OBJECTIVETo evaluate the clinical efficacy of domestic sevoflurane by comparing the pharmacokinetic and pharmacodynamic characteristics of domestic sevoflurane and an imported product.

METHODSEighty patients undergoing general anesthesia for transabdominal hysterectomy were equally randomized into domestic sevoflurane group and imported sevoflurane group. The following data were recorded and compared: vital signs; change of sevoflurane concentrations in the induction period and recovery period; the time when inhaled sevoflurane concentration reached half of the pre-set concentration of the vaporizer; the time when the end-tidal sevoflurane concentration reached half of the pre-set concentration of the vaporizer; the time when the end-tidal sevoflurane concentration reached half of inhaled sevoflurane concentration; the time of the end-tidal sevoflurane concentration reached 0. 8 MAC in the induction period; the recovery time; the extubation time; and time to recovery of consciousness.

RESULTSThe general conditions of the two groups were not significantly different. The pharmacokinetic and pharmacodynamic parameters at the intra-operative time points as well as the minimal alveolar concentration, the inspired and end-tidal sevoflurane concentrations, and the time to recovery of consciousness also showed no significant differences between the two groups.

CONCLUSIONThe domestic sevoflurane has similar pharmacokinetic and pharmacodynamic characteristics as the imported products. It can serve as a cost-effective product for transabdominal hysterectomy.

Adolescent ; Adult ; Aged ; Anesthesia, Inhalation ; Anesthetics, Inhalation ; pharmacokinetics ; Double-Blind Method ; Female ; Humans ; Hysterectomy ; Methyl Ethers ; pharmacokinetics ; Middle Aged ; Young Adult

OBJECTIVETo summarize the clinical experience of hyperbaric oxygen therapy in the patients with groupment acute carbon monoxide poisoning.

METHOD172 patients with acute carbon monoxide poisoning were received hyperbaric oxygen therapy besides some other regular therapies from january 2007 to december 2011. The clinical effect were analyzed retrospectively.

RESULTS160 patients were cured (93%), 12 cases improved (7%), the total effective rate was 100%. The cure rate of the patients with hyperbaric oxygen therapy within 6 hours after the poisoning for 100% (115/115), It was significantly higher than that of patients treated for more than 6 hours [The cure rate was 78.9% (45/57)], The difference was statistically significant (P < 0.05).

CONCLUSIONTreated by hyperbaric oxygen therapy early enough in the patients with acute carbon monoxide poisoning, can prevent or reduce the occurrence of delayed encephalopathy, decreasing disability and mortality.

Acute Disease ; Adolescent ; Adult ; Carbon Monoxide Poisoning ; therapy ; Humans ; Hyperbaric Oxygenation ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective: To analyze the effect of acupuncture versus hormone replacement therapy (HRT) for premature ovarian insufficiency (POI). Methods: China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), China Biology Medicine Disc (CBM), Web of Science, Cochrane Library, PubMed, and Excerpta Medica Database (EMBASE) were searched up to January 31st, 2019 to identify randomized controlled trials (RCTs) evaluating the effect of acupuncture for POI. The primary outcome was the level of basal serum follicle- stimulating hormone (FSH). Secondary outcomes included serum levels of luteinizing hormone (LH), estradiol (E2) and anti-Müllerian hormone (AMH). Two authors extracted data independently and assessed the risk of bias and the methodological quality using the Cochrane's tool. Meta-analysis was conducted by RevMan version 5.3. Results: Eight eligible RCTs with a total of 496 POI patients were included in the meta-analysis. The pooled results showed that there was a significant reduction in the basal serum FSH level (MD=-5.82, 95％CI:-9.76 to -1.87, I2=82％, P=0.004) and a remarkable elevation in the basal E2 level (SMD=0.93, 95％CI: 0.34 to 1.52, I2=88％, P=0.002) in the acupuncture group when compared with the control. Subgroup analysis showed that compared with HRT, a significant decrease in the FSH level was observed in both acupuncture alone (MD=-4.53, 95％CI:-8.96 to -0.10, I2=73％, P=0.04) and acupuncture plus HRT (MD=-9.60, 95％CI:-17.60 to -1.61, I2=50％, P=0.02), while a remarkable elevation of E2 was only found in acupuncture plus HRT (SMD=1.43, 95％CI: 1.03 to 1.82, I2=0％, P<0.00001). There was no significant difference in the LH level between acupuncture and HRT (MD=-3.16, 95％CI:-9.41 to 3.10, I2=0％, P=0.32), only one trial reported AMH, and no significant difference was found between acupuncture and HRT. Conclusion: The present study indicated that acupuncture had an advantage over HRT in reducing serum FSH level and increasing serum E2 level in women with POI. However, evidence supporting the finding is limited due to the small sample size, potential methodological flaws and significant heterogeneity. Hence, this conclusion still needs to be verified by high-quality RCTs.

