Myasthenia gravis patients are hypersensitive to nondepolarizing relaxants, such as alcuronium, an intermediate-long nondepolarizing agent. This study observed the effects of alcuronium treatment in myasthenia gravis ...Myasthenia gravis patients are hypersensitive to nondepolarizing relaxants, such as alcuronium, an intermediate-long nondepolarizing agent. This study observed the effects of alcuronium treatment in myasthenia gravis patients as compared with non-MG patients during operation. Ten MG patients (Ossermann class I - IV, scheduled for thymectomy) and 10 non-MG patients (ASA class I-Ⅱ, scheduled for operation) were selected. An induction dose of alcuronium 0. 2 mg/kg and thiopental 4-6 mg/kg was given , followed by intubation and ventilation with 50% nitrous oxide in oxygen and 0.5-1. 5% ethrane. Neuromuscular transmission was monitored using an accelerogragh and degrees of neuromuscular function at different depths were recorded. There were statistically significant differences between the two groups. The effect of alloferin in the MG group was quicker and deeper.This study also found a relation between MG class and the recovery of respiration: Respiratory recovery was quicker in classes I-Ⅱthan in classes Ⅲ-Ⅳ.展开更多
Sepsis and related syndromes are the major cause of multiple organ failure and death in patients with critical illnesses. Neuroendocrine dysfunction has long been thought to be an important event in sepsis. In clinic,...Sepsis and related syndromes are the major cause of multiple organ failure and death in patients with critical illnesses. Neuroendocrine dysfunction has long been thought to be an important event in sepsis. In clinic, optimal management of the hormones could alleviate severe complications in sepsis. In this article, we review the dysfunction ofneuroendocrine system as well as autonomic nervous system in sepsis, and summarize the respective therapy strategies.展开更多
We hypothesized that neuroprotective agents targeting various pathways involved in cerebral ischemia/reperfusion(I/R)injury might be superior to that targeting single pathway.Here,we prepared a fusion protein(B-I)by c...We hypothesized that neuroprotective agents targeting various pathways involved in cerebral ischemia/reperfusion(I/R)injury might be superior to that targeting single pathway.Here,we prepared a fusion protein(B-I)by combining anti-apoptotic Bcl-x L(B)and anti-inflammatory IL-10(I).B-I could cross blood brain barrier by its N-terminal TAT domain,and be cleaved into separate B and I by Caspase-1.B-I treatment significantly reduced the cerebral infarct volume,better than B or I treatment alone,and equivalent to B and I treatment(B+I).Treatment with B or B-I significantly attenuated I/R-induced neuronal apoptosis as shown by the decrease in apoptotic rate and the inhibition of caspase-3 activity.Moreover,all recombinant proteins,especially B-I,remarkably attenuated I/R-induced up-regulation of TNF-α.These results suggested that fusion protein B-I inhibiting both inflammation and apoptosis provided better neuroprotective effects than inhibiting either one alone.Our study suggested that multiple pathways targeting brain I-R injury could enhance the neuroprotective effect,and it provided a new idea for the study of neuroprotective drugs for ischemic stroke.展开更多
Objective：To observe the therapeutic efficacy of acupuncture plus Tai Ji Quan （Tai Chi） in recovering the neurological function and treating depression state in post-stroke depression patients,together with a 12-mo...Objective：To observe the therapeutic efficacy of acupuncture plus Tai Ji Quan （Tai Chi） in recovering the neurological function and treating depression state in post-stroke depression patients,together with a 12-month follow-up.Methods：A total of 105 eligible post-stroke depression patients were randomized into an acupuncture plus Tai Ji group （53 cases） and a control group （52 cases） based on their visiting sequence.The patients all received routine treatment and rehabilitation training for stroke.In addition,the control group was given oral administration of citalopram hydrobromide tablets,1 month as a course of treatment,for 3 courses in total.Meanwhile,the acupuncture plus Tai Ji group received acupuncture and practiced Tai Ji Quan,for 1 month and 12 months respectively.Before the intervention,after 1-month intervention and 12 months later,the