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Objective:To evaluate the effect of gender factor on efficacy of remimazolam combined with alfentanil in the patients undergoing gastrointestinal endoscopy.Methods:Two hundred patients, aged 18-64 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists Physical Status classificationⅠor Ⅱ, scheduled for elective gastrointestinal endoscopy, were divided into 2 groups ( n=100 each) according to gender: male group (group M) and female group (group F). Remimazolam 0.2-0.3 mg/kg and alfentanil 5-7 μg/kg were intravenously injected, remimazolam 0.5-0.7 mg·kg -1·h -1 was continuously infused during operation to maintain the modified observer′s assessment of alert/sedation score<3 points, and alfentanil 2 μg/kg was administered when necessary. The consumption of remimazolam and alfentanil, examination time, recovery time and time of post-anesthesia care unit stay were recorded. The satisfaction scores of examination physicians and patients were recorded. The occurrence of adverse reactions such as injection pain, intraoperative body movement, respiratory depression, hypotension, bradycardia and hiccups and postoperative dizziness, nausea, vomiting, fatigue, abdominal pain and abdominal distension were recorded. Results:There was no significant difference in the consumption of remimazolam and alfentanil, examination time, recovery time, satisfaction scores of examination physicians and patients between the two groups ( P>0.05). There was no significant difference in the incidence of respiratory depression, hypotension, bradycardia, injection pain, body movement, hiccups, abdominal pain, abdominal distension, and fatigue between the two groups ( P>0.05). Compared with group M, the time of post-anesthesia care unit stay was significantly prolonged, and the incidence of postoperative dizziness, nausea and vomiting was increased in group F ( P<0.05). Conclusions:Remimazolam combined with alfentanil provides better efficacy in male patients than in female patients undergoing gastrointestinal endoscopy.
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There is no fast-acting treatment strate-gies against Alzheimer's disease(AD),in particular dementia-related wandering.N,N-dimethyltryptamine(DMT)is a natural psychedelic that may have rapid-onset nootropic effects.In this study,5×FAD transgenic mice which recapitulated amyloid neuropathological features of AD received one single injection of 6 or 12 mg·kg-1 DMT and tested at 0.5,1,and 2 h thereafter in Y-maze for spatial memory.5×FAD transgenic mice exhibited pro-nounced decreases in time spent,number entered,and distance travelled in the novel arm of Y-maze.DMT at 12 mg·kg-1 partially or completely reversed the three behavioral indices at multiple time points,up to 2 h post injection.The rapid-onset behavioral improvement was consistent with pharmacokinetic analysis of DMT,showing approximately 30 min to reach the maximum concentra-tion in the brain tissue.The transgenic mice also displayed dramatically impaired hippocampal long-term potentiation(LTP),an electrophysiological feature of memory forma-tion and consolidation.DMT potently enhanced LTP and restored intracellular calcium activity,expression and phosphorylation of calcium/calmodulin-dependent protein kinase Ⅱ(CaMK Ⅱ)and AMPA-type glutamate receptor 1(GluR1),the two key calcium-activated mediators involved in LTP induction.Adenosine triphosphate(ATP)is purinergic signalling molecules that are involved in LTP induction and maintenance.DMT rapidly increased mito-chondrial ATP dynamics in in vivo and in vitro models.These results suggest that DMT rapidly improve spatial memory and hippocampal LTP by restoring the CaMK Ⅱ-GluR1 signaling pathway and mitochondrial ATP produc-tion.It may be served as a fast-acting nootropic agent for the treatment of AD in particular wandering.
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Cysteine protease inhibitor SN (CST1) is one of the members of type 2 Cystatin superfamily. It is widely expressed and distributed in mammals. It contains many types of CST proteins and is located on chromosome 20p11.2. Cystatin SN has a variety of biological functions and is involved in the occurrence and development of tumor genesis and metastasis, inflammation, cell cycle and aging.
