Objective To evaluate the effect of midazolam on platelet activation in patients with coronary heart disease (CHD) .Methods Brachial venous blood samples 5 ml drawn from 10 healthy adult volunteers and 40 patients with CHD were anticongulated with 3.8 % sodium citrate. Platelet rich plasma (PRP) 3 ml was obtained by centrifngation at 800 rpm for 8 min. Experiment Ⅰ : Ten portions of PRP from healthy adult volunteers served as control group with 1 ml for each (group ⅠC, n = 10). Forty portions of PRP from patients with CHD were randomly divided into 4 groups (n = 10 each): ⅠM0, ⅠM1,ⅠM2 and ⅠM3. In group ⅠC and ⅠM0, midazolam was not added while in group ⅠM1 , ⅠM2 and ⅠM3, midazolam was added with the final concentration at 100, 200 and 400 ng/ml respectively and the PRPs were then incubated for 3 min. The platelet aggregation rote was determined using turbidimetric method. Experiment Ⅱ : After the remaining PRP was eentrifnged at 2000 r/ rain for 5 min, washed platelets (WPs) were obtained. Ten portions of WPs from healthy adult volunteers served as control group with 1 ml for each (group ⅡC, n = 10). Forty portions of WPs from patients with CHD were randomly divided into 4 groups (n = 10 each) : ⅡM0, ⅡM1, ⅡM2 and ⅡM3· In group ⅡC and ⅡM0, midazolam was not added while in group Ⅱ, ⅡM2 and ⅡM3, midazolam was added with the final concentration at 100, 200 and 400 ng/ml respectively and the WPs were then incubated for 3 min. The content of platelet cAMP and were measured by enzyme immunoassay. Results Platelet aggregation rate was significantly higher in group ⅠM0 than in group ⅠC(P<0.01). Compared with groupⅠM0, platelet aggregation rate was significantly decreased in group ⅠM2 and ⅠM3(P<0.01) but there was no significant change in group ⅠM1 (P >0.05). The content of platelet cAMP was significantly decreased while the level of TXB2 was significantly increased in group ⅡM0 as compared with group ⅡC (P < 0.01). Compared with group Ⅱ M0, the content of platelet cAMP was significantly increased (P <0.05 or 0.01) while the level of TXB2 was significantly decreased in group ⅡM2 and ⅡM3(P< 0.01), but there was no significant change in group ⅡM1 (P > 0.05). Conclusion Midazolam 200 and 400 ng/ml can inhibit the platelet activation through increasing the content of platelet cAMP and reducing the production of TXA2 in vitro.

Objective To explore the effects of fentanyl on expression of δ receptor and β-arrestin 1 in locus ceruleus of chronic morphinetolerant rats. Methods 40 male SD rats were randomly allocated to 5 groups with 8 cases in each group. Group NS received only normalsaline 1 ml/kg twice; Group M received morphine 10 mg/kg followed by normal saline 1 ml/kg; Groups MF1, MF2 and MF3 receivedmorphine 10 mg/kg followed by fentanyl 3, 6, 12 μg/kg respectively. All animals were killed on the 9th day after measurement of painthreshold. Locus ceruleus was removed for determination of the expression of mRNA (RT-PCR) and protein (Western blotting) of δ receptorand β-arrestin 1. Results The expression of δ receptor and β-arrestin 1 was significantly decreased in Group M than in Group NS (P<0.01).There was no significant difference in the expression of δ receptor mRNA and protein in Groups MF1, MF2 and MF3, and Group M (P>0.05).The expression of β-arrestin 1 mRNA and protein in Groups MF2 and MF3 significantly increased (P<0.05). Conclusion Fentayl with thedose of 6 and 12 μg/kg can dose-dependently increase the expression of β-arrestin 1 but δ receptor in locus ceruleus of chronic morphine tolerantrats.

