ABSTRACT
Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) at Neiguan on dexmedetomidine-induced bradycardia in patients.Methods:Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 20-50 yr, weighing 48-60 kg, scheduled for elective gynecological surgery under general anesthesia, were divided into 2 groups ( n=30 each) using a random number table method: control group (group C) and TEAS group (group T). Dexmedetomidine 1 μg/kg was infused intravenously over 10 min followed by intravenous infusion 0.5 μg·kg -1·min -1 in two groups, and the patients in group T simultaneously received TEAS (frequency 2/100 Hz, disperse-dense wave, intensity 5-10 mA according to the current that could be tolerated) at bilateral Neiguan acupoints.The stimulator was only connected, and no current was given in group C. Before the infusion of dexmedetomidine (T 0) and at 10 min of dexmedetomidine infusion (T 1), mean arterial pressure (MAP) and heart rate (HR) was recorded, and electrocardiogram (ECG) was collected to calculate the PR interval, QT interval, QT interval, Tp-e interval and index of cardiac electrophysiological balance (iCEB). The development of arrhythmia was recorded. Results:Compared with the baseline value at T 0, HR was significantly decreased, and QT interval and PR interval were prolonged at T 1 in two groups, and iCEB was increased, and Tp-e interval was prolonged at T 1 in group C ( P<0.05). Compared with group C, HR was significantly increased, PR interval and Tp-e interval were shortened at T 1, and the incidence of bradycardia and atrioventricular block was increased in group T ( P<0.05). Conclusion:TEAS at Neiguan can decrease the risk of bradycardia induced by dexmedetomidine, and the mechanism may be related to shortening atrioventricular conduction time and reducing heterogeneity of ventricular repolarization in patients.
ABSTRACT
Objective:To evaluate the effect of electroacupuncture postconditioning on the expression of microRNA-1 (miRNA-1) in rats with arrhythmias induced by myocardial ischemia-reperfusion (I/R).Methods:Twenty-four clean-grade healthy adult male Sprague-Dawley rats, aged 2-3 months, weighing 280-320 g, were divided into 3 groups ( n=8 each) using a random number table method: sham operation group (S group), I/R group and electroacupuncture postconditioning group (EP group). The model of myocardial reperfusion arrhythmia was established by ligating the left anterior descending branch of coronary artery for 30 min followed by 30-min reperfusion in anesthetized rats.The artery was only isolated without ligation after thoracotomy in group S. Bilateral Neiguan acupoints were stimulated for 30 min starting from the time point immediately after reperfusion in EP group.The occurrence of arrhythmia during reperfusion was recorded.The rats were sacrificed at 30 min of reperfusion, and hearts were removed for examination of the pathological changes of the myocardium and for determination of miRNA-1 expression (by quantitative real-time polymerase chain reaction) and expression of Kir2.1 and connexin 43 (Cx43) (by Western blot). Results:Compared with S group, the incidence of arrhythmia was significantly increased, the expression of miRNA-1 was up-regulated, and the expression of Kir2.1 and Cx43 was down-regulated in I/R and EP groups ( P<0.05). Compared with I/R group, the incidence of arrhythmia was significantly decreased, the expression of miRNA-1 was down-regulated, and the expression of Kir2.1 and Cx43 was up-regulated in EP group ( P<0.05). The pathological changes of myocardium were accentuated in I/R and EP groups when compared with S group, and the pathological changes were significantly attenuated in EP group when compared with I/R group. Conclusion:The mechanism by which electroacupuncture postconditioning reduces the occurrence of reperfusion arrhythmia is related to up-regulation of Kir2.1 and Cx43 expression after down-regulation of miRNA-1 expression in rats.
ABSTRACT
Objective To evaluate the effects of different concentrations of desflurane on the electrophysiological stability of hearts in female patients.Methods Forty female patients,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 20-50 yr,weighing 45-77 kg,scheduled for elective surgery with general anesthesia,were divided into 2 groups (n =20 each) using a random number table method:0.6 MAC group (group D1) and 1.3 MAC group (group D2).The intravenous access was opened after admission to the operating room,midazolam 0.1 mg/kg,vecuronium 0.1 mg/kg,fentanyl 3 μg/kg and etomidate 0.3 mg/kg were injected intravenously,and mechanical ventilation was performed after tracheal intubation.The concentrations of desflurane reached 0.6 and 1.3 MAC in D1 and D2 groups,respectively.Twelve-lead electrocardiograms were collected before anesthesia induction (T1),at 5 min after intubation (T2) and at 20 min after reaching the set concentration of desflurane (T3).The QT interval and Tpe interval were measured,the QTc interval,Tp-e/QT ratio and index of cardiac electrophysiological balance were calculated,and the development of arrhythmia was also observed.Results The QT interval and QTc interval were significantly longer,and the Tp-e/QT ratio was lower at T3 than at T1,2 in two groups (P＜ 0.05).There was no significant difference in QT interval,Tp-e/QT ratio or index of cardiac electrophysiological balance at each time point between two groups (P＞0.05).No arrhythmia was found in neither group.Conclusion The clinical concentration of desflurane affects the electrophysiological stability of hearts to some extent in female patients without causing arrhythmia.