BACKGROUND/AIMS: A large number of studies have shown that function constipation (FC) has an extremely high incidence of mental and psychological disorders. Cranial electrotherapy stimulation (CES) was applied to the treatment of psychological disorders such as anxiety and depression. We explored the effects of CES combined with biofeedback therapy (BFT) on the psychological state, clinical symptoms, and anorectal function in patients with FC. METHODS: A total of 74 patients with FC were randomly divided into 2 groups. The control group received BFT. CES combined with BFT was carried out in the experiment group. All patients were assessed using the self-rating anxiety scale (SAS), self-rating depression scale (SDS), and Wexner constipation score at baseline and the end of each course. Anorectal manometry and balloon expulsion tests were performed before and after treatment. RESULTS: After treatment, the participants in the experiment group had significantly lower score SAS, SDS, and Wexner constipation scores than the control group (all P < 0.05). The number of successful expulsion in the experiment group was larger than the control group (P = 0.016). CONCLUSIONS: CES combined with BFT was effective in improving the psychological status of anxiety, depression, and bowel symptoms in patients with FC.
Anxiety ; Biofeedback, Psychology* ; Constipation* ; Depression ; Electric Stimulation Therapy* ; Humans ; Incidence ; Manometry ; Treatment Outcome

OBJECTIVETo investigate the impact of cuff pressure on airway leak pressure in laryngeal mask airway(LMA)Supreme and Flexible.

METHODSPatients about to have elective breast surgery were divided into Supreme group(35 cases)and Flexible group(33 cases). After general induction of anesthesia,LMA Supreme or Flexible was inserted by one anesthesiologist. We confirmed the LMA location,adjusted the cuff pressure,and recorded the peak airway leak pressures under different cuff pressures(10,20,30,40,and 50 cmH2O).

RESULTSIn Supreme group,peak airway leak pressures [(24.46±5.43),(25.11±5.51),(25.86±5.57),(26.17±5.72)cmH2O] under 20,30,40,and 50 cmH2O cuff pressure showed no significant difference(P>0.05)between each other,but significantly higher than that under 10 cmH2O cuff pressure(20.80±4.63)cmH2O(P<0.05). And in the Flexible group,peak airway leak pressures [(20.09±2.98),(20.70±3.08),(21.21±3.15)cmH2O] under 30,40,50 cmH2O cuff pressure also showed no significant difference(P>0.05)between each other,but significantly higher than those under 10 or 20 cmH2O cuff pressure [(17.52±2.39),(18.61±2.42)cmH2O]. Mean peak airway leak pressure [(25.40±5.52) cmH2O] of LMA Supreme was significantly higher than that of LMA Flexible(20.67±3.06)cmH2O(P<0.05).

CONCLUSIONSMean airway leak pressure of LMA Supreme is higher than LMA Flexible. The lowest cuff pressure to meet the tightness requirement with LMA Supreme is 20 cmH2O,which is lower than Flexible(30 cmH2O).

Air Pressure ; Anesthesia ; methods ; Humans ; Laryngeal Masks ; Materials Testing

OBJECTIVETo develop a high-throughput screening assay for Farnesoid X receptor (FXR) agonists based on mammalian one-hybrid system (a chimera receptor gene system) for the purpose of identifying new lead compounds for dyslipidaemia drug from the chemical library.

METHODScDNA encoding the human FXR ligand binding domain (LBD) was amplified by RT-PCR from a human liver total mRNA and fused to the DNA binding domain (DBD) of yeast GAL4 of pBIND to construct a GAL4-FXR (LBD) chimera expression plasmid. Five copies of the GAL4 DNA binding site were synthesized and inserted into upstream of the SV40 promoter of pGL3-promoter vector to construct a reporter plasmid pG5-SV40 Luc. The assay was developed by transient co-transfection with pG5-SV40 Luc reporter plasmid and pBIND-FXR-LBD (189-472) chimera expression plasmid.

