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ObjectiveTo compare the effects of programmed intermittent epidural bolus （PIEB） and continuous epidural infusion （CEI） on enhanced recovery after cesarean section. MethodsTotally 120 women scheduled to undergo elective cesarean section under combined spinal and epidural anesthesia， aged 18-45 years， with single fetus， full-term pregnancy （≥37 weeks）， ASA grade II or III， were recruited， with 60 cases in each group. At the end of the surgery， after a similar epidural loading dose， patients were randomLy assigned to receive either PIEB （6 mL·h-1 beginning 30 minutes after the loading dose） or CEI （6 mL·h-1， beginning immediately after the loading dose） for the maintenance of analgesia with 0.1% ropivacaine. At 2， 6， 12， 24 and 36 h postoperatively， VAS score was used to evaluate the composite pain， and Bromage Score was used to evaluate the degree of lower extremity motor block. The time to first flatus， time to first ambulation and the satisfaction scores were also recorded. ResultsThe VAS scores at 12， 24 and 36 h postoperatively and the lower extremity motor block scores at 6， 12 and 24 h postoperatively in the PIEB group were significantly lower than those in the CEI group （P < 0.01）. The epidural analgesic dosage was less in the PIEB group than that of the CEI group （P=0.002）. The time to first flatus and time to first ambulation were significantly shorter than those in the CEI group （P < 0.05）. The satisfaction scores were significantly higher in the PIEB group than in the CEI group （P < 0.05）. There was no significant difference in the first urination time after urinary catheter removal and the length of hospital stay between the two groups （P > 0.05）. ConclusionCompared with CEI， PIEB provides better postoperative analgesia， less motor block scores， lower epidural analgesic dosage， shorter the time to first flatus and defecation and time to first ambulation， and greater patient satisfaction， which is more consistent with the ERAS concept of analgesia.
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Objective To study the chemical constituents of the dried roots of Lepidium meyenii cultivated in Lijiang. Methods The samples were extracted by 90% alcohol, and then isolated by silica column, MCI, and HPLC. The structures of the isolated compounds were elucidated by NMR techniques including 2D NMR such as HSQC, HMBC, and COSY. The cytotoxic activity of the new compound against five cell lines (NB4, A549, PC3, SHSY5Y, and MCF7) was evaluated by MTT methods. Results Three macamides were isolated and identified as N-(3,4-dimethoxybenzyl) hexadec-9Z-enamide (1), N-benzyl-13-oxo-9E,11E-octadecadienamide (2) and N-(3,4-dimethoxybenzyl)-hexadecanamide (3) from this plant. Conclusion Compound 1 is a new compound named macalepidiumide A and shows no significant cytotoxic activity.
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Objective To study the chemical constituents from the whole plant of Swertia cincta. Methods The chemical constituents were purified by chromatographic methods such as silica gel column and Sephadex LH-20. The structures of these compounds were elucidated by MS, IR, and NMR analyses. Results Two compounds were isolated from S. cincta. Conclusion Compound 1 is a new compound named swercinctlactone A. Compound 2 is identified as (±)-gentiolactone and its configuration is confirmed by single crystal X-ray diffraction and optical specific rotation.
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An investigation on the chemical constituents of the 90% EtOH extract of Perovskia atriplicifolia led to the isolation of fifteen compounds from the EtOAc fraction. Based on the detailed spectral analysis (MS, 1D and 2D NMR), as well as comparison with the literatures, the structures of compounds 1-15 were determined as cirsimaritin (1), salvigenin (2), syringaldehyde (3), vinyl caffeate (4), 2α, 3α-dihydroxyolean-12-en-28-oicacid (5), 2α, 3α-dihydroxyurs-12-en-28-oicacid (6), niga-ichigoside F1 (2α, 3β, 19α, 23- tetrahydroxyurs - 12-en-28-oicacid- O-β-D- glucopyranoside, 7), sericoside (8), 4-epi-niga-ichigoside F1 (2α, 3β, 19α, 24-tetrahydroxyurs-12-en-28-oicacid O-β-D-glucopyranoside, 9), 2α, 3β, 24-trihydroxyolean-12-en-28-oicacid O-β-D-glucopyranosyl-(1 --> 2) - β-D-glucopyranoside (10), pruvuloside A (11), asteryunnanoside A [2α, 3β, 23-trihydroxyolean-12-en-28-oicacid O-β-D-glucopyranosyl-(1 --> 2)-β- D- glucopyranoside,12], rosmarinic acid methyl ester (13), β-sitosterol (14), and daucosterol (15), respectively. Compounds 1-13 were isolated from the Perovskia genus for the first time. All the compounds were obtained from P. atriplicifolia for the first time.
