RESUMO
BACKGROUND: The 2022 ASA guidelines recommend the video laryngoscope, video stylet, and flexible videoscope as airway management tools. This study aims to compare the efficacy of three airway devices in intubating patients with difficult airways. METHODS: A total of 177 patients were selected and randomized into the following three groups: the video laryngoscope group (Group VL, n = 59), video stylet group (Group VS, n = 59), and flexible videoscope group (Group FV, n = 59). The success rate of the first-pass intubation, time of tracheal intubation, level of glottic exposure, and occurrence of intubation-related adverse events were recorded and analyzed. RESULTS: All patients were successfully intubated with three devices. The first-pass intubation success rate was significantly higher in Groups VS and FV than in Group VL (96.61% vs. 93.22% vs. 83.05%, P < 0.01), but it was similar in the first-pass intubation success rate between Groups VS and FV(P > 0.05). The number of patients categorized as Wilson-Cormack-Lehane grade I-II was fewer in Group VL than in Groups VS and FV (77.97% vs. 98.30% vs. 100%, P = 0.0281). The time to tracheal intubation was significantly longer in Group FV(95.20 ± 4.01) than in Groups VL(44.56 ± 4.42) and VS(26.88 ± 4.51) (P < 0.01). No significant differences were found among the three groups in terms of adverse intubation reactions (P > 0.05). CONCLUSIONS: In patients with difficult airways requiring intubation, use of the video stylet has the advantage of a relatively shorter intubation time, and the flexible videoscope and video stylet yield a higher first-pass intubation success rate and clearer glottic exposure than the use of the video laryngoscope. TRIAL REGISTRATION: Chinese Clinical Trial Registry. No: ChiCTR2200061560, June 29, 2022.
Assuntos
Intubação Intratraqueal , Laringoscópios , Humanos , Manuseio das Vias Aéreas/instrumentação , Manuseio das Vias Aéreas/métodos , Povo Asiático , Intubação Intratraqueal/efeitos adversos , Intubação Intratraqueal/instrumentação , Intubação Intratraqueal/métodos , Gravação em Vídeo , ChinaRESUMO
<p><b>OBJECTIVE</b>To explore the function and target pathway of the correlated differential gene of coronary heart disease (CHD) of blood stasis syndrome (BSS).</p><p><b>METHODS</b>Patients of the genealogical CHD of BSS (group A) and the genealogical CHD of non-BSS (group B), the genealogical non-CHD of BSS (group C), the genealogical healthy subjects (group D), the non-genealogical CHD of BSS (group E), the non-genealogical healthy subjects (group F) were recruited in this study. The differential gene expression spectrums were studied using gene chip technique. The molecular functions of differential genes were analyzed and illustrated by gene ontology (GO) analysis. The differential gene pathways were found out at BioCarta and KEGG. The meaningful target pathways were screened by hypergeometric distribution statistical method. The differential genes were verified using Real-time fluorescent quantitative PCR.</p><p><b>RESULTS</b>(1) By screening the gene chip data (with FC > or =3), we found the expressions of differential genes of CHD of BSS were mainly involved in chemokine, interleukin cytokine, alexin system, matrix metal proteinase system, fibroblastic growth factor, endothelial cell adhesion molecule, and so on. (2) By GO analysis of related differential genes (P < 0.05), we found the molecular functions of differential genes associated with CHD BSS. (3) By BioCarta and KEGG pathway analysis, we found the target pathways of the hereditary correlated differential genes of CHD BSS with significance were mainly involved in inflammation, plaque formation, endothelial injury, and so on. The results of Real-time fluorescent quantitative RT-PCR proved the accuracy of the gene chip.</p><p><b>CONCLUSION</b>The hereditary correlated differential genes of CHD BSS were closely associated with inflammation, plaque formation, and endothelial injury.</p>
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Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Estudos de Casos e Controles , Doença das Coronárias , Diagnóstico , Genética , Medicina Tradicional Chinesa , Métodos , Análise de Sequência com Séries de Oligonucleotídeos , Linhagem , TranscriptomaRESUMO
Syndrome is the core content of Chinese medicine. It is difficult to study in the present stage. The research thoughts on the heart blood stasis syndrome were explored in this paper by disease and syndrome combination, animal models, systems biology, and medical models, and so on.
