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IntroductionPostoperative ileus (POI), a common complication after surgery, severely affects postoperative recovery. It is unclear whether pretreatment with transcutaneous electrical acupoint stimulation (TEAS) can improve recovery from POI. This trial will evaluate the effects of pretreatment with TEAS on POI.Methods and analysisThis will be a prospective, randomised controlled trial. American Society of Anesthesiologists (ASA) physical status classification I–III level patients, aged 18–75 years and scheduled for laparoscopic colon surgery, will be included in the study. It is planned that 146 subjects will be randomised to the TEAS and sham TEAS (STEAS) groups. The groups will undergo two sessions of TEAS/STEAS daily for 3 days before surgery, with a final TEAS/STEAS treatment 30 min before anaesthesia. The primary endpoint of the study will be time to first defaecation. Secondary endpoints will include time to first flatus, time to tolerance of oral diet, GI-2 (composite outcome of time to first defaecation and time to tolerance of oral diet), time to independent walking, length of hospital stay, postoperative pain Visual Analogue Scale score on the first 3 days after surgery, analgesic requirements, complications and plasma concentrations of interferon-β (IFN-β), IFN-γ, interleukin-6 (IL-6) and IL-1β. Multiple linear regression will be used to identify independent predictors of outcome measures.Ethics and disseminationThis study has been approved by the Chinese Registered Clinical Trial Ethics Review Committee (No. ChiECRCT-20170084). The results of the trial will be published in an international peer-reviewed journal.Trial registration numberThis study has been registered with the Chinese Clinical Trial Registry (No. ChiCTR-INR-17013184).Trial statusThe study was in the recruitment phase at the time of manuscript submission.

Background: Though Cardiac surgery under cardiopulmonary bypass (CPB) under epidural anesthesia in conscious patients is associated with increased risk of epidural hematoma. We developed a monitored anesthesia care (MAC) platform for cardiac surgery under CPB. In the current prospective study, we investigated the safety and effectiveness of the MAC platform versus intubated general anesthesia (IGA) in patients receiving elective open-heart surgery. Methods: The study included adult patients who were scheduled to undergo open-heart surgery under CPB at our hospital between April 2012 and February 2017. MAC consisted of local anesthesia at the site of sternotomy, sedation with dexmedetomidine, analgesia with remifentanil/sufentanil, and electroacupuncture. MAC versus IGA was chosen by the patients. Findings: Eleven patients received MAC and 13 patients received IGA. The two groups were comparable in the demographic, baseline and operative variables. No conversion occurred from MAC to IGA. No major complications occurred during the surgery in both groups. No confirmed awareness events after surgery were reported in both groups. There was no statistical difference in the incidence of postoperative complications between the two groups (P >0.05). The intraoperative consumption of sufentanil and remifentanil was significantly lower in the MAC group than the IGA group (P < 0.001). The time to drinking was significantly shorter in the MAC group (2.14±0.90 h) than the IGA group (22.31±3.33 h) (P

Background Cardiac surgery involving cardiopulmonary bypass (CPB) is known to be associated with a transient postoperative immunosuppression. When severe and persistent, this immune dysfunction predisposes patients to infectious complications, which contributes to a prolonged stay in the intensive care unit (ICU), and even mortality. Effective prevention and treatment methods are still lacking. Recent studies revealed that acupuncture-related techniques, such as electroacupuncture and transcutaneous electrical acupoint stimulation (TEAS), are able to produce effective cardioprotection and immunomodulation in adult and pediatric patients undergoing cardiac surgery with CPB, which leads to enhanced recovery. However, whether perioperative application of TEAS, a non-invasive technique, is able to improve immunosuppression of the patients with post-cardiosurgical conditions is unknown. Thus, as a preliminary study, the main objective is to evaluate the effects of TEAS on the postoperative expression of monocytic human leukocyte antigen (-D related) (mHLA-DR), a standardized “global” biomarker of injury or sepsis-associated immunosuppression, in patients receiving on-pump coronary artery bypass grafting (CABG). Methods This study is a single-center clinical trial. The 88 patients scheduled to receive CABG under CPB will be randomized into two groups: the group receiving TEAS, and the group receiving transcutaneous acupoint pseudo-electric stimulation (Sham TEAS). Expression of mHLA-DR serves as a primary endpoint, and other laboratory parameters (e.g., interleukin [IL]-6, IL-10) and clinical outcomes (e.g., postoperative infectious complications, ICU stay time, and mortality) as the secondary endpoints. In addition, immune indicators, such as high mobility group box 1 protein and regulatory T cells will also be measured. Discussion The current study is a preliminary monocentric clinical trial with a non-clinical primary endpoint, expression of mHLA-DR, aiming at determining whether perioperative application of TEAS has a potential to reverse CABG-associated immunosuppression. Although the immediate clinical impact of this study is limited, its results would inform further large-sample clinical trials using relevant patient-centered clinical outcomes as primary endpoints. Trial registration ClinicalTrials.gov, NCT02933996. Registered on 13 October 2016.

