1.Main physiological changes in skeletal muscle aging and the multimechanism regulatory role of exercise
Chaowen HOU ; Zhaojin LI ; Jianda KONG ; Shuli ZHANG
Chinese Journal of Tissue Engineering Research 2026;30(6):1464-1475
BACKGROUND:Skeletal muscle aging is associated with various chronic diseases.Exercise is considered an important means to delay this process,but the multimechanism regulation of exercise intervention strategies still requires in-depth exploration.OBJECTIVE:To systematically outline the main physiological changes in skeletal muscle aging and explore the multiple mechanisms by which exercise regulates these changes,thereby providing a theoretical basis for basic research and clinical applications.METHODS:By searching databases such as Web of Science,PubMed,Embase,CNKI,WanFang,and VIP,relevant literature from database inception to October 2024 was retrieved by the first author,including original research articles and reviews.The search terms were"skeletal muscle aging,sarcopenia,exercise regulation,physical activity,chronic inflammation,inflammaging,mitochondrial dysfunction,extracellular matrix fibrosis,lipid mediators,satellite cells"in English and Chinese.Literature was screened based on inclusion and exclusion criteria,and the included 95 articles underwent quality assessment and data extraction.RESULTS AND CONCLUSION:(1)The core manifestations of skeletal muscle aging are the decline in muscle mass,strength,and function,closely related to various physiological changes.The decreased protein synthesis capacity and accelerated degradation rate in muscles lead to muscle atrophy and functional decline.Additionally,dysfunction of satellite cells is considered a key factor in the reduced regenerative capacity of muscles.Mitochondrial dysfunction is another important factor leading to muscle fatigue and energy metabolism disorders,directly affecting the metabolic activity and endurance of skeletal muscles.Chronic inflammatory responses and extracellular matrix fibrosis further exacerbate muscle aging.These factors interact synergistically,collectively resulting in skeletal muscle degeneration.(2)Exercise is widely recognized as an important means to delay skeletal muscle aging.Exercise alleviates chronic low-grade inflammatory responses in skeletal muscle by regulating the immune system,increasing the secretion of anti-inflammatory factors,and inhibiting the expression of pro-inflammatory factors,thereby mitigating the damage of inflammation to muscles.Exercise also enhances mitochondrial biogenesis and function,improves the muscle's energy metabolism capacity,and consequently increases endurance and strength.Furthermore,exercise regulates lipid metabolism and the synthesis of lipid mediators,reduces fat accumulation and alleviates fat-induced inflammatory responses,thereby further protecting skeletal muscles.The mechanical stimulation from exercise promotes the remodeling of the extracellular matrix,reduces fibrosis occurrence,and improves muscle structure and function.Additionally,exercise activates satellite cells,enhancing the regenerative capacity of skeletal muscles,especially notable with strength training and high-intensity interval training.(3)Future research should include large-scale,multicenter clinical trials to evaluate the comprehensive effects of long-term exercise interventions on skeletal muscle aging.By analyzing data from genomics,metabolomics,and other fields,exploring individual differences in responses to exercise interventions can provide more precise theoretical bases for personalized exercise strategies.Besides exercise,the impacts of other interventions such as nutritional supplementation and pharmacological treatments on skeletal muscle aging should not be overlooked.Future studies can explore the combined use of exercise with these interventions to achieve more significant effects.
