Wei Zhang

Zhengzhou University, Cheng, Henan Sheng, China

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Publications (21)38.95 Total impact

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    ABSTRACT: This study aimed to investigate whether CYP3A4*1G genetic polymorphism influences the metabolism of fentanyl in human liver microsomes in Chinese patients. The human liver microsomes were obtained from 88 hepatobiliary surgery patients who accepted liver resection surgery in this study. A normal liver sample (confirmed by the Department of Pathology) was taken from the outer edge of the resected tissue. The metabolism of fentanyl in human liver microsomes was studied. The concentration of fentanyl was measured by high performance liquid chromatography. The CYP3A4*1G variant allele was genotyped using the PCR restriction fragment length polymorphism method. The frequency of the CYP3A4*1G variant allele was 0.188 in the 88 Chinese patients who had received hepatobiliary surgery. The metabolic rate of fentanyl in patients homozygous for the *1G/*1G variant (0.85 ± 0.37) was significantly lower than that in patients bearing the wild-type allele *1/*1 (1.89 ± 0.58) or in patients heterozygous for the *1/*1G variant (1.82 ± 0.65; p < 0.05). There were no gender-related differences in the metabolic rate of fentanyl (p > 0.05) nor was there any correlation between age and metabolic rate of fentanyl (p > 0.05). Results from different hepatobiliary diseases showed no significant difference in the metabolic rate of fentanyl (p > 0.05). The difference of CYP3A4 mRNA among different CYP3A4*1G variant alleles was significant (p < 0.05). There was positive correlation between CYP3A4 mRNA and metabolic rate of fentanyl (p < 0.01). CYP3A4*1G genetic polymorphism decreases the metabolism of fentanyl. There is a positive correlation between CYP3A4 mRNA level and metabolism of fentanyl. © 2015 S. Karger AG, Basel.
    Pharmacology 06/2015; 96(1-2):55-60. DOI:10.1159/000433441 · 1.67 Impact Factor
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    ABSTRACT: CYP3A4*1G (G > A) in human CYP3A4 intron 10 is associated with therapeutic effects of CYP3A4-metabolized drugs. The aim of this study was to predict its function in the regulation of CYP3A4 expression. Functional analysis of the CYP3A4*1G allele was performed using bioinformatic methods and enhancer or promoter reporter assays in HepG2 cells. Transcription regulatory elements like CAATboxes, TATA-boxes, Sp1, SMARCA3.01, and Box II-like sequence were present in the intron 10 of CYP3A4. SMARCA3.01 and Box II-like sequence were responsible for differential binding of transcription factors on the CYP3A4*1G allele. In CYP3A4*1G, the G allele enhanced expression of the CYP3A4 promoter in a position-dependent and orientation-dependent manner, however, the A allele enhanced expression of the CYP3A4 promoter in a position-independent and orientation-independent manner. In addition, the G allele and the A allele both displayed strong transcriptional activation, but the latter showed higher promoter activity than the former. Also, the A allele showed greater activity than the CYP3A4 promoter. These results in vitro suggest that CYP3A4*1G regulates CYP3A4 intron 10 enhancer and promoter activity in an allelic-dependent manner.
    International journal of clinical pharmacology and therapeutics 05/2015; 53(8). DOI:10.5414/CP202272 · 1.22 Impact Factor
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    ABSTRACT: The solute carrier organic anion-transporting polypeptides (OATPs) are a family of transporter proteins that have been extensively recognized as key determinants of absorption, distribution, metabolism and excretion of various drugs because of their broad substrate specificity and wide tissue distribution as well as the involvement of drug-drug interaction. Human OATP1A2 is a drug uptake transporter known for its broad substrate specificity, including many drugs in clinical use. OATP1A2 expression has been detected in the intestine, liver, brain and kidney. A considerable number of single nucleotide polymorphisms have been found for the OATP1A2 gene. A number of studies have shown that the cellular uptake and pharmacokinetic behavior of some drugs may be impaired in the case of certain OATP1A2 variants. Interestingly, some studies show that the mRNA expression of OATP1A2 is nearly 10-fold higher in breast cancer compared with adjacent healthy breast tissues. This review is, therefore, focused on the genetic polymorphisms, function and clinical relevance of OATP1A2 as well as on the substrates transported by it. © 2015 S. Karger AG, Basel.
