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BACKGROUND@#Postoperative pulmonary complications often lead to increased mortality and financial burden. Residual paralysis plays a critical role in postoperative pulmonary complications. This meta-analysis was performed to determine whether sugammadex overmatches neostigmine in reducing postoperative pulmonary complications.@*METHODS@#PubMed, Embase, Web of Science, Medline through Ovid, Cochrane Library, Wanfang, China National Knowledge Infrastructure, and Chinese BioMedical Literature Databases were searched from their inception to 24 June, 2021. Random effects models were used for all analyses. Cochrane risk of bias tool was used to assess the quality of RCTs, while Newcastle Ottawa Quality Assessment Scale was used to assess for the quality of cohort studies.@*RESULTS@#Seventeen studies were included in the meta-analysis. Pooled data from cohort studies showed reversing neuromuscular blocking with sugammadex had less risk of compound postoperative pulmonary complications (relative risk [RR]: 0.73; 95% confidence interval [CI]: 0.60-0.89; P = 0.002; I2 = 81%), pneumonia (RR: 0.64; 95% CI: 0.48-0.86; I2 = 42%) and respiratory failure (RR: 0.48; 95% CI: 0.41-0.56; I2 = 0%). However, pooled data from RCTs did not show any difference between the two groups in pneumonia (RR: 0.58; 95% CI: 0.24-1.40; I2 = 0%) and no respiratory failure was reported in the included RCTs. The difference was not found between sugammadex and neostigmine about atelectasis in pooled data from either RCTs (RR: 0.85; 95% CI: 0.69-1.05; I2 = 0%) or cohort studies (RR: 1.01; 95% CI: 0.87-1.18; I2 = 0%).@*CONCLUSION@#The evidence of superiority of sugammadex was limited by the confounding factors in cohort studies and small scale of RCTs. Whether sugammadex precedes neostigmine in preventing pulmonary complications after surgery is still unknown. Well-designed RCTs with large scale are needed.@*REGISTRATION@#PROSPERO ( https://www.crd.york.ac.uk/PROSPERO/ ); CRD 42020191575.
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Humans , Sugammadex/therapeutic use , Neostigmine/therapeutic use , Neuromuscular Blockade , Postoperative Complications/prevention & control , Pneumonia , Respiratory InsufficiencyABSTRACT
【Objective】 To investigate the relationship between cerebrospinal fluid exosome-derived miR-630 and the function of brain microvascular endothelial cells （BMECs）. 【Methods】 The subarachnoid hemorrhage endothelial cell model was established to evaluate the effect of hemorrhagic cerebrospinal fluid （BCSF） on BMECs’ proliferation by MTT assay and cell cycle analysis. qRT-PCR and immunofluorescence staining were used to detect the expressions of endothelial cell tight junction protein （ZO-1） and adhesion molecule （ICAM-1 and VCAM-1）. Changes in NOx concentration were detected by radioimmunoassay. The cerebrospinal fluid exosomes in the experimental group （co-incubated with BCSF） and the control group （normal cerebrospinal fluid） were isolated and identified， and differences in the expressions of cerebrospinal fluid exosomal miR-630 between the two groups were compared. BMECs work changes after the intervention with miR-630 analogue were observed. 【Results】 The proliferation of BMECs was significantly inhibited in the experimental group； the mRNA and protein levels of ICAM-1， VCAM-1 and ZO-1 were significantly decreased， and the function of endothelial cells was significantly inhibited （P<0.05）. After the successful separation and identification of cerebrospinal fluid exosomes， the expression of miR-630 was significantly lower in the experimental group than in the control group （P<0.05）. The function of BMECs was significantly improved with miR-630 mimics. 【Conclusion】 The low expression of miR-630 in cerebrospinal fluid exosomes after subarachnoid hemorrhage is closely related to BMECs injury.
