ABSTRACT
Objective:To evaluate the safety of naborphine hydrochloride combined with propofol in painless colonoscopy diagnosis and treatment of hypertensive patients.Methods:From October 2018 to September 2020, 900 patients with ASA grade Ⅰ to Ⅲ, aged 18 to 65, who underwent colonoscopy in Zhuhai Hospital Affiliated to Jinan University and Shanghai East Hospital Affiliated to Tongji University were prospectively selected. According to the random number table method, the patients were divided into 3 groups ( n=300): naborphine hydrochloride group 1 (N1 group, intravenous injection of 0.05 mg/kg naborphine hydrochloride); naborphine hydrochloride group 2 (N2 group, intravenous injection of 0.1 mg/kg naborphine hydrochloride); sufentanil group (SF group, intravenous injection of 0.1 μg/kg sufentanil). During anesthesia induction, propofol was combined with sedation, and the dose of propofol was 1.5 mg/kg. The systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), pulse oxygen saturation (SpO 2), respiratory rate (RR), and mean arterial pressure (MAP) of the three groups were compared before anesthesia (T 0), during induction (T 1), 1 min after induction (T 2), 2 min after induction (T 3), 3 min after induction (T 4) and 4 min after induction (T 5), and the bispectral index (BIS) were monitored. At the same time, the examination time, total dosage of propofol, recovery time, postoperative Visual Analogue Scale (VAS) score and perioperative anesthesia related adverse reactions of the three groups were compared. Results:There was no significant difference among the three groups in examination time, total dosage of propofol, recovery time, postoperative VAS score and adverse anesthetic reactions (all P>0.05). There was no significant difference in HR, SpO 2 and RR among the three groups at different time points (all P>0.05). The SBP, DBP and MAP in N1 group at T 1, T 3, T 4 and T 5 were lower than those in SF group (all P<0.05); The SBP, DBP and MAP in N2 group at T 1, T 3 and T 4 were higher than those in N1 group (all P<0.05). The BIS in T 3 and T 4 of N2 group was higher than that of N1 group (all P<0.05). Conclusions:0.1 mg/kg naborphine hydrochloride combined with propofol for painless enteroscopy in patients with hypertension has fine anesthetic effect and safety.
ABSTRACT
mRNA therapy, which involves the use of mRNAs as drugs for disease treatment, is a new kind of gene therapy. It can either treat diseases caused by gene deficiency or repair tissue through the expression of functional proteins, or be applied to immunothera-py through the expression of antigens, antibodies, or receptors, and is thus, of great value for various clinical applications. In tumor im-munotherapy, mRNA that encodes tumor-related antigens, or specific antigens, antibodies, or receptors enters the cytoplasm and is translated into proteins, which then induce specific immune responses, thereby enabling disease prevention and treatment. With the development of immunotherapy and mRNA technologies, mRNA therapy for malignant tumors and infectious diseases has entered the stage of clinical applications. This review briefly introduces the synthesis, purification, and modification of mRNA, with emphasis on mRNA-based tumor immunotherapy, clinical trial results, and key opportunities and challenges in the development of new drugs.
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Objective To evaluate the efficacy of parecoxib sodium for preemptive analgesia.Methods PubMed,EMBASE,Cochrane Library,and CNKI database were searched for randomized placebo-controlled trials involving the efficacy of parecoxib sodium for preemptive analgesia.The modified Jadad scale was used for quality assessment.Evaluation indexes included VAS scores at 1,6,12 and 24 h after operation,consumption of morphine within 24 h after operation,and incidences of nausea and vomiting after operation.Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0.2 software.Results Fourteen randomized placebo-controlled trials involving 1086 patients were included in our meta-analysis.The modified Jadad scale scores for the 14 studies were ≥ 4.The patients were divided into 2 groups:placebo group and parecoxib sodium 40 mg injected before operation group.The results of meta-analysis showed that VAS scores at 1,6,12 and 24 h after operation were significantly decreased,the consumption of morphine within 24 h after operation was reduced,and the incidences of nausea and vomiting after operation were decreased in parecoxib sodium 40 mg injected before operation group as compared with placebo group (P ＜ 0.05).Conclusion Intravenous injection of parecoxib sodium 40 mg before operation can produce significant preemptive analgesic efficacy and is helpful in decreasing the adverse effect of postoperative analgesia.
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Objective To investigate the effect of gabapentin on the activation of glial cells in the spinal cord after chronic constrictive injury (CCI) to sciatic nerve in rats.Methods Twenty-four male SD rats weighing 180-220 g were randomly divided into 3 groups (n = 8 each): group Ⅰ sham operation (group S), group Ⅱ CCI and group Ⅲ gabapentin + CCI. Right sciatic nerve was exposed and 4 loose ligatures were placed with 6-0chromic catgut. Seven days after operation gabapentin 50 mg/kg in 5 ml was given by intragastric gavage twice a day for 5 days in group Ⅲ. Paw withdrawal threshold to mechanical stimulation with von Frey filaments was measured one day before (baseline) and at 7, 15 d after operation. The animals were killed at 15 d after operation. The lumbar segment L4-5 of the spinal cord was removed. Immunohistochemical double mark technique was used to detect the activation of astrocytes and microglias in the spinal cord. Results Paw withdrawal threshold to mechanical stimulation was significantly decreased on the 7th and 15th day after CCI operation in group CCI as compared with group S. After 5 day treatment with gabapentin, the withdrawal threshold to von Frey hair stimulation was significantly higher in group Ⅲ than in group Ⅱ . The activation of astrocytes and microglias in the spinal cord was significantly enhanced in group CCI as compared with group S. Treatment with gabapentin significantly inhibited CCI-induced activation of astrocytes and microglias in the spinal cord. ConclusionGabapentin reduces neuropathic pain by inhibiting activation of glial cells in the spinal cord.