    Pharmacology 04/2015; 95(3-4):201-208. DOI:10.1159/000381313 · 1.67 Impact Factor
  • Sheng-na Han · Pei Wang · Wei Zhang · Li-rong Zhang
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    ABSTRACT: To investigate the effect of midazolam on human ether-a-go-go (hERG) K+ channels exogenously expressed in human embryonic kidney cells (HEK-293) and the underlying molecular mechanisms. Whole-cell patch clamp technique was used to record WT, Y652A and F656C hERG K+ current expressed in HEK-293 cells. Midazolam inhibited hERG K+ current in a concentration-dependent manner, the half-maximum block concentrations (IC50) values were (1.31 ± 0.32) µmol/L. The half-activation voltage (V1/2) were (2.32 ± 0.38) mV for the control and (-1.96 ± 0.83) mV for 1.0 µmol/L midazolam. The half-inactivation voltage (V1/2) was slightly shifted towards negative voltages from (-49.25 ± 0.69) mV in control to (-57.53 ± 0.53) mV after 1.0 µmol/L midazolam (P < 0.05). Mutations in drug-binding sites (Y652A or F656C) of the hERG channel significantly attenuated the hERG current blockade by midazolam. Midazolam can block hERG K+ channel and cause the speed of inactivation faster. Mutations in the drug-binding sites (Y652 or F656) of the hERG channel were found to attenuate hERG current blockage by midazolam.
    Zhongguo ying yong sheng li xue za zhi = Zhongguo yingyong shenglixue zazhi = Chinese journal of applied physiology 03/2015; 31(2):143-7.
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    ABSTRACT: Peripheral nerve injury-induced changes in gene transcription and translation in primary sensory neurons of the dorsal root ganglion (DRG) are considered to contribute to neuropathic pain genesis. Transcription factors control gene expression. Peripheral nerve injury increases the expression of myeloid zinc finger protein 1 (MZF1), a transcription factor, and promotes its binding to the voltage-gated potassium 1.2 (Kv1.2) antisense RNA gene in the injured DRG. However, whether DRG MZF1 participates in neuropathic pain is still unknown. Here, we report that blocking the nerve injury-induced increase of DRG MZF1 through microinjection of MZF1 siRNA into the injured DRG attenuated the initiation and maintenance of mechanical, cold, and thermal pain hypersensitivities in rats with chronic constriction injury (CCI) of the sciatic nerve, without affecting locomotor functions and basal responses to acute mechanical, heat, and cold stimuli. Mimicking the nerve injury-induced increase of DRG MZF1 through microinjection of recombinant adeno-associated virus 5 expressing full-length MZF1 into the DRG produced significant mechanical, cold, and thermal pain hypersensitivities in naïve rats. Mechanistically, MZF1 participated in CCI-induced reductions in Kv1.2 mRNA and protein and total Kv current and the CCI-induced increase in neuronal excitability through MZF1-triggered Kv1.2 antisense RNA expression in the injured DRG neurons. MZF1 is likely an endogenous trigger of neuropathic pain and might serve as a potential target for preventing and treating this disorder.
    Pain 01/2015; 156(4). DOI:10.1097/j.pain.0000000000000103 · 5.21 Impact Factor
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    Na Xing · Xin Wei · Yanzi Chang · Yingying Du · Wei Zhang
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    ABSTRACT: Background Low-flow sevoflurane anesthesia has been shown to influence renal function in rats, but not in adult humans. Presently, no study has assessed the effects of sevoflurane on renal function in low birth weight infants. Our aim was to study the renal function in low birth weight infants undergoing surgery with low-flow sevoflurane anesthesia. Methods Forty infants graded as American Society of Anesthesiologists (ASA) grade I or II undergoing abdominal surgery were selected. After the induction of anesthesia, they received sevoflurane semi-closed inhalation anesthesia with an oxygen flow rate of 1 L/minute. According to patient vital signs, in-tidal sevoflurane concentration was maintained at 2.5%–4.0%. Peripheral vein blood samples and urine specimens were obtained before surgery (T0), at the end of surgery (T1), and 24 (T2), 48 (T3), and 72 hours (T4) after surgery. Serum creatinine (Cr), blood urea nitrogen (BUN), urinary retinol binding protein (RBP), and β-N-acetyl-glucosaminidase (NAG) levels were determined at these time points. Also, a temperature probe was inserted into the center of a soda lime canister and temperature readings were obtained. Results There were no significant differences in Cr and BUN before and after surgery (P > 0.05). However, RBP and NAG levels increased after surgery (P < 0.05), but returned to preoperative levels 72 hours (T4) after surgery. The highest soda lime temperature was 37.3 ± 3.1°C. Conclusions Low-flow sevoflurane semi-closed inhalation anesthesia has no significant effect on the renal function of low birth weight infants.
