Pharmacokinetic study of five ingredients from Chitong xiaoyanling granules in rats / 中国药房

OBJECTIVE To study the pharmacokinetics of paeoniflorin， hesperidin， naringenin， formononetin and enoxolone from Chitong xiaoyanling granules in rats. METHODS Six male SD rats fasted but not deprived of water for 12 h were given Chitong xiaoyanling granules （5.0 g/kg） intragastrically at one time. Blood was collected from inner canthus of rats at different time points after administration. Plasma samples were pretreated with acetonitrile precipitated protein （sulfamethoxazole as internal standard）， and the concentrations of 5 ingredients in plasma were determined by liquid chromatography-tandem mass spectrometry （LC-MS/MS）. The pharmacokinetic parameters of each ingredient were calculated using DAS 3.0 software. RESULTS After intragastric administration of Chitong xiaoyanling granules， tmax and t1/2 of formononetin were the shortest among 5 ingredients （0.25 h and 0.39 h， respectively）. For naringenin and enoxolone， the tmax was shorter， but t1/2 was longer， and there was an obvious double-peak phenomenon in the drug-time curve of naringenin. Compared with the other three components， cmax and AUC of paeoniflorin and hesperidin were not directly proportional to the content of in vitro components. CONCLUSIONS Formononetin， naringin and enoxolone in Chitong xiaoyanling granules were absorbed rapidly in rats， while paeoniflorin and hesperidin were absorbed slowly.

Research on the time evolution trend and influencing factors of the mortality of major diseases of urban residents in China in 2011-2020 / 公共卫生与预防医学

Objective To explore the development trend and influencing factors of major diseases of urban residents, and to construct a prediction model of _heart disease mortality. Methods One-way analysis of variance (Duncan's test at a=0.05) and correlation analysis were used to analyze the significant differences between the different categories of disease mortality and the correlation with the influencing factors. The exponential function was used to fit the relationship between the proportion of the elderly population and the death rate of heart disease at various stages, and the prediction model of heart disease mortality was constructed through the stepwise regression equation. Results The mortality rate of heart disease and cerebrovascular disease showed a rising trend. The incidence of the four major diseases in men was significantly higher than that in women (P2 > 98, P<0.01). Conclusion According to the results of the survey, the influencing factors of major diseases and the high-risk population should be focused on prevention and treatment. It is recommended that the prevention and treatment of heart disease is carried out for the aged 60+ and the prevention and treatment of cerebrovascular diseases is carried out for the aged 80.

Effects of PDCA method on improving the accuracy of the Autar Deep Venous Thrombosis Scale / 中国实用护理杂志

Objective:To investigate the effects of PDCA method on improving the accuracy of the Autar Deep Venous Thrombosis (DVT) Scale used by nurses to assess the risk of deep venous thrombosis in surgical patients.Methods:Applied the way of PDCA, namely, raising questions, analyzing reasons, implementing measures, feeding back effects to professional explanate the difficulty in using the scale, moreover, training the nurses used level education method between August 2017 and December2018.The accuracy and consistency of the scale were compared before and after interventions.Results:A total 396 patients were evaluated in the study. There were significant differences in the consistency of evaluation among hospitalized, post-operative and discharged patients after intervention compared with before intervention ( P< 0.0167).The consistency of assessment of team members and responsible nurses increased from 68 to 120 cases, and the consistency of assessment reached 90.91%. The Kappa consistency of assessment of responsible nurses and team members increased from 0.354 before intervention to 0.879 after intervention. The effect was remarkable. Conclusions:PDCA cycle method is based on the problems found in clinical practice. It clarifies the professional terms and rules used in the scale, improves the accuracy and consistency of the Autar DVT scale used by nurses, correctly reflects the risk of thrombosis, ensures the safety of patients, and is worthy of promotion and reference.

A study of prospect and review on risk assessment tools for deep vein thrombosis / 中国实用护理杂志

Deep venous thrombosis (DVT) is an acute critical disease with high clinical incidence and easy to be misdiagnosed and missed. Not early assessment and effective prevention, it is very easy to lead to the occurrence of post thrombotic syndrome and pulmonary embolism, with high mortality and a serious threat to the life safety of the patients. The early and effective individual assessment of the DVT risk assessment tool is the basis for risk stratification and appropriate preventive measures. It is the key to reduce the incidence of DVT, misdiagnosis rate, missed diagnosis rate, incidence of complications and mortality. This paper is to review the research progress of individual DVT risk assessment tools at home and abroad, with a view to the same kind. The development of the research can be used for reference.

