Effects of colloid preload on the incidence of hypotension in spinal anesthesia for cesarean section: a systematic review and meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#Hypotension is a common complication caused by spinal anesthesia (SA), which may have adverse impacts on the condition of the parturient and fetus. Liquid infusion was found to be relatively effective for reducing the incidence of hypotension. However, the question of whether colloid preload can optimize hemodynamic variables in the cesarean section remains controversial. This study aims to determine the effects of colloid preload on the incidence of hypotension induced by SA in elective cesarean section.@*METHODS@#Related keywords were searched on PubMed, EMBASE, and Cochrane Library from inception dates to May 2020. Studies included were evaluated for eligibility and quality. The primary outcome was the intra-operative incidence of hypotension and severe hypotension. The secondary outcomes included the lowest intra-operative systolic blood pressure, the maximal intra-operative heart rate, the intra-operative needs of ephedrine and phenylephrine, the incidence of maternal nausea and/or vomiting, and neonatal outcomes (umbilical artery pH and Apgar scores). Apart from the above, RevMan 5.3 was used for the data analysis.@*RESULTS@#Altogether nine randomized controlled trials were included in the meta-analysis. There were no significant differences in the incidence of intra-operative hypotension, severe hypotension, or neonatal outcomes between the colloid preload group and control group, except for the umbilical artery pH.@*CONCLUSION@#This meta-analysis suggests that colloid preload does not significantly reduce the incidence of hypotension associated with SA in elective cesarean section.

Neuromuscular Pharmacodynamics of Rocuronium in Diabetic Rats / 中国医学科学院学报

Objective To investigate diabetes-mediated changes in the neuromuscular pharmacodynamics of rocuronium in rats. Methods Diabetes mellitus was induced by a single injection of streptozotocin in rats.A total of 24 male SD rats were assigned to four groups using random number table:the normal control group,diabetic 2-week group,diabetic 4-week group,and diabetic 8-week group(6 rats per group).The sciatic nerve was stimulated in a rain-of-four(TOF)pattern,and the twitch tension changes in the tibialis anterior muscle were demonstrated by mechanomyography after intravenous injection of rocuronium in vivo.The time course characteristics of rocuronium,including onset time,and the recovery time from rocuronium injection to TOF ratio 75%(RT75%)and 90%(RT90%),were recorded,and half maximal inhibitory concentration(IC)values of rocuronium were determined using a four-parameter dose response curve. Results Compared with the normal controls,the diabetic rats had significantly prolonged onset time of rocuronium,while the RT75% and RT90% were decreased at all rocuronium doses(PConclusion Diabetes is associated with the rat skeletal muscle hyposensitivity to rocuronium,which is featured by prolonged onset time of rocuronium,decreased RT 75% and RT 90%,and right shift of the cumulative dose-response curve of rocuronium.

Effects of a monomer purified from Paris Polyphylla (PP-22) on proliferation and apoptosis of human gastric carcinoma MGC803 cells / 中国药学杂志

OBJECTIVE: To investigate the effects of a monomer purified from Paris Polyphylla (PP-22) on proliferation, apoptosis of human gastric carcinoma MGC803 cells and to study the sensitizing effect of PP-22 on the proliferation of MGC803 cells to chemo-therapeutic drugs 5-fluorouracil (5-Fu) or lobaplatin. METHODS: MTT assay and cell colone formation inhibitory assay were used to determine the inhibitory effect of PP-22 on human gastric carcinoma MGC803 cells. The sensitizing effects of PP-22 on MGC803 cells to chemotherapeutic drugs 5-Fu, lobaplatin were determined by MTT assay. The percentage of apoptotic cells and cell cycle distribution were determined by flow cytometry. The expression of cell apoptosis associated proteins were analyzed by Western blotting. RESULTS: MTT assay showed that PP-22 inhibited gastric carcinoma MGC803 cells proliferation in dose-dependent manner (r=0.90, P<0.05), but did not inhibit the growth of normal liver L02 cells at the same concentration. Cell colony formation inhibitory assay demonstrated that cell clones decreased with the increase of drug concentrations. The chemosensitivity of 5-Fu, or lobaplatin combined with PP-22 was improved compared with PP-22 group, respectively. PI staining analysis showed that the cell cycle was arrested at S phase. Western blotting detecting showed that the expression of Caspase-9, Caspase-3 were downregulated, the anti-apoptotic protein Bcl-2 is downregulated and pro-apoptotic protein Bak upregulated. CONCLUSION: PP-22 inhibits proliferation and induces apoptosis of MGC803 cells effectively and also sensitizes MGC803 cells to chemotherapeutic drugs.