    BMC Anesthesiology 01/2015; 15(1). DOI:10.1186/1471-2253-15-6 · 1.38 Impact Factor
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    ABSTRACT: Nuclear factor kappa B (NF-κB) in the spinal cord is involved in pro-inflammatory cytokine-mediated pain facilitation. However, the role of NF-κB activation in chronic morphine-induced analgesic tolerance and the underlying mechanisms remain unclear. In the present study, we found that the level of phosphorylated NF-κB p65 (p-p65) was increased in the dorsal horn of the lumbar 4-6 segments after intrathecal administration of morphine for 7 consecutive days, and the p-p65 was co-localized with neurons and astrocytes. The expression of TNF-α and IL-1β was also increased in the same area. In addition, pretreatment with pyrrolidinedithiocarbamate (PDTC) or SN50, inhibitors of NF-κB, prevented the development of morphine analgesic tolerance and alleviated morphine withdrawal-induced allodynia and hyperalgesia. The increase in TNF-α and IL-1β expression induced by chronic morphine exposure was also partially blocked by PDTC pretreatment. In another experiment, rats receiving PDTC or SN50 beginning on day 7 of morphine injection showed partial recovery of the anti-nociceptive effects of morphine and attenuation of the withdrawal-induced abnormal pain. Meanwhile, intrathecal pretreatment with lipopolysaccharide from Rhodobacter sphaeroides, an antagonist of toll-like receptor 4 (TLR4), blocked the activation of NF-κB, and prevented the development of morphine tolerance and withdrawal-induced abnormal pain. These data indicated that TLR4-mediated NF-κB activation in the spinal cord is involved in the development and maintenance of morphine analgesic tolerance and withdrawal-induced pain hypersensitivity.
    Neuroscience Bulletin 12/2014; 30(6):936-48. DOI:10.1007/s12264-014-1483-7 · 2.51 Impact Factor
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    ABSTRACT: Tracheobronchial rupture is an uncommon but potentially serious complication of endotracheal intubation. The most likely cause of tracheal injury is massive overinflation of the endotracheal tube cuff and pre-existing tracheal wall weakness. We review the relevant literature and predisposing factors contributing to this complication. Only articles that reported at least the demographic data (age and sex), the treatment performed and the outcome were included. Papers that did not detail these variables were excluded. We also focus on a case of tracheal laceration after tracheal intubation in a patient with severe thyroid carcinoma. This patient received surgical repair and recovered uneventfully. Two hundred and eight studies that reported cases or case series were selected for analysis. Most of the reported cases (57·2%) showed an uneventful recovery after surgical therapy. The overall mortality was 19·2% (40 patients). Our patient too recovered without any serious complication. Careful prevention, early detection and proper treatment of the problem are necessary when tracheal rupture occurs. The morbidity and mortality associated with tracheal injury mandate a high level of suspicion and expedient management.
    International Wound Journal 05/2014; DOI:10.1111/iwj.12291 · 2.15 Impact Factor
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    ABSTRACT: Paravertebral block (PVB) has been shown to be an ideal aid for analgesia after thoracic or abdominal surgery. The authors studied the safety and efficacy of the single-dose and bilateral ultrasound-guided (USG)-PVB before combined thoracoscopic-laparoscopic esophagectomy (TLE) along with intravenous sufentanil analgesia as a method of pain relief in comparison with intravenous sufentanil as a sole analgesic agent. Prospective, randomized study. Single university hospital. Fifty-two patients undergoing TLE. A USG-PVB was performed before surgery using a solution of 30 mL of 0.5% ropivacaine by 3 injections of 10 mL each at the right T5 and bilateral T8 (PVB group,n = 26) or the saline injection of 10 mL at every site (control group, n = 26). Successful PVBs were achieved in all patients of the PVB group. Intraoperative mean remifentanil usage and end-tidal sevoflurane concentration were lower in the PVB group (p<0.001). Hemodynamic parameters were stable in both groups. Postoperative pain scores both at rest and on coughing were lower during the first 8 hours in the PVB group than those in the control group (p<0.05). Cumulative sufentanil consumption delivered by patient-controlled analgesia (PCA) was significantly lower in the PVB group at all time points (p<0.05). Postoperative pulmonary function was better at the third postoperative day in the PVB group (p<0.05), with quicker hospital discharge and lower hospital costs (p< 0.05). The single-dose and bilateral PVB given before TLE combined with sufentanil may provide better postoperative analgesia and early discharge in patients undergoing TLE.