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Drugs, Chinese Herbal , Chemistry , Lamiaceae , Chemistry , Magnetic Resonance Spectroscopy , Molecular Structure , Spectrometry, Mass, Electrospray IonizationABSTRACT
Objective To discuss a real-time fluorescence quantitative polymerase chain reaction (FQ-PCR) wether if can be used to detect Brucella. Methods According to the BCSP31 gene sequences specific for Brucella, one pair of primers and one TaqMan probe were designed. A real-time PCR was developed with the BCSP31 fragments cloned into PMD18-T vector. The standard cure was established and the sensitivity, the species specificity and the stability of the assay were evaluated. The clinical blood specimens were detected by QT-PCR and compared with clinical diagnosis. Results The standard curve was established with the standard template and the relationship between the Ct and the DNA copy number was linear(r=0.999). The sensitivity of the real-time PCR was 5 copies/μl. The sensitivity of the common PCR was 5×102 copies/μl. The sensitivity was about 100 times higher than common PCR. Species specificity of this FQ-PCR assay evaluated using genomic DNA from 6 Bmcella strains and 5 non-Brucella strains and strong fluorescence was detected in all Brucella strains. The CV of intra-assay and inter-assay reproducibility were 0.71%,7.23%, reprectively. Twenty-four specimens from clinical brucellosis cases, 19 showed positive, the positive coincident rate was 79%(19/24). The negative results were obtained for all 31 negative control, and the negative coincident rate was 100%(31/31). Two were positive from all 30 specimens clinically suspected. Conclusions Highly specific, sensitive, repeatable and coincidental with clinic, this FQ-PCR is quite useful for rapid detection of tiny DNA of Brucella in various samples and laboratory diagnosis.
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<p><b>OBJECTIVE</b>To investigate the effect of flurbiprofen preemptive analgesia combined with intravenous propofol anesthesia in induced abortion.</p><p><b>METHODS</b>Totally 175 women (ASA class I) undergoing induced abortion were randomized into 5 groups. In K10, K5, and K1 groups, the patients were given 50 mg flurbiprofen 10, 5 and 1 min before the operation, respectively, and in F group, 1 microg/kg of fentanyl was administered 10 min before the operation. All the 4 groups had intravenous induction with 2 mg/kg propofo1. The patients in P group received propofol at 2 mg/kg as the control group. The heart rate (HR), mean arterial pressure (MAP) and SpO2 were monitored during the operation, and the induction time, recovery time, propofol dosage and adverse effect were recorded. The anesthetic effect of the protocols was assessed according to the visual analogue scale (VAS) and the overall patient satisfaction.</p><p><b>RESULTS</b>HR, MAP, propofol consumption and the incidences of adverse effects during the operation were significantly higher in P group than in the other groups. F group had the highest incidence of respiratory depression among the 5 groups. The VAS in K10 group was significantly lower than that in K5 and K1 groups (P<0.05), but similar to that in F group (P>0.05). The overall patients' satisfaction was significantly higher than that in the other 4 groups.</p><p><b>CONCLUSION</b>Flurbiprofen preemptive analgesia combined with intravenous propofol is safe and effective for anesthesia during induced abortion.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Abortion, Induced , Analgesics , Therapeutic Uses , Anesthesia , Methods , Anesthetics, Intravenous , Therapeutic Uses , Drug Therapy, Combination , Flurbiprofen , Therapeutic Uses , Propofol , Therapeutic Uses , Time Factors , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To compare efficacy and side effects of patient-controlled epidural analgesia (PCEA) with levobupivacaine, ropivacaine and racemic bupivacaine after cesarean section.</p><p><b>METHODS</b>In this prospective, randomized double-blind study, 90 ASA I-II full-term nulliparous women (aged 25-38 years with body weight of 59-87 kg) undergoing elective cesarean section under spinal-epidural anesthesia equally allocated into 3 groups. PCEA was administered with 0.125% levobupivacaine and 20 microg/ml morphine (group L, n=30), 0.125% ropivacaine and 20 microg/ml morphine (group R, n=30), and 0.125% bupivacaine and 20 microg/ml morphine (group B, n=30), respectively. The Visual Analog Scale (VAS) score, satisfaction rate, patients' overall impression of treatment, modified Bromage motor score, and incidence of side effects were recorded at regular intervals after operation.</p><p><b>RESULTS</b>The three groups were comparable with respect to the efficacy of analgesia, patients' overall impression of treatment, motor blockade and side effects. There was significant difference in patients' satisfaction rate between group R (70%) and the other two groups (93.3% in group L and 96.6% in group B, P<0.05).</p><p><b>CONCLUSION</b>PCEA with 0.125% levobupivacaine and morphine 20 microg/ml produces better analgesic effect with little side effects after cesarean section.</p>