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There are two source plants for the traditional Chinese medicine Murrayae Folium et Cacumen (MFC) in Chinese Pharmacopoeia, i.e. Murraya exotica L. and M. paniculata (L.) Jack. Herein, a chemical comparison of M. exotica and M. paniculata by high performance liquid chromatography (HPLC) fingerprint analysis coupled with chemometrics and network pharmacology was performed. The main peaks in the fingerprints were identified by liquid chromatography coupled with ion trap/time-of-flight mass spectrometry (LC-IT-TOF-MS) and authenticated by references. The chemometrics results showed that the HPLC fingerprints of these two species were clearly divided into two categories using hierarchical cluster analysis (HCA) and principal component analysis (PCA), and a total of 13 significantly differentiated markers were screened out by orthogonal partial least squares-discriminant analysis (OPLS-DA). However, the following network pharmacology analysis showed that these discriminated markers were found to act via many common targets and metabolic pathways, indicating the possibly similar pharmacological effects and mechanisms for M. exotica and M. paniculata. The above results provide valuable evidence for the equivalent use of these two plants in clinical settings. Moreover, the chromatographic fingerprint analysis coupled with chemometrics and network pharmacology supplies an efficient approach for the comparative analysis of multi-source TCMs like MFC.
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Objective To explore the relationship of impaired brain function after emergency inhalation anesthesia of sevoflurane com -bined with nitrous oxide and cyclic AMP response element binding protein(CREB)signal pathway.Methods A total of 442 patients who were admitted into our hospital from January 2014 to April 2017 were selected as the object of this study.And these patients were divided into 3 groups according to different anesthesia ways,namely the inhalation anesthesia group(118 cases),the local anesthesia group(206 cases), and the control group(118 cases).The blood cyclic adenosine monophosphate(cAMP)concentration were examined by the mini mental state examination(MMSE)score scale.At the same time,the 60 rats were randomly divided into the anesthesia group(n=30)and the con-trol group(n=30).The learning and memory function of the two groups were evaluated by Morris water maze test,and the expressions of cAMP and CREB were measured.Results The blood cAMP concentration and MMSE score in the inhalation anesthesia group were signifi -cantly decreased after inhalation anesthesia(P<0.05).In the place navigation test,rats of the anesthesia group cost much more time to find the platform compared with rats in the control group, and rats of the anesthesia group encountered less times of crossing the platform com-pared with rats in the control group,and the difference was significant(P<0.05).Western blot showed that patients of the anesthesia group had lower cAMP and expression of p-CREB protein,with significant difference(P<0.05).Conclusion Brain function decline after sevoflu-rane inhalation anesthesia combined with nitrous oxide may induced by increasing the nucleus of the second messenger CAMP /Ca2+pathway and decreasing the expression of CREB.
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Objective To study the effect of passive motion from lower extremity on electromyography (EMG) activity of major muscles when the back under head down tilting state. Methods Thirty healthy subjects were selected. The EMGs of erector spinal and trapezius muscles were recorded and analyzed when human body was under head-down tilting at angel of 0°, 10°, 20° and 27° in static mode, respectively, in sway mode (along the axis of Z with frequencies of 120 and 140/min， respectively) and in vibration mode (along the axis of Y with frequency of 680/min) with the help of multifunctional test bed. Results In the static mode, the median frequency (MF) decreased with the increase of head-down titling angle; in the sway mode, the MF at each of 4 head-down tilting angles was smaller than that in the static mode. When the frequency was 120/min, the MF decreased with head-down tilting angle increasing, but when the frequency reached 140/min, the variation of MF became irregular. In the vibration mode, the MF increased with the increase of head-down tilting angle and was larger than that in the static mode. Conclusions In the static mode, the muscle fatigue increased with the head down tilting angle increasing; in the vibration mode, smaller head-down tilting angle should be selected to achieve better treatment effect; but in the sway mode, larger head-down tilting angle would be better, and the sway frequency should be set lower than 120/min to avoid potential damage due to excessive muscle fatigue.