Aiming at the study of underwater vehicle noise extraction in the measurement, a method based on blind source separation (BBS) is presented, and the kernel independent component analysis (KICA) is used in the separation of underwater vehicle noise. The principle and algorithm is introduced and the simulation is carried on to compare with the traditional ICA algorithm in BBS. The simulation results show that KICA not only separates the underwater vehicle noise effectively but also is more accurate than the traditional ICA algorithm.

Background: The coronary artery bypass grafting (CABG) is a surgery to relieve angina and reduce mortality of coronary heart disease. However, the patient is more prone to have immunosuppression after the surgery, causing secondary infection, and it is closely correlated to the occurrence and progress of tumor after surgery. More and more studies revealed that needle puncture was able to effectively regulate the function of immune system. However, its perioperative application is unclear. Therefore, this clinical study is aimed to evaluate whether the effect of Transcutaneous Electrical Acupoint Stimulation (TEAS) on improvement of immunosuppression of patients after receiving CABG. Methods: This clinical study was a single-center clinical trial. The 88 patients scheduled to receive CABG under extracorporeal circulation were randomized into 2 groups: the group of TEAS combined with general anesthesia (TEAS+GA), and the group of transcutaneous acupoint pseudo - electric stimulation combined with general anesthesia (Sham TEAS+GA). Human leukocyte antigen of monocyte (mHLA-DR) was the main endpoint to evaluate on the improvement of immunosuppression of patient after surgery. In addition, the monitoring indicators, such as interleukin-6 (IL-6), reactive protein C (CRP), high mobility group protein 1 (HMGB1), regulatory T cell (Treg) and secondary infection, etc., were recorded, and further statistical analysis was conducted. Discussion: This study performs TEAS intervention on patients scheduled to receive CABG under extracorporeal circulation in perioperative period, to improve their postoperative immunosuppression, reduce postoperative complications, reduce secondary infection rate, shorten hospital stay and improve the patient’s outcome. This study also aims to provide clinical evidence for application of this technique. However, TEAS related parameters in this study (stimulus intensity and waveform, intervention timing and duration, etc.) should be further optimized. Trial registration: This study was approved by Ethics Committee of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine with the number 2016-455-06-01. The results of the trial will be published in an internationally peer-reviewed journal. This study was registered at ClinicalTrials with the Identifier NCT02933996 on 13 October 2016, https://www.clinicaltrials.gov/ct2/show/NCT02933996 Keywords: CABG; TEAS; immunosuppression; mHLA-DR

Background: A parallel-group randomized controlled trial (RCT) was conducted to evaluate the effect of combining the interscalene brachial plexus block (IBPB) with Intravenous–inhalation combined anesthesia to isolated Intravenous–inhalation anesthesia in the upper extremity fractures surgery of elderly patients. Methods: One hundred elderly patients who underwent upper extremity surgery were randomly assigned to received isolated Intravenous–inhalation combined anesthesia (group CI, n = 50) and IBPB associated with Intravenous–inhalation combined anesthesia (group NB, n = 50). Associated side effects, recovery time after operation, as well as the dose of intraoperative vasoactive agents and auxiliary drugs were noted. Results: The two groups were not significantly different in gender (P = 0.539), ages (P = 0.683) and weight (P = 0.212). Five patients (10%) in the group NB and 17 patients (34%) in the group CI suffered from preoperative hypotension (P = 0.004). Besides, lower incidence of other adverse effects such as mental stress, incision pain and hypertension were also found in the group NB; however, the differences were not statistically significant (P > 0.05). The consumption of general anesthetics in the group NB was significantly less than that of the group CI (propofol, P = 0.004; lsoflurane, P

Objective To observe postoperative effect of electroacupuncture (EA) of different frequencies in acupuncture anesthesia combined with drugs on patients undergoing thyroid surgery. Methods One hundred and twenty patients undergoing thyroid surgery were randomly divided into a 2Hz electroacupuncture anesthesia group (group A), a 100 Hz electroacupuncture anesthesia group (group B), a 2Hz/100 Hz electroacupuncture anesthesia group (group C) and a cervical plexus block group (group D) in accordance with the random number table method, with 30 patients in each group. In group A, group B and group C, electroacupuncture was applied at bilateral Futū ( LI 18), Hegŭ ( LI 4) and Neiguān ( PC 6) at frequencies of 2 Hz, 100 Hz and 2 Hz/100 Hz respectively for 30 min. The needles were retained till the end of the surgery. Dolantin and atropine were intramuscularly injected In group D, bilateral cervical plexus block was produced with a mixture of 1% lidocaine and 0.375% bupivicaine. Before surgery, pain threshold and threshold of pain tolerance were determined; during surgery, the duration of surgery was recorded; and after surgery, QOLS (Quality Of Life Score) and PHS (Prince-Henry Score) were assessed. Results PHS in group A, group B and group C were lower than that in group D, respectively (0.20±0.41, 0.17±0.38, 0.10±0.31 vs 0.40±0.50, P Conclusion Acupuncture anesthesia combined with drugs has better postoperative effect than drug anesthesia. Electroacupuncture of different frequencies can significantly improve general quality of life of patients, so patients recover well after thyroid surgery. As patients in group C suffered from the slightest pain with the highest quality of life, they recovered best within the shortest time. Electroacupuncture at frequency of 2 Hz/100 Hz can better play postoperative analgesic effect.