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Objective:To observe the peripapillary atrophy (PPA) and peripapillary choroidal vascularity index (CVI) in patients with different degrees of myopia and to analyze their correlations.Methods:A cross-sectional clinical study. From September 2021 to December 2021, 281 mypoic patients of 281 eyes treated in Eye Hospital of Wenzhou Medical University at Hangzhou were included in this study, and the right eye was used as the treated eye. There were 135 eyes in 135 males and 146 eyes in 146 females. The age was 28.18±5.78 years. The spherical equivalent refraction (SE) was -5.13±2.33 D. The patients were divided into three groups: low myopia group (group A, -3.00 D <SE≤-0.50 D), moderate myopia group (group B, -6.00 D≤SE≤-3.00 D);high myopia group (group C, SE<-6.00 D). The spherical equivalent refraction was statistically different among the three groups ( H=241.353, P<0.05). All of the affected eyes were examined by swept-source optical coherence tomography. Combined with B-scan image,assessment and area measurement of β area, γ area (β-PPA and γ-PPA) were carried out on the en-face image. After binarization of the collected images, the nasal, superior, temporal and inferior CVI of the optic disc were calculated. For comparison between groups, one-way ANOVA was used for continuous variables with normal distribution, Kruskal-Wallis test was used for continuous variables with abnormal distribution, and categorical variables were used χ2 inspection. Linear regression analysis was used for the relationship between β-PPA and γ-PPA area and peripapillary CVI of different regions. Linear regression analysis was used to evaluate the relationships between the area of peripapillary atrophy and peripapillary choroidal vascularity index in different regions. Results:There was no statistical difference in the incidence of β-PPA among the three groups ( χ2=4.672, P=0.097). The incidence of γ-PPA in group A was lower than that in group B anc C, and the difference was statistically different ( χ2=33.053, P<0.001), in which both group A was lower than group B and C. Among the three groups, the area of β-PPA and γ-PPA was statistically significant ( H=36.535, 39.503; P<0.001, 0.001); the β-PPA area of group A and B was lower than that of group C; the γ-PPA area was group A <group B <group C. Peripapillary CVI of different regions in group A, group B and group C was statistically significant ( F=11.450, 5.037, 6.018, 4.489; P<0.05). The temporal CVI in group C was lower than that in group A and B; The inferior CVI of group C was lower than that of group A, and the superior and nasal CVI of group B and C were lower than that of group A. In multivariate analysis, SE ( β=0.374, P<0.001), temporal CVI ( β=-0.299, P<0.001) were correlated with the area of β-PPA (adjusted R2=296, P<0.001); AL ( β=0.452, P<0.001), temporal CVI ( β=-0.220, P<0.001) were correlated with the area of γ-PPA (adjusted R2=0.309, P<0.001). Conclusions:The incidence and area of γ-PPA are increased in the higher degree of myopia group. The area of γ-PPA is positively correlated with the axial length, and both the area of β-PPA and γ-PPA are negatively correlated with temporal CVI.
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Idiopathic macular hole after the internal limiting membrane (ILM) is removed during surgery, the intraoperative optical coherence tomography can be used to observe the presence of debris tissue (RF) protruding into the vitreous cavity at the edge of the hole. Current studies suggest that RF may be caused by epiretinal proliferation and vitreomacular traction, but it is still controversial, and the influence of postoperative anatomical and functional recovery is not clear. Common points can still be found, some of the studies suggest that RF is not conducive to postoperative anatomical and functional recovery during the operation, ILM fragments remain on RF tissues after ILM peeling and re-staining. However, in some studies suggest that RF is beneficial to postoperative anatomical and functional recovery, and ILM fragments on RF are removed. This suggests that whether ILM is removed on RF lead to a certain influence on the postoperative efficacy. There are few researches on RF at present, so it is necessary to understand RF from its essence and assist judgment through histological analysis.
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Suspension bed are often used to treat and nurse the wounds of burn patients in clinic. Because of the suspension force, the patients′ activities are limited, and they stay in bed for a long time, which is very easy to cause foot drop, affecting the recovery of the patients. Aiming at this problem, we designed and made a foot drop prevention baffle made of stainless steel, which could withstand the buoyancy of the suspension bed, adjust the feet forwardly and backwardly, to the left and right according to the height of the patients and the distance of the feet to be separated, and keep the foot in a positive and external rotation position according to the comfort of the patients, which achieved good results in clinical application.