Clinical Observation of Entecavir Combined with Long-acting Interferon in the Treatment of HBeAg Positive Chronic Hepatitis B / 中国药房

OBJECTIVE:To observe therapeutic efficacy and safety of entecavir combined with long-acting interferon in the treatment of HBeAg positive chronic hepatitis B (CHB).METHODS:A total of 140 patients with HBeAg positive CHB selected from our hospital during May 2013-May 2015 were divided into observation group and control group according to random number table,with 70 cases in each group.Both groups received routine liver-protecting treatment;control group was additionally given Peginterferon α-2b injection 80 μg subcutaneously,once a week;observation group was additionally given Entecavir dispersible tablets 0.5 mg,po,qd,on the basis of control group.Both groups received treatment for consecutive 50 weeks.Clinical efficacies,liver function indexes before and after treatment,virological efficacies and the occurrence of ADR of 2 groups were observed.RESULTS:Each 5 cases withdrew from the study in 2 groups,and 130 cases (65 cases in each group) completed the study.Total response rate of observation group was 90.8％,which was significantly higher than 76.9％ of control group,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in the levels of ALT,AST,ALB or TBIL between 2 groups (P＞0.05).After treatment,the levels of ALT,AST and TBIL in 2 groups were decreased significantly,while ALB level was increased significantly,the observation group was significantly better than the control group,with statistical significance (P＜0.05).After 50 weeks of treatment,the negative conversion rate of HBV-DNA,HBeAg serology conversion rate and ALT normalizing rate of observation group were significantly higher than those of control group,and virologic breakthrough rate was significantly lower than control group,with statistical significance (P＜0.05).No severe ADR was found in 2 groups.There was no statistical significance in the incidence of ADR (P＞0.05).CONCLUSIONS:The entecavir combined with long-acting interferon show defmite therapeutic efficacy for HBeAg positive CHB,inhibit the replication of HBV and improve liver function of patients with good safety.

Observation on the therapeutic effect of interferon and Yanhuning combined with psychological intervention on children 's hand-foot-mouth disease / 中国生化药物杂志

Objective To investigate the clinical effect of combined treatment of children with hand foot and mouth disease Yanhuning combined with interferon, psychological intervention. Methods 80 children with HFMD in our hospital from January 2015 to March 2017 were selected,and according to the different treatment and nursing intervention divided into observation group and control group,40 cases in each groups. control group with routine nursing intervention in the observation group, interferon, interferon ,psychological nursing intervention mode of Yanhuning; the two groups of children with mental state improvement of clinical symptom, clinical resolution the treatment time and total efficiency, and the relevant data for comparative analysis. Results The psychological nursing mode of interferon Yanhuning (observation group) the clinical effect is better than that of interferon plus routine nursing intervention in children with hand foot and mouth disease (control group) the clinical effect of intervention, the psychological state of patients better than the control group, the clinical symptoms disappeared time was shorter than the control group, the total efficiency of treatment was higher than the control group, there was statistical significance the difference (P<0.05). Conclusion Children with HFMD selection effect of interferon psychological nursing intervention model of Yanhuning significantly, can effectively improve the clinical symptoms in children with mental state, fades in a short time, it is worthy of widely used intervention in children with hfmd.

Analysis study of the impact of JCI standard assisted with nursing performance appraisal system on nursing research / 中华医学科研管理杂志

Objective Set up a new performance management system with JCI standard that designed for improvement of nursing research.Methods Based on JCI standard,the new system was designed to be performed separately.Re-design a performance appraisal plan that will take account into nursing workload,care quality,nursing risk,nursing research,personal comprehensive quality etc.Results The average performance of the nurses in 42 wards had increased by 24.64％.In this system,research project application,and paper publishing was significantly improved.Projects Standardization was also improved.Enthusiasm of continuing education increased.Conclusions The system is helpful to improve the quality of nursing research.It can also help to assure the occupational stability of the clinical nurses and enthusiasm of nursing research.