Profile control and flooding technique is an effective way to enhance the oil recovery of low permeability reservoir.Analyzing the relation between oil and water interface and determining injection volume under different concentration is the key to success in profile controlling and flooding in low permeability reservoir .The research is about SJT-B collosol of physicochemical property under normal pressure and temperature.We also carry on the study on measuring SJT-B collosol interfacial tension for a long time under different concentration.Besides, we conduct the plugging degree experiment by injecting SJT-B collosol with the concentration of 0.8% in different permeability core.The lower the core permeability, the higher the plugging degree. By optimizing the injection pattern we conduct the three-tube parallel profile control and flooding experiment in the low permeability heterogeneous core.It indicates that SJT-B collosol mainly access to high permeability layer and have an effective plugging effect .The absorbed liquid rate of medium permeability layer is increased apparently ,while low permeability layer is increased slightly.The SJT-B collosol of injection method has efficient effect on enhancing the oil recovery of low permeability reservoir in late water flooding.

Background The present study aimed to compare the safety and efficacy for novices to conduct intubation with the Bonfils intubation fiberscope (BIF) using the transillumination-assisted or midline approach technique in patients with normal airways. Methods In this prospective randomized control study, 10 trainees were assigned to the transillumination-assisted technique group (T group) or the midline approach technique group (R group). Each trainee was required to conduct intubation in 50 patients. The primary outcome was intubation time. The secondary outcomes were success rate (%), number of attempts, and complications. Results Among the cases of successful intubation, the intubation time was not significantly different between the two groups (P > 0.05). The overall success rate of intubation was not significantly different between the two groups (P > 0.05). The intubation success rates at the first, second, and third attempts as well as the average intubation times were similar between the two groups (P > 0.05), but in patients receiving successful intubation at the second attempt, the intubation time was longer in the T group (P = 0.0006). The incidences of dry throat, sore throat, and hoarseness were higher in the T group (all P < 0.05). Conclusions For patients with a normal airway, the transillumination-assisted technique was unlikely to increase the success rate of intubation with the BIF compared with the midline approach technique, but led to more complications. Trial registration ChiCTR-INR-16009967, retrospectively registered on November 22, 2016 Electronic supplementary material The online version of this article (doi:10.1186/s12871-017-0322-6) contains supplementary material, which is available to authorized users.

Objective To observe the protective effect of acupuncture-drug compound anesthesia with different frequency electroacupuncture (EA) on stress reaction in patients of pneumonectomy and to explore potential mechanisms. Methods Eighty patients scheduled for pneumonectomy were randomly divided into four groups, group A, B, C and D, 20 cases in each group. General anesthesia and single lung protective mechanical ventilation were carried out in all the groups. Acupuncture was given at Houxī ( SI 3), Zhīgōu ( TE 6), Neiguān ( PC 6), and Hegŭ ( LI 4) 30 min before general anesthesia, and the acupuncture needles were connected with Han's acupoint nerve stimulator (HANS-200) in all the groups, but the acupuncture needles without needle bodies were pasted on the acupoints and EA was not given in the group A. 2 Hz continuous wave, 100 Hz continuous wave and 2 Hz/100 Hz EA were given in the group B, C and D respectively. The supplementary amount of anesthesia medicine, heart rate (HR) and mean arterial pressure (MAP) during pneumonectomy, and CD+4/CDCD+8 in venous blood before and one day after the surgery, and the contents of epinephrine (E) and Cortisol (Cor) in plasma after entering the operating room and before turning out the operating room were detected. Results During the operation, supplementary amounts of Fentanyl in the group B and C were lower than those in the group A and D (P The MAP in the four groups at tracheal intubation (T1) all were higher than those before anesthesia (T0) (all P 0.05), and the ascending extents in the group B and D were lower than that in the group A (both P CD+4/CD+8 in the group A after pneumonectomy was lower than that before the surgery (P 0.05). Contents of E and Cor after the operation were significantly increased in all the groups (all P Conclusion Acupuncture-drug compound anesthesia can attenuate the stress reaction so as to protect organs under the condition of less or same narcotic amount and can alleviate the fluctuation of MAP and HR at tracheal intubation and stabilize CD+4/CD+8 after pneumonectomy. Among them, 2 Hz and 2 Hz/100 Hz EA have better effects.