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Objective To explore the therapeutic effect of subcutaneous negative pressure drainage and absorbable suture in preventing postoperative complications of cranioplasty.Methods The clinical data of 175 cases of skull defect admitted and treated in Department of Neurosurgeryof the Affiliated Hospital of Binzhou Medical University from January 2012 to February 2018 were retrospectively analyzed.According to the different intraoperative treatment methods,97 cases were treated with thread suture to the galea aponeurotica combined with general drainage (the general drainage group),and 78 cases were treated with absorbable suture to the galea aponeurotica combined with negative pressure drainage(the negative pressure drainage group).The galea aponeurotica were sutured intermittently with both silk thread and absorbable suture,and the drainage tube was placed outside the metal titanium plate under the skin,and removed after 48-72 hours.The postoperative complications of the two groups were compared.Results The incidence rates of subcutaneous hemorrhage,knotting reaction,infection of incision in the negative pressure drainage group were 1.3％ (1/78),0.0％ (0/78),and 0.0％ (0/78),respectively,which were significantly lower than those in the average drainage group [11.3％ (11/97),20.6％ (20/97),7.2％ (7/97)],the differences were statistically significant (x2 =6.85,18.16,4.13,all P ＜ 0.05).Conclusion The application of absorbable suture suturing galea aponeurotica and subcutaneous negative pressure drainage in skull repair can significantly reduce and prevent postoperative complications of cranioplasty.
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Objective@#To explore the therapeutic effect of subcutaneous negative pressure drainage and absorbable suture in preventing postoperative complications of cranioplasty.@*Methods@#The clinical data of 175 cases of skull defect admitted and treated in Department of Neurosurgeryof the Affiliated Hospital of Binzhou Medical University from January 2012 to February 2018 were retrospectively analyzed.According to the different intraoperative treatment methods, 97 cases were treated with thread suture to the galea aponeurotica combined with general drainage(the general drainage group), and 78 cases were treated with absorbable suture to the galea aponeurotica combined with negative pressure drainage(the negative pressure drainage group). The galea aponeurotica were sutured intermittently with both silk thread and absorbable suture, and the drainage tube was placed outside the metal titanium plate under the skin, and removed after 48-72 hours.The postoperative complications of the two groups were compared.@*Results@#The incidence rates of subcutaneous hemorrhage, knotting reaction, infection of incision in the negative pressure drainage group were 1.3%(1/78), 0.0%(0/78), and 0.0%(0/78), respectively, which were significantly lower than those in the average drainage group[11.3%(11/97), 20.6%(20/97), 7.2%(7/97)], the differences were statistically significant(χ2=6.85, 18.16, 4.13, all P<0.05).@*Conclusion@#The application of absorbable suture suturing galea aponeurotica and subcutaneous negative pressure drainage in skull repair can significantly reduce and prevent postoperative complications of cranioplasty.
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Objective To conduct a Meta-analysis on the rate of adverse reaction related to rabies vaccine,so as to provide reference for rabies vaccine immunization in China.Methods We electronically searched databases including CNKI,VIP information resource integration service platform,WanFang Data,CBM,PubMed and The Cochrane Library,to collect studies on Chinese people who had received full rabies vaccination and recording all the adverse reactions,from January 2000 to July 2016.Inclusion and exclusion criteria were strictly followed.Meta-analysis for the adverse reaction rate was performed using the R software.Results A total of 29 related papers had met the inclusion criteria,with no publication bias noticed.A total number of 11 020 cases had adverse reactions,among all the 94 222 respondents,with an incidence of adverse reactions as 1.04％-47.78％.The overall incidence rate of adverse reaction was 9.82％ (95％CI:7.58％-12.72％).A combined local adverse reaction rate appeared as 12.05％ (95％CI:9.26％-15.69％).The systemic adverse reaction rate was 9.06％ (95％CI:7.07％-11.61％).The overall adverse reaction rate on aqueous vaccine was 32.39％ (95％CI:21.88％-47.94％).Combined adverse reaction rate of freeze dried vaccine appeared as 8.65％ (95％CI:4.54％-16.51％).Significant differences were seen between both groups (P＜0.05).Conclusions The local adverse reaction rate caused by rabies vaccination was higher than the systemic adverse reaction rate.The adverse reaction rate of aqueous rabies vaccine was higher than that of freeze dried rabies vaccine.Our results suggested that the aqueous vaccine should gradually be eliminated.