    Journal of cardiothoracic and vascular anesthesia 03/2014; 28(4). DOI:10.1053/j.jvca.2013.12.007 · 1.46 Impact Factor
  • Long He · Wei Zhang · Jie Zhang
    SEG Technical Program Expanded Abstracts 2013; 09/2013
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    ABSTRACT: Objective: This study investigated the influence of laparoscopic carbon dioxide (CO2) pneumoperitoneum on neonate circulation and respiration. Methods: The study included neonates undergoing elective laparoscopic abdominal surgery. CO2 insufflation pressure was maintained within 8-14 mmHg for pneumoperitoneum creation. Heart rate (HR), mean arterial pressure (MAP), peripheral oxygen saturation (SpO2), partial pressure of end-tidal carbon dioxide (P ETCO2) and maximum inspiratory pressure were monitored continuously. Arterial blood samples were collected: 5 min before pneumoperitoneum creation (baseline); 5, 10, and 20 min after CO2 insufflation; 10 min after CO2 exsufflation; 10 min after surgery. pH, partial pressure of CO2 (PaCO2) and arterial oxygen saturation (SaO2) were also measured. Results: Thirty-six neonates were included. HR and MAP significantly increased after pneumoperitoneum creation, then decreased to baseline after CO2 exsufflation. PaCO2 and P ETCO2 were significantly higher after pneumoperitoneum creation, whereas pH was significantly lower 20 min after pneumoperitoneum creation compared with baseline. No significant differences were observed in SpO2 and SaO2. Conclusion: CO2 pneumoperitoneum had a significant effect on neonatal circulation and respiration, suggesting that the pneumoperitoneal pressure should be limited within a certain range in neonates undergoing laparoscopic surgery.
    The Journal of international medical research 05/2013; 41(3). DOI:10.1177/0300060513481922 · 1.44 Impact Factor
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    ABSTRACT: Background: It has been increasingly reported that peripheral surgical trauma triggers neuroinflammatory processes associated with postoperative cognitive dysfunction, and that mitigating the neuroinflammatory effects of surgery prevents surgery-induced cognitive dysfunction. Endogenously produced hydrogen sulfide (H2S) has multiple functions in the brain, and an increasing number of studies have demonstrated its anti-inflammatory effects. The present study was designed to investigate the effects of sodium hydrosulfide (NaHS), an H2S donor, on the cognitive impairment of mice as they experience neuroinflammatory changes induced by surgery. Methods: Each mouse received 5 mg/kg NaHS or volume-matched vehicle administration by intraperitoneal injection once daily, 3 d before surgery, on the day of surgery, and for 3 d afterward. We assessed cognitive function using a Morris water maze and evaluated expression of proinflammatory cytokines tumor necrosis factor-α, interleukin-1β, and interleukin-6 in the serum and hippocampus. We performed each test 1, 3, and 7 d after surgery. Results: Hippocampal-dependent memory impairment in mice after surgery was associated with increased serum proinflammatory cytokines, as well as proinflammatory cytokine expression in the hippocampus. Presurgery treatment with NaHS, an H2S donor, significantly attenuated surgery-induced memory impairment and expression of proinflammatory cytokines in the serum and hippocampus. Conclusions: These findings suggest that intraperitoneal injections of NaHS could significantly mitigate surgery-induced memory impairment in mice, which is strongly associated with reduced levels of serum and hippocampal proinflammatory cytokines.
    Journal of Surgical Research 12/2012; 183(1). DOI:10.1016/j.jss.2012.12.003 · 1.94 Impact Factor
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    ABSTRACT: This report details our preliminary results for sheath-assisted tracheal intubation (SATI) for patients with acute dyspnea caused by severe stenoses in the larynx or trachea. Of 289 patients with acute dyspnea who required tracheal intubation in the emergency department of our hospital, 21 who experienced intubation difficulty or failure were entered into this study. Data on technical success, clinical outcome, and complications related to SATI were collected and analyzed retrospectively. Sheath-assisted tracheal intubation was successful in all patients. Clinical success was observed in all patients 1 to 7 days after the procedure. Tracheal stents or incisions, or both, were performed 1 to 3 days after SATI for all patients, once their general physical condition had improved. During follow-up, acute dyspnea had resolved in all patients. At the time of this report, 18 patients were well, with no dyspnea, but 3 patients had died, 2 of lung cancer and 1 of carcinoma of the larynx. Shealth-assisted tracheal intubation is a safe and feasible procedure, and may serve as an additional treatment option for patients with acute dyspnea caused by severe stenoses of the larynx or trachea.