That griping and predicting concrete strength is crucial importance for shorten design cycle of cement concrete proportion and control efficiently key construction node in time. The paper exposited systematically experimental method of strength estimation of cement concrete and corresponding research progress at present, and the prospect was also analyzed. It is very necessary to promote research work of experiment and analysis method because strength estimation of cement concrete is paramount. It has important meaning for delving into the aspect through above discussion in the future.

The bark of Wikstroemia indica is rich in daphnoretin, which has strong antiviral and anti-tumour activities. In order to optimise the extraction conditions of daphnoretin from the bark of W. indica, various extraction parameters were chosen to identify their effects on daphnoretin extraction. Response surface methodology (RSM) was applied to obtain the optimal combination of these parameters. Results showed that the optimisation conditions for daphnoretin extraction were: ethanol concentration 67.44%, extraction time 49.44 min, temperature 60.19 °C and liquid–solid ratio 23.49:1. The maximum extraction of daphnoretin obtained experimentally was 2.18‰. The mathematical model developed was found to fit well with the experimental data. Further, four kinds of human cancer cell lines, HeLa, A549, CNE and HEp-2, were tested in vitro to explore the anti-tumour spectrum of daphnoretin. It was found for the first time that daphnoretin showed significant inhibition on the proliferation of CNE and HeLa cells.

To evaluate the effect of electro-acupuncture (EA) on gastric mucosal oxygenation and systemic inflammatory response in patients undergoing endoscopic sinus surgery with controlled hypotension (CH), and to explore its protective effect on gastric mucosa.Fifty-four patients, 18-65 years old, grade I-II of American Society of Anesthesiology (ASA), who were scheduled for endoscopic sinus surgery were randomly assigned to two groups, group A (general anesthesia group) and group B (general anesthesia combined EA anesthesia group), 27 in each group. Conrolled hypotension was executed during operation, and mean arterial pressure (MAP) was maintained at 55-65 mmHg. After tracheal intubation gastric tesiometer catheter was indwelled through nasal cavity or oral cavity. After successful indwelling, it was connected with gastric mucosa monitoring mode of multifunctional parameters monitor. Patients' MAP and heart rate (HR), pHi, partial pressure of carbon dioxide (PgCO2), arterial partial pressure of carbon dioxide (Pg-aCO2) and endtidal pressure of carbon dioxide (Pg-etCO2) were measured and recorded at T, (immediately before induced hypotension), T, (20 min following induced hypotension to target MAP), T2 (40 min following induced hypotension to target MAP), T3 (20 min after ending induced hypotension), and T4(40 min after ending induced hypotension). Blood samples were intravenously collected, TNF-alpha, IL-1, and IL-6 were detected by ELISA 24 h before operation, during operation (T3), and 24 h after operation.After hypotension was induced, Pg-CO2, Pg-aCO2 and Pg-etCO2 increased significantly (P0.01, P0.05), while pHi decreased significantly (P0.01) in both groups at T1-T4 than those at T0. During T1-T4, PgCO2, Pg-aCO2, and Pg-etCO2 were higher (P0.01, P0.05), while pHi was lower in group A than in group B (P0.01). Furthermore, TNF-alpha, IL-1, and IL-6 increased significantly in both groups during operation and 24 h after operation, when compared with those 24 h before operation (P0.01, P0.05). TNF-alpha and IL-1 in group A were higher than those in group B (P0.05) during operation and 24 h after operation, but with no significant difference in the plasma concentration of IL-6 (P0.05).EA exerted obvious protective effect of gastric mucosal injury in endoscopic sinus surgery with controlled hypotension, which might be achieved by increasing gastric mucosal blood flow, maintaining oxygen supply and demand, inhibiting inflammatory response, and alleviating injury of gastric mucosal barrier.

The endometrium is hostile to embryo implantation except during the ‘window of receptivity’. A change in endometrial gene expression is required for the development of receptivity. Calbindin-d9k (CaBP-d9k) and calbindin-d28k (CaBP-d28k) are proteins possessing EF-hand motifs which have high affinity for Ca2+ions. Previously, it has been demonstrated that, in mouse endometrium, the expression of both calbindins is highly regulated during implantation and that both proteins play critical but functionally redundant roles at implantation. This study was the first to determine the expression of these two calbindins in the human and rhesus monkey endometrium. Initial RT-PCR analysis demonstrated that CaBP-d28k but not CaBP-d9k mRNA expression is detectable in the endometrium of both species. Western blot analysis confirmed the presence of immuno-reactive CaBP-d28k protein in the primate endometrium. Furthermore, the endometrial expression pattern of CaBP-d28k mRNA and protein was examined by Northern blot analysis and immunohistochemistry respectively in both species across the menstrual cycle and during early pregnancy. Semi-quantitative statistical analysis of the immunohistochemistry results revealed that, in the human, CaBP-d28k protein expression was maximal in luminal and glandular epithelium during the mid-secretory phase, coinciding with the time when the endometrium is receptive to embryo implantation. Expression in rhesus monkey showed a similar trend. These results suggest that, in the primate endometrium, only CaBP-d28k is expressed and that the specific regulation of this calbindin is potentially important for the establishment of uterine receptivity.