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Objective To conduct a Meta-analysis on the rate of adverse reaction related to rabies vaccine,so as to provide reference for rabies vaccine immunization in China.Methods We electronically searched databases including CNKI,VIP information resource integration service platform,WanFang Data,CBM,PubMed and The Cochrane Library,to collect studies on Chinese people who had received full rabies vaccination and recording all the adverse reactions,from January 2000 to July 2016.Inclusion and exclusion criteria were strictly followed.Meta-analysis for the adverse reaction rate was performed using the R software.Results A total of 29 related papers had met the inclusion criteria,with no publication bias noticed.A total number of 11 020 cases had adverse reactions,among all the 94 222 respondents,with an incidence of adverse reactions as 1.04％-47.78％.The overall incidence rate of adverse reaction was 9.82％ (95％CI:7.58％-12.72％).A combined local adverse reaction rate appeared as 12.05％ (95％CI:9.26％-15.69％).The systemic adverse reaction rate was 9.06％ (95％CI:7.07％-11.61％).The overall adverse reaction rate on aqueous vaccine was 32.39％ (95％CI:21.88％-47.94％).Combined adverse reaction rate of freeze dried vaccine appeared as 8.65％ (95％CI:4.54％-16.51％).Significant differences were seen between both groups (P＜0.05).Conclusions The local adverse reaction rate caused by rabies vaccination was higher than the systemic adverse reaction rate.The adverse reaction rate of aqueous rabies vaccine was higher than that of freeze dried rabies vaccine.Our results suggested that the aqueous vaccine should gradually be eliminated.
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Amyloid beta-peptides ( Aβ) is the key pathological feature of Alzheimer’s Disease (AD). Various factors contrib-ute to the accumulations of Aβ in the brains of patients. Among them, blood-brain barrier ( BBB) plays a crucial role in trans-porting Aβ between the brain and the bloodstream while this transfer function is mediated by the receptor of Aβon BBB. The abnormality of Aβ transport and related receptor expression can be detected in the brains of patients with AD, resulting in an un-usual increase in Aβlevels unusually increased . This review e-laborates the structure and function of BBB, the transport of Aβand the expression and transport mechanism of the related recep-tor, as well as summarizes the possible clearance strategy of Aβacross the BBB.
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Objective To investigate the effects of Dihuang-Yinzi on cognition and energy metabolism of AD (Alzheimer’s disease) mice. Methods 60 Male APPsw/PS1ΔE9 mice were divided into 5 groups model, positive drug (Aricept), high, medium and low dosage of Dihuang-Yinzi. C57BL/6J mice with same age were served as normal control. All groups were orally administrated for 150 days. The spatial memory and passive avoidance were measured. The energy charge, activity of complex I, II and IV of respiratory chain, enzymatic activity of ATPase and mitochondrial membrane potential were assayed. Results APPsw/PS1ΔE9 mice showed significant impairments in cognition and energy production [(0.39±0.02),(3.28± 0.37)μOD/(min?μg),(0.19±0.04)mOD/(min?μg),(0.26±0.03)mOD/(min?μg),(0.19±0.02),(0.30±0.03)、(3.49±0.73)]with compaired to normal control[(0.57±0.06),(8.74±1.57)μOD/(min?μg),(0.43± 0.02)mOD/(min?μg),(0.69±0.02)mOD/(min?μg),(0.65±0.02),(0.51±0.01),(7.41±1.28)]. Dihuang-Yinzi ameliorates cognition decline, promotes acitivity of energy production related enyzmes, and restores mitochondrial membrane potential in AD mice[(0.57 ± 0.07),(8.42 ± 1.74)μOD/(min ?μg),(0.64 ± 0.03)mOD/(min?μg),(0.68±0.04),(0.55±0.01),(6.69±1.03), P<0.01 or 0.05]. Conclusion Dihuang-Yinzi could improve cognition and energy metabolism of APPsw/PS1ΔE9 mice by protecting mitochondria from pathologic injury.
