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Methamphetamine (Meth) abuse can cause serious mental disorders, including anxiety and depression. The gut microbiota is a crucial contributor to maintaining host mental health. Here, we aim to investigate if microbiota participate in Meth-induced mental disorders, and the potential mechanisms involved. Here, 15 mg/kg Meth resulted in anxiety- and depression-like behaviors of mice successfully and suppressed the Sigma-1 receptor (SIGMAR1)/BDNF/TRKB pathway in the hippocampus. Meanwhile, Meth impaired gut homeostasis by arousing the Toll-like receptor 4 (TLR4)-related colonic inflammation, disturbing the gut microbiome and reducing the microbiota-derived short-chain fatty acids (SCFAs). Moreover, fecal microbiota from Meth-administrated mice mediated the colonic inflammation and reproduced anxiety- and depression-like behaviors in recipients. Further, SCFAs supplementation optimized Meth-induced microbial dysbiosis, ameliorated colonic inflammation, and repressed anxiety- and depression-like behaviors. Finally, Sigmar1 knockout (Sigmar1-/-) repressed the BDNF/TRKB pathway and produced similar behavioral phenotypes with Meth exposure, and eliminated the anti-anxiety and -depression effects of SCFAs. The activation of SIGMAR1 with fluvoxamine attenuated Meth-induced anxiety- and depression-like behaviors. Our findings indicated that gut microbiota-derived SCFAs could optimize gut homeostasis, and ameliorate Meth-induced mental disorders in a SIGMAR1-dependent manner. This study confirms the crucial role of microbiota in Meth-related mental disorders and provides a potential preemptive therapy.
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ObjectiveTo determine the incidence and characteristics of adverse events following immunization （AEFI） in 2016‒2020 in Dazu District of Chongqing， and evaluate the AEFI surveillance information system and provide scientific evidence for vaccine safety. MethodsDescriptive epidemiological analysis was performed on the cases collected by the AEFI surveillance system. Incidence and coverage of AEFI were then presented. ResultsA total of 319 AEFI cases were reported in 2016‒2020. Reported incidence of AEFI was determined to be 24.64/105 doses. The proportion of timely reporting AEFI within 48 hours was 94.04% and that of timely investigation within 48 hours was 98.41%. The proportion of completing the AEFI survey was 100.00% and that of AEFI classification was 99.69%. The male to female ratio was 1.28∶1. Majority of the AEFI cases were less than 1 year old （64.26%， 205/319）， from April to September （68.97%， 220/319）， and reported at 0‒1 day post-immunization （89.34%， 285/319）. Moreover， the reported incidence differed significantly between time periods （χ2=32.481，P<0.05） and time intervals from vaccination to occurrence of AEFI （χ2=961.408， P<0.05）. Coverage of reporting AEFI at county level reached 100％. In addition， non-severe AEFI cases accounted for 98.43% （314/319） and no death case was reported. General events， such as fever， redness， and scleroma， accounted for 80.56% （257/319）， whereas rare adverse events accounted for 15.99% （51/319）. The reported incidence of NIP vaccines was highest in the diphtheria tetanus acellular pertussis combined vaccine， followed by measles and rubella combined attenuated vaccine and diphtheria tetanus combined vaccine. Clinical diagnosis of rare adverse events was mainly allergic rashes. ConclusionThe AEFI surveillance information system in Dazu District of Chongqing achieves efficient monitoring of AEFI. It has proven that the vaccines are generally safe and immunization strategies may be continuously implemented. Furthermore， the sensitivity of AEFI surveillance should be improved through multiple approaches.
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Objective:To evaluate the effect of sedation management based on visual analysis of electroencephalography (EEG) on postoperative delirium in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods:Eighty patients, aged ≥ 18 yr, of American Society of Anesthesiologists physical status Ⅲ or Ⅳ, with New York Heart Association Ⅱ-Ⅳ, scheduled for elective cardiac valve replacement with CPB, were randomly divided into visual analysis of EEG-guided sedation management group (group A, n=40) and BIS-guided sedation management group (group B, n=40). The target plasma concentration of propofol was adjusted to maintain the depth of anaesthesia at grade C or grade D in group A and BIS value at 40-60 in group B. Propofol consumption during CPB and total consumption of propofol during surgery, requirement for vasoactive agents during surgery, and parameters of intraoperative arterial blood gas analysis were recorded.Postoperative delirium was evaluated using Confusion Assessment Method for the Intensive Care Unit (ICU) at 1-7 days after surgery.Extubation time, length of ICU stay, length of postoperative hospital stay and intraoperative awareness were also recorded. Results:Compared with group B, the length of postoperative hospital stay was significantly shortened, the incidence of postoperative delirium was decreased, and no significant change was found in the parameters of arterial blood gas analysis, propofol consumption, requirement for vasoactive agents, extubation time, or length of postoperative ICU stay in group A ( P<0.05). No intraoperative awareness occurred in both groups. Conclusion:Sedation management based on visual analysis of EEG is helpful in decreasing the development of postoperative delirium in the patients undergoing cardiac valve replacement with CPB.