To evaluate the effect of Dexmedetomidine and Midazolam on respiratory and circulation in patients experiencing open heart surgery under acupuncture-assisted general anesthesia.Sixty patients undergoing open heart surgery (cardiac valve replacement surgery and aortic valve replacement surgery) were randomly and equally divided into Dexmedetomidine (D) and Midazolam (M) groups. Electroacupuncture (EA) was applied to bilateral Yunmen (LU 2), Zhongfu (LU1), Lieque (LU7) and Neiguan (PC6). For patients of group D, Dexmedetomidine (i.v., loading dose: 1 microg/kg, and succedent dose: 0.2-1 microg x kg(-1) x h(-1)) was given. For patients of group M, Midazolam (i.v., loading dose: 0.05 mg/kg, succedent dose: 0.01-0.03 mg x kg(-1) x h(-1)) was given. Arterial oxygen pressure (PaO2), arterial carbondioxide tension (PaCO2), O2 saturation (SPO2), mean arterial pressure (MAP), heart rate (HR), anesthetic effect, time of spontaneous breathing recovery, and time of resuscitation were recorded before operation (T0), immediately after skin incision (T1), immediately after sternotomy (T2), before suspension of cardiopulmonary bypass (CPB, T3), immediately after cardiac re-beating (T4), immediately after CPB cessation (T5), and at the end of surgery (T6).Before operation, no significant differences were found between the group D and M in the levels of PaO2, PaCO2 and SPO2 (P0.05). The PaO2 and SPO2 levels after skin incision, sternotomy, before suspension of CPB and at the end of surgery were significantly lower in group M than in group D (P0.05), while the le- vels of PaCO2 after skin incision, sternotomy, before suspension of CPB and at the end of surgery, and HR after skin incision, sternotomy, before suspension of CPB, after heart re-beating,after CPB cessation and at the end of surgery in group M were considerably higher than those in group D (P0.05). In addition, the time of spontaneous breathing recovery of group M was significantly later than that of group D (P0.05). No significant differences were found between the two groups in MAP levels at the 6 time-points during surgery, in the PaO2, PaCO2 and SPO2 levels at the time-points of post-cardiac re-beating, and after CPB cessation (P0.05). It suggested that the respiration and circulation states in group D were more smoothly than those in group M. There was no significant difference between the two groups in the time of resuscitation (P0.05).Dexmedetomidine is superior to Midazolam in analgesia, and improving respiration and circulation functions for open heart surgery patients under acupuncture-assisted general anesthesia.

To observe the clinical effect of electric stimulation of long-term retaining needle on analgesia after laparoscopic cholecystectomy (LC) and the impacts on the post-surgical flatus time.Under static absorptive composite general anesthesia, 90 cases of LC were randomized into three groups, 30 cases in each one. In the control group, the analgesia was not applied after LC. In the analgesia-pumper group, the patient controlled intravenous analgesia (PCIA) was used. In the needle-retaining group, the electric acupuncture stimulator was used. The needles were inserted transversely at Riyue (GB 24), Qichong (ST 30) and Yanglingquan (GB 34) and fixed with sterile sticker. Separately, in 8 h and 24 h after surgery, the electric acupuncture stimulation with disperse-dense wave, 2 Hz/100 Hz frequency was applied continuously for 30 min. Visual analogue scale (VAS), adverse reactions such as vomiting and nausea and the postoperative flatus time in 2, 4, 8, 12, 24 and 36 h after surgery were observed and recorded in the three groups.In 2, 4, 8, 12 and 24 h after surgery, VAS scores in the needle-retaining group and the analgesia-pumper group were all lower than those in the control group (P0.05, P0.01). The analgesia effect at the above time points in the needle-retaining group was better than that in the analgesia-pumper group (all P0.05). There was not adverse reaction in the needle-retaining group. But there were 3 cases of somnolence, 6 cases of nausea and 3 cases of vomiting in the analgesia-pumper group, and 2 cases of nausea and 1 case of vomiting in the control group. The flatus time was quite earlier in the needle-retaining group as compared with the other two groups [(14.77 +/- 4.99) h vs (18.50 +/- 4.22) h, P0.01; (14.77 +/- 4.99) h vs (18.17 +/- 4.69) h, P0.05].The electric stimulation of long-term retaining needle is safe and effective in analgesia after LC. It avoids the adverse reactions of analgesics and promotes postoperative flatus.