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Objective To provide reference basis for protection and sustainable utility of S. baicalensis by a large scale of nationwide resources survey of Scutellaria baicalensis Georgi in China. Methods On the basis of literature research, survey was conducted on geographical distribution, resources reserves, recovery and growth of the resources status etc. of S. baicalensis. Results The wild resources of S. baicalensis was wildly distributed in the emperate zone in north of China and the distribution was discontinuous. Large differences were showed between different populations in entironment, coenotype and plant morphology. The cultivated resources of S. baicalensis were mainly distributed in Shanxi, Hebei, Gansu, Shandong provinces and Inner Mongolia autonomous region. There were diverse cultivation models and differences existed in production and quality in different regions. Conclusion Destruction of the wild resources and unstable of the resource quality were two main problems of S. baicalensis resources. It was suggested that researches on quality formation and control should be carried out, and institutional guarantee was essential to protect and sustainable use the plant resources of S. baicalensis.
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A total of 52 patients with chronic lateral epicondylitis were randomly assigned into platelet-rich plasma (PRP) (n =28) or corticosteroid (n =24) group.The visual analog pain scale (VAS) and Mayo elbow score had no significant difference between two groups within 1 week post-treatment.However,VAS and Mayo elbow score improved more significantly in PRP group versus corticosteroid group at Month 1 and 6 post-treatment (P ＜ 0.05).The PRP trigger point injection treatment of elbow lateral epicondylitis achieved clinical outcomes and it was superior to glucocorticoid treatment.
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People pay more and more attention to the prolongation of QT interval caused by drugs because it could probably result in lethal arrhythmia. This article introduces mechanisms, risk factors and guidelines for QT interval, and also reviews drugs withdrawal from the market due to the results of prolongations of QT interval. It discusses as well the value of new drugs in the QT interval for the evaluation of safety.
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Female , Humans , Male , Death, Sudden, Cardiac , Drug-Related Side Effects and Adverse Reactions , Long QT Syndrome , Risk FactorsABSTRACT
This paper summarizes the current situation and restricting factors of the Yunnan traditional Chinese medicine industry. With further analysis comparing, the research puts forward some suggestions and strategic countermeasures to promote the development of the Yunnan traditional Chinese medicine industry.
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Drug Industry , Medicine, Chinese TraditionalABSTRACT
Objective To discuss the diagnosis,differential diagnosis and treatment of obstructive jaundice in infants.Methods Infants with obstructive jaundice were examined by ECT to obtain dynamic images of the liver,biliary tract and intestine to find out the position and nature of the obstruction.Results Eight patients with delayed nuclide imagining were diagnosed as obstructive jaundice of cholestasis.Five of which with aggravated jaundice were cured by biliary irrigation and 3 by medication.For 16 patients with congenital biliary atresia,10 were exterior hepatic types and 6 interior hepatic types.They had the nuclide image of liver and biliary tract.Ten cases of the exterior hepatic types and four cases of the interior types received the Kasai operation.And bile was drained after the surgery.Seven patients survived and 4 of interior heaptic types died postoperatively.Due to bile fistula,3 patients died after the hepato-porto-jejunostomy for internal drainage.Two patients of interior hepatic types who had no operation died of the hepatic failure.Conclusion The nature and position of obstructive jaundice could be identified by nuclide imaging.Young patients with jaundice of cholestasis could be treated by antiinflamation,liver function protection,Hymecromone and Dexamethasone for two weeks.Once the serum bilirubin rises,operation would be indicated.In the case of congenital biliary atresia,operation should be done earlier on the basis of medication.
