪酸去饱和酶ADS2(Δ9 fatty acid desaturase)基因与抗寒性的关系。【方法】基于前期转录组结果,采用一步定向克隆法得到BrADS2基因;构建GFP融合表达载体,通过注射法在烟草下表皮细胞进行瞬时转化,同时采用农杆菌侵染法侵染‘中双11号’;利用qRT-PCR技术,检测抗寒性不同的白菜型冬油菜品种叶片中ADS2基因的表达模式,并对低温下冬油菜的形态变化和抗氧化酶活性、电导率含量进行分析。【结果】白菜型冬油菜BrADS2基因可编码307个氨基酸,该基因编码的蛋白具有亲水性特性;qRT-PCR结果显示,BrADS2基因的表达量呈先升后降的单峰型变化,且在-4℃时表达量达到峰值;亚细胞定位结果显示BrADS2蛋白在细胞质和细胞膜上表达;低温处理下3个品种叶片的相对电导率、抗氧化物酶活性均显著上升,强抗寒品种抗氧化酶活性高于弱抗寒品种,电导率却相反;农杆菌介导侵染‘中双11号’下胚轴后获得15株转基因阳性苗,且转基因油菜阳性植株叶中的BrADS2基因表达量均显著高于野生型。【结论】推测BrADS2基因在白菜型冬油菜膜脂不饱和调节中起重要作用,揭示了ADS2基因与冬油菜抗低温胁迫的关系。

ADSORPTIVE STRIPPING VOLTAMMETRY OF A FENTANYL DERIVATIVE DNPME AT Hg ELECTRODE

A quasi-reversible reduction peak of a fentanyl derivative DNPME is found by cyclic voltammetry at Hg electrode. E_(pc)=-1.58 V (vs. Ag/AgCl). The cathodic peak shows adsorptive characteristics. The adsorbed species is DNPME neutral molecule. The method for measuring trace amount of DNPME by adsorptive stripping voltammetry is established.

基于改进型多斜Ⅲ技术的7位半AD转换器设计

高精度测试仪器在环境试验中扮演着重要角色,而积分型AD转换器被广泛的应用在高精度测试仪器中。针对传统型积分型AD转换器转换速率较低的问题,提出了一种提高转换速率的改进型多斜ⅢAD转换器,详细的介绍了其原理和设计思路。该转换器以单片机与CPLD一同控制积分型ADC,在积分末尾利用单片机片内ADC测量积分器的残留电压,以达到提高转换速率的目的。经理论分析该AD转换器比传统型转换速率快836倍,分辨率可达到31位,在±10V直流电压测量中可实现7位半分辨率。

Comparison of dexmedetomidine and fentanyl as adjuvants for ropivacaine for epidural anesthesia:a Meta-analysis of randomized controlled trial

Objective:To systematically review the efficacy of dexmedetomidine and fentanyl as adjuvants for ropivacaine for epidural anesthesia.Methods:We searched the Cochrane Library,PubMed,Embase,CNKI,VIP,WanFang Database,search time from the year of construction to December 2018 for all randomized controlled trials(RCTs)about the efficacy of dexmedetomidine versus fentanyl as adjuvants for ropivacaine for epidural anesthesia.The quality of the studies evaluated by the method recommended by Cochrane Collaboration.Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.3 software.Results:Eight RCTs involving 592 Patients were included in our Meta-analysis.The results of meta-analysis showed that compared with fentanyl,dexmedetomidine can reduce the incidence of postoperative nausea and vomiting in patients with ropivacaine epidural anesthesia[OR=0.43,95%CI(0.29,0.66),P<0.0001]and the incidence of post-cold[OR=0.34,95%CI(0.18,0.63),P<0.0001],accelerated onset of analgesia[MD=-2.78,95%CI(-4.81,-0.75),P<0.0001],prolonged time of analgesia[MD=99.04,95%CI(82.73,115.34),P<0.0001],enhanced sedation in non-cesarean section[MD=1.01,95%CI(0.87,1.15),P<0.0001],but increased the incidence of dry mouth[OR=5.63,95%CI(2.85,11.10),P<0.0001],shortening the duration of nerve block[MD=-4.35,95%CI(-7.31,-1.40),P<0.0001],sedation was not as good as fentanyl in cesarean section[MD=-0.89,95%CI(-1.39,-0.38),P<0.0001].Conclusion:Available evidence suggests that dexmedetomidine,as an adjuvant for ropivacaine for epidural anesthesia,has a better analgesic effect than fentanyl,and can reduce the incidence of nausea,vomiting,and chills,but should pay attention to its risk of dry mouth and the sedative effect on different operations.

基于FPGA与AD9786的调制解调电路的设计

谐振式光学陀螺因其高理论精度、小型化以及高稳定性受到了国内外的强烈关注。针对于谐振式光学陀螺检测信号微弱的特点,需要对该信号进行调制解调,以实现陀螺的稳定输出,设计了一种基于FPGA和AD9786的高精度模拟信号源,该信号以FPGA作为核心控制单元,AD9786作为数模转换器,实现16位的高精度DA转换,通过上位机实现指令的通信过程,可实现不同频率的交流信号。该实验结果表明,该系统符合陀螺测试系统调制解调要求,通过上位机对不同输出信号进行测试,且测试结果无纹波时输出噪声Vrms269μV,交流信号精度达到0.01%,最高频率可达到2M,稳定性高。