Intraoperative management of potentially fatal arrhythmias after anesthesia induced by severe hypokalemia: A case report / 北京大学学报(医学版)

Severe hypokalemia is defined as the concentration of serum potassium lower than 2.5 mmol/L, which may lead to serious arrhythmias and cause mortality. We report an unusual case of potentially fatal ventricular arrhythmias induced by severe hypokalemia in a patient undergoing laparoscopic partial nephrectomy in Peking University Third Hospital due to irregular use of indapamide before operation. Indapamide is a sulfonamide diuretic with vasodilative and calcium antagonistic effects, which enhances sodium delivery to the renal distal tubules resulting in a dose-related increase in urinary potassium excretion and decreases serum potassium concentrations. The electrolyte disorder caused by the diuretic is more likely to occur in the elderly patients, especially those with malnutrition or long-term fasting. Hence, the serum potassium concentration of the patients under indapamide therapy, especially elderly patients, should be monitored carefully. Meanwhile, the potassium concentration measured by arterial blood gas analysis is different from that measured by venous blood or laboratory test. According to the previous research, the concentration of potassium in venous blood was slightly higher than that in arterial blood, and the difference value was 0.1-0.5 mmol/L. This error should be taken into account when rapid intravenous potassium supplementation or reduction of blood potassium level was carried out clinically. In the correction of severe hypokalemia, the standard approach often did not work well for treating severe hypokalemia. The tailored rapid potassium supplementation strategy shortened the time of hypokalemia and was a safe and better treatment option to remedy life-threatening arrhythmias caused by severe hypokalemia with a high success rate. Through the anesthesia management of this case, we conclude that for the elderly patients who take indapamide or other potassium excretion diuretics, the electrolyte concentration and the general volume state of the patients should be comprehensively measured and fully evaluated before operation. It may be necessary for us to reexamine the serum electrolyte concentration before anesthesia induction on the morning of surgery in patients with the history of hypokalemia. For severe hypokalemia detected after anesthesia, central venous cannulation access for individualized rapid potassium supplementation is an effective approach to reverse the life-threatening arrhythmias caused by severe hypokalemia and ensure the safety of the patients.

Lignans and sesquiterpenes from Schisandra tomentella A. C. Smith.

This is the first phytochemical investigation of Schisandra tomentella A. C. Smith. 11 lignans and 8 sesquiterpenoids, were isolated from the stems of S. tomentella, including two undescribed lignans, tomentaschinins A-B (1-2), and two new sesquiterpenoids, tomentaschinnes A-B (3-4). Their structures were elucidated based on the interpretation of their spectroscopic data. Cytotoxicity and MDR reversal effect of these compounds were screened on multidrug resistance cancer cell line MCF-7/ADR, and results showed gomisin M2 (7) could promote the efficacy of adriamycin against MCF-7/ADR.

Article Effect and Mechanism of Ganoderma lucidum Polysaccharides on Human Fibroblasts and Skin Wound Healing in Mice.

OBJECTIVE: To investigate the effects of Ganoderma lucidum polysaccharides (GL-PS) on human fibroblasts and skin wound healing in Kunming male mice and to explore the putative molecular mechanism. METHODS: Primary human skin fibroblasts were cultured. The viability of fibroblasts treated with 0, 10, 20, 40, 80, and 160 µg/mL of GL-PS, respectively were detected by 3-4,5-dimethyl-2-thiazolyl-2,5-diphenyl-2-Htetrazolium bromide (MTT). The migration ability of fibroblasts treated with 0, 10, 20, and 40 µg/mL of GL-PS were measured by transwell assay. The secretion of the C-terminal peptide of procollagen type I (CICP) and transforming growth factor-ß1 (TGF-ß1) in the cell supernatant was tested by enzyme-linked immunosorbent assay. The expression of ß-catenin was detected by Western blot. Furthermore, the Kunming mouse model with full-layer skin resection trauma was established, and was treated with 10, 20, and 40 mg/mL of GL-PS, respectively as external use. The size of the wound was measured daily, complete healing time in each group was recorded and the percentage of wound contraction was calculated. RESULTS: Compared with the control group, 10, 20, and 40 µg/mL of GL-PS significantly increased the viability of fibroblasts, promoted the migration ability of fibroblasts, and up-regulated the expressions of CICP and TGF-ß1 in fibroblasts (Plt;0.05 or Plt;0.01). The expression of ß-catenin in fibroblasts treated with 20 and 40 µg/mL of GL-PS was significantly higher than that of the control group (Plt;0.01). Furthermore, after external use of 10, 20, and 40 mg/mL of GL-PS, the rates of wound healing in mice were significantly higher and the wound healing time was significantly less than the control group (Plt;0.05 or Plt;0.01). CONCLUSION: A certain concentration of GL-PS may promote wound healing via activation of the Wnt/ß-catenin signaling pathway and up-regulation of TGF-ß1, which might serve as a promising source of skin wound healing.

