Comparison of the median effective concentration (EC50) and effect of sevoflurane with or without remifentanil in cesarean section with supreme laryngeal mask under narcotrend monitoring: a randomized trial.

BACKGROUND: Remifentanil combined with sevoflurane is a standard protocol for obstetric general anesthesia (GA). METHODS: In this study, we performed a randomized clinical trial to evaluate whether remifentanil has an effect on the median effective concentration (EC50) of sevoflurane and compare anesthetic outcomes of them in cesarean section with Supreme™ laryngeal mask airway (SLMA) under narcotrend monitoring. Ninety parturients with singleton births undergoing elective cesarean delivery (CD) with initial inhaled 1.0 minimum alveolar concentration (MAC) sevoflurane for anesthesia maintenance were assigned to three groups randomly and evenly: Group A (0.05 µg·kg-1·min-1 remifentanil combined with sevoflurane), Group B (0.1 µg·kg-1·min-1 remifentanil combined with sevoflurane), and Group C (normal saline combined with sevoflurane). Narcotrend was used to monitor the depth of anesthesia during the operation, with the level of anesthesia depth controlled within the D-E stage. The EC50 of sevoflurane was determined by Dixon's sequential method. The Narcotrend index, amount of bleeding, neonatal Apgar score, and corresponding treatment measures in the three groups were recorded. RESULTS: The results showed that the estimated EC50 of sevoflurane for obstetric GA was 0.80 MAC (95% CI: 0.63-0.95 MAC) in group A, 0.82 MAC (95% CI: 0.63-0.96 MAC) in group B, and 0.80 MAC (95% CI: 0.63-0.95 MAC) in group C. There was no statistically significant difference in the estimated EC50 of sevoflurane, time to wakefulness, Apgar score, amount of intraoperative bleeding, and postoperative bleeding within 24 hours between the three groups (all P>0.05). CONCLUSIONS: The addition of remifentanil at 0.05-0.1 µg·kg-1·min-1 did not change the EC50 of sevoflurane and anesthetic quality. The concentration of inhaled anesthetics can be minimized with Narcotrend monitoring. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000034512.

Long noncoding RNA MALAT1 associates with the malignant status and poor prognosis in glioma.

The metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) is a bona fide long noncoding RNA (lncRNA). LncRNA MALAT1 was discovered as a prognostic factor for lung cancer metastasis but also has been linked to several other human tumor entities. However, little is known about the role of lncRNA MALAT1 in glioma patients. The aim of this study was to identify the role of lncRNA MALAT1 in the pathogenesis of glioma; we analyzed the relationship of lncRNA MALAT1 expression with clinicopathological characteristics in glioma patients. In our results, lncRNA MALAT1 expression was increased in glioma tissues compared with paired adjacent brain normal tissues (P < 0.001). Furthermore, lncRNA MALAT1 was associated significantly with WHO grade (I-II vs. III-IV; P = 0.007) and tumor size (< 3 cm vs. T ≥ 3 cm; P = 0.008). However, lncRNA MALAT1 expression was not associated significantly with age (<45 vs. ≥ 45, P = 0.343), gender (female vs. male, P = 0.196), family history of cancer (yes vs. no, P = 0.665), and tumor location (supratentorial vs. infratentorial, P = 0.170). Moreover, the level of lncRNA MALAT1 expression was markedly correlated with the glioma patients' overall survival (P < 0.001). Multivariate analysis suggested that increased lncRNA MALAT1 expression was a poor independent prognostic predictor for glioma patients (P = 0.002). In conclusion, lncRNA MALAT1 plays an important role on glioma progression and prognosis and may serve as a convictive prognostic biomarker for glioma patients.

[Causes of neonatal death in the Xiaogan region of Hubei Province between 2007 and 2010].