2.Main physiological changes in skeletal muscle aging and the multimechanism regulatory role of exercise
Chaowen HOU ; Zhaojin LI ; Jianda KONG ; Shuli ZHANG
Chinese Journal of Tissue Engineering Research 2026;30(6):1464-1475
BACKGROUND:Skeletal muscle aging is associated with various chronic diseases.Exercise is considered an important means to delay this process,but the multimechanism regulation of exercise intervention strategies still requires in-depth exploration.OBJECTIVE:To systematically outline the main physiological changes in skeletal muscle aging and explore the multiple mechanisms by which exercise regulates these changes,thereby providing a theoretical basis for basic research and clinical applications.METHODS:By searching databases such as Web of Science,PubMed,Embase,CNKI,WanFang,and VIP,relevant literature from database inception to October 2024 was retrieved by the first author,including original research articles and reviews.The search terms were"skeletal muscle aging,sarcopenia,exercise regulation,physical activity,chronic inflammation,inflammaging,mitochondrial dysfunction,extracellular matrix fibrosis,lipid mediators,satellite cells"in English and Chinese.Literature was screened based on inclusion and exclusion criteria,and the included 95 articles underwent quality assessment and data extraction.RESULTS AND CONCLUSION:(1)The core manifestations of skeletal muscle aging are the decline in muscle mass,strength,and function,closely related to various physiological changes.The decreased protein synthesis capacity and accelerated degradation rate in muscles lead to muscle atrophy and functional decline.Additionally,dysfunction of satellite cells is considered a key factor in the reduced regenerative capacity of muscles.Mitochondrial dysfunction is another important factor leading to muscle fatigue and energy metabolism disorders,directly affecting the metabolic activity and endurance of skeletal muscles.Chronic inflammatory responses and extracellular matrix fibrosis further exacerbate muscle aging.These factors interact synergistically,collectively resulting in skeletal muscle degeneration.(2)Exercise is widely recognized as an important means to delay skeletal muscle aging.Exercise alleviates chronic low-grade inflammatory responses in skeletal muscle by regulating the immune system,increasing the secretion of anti-inflammatory factors,and inhibiting the expression of pro-inflammatory factors,thereby mitigating the damage of inflammation to muscles.Exercise also enhances mitochondrial biogenesis and function,improves the muscle's energy metabolism capacity,and consequently increases endurance and strength.Furthermore,exercise regulates lipid metabolism and the synthesis of lipid mediators,reduces fat accumulation and alleviates fat-induced inflammatory responses,thereby further protecting skeletal muscles.The mechanical stimulation from exercise promotes the remodeling of the extracellular matrix,reduces fibrosis occurrence,and improves muscle structure and function.Additionally,exercise activates satellite cells,enhancing the regenerative capacity of skeletal muscles,especially notable with strength training and high-intensity interval training.(3)Future research should include large-scale,multicenter clinical trials to evaluate the comprehensive effects of long-term exercise interventions on skeletal muscle aging.By analyzing data from genomics,metabolomics,and other fields,exploring individual differences in responses to exercise interventions can provide more precise theoretical bases for personalized exercise strategies.Besides exercise,the impacts of other interventions such as nutritional supplementation and pharmacological treatments on skeletal muscle aging should not be overlooked.Future studies can explore the combined use of exercise with these interventions to achieve more significant effects.
