Search

Shuai Miao,* Yu Yang,* Ruiling Li, Li Yin, Kai Zhang, Lijun Cheng, Xiaona Xu, Weiding Wang, Zhiqiang Zhao, Guangping Li Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhiqiang Zhao; Guangping LiTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, People’s Republic of ChinaTel +86-22-88328368Fax +86-22-28261158Email tic_tjcardiol@126.com; zzqzzqzhiqiang@163.comPurpose: Atrial remodeling takes part in the pathogenesis of atrial fibrillation (AF). Aliskiren, as a direct renin inhibitor, has been shown to exert protective effects against arrhythmia. The aim of this study was to investigate the potential role of aliskiren in atrial remodeling in a chronic intermittent hypoxia (CIH) rat model.Methods: A total of 45 Sprague–Dawley rats were randomly assigned into three groups (n=15 per group): control group; CIH group; and CIH with aliskiren (CIH-A) group. CIH and CIH-A rats were subjected to CIH for 6 h per day for 4 weeks. Atrial fibrosis was evaluated using Masson’s trichrome staining. Electrophysiological tests were conducted in the isolated perfused hearts to assess the atrial effective refractory period and inducibility of AF. Atrial ionic remodeling was measured using the whole-cell patch-clamp technique, and Western blotting and real-time quantitative polymerase chain reactionwere performed to evaluate changes in ion channels.Results: CIH induced obvious collagen deposition, and the abnormal fibrosis was significantly attenuated by aliskiren. The inducibility of AF was increased significantly in the CIH group compared with the control and CIH-A groups (23± 24.5% vs 2.0± 4.2% vs 5.0± 7.0%, respectively; P< 0.05). Compared with the control group, the densites of the calcium current (ICaL) and sodium current (INa) were reduced significantly in the CIH group (ICaL: − 3.16± 0.61 pA/pF vs − 7.13± 1.98 pA/pF; INa: − 50.97± 8.71 pA/pF vs − 132.58± 25.34 pA/pF, respectively; all P< 0.05). Following intervention with aliskiren, the reductions in ICaL and INa were significantly improved, and the ionic modeling changes assessed at the mRNA and protein levels were also significantly improved.Conclusion: CIH could alter atrial modeling and subsequently promote the occurrence and development of AF, which could be attenuated by treatment with aliskiren.Keywords: atrial fibrillation, aliskiren, chronic intermittent hypoxia, atrial remodeling

Jian Zhang,1,* Yang Yu,1,* Shuai Miao,2 Lu Liu,1 Shuyuan Gan,1 Xianhui Kang,1 Shengmei Zhu11Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 2Department of Anesthesiology, The Affiliated Hospital, Xuzhou Medical University, Xuzhou, China*These authors contributed equally to this workObjective: The aim of the current meta-analysis was to assess the effect of dexmedetomidine on emergence agitation (EA) and the recovery outcomes after general anesthesia in adults.Methods: We searched the PubMed, the Cochrane Central Register of Controlled Trials, Embase, Web of Science and clinicaltrials.gov for relevant randomized controlled trials (RCTs) investigating the effects of dexmedetomidine on the EA in adults after general anesthesia compared with placebo. The primary outcome was the incidence of EA. Secondary outcomes included other recovery outcomes after general anesthesia.Results: Twelve RCTs (842 participants) met the eligibility criteria. A conventional random-effects meta-analysis demonstrated that peri-operative intravenous dexmedetomidine could be effective for the prevention of EA [risk ratio (RR) 0.49, Trial Sequential Analysis (TSA)-adjusted 95% confidence interval (CI) 0.35–0.68, P