To observe the protective effect of transcutaneous electrical acupoint stimulation (TEAS) on cerebral tissue in elderly hip replacement operation patients during general anesthesia under controlled hypotension.Forty hip replacement operation patients were randomly divided into general anesthesia (GA) control group and TEAS + GA group (n = 20 in each group). Patients of the two groups during operation were treated with controlled hypotension for reducing blood loss. TEAS (2 Hz/100 Hz, 8-12 mA) was applied to bilateral Yuyao (EX-HN 4) and Fengchi (GB 20) and began 30 min before GA. General anesthesia was performed by intravenous injection of Midazolam, Diprivan, Fentanyl and Cis-atracurium, sevoflurane-inhaling, Remifentanil, etc., and the patient's mean arterial pressure was maintained to be about 70% of the normal level (controlled hypotension) by using venous administration of Remifentanil about 10 min after the operation. GEM Premier 3000 blood gas analyzer was used to analyze levels of the arterial oxygen (CaO2), internal jugular venous oxygen (CjvO2), arterio-venous oxygen content difference (Da-jvO2) and cerebral oxygen (CERO2) uptake rates of blood samples before controlled hypotension (T0), 20 min after controlled hypotension (T ). 40 min after controlled hypotension (T2) and 20 min after the end of controlled hypotension (T3).Self-comparison of each group showed that in comparison with pre-controlled hypotension, CjvO2 levels at the time-points of T, T2 and T3 were significantly increased in both GA control and TEAS+GA groups (P0.05), while Da-jvO2 and CERO2 uptake rate levels at the time-points of T,. T2 and T3 in these two groups were significantly decreased (P0.05). Comparison between two groups showed that CivO2 levels at the time-points of T2 and T3 were significantly higher in the TEAS + GA group than in the GA control group (P0. 05). while Da-jvO2 and CERO2 uptake rate levels at the time-point of T2 were obviously lower in the TEAS + GA group than in the GA control group(P0. 05), suggesting a reduction of cerebral oxygen consumption after TEAS. No significant differences were found between these two groups in blood CjvO2, Da-jvO2 and CERO2 uptake rate levels at the time-points of T0 and T1 (P0.05).TEAS can reduce cerebral oxygen uptake rate in elderly patients undergoing hip replacement during controlled hypotension, suggesting a protective effect of TEAS on patient's cerebral tissue.

A large number of clinical trials and animal experiments have been carried out to focus on neurochemical mechanisms of acupuncture analgesia including postoperation pain relief, which may provide guidance for developing a novel clinical approach for postoperative analgesia. In the present paper, the authors review new progresses of researches on acupuncture analgesia for postoperative pain and side effects in the past few years from thyroidectomy, chest surgery, abdominal surgery, five sense organs (ear, nose, eye and throat) surgery, and others. Regarding the mechanism of acupuncture, central neurotransmitters (including the endop endorphin, 5-HT, gamma-aminobutyric acid, etc.), immune cytokines, cytokines from the spinal glia cells are complicated in the process of acupuncture analgesia. A lot of findings of researches demonstrated that acupuncture therapy is effective in reducing postoperative pain and adverse reactions as nausea, vomiting, etc. As a common technique widely used in the field of clinical medicine, the underlying mechanisms of acupuncture therapy for relieving post-surgery pain and side-effects should be studied profoundly in the future.

To assess the impacts on postoperative nausea and vomiting of the patients with laparoscopic surgery undergoing the general anesthesia by electroacupuncture (EA) at different frequencies at bilateral Neiguan (PC 6).One hundred and twenty female patients with laparoscopic surgery undergoing the general anesthesia were randomized into 4 groups: 2 Hz EA treatment group (group A), 2 Hz/100 Hz EA treatment group (group B), 100 Hz EA treatment group (group C) and a control group (group D), 30 cases in each one. The same anesthetic program was adopted in each group. For the patients in A, B and C groups, in the first half a hour undergoing the conventional drug anesthesia, acupuncture was applied to bilateral Neiguan (PC 6). After arrival of qi, HANS-200A electroacupuncture apparatus was connected, at the frequency as 2 Hz, 2 Hz/100 Hz and 100 Hz separately. The electric stimulation was discontinued at the end of surgery. The life physical signs after surgery, the occurrence of postoperative nausea and vomiting and the severity grades of postoperative nausea and vomiting were observed and recorded for the patients in each group.The differences in the postoperative 1 h heart rate, mean arterial pressure (MAP), finger pulse oxygen saturation and respiratory frequency were not significant statistically in comparison of the patients among groups (all P0.05). The incidence of postoperative nausea and vomiting of the patients in group B was lower apparently than that in A, C and D groups [10.0% (3/30) vs 30.0% (9/30), 36.7% (11/30), 53.3% (16/30), all P0.01]. The severity of postoperative nausea and vomiting of the patients in group B was lower apparently than that in the rest three groups (all P0.01).The electroacupuncture at 2 Hz/100 Hz reduces effectively the incidence and the severity of postopera tive nausea and vomiting of the patients with laparoscopic surgery undergoing the general anesthesia.