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Objective To evaluate the effect of dexmedetomidine on postoperative outcomes in pa-tients undergoing off-pump coronary artery bypass grafting ( OPCABG) . Methods One hundred and twen-ty-two patients of both sexes, aged 40-75 yr, with body mass index of 18. 5-32. 0 kg∕m2 , of American So-ciety of Anesthesiologists physical status Ⅲ or Ⅳ, with New York Heart Association Ⅱ or Ⅲ, with lelf ventricular ejection fraction>40％, scheduled for elective OPCABG, were divided into 2 groups ( n=61 each) using a random number table method: dexmedetomidine group ( group D) and control group ( group C) . Dexmedetomidine was intravenously infused in a loading dose of 0. 6μg∕kg at 15 min before anesthesia induction, followed by a continuous infusion of 0. 4 μg · kg-1 · h-1 until the end of surgical procedure in group D. The equal volume of normal saline was given instead in group C. The emergence time, extubation time, length of intensive care unit stay and postoperative length of hospital stay were also recorded. Results Compared with group C, the extubation time, length of intensive care unit stay, and postoperative length of hospital stay were significantly shortened, and the emergence time was prolonged in group D ( P<0. 05) . Conclusion Dexmedetomidine can promote postoperative outcomes in the patients undergoing OPCABG.
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Objective To study on the difference of serum iron(Fe) levels between normal healthy people and patients with AD in order to explore the effect of serum iron level on the phenotypical division of AD patients and discuss its influence and significance in the diet nursing of AD patients. Methods A total of 30 patients with AD in Guangzhou Huiai Hospital were selected as the "AD group" from June 2014 to August 2017, and 30 healthy people in the corresponding health center of Guangzhou Huiai Hospital were selected as "the health control group". Data of general information, serum iron and red blood cell (RBC) index were collected in these two groups. General statistical analysis and cluster analysis were made based on the data. Results RBC in healthy control group and AD group were 4.60(4.38,5.00)×1012/L and (4.32±0.51)×1012/L. Compared with the healthy control group, RBC in the AD group was lower and the difference was statistically significant (Z=2.493,P＜0.05). But, the other indexes were not significantly different (P＞0.05). There was no significant difference in the in Fe level, RBC, hemoglobin and other indexes in AD patients with the different severity of dementia (P＞0.05). Based on the level of Fe and RBC, the 60 cases can be divided into four types of different characteristics.The Fe of four types were(12.39±2.35)(, 13.55±2.07),[20.70(19.55,23.15)], [19.70(17.70,22.60)] μmol/L, the RBC were (4.07±0.30), [4.83(4.62,5.12)], [4.40(4.14,4.45)], [5.00(4.80,5.34)] × 1012/L. The HGB were (125.30 ± 8.74),(138.08±11.1), [136.00(127.00,139.00)], (151.91±13.49)g/L.The incidence of four types of AD, Fe level,RBC and hemoglobin content were different (t/Z/χ2=0.019-6.942, P＜0.05). Conclusions Based on Fe and RBC, the population can be divided into 4 types. "Low Fe and low RBC"Type, "High Fe and high RBC"Type, "Low Fe and high RBC"Type and"High Fe and low RBC"."Low Fe and low RBC"Type contains most AD patients while "High Fe and high RBC"Type contains the least. There are close in the distribution of objects between"Low Fe and high RBC" and "High Fe and low RBC". According to the characteristics of these four types, different dietary care programs may be required
