BACKGROUNDPerioperative disorder of magnesium, an important cation in the human body, may affect clinical anesthesia. The pharmacological data of propofol use, which is popularly used in the anesthesiology department and intensive care unit, is incomplete in Chinese patients. This study aimed to assess the effect of magnesium sulfate on the calculated plasma medial effective concentration (Cp50cal) of propofol at loss of response to command in Chinese females.

METHODSFifty patients undergoing gynecological laparoscopic surgery were randomly divided into the control group and the magnesium group. Before induction, magnesium sulfate (30 mg/kg) or placebo (equal volume of 0.9% saline) was given to patients in the magnesium group or the control group, respectively. Propofol was infused using a target-controlled infusion system, with a target concentration for each patient decided by up-and-down sequential allocation. After the equilibration between target plasma concentration and effective-site concentration, the state of consciousness was assessed. For determination of serum magnesium and calcium concentration, blood samples were taken before induction, after induction and at the end of surgery.

RESULTSThe Cp50cal was 2.52 µg/ml (2.47 - 2.57 µg/ml) for patients in the control group, and 2.46 µg/ml (2.41 - 2.51 µg/ml) for those in the magnesium group. A significant reduction of Cp50cal was observed (P = 0.021). There was a significant difference between the serum magnesium concentrations after induction and at the end of the surgery (P < 0.05). In the magnesium group, there was a trend toward decreasing after surgery, while in the control group, Cp50cal decreased significantly (P < 0.01).

CONCLUSIONSCp50cal of propofol at loss of response to command was 2.52 µg/ml (2.47 - 2.57 µg/ml) for Chinese female adults in this study. Infusion of 30 mg/kg magnesium sulfate may reduce the Cp50cal of propofol at loss of consciousness, which implies that magnesium may enhance the pharmacological effects of propofol.

Adolescent ; Adult ; Anesthetics ; therapeutic use ; Female ; Humans ; Magnesium Sulfate ; therapeutic use ; Middle Aged ; Propofol ; blood ; pharmacokinetics ; therapeutic use ; Unconsciousness ; chemically induced ; Young Adult

OBJECTIVETo study the effects of using Compound Danshen Injection (CDI) and low molecular weight heparin (LMWH) on early severe preeclampsia women.

METHODSRetrospective analysis was carried out in 95 patients with early severe preeclampsia from October 2008 to January 2011. They were assigned to 3 groups based on anticoagulant drugs. The routine therapy of magnesium sulfate (MgSO4) was given to the MgSO4 group (40 cases); the MgSO4 + CDI was given to those in the CDI group (23 cases), the MgSO4 + LMWH group was given to those in the LMWH group (32 cases). The general data of all patients were collected to analyze their effects on labor, postpartum hemorrhage, reasons for terminating the pregnancy, and maternal complications.

RESULTS(1) The average gestational week (weeks) of terminating the pregnancy was 31.7 +/- 1.9 in the MgSO4 group, 33.0 +/- 1.8 in the CDI group, and 32.8 +/- 1.7 in the LMWH group. The average weight of newborn babies (g) was 1 450.5 +/- 402.3 in the MgSO4 group, 1 582.2 +/- 332.5 in the CDI group, and 1 590.0 +/- 340.1 in the LMWH group. There was no obviously difference in the average gestational weeks or the average weight of newborn babies among the three groups. (2) The way of terminating the pregnancy was uterine-incision delivery. The main reasons for operation were sequenced as maternal complications, unsatisfied control of the blood pressure, and fetal distress. (3) The maternal complications in the three groups were sequenced as renal failure (12 cases), placental abruption (9 cases), hemolysis, increased liver enzymes and low platelet (HELLP) syndrome (8 cases). Sixteen (40.0%) had complications in the MgSO4 group, 12 (52.2%) in the CDI group, and 15 (46.9%) in the LMWH group. No statistic difference existed among the 3 groups.

CONCLUSIONSLMWH and CDI were helpful to improving the therapeutic effects of severe preeclampsia patients. They did not increase adverse drug reactions. They seemingly had effects on prolonging the gestational week.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Heparin, Low-Molecular-Weight ; therapeutic use ; Humans ; Magnesium Sulfate ; therapeutic use ; Phenanthrolines ; therapeutic use ; Pre-Eclampsia ; drug therapy ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies

OBJECTIVETo re-evaluate the effects of different "cocktail therapy" to prevent from phlebitis induced by Chansu injection.

