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To explore the medication rules of herbal prescriptions for nonalcoholic fatty liver disease,and analyze the possible drug targets and interactions,in order to explore the mechanisms of the herbs. Randomized controlled trials of herbal prescriptions for treating nonalcoholic fatty liver disease were collected from CNKI,Wan Fang,VIP,Sino Med and PubMed databases. The properties,flavors and meridian tropism of herbs were analyzed by using systematic cluster analysis method with SPSS 19. 0 software. Subsequently,the association rules of herbs were analyzed by using Clementine 12. 0 software. Finally,the interactions between targets and relevant signaling pathways were analyzed by Traditional Chinese Medicine Systems Pharmacology Database(TCMSP),Search Tool for the Retrieval of Interacting Genes/Proteins(STRING) and Kyoto Encyclopedia of Genes and Genomes(KEGG). In the 88 prescriptions screened out,the commonly used herbs were Salvia miltiorrhiza,Bupleurum chinense,Alisma orientale,and Crataegus pinnatifida,and the potential signaling pathways were PPAR signaling pathway and calcium signaling pathway. The results showed that the main effects of herbal prescriptions were to improve blood flow/clear blood stasis,clear heatiness/dampness,promote digestion and strengthen spleen. And its mechanism of action may be achieved through the regulation of PPAR signaling pathway and calcium signaling pathway.
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Humans , Data Mining , Drugs, Chinese Herbal , Therapeutic Uses , Medicine, Chinese Traditional , Meridians , Non-alcoholic Fatty Liver Disease , Drug Therapy , Randomized Controlled Trials as Topic , Signal TransductionABSTRACT
Objective To investigate the clinical effects of laryngeal mask airway supreme and endotracheal intubation in patients undergoing laparoscopic cholecystectomy.Methods 90 patients with ASA grade Ⅰ-Ⅱ and normal blood pressure undergoing elective LC were randomly allocated to two groups: laryngeal masks group and tracheal tube group from March 2015 to March 2016.Changes in blood pressure,heart rate and postoperative throat pain degree before and after anesthesia were compared between the two groups.Results The blood pressure and heart rate were significantly increased in the patients than that of tracheal group after catheter insertion,and the blood pressure and heart rate of the patients in laryngeal mask group were not significantly changed.Throat and other complications incidence of the patients in the tracheal tube group was increased significantly after surgery than that in the laryngeal masks group.Conclusion The application of laryngeal mask airway general anesthesia method for the implementation of laparoscopic cholecystectomy has the advantages of easy operation and high safety,and it can help to maintain the stability of cardiovascular function.It is worthy of clinical application.
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Objective To observe the patients hemodynamic reactions to the different stimula-tions under different blood concentrations of propofol with remifentanil.Exerting the response surface methodology,the half of the maximum effective concentration of propofol and the interaction index of propofol with remifentanil were calculated.Methods A total of 120 patients for scheduled abdominal surgery,randomly divided into 12 groups(n = 10).TCI 12 different concentration combinations of propofol with remifentanil,also the the hemodynamic reactions to harmful stimulations of intubation and incising were observed.The data were analyzed by responding surface analysis.Results The in-teraction index of propofol and remifentanil under intubation was 0.523 0±0.223 7,that under inci-sing 0.361 3±0.148 4,half of the maximum effective concentration of propofol for intutation and in-cising was (6.878 7 ± 1.832 1 ) μg/ml and (4.41 1 6 ± 0.902 5 ) μg/ml respectively. Conclusion Propofol and remifentanil have a synergistic inhibitory effect on harmful cardiovascular reaction among Chinese.During the endotracheal intubation,the requirements of half of the maximum effective concentration of propofol and intensity of the synergy with remifentanil are greater than those during the incising.