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Objective@#To study on the difference of serum iron(Fe) levels between normal healthy people and patients with AD in order to explore the effect of serum iron level on the phenotypical division of AD patients and discuss its influence and significance in the diet nursing of AD patients.@*Methods@#A total of 30 patients with AD in Guangzhou Huiai Hospital were selected as the "AD group" from June 2014 to August 2017, and 30 healthy people in the corresponding health center of Guangzhou Huiai Hospital were selected as "the health control group". Data of general information, serum iron and red blood cell(RBC) index were collected in these two groups. General statistical analysis and cluster analysis were made based on the data.@*Results@#RBC in healthy control group and AD group were 4.60(4.38,5.00)×1012/L and (4.32±0.51)×1012/L. Compared with the healthy control group, RBC in the AD group was lower and the difference was statistically significant (Z=2.493, P<0.05). But, the other indexes were not significantly different (P>0.05). There was no significant difference in the in Fe level, RBC, hemoglobin and other indexes in AD patients with the different severity of dementia (P>0.05). Based on the level of Fe and RBC, the 60 cases can be divided into four types of different characteristics.The Fe of four types were (12.39±2.35) , (13.55±2.07) ,[20.70(19.55,23.15)], [19.70(17.70,22.60)] μmol/L, the RBC were (4.07±0.30), [4.83(4.62,5.12)], [4.40(4.14,4.45)], [5.00(4.80,5.34)]×1012/L. The HGB were (125.30±8.74), (138.08±11.1), [136.00(127.00,139.00)], (151.91±13.49)g/L.The incidence of four types of AD, Fe level, RBC and hemoglobin content were different (t/Z/χ2=0.019-6.942, P<0.05).@*Conclusions@#Based on Fe and RBC, the population can be divided into 4 types. "Low Fe and low RBC"Type, "High Fe and high RBC"Type, "Low Fe and high RBC"Type and"High Fe and low RBC"."Low Fe and low RBC"Type contains most AD patients while "High Fe and high RBC"Type contains the least. There are close in the distribution of objects between"Low Fe and high RBC" and "High Fe and low RBC". According to the characteristics of these four types, different dietary care programs may be required
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Objective To explore the potential laws of selecting points and using point massage to treat constipation by data mining.Methods Key words such as "constipation","point massage","acupressure",and "point rubbing" were used to collect data from TCM Clinical Diagnosis and Treatment Literature Database,Chinese Biomedical Literature Database,VIP Database,and Wanfang Database.After data pre-processing,descriptive analysis of frequency and association analysis of selecting points were conducted.Results Totally 371 documents involving 89 acupuncture points were included.The study population were mostly patients in departments of neurology,orthopedics and gastroenterology.The most common points were Point Tianshu (18.52％),Point Zhongwan (10.44％),Point Zusanli(10.25％),Point Zhigou(6.22％),Point Qihai(5.72％),Point Guanyuan(5.47％) and Point Daheng(5.66％).For constipation patients with different underlying diseases,there would be adjustments in selecting points.Conclusion The laws of selecting points for patients with constipation based on data mining can help nurses have a better understanding of using point massage to treat constipation.
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To observe the feasibility and safety of general anesthesia without muscle relaxant tracheal intubation combined with right stellate ganglion block (SGB) on patients undergoing oropharyngeal surgery.60 patients undergoing selective oropharyngeal surgery were randomly and equally divided into 2 groups:named in non muscle relaxation group and combination group.MAP,HR,SpO2 and PETCO2 were recorded before administration (T0),immediately before tracheal intubation(T1),and immediately after tracheal intubation(T2),and immediately after skin incision (T3).The VAS score at 4,8,12,24 h after surgery were also recorded.The difference of the satisfactory intubation conditions was not statistically significant.MAP and HR were increased at T2 and T3 as compared with non muscle relaxation group.Compared with combination group,HR increased at T2 and T3 in group A.The VAS of patients in combination group was lower than non muscle relaxation group (P ＜ 0.05).Stellate ganglion block on patients undergoing oropharyngeal surgery in general anesthesia without muscle relaxant might provide not only satisfactory intubation conditions but also provoke earlier recovery and improve the quality of postoperartive analgesia.