Shuai Miao,1,2 Lan Zou,1,2 Guanglei Wang,1,2 Xiuli Wang,1,2 Su Liu,1,2 Mengzhu Shi1,21Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, People’s Republic of China; 2Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, People’s Republic of ChinaBackground: Etomidate used for the induction of general anesthesia can result in myoclonus. We tested the hypothesis that pretreatment with dexmedetomidine (Dex) reduces the incidence of etomidate-induced myoclonus during the induction of general anesthesia.Materials and methods: One hundred patients who were scheduled for selective operations under general anesthesia were included in this randomized, double-blind controlled trial. Patients were randomized to receive either Dex 0.5 μg/kg in 20 mL of normal saline or the same volume of normal saline as pretreatment agents 15 mins before the injection of etomidate 0.3 mg/kg. The primary endpoint was the incidence of etomidate-induced myoclonus. Secondary endpoints were the severity of etomidate-induced myoclonus and the incidence of adverse effects from the onset of action of Dex or normal saline to the injection of etomidate, such as dizziness, respiratory depression, bradycardia, hypotension and nausea/vomiting.Results: All of the 100 patients completed the trial. Dex resulted in a significant 38% reduction in the number of patients who experienced etomidate-induced myoclonus: 13 (26%) vs 32 (64%) (P=0.0001). Additionally, the severity of myoclonus was also reduced in the Dex group than that in the placebo group (P=0.02). Incidence of dizziness, respiratory depression, bradycardia, hypotension and nausea/vomiting was similar in both groups.Conclusions: Pretreatment with Dex 0.5 μg/kg 15 mins before the induction of general anesthesia not only resulted in a 38% reduction in the incidence of etomidate-induced myoclonus, but also reduced the severity of myoclonus, without inducing any adverse effects.Keywords: general anesthesia, adverse effects, myoclonus

Jun Hua,1 Shuai Miao,2 Mengzhu Shi,2 Qing Tu,3 Xiuli Wang,2 Su Liu,2 Guanglei Wang,2 Jianhui Gan31Department of Anesthesiology, The 101 Hospital of Chinese People’s Libration Army, Wuxi, Jiangsu, People’s Republic of China; 2Department of Anesthesiology, The Affiliated Hospital of XuZhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 3Department of Anesthesiology, Tangshan People‘s Hospital, North China University of Science and Technology, Tangshan, Hebei, People’s Republic of ChinaObjective: To evaluate the effect of butorphanol on the prevention of myoclonus induced by etomidate.Materials and methods: We searched the PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure databases to collect relevant randomized controlled trials (RCTs) evaluating the effect of butorphanol on etomidate-induced myoclonus in January 2019 without any language restrictions. The primary outcome was the incidence of etomidate-induced myoclonus. Secondary outcomes included the incidence of myoclonus at various degrees and the incidence of adverse effects. Risk ratios (RRs) were calculated for binary outcomes. All statistical analysis were performed by using RevMan 5.3 software.Results: We identified 6 RCTs involving a total of 608 patients who reported the incidence of etomidate-induced myoclonus. In pooled analyses, the incidence of etomidate-induced myoclonus in the butorphanol group was significantly lower than that in the control group (RR =0.15, 95% CI [0.10, 0.22], P

Mengzhu Shi,1,* Shuai Miao,1,* Tianchu Gu,1 Dongyue Wang,1 Hui Zhang,1 Jindong Liu2 1Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China; 2Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China *These authors contributed equally to this work Objectives: Emergence delirium (ED) is a common neurologic complication that can not only distress children and their families in the early postanesthetic period, but can also have adverse effects on children in the long-term. This study aimed to investigate the effects of single-dose dexmedetomidine on ED in children with sevoflurane anesthesia and to observe postoperative behavioral changes through long-term follow-up.Methods: Patients aged 2–7 years, American Society of Anesthesiologists class (ASA) I or II, scheduled for tonsillectomy with and without adenoidectomy were randomized to receive dexmedetomidine 0.5 µg/kg (Group D) or volume-matched normal saline (Group C) over 10 minutes after induction of anesthesia. The primary outcome was the incidence of ED within 30 minutes after extubation. Other outcomes were the incidence of pain, extubation time, post-anesthesia care unit (PACU) length of stay after extubation, adverse events, and the incidence of negative postoperative behavioral changes (NPOBCs).Results: Ninety children completed the study. Compared with the control group (Group C), dexmedetomidine decreased the incidence of ED (31.1% vs 53.3%; P=0.033) and pain (28.9% vs 57.8%; P=0.006), but it prolonged extubation time (P