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Children are a high-risk group of burn, and burn pain is a special type of pain. Because children of different ages have different cognitive ability and behavioral response to pain, thus it is particularly difficult to effectively evaluate the pain. It is very important for medical staff to understand the pain of children, to define the adverse reactions of pain, to evaluate and take appropriate pain intervention measures in time and effectively. In this paper, different evaluation methods of burn pain in children and non-drug intervention related measures were reviewed in order to provide references for clinical practice.
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Objective To explore the working mode of continuous malaria elimination. Methods Judong Village in Congjiang County, Guizhou Province, which had the highest record of malaria incidence in the history of Guizhou Province, was selected as a pilot, a comprehensive prevention and control intervention was carried out aiming at the malaria epidemic, transmission and influencing factors, and the effect was evaluated after the intervention. Results From 2015 to 2016, through those intensive measures of constructing system, improving environment and health education, the people’s awareness of malaria prevention was increased, the people’s enthusiasm and initiatives to participate in the prevention and control of malaria were improved in Judong Village. Meanwhile, the roads were hardened and beautified, the dispose of sewage, feces and garbage was centralized. The awareness rate of malaria prevention knowledge of residents increased to 85% to 95%, and the formation rate of anti-mosquito behavior increased to 89.66%. The density of media Anopheles reduced from 0.56 to 0.07 mosquitoes per hour each mosquito catching platform. Conclusion A long-term mechanism for malaria prevention and control has been almost constructed in Judong Village, which facilitates the consolidation of malaria control achievements, and the progress towards malaria elimination.
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Objective To explore the working mode of continuous malaria elimination. Methods Judong Village in Congjiang County, Guizhou Province, which had the highest record of malaria incidence in the history of Guizhou Province, was selected as a pilot, a comprehensive prevention and control intervention was carried out aiming at the malaria epidemic, transmission and influencing factors, and the effect was evaluated after the intervention. Results From 2015 to 2016, through those intensive measures of constructing system, improving environment and health education, the people’s awareness of malaria prevention was increased, the people’s enthusiasm and initiatives to participate in the prevention and control of malaria were improved in Judong Village. Meanwhile, the roads were hardened and beautified, the dispose of sewage, feces and garbage was centralized. The awareness rate of malaria prevention knowledge of residents increased to 85% to 95%, and the formation rate of anti-mosquito behavior increased to 89.66%. The density of media Anopheles reduced from 0.56 to 0.07 mosquitoes per hour each mosquito catching platform. Conclusion A long-term mechanism for malaria prevention and control has been almost constructed in Judong Village, which facilitates the consolidation of malaria control achievements, and the progress towards malaria elimination.
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Children with burns often have uncooperative behaviors such as crying and struggling when changing dressing because of pain and fear, which affects dressing change of medical staff and increases the psychological burden of the family members of children and dressing change personnel. In order to solve the above problems, the author′s team designs and makes the mobile soothing screen for pediatric dressing change. Dressing change personnel are isolated from the children′s sight through the screen′s shielding function, and the children′s favorite program showed on the tablet computer attracts the children′s attention. The wound dressing change is completed by using the disposal window on the screen, which has good clinical application effects.
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Objective To evaluate the clinical effect of electromagnetic navigation system to locate the distal locking screw of tibia intramedullary nail. Methods From February 2010 to December 2016, 79 cases of tibia shaft fractures requiring treatment with intramedullary nailing were selected and divided into the navigation group and free hand locking group according to intramedullary nail locking methods. Forty-four cases in navigation group used an electromagnetic navigation system to lock the distal end of the intramedullary nail,while 35 cases in free hand locking group used a free-hand technique. The intraoperative X-ray exposure time,distal locking time,healing time, and the success rate of one-time distal locking were recorded compared between two groups. Results The average time of diatal locking using electromagnetic navigation technology was less than that of the free hand locking group,and the exposure time of fluoroscopy was also reduced, the differences were significant(P ＜ 0. 05). There was no difference in fracture healing time between the two groups(P ＞ 0. 05), one-time success rate of navigation group was 100％,which was higher than 37. 34％ of the free hand locking group, the difference was significant(P ＜ 0. 05). Conclusion Compared with free hand technology, the advantage of using electromagnetic navigation system to lock the distal nail of tibia intramedullary nail is high efficiency, short locking time and no radiation.