National Institute of Health stroke scale （NIHSS）,Barthel index （BI） and Hamilton depression rating scale （HAMD） were adopted for efficacy evaluation.Results：Prior to the intervention,there were no significant differences in HAMD,NIHSS and BI scores between the two groups （all P〉0.05）;after 1-month intervention,there were significant between-group differences in NIHSS,BI and HAMD scores （P〈0.05 or P〈0.01）;the 12-month follow-up revealed significant between-group differences in NIHSS,BI and HAMD scores （all P〈0.01）.In the treatment of stroke,the total effective rate was 84.4% in the acupuncture plus Tai Ji group,significantly higher than 68.9% in the control group （P〈0.05）;in the treatment of depression,the total effective rate was 86.7% in the acupuncture plus Tai Ji group,significantly higher than 77.8% in the control group （P〈0.05）.Conclusion：Acupuncture plus Tai Ji Quan can produce a significant efficacy in improving the limb motor function and depression in post-stroke depression patients.展开更多
Objective： To discuss the pathological characteristics of cervical spinal fracture complicating ankylosing spondylitis （AS） and the effect of combined anterior and posterior operation. Methods： Eighteen AS patien...Objective： To discuss the pathological characteristics of cervical spinal fracture complicating ankylosing spondylitis （AS） and the effect of combined anterior and posterior operation. Methods： Eighteen AS patients with traumatic cervical fracture-dislocation were treated operatively from January 2000 to January 2006. The symptom duration of AS was 14.5 years on average. Three cases had undergone osteotomy in lumbar spine. There were 4 cases of Grade A, 3 cases of Grade B, 9 cases of Grade C and 2 cases of Grade D according to Frankel＇s score. There were 15 cases of Grade III dislocation and 3 cases of Grade II. All patients underwent surgical procedures by combined anterior and posterior approach. Results： There were 4 anterior-posterior procedures, 8 anterior-posterior-anterior procedures and 6 posterior-anterior procedures. Seven patients had one stage operation and 11 cases underwent two stage surgeries. There was certain extent of neurological improvement in 14 incomplete paraplegic patients, but no improvement in 4 complete paraplegic patients. The follow-up period was 21.2 months on average and the time for bone fusion was 3.6 months. There were 4 complications during operation and a longterm complication in follow-up. Conclusions： The study suggests that anterior combined with posterior approach makes the spine stable and relieves the pressure immediately. It is a reasonable surgical strategy for treatment of cervical spinal fracture-dislocation with AS.展开更多
文摘Myasthenia gravis patients are hypersensitive to nondepolarizing relaxants, such as alcuronium, an intermediate-long nondepolarizing agent. This study observed the effects of alcuronium treatment in myasthenia gravis patients as compared with non-MG patients during operation. Ten MG patients (Ossermann class I - IV, scheduled for thymectomy) and 10 non-MG patients (ASA class I-Ⅱ, scheduled for operation) were selected. An induction dose of alcuronium 0. 2 mg/kg and thiopental 4-6 mg/kg was given , followed by intubation and ventilation with 50% nitrous oxide in oxygen and 0.5-1. 5% ethrane. Neuromuscular transmission was monitored using an accelerogragh and degrees of neuromuscular function at different depths were recorded. There were statistically significant differences between the two groups. The effect of alloferin in the MG group was quicker and deeper.This study also found a relation between MG class and the recovery of respiration: Respiratory recovery was quicker in classes I-Ⅱthan in classes Ⅲ-Ⅳ.
基金This study was supported by grants from the National Basic Research Program of China （No. 2005CB522602） and the National Natural Science Foundation of China （No. 30973120, No. 30672178, No. 30872683）.
文摘Sepsis and related syndromes are the major cause of multiple organ failure and death in patients with critical illnesses. Neuroendocrine dysfunction has long been thought to be an important event in sepsis. In clinic, optimal management of the hormones could alleviate severe complications in sepsis. In this article, we review the dysfunction ofneuroendocrine system as well as autonomic nervous system in sepsis, and summarize the respective therapy strategies.