    The Annals of thoracic surgery 08/2011; 92(2):710-3. DOI:10.1016/j.athoracsur.2011.03.004 · 3.85 Impact Factor
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    ABSTRACT: To find an alternative device to solve the difficult airway in children. Fifteen patients, all ASA I-II, aged from 1.5 to 9 years, who were undergoing elective surgeries were included. Difficult endotracheal intubation, but not difficult ventilation, was possible for all. The adult fiberoptic bronchoscope (FOB) was used to provide a vision of the glottis, and the CARTO catheter (a cardiac interventional catheter) with adjustable tip was used to induce the endotracheal tube. All patients were successfully intubated within 1-2 min at the first attempt. Combined use of adult FOB and CARTO catheter may be an alternative device for tracheal intubation in children with known difficult airway.
    Journal of Anesthesia 04/2011; 25(4):531-4. DOI:10.1007/s00540-011-1149-9 · 1.18 Impact Factor
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    ABSTRACT: Fentanyl is metabolised by cytochrome P450 (CYP) 3A4 and CYP3A5. Our previous work demonstrated that the CYP3A4*1G polymorphism significantly affects the post-operative fentanyl analgesic effect in Chinese women undergoing gynaecological surgery. However, whether CYP3A5*3, a frequent single nucleotide polymorphism of CYP3A5 in Chinese people, affects the post-operative analgesic effect of fentanyl is unclear. In this study, we assessed the influence of the CYP3A5*3 polymorphism and the interaction of the CYP3A5*3 and CYP3A4*1G polymorphisms on post-operative fentanyl analgesia in Chinese women undergoing gynaecological surgery. We enrolled 203 women scheduled for abdominal total hysterectomy or myomectomy under general anaesthesia. Intravenous fentanyl patient-controlled analgesia was provided post-operatively for adequate analgesia. Pain scores and fentanyl consumption were recorded 24 h post-operatively. Midazolam was used as a probe drug, and CYP3A activity was measured by plasma ratio of 1'-hydroxymidazolam to midazolam 1 h after intravenous administration of 0.1 mg kg-1 midazolam. Blood samples were genotyped for the CYP3A5*3 polymorphism. The frequency of the CYP3A5*3 allele was 72.4% in 203 patients. CYP3A activity did not differ among CYP3A5*3 genotypes. Fentanyl consumption 24 h post-operatively was lower with CYP3A5*1/*3 and CYP3A5*3/*3 polymorphisms than with CYP3A5*1/*1, but the differences were not statistically significant. However, combined with CYP3A4*1G polymorphism, post-operative fentanyl consumption at 24 h was significantly lower for the CYP3A5*1/*3 or CYP3A5*3/*3 group than the CYP3A5*1/*1 group. CYP3A5*3 is not the main genetic factor contributing to interindividual variation in the post-operative analgesic effect of fentanyl in Chinese women undergoing gynaecological surgery; an interaction between CYP3A5*3 and CYP3A4*1G polymorphisms can significantly influence the post-operative effect.
