[Efficacy of Ropivacaine injection at acupoints for labor analgesia and its effect on breastfeeding and serum prolactin].

OBJECTIVE: To investigate the efficacy of acupoint injection of Ropivacaine for labor analgesia and its effect on breastfeeding and prolactin secretion. METHODS: A total of 80 primipara who asked to receive labor analgesia were randomized into epidural analgesia group (n＝35) and acupoint injection group (n＝36), and other 36 primipara who refused to receive labor analgesia were subjected to the control group. The labor analgesia began to be performed when the puerpera's uterine orifice opened about ≥3 cm (the first stage of labor), including puerpera controlled epidural analgesia (PCEA, Sufentainil ＋ 0.1% Ropivacaine hydrochloride, 5 µg/mL at L3-L4 interspace, till the birth of fetus) or acupoint injection of Ropivacaine (0.2%, 1 mL/acupoint) at bilateral Hegu (LI4) and Sanyinjiao (SP6). The delivery situations such as the duration of labor, and number of cases who used oxytocin, obstetric-forceps-aided delivery, cesarean delivery were recorded. The serum prolactin concentration was assayed by using ELISA. The visual analogue scale (VAS) scores at the time points of T0 (about 3 cm widening of the orifice of uterus and before performing analgesia), T1 (30 min after labor analgesia), T2(about 10 cm widening of the orifice of uterus) and T3(coming out of fetal head). The duration of labor, ratio of use of oxytocin, onset time of breastfeeding, and times of breastfeeding within 24 postpartum hours were recorded accordingly. RESULTS: The VAS scores at time-points of T1, T2 and T3 were significantly lower in both epidural analgesia and acupoint injection groups in comparison with their own T0 and the control group (P<0.05), and were also considerably higher in the acupoint injection group than in the epidural analgesia group (P<0.05). The duration of the 2nd stage of labor (from complete opening of the uterus orifice to complete birth of the fetus) was significantly longer, (P<0.05) and the number of oxytocin-using puerpera was obviously bigger in the epidural analgesia group than in the control group (P<0.05). After partum, the 1st breastfeeding time was obviously earlier and the frequency of breastfeeding notably increased in both epidural analgesia and acupoint injection groups than in the control group (P<0.05), the serum prolactin content was remarkably higher in the acupoint injection group than in the epidural analgesia group (P<0.05). No significant differences were found between the acupoint injection and the control groups in the duration of the 1st and 2nd stages of labor, and in the numbers of oxytocin-using puerpera, obstetric forceps-aided birth and cesarean delivery (P>0.05), and between the epidural analgesia group and control group in the serum prolactin levels (P>0.05)．. CONCLUSION: Injection of Ropivacaine at LI4 and SP6 is effective for labor analgesia and raising prolactin level, and favorable to breastfeeding in the early postpartum period.

The Construction of Sustained-Release Systems of Tanshinone IIA and Sodium Tanshinone IIA Sulfonate by SBA-15 Mesoporous Material.

The basic problems of the low dissolution rate of Tanshinone IIA (TSN) and the instability and precipitation of sodium tanshinone IIA sulfonate (STS) injection limit their usage in clinical. For these facts, the study aims to improve the dissolution rate of TSN and to enhance the sustained release effects of TSN and STS by using SBA-15 mesoporous molecular sieve as a drug carrier. Furthermore, controlling the pore size of SBA-15 and using different loaded methods to achieve expectations and provide a novel scheme for existing Danshen formulations. The effect of loading methods on drug loading efficiency (DL%), as well as the influence of the pore size of SBA-15s, the drug polarities and release mediums on drug loading and release behaviors were analyzed. It was found that the DL% was enhanced with the enlargement of the pore size, and was higher of TSN than STS. The in vitro tests of drug-loaded SBA-15s confirmed that the dissolution rate of TSN was improved obviously as compared with pure TSN. Moreover, SBA-15s prolonged the release times up to 12 h of TSN and 60 h of STS and promoted the sustained-release behaviors by decreasing the pore size. To ascertain the kinetic mechanisms of these samples, the Korsmeyer-Peppas release model was employed and the fitted results indicated that TSN/SBA-15s followed Fickian diffusion and non-Fickian transport was the predominant kinetic release mechanisms for STS/SBA-15s.

[Effects of different doses of dexmedetomidine combined with ropivacaine for brachial plexus nerve block in children undergoing polydactyly surgery].