The aim of the present study was to investigate the inhibitory potential of glimepiride towards important UDP-glucuronosyltransferase (UGT) isoforms in human liver, which play a key role in the elimination of drugs. The recombinant UGT enzymes were used as enzyme source, and a nonspecific substrate 4-methylumbelliferone (4-MU) was utilized as substrate. The results showed that 100 microM of glimepiride inhibited UGT1A1, UGT1A3, UGT1A6, UGT1A9, UGT2B7 and UGT2B15 by 54.7%, 43.1%, 100%, 70.5%, 32.7 and 37.2%, respectively. Given that glimepiride exhibited strong inhibition towards UGT1A6, further inhibitory kinetic behaviour was determined. Glimepiride exerted concentration-dependent inhibition towards UGT1A6. Both Dixon and Lineweaver-Burk plots demonstrated that inhibition of UGT1A6 was best fit for noncompetitive inhibition type, and the inhibition kinetic parameter (Ki) was calculated to be 59.8 microM. Given that UGT1A6 plays a key role in detoxification of many drugs, more attention should be given when glimepiride was co-administered with the drugs mainly undergoing UGT1A6-mediated metabolism.

To observe the protective effect of acupuncture-drug compound anesthesia with different frequency electroacupuncture on stress reaction in pneumonectomy and to explore potential mechanisms.Eighty patients scheduled for pneumonectomy were randomly divided into four groups, named group A, B, C and D, 20 cases in each group. General anesthesia and single lung protective mechanical ventilation were produced in all the groups. They were treated with acupuncture at Houxi (SI 3), Zhigou (TE 6), Neiguan (PC 6), and Hegu (Li 4) 30 min before general anesthesia, and then with Han's acupoint nerve stimulator (HANS-200). The acupuncture needles without needle bodies were pasted on the acupoints and the electroacupuncture were not turned on in group A, and the 2 Hz continuous wave were produced in group B, and 100 Hz continuous wave were produced in group C and the 2 Hz/100 Hz were produced in group D. The supplementary anesthesia medicine during pneumonectomy, heart rate (HR), mean arterial pressure (MAP), CD4+ /CD/ in venous blood before and after the surgery, and the contents of epinephrine (E) and cortisol (Cor) in plasma at the time of inter-room and outer-room were detected.(1) The supplementary fentanyl in group B and C were lower than those in group A and D (P0.05, P0.01). (2) The MAP in the four groups at intratracheal intubation (T1) were all higher than those at before anesthesia (T0) (all P0.01), and the ascending extent in group B, C and D were lower than that in group A (all P0.01). The HR at T in group A was higher than that at T0 (P0.05) and there were no significant differences in the other groups (all P0.05), and the ascending extent in group B and D were lower than that in group A (both P0.05). The MAP and HR at the other moment in all the groups were maintained stable. (3) CD4+ /CD8+ in group A after pneumonectomy was lower than that before the surgery (P0.05), and there were no significant differences in the other groups (all P0.05). (4) The content of E and Cor after the surgery were all increased (all P0.01), and the ascending extent of E in group D was lower than that in group A (P0.05), and the ascending level of Cor in group B and D were lower than that in group A (P0.01) and group B compared with group C and D were got the same result.Acupuncture-drug compound anesthesia can attenuate the stress reaction so as to protect organs under the condition of less drug and can alleviates the undulate phenomenon of MAP and HR at intubation and stabilize CD4+ /CD8+ after pneumonectomy. Among them, the 2 Hz and 2 Hz/100 Hz electroacupuncture groups have the comparatively better effects.

To observe the anti-stress effect of acupuncture-assisted anesthesia in patients undergoing pulmonary lobectomy.A randomized, controlled, single-blind clinical trial was conducted in the present study. A total of 48 patients undergoing pulmonary lobectomy were randomized into regular general anesthesia (RGA), general anesthesia combined with 2 Hz electroacupuncture (EA) (GA+2 Hz-EA), general anesthesia combined with 2 Hz/100 Hz EA (GA+2 Hz/100 Hz-EA), and GA + 100 Hz-EA groups (n=12). EA (1-3 mA) was applied to bilateral Houxi (SI 3), Zhigou (SJ 6), Neiguan (PC 6) and Hegu (LI 4) for 30 min, followed by general anesthesia with midazolam (0.05 mg/kg), fentanyl (5 microg/kg), propofol (2 mg/kg), and vecuronium (0.1 mg/kg). The dosages of the anesthetics, heart rate (HR), systolic blood pressure (SBP), and bispectral index (BIS) of electroencephalogam during general anesthesia were recorded. Plasma adrenaline and cortisol concentrations were assayed by radioimmunoassay.In comparison with the RGA group, the dosages of supplementary propofol and fentanyl in both GA + 2 Hz-EA and GA + 100 Hz-EA groups,and that of propofol in the GA+2 Hz/100 Hz-EA group were decreased significantly (P0.05, P0.01). Compared to the RGA group, both HR and SBP values during trachea extubation in the GA+ 2 Hz/100 Hz-EA and GA + 100 Hz-EA groups were significantly lower (P0.01, P0.05). No significant differences were found between the GA+2 Hz/100 Hz-EA and RGA groups in the supplementary dose of fentanyl, between the GA+2 Hz-EA and RGA groups in HR and SBP values during trachea extubation, among the 4 groups in HR and SBP values before trachea extubation and in plasma adrenaline and cortisol levels (P0.05).Acupuncture-assisted anesthesia can decrease the dosage of general anesthetics, and effectively restrain cardiovascular stress reaction during trachea extubation in pulmonery lobectomy patients.