RESULTSAfter optimization, CDCA, a FXR natural agonist, could induce expression of the luciferase gene in a dose-dependent manner, and had a signal/noise ratio of 10 and Z' factor value of 0.65.

CONCLUSIONA stable and sensitive cell-based high-throughput screening model can be used in high-throughput screening for FXR agonists from the synthetic and natural compound library.

Base Sequence ; Cell Line ; DNA Primers ; DNA, Complementary ; DNA-Binding Proteins ; agonists ; chemistry ; genetics ; Humans ; Hypolipidemic Agents ; analysis ; Plasmids ; Receptors, Cytoplasmic and Nuclear ; agonists ; chemistry ; genetics ; Reproducibility of Results ; Transcription Factors ; agonists ; chemistry ; genetics ; Transfection

OBJECTIVESince the outbreak of a highly contagious new pneumonia, atypical pneumonia or severe acute respiratory syndrome (SARS) occurred in Guangzhou area, 33 children with this syndrome were treated in the authors' hospital. The present study aimed to understand clinical characteristics and prognosis of pediatric SARS patients in Guangzhou area.

METHODSClinical manifestations, laboratory and radiologic findings, therapeutic approaches and prognosis of the 33 children with SARS in Guangzhou area were analyzed.

RESULTSOf the 33 cases, 17 were males and 16 were females. The age was between 3 months to 13 years, and 3 - 12 years old patients accounted for 82%. Five (15%) cases had an evident history of contacting SARS patient before the symptoms occurred. Another 5 (15%) cases had a history that contacts of these patients (family members or friends) developed fever and/or cough later. The most common symptoms in this cohort were fever (100%) and cough (91%). Most of the cases had high fever, higher than 39 degrees C. Near half of the cases had nonproductive cough. The initial blood cells count showed that total white blood cell (WBC) count was (2.5 - 9.7) x 10(9)/L. In 22 (67%) cases the WBC count was < 5.0 x 10(9)/L, and in 10 (30%) WBC was (5.0 - 7.0) x 10(9)/L, in 18 cases most of the WBC were lymphocyte count. Chest radiograph showed patchy infiltrates, in 15 cases the changes were unilateral, and in 18 were bilateral. The radiologic changes developed fast, in some cases the changes progressed from one side to both sides. The opacity was absorbed slowly, significant absorption took in average two weeks. Elevated ALT was found in 3 cases and elevated CK-MB in 2 cases. Treatment included isolation, good ventilation of the ward, bed rest, supportive regimens, low volume oxygen inhalation, use of Chinese traditional medicine, antibiotics to prevent bacterial infection, and anti-inflammation therapy. All the patients recovered and discharged from hospital after a mean period of 10.0 +/- 3.8 days.

CONCLUSIONSARS in children may have its own characteristics. The main clinical manifestations were high fever and cough while no severe toxic symptoms, nor respiratory failure was seen; few symptoms or signs suggesting involvement of systems other than respiratory system were seen. Chest radiograph showed uni- or bilateral asymmetric air-space infiltrates which could worsen quickly and were absorbed slowly. Though there were severe changes in the lung, the patients might not have corresponding symptoms or signs. The total white blood cell count in peripheral blood did not increase. All the patients studied had a favorable outcome after the combined treatment.

Adolescent ; Anti-Bacterial Agents ; therapeutic use ; Bed Rest ; Child ; Child, Preschool ; China ; Cohort Studies ; Cough ; complications ; Female ; Fever ; complications ; Humans ; Infant ; Length of Stay ; Lung ; drug effects ; microbiology ; pathology ; Male ; Prognosis ; Severe Acute Respiratory Syndrome ; complications ; diagnosis ; therapy ; Treatment Outcome

OBJECTIVETo investigate the xanthones from Tibetan medicine Halenia elliptica and their antioxidant activity.

