Background Sufentanil target controlled infusion （TCI） provides stable analgesia, better hemodynamic control than a bolus injection of intravenous anesthetics, anticipated recovery and improved quality of anesthesia...Background Sufentanil target controlled infusion （TCI） provides stable analgesia, better hemodynamic control than a bolus injection of intravenous anesthetics, anticipated recovery and improved quality of anesthesia during perioperative period. This study evaluated the accuracy and feasibility of TCI system for sufentanil at high concentrations in Chinese surgical patients. Methods Twelve low risk adult patients undergoing elective surgery under general anesthesia were included in this study. Sufentanil was administered with a specific TCI system incorporating the population pharmacokinetic data of sufentanil previously reported, using a target effect-site concentration of sufentanil 4 or 6 ng/ml. Sufentanil TCI duration was 30 minutes. Frequent arterial blood samples were taken during and up to 24 hours after sufentanil TCI for determination of plasma sufentanil concentrations by liquid chromatography-mass spectrometry/mass spectrometry. The changes of circulatory system function during the procedure, recovery profile and adverse effects were recorded. Measured plasma sufentanil concentrations were compared with the values predicted by the TCI system. The bias （median performance error, MDPE）, precision （median absolute performance error, MDAPE） and wobble （variability of performance error） of the sufentanil TCI system were determined. Results All patients had stable cardiovascular variables during induction and maintenance of anesthesia. Time to eye opening and extubation were （5.6±1.7） minutes when TCI set to 4 ng/ml and （7.2±2.3） minutes when set to 6 ng/ml. There was no episode of agitation, muscle rigidity or intraoperative awareness. The bias （MDPE）, precision （MDAPE） and wobble of the sufentanil TCI system were -3.7%, 18.9% and 19.6% respectively during TCI, and the MDPE, MDAPE and wobble were -29.1%, 31.7% and 15.0% respectively after TCI （up to 8 hours）. Conclusions The TCI system programmed for sufentanil at 4 or 6 ng/ml was considered acceptable for clinical use i展开更多
The ecological effect of reclaimed water irrigation and fertilizer application on the soil environment is receiving more attention.Soil microbial activity and nitrogen（N）levels are important indicators of the effect...The ecological effect of reclaimed water irrigation and fertilizer application on the soil environment is receiving more attention.Soil microbial activity and nitrogen（N）levels are important indicators of the effect of reclaimed water irrigation on environment.This study evaluated soil physicochemical properties and microbial community structure in soils irrigated with reclaimed water and receiving varied amounts of N fertilizer.The results indicated that the reclaimed water irrigation increased soil electrical conductivity（EC）and soil water content（SWC）.The N treatment has highly significant effect on the ACE,Chao,Shannon（H）and Coverage indices.Based on a 16S ribosomal RNA（16S rRNA）sequence analysis,the Proteobacteria,Gemmatimonadetes and Bacteroidetes were more abundant in soil irrigated with reclaimed water than in soil irrigated with clean water.Stronger clustering of microbial communities using either clean or reclaimed water for irrigation indicated that the type of irrigation water may have a greater influence on the structure of soil microbial community than N fertilizer treatment.Based on a canonical correspondence analysis（CCA）between the species of soil microbes and the chemical properties of the soil,which indicated that nitrate N（NO3-–-N）and total phosphorus（TP）had significant impact on abundance of Verrucomicrobia and Gemmatimonadetes,meanwhile the p H and organic matter（OM）had impact on abundance of Firmicutes and Actinobacteria significantly.It was beneficial to the improvement of soil bacterial activity and fertility under 120 mg kg^-1 N with reclaimed water irrigation.展开更多
Background The adjunction of ultrasound to nerve stimulation has been proven to improve single-injection peripheral nerve block quality. However, few reports have been published determining whether ultrasound can faci...Background The adjunction of ultrasound to nerve stimulation has been proven to improve single-injection peripheral nerve block quality. However, few reports have been published determining whether ultrasound can facilitate continuous nerve blocks. In this study, we tested the hypothesis that the addition of ultrasound to nerve stimulation facilitates femoral nerve blocks with a stimulating catheter.Methods In this prospective randomized study, patients receiving continuous femoral nerve blocks for total knee replacement were randomly assigned to either the ultrasound guidance combined with stimulating catheter group （USNS group; n=60） or the stimulating catheter alone group （NS group; n=60）. The primary end point was the procedure time （defined as the time from first needle contact with the skin until correct catheter placement）. The numbers of needle passes and catheter insertions, onset and quality of femoral nerve blocks, postoperative pain score, and early knee function were also recorded.Results The procedure time was significantly less in the USNS group than in the NS group （9.0 （6.0-22.8） minutes vs.13.5 （6.0-35.9） minutes, P=0.024）. The numbers of needle passes and catheter insertions were also significantly less in the USNS group. A greater complete block rate was achieved at 30 minutes in the USNS group （63.3% vs. 38.3%;P=0.010）. The postoperative pain score, the number of patients who required bolus local anesthetic and intravenous patient-controlled analgesia, and knee flexion on the second postoperative day were not significantly different between the two groups of patients.Conclusions Ultrasound-assisted placement of a stimulating catheter for femoral nerve blocks decreases the time necessary to perform the block compared with just the nerve-stimulating technique. In addition, a more complete blockade is achieved using the ultrasound-assisted technique.展开更多