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Objective To evaluate the relationship between histone deacetylase 3 (HDAC3) expression and the mechanism underlying mitigation of remifentanil postconditioning-induced protection of diabetic cardiomyocytes.Methods H9c2 cells were cultured in DMEM/F12 culture medium supplemented with 10％ fetal bovine serum.The cells were seeded in 6-well plates (2 ml/well) at a density of 105 cells/ml.After the cells were cultured for 12 h,the cells were attached to the wall and cultured for 48 h in the normoglycemic (5.5 mmol/L) or hyperglycemic (25 mmol/L) DMEM culture medium.The cells were then randomly divided into 6 groups (n =18 each) using a random number table:control group (group CON),hypoxia/reoxygenation group (group H/R),remifentanil postconditioning group (group RPC),hyperglycemia group (group HG),hyperglycemia plus hypoxia/reoxygenation group (group HG-H/R),and hyperglycemia plus remifentanil postconditioning group (group HG-RPC).In H/R,RPC,HG-H/R and HG-RPC groups,the cells were exposed to 95％ N2-5％ CO2 in an incubator for 5 h after changing the culture medium for Tyrode solution.In H/R and HG-H/R groups,the culture medium was changed to the DMEM/F12 culture medium supplemented with 10％ fetal bovine serum and glucose at the corresponding concentration,and the cells were then incubated for 1 h.In RPC and HG-RPC groups,the cells were incubated in the DMEM culture medium containing remifentanil at the final concentration of 1 μmol/L,and the cells were then incubated for 1 h.At 1 h of reoxygenation,the cell viability was measured by CCK-8 assay,the cell apoptosis was detected by AnnexinV-FITC/PI flow cytometry,and the expression of HDAC3 and caspase-3 in cells was detected by Western blot.The apoptotic rate was calculated.Results Compared with group CON,the cell viability was significantly decreased,the cell apoptotic rate was significantly increased,and the expression of caspase-3 and HDAC3 was significantly up-regulated in group H/R (P＜ 0.05).Compared with group H/R,the cell viability was significantly increased,the apoptotic rate was significantly decreased,and the expression of caspase-3 and HDAC3 was significantly down-regulated in group RPC (P＜0.05).Compared with group HG,the cell viability was significantly decreased,the apoptotic rate was significantly increased,and the expression of cspase-3 and HDAC3 was significantly up-regulated in group HG-H/R (P＜0.05).There was no significant difference in the parameters mentioned above between group HG-RPC and group HG-H/R (P＞0.05).Conclusion The mechanism underlying mitigation of remifentanil postconditioning-induced protection of diabetic cardiomyocytes is associated with hyperglycemia-induced up-regulation of HDAC3 expression.
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Objective To evaluate the effect of multimodal warming regimen on the development of intraoperative hypothermia in the patients undergoing precise hepatectomy.Methods Sixty patients of both sexes,aged 28-64 yr,weighing 44-89 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ (Child-Pugh A),undergoing precise hepatectomy,were equally and randomly assigned into control group (group C) and muhi-model warming group (group M) using a random number table.A bed sheet was covered on the body exposed,and the abdominal cavity was washed using the room-temperature peritoneal layage fluid in group C.In group M,after admission to the operating room,the room temperature was raised to 25-26 ℃,the mattress was prewarmed using the medical heating blanket,the temperature was maintained at 40 ℃ during operation,the lower body was simultaneously covered using the forced-air warming system,and the temperature was maintained at 37-39 ℃;the solution used for infusion was warmed to 37 ℃ before anesthesia;the incisional area was washed with 0.9％ sodium chloride injection which was prewarmed to 37 ℃ during operation.The development of hypothermia,hypotension and respiratory depression was recorded during operation.Before induction of anesthesia,at 1 h after anesthesia,at the end of operation,and at 5 min before discharge from postanesthesia care unit (PACU),blood gas analysis was performed,and the pH value,base excess and lactate level were recorded.The intraoperative blood loss,emergence time,duration of PACU stay,and occurrence of shivering,agitation,nausea and vomiting were also recorded.Results Compared with group C,the incidence of intraoperative hypothermia,and shivering,agitation,nausea and vomiting in PACU were significantly decreased,the emergence time and duration of PACU stay were significantly shortened,the pH value was significantly increased at 5 min before discharge from PACU,and the base excess and lactate level were significantly decreased at the end of operation and 5 min before discharge from PACU in group M (P＜0.05 or 0.01).Conclusion Multimodal warming regimen can raise the quality of recovery from anesthesia and decrease the development of intraoperative hypothermia in the patients undergoing precise hepatectomy.