METHODPatients treated with Chansu injection were divided randomLy into 4 groups with 90 per group, control group, phentolaminum group, the magnesium sulfate group-phentolaminum group, and anisodamine-phentolaminum group. Patients in the control group only received the routine nursing treatment, and patients in the various experiment group received different interventions. The comparison was made in the morbidity and the starting time of occurrence of phlebitis, the severity of pain, duration of pain.

RESULTThe morbidity of phlebitis was 8%, 8%, 6%, respectively. The starting time of phlebitis occurrence was (22 +/- 4), (27 +/- 5), (28 +/- 7) h, respectively. The NRS of pain was (4.75 +/- 1.51), (3.27 +/- 1.02), (2.71 +/- 1.63), respectively. The duration time of pain was (4.25 +/- 1.36), (2.51 +/- 1.05), (2.19 +/- 1.13) d respectively. In control group, the morbidity of phlebitis, the starting time of occurrence of phlebitis, the severity of pain, duration of pain was 30%, (16 +/- 4) h, (6.34 +/- 1.21), (5.47 +/- 1.07) d, respectively. As compared with the control group, a significance difference was found between every group in three test groups and control group respectively (P<0.05).

CONCLUSIONThe morbidity and the starting time of occurrence of phlebitis, the severity of pain, duration of pain was significantly reduced respectively by two different "cocktail therapy".

Adult ; Aged ; Animals ; Anura ; Bufanolides ; administration & dosage ; adverse effects ; Drug Therapy, Combination ; Humans ; Magnesium Sulfate ; therapeutic use ; Male ; Middle Aged ; Phentolamine ; therapeutic use ; Phlebitis ; drug therapy ; etiology ; prevention & control ; Solanaceous Alkaloids ; therapeutic use ; Young Adult

OBJECTIVETo investigate the effects of magnesium sulfate on traumatic brain edema and explore its possible mechanism.

METHODSForty-eight Sprague-Dawley (SD) rats were randomly divided into three groups: Control, Trauma and Treatment groups. In Treatment group, magnesium sulfate was intraperitoneally administered immediately after the induction of brain trauma. At 24 h after trauma, total tissue water content and Na(+), K(+), Ca(2+), Mg(2+) contents were measured. Permeability of blood-brain barrier (BBB) was assessed quantitatively by Evans Blue (EB) dye technique. The pathological changes were also studied.

RESULTSWater, Na(+), Ca(2+) and EB contents in Treatment group were significantly lower than those in Trauma group (P<0.05). Results of light microscopy and electron microscopy confirmed that magnesium sulfate can attenuate traumatic brain injury and relieve BBB injury.

CONCLUSIONSTreatment with MgSO4 in the early stage can attenuate traumatic brain edema and prevent BBB injury.

Animals ; Blood-Brain Barrier ; drug effects ; metabolism ; Brain Edema ; drug therapy ; pathology ; physiopathology ; Cerebral Cortex ; chemistry ; pathology ; Disease Models, Animal ; Magnesium Sulfate ; pharmacokinetics ; therapeutic use ; Neuroprotective Agents ; pharmacokinetics ; therapeutic use ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo observe the effect of low molecular weight heparin calcium (LMWHC) combined Compound Danshen Injection (DI) on nephrotic syndrome patients with early onset severe preeclampsia.

METHODSTotally 80 nephrotic syndrome patients with early onset severe pre-eclampsia were randomly assigned to four groups voluntarily, i.e., Group A (22 cases, treated by magnesium sulfate), B (19 cases, treated by magnesium sulfate plus LMWHC), C (21 cases, magnesium sulfate plus DI), D (18 cases, magnesium sulfate plus LMWHC and DI). Umbilical arterial S/D ratios, amniotic fluid index (AFI), prolonged gestational age, placenta weight, neonatal weight, and Apgar score were compared among the four groups.

RESULTSCompared with before treatment in the same group, umbilical arterial S/D ratios decreased in the four groups (P <0. 05). AFI decreased in Group A, while it increased in Group B, C, and D (P<0. 05). Compared with Group A at the same time point, umbilical arterial S/D ratios decreased, and AFI increased in Group B, C, and D (P <0. 01 , P <0. 05). Prolonged gestational age and neonatal weight were increased in Group B, C, and D (P <0. 01, P <0. 05). Placenta weight were increased in Group B and D (P <0. 05). Apgar scores at 1 and 5 min were improved in Group D (P <0. 05). Compared with Group B and C at the same time point, umbilical arterial S/D ratios decreased, and AFI increased in Group D (P<0. 05). Compared with Group B, prolonged gestational age and placenta weight were decreased in Group C, but prolonged gestational age and placenta weight were increased in Group D (P <0.05). Compared with Group C, prolonged gestational age, placenta weight, and neonatal weight were increased in Group D (P <0. 05).