OBJECTIVE: To observe the anesthetic effect and safety of different doses of dexmedetomidine combined with ropivacaine for brachial plexus nerve block in children undergoing polydactyly surgery. METHODS: Eighty children undergoing polydactyly surgery were randomized into 4 groups to receive brachial plexus nerve block with dexmedetomidine at 0.25, 0.50 or 0.75 µg/kg combined with 0.25% ropivacaine (0.20 mL/kg) (D1, D2, and D3 groups, respectively) or with 0.25% ropivacaine (0.20 mL/kg) only (control group). The onset time, duration of brachial plexus nerve block, awakening time, success rate, and incidence of complications were compared among the groups. Results In D2 and D3 groups, the onset time and awakening time were shorter and anesthesia lasted longer than those in the control group. The onset time and awakening time were shorter and anesthesia maintenance time was longer in D3 group than in D1 group. The success rates of brachial plexus nerve block were significantly higher in D1-3 groups than in the control group (P<0.05). Hematoma was found in one of the patients. In each of the 4 groups, laryngeal nerve block occurred in 1 child and respiratory depression in another; 2 or 3 patients had Horner syndrome, and 1 patient in D3 group experienced an episode of lowered heart beat to below 70 min-1. All the complications were managed properly and the patients all recovered uneventfully. CONCLUSION: Brachial plexus nerve block with 0.5 µg/kg dexmedetomidine combined with 0.25% ropivacaine (0.20 mL/kg) is safe for effective anesthesia in children undergoing surgery for polydactyly.

[Study on the Identification of Geographical Indication Wuchang Rice Based on the Content of Inorganic Elements].

Wuchang rice is a geographical indication product in China. Due to its high quality and low production, the phenome- non of fake is more and more serious. An effective identification method of Wuchang rice is urgent needed, for the maintenance of its brand image and interest of consumers. Base on the content of inorganic elements which are analyzed by ICP-AES and ICP-MS in rice, the identification model of Wuchang rice is studied combining with principal component analysis (PCA), Fisher discrimination and artificial neural network (ANN) in this paper. The effect on the identification of samples is poor through PCA, while the samples from Wuchang area and other areas can be identified accurately through Fisher discrimination and ANN. The average accurate identification ratio of training and verification set through Fisher discrimination is 93.5%, while the average accurate identification ratio through ANN is 96.4%. The ability to identify of ANN is better than Fisher discrimination. Wuchang rice can be identified accurately through the result of this research which provides a technology for the protection of geographical indications of this product.

Wendan decoction (温胆汤) for treatment of schizophrenia: a systematic review of randomized controlled trials.

OBJECTIVE: To assess the beneficial and adverse effects of Wendan Decoction (温胆汤, WDD) for the treatment of schizophrenia. METHODS: Five electronic databases were searched until May 2014, including the Chinese National Knowledge Infrastructure, the Chinese Biomedical Literature Database, the Chinese Scientist Journal Database, PubMed, and the Cochrane Central Register of Controlled Trials in the Cochrane Library. The randomized controlled trials (RCTs) testing WDD against placebo, antipsychotic drugs, or WDD combined with antipsychotic drugs against antipsychotic drugs alone were included. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards. RESULTS: Thirteen RCTs (involving 1,174 patients) were included and the methodological quality was evaluated as generally low. The pooled results showed that WDD combined with antipsychotic drugs were more effective in clinical comprehensive effect, Positive and Negative Syndrome Scale (PANSS) scores and Brief Psychiatric Rating Scale scores compared with antipsychotic drugs alone. However, WDD had less effectiveness compared with antipsychotics in clinical comprehensive effect; and WDD was not different from antipsychotic drugs for PANSS scores. The side effects were significantly reduced in the intervention group compared with the control group. CONCLUSIONS: WDD appears to be effective on improving symptoms in patients with schizophrenia. However, due to poor methodological quality in the majority of the included trials, the potential benefit from WDD needs to be confirmed in rigorous trials and the design and reporting of trials should follow the international standards.

Combined theoretical and experimental study on high diastereoselective chirality transfer based on [2.2]paracyclophane derivative chiral reagent.

