Analgesic effect of dezocine in different doses on elderly patients undergoing abdominal operation under general anesthesia and its influence on stress response to postoperative tracheal extubation.

OBJECTIVE: To study the analgesic effect of dezocine in different doses on elderly patients undergoing abdominal operation under general anesthesia and to investigate the influence of dezocine on stress response to postoperative tracheal extubation. PATIENTS AND METHODS: A total of 76 elderly patients undergoing abdominal operation under general anesthesia and postoperative analgesia in our hospital from January 2015 to January 2016 were selected, and patients treated with fentanyl were selected as the control group (fentanyl: 10 µg/kg, n=19). The patients were randomly divided into low-dose group (dezocine: 0.05 mg/kg, n=19), medium-dose group (dezocine: 0.1 mg/kg, n=19) and high-dose group (dezocine: 0.15 mg/kg, n=19). The patients in each group were intravenously injected with 0.1 mg/kg tropisetron. The tracheal catheter was withdrawn from patients in each group; the heart rate (HR), respiratory rate (RR), mean arterial pressure (MAP) and saturation of pulse oxygen (SpO2) of patients in each group before and at 10 min after tracheal extubation were recorded in detail; moreover, the visual analogue scale (VAS) score, Ramsay sedation score, occurrence rate of adverse reactions, Bruggrmann comfort scale (BCS) score and times of pressing analgesia pump after operation of patients in the four groups were evaluated at 4, 8, 12, 24 and 48 h after operation. RESULTS: Compared with those before operation, there were no statistically significant differences in HR, RR, MAP and SPO2 of patients in low-dose group, medium-dose group and high-dose group at 10 min after tracheal extubation, and HR, RR, MAP and SPO2 of patients in control group were significantly increased after tracheal extubation (p<0.05). The VAS scores of patients in low-dose group within 48 h were significantly higher than those in control group, medium-dose group and high-dose group (p<0.05). The Ramsay sedation scores of patients in low-dose group and medium-dose group were significantly lower than those in control group and high-dose group (p<0.05), and the BCS score of patients in low-dose group was lower than those in medium-dose group, high-dose group, and control group (p<0.05). Besides, the occurrence rates of postoperative adverse reactions of patients in control group and low-dose group were higher than those in medium-dose group and high-dose group (p<0.05), the times of pressing analgesia pump after operation of patients in low-dose group were more than those in control group, medium-dose group and high-dose group (p<0.05), and the times were reduced successively in low-dose group, medium-dose group, and high-dose group. Finally, the results of correlation analysis showed that the dose of dezocine was positively correlated with the Ramsay sedation score, but negatively correlated with the VAS score of patients. CONCLUSIONS: Dezocine can effectively enhance the analgesic effect on elderly patients receiving abdominal operation under general anesthesia in a dose-dependent manner. Moreover, dezocine can significantly reduce the stress response of elderly patients to postoperative tracheal extubation, and reduce the occurrence rate of adverse complications after abdominal operation under general anesthesia.

Combination therapy with metformin and fenofibrate for insulin resistance in obesity.

This randomized controlled study investigated metformin and fenofibrate, compared with metformin alone, for the treatment of peripheral insulin resistance in patients with simple obesity with hyperinsulinaemia but not diabetes. Participants were randomized to receive metformin (500 mg orally three times daily) plus either fenofibrate (200 mg orally once daily; n = 44) or placebo (n = 43) for 6 months. Blood pressure, free fatty acids (FFA), body mass index (BMI), lipid and insulin levels were recorded pre- and post-treatment. ß-Cell function and insulin resistance were measured by the homeostasis model assessment for insulin resistance (HOMA-IR) index. Both groups showed significant decreases in blood pressure, FFA, BMI and HOMA-IR relative to baseline. In addition, combined metformin and fenofibrate therapy showed significantly decreased fasting and postmeal insulin levels relative to baseline and relative to the placebo group. Both treatments were well tolerated. Metformin and fenofibrate can increase insulin sensitivity and recover ß-cell function in patients with simple obesity accompanied by insulin resistance.

Inhibition of the growth of human gastric carcinoma in vivo and in vitro by swainsonine.

In Europe, swainsonine has been studied widely for prevention of metastasis and cancer therapy. In order to investigate the effects and mechanisms of swainsonine on the human gastric carcinoma SGC-7901 cell, we carried out in vivo and in vitro experiments. After treatment with swainsonine, an effective dose and IC50 value of swainsonine for SGC-7901 cells were examined by MTT assay. Cell-cycle distribution and apoptotic rates were analyzed using FCM, and [Ca2+]i was measured using LSCM. The expression of p53, c-myc and Bcl-2 were determined using an immunocytochemical method. Simultaneously, 50 mice were divided randomly into five groups. Three groups were administrated swainsonine at dose of 3, 6 and 12 mg/kg body wt., two control groups were administrated N.S. 20 ml/kg body wt. and 5-Fu 20 mg/kg body wt., respectively, by intraperitoneal injection. The inhibition rate was calculated and pathological sections were observed. The growth of SGC-7901 cell is inhibited by swainsonine in vitro, with an IC50 value at 24 h of 0.84 microg/ml, and complete inhibition concentration is 6.2 microg/ml. After treatment with swainsonine at the concentrations of 0.5, 1.5 and 4.5 microg/ml for 24 h, the expression of apoptosis inhibiting gene p53 and bcl-2 decreases, and the apoptotic trigger gene c-myc increases markedly (p<0.05), as well as [Ca2+]i overloading, SGC-7901 cell is induced to apoptosis in the end. It is also found that the percentages of S phase are 38.8%, 39.7% and 29.6%, respectively (20.0% in control group and 23.2% in 5-Fu group). The rates of inhibition were 13.2%, 28.9%, 27.3%, respectively, when the nude mice were administered swainsonine (p<0.05 or 0.01). The structure of the tumor showed hemorrhage, necrosis and inflammatory cell infiltration. We therefore conclude that swainsonine could inhibit cell proliferation in vitro and the growth of human gastric carcinoma in vivo. The mechanisms of swainsonine-induced apoptosis may relate to [Ca2+]i overloading and the expression of apoptosis-related genes.

Measurement of the total cross section for hadronic production by e(+)e(-) annihilation at energies between 2.6-5 GeV

Using the upgraded Beijing Spectrometer, we have measured the total cross section for e(+)e(-) annihilation into hadronic final states at center-of-mass energies of 2.6, 3.2, 3.4, 3.55, 4.6, and 5.0 GeV. Values of R, sigma(e(+)e(-)-->hadrons)/sigma(e(+)e(-)-->&mgr;(+)&mgr;(-)), are determined.