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OBJECTIVE: To synthesize a prodrug of paclitaxel which is modified by palmitic acid at the 2'-hydroxyl position and prepare paclitaxel palmitate liposomes(PTX-PA-L), and then compare the pharmacodynamics and safety of PTX-PA-L in S180 tumorbearing rats with paclitaxel injection. METHODS: The derivative of paclitaxel was synthesized using 4-dimethylaminopyridine (DMAP) as acid binding agent and 1-(3-dimethylaminopropyl) -3-ethylenediamine(EDC) as dehydrating agent. PTX-PA was characterized by mass spectrometry and nuclear magnetic resonance spectroscopy(600 MHz 1H-NMR). PTX-PA-L were prepared using film dispersion-ultrasonic method. The particlesize and Zeta potential were measured using Malvern Zeta-sizer Nano S and the morphologywas characterized by TEM. The S180 sarcoma model in ICR mice was established to study the antitumor efficiency of PTX-PA-L in vivo. The hematological toxicity and body weight change of the mice were evaluated to study the safety of PTX-PA-L. RESULTS: The prodrug PTX-PA was synthesized successfully. The liposomes had good morphological characteristics and light blue opalescence and the particle size was(104.82 ± 1.23) nm. The pharmacodynamic study showed that compared with paclitaxel injection, PTX-PA-L had better antitumor efficacy on S180 tumor-bearing mice and the blood index indicated less decrease of white blood cells and neutrophils. CONCLUSION: PTX-PA-L can improve the antitumor efficacy significantly and reduce the toxicity of paclitaxel injection.
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Objective To establish a reversed phase high performance liquid chromatography method which couldb be ap-plied to determine the content of paclitaxel stearate(PTX-SA)and its bioactive metabolites paclitaxel(PTX)simultaneously. Methods Diazepam was chosen to be the internal standard and liquid-liquid extraction method was used for the preparation of sample solution with methyl tert-butyl ether.The two compounds were separated on Agilent Eclipse plus C18column (4.6 mm×250 mm,5 μm)with gradient elution by using mobile phase of acetonitrile(A)-methanol(B)-water(C),the detection wavelength was 227 nm and the column temperature was 30 ℃.The flow rate was 1 ml/min and the injection volume was 20 μl.Results The standard curve exhibited good linearity within the concentration of PTX-SA from 0.5-250 μg/ml(r=0.997 6)and PTX from 0.05-25 μg/ml(r=0.997 9),meanwhile the LOQ of PTX-SA and PTX were 0.15 and 0.05 μg/ml, respectively.The recoveries were both larger than 90% with RSD less than 5%.Moreover,the RSD of intra-day and inter-day assays were both less than 5%.Conclusion The method was simple,effective,stable and accurate which could be suitable for the determination of PTX-SA and PTX in pharmacokinetic study.
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Paclitaxel is a natural compound with efficient broad-spectrum antitumor activity .However ,the clinical ap-plication has been limited owing to the undesirable drawbacks ,such as the poor water-solubility ,cardiovascular toxicity and neurotoxicity .The design of paclitaxel prodrugs is an effective measure which can improve the drug's druggability ,alleviate its toxicity adverse effect and enhance its antitumor effect .With the in-depth research of prodrugs ,tumor-targeting paclitaxel pro-drugs which using the excessive receptors ,specific enzymes ,transporters ,reactive oxide species ,glutathione in tumor tissues as well as acidosis and hypoxia in tumors as specific targets ,have made great progress .The relevant literature about paclitaxel prodrugs were reviewed in this paper ,which targeted to the specific pathological and physiological features of tumor microenvi-ronment in recent years.