We report a paracyclophane N-Me thioamide chiral reagent for the asymmetric thio-Claisen rearrangement with high diasteroselectivity. Comparisons between candidate chiral reagent N-phenyl-N-([2.2]paracyclophan-4-yl)amide, N-methyl amide, N-phenyl thioamide, and N-methyl thioamide are made both by experiment and theoretical calculations to clarify the principle behind the high diasteroselectivity. Dynamic (1)H NMR phenomenon tested by varying temperature (VT) experiments has proved that N-Ph amides have triple splitting peaks, while N-Ph thioamide would reduce the number to two, further substituting the Ph to Me made dynamic phenomenon disappear. So the side chain is thought to be the most rigid in N-Me thioamide, which accounts for a structure prerequisite favoring high efficient chirality transfer. This is confirmed by theoretical calculation: remarkable energy difference exists between the Re and Si faces of the chiral molecule. To further clarify the possible pathways for thio-Claisen rearrangement, theoretical prediction is adopted. The result implies that the cisoid pathways will dominate the process. Further experiment confirmed this: with N-Me thioamide, the asymmetrical reaction affords γ-unsaturated thioamides in good yields and high diastereoselectivities up to 98%. After removing the thioamide auxiliaries under hydrolysis conditions, product ß,γ-substituted chiral alcohols reached high enantiopurity of 98% ee.

[Epidemiological characteristics of subclinical target organ damage in urban adult residents with hypertension in Tianjin and its relationships with renin-angiotensin-aldosterone system].

OBJECTIVE: To investigate the epidemiological characteristics of subclinical target organ damage (TOD) among urban adult residents with hypertension in Tianjin and evaluate its relationships with circulating renin-angiotensin-aldosterone system (RAAS). METHODS: An epidemiological survey was conducted on urban adult residents in Tianjin. The participants with uncomplicated hypertension were followed up to examine for target organ involvement, including left ventricular hypertrophy (LVH), carotid plaque or intima-media thickening (IMT), microalbuminuria (MAU) and estimated glomerular filtration rate (eGFR). Multivariate logistic regression was used to evaluate the relations between subclinical TOD and RAAS. RESULTS: A total of 1547 subjects with uncomplicated hypertension underwent further examinations for target organ involvement. The prevalence rates of LVH, carotid plaque, carotid IMT, MAU and eGFR < 60 ml×min(-1)×(1.73 m(2))(-1) were 37.7%, 38.2%, 35.4%, 33.7% and 4.4%, respectively. The prevalence rates were categorized according to the absence or presence of one marker, two or three markers of TOD at 20.5%, 34.7%, 33.7% and 11.1% respectively. According to the logistic regression analysis adjusting for age, gender, current smoking, current drinking, previous antihypertensive treatment, body mass index, mean systolic blood pressure, mean diastolic blood pressure, duration of hypertension and other risk factors, plasma renin activity (OR 0.870, 95%CI 0.791 - 0.958, P = 0.005) and plasma angiotensin II (OR 1.005, 95%CI 1.001 - 1.009, P = 0.021) levels were independently associated with LVH, serum aldosterone level was independently associated with carotid IMT or plaque (OR 1.025, 95%CI 1.000 - 1.050, P = 0.048) and MAU (OR 1.049, 95%CI 1.024 - 1.074, P < 0.001). CONCLUSION: Subclinical TOD is fairly common among urban adult residents with hypertension in Tianjin. And RAAS plays an important role in the pathogenesis of subclinical TOD.

Comparison of sirolimus- and paclitaxel-eluting stents in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction: a meta-analysis of randomized trials.

BACKGROUND: It has been reported that sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) have been more effective than bare-metal stents in reducing restenosis and cardiac events in a broad range of patients with coronary artery disease. However, it is unknown whether there might be differences between these two drug-eluting stents in terms of efficacy and safety in the setting of acute ST-segment elevation myocardial infarction (STEMI). HYPOTHESIS: The aim of the present study was to compare SES with PES in patients with acute STEMI undergoing primary percutaneous coronary intervention (PCI). METHODS: The published research was scanned by formal searches of electronic databases (PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials) from January 2001 to February 2010. Internet-based sources of information on the results of clinical trials in cardiology were also searched. RESULTS: A total of 4 randomized trials were included in the present meta-analysis, involving 1105 patients (550 in the SES group, 555 in the PES group). SES were significantly more effective in the reduction of angiographic binary (≥50%) restenosis (4.0% vs 9.6%, odds ratio 0.38, 95% confidence interval 0.19 to 0.74, P = 0.004) compared to PES. The differences between SES and PES were not statistically significant with respect to target vessel revascularization (TVR), stent thrombosis, cardiac death, and myocardial infarction. CONCLUSIONS: SES are superior to PES in reducing the incidence of restenosis in patients undergoing primary PCI for STEMI, with nonsignificant differences in terms of TVR, cardiac death, myocardial infarction, and stent thrombosis.