Study on relationship between SLC26A4 gene IVS16+10C>T mutation and hereditary deafness / 中国中西医结合急救杂志

Objective To investigate the relationship between hereditary deafness and SLC26A4 gene IVS16+10C>T mutation.Methods One hundred and two patients with hereditary deafness admitted to the Third Affiliated Hospital of Qiqihar Medical College from January 2014 to May 2016 were enrolled and assigned as the observation group, and another 102 cases with normal hearing were selected as the control group. The gene mutation types and hearing thresholds were detected in the two groups and compared between them, the mutations of alleles 1 and 2 situations of patients with GJB2 and SLC26A4 mutations were analyzed, Ab initio software was used to predict whether there was obstacle preventing the recognition on slice sites, and polymerase chain reaction (PCR) was adopted to detect the common mutation types of SLC26A4 gene.Results In 102 patients with hereditary deafness, the cases caused by SLC26A4 gene mutations were more than those caused by GJB2 gene mutations (30 cases vs. 15 cases). Compared with the normal hearing control group, the mutation rates of GJB2 and SLC26A4 genes were significantly increased in the observation group [GJB2: 14.71% (15/102) vs. 2.94% (3/102), SLC26A4: 29.41% (30/102) vs. 1.96%(2/102), bothP T mutation, indicating that IVS16+10C>T gene mutation was not the cause of genetic deafness.Conclusion There is no obvious relationship between the IVS16+10C>T mutation of SLC26A4 gene and patients with hereditary deafness, which may provide a basis clinically for the prediction of deafness occurrence in the patient's next generation.

Therapeutic effect of carvedilol combined valsartan on patients with chronic heart failure / 心血管康复医学杂志

Objective:To explore therapeutic effect of carvedilol combined valsartan on patients with chronic heart failure (CHF).Methods:A total of 98 CHF patients were selected from our hospital from Feb 2012 to Dec 2014. According to random number table,they were randomly and equally divided into control group (received valsartan therapy) and combined treatment group (received valsartan combined carvedilol therapy).Therapeutic effect and incidence rate of adverse reactions were compared between two groups.Results:There were no significant differ- ence in all cardiac function indexes before treatment between two groups (P>0.05 all).After treatment,compared with control group,there were significant reductions in HR [(95±14)beats/min vs.(74±16)beats/min],left ventricular end-diastolic dimension (LVEDd)[(74.9±2.9)mm vs.(50.9±1.7)mm],left ventricular end-sys- tolic dimension (LVESd)[(64.9±3.8)mm vs.(45.7±2.0)mm],left ventricular end-diastolic volume (LV- EDV)[(198.7±60.5)ml vs.(165.9±52.3)ml]and left ventricular end-systolic volume (LVESV)[(148.9± 62.7)ml vs.(111.4±51.7)ml];and significant rise in left ventricular ejection fraction (LVEF)[(34.2±6.5)%vs.(56.9±10.1)%]and stroke volume (SV)[(68.4±5.1)ml vs. (81.5±6.0)ml]in combined treatment group,P<0.05 or <0.01.Total effective rate of combined treatment group was significantly higher than that of valsartan group (91.8% vs.71.4%),P<0.01.There were all no apparent adverse reactions in both groups.Con-clusion:The therapeutic effect of valsartan combined carvedilol is significant and its safety is good in patients with chronic heart failure.

Effect of Crossing Nape Electroacupuncture on Deglutition and Pulmonary Infection in Post-cerebral Infarction Patients with Tracheotomy and Tracheal Intubation / 上海针灸杂志

ObjectiveTo investigate the clinical promoting effect of crossing nape electroacupuncture on the recovery of swallowing function and recovery from pulmonary infection in post-cerebral infarction patients with tracheotomy.MethodSixty post-cerebral infarction patients with cough reflex disorder and swallowing dysfunction associated with pulmonary infection receiving tracheotomy and tracheal intubation were subjects. They were allocated, using a random number table, to three groups, 20 cases each. In each group, the patients were enrolled in order of visits. The three groups were given the same basic treatment for fighting inflammation, resolving phlegm and improving blood supply. The crossing nape electroacupuncture group received bilateral points Fengchi (GB20), Yifeng (TE17), Dicang (ST4)-to-Jiache (ST6) and Lianquan (CV23) acupuncture with electrodes connected by left-right crossing. The acupuncture group received bilateral points Fengchi, Yifeng, Dicang-to-Jiache and Lianquan acupuncture without electrodes connected. The control group received basic treatment with Western drugs without acupuncture therapy. Observations were carried out using the Kubota’s water drinking test, the Toshima Ichiro Swallowing Assessment and the Clinical Pulmonary Infection Score. The clinical therapeutic effects were evaluated in the three groups.ResultThe therapeutic effects evaluated using the Kubota’s water drinking test and the Toshima Ichiro Swallowing Assessment were better in the crossing nape electroacupuncture group than in the acupuncture group and better in the acupuncture group than in the control group (P<0.05). The score of the Clinical Pulmonary Infection Score decreased in all the three groups. The promoting effect on recovery from pulmonary infection was marked in the crossing nape electroacupuncture group (P<0.01).ConclusionCrossing nape electroacupuncture has a marked improving effect on dysphagia in post-cerebral infarction patients with tracheotomy and tracheal intubation. It can promote recovery from pulmonary infection in post-cerebral infarction patients with cough reflex disorder receiving tracheotomy and tracheal intubation.