Synthesis, characterization, and anti-cancer activity of emodin-Mn(II) metal complex / 中国天然药物

To synthesize and characterize a novel metal complex of Mn (II) with emodin, and evaluate its anti-cancer activity. The elemental analyses, IR, UV-vis, atomic absorption spectroscopy, TG-DSC, (1)H NMR, and (13)C NMR data were used to characterize the structure of the complex. The cytotoxicity of the complex against the human cancer cell lines HepG2, HeLa, MCF-7, B16, and MDA-MB-231 was tested by the MTT assay and flow cytometry. Emodin was coordinated with Mn(II) through the 9-C=O and 1-OH, and the general formula of the complex was Mn(II) (emodin)2·2H2O. In studies of the cytotoxicity, the complex exhibited significant activity, and the IC50 values of the complex against five cancer cell lines improved approximately three-fold compared with those of emodin. The complex could induce cell morphological changes, decrease the percentage of viability, and induce G0/G1 phase arrest and apoptosis in cancer cells. The coordination of emodin with Mn(II) can improve its anticancer activity, and the complex Mn(II) (emodin)2·2H2O could be studied further as a promising anticancer drug.

Clinical effect of Sizi Zhongwang capsule combined with Western medical therapy in treating male sterility / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the clinical effect of Sizi Zhongwang Capsule (SZC) combined with Western medicine (WM) in treating male sterility.</p><p><b>METHODS</b>Two hundred and sixty-one male patients with sterility were assigned to 3 groups, 64 in the WM group were treated with conventional Western medical therapy alone, 87 in the SZC group were treated with SZC alone, and 110 in the combined group were treated with SZC combined Western medical therapy. The treatment lasted for 90 days in total. Changes of semen related parameters before and after treatment were observed, and the conditions of pregnancy in patients' spouse were followed-up.</p><p><b>RESULTS</b>The difference in semen related parameters before and after treatment showed insignificant in the WM group (P > 0.05), but it did show statistical significance in the SZC group and the combined group (P < 0.05, P < 0.01). Moreover, the best effect was shown in the combined group, showing significant difference to the other two groups (P < 0.01, P < 0.05). The pregnancy rate of patients' spouse in the combined treated group was higher than that in the other two groups (P < 0.01, P < 0.05).</p><p><b>CONCLUSION</b>SZC combined with Western medical therapy could effectively improve the quality of semen in males with infertility and enhance the pregnancy rate in their spouse.</p>

Clinical analysis of yuziwan in the treatment of 30 sterile men with abnormal protamine / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the clinical application and effects of Yuziwan in the treatment of male sterility patient with abnormal protamine.</p><p><b>METHODS</b>The changes of protamine, semen and sex hormones of 30 male sterility patients treated by Yuziwan were observed before and after the treatment.</p><p><b>RESULTS</b>After a 3-month course of treatment, 9 cases were cured, 15 obviously improved and 6 failed to respond. The ratio of histone to protamine was decreased from (1.34 +/- 0.52) before the treatment to (0.72 +/- 0.32) after it, with significant difference (P < 0.01), the semen quality obviously improved (P < 0.05), and the LH and T levels markedly raised (P < 0.01). Yuziwan evidently improved the abnormal protamine, sperm quality and endocrine function of the sterility patients.</p><p><b>CONCLUSION</b>Yuziwan has good curative effect on male sterility.</p>

Chemical composition of the volatile oil from Cynanchum stauntonii and its activities of anti-influenza virus.

The volatile oil of the roots of Cynanchum stauntonii was examined by gas chromatography-mass spectrometry (GC-MS). Thirty-eight constituents were identified. (E,E)-2,4-Decadienal, 3-efhyl-4-methypentanol, 5-pentyl-3H-furan-2-one, (E,Z)-2,4-decadienal and 2(3H)-furanone,dihydro-5-pentyl were found to be the major components. The volatile oil exhibited the activities against influenza virus in vitro (IC50s=64 microg/ml). In in vivo experiment, it prevented influenza virus-induced deaths in a dose-dependent manner.

A new experimental design for screening Chinese medicine formula.

In this paper, an appropriate scale screening for traditional Chinese medicine formula was developed in according to verified pharmacological experiments with uniform optimized experimental design and orthogonal optimized experimental design. Meanwhile, a most appropriate match of prescription dosage for curing vascular disease was got, which was based on NO value of pharmacodynamics experimental data and the endothelial cells configuration which would changed in a degree when damaged by hydration diamine. The appropriate scale of the formula was Ginkgo extraction: substance A:B:C = 100:20:50:0.01. This formula was more optimized and effective than other formula compared by pharmacological and validated experiments.