3.Comparison of short-term efficacy of drug-coated balloon angioplasty and plain old balloon angioplasty in the treatment of isolated popliteal artery chronic total occlusion and the influencing factors of primary patency rate
Xu DU ; Hekun DU ; Xiulin YANG ; Shuangnan LI ; Zhonglin NIE ; Chaowen YU ; Ran LU
Clinical Medicine of China 2025;41(2):140-146
Objective:To explore the short-term effect of drug-coated balloon angioplasty (DCBA) and common plain old balloon angioplasty (POBA) in the isolated popliteal artery chronic total occlusion (CTO), and to analyze the factors affecting the postoperative primary patency rate.Methods:A retrospective cohort study approach was used in this study. A total of 42 isolated popliteal CTO patients admitted to the First Affiliated Hospital of Bengbu Medical University from January 2020 to June 2022 were divided into two groups according to their different balloons: 24 as POBA group and 18 as DCBA group. The primary patency rate of target lesions, the clinically-driven target lesion revascularization(CD-TLR) rate, amputation and toe amputation rate, and the improvement of ankle-brachial index (ABI) and Rutherford grade at 6 and 12 months after surgery were compared.Measurement data with normal distribution was expressed as xˉ± s and means between two groups were compared using independent samples t-test. The percentage of counting data was calculated, and the rate between groups was compared by χ2 test or Fisher's exact probability method. Kaplan-Meier survival curve method was used to plot the survival curves of primary patency rate and CD-TLR free rate at 12 months after surgery, and Log rank test was used to compare the differences between groups . Univariate log rank test and multivariate Cox regression was used to analyze the factors affecting the primary patency rate at 12 months in patients with isolated popliteal CTO. Results:12 months after surgery, 4 patients in the DCBA group experienced lumen restenosis or occlusion while 12 patients in the POBA group experienced lumen restenosis or occlusion. The cumulative primary patency rate of target lesions in the DCBA group was higher than that in the POBA group (Log-rank χ2=4.03, P=0.045). ABI in the DCBA group at 6 and 12 months was greater than that in the POBA group [(0.91±0.11) vs (0.83±0.09), (0.84±0.11) vs (0.70±0.12), t=2.40, P=0.021, t=3.64 and P=0.001].There were no significant difference in cumulative CD-TLR exemption, amputation and amputation at 12 months, and Rutherford grade at 6 and 12 months for both groups(all P>0.05). The results of univariate analysis showed that DCBA as surgical method, hypertension and coronary heart disease were the influencing factors of the primary patency rate after chronic occlusion of the isolated popliteal artery (all P<0.05). The results of multivariate Cox regression analysis indicated that DCBA as surgical method was a protective factor for primary patency at 12 months (odds ratio =0.31,95% confidence interval: 0.10~0.870., P=0.038), while hypertension was an independent risk factor( OR=5.63,95% confidence interval: 1.54~20.56, P=0.009). Conclusions:The cumulative primary patency rate of target lesions 12 months after isolated popliteal CTO was higher than that of POBA. DCBA as surgical method was a protective factor for primary patency rate 12 months in patients with isolated popliteal CTO, while hypertension was an independent risk factor.
4.Proteomics and Network Pharmacology Reveal Mechanism of Xiaoer Huatan Zhike Granules in Treating Allergic Cough
Youqi DU ; Yini XU ; Jiajia LIAO ; Chaowen LONG ; Shidie TAI ; Youwen DU ; Song LI ; Shiquan GAN ; Xiangchun SHEN ; Ling TAO ; Shuying YANG ; Lingyun FU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(3):69-79
ObjectiveTo explore the pharmacological mechanism involved in the treatment of allergic cough (AC) by Xiaoer Huatan Zhike granules (XEHT) based on proteomics and network pharmacology. MethodsAfter sensitization by intraperitoneal injection of 1 mL suspension containing 2 mg ovalbumin (OVA) and 100 mg aluminum hydroxide, a guinea pig model of allergic cough was constructed by nebulization with 1% OVA. The modeled guinea pigs were randomized into the model, low-, medium- and high-dose (1, 5, 20 g·kg-1, respectively) XEHT, and sodium montelukast (1 mg·kg-1) groups (n=6), and another 6 guinea pigs were selected as the blank group. The guinea pigs in drug administration groups were administrated with the corresponding drugs by gavage, and those in the blank and model groups received the same volume of normal saline by gavage, 1 time·d-1. After 10 consecutive days of drug administration, the guinea pigs were stimulated by 1% OVA nebulization, and the