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Objective: To summarize our experience in the anesthetic management of conjoined twins undergoing one-stage surgical separation
Methodology: Medical records of conjoined twins admitted to our hospital for treatment and considered for surgical separation from 1996 to present were retrospectively reviewed. Four cases of conjoined twins underwent one-stage surgical separation under general anesthesia. Preoperative evaluation was performed to determine the extent of anatomical conjunction and associated anomalies. Anesthesia was simultaneously induced in all conjoined twins. The intubation procedure was successfully performed with the head slightly rotated to each baby's side, followed by the administration of vecuronium. Anesthetic agents were administered according to the estimated weight of each baby. One case of conjoined twins underwent surgical separation with cardiopulmonary bypass due to shared hearts
Results: All conjoined twins were successfully separated. No significant respiratory or cardiac events occurred during surgery except for one twin, which died after separation because of complicated congenital heart disease
Conclusions: Accurate preoperative evaluation, respiratory and circulatory management, and close cooperation of the multidisciplinary team are important aspects of anesthetic management of conjoined twins surgery
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<p><b>OBJECTIVE</b>To investigate the feasibility of applying (1)H-NMR-based pattern recognition in the studies of serum metabonomics in chronic heart failure (HF).</p><p><b>METHODS</b>(1)H-NMR technique was applied for examination of the serum samples from 9 patients with chronic heart failure and 6 healthy individuals. The data were analyzed for pattern recognition through principal component analysis (PCA) and Orthogonal Partial Least Square (OPLS) to determine the differences in serum metabolites between the two groups. The recognition ability of the two analysis methods were compared.</p><p><b>RESULTS</b>The serum (1)H-NMR spectra of heart failure patients and healthy individuals were significantly different. The PCA method failed to distinguish the patterns between the two groups, but OPLS clearly differentiated the two groups.</p><p><b>CONCLUSIONS</b>(1)H-NMR technique is effective in the study of serum metabolomics in chronic heart failure. The serum metabonomics of patients with chronic heart failure and the healthy individuals are significantly different. OPLS pattern recognition method is superior to PCA method in that the former can remove the influence of non-experimental factors and provide an improved characterization.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Chronic Disease , Heart Failure , Blood , Metabolism , Least-Squares Analysis , Magnetic Resonance Spectroscopy , Methods , Metabolome , Metabolomics , Methods , Natriuretic Peptide, Brain , Blood , Pattern Recognition, Automated , Principal Component Analysis , Uric Acid , BloodABSTRACT
<p><b>OBJECTIVE</b>To evaluate the relationship between myocardial energy expenditure (MEE) level and cardiac function in chronic heart failure (CHF) patients.</p><p><b>METHODS</b>A total of 99 CHF patients were divided into 3 groups according to the LVEF (HFNEF > or = 50%, n = 37; HFREF1 35.1% - 49.9%, n = 30; HFREF2 < or = 35%, n = 32) or the New York Heart Association (NYHA II, n = 26; III, n = 42; IV, n = 31) criteria. Thirty patients with cardiovascular disease and without CHF served as controls. Routine examinations including serum CRP (ELISA) and plasma NT-proBNP (chemiluminescence sandwich ELISA) were made on the next morning after admission; echocardiography was performed on the third day after admission. LVMW, LVMWI, RWT, LVIDd, LA, LV, LVEF, LVFS, E/A, EDT, IVRT, Tei index and MEE were measured or calculated.</p><p><b>RESULTS</b>MEE was significantly higher in HFREF patients than in controls (P < 0.01) and similar between HFNEF patients and controls (P > 0.05). MEE increased in proportion to decrease of LVEF and increase of NYHA grades in CHF patients (all P < 0.05). Bivariate analysis confirmed that MEE was significant correlated with LVMW, LVMWI, RWT, LVIDd, LA, LV, LVEF (r = -0.540, P < 0.01), LVFS (r = -0.454, P < 0.01), E/A, EDT, IVRT, Tei index, NYHA grades, CRP and NT-proBNP.</p><p><b>CONCLUSION</b>MEE derived from standard echocardiographic measurements is an effective indicator for myocardial bioenergetics and significantly correlated with cardiac function in CHF patients, especially in CHF patients with reduced LVEF.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Case-Control Studies , Chronic Disease , Echocardiography, Doppler , Energy Metabolism , Heart Failure , Diagnostic Imaging , Metabolism , Myocardium , Metabolism , Ventricular Function, LeftABSTRACT
<p><b>OBJECTIVE</b>To investigate whether terbutaline affects alveolar liquid clearance after oleic acid-induced lung injury in rats.</p><p><b>METHODS</b>Forty healthy Wistar rats (weighing 250-280 g) were randomly divided into five groups (n=8 in each group): the normal control group (control group), oleic acid injury group (injury group), terbutaline-treated group (terbutaline group), terbutaline plus amiloride-treated group (terbutaline+amiloride group) and terbutaline plus ouabain-treated group (terbutaline+ouabain group). Acute lung injury model was induced by intravenous oleic acid (0.25 ml/kg body weight). 24 hours later, 1.5 microCi (125) I-labeled 5% albumin solution (5 ml/kg body weight) was dripped into the lungs through trachea. The alveolar liquid clearance rate, extravascular lung water content, and arterial blood gas were measured 1 hour thereafter.</p><p><b>RESULTS</b>At 24 hours after infusion of oleic acid, the rats developed pulmonary edema and severe hypoxemia, with the alveolar liquid clearance rate decreased by 49.2% and the extravascular lung water content elevated by 47.9%. Compared with the rats in the injury group, terbutaline (10(-4) mol/L) significantly increased the alveolar liquid clearance rate, decreased the extravascular lung water content and improved hypoxemia. The effect of terbutaline was partly blocked by amiloride and ouabain, which were inhibitors of sodium transport. Terbutaline increased the alveolar liquid clearance rate by 63.7%, and amiloride and ouabain reduced the alveolar liquid clearance rate by 54.7% and 56.8%, respectively.</p><p><b>CONCLUSIONS</b>Terbutaline can accelerate alveolar liquid clearance through increasing sodium transport to attenuate pulmonary edema, thus improving gas exchange, which may have therapeutical effect on pulmonary edema after acute lung injury.</p>