Objective To evaluate the efficacy and safety of remifentanil and propefol combined with local anesthesia for cobiation-assisted upper-airway procedure (CAUP). Methods Eighty ASAⅠorⅡpatients aged 25-60 yr body mass index ≤ 35 kg/m2 with sleep apnea hypopnea syndrome scheduled for CAUP were randomly divided into 4 groups (n=20 each): normal saline group (S), propefol group (P), remifentanil group (R) and propoful + remifentanil group (PR). After topical anesthesia with 1% decicaine, the patients in group S, P, R or PR received iv infusion of normal saline 0.15 ml·kg-1·h-1 , propofol 25 μg·kg-1·min-1 , remifentanil 0.05 μg·kg-1·min-1, or propefol + remifentanil at the same rate respectively. Ten minutes later local infiltration anesthesia was performed in operative field with lidocaine containing epinephrine 1:200 000. Ramsay sedation score and verbal rating scale (VRS) were assessed every 5 min. VRS Ⅲwas defined as anesthesia failure in group S. It was also defined as anesthesia failure that Ramsay sedation score > 3 or occurrence of respiratory depression during increment of propofol or remifentanil in patients with VRS Ⅲ in the other 3 groups. BP and HR were recorded before coblation and 5 rain after coblation. Airway obstruction and apnea were also observed. Results Anesthesia achievement ratio was significantly higher in group R and PR (90% and 100% respectively) than in group S and P (40% and 65% respectively) (P<0.05). SP, DP and HR were significantly lower 5 rain after coblation in group R and PR than in group S (P < 0.05). There was no significant difference in incidence of adverse effects between the 4 groups(P>0.05). Conclusion Remifentanil or propofol-remifentanil combined with local anesthesia is safe and effective for CAUP.

Aim To synthesize 8-bromo-ethoxy Rhein and investigate its mechanisms and inhibition effect on hepatitis B surface antigen ( HBsAg ) and e antigen ( HBeAg) in HepG2.2.15 cells.Methods 8-bromo-ethoxy Rhein was synthesized based on the chemical structure of Rhein , and its structure was identified by IR,1 H-NMR and 13 C-NMR spectra.MTT assay was used to test the inhibitory effect of 8-bromo-ethoxy Rhein on HepG2.2.15 cells.After the cells treatment by 8-bromo-ethoxy Rhein , the HBsAg and HBeAg in cell supernatant were detected by ELISA .The expres-sion of hepatitis B virus X gene ( HBx) was detected by Western blot .The cell cycles were examined with flow cytometry.The intracellular free calcium concentration was detected by laser scanning confocal microscopy . Results The structure of 8-bromo-ethoxy Rhein was confirmed by IR,1 H-NMR and 13 C-NMR.MTT results showed that synthetic product and Rhein could inhibit the cell proliferation in HepG2.2.15 cells.After trea-ted with 8-bromo-ethoxy Rhein and Rhein for 72 h,the half inhibitory concentration 50%( IC50 ) was 14.29 mg? L-1 and 11.59 mg? L-1 , respectively .Using non-cytotoxic dose of 8-bromo-ethoxy Rhein , the inhibitory effect on HBsAg and HBeAg was gradually enhanced with increasing 8-bromo-ethoxy Rhein concentration . The inhibitory effect of synthetic product on hepatitis B virus was better than that of Rhein .8-bromo-ethoxy Rhein could down-regulate the expression of HBx , in-tracellular calcium ion concentration and block the hepatitis B virus ( HBV ) replication.Flow cytometry results showed 8-bromo-ethoxy Rhein didn′t affect the cell cycle .Conclusions Compare with Rhein , the synthesis of 8-bromo-ethoxy Rhein shows stronger inhi-bition on hepatitis B virus in HepG2.2.15, and its mechanisms may involve down-regulating the expres-sion of HBx and reducing calcium ion concentration .