coughs were observed. The pathological changes in the lung tissue were observed by hematoxylin-eosin staining. The enzyme-linked immunosorbent assay was performed to measure the levels of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), superoxide dismutase (SOD), and malondialdehyde (MDA) in the bronchoalveolar lavage fluid (BALF) and immunoglobulin G (IgG) and immunoglobulin A (IgA) in the serum. Immunohistochemistry (IHC) was employed to observe the expression of IL-6 and TNF-α in the lung tissue. Transmission electron microscopy was employed observe the alveolar type Ⅱ epithelial cell ultrastructure. Real-time PCR was employed to determine the mRNA levels of IL-6, interleukin-1β (IL-1β), and TNF-α in the lung tissue. Label-free proteomics was used to detect the differential proteins among groups. Network pharmacology was used to predict the targets of XEHT in treating AC. The Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis was performed to search for the same pathways from the results of proteomics and network pharmacology. ResultsCompared with the blank group, the model group showed increased coughs (P<0.01), elevated levels of CRP, TNF-α, IL-6, and MDA and lowered level of SOD in the BALF (P<0.05, P<0.01), elevated levels of IgA and IgG in the serum (P<0.05, P<0.01), congestion of the lung tissue and infiltration of inflammatory cells, increased expression of IL-6 and TNF-α (P<0.01), large areas of low electron density edema in type Ⅱ epithelial cells, obvious swelling and vacuolization of the organelles, karyopyknosis or sparse and dissolved chromatin, and up-regulated mRNA levels of IL-6, IL-1β, and TNF-α (P<0.01). Compared with the model group, the drug administration groups showed reduced coughs (P<0.01), lowered levels of CRP, TNF-α, IL-6, and MDA and elevated level of SOD in the BALF (P<0.05, P<0.01), alleviated lung tissue congestion, inflammatory cell infiltration, and type Ⅱ epithelial cell injury, and decreased expression of IL-6 and TNF-α (P<0.01). In addition, the medium-dose XEHT group and the montelukast sodium group showcased lowered serum levels of IgA and IgG (P<0.05, P<0.01). The medium- and high-dose XEHT groups and the montelukast sodium showed down-regulated mRNA levels of IL-6, IL-1β, and TNF-α and the low-dose XEHT group showed down-regulated mRNA levels of IL-6 and TNF-α (P<0.05, P<0.01). Phospholipase D, mammalian target of rapamycin (mTOR), and epidermal growth factor receptor family of receptor tyrosine kinase (ErbB) signaling pathways were the common pathways predicted by both proteomics and network pharmacology. ConclusionProteomics combined with network pharmacology reveal that XEHT can ameliorate AC by regulating the phospholipase D, mTOR, and ErbB signaling pathways.
5.Comparison of short-term efficacy of drug-coated balloon angioplasty and plain old balloon angioplasty in the treatment of isolated popliteal artery chronic total occlusion and the influencing factors of primary patency rate
Xu DU ; Hekun DU ; Xiulin YANG ; Shuangnan LI ; Zhonglin NIE ; Chaowen YU ; Ran LU
Clinical Medicine of China 2025;41(2):140-146
Objective:To explore the short-term effect of drug-coated balloon angioplasty (DCBA) and common plain old balloon angioplasty (POBA) in the isolated popliteal artery chronic total occlusion (CTO), and to analyze the factors affecting the postoperative primary patency rate.Methods:A retrospective cohort study approach was used in this study. A total of 42 isolated popliteal CTO patients admitted to the First Affiliated Hospital of Bengbu Medical University from January 2020 to June 2022 were divided into two groups according to their different balloons: 24 as POBA group and 18 as DCBA group. The primary patency rate of target lesions, the clinically-driven target lesion revascularization(CD-TLR) rate, amputation and toe amputation rate, and the improvement of ankle-brachial index (ABI) and Rutherford grade at 6 and 12 months after surgery were compared.Measurement data with normal distribution was expressed as xˉ± s and means between two groups were compared using independent samples t-test. The percentage of counting data was calculated, and the rate between groups was compared by χ2 test or Fisher's exact probability method. Kaplan-Meier survival curve method was used to plot the survival curves of primary patency rate and CD-TLR free rate at 12 months after surgery, and Log rank test was used to compare the differences between groups . Univariate log rank test and multivariate Cox regression was used to analyze the factors affecting the primary patency rate at 12 months in patients with isolated popliteal CTO. Results:12 months after surgery, 4 patients in the DCBA group experienced