CONCLUSIONTreatment of nephrotic syndrome patients with early onset severe pre-eclampsia by LMWHC combined DI could prolong gestational ages, obviously improve prenatal outcomes, with better effect obtained than using any of them alone.

Calcium ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gestational Age ; Heparin, Low-Molecular-Weight ; therapeutic use ; Humans ; Magnesium Sulfate ; Nephrotic Syndrome ; drug therapy ; Phenanthrolines ; Pre-Eclampsia ; drug therapy ; Pregnancy ; Salvia miltiorrhiza

OBJECTIVETo re-evaluate the effects of different treatments to prevent from phlebitis induced by Chansu injection.

METHODPatients treated with Chansu injection were divided randomly into 4 groups with 50 per group, control group, the magnesium sulfate group, phentolaminum group, and anisodamine group. Patients in the control group only received the routine nursing treatment, and patients in the various experiment group received different interventions. The comparison was made in the morbidity and the starting time of occurrence of phlebitis, the severity of pain, duration of pain.

RESULTThe morbidity of phlebitis was 8%, 8%, 6% respectively. The starting time of phlebitis occurrence was (21 +/- 9.31) , (22.34 +/- 10.15), (20.19 +/- 11.23) h, respectively. The NRS of pain was (4. 15 +/- 1.03), (3.26 +/- 1.17), (4.32 +/- 1.36), respectively. The duration time of pain was (4.05 +/- 1.21), (3.37 +/- 1.17), (3.19 +/- 1.67) d, respectively. In control group, the morbidity of phlebitis, the starting time of occurrence of phlebitis, the severity of pain, duration of pain was 24%, (17 +/- 6.32) h, (6.58 +/- 1.29), (5.32 +/- 1.12) d, respectively. As compared with the control group, a significance difference was found between every group in three test groups and control group respectively (P<0.05).

CONCLUSIONThe morbidity and the starting time of occurrence of phlebitis, the severity of pain, duration of pain was significantly reduced respectively by external appication of magnesium sulfate, anisodamine, and intravenous drip infusion of phentolaminum.

Adult ; Aged ; Aged, 80 and over ; Bufanolides ; adverse effects ; Female ; Humans ; Infusions, Intravenous ; Magnesium Sulfate ; therapeutic use ; Male ; Middle Aged ; Morbidity ; Phentolamine ; administration & dosage ; Phlebitis ; chemically induced ; prevention & control ; Solanaceous Alkaloids ; therapeutic use ; Time Factors

OBJECTIVETo investigate the effect of ischemic reperfusion(I-R) on the expression of P-selectin(Ps) of platelets, CD11b of leukocytes, monocyte chemotactic protein-1(MCP-1) mRNA of myocardial tissue and the protective role of MgSO(4).

METHODSIschemic reperfusion rat model was established in the experiments. All animals were randomly divided into 3 groups sham group, I-R group and Mg(2+) group. The expression of Ps of platelets and CD11b of leukocytes was determined by flowcytometry and the expression of MCP-1 mRNA of myocardial tissue was measured by RT-PCR admission and at 5, 30, 60, 180, 360 min of reperfusion (R5, R30, R60, R180, R360).

RESULTSThe expression of Ps of platelets in I-R group began to rise at R5 and peaked at R60 P<0.01); the expression of CD11b of leukocytes was significantly higher than that of the control groups P<0.01 and P<0.05) the expression of MCP-1 mRNA of myocardial tissue began to rise at R60,reaching the highest at R360 P<0.01) the concentration of Ca(2+) of the serum was significantly higher than that of the control groups P<0.01 and P<0.05). MgSO(4) inhibited the expression of Ps of platelets and MCP-1 mRNA of myocardial tissue and decreased serum Ca(2+)concentration, but did not affect the expression of CD11b of leukocytes.

CONCLUSIONI-R can increase the expression of cell adhesion molecules and cell chemotactic factor. MgSO(4) may protect myocardial tissue from ischemic reperfusion injury by inhibiting the expression of Ps of platelets and MCP-1 mRNA of myocardial tissue and decreasing the concentration of Ca(2+) of the serum.