文摘Background Sufentanil target controlled infusion （TCI） provides stable analgesia, better hemodynamic control than a bolus injection of intravenous anesthetics, anticipated recovery and improved quality of anesthesia during perioperative period. This study evaluated the accuracy and feasibility of TCI system for sufentanil at high concentrations in Chinese surgical patients. Methods Twelve low risk adult patients undergoing elective surgery under general anesthesia were included in this study. Sufentanil was administered with a specific TCI system incorporating the population pharmacokinetic data of sufentanil previously reported, using a target effect-site concentration of sufentanil 4 or 6 ng/ml. Sufentanil TCI duration was 30 minutes. Frequent arterial blood samples were taken during and up to 24 hours after sufentanil TCI for determination of plasma sufentanil concentrations by liquid chromatography-mass spectrometry/mass spectrometry. The changes of circulatory system function during the procedure, recovery profile and adverse effects were recorded. Measured plasma sufentanil concentrations were compared with the values predicted by the TCI system. The bias （median performance error, MDPE）, precision （median absolute performance error, MDAPE） and wobble （variability of performance error） of the sufentanil TCI system were determined. Results All patients had stable cardiovascular variables during induction and maintenance of anesthesia. Time to eye opening and extubation were （5.6±1.7） minutes when TCI set to 4 ng/ml and （7.2±2.3） minutes when set to 6 ng/ml. There was no episode of agitation, muscle rigidity or intraoperative awareness. The bias （MDPE）, precision （MDAPE） and wobble of the sufentanil TCI system were -3.7%, 18.9% and 19.6% respectively during TCI, and the MDPE, MDAPE and wobble were -29.1%, 31.7% and 15.0% respectively after TCI （up to 8 hours）. Conclusions The TCI system programmed for sufentanil at 4 or 6 ng/ml was considered acceptable for clinical use i
基金the financial support for this research from the National High-Tech R&D Program of China (2012AA101404)the National Natural Science Foundation of China (51209208, 51479201)
文摘The ecological effect of reclaimed water irrigation and fertilizer application on the soil environment is receiving more attention.Soil microbial activity and nitrogen（N）levels are important indicators of the effect of reclaimed water irrigation on environment.This study evaluated soil physicochemical properties and microbial community structure in soils irrigated with reclaimed water and receiving varied amounts of N fertilizer.The results indicated that the reclaimed water irrigation increased soil electrical conductivity（EC）and soil water content（SWC）.The N treatment has highly significant effect on the ACE,Chao,Shannon（H）and Coverage indices.Based on a 16S ribosomal RNA（16S rRNA）sequence analysis,the Proteobacteria,Gemmatimonadetes and Bacteroidetes were more abundant in soil irrigated with reclaimed water than in soil irrigated with clean water.Stronger clustering of microbial communities using either clean or reclaimed water for irrigation indicated that the type of irrigation water may have a greater influence on the structure of soil microbial community than N fertilizer treatment.Based on a canonical correspondence analysis（CCA）between the species of soil microbes and the chemical properties of the soil,which indicated that nitrate N（NO3-–-N）and total phosphorus（TP）had significant impact on abundance of Verrucomicrobia and Gemmatimonadetes,meanwhile the p H and organic matter（OM）had impact on abundance of Firmicutes and Actinobacteria significantly.It was beneficial to the improvement of soil bacterial activity and fertility under 120 mg kg^-1 N with reclaimed water irrigation.
文摘Background The adjunction of ultrasound to nerve stimulation has been proven to improve single-injection peripheral nerve block quality. However, few reports have been published determining whether ultrasound can facilitate continuous nerve blocks. In this study, we tested the hypothesis that the addition of ultrasound to nerve stimulation facilitates femoral nerve blocks with a stimulating catheter.Methods In this prospective randomized study, patients receiving continuous femoral nerve blocks for total knee replacement were randomly assigned to either the ultrasound guidance combined with stimulating catheter group （USNS group; n=60） or the stimulating catheter alone group （NS group; n=60）. The primary end point was the procedure time （defined as the time from first needle contact with the skin until correct catheter placement）. The numbers of needle passes and catheter insertions, onset and quality of femoral nerve blocks, postoperative pain score, and early knee function were also recorded.Results The procedure time was significantly less in the USNS group than in the NS group （9.0 （6.0-22.8） minutes vs.13.5 （6.0-35.9） minutes, P=0.024）. The numbers of needle passes and catheter insertions were also significantly less in the USNS group. A greater complete block rate was achieved at 30 minutes in the USNS group （63.3% vs. 38.3%;P=0.010）. The postoperative pain score, the number of patients who required bolus local anesthetic and intravenous patient-controlled analgesia, and knee flexion on the second postoperative day were not significantly different between the two groups of patients.Conclusions Ultrasound-assisted placement of a stimulating catheter for femoral nerve blocks decreases the time necessary to perform the block compared with just the nerve-stimulating technique. In addition, a more complete blockade is achieved using the ultrasound-assisted technique.
