Low-dose Simvastatin Increases Skeletal Muscle Sensitivity to Caffeine and Halothane / 中国医学科学杂志(英文版)

Objective To determine whether the myotoxic side effects of statin simvastatin affect skeletal muscle's sensitivity to caffeine and halothane.Methods Primary cultured neonate rat skeletal myotubes were treated with 0.01-5.0 μmol/L simvastatin for 48 hours. MTT was used to evaluate cellular viability. The gross morphology and microstructure of the myotubes were observed with a light and electron microscope, respectively. The intracellular calcium concentrations ([Ca]i) at rest and in response to caffeine and halothane were investigated by fluorescence calcium imaging. Data were analyzed by analysis of variance (ANOVA) test.Results Simvastatin (0.01-5.0 μmol/L) decreased myotube viability, changed their morphological features and microstructure, and increased the resting [Ca]i in a dose-dependent manner. Simvastatin did not change myotube's sensitivity to low doses of caffeine (0.625-2.5 mmol/L) or halothane (1.0-5.0 mmol/L). In response to high-dose caffeine (10.0 mmol/L, 20.0 mmol/L) and halothane (20.0 mmol/L, 40.0 mmol/L), myotubes treated with 0.01 μmol/L simvastatin showed a significant increase in sensitivity, but those treated with 1.0 μmol/L and 5.0 μmol/L simvastatin showed a significant decrease. The sarcoplasmic reticulum Castorage peaked in the myotubes treated with 0.01 μmol/L simvastatin, but it decreased when cells were treated with higher doses of simvastatin (0.1-5.0 μmol/L).Conclusions The myotoxic side effect of simvastatin was found to change the sensitivity of myotubes in response to high-dose caffeine and halothane. When dose was low, sensitivity increased mainly because of increased Cacontent in the sarcoplasmic reticulum, which might explain why some individuals with statin-induced myotoxic symptoms may show positive caffeine-halothane contracture test results. However, when the dose was high and the damage to the myotubes was severer, sensitivity was lower. It is here supposed that the damage itself might put individuals with statin-induced myotoxic symptoms at greater risks of presenting with rhabdomyolysis during surgery or while under anesthesia.

Clinical Effect of Acupuncture Combined with Rehabilitation on Dysphagia after Stroke at Different Stage / 中国康复理论与实践

@#Objective To observe the therapeutic effect of acupuncture combined with rehabilitation on dysphagia after stroke at differentstage. Methods According to the randomized trial principle, 155 cases were divided into two groups: control group (n=80) and observationgroup (n=75). The control group was treated with rehabilitation training, and the observation group was treated with acupuncture and rehabilitationtraining, 5 times every week for 4 weeks. The two groups were assessed by TCM swallowing assessment scores and Kubota testbefore and after treatment. Results According to Kubota test, the total rate was 66.67% in the control group and 89.33% in the observationgroup with a significant difference between the groups (P<0.001). In the observation group, the total rate was 90.48% at acute stage and88.89% at the convalescence stage with a significant difference (P<0.01). According to TCM swallowing assessment, the total rate was64.00% in the control group and 74.67% in the observation group with no significant difference between the groups (P<0.05). In the observationgroup, the total rate was 90.48% at acute stage and 68.52% at the convalescence stage with a significant difference (P<0.001). ConclusionAcupuncture combined with rehabilitation facilitates to improve the swallowing function in stroke patients following dysphagia especiallyat acute stage.

Effect of intraoperative using cell saver on blood sparing and its impact on coagulation function / 中国医学科学院学报

<p><b>OBJECTIVE</b>To observe the effectiveness of using cell saver (CS) during surgery on blood sparing and its impact on patient's hematology and coagulation function.</p><p><b>METHODS</b>One-hundred and thirty-eight patients undergoing elective surgery were recruited for intraoperative blood salvage using CS. Blood routine, blood chemistry and coagulation function were measured before surgery, after infusion of salvaged blood and postoperative day 1, respectively.</p><p><b>RESULTS</b>In total, 112,056 ml of packed red blood cells were collected, with a mean value of 812 ml per patient. The percentage of autologous blood transfusion volume to the total blood transfusion volume was from 48% to 89%. Allogenic blood transfusion rate was from 5% to 100%. Compared with the values before surgery, the hemoglobin concentration, platelet count, plasma total protein and fibrinogen concentration decreased significantly after the transfusion of salvaged blood and the first postoperative day (P < 0.05 or P < 0.01), while the prothrombin time was significantly prolonged (P < 0.05).</p><p><b>CONCLUSIONS</b>The use of CS during surgery can, to a certain extent, reduce the requirement of allogenic blood. However, reinfusion of large amount of salvaged blood may affect coagulation function.</p>

Perioperative melatonin secretion rhyme in patients undergoing coronary artery bypass grafting surgery / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate perioperative patterns of melatonin and cortisol secretion rhyme in patients undergoing coronary artery bypass grafting surgery.</p><p><b>METHODS</b>Eleven male patients scheduled for elective coronary artery bypass grafting surgery (CABG) under hypothermic cardiopulmonary bypass (CPB) were enrolled in the study. Anesthesia was induced and maintained with propofol (3 mg.kg-1.h-1) and supplemented with fentanyl (15 micrograms/kg). Blood samples were taken during surgery at specific time-points and every 3 h in the immediate postoperative period and postoperative day 2 and day 3. Plasma melatonin and cortisol levels were measured by radioimmunoassay and enzyme-linked immunosorbent assay respectively.</p><p><b>RESULTS</b>During surgery, plasma melatonin levels were below the minimum sensitivity level but low levels, without circadian variation, were measured during the immediate postoperative period. During postoperative day 2 and day 3, circadian secretion patterns of melatonin were present in 10 patients and showed an inverse correlation with light intensity exposed (r = -0.480, P = 0.01). Plasma cortisol levels in the immediate postoperative period were significantly higher than those before induction of anesthesia (P < 0.01). During postoperative day 2 and day 3, only 3 patients regained circadian secretion of cortisol.</p><p><b>CONCLUSIONS</b>It is concluded that melatonin and cortisol secretion are disrupted during cardiac surgery and in the immediate postoperative period.</p>