    European Journal of Anaesthesiology 04/2011; 28(4):245-50. DOI:10.1097/EJA.0b013e3283438b39 · 2.94 Impact Factor
  • Long He · Jie Zhang · Wei Zhang
    SEG Technical Program Expanded Abstracts 2011; 01/2011
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    ABSTRACT: To investigate whether the CYP3A4*1G genetic polymorphism contributes to the variability in CYP3A activity and response to fentanyl. One hundred and forty-three gynecologic patients who were scheduled to undergo abdominal total hysterectomy or myomectomy with general anesthesia were enrolled in this study. Intravenous fentanyl patient-controlled analgesia was provided postoperatively for satisfactory analgesia. The degrees of pain at rest during PCA treatment were assessed with visual analog scale. The fentanyl consumption and occurrence of any adverse effects were recorded in the first 24 h postoperatively. CYP3A activity was measured by plasma 1'-hydroxymidazolam-to-midazolam ratio 1 h after intravenous administration of 0.1 mg/kg midazolam. CYP3A4*1G variant allele was genotyped using the polymerase chain reaction-restriction fragment length polymorphism method. The frequency of the CYP3A4*1G variant allele was 0.269 in 143 Chinese gynecologic patients. The activity of CYP3A4 in patients homozygous for the *1G/*1G variant (0.34 +/- 0.15) was significantly lower than that in patients bearing the wild-type allele (*1/*1) (0.46 +/- 0.14) or in patients heterozygous for the *1/*1G variant (0.46 +/- 0.12) (P < 0.05). The patients with the CYP3A4*1G/*1G genotype needed less fentanyl (227.8 +/- 55.2 microg) to achieve pain control than patients carrying the CYP3A4*1/*1 (381.6 +/- 163.6 microg) and CYP3A4*1/*1G (371.9 +/- 180.1 microg) genotypes (P < 0.05) during the first 24 h postoperatively. There was no significant difference in incidence of adverse events among the different genotype groups (P > 0.05). CYP3A4*1G genetic polymorphism decreases CYP3A activity and fentanyl consumption for postoperative pain control.
    European Journal of Clinical Pharmacology 09/2009; 66(1):61-6. DOI:10.1007/s00228-009-0726-4 · 2.97 Impact Factor
  • GuangLun Xie · Wei Zhang · YanZi Chang · QinJun Chu
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    ABSTRACT: After surgery and anesthesia, many elderly patients show a decline in cognitive function. This condition is called postoperative cognitive dysfunction (POCD). POCD, a distressing complication after surgery, is independently associated with poor short-term and long-term outcomes. Many pathophysiological mechanisms have been implicated in development of POCD, but the exact cascade leading to its development is unclear. Animal studies show that cytokines from inflammatory response are involved in with cognitive dysfunction. Simultaneously, emerging evidences indicate that inflammatory response represents a potential pathogenic factor in many central cognitive diseases. A similar story may be occurring during perioperative process in patients. Surgical trauma, anesthesia, and stress response induced perioperative nonspecific inflammatory response. We hypothesize that perioperative inflammatory response promotes the development of POCD in elderly surgical patients, and some measures against perioperative inflammatory response should be considered as a new pathway to prevention of POCD.
    Medical Hypotheses 05/2009; 73(3):402-3. DOI:10.1016/j.mehy.2009.01.056 · 1.07 Impact Factor
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    ABSTRACT: To determine the half-effective dose (IED50) of rocuronium for intratracheal intubation in female patients of different ages by sequential experiments and evaluate the effect of age on IED50 of rocuronium. Forty ASA class I-II female patients undergoing elective surgery under general anesthesia were randomly divided (n = 20) into young patient group and elderly patient group. The intratracheal intubation dose was divided into 4 grades by geometric progression, namely 0.24, 0.29, 0.35, and 0.42 mg/kg in the young patient group and 0.22, 0.26, 0.31, and 0.37 mg/kg in the elderly group. The IED(50) and 95% confidence interval (95%CI) of rocuronium during intubation in both groups were determined by sequential experiments. The IED50 was 0.284 mg/kg in the elderly patient group, which was 91% that of in the young patient group (0.312 mg/kg), showing significant difference between the two groups (P < 0.05). The IED50 of rocuronium is significantly lower in elderly female patients than in young female patients, suggesting the necessity of reducing the dose of rocuronium accordingly in anesthesia induction in elderly female patients.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 11/2008; 28(10):1886-7.
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    Jie Zhang · Wei Zhang · Bin Li
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    ABSTRACT: We evaluated sevoflurane requirements during combined general-epidural anesthesia with different concentration of ropivacaine. Fifty-six patients were randomly divided into three groups to epidurally receive saline, 0.2% ropivacaine or 1% ropivacaine. Sevoflurane concentration was adjusted to maintain certain anesthesia depth. BIS values and end-tidal sevoflurane concentrations were recorded at time points of pre-intubation and 5 min, 10 min, 15 min, 20 min, 25 min, 30 min after intubation. End-tidal sevoflurane was significantly lower in the group receiving higher concentration of sevoflurane. Epidural anesthesia can decrease sevoflurane requirements to a larger extent when a higher concentration of ropivacaine was applied.
    Anesthesia and analgesia 05/2007; 104(4):984-6. DOI:10.1213/01.ane.0000258765.16164.27 · 3.47 Impact Factor