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Objective To investigate the relationship between mean platelet volume (MPV) and diabetic macular edema (DME) in type 2 diabetic patients.Methods The study included 4 patient groups:40 healthy control as group 1,40 diabetic patients without diabetic retinopathy(DR) as group 2,40 DR patients without DME as group 3,and 40 DR patients with DME as group 4.Then the collection of general information,fundus photograph and OCT were conducted for the measurement and comparison of serum levels of platelet parameters including platelet count (PLT),MPV,platelet distribution width (PDW) and plateletcrit (PCT).Results Significant differences were found in MPV and PDW among the four groups (all P ＜ 0.05),but there was no significant difference in PLT and PCT levels (all P ＜ 0.05).Furthermore,MPV and PDW level was (11.07 ± 1.06)fL and (13.57 ±2.25)fL in group 3,as well as (11.27 ±0.85)fL and (13.89 ± 1.76)fL in group 4,respectively,which were both significantly higher than those in group 1 [(10.41 ±0.63)fL and (11.93 ± 1.22)fL] as well as in group 2 [(10.38 ± 0.51) fL and (12.33 ± 1.28) fL] (all P ＜ 0.05).Both MPV and PDW levels of group 4 were higher than those of group 3,but there was no significant difference (P =0.254,0.388).As for males,MPV level was increased gradually in group 2 [(10.29 ±0.58)fL],group 3 [(10.67 ± 1.08)fL] and group 4 [(11.42 ±0.90) fL] (all P＜0.05),but there was no significant difference between group 1 [(10.27 ± 0.55)fL] and group 2.For females,MPV level was (11.37 ± 0.69) fL in group 3 and (11.13 ± 0.79) fL in group 4,both which were significantly higher than that in group 1 [(10.55 ± 0.70) fL] and group 2 [(10.42 ± 0.49) fL],respectively (all P ＜ 0.05),but there was no significant difference between group 3 and group 4 (P ＞ 0.05).Conclusion High MPV level may be an important risk factor for the development of DME in DR patients.Platelet parameter surveillance can aid in the monitoring of this disease.
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Objective To synthesize a lipophilic prodrug of triptolide (TP) and improve its druggability .Methods Trip-tolidestearate (TP-SA)was synthesized via the DMAP-catalyzed DCC method and identified by MS ,1H-NMR and 13C-NMR. The shake-flask method was used to study the oil/water partition coefficient .The preparations of TP and TP-SA liposomes and emulsions were compared .Their encapsulation efficiency and stability were investigated .Results TP-SA was synthesized suc-cessfully .Its log P in octanol/water system was 2 .33 .It was difficult to prepare TP liposome or emulsion .By contrast ,TP-SA liposome and emulsion can be prepared successfully with the same formulation process .The particle size of TP-SA lipo-somes were about 90 nm and TP-SA emulsions were about 110 nm .The encapsulation efficiency was above 95% .Their stabili-ty were studied at 4℃ and 25℃ .The preparation parameters ,such as particle size and encapsulation efficiency ,had no signif-icant change in a week .Conclusion Triptolide stearate enhanced drug lipophilicity .Its druggability was improved significant-ly .These data can be used for the TP related drug design and development .
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Objective To study the different curative effect between r-tPA application and urokinase in the interventional therapy for acute and severe pulmonary embolism.Methods Analyzed the clinical date of 22 cases acute and severe pulmonary embolism patients,and classified them into two groups according to the application of r-tPA and urokinase to compare the changes of their blood pressure,heart rate,arterial partial pressure of oxygen,hemachrome and pulmonary arterial pressure before and after therapy,meanwhile,record the thrombolysis time that the two groups took.Results The thrombolysis effect time adopting urokinase was remarkably longer than that thrombolysis adopting r-tPA(P<0.05); The blood pressure,heart rate,arterial partial pressure of oxygen of the two groups gained remarkable improvement after therapy(P<0.05).The pulmonary arterial pressure of the urokinase group dropped obviously after operation(P<0.05),while the r-tPA group dropped not so significantly after operation.The hemachrome of the two groups did not dropped significantly after operation.Conclusion The r-tPA and urokinase are both effective to interventional therapy for acute and severe pulmonary embolism,while r-tPA can clearly shorten the time in thrombolysis and could reduce any bleeding risk.