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Objective To improve the fixation method of indwelling needle inserted in the tail vein in rats to keep the inserted needle for a longer indwelling time .Methods One hundred healthy Wistar rats ( age 5~6 months, male:female=1:1) were randomly divided into two groups: the experimental group and the control group .Rats in both groups received the same tail vein indwelling needle puncture and cannulation .The control group got the traditional fixation , namely fixed by sticking with 3M transparent dressing paste .The experimental group received in addition to the traditional fixation, a 0.1 mm-thick aluminum tube placed outside the needle fixation site .The indwelling time in the rats were recorded and analyzed .Results The indwelling time was (166.86 ±9.03) h and (20.24 ±5.04) h in the experimental and control groups, respectively (t =68.546, P<0.01).Conclusions Our improved method is safe and reliable.It can prolong the indwelling time of the punctured intravenous indwelling needle , and provides a useful rat model in studies on the complications of intravenous indwelling needle kept for a longer time .
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Objective To evaluate the relationship between glucose-regulated protein 78 (GRP78) and diabetes mellitus-induced influence on myocardial protection provided by remifentanil postconditioning in vitro.Methods H9c2 cells were cultured in DMEM/F12 culture medium supplemented with 10％ fetal bovine serum.The cells were seeded in 96-well (100 μl/well) or 6-well (2 ml/well) plates at the density of l05 cells/ml.The cells were then randomly divided into 6 groups (n =24 each) using a random number table:normoglycemic control group (group NC),normoglycemic hypoxia/reoxygenation (H/R) group (group NHR),normoglycemic remifentanil postconditioning group (group NRP),hyperglycemic control group (group HC),hyperglycemic H/R group (group HHR),and hyperglycemic remifentanil postconditioning group (group HRP).In NC,NHR and NRP groups,the cells were cultured in normoglyccmic culture medium (5.5 mmol/L) for 48 h.In HC,HHR and HRP groups,the cells were incubated in hyperglycemic culture medium (25.0 mmol/L) for 48 h.In NHR,NRP,HHR and HRP groups,after changing the culture medium for Tyrode solution,the cells were exposed to 95％ N2-5％ CO2 in an incubator at 37 ℃ for 5 h.Subsequently,in NHR and HHR groups,the culture medium was changed to DMEM/F12 culture medium supplemented with 10％ fetal bovine serum and glucose at the corresponding concentration,and the cells were incubated for 1 h;in NRP and HRP groups,the cells were incubated for 1 h in the DMEM culture medium containing remifentanil at the final concentration of 1 μmol/L.At 1 h of reoxygenation,the cells of 9 wells in each group were selected to measure the cell viability by CCK8 assay,the cells of 12 wells in each group were selected to determine the activity of lactic dehydrogenase (LDH) released in the supernatant using colorimetric method,and the cells of 3 wells in each group were selected to detect the expression of GRP78 by Western blot.Results Compared with group NC,the cell viability was significantly decreased,the LDH activity was increased,and the expression of GRP78 was up-regulated in group NHR.Compared with group NHR,the cell viability was significantly increased,the LDH activity was decreased,and the expression of GRP78 was down-regulated in group NRP,and the cell viability was significantly decreased,the LDH activity was increased,and the expression of GRP78 was up-regulated in group HRP.Compared with group HC,the cell viability was significantly decreased,the LDH activity was increased,and the expression of GRP78 was up-regulated in group HHR.There was no significant change in the parameters mentioned above between group HRP and group HHR.Compared with group NRP,the cell viability was significantly decreased,the LDH activity was increased,and the expression of GRP78 was up-regulated in group HRP.Conclusion Up-regulation of GRP78 expression may be involved in the mechanism by which diabetes mellitus negates myocardial protection induced by remifentanil postconditioning in vitro.