METHODSColumn chromatography over normal phase silica gel, reversed phase silica gel, Sephadex LH-20, and recrystallization techniques were used to isolate and purify constituents from Halenia elliptica. Infrared spectrometry, mass spectrometry, and nuclear magnetic resonance spectrometry were used to identify the structure of compounds. The antioxidant activity was evaluated by measuring the content of malondialdehyde product in mice liver cell microsomal induced by ferrous-cysteine.

RESULTSEight xanthones (compound I-VIII) were isolated and identified from the ethyl acetate extract of Halenia elliptica, among which 1,7-dihydroxy-2,3,5-trimethoxyxanthone was a novel compound. Compound I, III at 10 microg/ml and 100 microg/ml could inhibit the production of malondialdehyde in mouse liver microsomes in vitro.

CONCLUSIONEight xanthones were isolated and they have certain antioxidant activity.

Antioxidants ; chemistry ; isolation & purification ; pharmacology ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Gentianaceae ; chemistry ; Glycosides ; chemistry ; isolation & purification ; pharmacology ; Plants, Medicinal ; chemistry ; Xanthenes ; isolation & purification ; pharmacology ; Xanthones ; chemistry ; isolation & purification ; pharmacology

AIMTo investigate the chemical constituents of the Tibetan herbal medicine Halenia elliptica by guidance of in vivo absorption and distribution of the constituents.

METHODSHPLC with a diode array detector (DAD) and HPLC-MS were used for detecting the constituents of extracts of Halenia elliptica and animal samples. Several kinds of column chromatography were used for the isolation and purification of the main in vivo absorbed and distributed compounds from the extract of Halenia elliptica.

RESULTSSix main components detected in the extracts of the animal samples were isolated from the ethanolic extract of Halenia elliptica.

CONCLUSIONAfter rats were treated with different extracts of Halenia elliplica, low polar components xanthone aglycon of Halenia elliptica were clearly observed in the extracts of liver, lipid, blood, hidney, heart and brain tissue of rats, while the polar components xanthone glycosides were detected in very small amounts in the animal samples. The xanthone glycosides can be decomposed into xanthone aglycons during the digestion, absorption and metabolism procedure. Therefore, the in vivo activity of the xanthone glycosides might be exhibited by their decomposed products. It is an accessibly valuable method to investigate chemical components of herbal medicines under the guidance by detecting in vivo absorption and distribution of chemical components of the herbal medicine extract.

Absorption ; Animals ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; isolation & purification ; pharmacokinetics ; Female ; Gentianaceae ; chemistry ; Glycosides ; isolation & purification ; pharmacokinetics ; Plants, Medicinal ; chemistry ; Rats ; Rats, Wistar ; Tissue Distribution ; Xanthones ; isolation & purification ; pharmacokinetics

Objective To investigate the correlation between the relevant indexes of plasma slucose and TCM symptoms and syndrome types in the patients with different complications of type 2 diabetes.Methods On the base of clinical data from 2 501 cases of type 2 diabetes Bayesian network technique was applied to analyse the network relation among 82 variables including fasting plasma glucose,2-hour postprandial plasma glucose,glycated hemoglobin,syndrome,tongue and pulse in the patients with type 2 diabetes accompanied by encephalopathy,nephrosis and hypertension.Results In the patients with type 2 diabetes accompanied by encephalopathy when the indexes of fasting plasma glucose and 2-hour postprandial plasma glucose were abnormal the syndrome type wag qi deficiency mainly,and when the index of glycated hemoglobin was abnormal the syndrome types were qi deficiency and yin deficiency commonly.In the patients with type 2 diabetes accompanied by nephrosis when the indexes of fasting plasma gluc08e were abnormal the syndrome type Was yang deficiency mainly,and when the indexes of 2-hour postprandial plasma glucose and glycated hemoglobin were abnormal the syndrome types were mainly qi deficiency,or qi deficiency combined with excessive heat and yin deficiency.In the patients with type 2 diabetes accompanied by hypertension when the indexes of fasting plasma glucose,2-hour postprandial plasma glucose and glycated hemoglobin were abnormal the syndrome types were mainly yin deficiency or yin deficiency combined with excessive heat. The predictability of complications by common syndromes was observed. Conclusion Bayesian network technique is apposite to the objective research of TCM syndromes. This study is a reference to the early prediction of chronic complications of type 2 diabetes,and also explores initially the objective research of TCM syndromes.