RESUMO
Background: Propofol is a widely used intravenous anesthetic in clinic. However, it is easy to cause serious circulatory fluctuation in elderly patients, so the dose should be reduced as appropriate. Studies have shown that wrist-ankle acupuncture (WAA) can reduce the dosage of propofol in patients undergoing painless endoscopy. Unfortunately, there is no report on whether WAA will reduce the dosage of propofol when used for anesthesia in elderly patients. The purpose of this study is to observe the effect of WAA on propofol dosage in elderly patients, and to provide a new method for maintaining circulatory stability in elderly patients under general anesthesia. Methods: From October 2022 to December 2022, Hebei Provincial Hospital of Traditional Chinese Medicine was selected. Forty-four elderly patients undergoing general anesthesia in urology department were randomly divided into two groups according to the complete random method with WAA group, consisting of 22 individuals, and non-WAA (NWAA) group, also consisting of 22 individuals. Both groups were treated with WAA or false needle acupuncture at the same site before anesthesia, respectively, and the needle was kept until the operation was finished. During the operation, the dosage of propofol was adjusted according to the depth of field monitoring density spectrum array (DSA) and anesthesia consciousness index (Ai) with anesthesia monitor. Results: A total of 44 patients participated in this study, and all of them completed the experiment. There were no significant difference in sex, age, height, weight, duration of anesthesia, liver and kidney function, score of Fried frailty scale, activity of daily living (ADL), age-adjusted Charlson comorbidity index (aCCI) and mini-cognitive test (Mini-Cog) between the two groups (P>0.05), but the total dose of propofol (WAA =121.5, NWAA =170.5) mg and maintenance dose (WAA =1.02±0.55, NWAA =1.76±0.67) mg/kg/h, utilization rate of vasoactive drugs during operation, recovery time after anesthesia (WAA =2, NWAA =3) min and surgeon satisfaction (WAA =9, NWAA =8.5) had significant differences (P<0.05). Conclusions: Compared with NWAA group, WAA group could reduce the dosage of propofol in anesthesia for elderly patients with exocrine secretion and was beneficial to circulatory stability. Trial Registration: Chinese Clinical Trial Registry (ID: ChiCTR2100054132).
RESUMO
PURPOSE: Berbamine (Ber), a bioactive constituent extracted from a traditional Chinese medicinal herb, has been shown to exhibit broad inhibitory activity on a panel of cancer cell types. However, its effects and the underlying molecular mechanisms on gastric cancer (GC) remain poorly understood. METHODS: The anti-growth activity of Ber on two GC cell lines and normal gastric epithelial cell line were evaluated using MTS and clone formation assay. Flow cytometry analysis was employed to evaluate the cell cycle distribution and apoptosis of GC cells. Western blot and quantitative PCR (qPCR) analysis were employed to investigate the anti-GC mechanism of Ber. The inhibitory activity and binding affinity of Ber against BRD4 were evaluated by homogeneous time-resolved fluorescence (HTRF) and surface plasmon resonance (SPR) assay, respectively. Molecular docking and molecular simulations were conducted to predict the interaction mode between BRD4 and Ber. RESULTS: The results demonstrated that Ber reduced the proliferation of GC cell lines SGC-7901 and BGC-823 and induced cell cycle arrest and apoptosis. Mechanistically, Ber was identified as a novel natural-derived BRD4 inhibitor through multiple experimental assay, and its anti-GC activity was probably mediated by BRD4 inhibition. Molecular modeling studies suggested that Ber might bind to BRD4 primarily through hydrophobic interactions. CONCLUSION: Our study uncovered the underlying anti-GC activity of Ber in vitro and suggested that Ber holds promise as a potential lead compound in the discovery of novel BRD4 inhibitors.