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Objective To investigate the acute toxicity of intravenous isoflurane in Beagles.Methods Six healthy adult Beagles of both sexes aged 6-8 months weighing 6-8 kg were used in this study.Isoflurane injectio (120 mg/ml) in 30% hpid emulsion was injected intravenously. Femoral artery was cannulated for direct BP monitoring.ECG was continuously monitored.The maximal tolerance dose (MTD) and approximate lethal dose (ALD) were determined by up-and-down technique. The initial dose was 3.0 ml/kg. The dose was decreased/increased by 0.3 ml/kg if the previous animal died/survived.The survived dogs were observed for 2 weeks.Autopsy and histopathological examination were performed on all dead Beagles.Results The ALD and MTD of intravenous isoflurane were 252 and 216 mg/kg. Autopsy and histopathological examination did not show any abnormality.Conclusion Cardiopulmonary depression is the main manifestation of the acute toxicity of intravenous isoflurane in Beagles.
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In this paper, we investigated five model counties for their application of medical technologies to explore the mechanism for sustainable development of appropriate medical technologies in rural areas of Ningxia, The investigation involved the governmental role at all levels in the choice of appropriate technologies, the funding system, the stimulation system and the evaluation system.
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GlyoxalaseⅠthat presents in all human tissues detoxifies α-oxoaldehydes and prevents the formation of advanced glycation end products(AGEs).AGEs and their main precursor namely methylglyoxal(MG)produce cytotoxicity and have extensive relationship with diabetic complications.Therefore,to elevate glyoxalaseⅠactivity may be a new path to release such complications.
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<p><b>OBJECTIVE</b>Based on relevent theory of prescription and syndrome, to compare the gene expression differences of TLR2, TRAF6, and Faslg with adjuvant arthritis in rat spleen among Wutou decoction, Guizhi Shaoyao Zhimu decoction and Baihu Guizhi decoction.</p><p><b>METHOD</b>The experiment animal model of adjuvant arthritis in rats was established. Relative expression amount of TLR2, TRAF6, and Faslg in rats spleen was detected by SYBR Green I dye methods and implementation of fluorescence quantitative PCR technology with 18sRNA as an internal gene. 2(delta delta CT) method was used for computing and data analysis.</p><p><b>RESULT</b>TLR2, TRAF6, and Faslg gene in adjuvant arthritis rat spleen was significantly higher than those in the blank group. The various doses of Wutou decoction, Guizhi Shaoyao Zhimu decoction and Baihu Guizhi decoction can significantly inhibit or reduce the abnormally high expression of TLR2, TRAF6, and Faslg genes. The gene expression level caused by three decoctions mentioned above was followed by strong to weak as Wutou decoction Guizhi Shaoyao Zhimu decoction and Baihu Guizhi decoction with the clinical equivalent dose, but the strength of the trend to reduce the role of TRAF6 is just the opposite with the TLR2 and Faslg genes.</p><p><b>CONCLUSION</b>Wutou decoction, Guizhi Shaoyao Zhimu decoction and Baihu Guizhi decoction can reduce the abnormally high expression of TLR2, TRAF6 and Faslg in rat spleen with adjuvant arthritis, but the differences of intensity exist and remain relatively consistent with that of pharmacodynamics and regulation trends of T cell subsets. Results suggest that the suppression of TLR2/TRAF6 signal pathway and apoptosis Faslg receptor gene may be the reasons that the pharmacodynamics of three decoctions on peripheral T cell subsets in regulating intensity was different.</p>
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Animals , Male , Rats , Arthralgia , Drug Therapy , Genetics , Metabolism , Pathology , Calibration , Drugs, Chinese Herbal , Pharmacology , Therapeutic Uses , Fas Ligand Protein , Genetics , Metabolism , Gene Expression Regulation , Rats, Sprague-Dawley , Reverse Transcriptase Polymerase Chain Reaction , Signal Transduction , TNF Receptor-Associated Factor 6 , Genetics , Metabolism , Toll-Like Receptor 2 , Genetics , MetabolismABSTRACT
In clinical anesthetic practice, anesthetists usually use two or more drugs to achieve anesthetized state. For appropriate administration, anesthetists must understand interactions between drugs. In order to quantitatively describe drug interactions, researchers have established a large variety of pharmacodynamic interaction models. So far, the widely-applied models are Isobolograms and Logistic regression model. Recently, a new pharmacodynamic interaction model that adopts response surface methodology has been used to investigate drug interactions; it has been noted to be of great value in anesthetic practice.