Objective To investigate the effect of midazolam on expression of adhesion molecules on the platelet membrane surface in patients with coronary heart disease (CHD) .Methods Blood samples were taken from 10 healthy volunteers and 40 patients with CHD and anticoagulated with 3.8% sodium citrate. Platelet rich plasma (PRP) was obtained by centrifugation at 800 r/min for 8 min at room temperature. Ten volunteers served as control group (group E). The 40 patients with CHD were randomly divided into 4 groups ( n = 10 each) : group A, B, C and D. In group E and group A PRP was incubated without midazolam while in group B, C and D PRP was incubated with midazolam 100 (B) , 200 (C) and 400 ng?ml-1 (D) for 3 min. The inhibitory effect of midazolam on expression of CD154, CD41/61 and CD26p on the platelet membrane surface was determined by flow cytometry. Results The five groups were comparable with respect to age, sex (M/F ratio) , body weight, platelet count, bleeding and coagulation time. The expression of CD154, CD41/61 and CD62p on the platelet surface was significantly increased in patients with CHD. Midazolam 200 and 400 ng?ml-1 inhibited the expression of CD154, CD41/61 and CD62p on the platelet membrane surface in patients with CHD, whereas midazolam 100 ?g?ml-1 had no significant effect on CD154, CD41/61 and CD62p. Conclusion The expression of adhesion molecules on the platelet membrane surface is greater in patients with CHD than in healthy adults. Midazolam 200 and 400 ng?ml-1 can inhibit the expression of CD154, CD41/61 and CD62p on the platelet membrane surface.

Objective:To investigate changes of platelets and coagulation function in patients undergoing cardiac valvular replacement surgery during cardiopulmonary bypass(CPB).Methods: Thirty patients scheduled for elective cardiac valvular replacement were equally randomlized to 2 groups: control group and propofol group. In control group anesthesia was induced with midazolam 0.05 mg?kg -1,fentanyl 0.01 mg?kg -1 and vecuronium 0.1-0.2 mg?kg -1, and maintained with isoflurane,fentanyl and vecuronium. In propofol group anesthesia was induced with midazolam 0.05 mg?kg -1,fentanyl 0.005-0.01 mg?kg -1,propofol 1.5 mg?kg -1 and vecuronium 0.1-0.2 mg?kg -1, and propofol 4-5 mg?kg -1?h -1 was administered during operation with isoflurane,fentanyl and vecuronium. Blood samples were taken from jugular vein to assay SonACT, clot rate and platelet function with Sonoclot ananlysis, and to measure platelet count, PT and APTT before anesthesia, 5 min after induction,before CPB,10 min after CPB and at the end of operation.Results: Compared with those before anesthesia, PF, clot rate, platelet count, PT and APTT in both groups significantly decreased 10 min after CPB and at the end of operation(P

Objective:To explore the relationship between the triglyceride glucose (TyG) index and the risk of developing hypertension among rural Chinese adults.Methods:A prospective cohort study was conducted from 2007 to 2008, involving 20 194 adults selected through random cluster sampling from a rural community in Luoyang City, Henan Province. Follow-ups were carried out in 2013-2014 and 2018-2020. After excluding participants with hypertension at baseline, those with missing TyG index data, individuals who passed away during follow-up, and those with incomplete hypertension status at the second visit, 9 802 participants were included in the analysis. Baseline and follow-up assessments included questionnaire interviews, physical measurements (including blood pressure), and blood sample collection for fasting lipid and glucose levels. Participants were divided into four groups according to TyG index quartiles, and a modified Poisson regression model was utilized to assess the association between TyG index quartiles and hypertension risk.Results:The study cohort comprised 9 802 participants with a median age of 48 (39, 57) years, including 3 803 males (38.80%). Participants were distributed across TyG index quartiles as follows: TyG<8.2 group (2 224 individuals), TyG 8.2-8.5 group (2 653 individuals), TyG 8.6-8.9 (2 441 individuals), and TyG≥9.0 (2 484 individuals). Over a follow-up period of (11.1±1.3) years, 3 378 subjects developed hypertension, resulting in a cumulative incidence of 34.46% (3 378/9 802). The risk of hypertension increased with higher TyG index quartiles ( Ptrend<0.05). Compared to the TyG<8.2, the TyG 8.2-8.5 ( RR=1.11, 95% CI 1.01-1.22, P=0.023), TyG 8.6-8.9 ( RR=1.16, 95%CI 1.06-1.27, P=0.023), and TyG≥9.0 ( RR=1.20, 95%CI 1.10-1.31, P=0.023) exhibited increased hypertension risk after adjusting for age, gender, educational level, and other potential confounders. Subgroup analyses based on gender and age at baseline yielded results consistent with the main analysis. Conclusions:The TyG index is positively correlated with the risk of developing hypertension in the rural adult population.