A HPLC method was developed for the determination of mangiferin in rat plasma and aqueous humor. 4-Nitrophenol was used as internal standard. Analysis was performed on a Cosmosil ODS C18 analytical column (4.6 mm x 250 mm, 5 microm) with mobile phase consisting of methanol-water (40: 60) with 2% glacial acetic acid at a flow rate of 1.0 mL x min(-1). The calibration curve of mangiferin in rat plasma and aqueous humor showed excellent linear behaviors over the investigated concentration of 0. 50-250.00 mg x L(-1) in plasma and 0.10-10.00 mg x L(-1) in aqueous humor, respectively, and the correlation coefficients were all above 0.995 4. The intra-day and inter-day precisions for all samples were measured to be below 12%. The limit of quantitation was 0.10 mg x L(-1) and low enough for the determination of mangiferin in all samples. The validated method has been successfully applied to preliminary pharmacokinetics study of mangiferin in rat plasma and aqueous humor.
Animals ; Aqueous Humor ; chemistry ; Chromatography, High Pressure Liquid ; Female ; Male ; Nitrophenols ; analysis ; Rats ; Rats, Wistar ; Reproducibility of Results ; Sensitivity and Specificity ; Xanthones ; blood ; pharmacokinetics

Objective To investigate the burden status quo of caregivers in stroke patients with home enteral nutrition and to analyze the factors influencing the caregivers burden.Methods A total of 202 direct caregivers in stroke patients with enteral nutrition treatment during hospitalization period in this hospital and continued home enteral nutrition after discharge from hospital were collected as the study subjects.The Caregiver Burden Inventory,Self—Rating Anxiety Scale,Self—Rating Depression Scale,patients and caregivers general condition questionnaire were adopted to conduct the survey.The burden level status of caregivers and its related influencing factors were statistically analyzed.Results The results showed that the burden total score in 202 caregivers receiving the investigation was (50.17± 9.75) points.The univariate analysis results showed that that the age of caregivers,family income per capita level,whether caregivers having negative emotions (anxiety or depression),care time,NIHSS scores of patients and feeding mode burden score had statistical differences (P＜0.05).The multivariate analysis results showed that the care time of caregivers,feeding mode,accompanying anxietyor depression in caregivers,NIHSS scores of patients were the main influencing factors of caregivers burden(P＜0.05).Conclusion The caregivers have a great burden in caring the patients,which should arouse attention.

Objective To analyze the application value of transvaginal ultrasonography(TVS)combined with contrast-enhanced ultrasound(CEUS)in the diagnosis of cesarean scar pregnancy(CSP).Methods Sixty patients with CSP confirmed by operation and pathology admitted to the First Hospital of Jiaxing from January 2022 to November 2023 were retrospectively analyzed.TVS and CEUS were examined before operation.The detection rate and type diagnosis of CSP were compared between TVS and CEUS alone and combined diagnosis.The receiver operating characteristic(ROC)curve was used to analyze the efficiency of TVS and CEUS in identifying gestational cesarean scar pregnancy(GCSP).Results Among the 60 patients with CSP,53 patients with GCSP and 7 patients with mass cesarean scar pregnancy(MCSP)were confirmed by surgery and pathology.The detection rate of CSP by TVS combined with CEUS(98.33％)was significantly higher than that by TVS or CEUS(P＜0.05),and the detection rate of CSP by CEUS was significantly higher than that by TVS(P＜0.05).The detection rate of GCSP by TVS combined with CEUS(100.00％)was significantly higher than that by TVS or CEUS(P＜0.05).The area under the curve(AUC)of TVS combined with CEUS for identifying GCSP was the largest,which was 0.857.The sensitivity was 100.00％,and the specificity was 71.40％.The detection rate of MCSP by TVS combined with CEUS was significantly higher than that by TVS(P＜0.05).Conclusion TVS combined with CEUS can effectively improve the clinical detection rate of CSP,which is conducive to the diagnosis of CSP classification,and has important application value.