Animals ; CD11b Antigen ; genetics ; Calcium ; blood ; Chemokine CCL2 ; genetics ; Gene Expression ; Magnesium Sulfate ; therapeutic use ; Male ; Myocardial Reperfusion Injury ; metabolism ; prevention & control ; P-Selectin ; genetics ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley

OBJECTIVEThere was consanguineous relationship between caspase-3 and early damage after hypoxia and ischemia. Caspase-3 plays a key role in the process of apoptosis in neuron. Magnesium sulfate could protect neuron from injuries, but the mechanism was not clear. The study was to investigate the expression of caspase-3 mRNA in the hippocampus of seven-day-old hypoxic-ischemic rats and the possible mechanism of neural protection with magnesium sulfate.

METHODSThe model of seven-day-old hypoxia-ischemia rats was established. The rats were divided randomly into 6 groups as follows: (1) normal control (n = 4); (2) sham surgery control (n = 4); (3) hypoxia-ischemia (n = 4); (4) sodium chloride injection with hypoxia-ischemia (n = 4); (5) magnesium sulfate pre-injection with hypoxia-ischemia (n = 4); (6)magnesium sulfate post-injection with hypoxia-ischemia (n = 4). The therapy groups received a bolus injection of 500 mg/kg magnesium sulfate intraperitoneally 0.5 hour before or after hypoxia-ischemia. Semi-quantitative RT-PCR was used to measure caspase-3 mRNA expression in the hippocampus 24 hours after hypoxia-ischemia.

RESULTSThe expression of caspase-3 mRNA was significantly increased in the hippocampus of the hypoxia-ischemia pups (1.88 +/- 0.36 vs 0.97 +/- 0.46, P < 0.05). The expression of caspase-3 mRNA in rats with magnesium sulfate pre-injection and post-injection decreased significantly (1.54 +/- 0.49, 1.65 +/- 0.48 vs 1.88 +/- 0.36, P < 0.05).

CONCLUSIONCaspase-3 was activated in the hippocampus of the seven-day-old rats 24 hours after hypoxia-ischemia. The suppression of the expression of caspase-3 mRNA in the hippocampus was probably related to the protective effect of magnesium sulfate on the brain injury of hypoxia-ischemia.

Animals ; Animals, Newborn ; Caspase 3 ; Caspases ; genetics ; Female ; Gene Expression Regulation, Enzymologic ; Hippocampus ; blood supply ; metabolism ; Hypoxia-Ischemia, Brain ; physiopathology ; prevention & control ; Magnesium Sulfate ; therapeutic use ; Male ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction

