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Local anesthesia with ropivacaine for patients undergoing laparoscopic cholecystectomy

World Journal of Gastroenterology 2009年第19期15卷 2376-2380页

作者： Chun-Nan Yeh Hsiang-Lin Lee Chun-Yi Tsai Chih-Chung Lin Tzu-Chieh Chao Ta-Sen Yeh Yi-Yin Jan Department of Surgery Chang Gung Memorial HospitalChang Gung University5 Fu-Hsing StreetKwei-ShanTaoyuan 33375TaiwanChina Department of Anesthesiology Chang Gung Memorial HospitalChang Gung University5 Fu-Hsing StreetKwei-ShanTaoyuan 33375TaiwanChina

AIM:To investigate the effect of pain relief after infu-sion of ropivacaine at port sites at the end of ***:From October 2006 to September 2007,72 patients undergoing laparoscopic cholecystectomy(LC) were randomized into two groups of 36 *** group received ropivacaine infusion at the port sites at the end of LC and the other received normal saline.A visual analog scale was used to assess postoperative pain when the patient awakened in the operating room,6 and 24 h after surgery,and before *** amount of analgesics use was also *** demographics,laboratory data,hospital stay,and perioperative complications were compared between the two ***:There was no difference between the two groups preoperatively in terms of demographic and lab-oratory *** surgery,similar operation time,blood loss,and no postoperative morbidity and mortality were observed in the two ***,a significantly lower pain score was observed in the patients undergo-ing LC with local anesthesia infusion at 1 h after LC and at *** analgesic use,the amount of meperidine used 1 h after LC and the total used during admission were lower in patients undergoing LC with local anesthesia *** group also had a shorter hospital ***:Local anesthesia with ropivacaine at the port site in LC patients signif icantly decreased post-operative pain *** explains the lower meperidine use and earlier discharge for these patients.

关键词： Prospective randomized trial Localanesthesia Ropivacaine normal saline Laparoscopic cholecystectomy

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Distribution and differentiation of myeloid-derived suppressor cells after fluid resuscitation in mice with hemorrhagic shock

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2017年第1期18卷 48-58页

作者： Jiu-kun JIANG Wen FANG Liang-jie HONG Yuan-qiang LU Department of Emergency Medicine the First Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310003 China Key Laboratory of Combined Multi-organ Transplantation the First Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310003 China

Objective： To investigate the distribution and differentiation of myeloid-derived suppressor cells （MDSCs） in hemorrhagic shock mice, which are resuscitated with normal saline （NS）, hypertonic saline （HTS）, and hydroxyethyl starch （HES）. Methods： BALB/c mice were randomly divided into control, NS, HTS, and HES resuscitation groups. Three subgroups （n=8） in each resuscitation group were marked as 2, 24, and 72 h. Flow cytometry was used to detect the MDSCs, monocytic MDSCs （M-MDSCs）, and granulocytic/neutrophilic MDSCs （G-MDSCs） in peripheral blood nucleated cells （PBNCs）, spleen single-cell suspension, and bone marrow nucleated cells （BMNCs）. Results： The MDSCs in BMNCs among three resuscitation groups were lower 2 h after shock, in PBNCs of the HTS group were higher, and in spleen of the NS group were lower （all P〈0.05 vs. control）. The M-MDSC/G-MDSC ratios in PBNCs of the HTS and HES groups were lower （both ,P〈0.05 vs. control）. At 24 h, the MDSCs in PBNCs of the NS and HTS groups were higher, while the spleen MDSCs in the HTS group were higher （all P〈0.05 vs. control）. The M-MDSC/ G-MDSC ratios were all less in PBNCs, spleen, and BMNCs of the NS and HTS groups, and were lower in BMNCs of the HES group （all P〈0.05 vs. control）. At 72 h, the elevated MDSCs in PBNCs were presented in the HTS and HES groups, and in spleen the augment turned up in three resuscitation groups （all P〈0.05 vs. control）. The inclined ratios to M-MDSC were exhibited in spleen of the NS and HTS groups, and in PBNCs of the NS group; the inclination to G-MDSC in BMNCs was shown in the HES group （all P〈0.05 vs. control）. Conclusions： HTS induces the earlier ele- vation of MDSCs in peripheral blood and spleen, and influences its distribution and differentiation, while HES has a less effect on the distribution but a stronger impact on the differentiation of MDSCs, especially in bone marrow.

关键词： Hemorrhagic shock Hydroxyethyl starch Hypertonic saline Myeloid-derived suppressor cells normal saline

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Increase in chloride from baseline is independently associated with mortality in intracerebral hemorrhage patients admitted to intensive care unit:A retrospective study

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Journal of Intensive Medicine 2022年第4期2卷 274-281页

作者： Dawei Zhou Tong Li Dong Zhao Qing Lin Dijia Wang Chao Wang Rongli Zhang Department of Critical Care Medicine Beijing Tongren HospitalCapital Medical UniversityNo.1 Dongjiaominxiang StreetDongcheng DistrictBeijing 100730China

Background:Hyperchloremia is associated with increased mortality in critically ill *** objective of this study was to investigate the association between increased chloride levels and mortality outcomes in intracerebral hemorrhage(ICH)patients admitted to the intensive care unit(ICU).Methods:We performed a retrospective study of all patients diagnosed with ICH and included in the Medical Information Mart for Intensive Care(MIMIC-III)from 2001 to *** criteria were the first diagnosis of ICH,ICU length of stay(LOS)over 72 h,and not receiving hypertonic saline *** chloride perturbation within 72 h of admission was evaluated as a predictor of *** increase in chloride from baseline was dichotomized based on an increase in chloride in 72 h(≤5 mmol/L or>5 mmol/L).The primary outcome was 90-day ***:A total of 376 patients(54.5%male,median age 70 years,interquartile range:58–79 years)were *** overall 90-day mortality was 32.2%(n=121),in-hospital mortality was 25.8%(n=97),and Day 2 acute kidney injury(AKI)occurred in 29.0%(n=109)of *** prevalence of hyperchloremia on admission,during the first 72 h,and an increase in chloride(>5 mmol/L)were 8.8%,39.4%,and 42.8%,*** adjusting for confounders,the hazard ratio of increase in chloride(>5 mmol/L)was 1.66(95%confidence interval:1.05–2.64,P=0.031).An increase in chloride(>5 mmol/L)was associated with a higher odds ratio for 90-day mortality in both the AKI and non-AKI ***:An increase in chloride from baseline is common in adult patients with ICH admitted to *** increase is significantly associated with elevated *** results support the significance of diligently monitoring chloride levels in these patients.

关键词： Intracerebral hemorrhage Hyperchloremia normal saline Serum chloride Mortality

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