lumen restenosis or occlusion while 12 patients in the POBA group experienced lumen restenosis or occlusion. The cumulative primary patency rate of target lesions in the DCBA group was higher than that in the POBA group (Log-rank χ2=4.03, P=0.045). ABI in the DCBA group at 6 and 12 months was greater than that in the POBA group [(0.91±0.11) vs (0.83±0.09), (0.84±0.11) vs (0.70±0.12), t=2.40, P=0.021, t=3.64 and P=0.001].There were no significant difference in cumulative CD-TLR exemption, amputation and amputation at 12 months, and Rutherford grade at 6 and 12 months for both groups(all P>0.05). The results of univariate analysis showed that DCBA as surgical method, hypertension and coronary heart disease were the influencing factors of the primary patency rate after chronic occlusion of the isolated popliteal artery (all P<0.05). The results of multivariate Cox regression analysis indicated that DCBA as surgical method was a protective factor for primary patency at 12 months (odds ratio =0.31,95% confidence interval: 0.10~0.870., P=0.038), while hypertension was an independent risk factor( OR=5.63,95% confidence interval: 1.54~20.56, P=0.009). Conclusions:The cumulative primary patency rate of target lesions 12 months after isolated popliteal CTO was higher than that of POBA. DCBA as surgical method was a protective factor for primary patency rate 12 months in patients with isolated popliteal CTO, while hypertension was an independent risk factor.
6.Effect of Osteoking on Inflammatory Injury and NF-κB/NFATc1 Signaling Pathway in Model Mice with Postmenopausal Osteoporosis
Tiantian YU ; Ruibing FENG ; Qing WANG ; Chaowen LI ; Jiahao CHEN ; Ruixuan JIANG ; Yinshuai DING ; Yong HUANG ; Hao HU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(10):62-69
ObjectiveTo explore the possible mechanism of Osteoking (OK) on postmenopausal osteoporosis (PMOP). MethodForty adult female mice were randomly divided into a sham operation (Sham) group, osteoporosis model (OVX) group, estradiol intervention (E2) group, and OK group, with 10 mice in each group. The modeling was completed by conventional back double incision ovariectomy, and the corresponding drugs were given one week later. After 12 weeks, the body mass and uterine index of mice were measured, and the pathological changes of bone tissue and the number of osteoclasts (OCs) were determined by hematoxylin-eosin (HE) and tartrate-resistant acid phosphatase (TRAP) staining, respectively. Bone mineral density (BMD), trabecular number (Tb.N), trabecular separation (Tb.Sp), and bone volume fraction (BV/TV) were measured by microcomputed tomography (Micro-CT). The maximum load of the femur was detected by a three-point bending test. The contents of tumor necrosis factor-α (TNF-α) and bone resorption marker C-terminal telopeptide of type Ⅰ collagen (CTX-1) were measured by enzyme linked immunosorbent assay (ELISA). The protein expression levels of nuclear factor-kappa B p65 (NF-κB p65), phosphorylated nuclear factor-kappa B p65 (p-NF-κB p65), nuclear factor kappa B inhibitor alpha (IκBα), phosphorylated nuclear factor kappa B alpha (p-IκBα), nuclear factor of activated T cells 1 (NFATc1), and proto-oncogene (c-Fos) were detected by Western blot. The mRNA expressions of OCs-related specific genes matrix metalloproteinase-9 (MMP-9), NFATc1, TRAP, cathepsin K (CTSK), and c-Fos were detected by real-time fluorescence quantitative polymerase chain reaction (Real-time PCR). ResultCompared with the Sham group, the uterine index decreased significantly in the OVX group, and the body mass (BMI) increased significantly. The structure of bone trabeculae was completely damaged, and the number of OCs increased. BMD, Tb.N, BV/TV, and maximum load decreased, while Tb.Sp was up-regulated. The levels of TNF-α and CTX-1 in serum were up-regulated. The protein expressions of c-Fos, p-NF-κB p65/NF-κB p65, NFATc1, and p-IκBα/IκBα were increased. The mRNA expressions of NFATc1, c-Fos, CTSK, TRAP, and MMP-9 were up-regulated (P<0.05, P<0.01). Compared with the OVX group, the body mass of the OK and E2 groups decreased, and the uterine index increased. The bone trabeculae increased, and the number of OCs decreased. BMD, Tb.N, BV/TV, and maximum load increased, while Tb.Sp decreased. The levels of TNF-α and CTX-1 in serum were decreased. The protein expressions of c-Fos, p-NF-κB p65/NF-κB p65, NFATc1, and p-IκBα/IκBα were decreased, and the mRNA expressions of NFATc1, c-Fos, CTSK, TRAP, and MMP-9 were decreased (P<0.05, P<0.01). ConclusionOK can inhibit the NF-κB/NFATc1 signaling pathway and reduce bone mass loss by reducing the level of inflammatory injury factors in PMOP mice, which is one of the mechanisms for treating PMOP.