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Molecular targeted therapy plays an important role in the treatment of gastrointestinal cancer.In recent years,a large number of targeted drugs have been developed and tested in clinical trials to verify their efficacy and security.The better efficacy and security of targeted drugs represented by monoclonal antibodies and tyrosine kinase inhibitors have been demonstrated in each phase of clinical trials.
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<p><b>OBJECTIVE</b>To explore the effects of rat bone mesenchymal stem cell (BMSC) transplantation on retinal neovascularization, and to observe the changes of hypoxia-inducible factor-1 alpha (HIF-1α) and vascular endothelial growth factors (VEGF) in rats with oxygen-induced retinopathy (OIR).</p><p><b>METHODS</b>Seventy-two seven-day-old Sprague-Dawley rats were randomly divided into three groups: normal control (CON), model (OIR) and BMSC transplantation. In the BMSC transplantation group, BMSCs were transplanted 5 days after oxygen conditioning. The phosphate buffered saline of the same volume was injected in the CON and OIR groups. The OIR model was prerpared according to the classic hyperoxygen method. At seven days after transplantation, retinal neovascularization was examined by retinal flat-mount staining and hematoxylin eosin (HE) staining. The expression of HIF-1α and VEGF proteins was examined by immunohistochemistry staining and Western blot analysis.</p><p><b>RESULTS</b>The retinal flat-mount staining results showed that the vessels were well organized in the CON group, but the vessels were irregularly organized, and lots of nonperfusion areas were observed in the OIR group. The large vessels were a bit circuitous, the retinal vessels were relatively organized, and less nonperfusion areas were noted in the BMSC transplantation group. The HE staining results showed that many neovessels and preretinal neovascular (pre-RNC) cells were observed on the internal limiting membrane in the OIR group. There were less pre-RNC cells in the BMSC transplantation group compared with the OIR group (P<0.01). The immunohistochemistry analysis showed that more HIF-1αand VEGFcells were observed in the OIR group compared with the CON group, and less HIF-1αand VEGFcells were observed in the BMSC transplantation group compared with OIR group (P<0.05). The Western blot analysis showed the expression of HIF-1α and VEGF proteins in the OIR group was significantly higher than that in the CON group. The expression of HIF-1α and VEGF proteins in the BMSC transplantation group was lower than that in the OIR group (P<0.01).</p><p><b>CONCLUSIONS</b>BMSC transplantation therapy could alleviate retinal neovascularization in OIR rats, and its mechanisms might be associated with the inhibition of the expression of HIF-1α and VEGF proteins.</p>
Subject(s)
Animals , Female , Male , Rats , Animals, Newborn , Hypoxia-Inducible Factor 1, alpha Subunit , Mesenchymal Stem Cell Transplantation , Rats, Sprague-Dawley , Retina , Chemistry , Retinal Neovascularization , Retinopathy of Prematurity , Metabolism , Therapeutics , Vascular Endothelial Growth Factor AABSTRACT
Objective:To investigate the effects of rocuronium in the intravenous anesthesia in children with cleft lip and palate repair.Methods:According to random number table,96 children with cleft lip and palate aged 1-3 years underwent general anesthesia for surgery were divided into 3 groups (n =32).The children in group A,B and C received intravenous injection of rocuronium at 0.6,0.9 and 1.2 mg/kg,respectively.The anesthesia effects were observed.Accelerometry (TOF-Watch(@) SX) was used to monitor neuromuscular transmission.Results:Intubating conditions ranged from good to excellent in all children.The onset time of anesthesia in Group C was significantly shorter(P ＜ 0.05),the duration of neuromuscular block was significantly longer in group C than in group A and B (P ＜ 0.05).The recovery index in group C was significantly longer than that in group A and B (P ＜ 0.05,A vs B,P ＞ 0.05).Muscle relaxant residual incidence in group C was higher than that in group A and B (P ＜ 0.05,A vs B,P ＞ 0.05).Conclusion:Rocuronium at 0.6 mg/kg or 0.9 mg/kg are effective for excellent tracheal intubation,with faster onset time and recovery time,low incidence of postoperative residual curarization(PORC) in children with cleft lip and palate repair.