ABSTRACT
Objective To evaluate the effect of sevoflurane on the electrophysiological stability of i-solated rat hearts subjected to hypothermic perfusion. Methods Clean-grade healthy adult male Sprague-Dawley rats, weighing 280-360 g, were heparinized and anesthetized with pentobarbital sodium. Their hearts were excised and perfused in a Langendorff apparatus with K-H solution saturated with 95％ O2-5％CO2 at 37℃. Twenty-four Langendorff-perfused hearts were divided into 4 groups ( n=6 each) using a ran-dom number table method: control group ( C group ) , sevoflurane group ( S group ) , 32 ℃ hypothermia group ( H group) and 32℃ hypothermia plus sevoflurane group ( HS group) . After 15 min of equilibration, the isolated hearts were continuously perfused for 30 min with K-H solution at 37℃, with K-H solution con-taining 2. 3％ sevoflurane at 37 ℃, with K-H solution at 32 ℃, and with K-H solution containing 2. 3％sevoflurane at 32℃ in C, S, H and HS groups, respectively. Heart rate and monophasic action potential in three layers of the left ventricular anterior wall were recorded at 15 min of equilibration ( T0 ) and 30 of con-tinuous perfusion ( T2 ) , the transmural dispersion of repolarization ( TDR) were calculated, and the occur-rence of arrhythmia was observed. Results Compared with C and S groups, the heart rate was significantly decreased and TDR was enlarged at T1 , and the incidence of arrhythmia was increased in H and HS groups ( P<0. 05) . Compared with H group, TDR was significantly reduced at T1 , and the incidence of arrhythmia was decreased in HS group ( P<0. 05) . Conclusion Sevoflurane can improve the electrophysiological in-stability of isolated rat hearts subjected to hypothermic perfusion, and thus decrease the development of ar-rhythmia.
ABSTRACT
Objective To observe the clinical effect of Shenwuyizhi capsule in the treatment of vascular dementia.Methods According to the digital table method,80 patients with vascular dementia were divided into the treatment group and control group,each group with 40 cases.On the basis of routine treatment,the control group was treated with piracetam tablets,and the treatment group was treated by the Shenwuyizhi capsule.60 d for 1 course.Before and after treatment,the simple mental state examination(MMSE) scale scores,Blessed behavior scale scores were compared between the two groups.Results Before and after treatment,the MMSE score,Bcessed behavior scale scores of the two groups were significantly improved (all P ＜ 0.05).After treatment,the MMSE score,Bcessed behavior scale scores of the treatment group were (19.83 ± 5.24) points,(7.18 ± 4.21) points,respectively,which were better than those of the control group [(20.01 ± 4.89) points,(7.23 ± 3.99) points] (t =4.148,2.141,all P ＜0.05).Conclusion Shenwuyizhi capsule can improve the light,moderate cognitive function in patients with vascular dementia,and improve memory and computing power,directional force,and enhance patient behavior ability,and reduce dementia symptoms,with good curative effect in the near future.
ABSTRACT
Objective To explore the effect of Xiongbiyihao mixture in the treatment of coronary heart disease with angina pectoris.Methods 90 coronary heart disease patients with angina pectoris were divided into the treatment group( 60 cases) and control group( 30 cases).The control group was given routine westerm medicine therapy,and the treatment group was administered with Xiongbiyihao mixture at the base of the control group.Ater treatment,the heart disease attack frequency,duration,and degree,clinical symptoms and electrocardiogram changes of the two groups were observed.Results The total efficiency symptoms of and electrocardiogram of the treatment group was 95.0％,90.0％,respectively,and was higher than that of the control group(76.7％,73.3％ ) ( x2 =9.7,x2 =7.8,all P ＜ 0.05).Conclusion Xiongbiyihao mixture could effectively improve the coronary blood,reduce myocardial ischemia,and alleviate the symptoms of angina pectoris,chest tightness,chest pain.It is safe and effective in the treatment of angina pectoris,and worthy of clinical application.