7.Radioactivity level and risk assessment of thorium in surface water in Sichuan Province, China, 2016-2021
Hui TANG ; Yuandong LI ; Chaowen BI ; Wanchong MAO ; Qian WANG ; Qiang YU ; Xin LIU ; Cheng CHEN
Chinese Journal of Radiological Health 2023;32(4):438-443
Objective To investigate the content of thorium (Th) in surface water in Sichuan Province, China, and to evaluate Th-associated health risk via water intake for residents. Methods Twenty-three monitoring sections were set in main surface water bodies in Sichuan Province. From 2016 to 2021, the Th radioactivity level in the water bodies was measured during dry and normal-water seasons. The health risk of residents was evaluated by calculating radioactive Th intake from the surface water bodies combined with the use of a health risk assessment model. Results The Th radioactivity level of the surface water bodies in Sichuan Province was 0.02-0.67 μ./L. There was no significant difference in the Th radioactivity level of different years or different surface water bodies (P > 0.05). A significant difference was observed in the Th radioactivity level of different water seasons (P < 0.05). The total mean annual committed effective doses of Th in all age groups caused by drinking water and water immersion ranged from 3.14 × 10−8 to 8.75 × 10−7 Sv, all lower than the World Health Organization (WHO)-recommended reference level of 0.1 mSv. The overall carcinogenic risks for residents in all age groups ranged from 3.93 × 10−10 to 1.09 × 10−8, all below the most rigorous control limits issued by WHO and International Commission on Radiological Protection. Conclusion The Th-associated health risk via direct water intake and water immersion in main surface water bodies of Sichuan Province is at an acceptable level. Th in main surface water bodies of Sichuan Province is safe for all age groups.
8.20()-Protopanaxatriol promotes the binding of P53 and DNA to regulate the antitumor network multiomic analysis.
Zhihua WANG ; Wenbo WU ; Xiangchen GUAN ; Shuang GUO ; Chaowen LI ; Ruixue NIU ; Jie GAO ; Min JIANG ; Liping BAI ; Elaine Laihan LEUNG ; Yuanyuan HOU ; Zhihong JIANG ; Gang BAI
Acta Pharmaceutica Sinica B 2020;10(6):1020-1035
Although the tumor suppressor P53 is known to regulate a broad network of signaling pathways, it is still unclear how certain drugs influence these P53 signaling networks. Here, we used a comprehensive single-cell multiomics view of the effects of ginsenosides on cancer cells. Transcriptome and proteome profiling revealed that the antitumor activity of ginsenosides is closely associated with P53 protein. A miRNA-proteome interaction network revealed that P53 controlled the transcription of at least 38 proteins, and proteome-metabolome profiling analysis revealed that P53 regulated proteins involved in nucleotide metabolism, amino acid metabolism and "Warburg effect". The results of integrative multiomics analysis revealed P53 protein as a potential key target that influences the anti-tumor activity of ginsenosides. Furthermore, by applying affinity mass spectrometry (MS) screening and surface plasmon resonance fragment library screening, we confirmed that 20()-protopanaxatriol directly targeted adjacent regions of the P53 DNA-binding pocket and promoted the stability of P53-DNA interactions, which further induced a series of omics changes.