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Objective To evaluate the relationship between endoplasmic reticulum stress and diabetes mellitus (DM)-caused influence on cardioprotection induced by remifentanil postconditioning in rats.Methods Adult male Sprague-Dawley rats,weighing 250-300 g,were used in the study.A model for type 1 DM was established by intraperitoneal streptozotocin 50 mg/kg and confirmed by blood glucose ≥ 16.7 mmol/L.Thirty six rats with type 1 DM were randomly divided into 3 groups (n =12 each) using a random number table:sham operation group (DM-S group),myocardial ischemia-reperfusion (I/R) group (DM-I/R group) and remifentanil postconditioning group (DM-R group).Another 36 normal rats were exposed to single intraperitoneal injection of sodium citrate-hydrochloric acid buffer solution and served as control group.Two weeks later 36 normal rats with nondiabetes mellitus were also randomly divided into 3 groups (n =12 each) using a random number table:sham operation group (NDM-S group),myocardial I/ R group (NDM-I/R group) and remifentanil postconditioning group (NDM-R group).Myocardial I/R was produced by 30 min occlusion of left anterior descending branch of coronary artery followed by 120 min reperfusion.Remifentanil postconditioning was induced by 10 min infusion of remifentanil 10 μg · kg-1 · min 1 via the femoral vein starting from 5 min before reperfusion.Before ischemia and at 30 and 120 min of ischemia,MAP,SP and HR were recorded and rate-pressure product (RPP) was calculated.At 120 min of reperfusion,arterial blood samples were collected for measurement of plasma cardiac troponin I (cTnI) concentration.The animals were then sacrificed and hearts were removed for determination of myocardial infarct size (IS).The left 6 rats from each group were sacrificed at 120 min of reperfusion,the specimens from their left ventricular apex were obtained to detect the expression of endoplasmic reticulum stress marker glucose-regulated protein 78 (GRP78),C/EBP homologous protein (CHOP) and caspase-12 by Western blot.Results MAP and RPP were significantly decreased,the plasma concentration of cTnI was increased,changes of cardiac infarction were found,and the expression of GRP78,CHOP and caspase-12 was up-regulated in diabetic and nondiabetic rats.Remifentanil postconditioning could inhibit the expression of GRP78,CHOP and caspase-12,increase MAP and RPP,decrease the plasma concentration of cTnI,and reduce myocardial infarct size in nondiabetic rats,but it had no such effects in the diabetic rats.The expression of GRP78,CHOP and caspase-12 was significantly higher after remifentanil postconditioning in diabetic rats than in nondiabetic rats.Conclusion Enhanced endoplasmic reticulum stress is involved in DM-caused loss of cardioprotection induced by remifentanil postconditioning in rats.
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Objective To understand the awareness degree and the dietary intake of acrylamide (AA) in food among preventive medicine professional undergraduate students in a university of Xianyang city .Methods 28 kinds of fried and baked food frequently eaten by undergraduates were selected as the respondents .The food-frequency method was adopted to perform the questionnaire in-vestigation on 248 undergraduates sampled from grade 1-5 of preventive medicine professional undergraduate students by the clus-ter sampling .Results More than 38 .71% of the investigated students had never known about the acrylamide ,32 .26% of the inves-tigated students had heard but did not know what it was ,11 .26% students knew about its hazard .The AA dietary intake was about 31 .57 μg/d per person ,and there was no statistical difference in the AA dietary intake between different sexes and grades .Conclu-sion The awareness degree of AA among investigated preventive medicine professional undergraduates is relatively low .Therefore it is necessary to strengthen the publicity and education of the AA-related food safety knowledge .
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Objective To investigate the effect of sufentanil postconditioning on myocardial ischemiareperfusion (I/R) injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB).Methods Sixty ASA Ⅱ or Ⅲ patients ( NYHA Ⅱ or Ⅲ ) of both sexes,aged 19-64 yr,scheduled for cardiac valve rreplacement under CPB,were randomly divided into 4 groups ( n =15 each):control group ( group C),sufentanil 0.5 μg/kg group (group S1 ),sufentanil 1.0 μg/kg group (group S2 ) and sufentanil 2.0 μg/kg group ( group S3 ).In groups S1,S2 and S3,sufentanil 0.5,1.0 and 2.0 μg/kg were infused over 2 min via aortic root 5 min before aortic unclamping respectively.In group C,the equal volume of normal saline (2 ml/kg) was infused instead of sufentanil.Blood samples were taken from the radial artery immediately before induction of anesthesia ( T2 ) and at 2,4,8,24 and 48 h after aortic unclamping ( T1-5 ) for determination of plasma concentrations of cardiac troponin-I (cTnI) and malondialdehyde (MDA) and activities of creatine kinase isoenzyme-MB (CK-MB) and superoxide dismutase (SOD).The duration of CPB,time of aortic clamping,extubation time,duration of stay in ICU,and myocardial contractility score and volume of drainage at 24 h after the operation were recorded.The restoration of spontaneous heart beat and adverse cardiovascular events were observed.Results The plasma cTnI,and MDA concentrations and CK-MB activity were significantly lower,while the SOD activity was significantly higher at T1-3 in group S1 than in group C ( P ＜ 0.05).The plasma cTnl concentration and CK-MB activity were significantly lower at T1-5,the plasma MDA concentration was significantly lower at T1-4,and SOD activity was significantly higher at T1-4,the extubation time and duration of stay in ICU were significantly shorter,and the myocardial contractility score at 24 h after the operation and incidence of adverse cardiovascular events were significantly lower in groups S2,3 than in group C ( P ＜ 0.05),The plasma cTnl concentration and CK-MB activity were significantly lower at T4,5,The plasma MDA concentration was significantly lower at T4,the SOD activity was significantly higher at T3,4,and the myocardial contractility score at 24 h after the operation was significantly lower in groups S2,3 than in group S1 ( P ＜ 0.05).Conclusion Sufentanil postconditioning can relieve myocardial I/R injury in patients undergoing cardiac valve replacement under CPB,and the mechanism is related to inhibition of lipid peroxidation.