OBJECTIVE: To study the causes of neonatal death in the Xiaogan region of Hubei Province between 2007 and 2010. METHODS: The causes of 664 cases of neonatal death between 2007 and 2010, from 7 counties (cities) of the Xiaogan region of Hubei Province, were investigated. RESULTS: Neonatal mortality in the Xiaogan region between 2007 and 2010 accounted for 51.12% of under-five mortality. The top three causes of neonatal death in this region were preterm birth/low birth weight, birth asphyxia and congenital diseases. CONCLUSIONS: It is important to reduce neonatal mortality through the prevention of preterm birth, low birth weight, birth asphyxia and congenital defects.

[Effects of acupuncture at different Shichen (traditional twelve two-hour periods) on serum SOD and MDA in guinea pigs].

UNLABELLED: OBJECTIVE To compare anti-oxidative effects of acupuncture at different Shichen (traditional twelve two-hour periods) accordin-17:00), You (17:00-19:00), Xu (19:00-21:00), Hui (21:00-23:00) periods according to the eight methods of the intelligent turtle, once each day, for 7 consecutive days. Changes of malondialdehyde (MDA) content and superoxide dismutase (SOD) activity after treatment were observed. RESULTS: SOD activities and MDA contents at the 12 periods were different in the healthy guinea pigs, SOD activity at Wu period was the highest and the lowest at Zi period; MDA content was the highest at Zi period and the lowest at Wu period. The needling method according to eight methods of the intelligent turtle could increase SOD activity in the guinea pigs. The increasing amplitude of SOD activity was the largest at Mao period and the smallest at the Wu period; it also could decreased MDA content, the decreasing amplitude of MDA was the largest at Wu period and the smallest at Hai period. CONCLUSION: Acupuncture at different periods according to eight methods of intelligent turtle has different effects on serum SOD and MDA, which can increase SOD activity and decrease MDA content in the healthy guinea pig.

[Effects of eight methods of intelligent turtle on free radical metabolism in the kidney-yang deficiency model guinea pigs].

OBJECTIVE: To observe effects of moxibustion according to opening points on time in eight methods of intelligent turtle on aging and the mechanism. METHODS: Healthy and adult guinea pigs were randomly divided into 5 groups, a prevention group of kidney-yang deficiency model with eight method of intelligent turtle (group I), a prevention group of kidney-yang deficiency model (group II) with moxibustion at Mingmen (GV 4), a group of treatment group of kidney-yang deficiency model with eight methods of intelligent turtle (group III), a treatment group of kidney-yang deficiency model (group IV) with moxibustion at Mingmen (GV 4) and a control group of kidney-yang deficiency. Effects of moxibustion according to opening on time in eight methods of intelligent turtle and moxibustion at Mingmen (GV 4) on superoxide dismulase (SOD) activity and malondialdehyde (MDA) level were compared. RESULTS: After modeling, no signs of kidney-yang deficiency and no significant changes of SOD and MDA were found in group I and II; but obvious symptoms of kidney-yang deficiency and decrease of SOD (P < 0.01) and increase of MDA (P < 0.01 or P < 0.05) were found in group III, IV and V; after treatment, in the group III); the symptoms of kidney-yang deficiency basically disappeared, SOD increased (P < 0.01) and MDA decreased (P < 0.01), with no significant differences as compared with those before modeling (P > 0.05); in the group N, the symptoms of kidney-yang deficiency significantly improved and SOD increased (P < 0.05) with difference as compared with those before modeling (P < 0.05), and MDA decreased (P < 0.05), but with no significant difference compared with that before modeling (P > 0.05); the symptoms of kidney-yang deficiency, SOD and MDA did not significantly change in group V (P > 0. 05). CONCLUSION: Both moxibustion according to opening points on time in eight methods of intelligent turtle and moxibustion at Mingmen (GV 4) can effectively regulate free radical metabolism and have obvious action of preventing and treating kidney-yang deficiency in the model guinea pigs, and the therapeutic action of moxibustion according to opening points on time in eight methods of intelligent turtle is better than that of moxibustion at Mingmen (GV 4).