Development and Evaluation of an Information Gathering Soft-ware Platform for Spleen System Inquiry in Traditional Chinese Medicine / 中国中医药信息杂志

Objective To develop an information gathering soft-ware platform for spleen system inquiry of TCM, and to discuss the practicability and feasibility of applying computer technology to standardizing management of TCM inquiry data. Methods Based on the TCM Spleen System Inquiry Scale, combined with clinical practice of TCM diagnosis and treatment, an inquiry information gathering soft-ware platform for TCM spleen system was designed. The platform was interfaced with B/S structure, and in the use of computer programming languages, the platform possessed the good functions of data collection, storage, query, export and print, etc. In addition to this, by calling the correct algorithm, it contents users with analysis and statistics on the target data set. Results The platform designed has been initially equipped with the functions of collecting, storing, inquiry, deleting, modifying, exporting and printing the inquiry-based four diagnostic data for TCM spleen system diseases. And to some extent, it also achieves standardization and objectification of the collection of TCM Spleen System Inquiry Scale. Conclusion It is practicable and feasible to applying computer technology into standardizing management of TCM inquiry informations. Besides, it could act as the direction for the research of TCM four diagnostic data in the future.

The inhibitory effect of bone morphogenetic protein 7 on proliferation of rat hepatic stellate cells / 中华传染病杂志

ObjectiveTo investigate the inhibitory effect of bone morphogenetic protein 7 (BMP7) on proliferation of rat hepatic stellate cells (HSC).MethodsHSC-T6 cells were cultured in vitro,and divided into four groups:control group,transforming growth factor (TGF) β1 group,TGFβ1 + BMP7 group,and TGFβ1 + BMP7 + Noggin group. The mRNA expressions of smad1,α-smooth muscle actin (α-SMA),gremlin and fibronectin (FN) were determined by semi-quantitative reverse transcriptasepolymerasechainreaction(RT-PCR).Theproteinexpressionsof phosphorylated-smad1/5/8 (P-smad1/5/8),α-SMA and gremlin were detected by Western blot.The statistical analysis were done using one-factor analysis of variance,LSD-t test,Dunnett's T3 test and Pearson linear correlation analysis.ResultsPhosphorylated-smad1/5/8,α-SMA,gremlin and FN were expressed on HSC-T6 cells in control group,which were significantly up-regulated after TGFβ1 stimulation (P＜0.05).The expressions of α-SMA,gremlin and FN were significantly down-regulated in TGFβ1 + BMP7 group compared with TGFβ1group, while P-smad1/5/8 expression was upregulated (1.613±0.031 vs.2.503±0.014; t=34.89,P＜0.05).The expressions of α-SMA,gremlin and FN in TGFβ1 + BMP7 + Noggin group were up-regulated than those in TGFβ1 + BMP7 group,while P-smad1/5/8 was down-regulated (t=34.05,P＜0.05).There was no difference of total smad1 mRNA expression among each group.ConclusionThese results collectively suggest that BMP7 strongly inhibits the expressions of α-SMA,gremlin and FN.

CD4+ CD25+ CD127dim/- regulatory T lymphocytes promote the proliferation and functions of hepatic stellate cells / 中华传染病杂志