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Humans , Algorithms , Anesthetics , Pharmacokinetics , Pharmacology , Computer Simulation , Dose-Response Relationship, Drug , Drug Interactions , Drug Synergism , Logistic ModelsABSTRACT
The different growing habitats of Bupleurum chinense were investigated in Donglin mountain & Wuling mountain areas, the saikosaponin a and d in samples of B. chinense collected from different habitats were determined by HPLC. Results showed that B. chinense distributed in various habitats, such as meadow, understory and brushy. Significant differences of saikosaponin contents were observed. The higher saikosaponins contents were showed in samples from meadow habitats, while the lower saikosaponins contents in samples from understory and brushy habitats. The ventilation situation and light condition showed positive correlation with the saikosaponins accumulation in B. chinense. It could be concluded that growing habitats play an important role in accumulation of saikosaponins in B. chinense.
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Bupleurum , Chemistry , China , Chromatography, High Pressure Liquid , DNA Primers , Genetics , Ecosystem , Oleanolic Acid , SaponinsABSTRACT
Objective To examine the effects of different doses of midazelam on ED50 of emulsified isoflurane and to determine the type of interaction between them for hypnosis by isobelographic analysis in rats. Methods One hundred and twenty-five adult male SD rats weighing 240-300 g were randomized into 5 groups (n=25 each): group Ⅰmidazolam (M); group Ⅱ emulsified isnflurane (Ⅰ); group Ⅲ ,Ⅳ ,Ⅴ, 1/4, 1/2 and 3/4 ED50 of midazelam for hypnosis + emulsified isoflurane (MI1 , MI2, MI3). Up-and-down sequential experiment was used to determine ED50of midazolam and emulsified isoflurane for loss of righting reflex in group Ⅰ -Ⅴ . The intial dose of midazolm was 17.3 mg/kg in group M. The initial doses of emulsified isoflurane (120 mg/ml) were 0.55 (in group Ⅰ, 0.22 (MI1), 0.19 (MI2) and 0.12 ml/kg (MI3) respectively. In group MI1-3 midazolam was injected over 15 seconds and after an interval of 2.5 min emulsified isoflurane was injected over 10 s. ED50 was calculated using Dixon-Mood method. Isebolographic and algebraic analyses were used to determine the type of interaction between midazolam and emulsified isoflurane. Results The five groups were comparable with respect to M/F sex ratio and body weight. The Edso of midazolam was 26.0 mg/kg in group M. Midazolam 6.5, 13.0 and 19.5 mg/kg were given in group MI1 , MI2 and MI3 respectively. The ED50 of emulsified isoflurane was 0.67 (ingroup Ⅰ), 0.30 (MI1), 0.22 (MI2) and 0.18 ml/kg (MI3) respectively. The isobolographic analysis indicated that with increasing doses of midazolam, the Edw of emulsified isoflurane decreased progressively in a non-linear fashion. The isobolographic and algebraic analyses demonstrated that the interaction between midazolam and emulsified isoflurane was synergistic for hypnosis. Conclusion The hypnosis is synergistic when midazolam 6.5,13 mg/kg are combined with emulsified isoflurane and additive when midazolam 19.5 mg/kg is combined with emulsified isoflurane.