RESUMEN
OBJECTIVES: To observe the therapeutic effect of transcutaneous electrical acupoint stimulation (TEAS) based on the theory of "qi ascending and descending movement" in patients after general anesthesia laparoscopic cholecystectomy, so as to explore the impact of TEAS on the autonomic nervous system and gastrointestinal function of patients. METHODS: A total of 204 patients scheduled to undergo general anesthesia laparoscopic cholecystectomy were selected and randomly divided into control, double acupoints and multiple acupoints groups, with 68 cases in each group. For patients in the multiple acupoints group, TEAS was applied at Zusanli (ST36), Tiantu (CV22), Danzhong (CV17), Zhongwan (CV12), Taichong (LR3), and Neiguan (PC6) 30 min before anesthesia induction until the end of the surgery. In the double acupoints group, TEAS was applied only at ST36 and PC6. No electrical stimulation was applied in the control group. The postoperative bloating, bowel sound recovery time, first farting time, first defecation time, length of hospital stay, nausea and vomiting were compared among the three groups. Heart rate variability was monitored by twelve-lead electrocardiogram to evaluate the autonomic nervous function of the patients, including the low frequency power/high frequency power ratio (LF/HF), the standard deviation of all sinus RR intervals (SDNN), and the root mean square of difference between successive normal RR intervals (RMSSD). RESULTS: At 6 h and 24 h after surgery, the symptoms of bloating, nausea and vomiting in the multiple acupoints group and double acupoints group were significantly improved compared to the control group (P<0.05), and the multiple acupoints group was superior to the double acupoints group (P<0.05). Compared with the control group, the bowel sound recovery time, first farting time, first defecation time, and length of hospital stay were significantly shorter (P<0.05) in the multiple acupoints group and double acupoints group, and the multiple acupoints group was superior to the double acupoints group (P<0.05). At 1 d and 2 d after surgery, compared with the control group, LF/HF was decreased (P<0.05) while SDNN and RMSSD were increased (P<0.05) in the multiple acupoints group and double acupoints group, and there was a significant difference between the two groups (P<0.05). CONCLUSIONS: TEAS treatment based on the theory of "qi ascending and descending movement" can relieve gastrointestinal dysfunction, reduce early postoperative sympathetic nerve excitement and maintain parasympathetic nerve tension in patients after general anesthesia laparoscopic cholecystectomy, thereby promoting gastrointestinal function recovery.
Asunto(s)
Colecistectomía Laparoscópica , Estimulación Eléctrica Transcutánea del Nervio , Humanos , Colecistectomía Laparoscópica/efectos adversos , Puntos de Acupuntura , Qi , Sistema Nervioso Autónomo , Náusea , Vómitos , Anestesia GeneralRESUMEN
Based on the one-year observational data of volatile organic compounds ï¼VOCsï¼ in an urban area of Yuncheng in 2021ï¼ the concentrationï¼ compositionï¼ sourcesï¼ and ozone-sensitive species of VOCs in four seasons were analyzed. The results showed that the average annual concentration of VOCs was ï¼32.1 ±24.2ï¼×10-9ï¼ i.e.ï¼ at the national middle level. The seasonal concentrations of VOCs were in the order ofï¼ winter ï¼46.3×10-9ï¼> autumn ï¼35.5×10-9ï¼> spring ï¼25.6×10-9ï¼> summer ï¼21.2×10-9ï¼. Alkanes and OVOCs were the most dominant VOCs compoundsï¼ accounting for 69.0%-80.4% of TVOCs in Yuncheng. Affected by changes in source emissionsï¼ the proportion of OVOCs was higher in spring and summer ï¼41%-43%ï¼ï¼ whereas the proportion of alkanes was higher in autumn and winter ï¼42%-43%ï¼. Vehicle exhaustï¼ LPG/NGï¼ industrial productionï¼ and combustion sources were identified as the main sources of VOCs in Yuncheng. The largest contributors in the four seasons were vehicle exhaust ï¼28.5% in springï¼ï¼ secondary + combustion sources ï¼29.0% in summerï¼ï¼ LPG/NG sources ï¼30.4% in autumnï¼ï¼ and coal combustion ï¼27.3% in winterï¼. The ozone formation was located in the transitional regime in summer and in the VOC-limited regime in other seasons. Ozone production was more sensitive to alkenes ï¼isopreneï¼ ethyleneï¼ and propeneï¼ï¼ OVOCs ï¼acetaldehyde and propanalï¼ï¼ and aromatics ï¼xyleneï¼ tolueneï¼ and benzeneï¼. Winter was more sensitive to ethyleneï¼ and the other seasons were more sensitive to isoprene. The primary emission sources related to these sensitive species should be reduced to achieve the goal of air quality improvement.
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BACKGROUND: Increased red blood cell distribution width (RDW) is associated with adverse outcomes in patients with heart failure (HF). The objective of this study was to compare the differences in the predictive value of RDW in patients with HF due to different causes. METHODS: We retrospectively investigated 1,021 HF patients from October 2009 to December 2011 at Fuwai Hospital (Beijing, China). HF in these patients was caused by three diseases; coronary heart disease (CHD), dilated cardiomyopathy (DCM) and valvular heart disease (VHD). Patients were followed-up for 21 ± 9 months. RESULTS: The RDW, mortality and survival duration were significantly different among the three groups. Kaplan-Meier analysis showed that the cumulative survival decreased significantly with increased RDW in patients with HF caused by CHD and DCM, but not in those with HF patients caused by VHD. In a multivariable model, RDW was identified as an independent predictor for the mortality of HF patients with CHD (P < 0.001, HR 1.315, 95% CI 1.122-1.543). The group with higher N-terminal pro-brain natriuretic peptide (NT-proBNP) and higher RDW than median had the lowest cumulative survival in patients with HF due to CHD, but not in patients with HF due to DCM. CONCLUSIONS: RDW is a prognostic indicator for patients with HF caused by CHD and DCM; thus, RDW adds important information to NT-proBNP in CHD caused HF patients.
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Recombinant human neuregulin-1 (rhNRG-1) improves cardiac function in animal models of doxorubicin (DOX)-induced cardiomyopathy, but the underlying mechanism remains largely unknown. Here, we confirm a role for rhNRG-1 in attenuating DOX-induced autophagy and define the signaling pathways through which it mediates some of its effects. Neonatal rat ventricular myocytes were subjected to different treatments both to induce autophagy and to determine the effects of rhNRG-1 on the process. The rhNRG-1 inhibited DOX-induced autophagy, reduced reactive oxygen species production and increased protein expression of Bcl-2, effects that were recapitulated when the cells were treated with the antioxidant N-acetylcysteine. These effects were blocked by the phosphatidylinositol 3-kinase inhibitor LY294002, pointing to the involvement of the Akt pathway in mediating the process. Inhibition of Bcl-2 expression with small interfering RNA silencing also inhibited rhNRG-1's ability to attenuate DOX-induced autophagy. The rhNRG-1 is a potent inhibitor of DOX-induced autophagy and multiple signaling pathways, including Akt and activation of reactive oxygen species, play important roles in the anti-autophagy effect. The rhNRG-1 is a novel drug that may be effectively therapeutically in protecting further damage in DOX-induced damaged myocardium.