Objective: To describe the current status and trends in the outcomes and care practices of extremely preterm infants at 22-25 weeks' gestation age from the Chinese Neonatal Network (CHNN) from 2019 to 2021. Methods: This cross-sectional study used data from the CHNN cohort of very preterm infants. All 963 extremely preterm infants with gestational age between 22-25 weeks who were admitted to neonatal intensive care units (NICU) of the CHNN from 2019 to 2021 were included. Infants admitted after 24 hours of life or transferred to non-CHNN hospitals were excluded. Perinatal care practices, survival rates, incidences of major morbidities, and NICU treatments were described according to different gestational age groups and admission years. Comparison among gestational age groups was conducted using χ² and Kruskal-Wallis tests. Trends by year were evaluated by Cochran-Armitage and Jonckheere-Terpstra tests for trend. Results: Of the 963 extremely preterm infants enrolled, 588 extremely preterm infants (61.1%) were male. The gestational age was 25.0 (24.4, 25.6) weeks, with 29 extremely preterm infants (3.0%), 88 extremely preterm infants (9.1%), 264 extremely preterm infants (27.4%), and 582 extremely preterm infants (60.4%) at 22, 23, 24, and 25 weeks of gestation age, respectively. The birth weight was 770 (680, 840) g. From 2019 to 2021, the number of extremely preterm infants increased each year (285, 312, and 366 extremely preterm infants, respectively). Antenatal steroids and magnesium sulfate were administered to 67.7% (615/908) and 51.1% (453/886) mothers of extremely preterm infants. In the delivery room, 20.8% (200/963) and 69.5% (669/963) extremely preterm infants received noninvasive positive end-expiratory pressure support and endotracheal intubation. Delayed cord clamping and cord milking were performed in 19.0% (149/784) and 30.4% (241/794) extremely preterm infants. From 2019 to 2021, there were significant increases in the usage of antenatal steroids, antenatal magnesium sulfate, and delivery room noninvasive positive-end expiratory pressure support (all P<0.05). Overall, 349 extremely preterm infants (36.2%) did not receive complete care, 392 extremely preterm infants (40.7%) received complete care and survived to discharge, and 222 extremely preterm infants (23.1%) received complete care but died in hospital. The survival rates for extremely preterm infants at 22, 23, 24 and 25 weeks of gestation age were 10.3% (3/29), 23.9% (21/88), 33.0% (87/264) and 48.3% (281/582), respectively. From 2019 to 2021, there were no statistically significant trends in complete care, survival, and mortality rates (all P>0.05). Only 11.5% (45/392) extremely preterm infants survived without major morbidities. Moderate to severe bronchopulmonary dysplasia (67.3% (264/392)) and severe retinopathy of prematurity (61.5% (241/392)) were the most common morbidities among survivors. The incidences of severe intraventricular hemorrhage or periventricular leukomalacia, necrotizing enterocolitis, and sepsis were 15.3% (60/392), 5.9% (23/392) and 19.1% (75/392), respectively. Overall, 83.7% (328/392) survivors received invasive ventilation during hospitalization, with a duration of 22 (10, 42) days. The hospital stay for survivors was 97 (86, 116) days. Conclusions: With the increasing number of extremely preterm infants at 22-25 weeks' gestation admitted to CHNN NICU, the survival rate remained low, especially the rate of survival without major morbidities. Further quality improvement initiatives are needed to facilitate the implementation of evidence-based care practices.
Infant ; Infant, Newborn ; Male ; Humans ; Female ; Pregnancy ; Infant, Extremely Premature ; Gestational Age ; Magnesium Sulfate/therapeutic use* ; Cross-Sectional Studies ; Infant, Premature, Diseases/epidemiology* ; Infant, Newborn, Diseases ; Steroids ; Intensive Care Units, Neonatal ; China/epidemiology*

OBJECTIVETo observe the effect of magnesium sulfate, Nifedipine Tablet (NT) combined Salvia Injection (SI) on endothelin-1 (ET-1), nitric oxide (NO), thromboxane A2(TXA2), prostacyclin I2(PG2), and hemorheology of preeclampsia patients.

METHODSTotally 704 preeclampsia patients were randomly assigned to the treatment group and the control group, 352 cases in each group. All patients were treated with magnesium sulfate combined NT (on the first day: slow intravenous injection of magnesium sulfate 5 g + intravenous dripping of magnesium sulfate injection 10 g + oral administration of NT 30 mg; on the second and third day, intravenous dripping of magnesium sulfate injection 10 g + oral administration of NT 30 mg), while those in the treatment group were dripped with SI additionally at 20 mL per day for 3 consecutive days. Before and after treatment plasma levels of endothelin-1 (ET-1), nitric oxide (NO), TXA2, PGi2, and hemorheology indicators [such as high blood viscosity (HBV), low blood viscosity (LBV), plasma viscosity (PV), erythrocyte rigidity index (ERI), fibrinogen (FIB)] of two groups were detected.

RESULTSCompared with the same group before treatment, serum levels of ET-1, TXA2, HBV, LBV, PV, ERI, and FIB decreased in the two groups after treatment (P <0. 05), but levels of NO and PG2 increased (P <0. 05). Compared with the control group in the same period, levels of ET-1, TXA2, HBV, LBV, PV, ERI, and FIB decreased in the treatment group after treatment (P <0. 05), but levels of NO and PGI2 increased (P <0. 05).

CONCLUSIONMagnesium sulfate, NT combined SI could effectively regulate the balance of ET-1/NO and TXA2/PGI2, and improve hemorheology of preeclampsia patients.

Drug Therapy, Combination ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Endothelin-1 ; metabolism ; Epoprostenol ; metabolism ; Female ; Hemorheology ; Humans ; Injections ; Magnesium Sulfate ; administration & dosage ; pharmacology ; therapeutic use ; Nifedipine ; administration & dosage ; pharmacology ; therapeutic use ; Nitric Oxide ; metabolism ; Pre-Eclampsia ; drug therapy ; Pregnancy ; Salvia ; Tablets ; Thromboxane A2 ; metabolism