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<p><b>BACKGROUND</b>There is few study to determine whether the use of the lightwand technique alone could achieve effective, safe and successful awake endotracheal intubation (ETI), therefore we designed a prospective clinical study to systematically evaluate the feasibility, safety and efficacy of awake ETI using the lightwand alone in patients with difficult airways.</p><p><b>METHODS</b>Seventy adult patients with difficult airways were enrolled in this study. After the desired sedation with fentanyl and midazolam, airway topical anesthesia was performed with 9 ml of 2% lidocaine, which were in order sprayed in three aliquots at 5 minutes intervals into the supraglottic (two doses) and laryngotracheal areas (one dose) using a combined unit of the lightwand and MADgic atomizer. After airway topical anesthesia, awake ETI was performed using a Lightwand. Subjective assessments by patients and operators using the visual analogue scores (VAS), and objective assessments by an independent investigator using patients' tolerance and reaction scores, coughing severity, intubating conditions and cardiovascular variables were taken as the observed parameters.</p><p><b>RESULTS</b>Of 210 airway sprays, 197 (93.8%) were successfully completed on the first attempt. The total time for airway spray was (14.6 +/- 1.5) minutes. During airway topical anesthesia, the average patients' tolerance scores were 1.7 - 2.3. After airway topical anesthesia, the mean VAS for discomfort levels that the patients reported was 6.5. Also airway topical anesthesia procedure was rated as acceptable and no discomfort by 94.3% of patients. The lightwand-guided awake ETI was successfully completed on first attempt within 29 seconds in all patients. During awake ETI, patients' reaction and coughing scores were 1.9 and 1.6, respectively. All patients exhibited excellent or acceptable intubating conditions. Cardiovascular monitoring revealed that changes of systolic blood pressure and heart rate at each stage of airway manipulations were less than 20% of baseline values. The postoperative follow-up showed that 95.7% of patients had no recall or slight memories of all airway instrumentation. The incidence of postoperative mild airway complications was 38.6%.</p><p><b>CONCLUSION</b>Alone use of the lightwand technique can achieve effective, safe and successful awake ETI in patients with difficult airways.</p>
Subject(s)
Adult , Humans , Middle Aged , Young Adult , Airway Obstruction , Anesthetics, Local , Conscious Sedation , Intubation, Intratracheal , Methods , Lidocaine , Prospective Studies , WakefulnessABSTRACT
Objective To investigate the effect of pre-emptive intrathecal (IT) administration of L-NAME, a non-selective nitric oxide synthase (NOS) inhibitor on calcitonin gene-related peptide (CGRP) expression in the dorsal horn of spinal cord in a rat model of neuropathic pain. Methods Ninety-six female adult SD rats weighing 220-310 g were randomly divided into four groups with 24 animals in each group : group A received IT 0.9% NaCl 15 min before sham operation; group B received IT 0.9% NaCl 15 min before right sciatic nerve ligation; group C received IT L-NAME 250 mg in 10?l 15 min before sham operation and group D received IT L-NAME 250 ?g in 10 ?l15 min before sciatic nerve ligation. The animals were anesthetized with intraperitoneal pentobarbital 50 mg?kg-1. A PE-10 catheter was placed in subarachnoid space with the tip of the catheter reaching the lumbar enlargement region. The animals were allowed to recover for 3-4 days and only those waking normally were used in the study. Right sciatic nerve was exposed and four loose ligatures were placed on the sciatic nerve according to the method described by Bennet. In sham operation the sciatic nerve was exposed but not ligated. The animals were sacrificed on the 1 st, 4 th, 7 th and 14 th day after operation. The lumbar segment of spinal cord was immediately removed. The CGRP expression in the ligated-side dorsal horn was assessed with immuno-histochemistry technique. Results In group B and D CGRP expression in the ligated side dorsal horn was significantly increased on the 4th, 7th and 14th day after operation as compared with that in group A. There was no significant difference in the CGRP expression in the ligated side dorsal horn between group A and C as well as between B and D. Conclusion Pre-emptive IT administration of L-NAME cannot inhibit the increase in CGRP expression in dorsal horn induced by peripheral nerve injury, suggesting that the neuropathic pain mediated by NO is not related to the release of calcitonin gene-related peptide.
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Objective To investigate the effect of intrathecal (IT) administration of L-NAME , a nonselective nitric oxide synthase (NOS) inhibitor, on c-fos expression in spinal cord induced by neuropathic pain. Methods Eighty-four female SD rats weighing 220-310g, which showed no signs of never injury 3 to 4 days after IT catheterization with the tip of catheter reaching the lumbar region, were divided into 4 groups at random: group A received IT 0.9% NaCl 10?g 15min before sham operation ( n = 16); group B received IT 0.9% NaCl 10?l 15min before ligation of sciatic nerve ( n =24); group C received IT L-NAME 10?l (250?g) 15min before sham operation ( n = 16); group D received IT L-NAME 10?l (250?g) 15min before ligation of sciatic nerve (n =24) . The animal in each group were further divided into 4 subgroups ( n = 4-6) and sacrificed on 1st, 3rd, 7th and 14th day after operation. In addition 4 rats which had received no operation of any kind were sacrificed and served as control. The c-fos expression in ipsilateral dorsal horn of spinal cord was detected by immunohistochemistry technique. Results In normal rats in control group (no IT catheterization, no operation) there were only a few fos-positive neurone (3.4? 0.9). The c-fos expression in the ipsilateral dorsal horn of spinal cord greatly increased both in group A and B. In group B there were more fos-positive neurons (FLIN) in the ipsilateral dorsal horn on the 3rd, 7th and 14th day as compare with group A. With pre-emptive intrathecal administration of L-NAME, the increase in ipsilateral c-fos expression induced by ligation of sciatic nerve was inhibited. In group D the number of fos-positive neurons in ipsilateral dorsal horn decreased by 53.8%, 57.1% and 43.2% on the 3rd, 7th and 14th day after operation as compare with group B. On the 1st day afteroperation there was no difference-in FLIN in the ipsilateral dorsal horn between group B and D. Conclusion Nitric oxide plays an important role in mediating the neuropathic pain which can be effectively attenuated or prevented by pre-emptive IT administration of L-NAME.
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A new upsurge of discussion about euthanasia was started in the late 1970s. More than 20 years later, although there is no improvement in the legislation of euthanasia, the voice to require euthanasia legalization has never stopped. Through the analysis of investigation among 519 full - time technical college students, we consider that the condition for legalizing euthanasia has matured in our country.