基金National Natural Science Foundation of China(Grant No.81573333,81503060)
文摘We hypothesized that neuroprotective agents targeting various pathways involved in cerebral ischemia/reperfusion(I/R)injury might be superior to that targeting single pathway.Here,we prepared a fusion protein(B-I)by combining anti-apoptotic Bcl-x L(B)and anti-inflammatory IL-10(I).B-I could cross blood brain barrier by its N-terminal TAT domain,and be cleaved into separate B and I by Caspase-1.B-I treatment significantly reduced the cerebral infarct volume,better than B or I treatment alone,and equivalent to B and I treatment(B+I).Treatment with B or B-I significantly attenuated I/R-induced neuronal apoptosis as shown by the decrease in apoptotic rate and the inhibition of caspase-3 activity.Moreover,all recombinant proteins,especially B-I,remarkably attenuated I/R-induced up-regulation of TNF-α.These results suggested that fusion protein B-I inhibiting both inflammation and apoptosis provided better neuroprotective effects than inhibiting either one alone.Our study suggested that multiple pathways targeting brain I-R injury could enhance the neuroprotective effect,and it provided a new idea for the study of neuroprotective drugs for ischemic stroke.
文摘Objective：To observe the therapeutic efficacy of acupuncture plus Tai Ji Quan （Tai Chi） in recovering the neurological function and treating depression state in post-stroke depression patients,together with a 12-month follow-up.Methods：A total of 105 eligible post-stroke depression patients were randomized into an acupuncture plus Tai Ji group （53 cases） and a control group （52 cases） based on their visiting sequence.The patients all received routine treatment and rehabilitation training for stroke.In addition,the control group was given oral administration of citalopram hydrobromide tablets,1 month as a course of treatment,for 3 courses in total.Meanwhile,the acupuncture plus Tai Ji group received acupuncture and practiced Tai Ji Quan,for 1 month and 12 months respectively.Before the intervention,after 1-month intervention and 12 months later,the National Institute of Health stroke scale （NIHSS）,Barthel index （BI） and Hamilton depression rating scale （HAMD） were adopted for efficacy evaluation.Results：Prior to the intervention,there were no significant differences in HAMD,NIHSS and BI scores between the two groups （all P〉0.05）;after 1-month intervention,there were significant between-group differences in NIHSS,BI and HAMD scores （P〈0.05 or P〈0.01）;the 12-month follow-up revealed significant between-group differences in NIHSS,BI and HAMD scores （all P〈0.01）.In the treatment of stroke,the total effective rate was 84.4% in the acupuncture plus Tai Ji group,significantly higher than 68.9% in the control group （P〈0.05）;in the treatment of depression,the total effective rate was 86.7% in the acupuncture plus Tai Ji group,significantly higher than 77.8% in the control group （P〈0.05）.Conclusion：Acupuncture plus Tai Ji Quan can produce a significant efficacy in improving the limb motor function and depression in post-stroke depression patients.
文摘Objective： To discuss the pathological characteristics of cervical spinal fracture complicating ankylosing spondylitis （AS） and the effect of combined anterior and posterior operation. Methods： Eighteen AS patients with traumatic cervical fracture-dislocation were treated operatively from January 2000 to January 2006. The symptom duration of AS was 14.5 years on average. Three cases had undergone osteotomy in lumbar spine. There were 4 cases of Grade A, 3 cases of Grade B, 9 cases of Grade C and 2 cases of Grade D according to Frankel＇s score. There were 15 cases of Grade III dislocation and 3 cases of Grade II. All patients underwent surgical procedures by combined anterior and posterior approach. Results： There were 4 anterior-posterior procedures, 8 anterior-posterior-anterior procedures and 6 posterior-anterior procedures. Seven patients had one stage operation and 11 cases underwent two stage surgeries. There was certain extent of neurological improvement in 14 incomplete paraplegic patients, but no improvement in 4 complete paraplegic patients. The follow-up period was 21.2 months on average and the time for bone fusion was 3.6 months. There were 4 complications during operation and a longterm complication in follow-up. Conclusions： The study suggests that anterior combined with posterior approach makes the spine stable and relieves the pressure immediately. It is a reasonable surgical strategy for treatment of cervical spinal fracture-dislocation with AS.
