Objective To investigate the influence of continuous infusion of low-dose dexmedetomidine (DEX) on the hemodynamic in elderly surgical patients during induction of combined spinal-epidural anesthesia (CSEA).Methods Fifty elderly lower limb surgical patients were randomly divded into DEX group and control group(25 cases each).After the cannulation of left radial artery,the non-invasive hemodynamic monitor was connected,and the hemodynamic index was continuously monitored,including systolic blood pressure (SBP),diastolic blood pressure(DBP),heart rate(HR);and respiratory index was monitored,including respiration rate(RR),pulse oxygen saturation( SpO2 ).Before CSEA,the patients in DEX group were administered DEX of loading dose(0.5 μg · kg-1),then continuously infused with DEX at 0.2 ～ 0.4μg · kg-1 · h-1 to keep Ramsay sedation score from 4point to 5point,and SpO2 ≥95％.Normal saline was administered with an equal volume in control group.The SBP,DBP,HR,RR,SpO2 were recorded immediately at the T0,T1,T2,T3,T4 and T5.Results All hemodyanmic and respiratory parameters in both groups were normal during induction.Compared with T2 in DEX group,differences of SBP and DBP between two groups were statistically significant,and the value significantly lower at T3 (P ＜ 0.05 ) ;compared T2 with T1 in control group,differences of SBP,DBP and HR among three groups were statistically significant,and the value was significantly higher at T2 ( P ＜ 0.05 ).Compared with T2,SBP,DBP,HR were significantly lower than T3,( P ＜0.05).And RR of T1,T2,T3,T4,T5 in DEX group was significanfly lower than T0,with statistical significance( P ＜0.05) ;the difference of RR among different time was not statistically significant in control group(P ＞ 0.05 ).Conclusion The continuous infusion of small-dosage DEX during CSEA in elderly lower limb surgical patients may have little impact on cardiac function index when achieved effective sedation and analgesia.

Pregnancy ; Female ; Humans ; Pregnancy Outcome ; Cross-Sectional Studies ; Lupus Erythematosus, Systemic/epidemiology* ; Pregnancy Complications/epidemiology* ; Menstruation Disturbances

ObjectiveTo explore the distribution mechanism of network modules in the combined treatment of liver cancer with Jiuwei Zhengxiao granules （JWZX） based on the analysis framework of module pharmacology. MethodThe cell experiment and the animal experiment were carried out to investigate the in vitro anti-liver cancer efficacy of JWZX of different concentrations and the effect on the survival time of H22 ascites tumor mice. By virtue of the analysis strategy of modular pharmacology，the distribution characteristics of nine Chinese drugs in the liver cancer disease network modules were investigated based on the constructed liver cancer disease network and module division by MCODE. In this study，the average degree （AD） of the nodes in the modules was used as an index to screen the main modules of the disease，and the intervention of the sovereign drugs，minister drugs，and assistant drugs on the main modules was explored. Finally，the Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis was performed on the drug-acted modules by Metascape. ResultAs revealed by the cell experiment，JWZX could significantly inhibit the proliferation of H22 cells. The animal experiment demonstrated that the medium- and high-dose JWZX could significantly prolong the survival time of mice with H22 ascites tumor （P<0.05，P<0.01）. The distribution of targets of JWZX in the liver cancer disease network modules showed that JWZX interfered with tumor necrosis factor （TNF），epidermal growth factor receptor （EGFR），vascular endothelial growth factor A （VEGFA），transcription factor （JUN），tumor protein p53 （TP53），and other 26 targets and 8 modules. The sovereign drug Ginkgo Semen mainly intervened in modules 3 and 8，and the minister drugs such as Centipeda Herba jointly intervened in modules 1，3，5，8，10，and 12. Centipeda Herba and Phyllanthi Fructus intervened in module 7 and module 19 individually. Artemisiae Annuae Herba and other assistant drugs jointly intervened in modules 3，5，10，and 12. KEGG pathway enrichment analysis found that 135 pathways were enriched in 8 modules，and the pathway functions involved 12 categories including cancer，signal transduction，immune system，endocrine system，and amino acid metabolism. The functions of the four major modules involved cancer，signal transduction，and immune system. According to the results of literature verification，the key links of JWZX on the liver cancer disease network and the core mechanism were presumedly related to the inhibition of phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） and hypoxia-inducible factor-1 （HIF-1） signaling pathways，reduction of the immunosuppressive effect in the tumor microenvironment，and improvement of the anti-tumor immune response. ConclusionJWZX possesses pharmacological activity against liver cancer，and the therapeutic efficacy was achieved through the multiple targets，multiple modules，and multiple functions of drugs alone or in combination to intervene in the disease. The present study reduced the complexity of drug-disease target network analysis with module analysis strategy and explored the network module distribution mechanism of JWZX in the treatment of liver cancer，which provides a new idea for interpreting the complex mechanism of prescription compatibility.