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Animais , Humanos , Modelos Animais de Doenças , Medicina Tradicional ChinesaRESUMO
<p><b>OBJECTIVE</b>To research the plasmic metabolites and metabolic pathway of Xin-blood stasis syndrome (XBSS).</p><p><b>METHODS</b>Plasma metabolic products in patients of coronary heart disease (CHD) with XBSS or non-XBSS and subjects in the control group were identified by gas chromatographic mass spectrometry (GC-MS) type QP2010, the changes of their main elements in different groups were analyzed by principal components analysis (PCA) and partial least squares (PLS) analysis.</p><p><b>RESULTS</b>PCA showed that as compared with that in the control group, in the CHD-XBSS group, contents of lactic acid, beta-hydroxy butanoic acid, urea, oleic acid, octadecanoic acid and arachidonic acid were higher and that of citric acid was lower. PLS analysis showed significant difference between the control group and the other two groups, and the latter two groups tend to be of a same category. The occurrence of XBSS was positively correlated with octadecanoic acid, arachidonic acid, urea, lactic acid and beta-hydroxy, butanoic acid contents, and negatively correlated with oleic acid, L-proline, glycine, and citric acid contents. According to VIP, the degree of correlation between variables with drug interven- tion, from high to low, were ranked as arachidonic acid, octadecanoic acid, lactic acid, urea, beta-hydroxy butanoic acid, linoleic acid, glucose, alanine, oleic acid and proline. Discrepancy analysis on 11 changeful metabolites showed that the contents of arachidonic acid, octadecanoic acid, lactic acid, urea, beta-hydroxy butanoic acid and oleic acid increased in CHD patients, especially in those with XBSS (P < 0.01). In CHD patients, contents of lactic acid, beta-hydroxy butanoic acid, linoleic acid and glucose in patients of XBSS pattern were higher than in non-XBSS pattern (P < 0.01); content of linoleic acid, glucose, alanine and proline decreased in non-XBSS pattern while increased in XBSS pattern. Content of glucose in CHD-XBSS patients was significantly higher than that in the healthy control (P < 0.01). Content of citric acid was lower in CHD patients, and showed significant difference between that in CHD-XBSS patients and healthy control (P < 0.01).</p><p><b>CONCLUSIONS</b>The major plasmic metabolites in CHD-XBSS patients are arachidonic acid, octadecanoic acid, lactic acid, urea, citric acid, beta-hydroxybutyric acid, oleic acid, glucose, and alanine. Analyzed from plasmic metabolite spectrum view, CHD-XBSS is related with lipid metabolism and glyco-metabolism, also with the stress induced by hypoxia and agonia.</p>
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ácido Araquidônico , Sangue , Doença das Coronárias , Sangue , Diagnóstico , Diagnóstico Diferencial , Cromatografia Gasosa-Espectrometria de Massas , Ácido Láctico , Sangue , Análise dos Mínimos Quadrados , Medicina Tradicional Chinesa , Metaboloma , Metabolômica , Métodos , Análise de Componente Principal , Ácidos Esteáricos , SangueRESUMO
<p><b>OBJECTIVE</b>To explore the function of vascular endothelial cell (VEC) in patients with coronary heart disease (CHD) of Xin-blood-stasis syndrome.</p><p><b>METHODS</b>Some vasoactive substances produced by VEC were detected and analyzed in patients with CHD of or without Xin blood stasis syndrome in group A (n=112) and group B (n=108) respectively, also in patients with non-CHD but of Xin-blood-stasis syndrome in group C (n=110), and healthy persons in group D (n=100), including nitric oxide (NO), endothelin (ET), angiotensin H (Ag II), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule -1 (sVCAM-1).</p><p><b>RESULTS</b>The abnormality degree of ET, Ag II , sICAM-1 and sVCAM-1 in various groups showed such a tendency as group A> group B> group D (P < 0.01 or P < 0.05), while no significant difference in these criteria between group A and group C was shown (P > 0.05).</p><p><b>CONCLUSION</b>The vasoactive substances secreted by VEC are closely related to the formation and progression of CHD, and are likely to be important pathological markers of blood-stasis syndrome in CHD.</p>
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença da Artéria Coronariana , Diagnóstico Diferencial , Células Endoteliais , Metabolismo , Fisiologia , Endotelinas , Metabolismo , Molécula 1 de Adesão Intercelular , Metabolismo , Medicina Tradicional Chinesa , Óxido Nítrico , MetabolismoRESUMO
<p><b>OBJECTIVE</b>To explore the relationship between the insertion/deletion (I/D) polymorphism of angiotensin converting enzyme (ACE), and blood stasis syndrome (BSS) in patients with coronary heart disease (CHD).</p><p><b>METHODS</b>The ACE gene type in 48 patients of CHD of BSS type, 52 CHD patients of non-BSS type and 54 healthy subjects (control) was determined by PCR assay, also levels of endothelin (ET), angiotensin II (Ag II), and nitric oxide (NO) were determined.</p><p><b>RESULTS</b>Occurrence of DD genotype and allele genotype of ACE gene was higher in patients of BSS than that in patients of non-BSS and control (P < 0.01). ET/NO level was higher in patients of BSS than that in control (P < 0.01). ET and Ag II levels in patients of BSS were significantly higher than those in patients of non-BSS (P < 0.05) and control (P < 0.01). Levels of ET/NO and Ag II in subjects with DD genotype in various groups were higher than those in subjects with Ag II or ID genotype, the highest level occurred in patients of BSS with DD genotype, when compared with the other two groups, the difference in Ag II was significant (P < 0.05 and P < 0.01), when compared with control, the difference in ET/NO was significant (P < 0.01).</p><p><b>CONCLUSION</b>DD genotype of ACE gene may be the susceptible gene of CHD in patients of BSS type.</p>
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Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Alelos , Angina Pectoris , Genética , Angiotensina II , Sangue , Doença da Artéria Coronariana , Genética , Diagnóstico Diferencial , Endotelinas , Sangue , Predisposição Genética para Doença , Genética , Genótipo , Medicina Tradicional Chinesa , Óxido Nítrico , Sangue , Peptidil Dipeptidase A , Genética , Polimorfismo GenéticoRESUMO
<p><b>OBJECTIVE</b>To explore the dynamic change of Phlegm-stasis in the rat atherosclerotic model as the time goes on.</p><p><b>METHODS</b>Adopting high fat forage fed to develop the atherosclerotic model in rats, and the changes of blood lipid, hemorrheology, blood glucose, insulin and vascular smooth muscle cell (VSMC) actin expression were detected by biochemical and immunohistochemical assay at various time points after modeling.</p><p><b>RESULTS</b>The expression of VSMC actin gradually increased along with the change of model rats' Syndrome from Phlegm to stasis, i.e., the change of parameters, including blood lipid, hemorrheologic parameters, blood glucose, insulin and insulin sensitive indexes along with the aggravation of disease.</p><p><b>CONCLUSION</b>The expression of VSMC actin could be the molecular mechanism for the Syndrome developing from Phlegm to stasis in atherosclerotic rats.</p>