ObjectiveTo investigate whether CD4+ CD25+ CD127dim/- regulatory T lymphocytes (Treg) can induce the proliferation of hepatic stellate cells (HSC) and expression of fibrosis-related factors on HSC in vitro and further to explore the mechanism of Treg inducing fibrogenesis. MethodsHSC LX-2 cells were subcultured.CD4+ CD25+ CD127dim/- cells were purified using magnetic cell separation. The HSC were co-cultured with Treg by direct contact or by Transwell system in vitro. The HSC cultured alone was used as control. Cell proliferation was measured by CCK-8 assay.The expression of transforming growth factor (TGF)-β1 was detected by enzyme-linked inmunosorbent assay (ELISA), and the expressions of hyaluronic acid (HA) and precollagen Ⅲ (PC Ⅲ ) were detected by radio immunoassay (RIA). The data were analyzed by LSD-t test. ResultsHSC proliferation was strongest when Treg∶ HSC= 1.5∶ 1. The absorbance in direct contact co-culture group and Transwell system co-culture group was (0. 713±0. 032) cpm and (0. 735±0. 028) cpm, respectively, both of which were higher than that in control group [(0. 677 ± 0. 029) cpm](t = 5. 4003 and 8. 7878,respectively; both P＜0. 01). The concentrations of TGF-β1 in the supernatant were (781. 59 ±76.45) pg/mL and (813. 53±60. 62) pg/mL, respectively in direct contact co-culture group and Transwell system co-culture group, which were significantly higher than that in control group [(722.51±59. 66) pg/mL](t = 4.0014 and 6. 1653, respectively; both P＜0.01).The concentrations of HA were (433. 575±27.90) ng/mL and (445.40±23.73) ng/mL, respectively in direct contact co-culture group and Transwell system co-culture group, which were higher compared to that in control group [-(415. 83±19.44) ng/mL](t =3. 3124 and 5. 5231, respectively; both P＜0.01). Likewise, the concentrations of PCⅢ were (21. 93± 1.71) and (23. 125± 1.87) ng/mL in direct contact group and Transwell group, respectively compared to (20. 10± 1.49) ng/mL in control group (t = 4. 8082 and 7. 9436, respectively; both P ＜ 0.01).Furthermore, the absorbance,concentrations of TGF-β1, HA and PC Ⅲ in Transwell co-culture group were all higher compared to direct contact group (t = 3. 3875, 2.1639, 2. 2107 and 3.1354, respectively; all P＜0. 05).ConclusionsThe cell proliferation and the expressions of fibrosis-related factors in HSC increase greatly after co-cultured with CD4+ CD25+ CD127dim/-Treg. Therefore, Treg may play an important role in inducing liver fibrogenesis.

In situ absorption and metabolism of stilbene glycoside in rat / 药物分析学报

Stilbene glycoside (TSG) has been shown to have many beneficial properties. It is therefore essential to understand the absorption and metabolism of TSG in detail. We determined the recovery of TSG and its metabolites (TSG sulfate/glucuronides) in rat gastric contents, gastric mucosa, portal vein plasma, celiac arterial plasma, bile, and urine after administration of 15mg of TSG in 0.5mL physiological saline or incubation for 20min in situ in the stomach of rats. Within 20min, (64.0±9.8)% of the administered TSG disappeared from the stomach; later, TSG was recovered in both free and conjugated forms in plasma and bile, but not in urine. On the other hand, only free TSG was detected in the gastric contents and mucosa; it was also detected in the portal vein plasma as (48.1±3.5)% of the total TSG (all forms of TSG). However, the proportion of free TSG in the celiac arterial plasma and bile decreased to 4%-10%. In addition, the proportion of free TSG to total TSG in the liver microsome incubation mixture after TSG was incubated in liver microsome at 37℃ for 30min was very low [(10.6 ± 2.6)%]. These results indicate that TSG could be quickly absorbed from the rat stomach, conjugated in liver and excreted in bile. Such novel information would be helpful for the use of TSG as a beneficial natural product which may improve its proposed efficacy in preventing chronic diseases.

Prediction value of the early prediction score system of multiple organ dysfunction syndrome in the elderly / 中华急诊医学杂志

Objective To evaluate the prediction value of the early prediction score system of multiple organ dysfunction syndrome in the elderly (MODSE). Method A total of 393 patients with pulmonary infection, who were above60 years old, were divided into non MODSE(n =224) and MODSE group(n = 169) and were scored by the early prediction score system of MODSE. Independent-samples t Test was used to analyze the difference of forecast score between MODSE and non MODSE group. Receiver operating characteristic (ROC) curve was drawn,and the area under the curve was calculated. The prediction accuracy of scores for MODSE was assessed using sen-sitivity and specificity, and the optimal forecast point for MODSE was found. Results The score of MODSE group was higber than that of non MODSE[(19.38±12.049) vs. (45.78±20.257), P <0.001]. The area under the ROC curve was 0.889 (P <0.001) ond 95% (0.857～0.920). As the value of forecast score was 27.5, the sensitivity of the early prediction score system of MODSE was 82.8 %, the specificity of the early prediction score system of MODSE was 80.3 %. Conclusions The early prediction score system of MODSE is valuable in predic-tion of MODSE, which may be used to forecast MODSE and find the high risk population of MODSE.