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Objective To evaluate the effect of emulsified isoflurane preconditioning on myocardial iachemia-reperfusion (I/R) injury in rabbits.Methods Thixty-two male New Zealand white rabbits weighing 2.5-3.0 kg were randomly divided into 4 groups(n=8 each):group Ⅰ I/R;group Ⅱ isoflurane preconditioning (group Ⅰ);group Ⅲ emulsified isoflurane preconditioning (group EI) and group Ⅳ intralipid (group INT).Myocardial I/R was induced by 30 min occlusion of left anterior descending branch of coronary artery followed by 180 min of reperfusion.After 30 min of post-preparation equilibration.the animal inhaled 3%isoflurane for 30 min followed by 15 min washout in group Ⅰ(group Ⅱ);8% emulsified isoflurane 8-10 ml was injected iv at 1 ml/s followed by continuous infusion at 6-8 ml·kg-1·h-1,maintaining end-tidal isoflurane concentration at 1.28% for 30 min in group EI (groupⅢ);30% intralipid 9 ml was injected iv at 1 ml/s fullowed by continuous infusion at 7 ml·kg-1·h-1 for 30 min in group INT (group IV).HR and BP were monitored and recorded at 30 min of post-preparatory equilibration(T0),before ischemia(T1),at the beginning of ischemia(T2),at 30 min ofischemia(T3),60,120 and 180 min of reperfnsion(T4,5,6).HR-SP product (RPP) was calculated.Infarct size (IS) was determined by TIC staining.Blood samples were taken from carotid artery at T6 for determination of serum CK and LDH activities and IL-6 and IL-10 concentrations.Results HR,MAP and RPP were decreasing during T2-6, but there was no significant difference in HR, MAP and RPP among the 4 groups.The infarct size was signigicantly smaller, serum CK and LDH activities and IL-6 concentration were significantly lower while serum IL-10 concentration was significantly higher in group I and EI than in group I/R and INT.Conclusion Emulsified isoflurane preconditioning can attenuate myocardial I/R injury by inhibiting inflammatory response.
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Objective To evaluate the effect of remffentanil postconditioning on myocardial ischemiareperfusion (I/R) injury in patients undergoing open heart surgery under CPB.Methods Thirty patients (ASA grade Ⅱ or Ⅲ, NYHA class Ⅰ or Ⅱ ) of both sexes aged 18-45 yr undergoing repair: of ventricular septal defect and/or atrial septal defect under CPB were randomly divided into 2 groups ( n = 15 each): control group (group C)and remifentanil postconditioning group (group R). Anesthesia was induced with midazolam, sufcntanil, propofol and rocuronium. The patients received 5 min infusion of remifentanil at 4 μg · kg- 1 · min - 1 8 min before aortic unclamping in group R, while the patients received equal volume of normal saline in group C. Blood samples were obtained from the right internal jugular vein for determination of plasma concentrations of cardiac troponin-I (cTnI)and MDA and activities of CK-MB and SOD before induction of anesthesia (baseline) and at4, 8, 24 and48 h after aortic unclamping. Results The plasma concentrations of cTnI and MDA and activity of CK-MB were significantly lower, while the plasma SOD activity was significantly higher at 4 and 8 h after aortic unclmping, and the plasma concentration of MDA was significantly lower at 24 h after aortic unclamping in group R than in group C ( P ＜ 0.05 ). Conclusion Remifentanil postconditioning can attenuate myocardial I/R injury in patients undergoing open heart surgery under CPB through inhibiting lipid peroxidation.