Aim: To investigate the effect of intraoperative amino acid infusion on blood glucose in patients under general anesthesia combined with epidural block. Methods: 36 patients were randomly assigned to receive an intraoperative infusion of 18 compound amino acids (group AA) or lactated Ringer solution (group LR) at 2 ml·kg–1·h–1. Nasopharyngeal temperature, and blood glucose, plasma insulin, C-peptide and glucagon concentrations were measured 30 min before induction (T0), 10 min after induction (T1), 30 min and 2 h after skin incision (T2, T3), and 30 min and 2 h postoperatively (T4, T5). Results: Nasopharyngeal temperature values, which decreased during surgery in both groups, were significantly higher in group AA than in group LR from T3 to T5. Compared with T0, the blood glucose concentration increased significantly from T2 in group AA and T3 in group LR to T5. Plasma insulin and C-peptide concentrations did not change significantly in group LR, while both increased significantly in group AA from T1 to T4. The plasma glucagon concentration did not change significantly in either group. Conclusion: Intraoperative amino acid infusion in patients under general anesthesia combined with epidural block may accelerate the increase of blood glucose concentration and stimulate insulin secretion, and can alleviate hypothermia during the later period of surgery and postoperatively.
Objective:Neostigmine can produce analgesia by acting on the spinal cord. This study was to determine the optimal single-dose of epidural neostigmine for postoperative analgesia after partial hepatectomy.Patients and Methods:Twenty-six patients undergoing elective partial hepatectomy under general anesthesia combined with epidural block were studied. The dose of epidural neostigmine was determined using Dixon's up-and-down method, starting from neostigmine 100 μg with an interval of 25 μg. Thirty minutes after skin incision, a predetermined dose of neostigmine was injected via the epidural catheter. Each patient received 0.125% bupivacaine and fentanyl 2 μg/ml for patient controlled epidural analgesia (PCEA) after the operation. Assessment of analgesia quality was performed at 8 h and 24 h after the operation.Results:The ED50 of epidural neostigmine in combination with PCEA for satisfactory analgesia was 226.78 ± 33.20 μg. Probit analysis showed that the ED50 and ED95 of epidural neostigmine were 228.63 μg (95% CI = 197.95–299.77 μg) and 300.12 μg (95% CI = 259.44–741.65 μg), respectively.Conclusion:The ED50 and ED95 of epidural neostigmine in combination with PCEA for satisfactory analgesia after partial hepatectomy were 228.63 μg (95% CI = 197.95–299.77 μg) and 300.12 μg (95% CI = 259.44–741.65 μg).
The purpose of this document is to describe a methodology to select the most adequate time-frequency distribution (TFD) kernel for the characterization of impedance cardiography signals (ICG). The predominant ICG beat was extracted from a patient and was synthetized using time-frequency variant Fourier approximations. These synthetized signals were used to optimize several TFD kernels according to a performance maximization. The optimized kernels were tested for noise resistance on a clinical database. The resulting optimized TFD kernels are presented with their performance calculated using newly proposed methods. The procedure explained in this work showcases a new method to select an appropriate kernel for ICG signals and compares the performance of different time-frequency kernels found in the literature for the case of ICG signals. We conclude that, for ICG signals, the performance (P) of the spectrogram with either Hanning or Hamming windows (P = 0.780) and the extended modified beta distribution (P = 0.765) provided similar results, higher than the rest of analyzed kernels. Graphical abstractFlowchart for the optimization of time-frequency distribution kernels for impedance cardiography signals.
Monte-Carlo was applied to generate random traffic flow after frequent, moderate and rare earthquake respectively based on sample of vehicle investigation in“907”Zhaotong, Yiliang earthquake (2012), Yunnan province, considering vehicle parameters, such as types, driving, distance, ratio in earthquake-relief campaign. Vehicle load effect was analyzed for different spans of Simply Supported Beam Bridge, then characteristic value of lane loading which ruled by 《General Code Designs of Highway Bridges and Culverts(JTG D60-04)》(China) was revised. Research can not only provide standard for rapid estimate and repair of bridge after earthquake, but also give theoretical basis for revising anti-seismic codes or guidelines in China.
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