The reversal effect of tamoxifen on the expression of MDR1 in pancreatic cancer / 中国现代普通外科进展

Objective:To study the reversal effect of tamoxifen(TAM)on the expression of mdr1 in human pancreatic cancer cell lines.Methods:The inhibtion effect of TAM on pancreatic cancer cell line SW1999、Capan-Ⅱ and mammary cancer cell line T47D were studied;The influence of TAM on mdr1 protein/mRNA expression in SW1999、Capan-Ⅱ and T47D were studied using the method of flow cytometer and RT-PCR.Results:The high dose TAM could inhibit Capan-Ⅱ cell line.TAM could reverse the expression of mdr1 protein and mRNA in Capan-Ⅱ cell line and T47D cell line. Conclusion:The high dose TAM could inhibit Capan-Ⅱ cell line,maybe related with reduction of the expression of mdr1 protein and mRNA.

The effect of postoperative patient-controlled-epidural-analgesia on respiratory function in elderly patients / 中华麻醉学杂志

Objective To evaluate the effect of postoperative patient controlled epidural analgesia (PCEA) on respiratory function in patients aged over 65 years Methods 41 ASA Ⅰ Ⅱ patients (male 22,female 19)aged between 65 80 years, weighing 58 78kg, scheduled for upper abdominal surgery were divided randomly into two groups: control group(n=20)and PCEA group(n=21) Epidural block was performed at T 8 9 with an epidural catheter inserted cranially for 4 cm A test dose of 1 5% lidocaine 4 5ml was given via epidural catheter When epidural blockade was confirmed, general anesthesia was induced with diazepam 0 2mg?kg -1 ,etomidate 0 3 mg?kg -1 ,fentanyl 4?g?kg -1 and vecuronium 0 1mg?kg -1 ,and maintained with epidural 0 5% bupivacaine infusion (6 7ml/2h) combined with inhalation of low concentration of isoflurane and intermittent iv boluses of fentanyl and vecuronium For postoperative analgesia in control group intramuscular pethidine was given on demand; In PCEA group PCEA was used A loading dose of 3ml of 0 15% bupivacaine mixture (morphine 10mg and haloperidol 5mg/0 15% bupivacaine 100ml) followed by continuous infusion of 0 5 1ml/h Superimposed by boluses of 2ml with a lock out time of 25min The maximal amount of bupivacaine mixture was 8ml/h VAS, Bruggman′s comfort scale and Rawsay′s sedation score were evaluated BP, HR, respiratory rate (RR) and SpO 2 were measured and recorded every 30min 4 h after operation Vital volume, Forced vital capacity, forced expiratory volume (first second:FEV 1 0 ),PEEP, MMEF were measured before operation and on 1st,3rd,5th and 7th postoperative days Blood gas analysis was checked before operation, during operation (30min and 90min after induction of anesthesia) and the 1st,3rd, 5th and 7th postoperative days Results The total amount of narcotic in 72h was 11 36mg (morphine equivalent dose) in control group and 5 4mg in PCEA group VAS was higher in control group than PCEA group The postoperative respiratory function was significantly better in PECA group Conclusions In elderly patient after upper abdominal operation PECA can greatly improve the respiratory function with better analgesia

Effect of midazolam pretreatanent on neurotoxicity of ropivacaine in rats / 中华麻醉学杂志

Objective To investigate the preventive effect of midazolam pretreatment against neurotoxicity of ropivacaine and the underlying mechanism. Methods Thirty male SD rats aged 4-6 months weighing 250-300 g were randomly divided into 3 groups with 10 animals in each group: group Ⅰ blank control; group Ⅱ ropivacaine (R) and group Ⅲ midazolam-ropivacaine (M-R). In group R and M-R 0.75% ropivacaine was infused i.v. at a rate of 0.5 ml?min-1 until the animal developed convulsion. The animals were killed and brains were immediately removed for detennination of glutamate, aspartate, glycine and GABA content in the brain. Venous blood samples were taken for determination of pH and plasma concentration of lactate. The total amount of ropivacaine infused was calculated.Results The plasma lactate concentration was significantly higher and pH was significantly lower in group R than in blank control group. The concentrations of the 4 amino acids in the brain were significantly increased in group R and M-R as compared with the blank control group. The aspartate, glycine and GABA contents in the brain were significantly lower in M-R group than in R group. The total amount of ropivacaine infused i.v. was significant larger in group M-R than in group R.Conclusion Midazolam pretreatment can prevent the neurotoxicity of ropivacaine by modulating the balance between excitatory and inhibitory amino acids.