9.Value of serum amyloid A in patients with acute exacerbation of chronic pulmonary diseases
Yancong LI ; Jiesi ZHANG ; Chaowen GUO ; Jianzhi YUAN ; Fuyi LI
The Journal of Practical Medicine 2017;33(14):2349-2352
Objective To assess the value of serum amyloid A(SAA)in patients with acute exacerbation of chronic pulmonary diseases. Methods Seventy AECOPD patients were randomly chosen. The AECOPD patients were divided into bacterial infection induced group and non-bacterial infection induced group by sputum bacteria culture. Thirty five SCOPD patients were chosen as control group. General data was collected. Lung function ,chest X ray,blood routine,CRP,SAA,IL6 and PCT were deteced and compared in the 3 groups. The diagnostic value of SAA to distinguish bacterial infection induced AECOPD was estimated. Results SAA of both AECOPD sub-groups were significantly higher than that of healthy controls. SAA in infection group is higher that that in exacerba-tion group. In terms of ROC curve,AUC was 0.8682 for SAA to distinguish merging bacterial infection,and the cut-off value was 72.10 mg/L with sensitivity of 94.29% and specificity of 65.71%. Conclusion SAA increases in AECOPD patients,and more obviously in AECOPD patients with bacterial infection. SAA may be used as a reliable biomarker not only to distinguish AECOPD patients from SCOPD patients ,but also distinguish merging bacterial infection during AECOPD.
10.Application of epidural anesthesia combined with propofol sedation performed by targeted concentration infusion in patients undergoing total pelvic floor reconstruction surgery
Na ZHAO ; Chaowen LIU ; Bo CHENG ; Youchang LI
Chongqing Medicine 2015;(23):3213-3215
Objective To evaluate the feasibility of combining the sedation performed by propofol targeted concentration in-fusion with epidural anesthesia in patients undergoing total pelvic floor reconstruction.Methods A total of 80 eligible patients were recruited and were assigned randomly into the study group(n=40)and the control group(n=40).All patients in both groups were administered epidural anesthesia with the puncture and catheter placing in the space between the 2nd-3rd lumbar vertebras.After the epidural anesthesia,patients in the study group were administered propofol by targeted concentration infusion (TCI)system. The plasma concentration of propofol was modulated to obtain the BIS maintaining between 65-80,and the OAA/S maintaining at 3 scores.The propofol was continuously infused until closing the incision.Values of HR,MAP at different time points in the opera-tion were recorded,and the plasma concentrations of propofol,the incidences of adverse events were recorded.Results The HR and MAP of patients in the study group decreased at T1 (given the anesthetic),T2 (the beginning of the operation),T3 (the beginning of the operation),compared with those at T0 (before the anesthetic)and T4 (30 min after the operation)(P <0.05).The HR and MAP of patients in the control group elevated at T2 ,T3 ,compared with those at T0 and T4 (P <0.05).The HR of study group at T1 ,T2 , T3 and the MAP at T2 were lower than those in control group.In study group,two asphyxia patients were founded.The incidence of shivering in the study group was lower than that in control group (P =0.014).No statistical difference was found in the incidences of other adverse event between this two groups (P >0.05).BIS of study group was (73.3 ±4.8)-(76.1 ±3.4),and the plasma concentrations of propofol was(1.32 ± 0.29 )μg/mL - (1.52 ± 0.26 )μg/mL.Conclusion The combination of propofol sedation performed by TCI and epidural anesthesia could be safely and effectively used in patients undergoing total pelvic floor reconstruc-tion.

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