Shuai Miao,* Mengzhu Shi,* Lan Zou, Guanglei Wang Department of Anesthesiology, The Affiliated Hospital of XuZhou Medical University, XuZhou, JiangSu, China *These authors contributed equally to this work Objective: Intrathecal dexmedetomidine (DEX) has been used to prevent shivering in patients undergoing cesarean section. The aim of this meta-analysis was to evaluate whether intrathecal DEX could prevent shivering in cesarean section after spinal anesthesia.Methods: We searched PubMed, Embase, Web of Science, and the Cochrane Library for randomized controlled trials (RCTs) comparing intrathecal DEX in cesarean section after spinal anesthesia with placebo and reporting on shivering, postoperative nausea and vomiting (PONV), hypotension, and bradycardia. Trial sequential analysis (TSA) was also carried out for RCTs comparing DEX with placebo. This meta-analysis has been registered on PROSPERO, and the registration number is CRD42017071640.Results: Six randomized clinical trials comparing 360 patients were included in this study. Compared with placebo, intrathecal DEX significantly reduced the incidence of shivering (risk ratio [RR]=0.40; 95% CI [0.26, 0.62]; P

Jian Zhang,1,* Shuai Miao,2,* Qing Tu,3 Mengzhu Shi,2 Lan Zou,2 Su Liu,2 Guanglei Wang2 1Department of Anesthesiology, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, China; 2Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China; 3Department of Anesthesiology, Tangshan People’s Hospital, North China University of Science and Technology, Tangshan, Hebei, China *These authors contributed equally to this study Objective: The aim of this study was to assess the effect of butorphanol on the prevention of opioid-induced cough by a meta-analysis.Materials and methods: We searched PubMed, Embase, The Cochrane Library, and the China National Knowledge Infrastructure database for relevant randomized controlled trials (RCTs) to demonstrate the efficacy of butorphanol on the prevention of opioid-induced cough. We used RevMan 5.3 to conduct a meta-analysis on each outcome.Results: Eight RCTs comparing 942 patients were included in this study. The pooled meta-analysis showed that the incidence of opioid-induced cough in the butorphanol group was significantly decreased compared with that of the control group (risk ratio [RR]=0.17, 95% CI [0.09, 0.33], P

Shuai Miao,1 Shi-Yao Zhou,2 Chun-Shan Han,3 Le-Ning Zhang,3 Hong-Bin Sun,3 Bin Yang3 1Department of Geriatrics, China-Japan Union Hospital of Jilin University, 2Department of Clinical Medicine, Jilin University, 3Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, People’s Republic of China Background: The MMP-7 basement membrane and extracellular matrix may be essential for tumor invasion and metastasis, and the results presented herein showed a relationship between MMP-7 expression and esophageal cancer (EC). However, its clinicopathological value for EC patients remains inconsistent. To clarify their associations, a meta-analysis of the relevant published literature was conducted.Materials and methods: Databases including PubMed, Embase, Web of Science, Cochrane Library, CISCOM, CINAHL, and Google Scholar were electronically searched. Only those studies analyzing MMP-7 expression in EC patients with regard to series of different demographic variables and clinicopathological stages (TNM stage, differentiation and invasion grade, and lymph-node [LN] metastasis) were eligible for inclusion. Summary odds ratios (ORs) were pooled in accordance with the random-effect model.Results: Fourteen clinical cohort studies (tumor samples =935) were incorporated into the current meta-analysis. Results revealed that increased MMP-7 expression in EC patients was positively correlated to TNM stage III–IV (OR 3.04, 95% confidence interval [CI] 1.43–6.46; P=0.004). Similar connections were also detected in the differentiation grade, invasion grade, and LN metastasis (all P