Paraquat (PQ)-induced pulmonary toxicity is known to result in pulmonary edema, infiltration of inflammatory cells and damage to the alveolar epithelium, which may progress to severe fibrosis. Matrix metalloproteinases (MMPs) and their physiological inhibitors, tissue inhibitors of matrix metalloproteinases (TIMPs), which degrade and remodel the excess extracellular matrix, are believed to play an important role in the development of fibrotic tissue. In this study, we examined the sequential expression of MMP-2, MMP-9 and TIMP-1 in a rat model of pulmonary fibrosis induced by PQ. Adult male Sprague-Dawley rats were treated intraperitoneally with PQ (20 mg/kg) and saline (control group). Rats were sacrificed at days 1, 3, 7 and 21 after the PQ treatment. Lungs were excised for histological evaluation and immunohistochemical analyses, as well as the determination of collagen content, gene expression by fluorimeter-based quantitive RT-PCR assay and gelatinolytic activity by zymography. Lung MMP-2 and -9 mRNA expression progressively increased and reached a peak on day 7 after PQ treatment, while TIMP-1 mRNA levels in the PQ-treated lungs reached a peak on day 21 after modeling. Lung zymography revealed an increase in progelatinase B, progelatinase A and their active forms. In conclusion, unbalanced MMP/TIMP-1 expression and excessive gelatinolytic activity contribute to PQ-induced pulmonary fibrosis. Their precise role should be studied in depth as they may represent relevant therapeutic targets for PQ poisoning-induced pulmonary fibrosis.

To study the changes in sciatic nerve blood flow and the expression of collagen type I after electric injury of rabbit nerve with different voltages.Thirty-six healty rabbits were randomized into 3 groups before receiving injury with electricity in voltages, i.e. 50 v, 75 v, and 100 v groups. The changes in blood flow of sciatic nerve were observed with Laser Doppler Flowmeter immediately after injury and 1, 4, 8 weeks after injury. The changes in the expression of collagen type I was observed by immunohistochemical method, and the positive expression rate was calculated.The sciatic nerve blood flow increased in all groups immediately after electric injury. In the 75 v and 100v groups, the nerve blood flow [(53 +/- 3 ), (48 +/- 5) PU] was obviously lower than that of normal value [(62 +/- 4) PU, P0.05]. There was little collagen type I deposition in 50 v group, while brown collagenous fibers in epineurium and perineurium were observed in 75 v and 100v groups 4 and 8 weeks after injury. The expression of collagen type I in all groups were obviously higher than that of normal value, and that in 75v and 100 v groups were higher than that in 50 v group at bachl time-point (P0.01).The restoration of sciatic nerve blood flow is postponed following by the injury with increase of the electrical voltage. The collagen deposition after electrical injury may be one of the reasons for nerve blood flow decrease.

The present study has determined the cellular distribution of cytochrome P450scc in human early placenta by immunohistochemistry and assessed the abundances of cytochrome P450scc protein in the villous tissue at 6-9 weeks of human pregnancy by Western blotting. The results showed that immunoreactive P450scc was mainly localized in the villous syncytiotrophoblast cells but not in the cytotrophoblast cells and the villous core, and that the expression of protein for cytochrome P450scc in human early placental villous tissues increased gradually with advancing weeks of pregnancy. Taken together, these findings suggest that the syncytiotrophoblast cells are the major site expressing P450scc in human early placenta, and that increasing expression of cytochrome P450scc in placental villi might establish a foundation, in terms of enzymology, for site-shift of progesterone biosynthesis from the corpus luteum to the placenta during human early pregnancy.

To investigate the relationship between abnormal cellular apoptosis of the decidual tissue during the early stages of gestation and failure of pregnancy.Samples of the decidual tissues of early gestation were obtained from 60 healthy women with pregnancy, and cellular apoptosis was assessed by using terminal transferase-mediated nick-end labeling (TUNEL). The expressions of Fas and FasL in the decidual tissues at different stages of gestation were examined by in situ hybridization and immunohistochemistry.On day 41 of normal pregnancy, evident apoptosis in the decidual tissues occurred with significantly enhanced Fas and FasL expressions, while obvious reduction in both the apoptotic cells and Fas and FasL expression was observed on day 54. In women with spontaneous abortion, increased apoptotic cells were present in the decidual tissues around day 55 of gestation when significantly enhanced Fas and FasL mRNA and protein expressions also took place, in comparison with those of healthy pregnant women on day 54.Abnormal apoptosis of the decidua during early gestation may be one of the mechanisms for spontaneous abortion, and the Fas pathway may play an important role in apoptosis induction.