Effects of Isoflurane on the Actions of Neuromuscular Blockers on the Muscle Nicotine Acetylcholine Receptors

Summary: In this study, we tested the hypothesis that volatile anesthetic enhancement of muscle relaxation is the result of combined drug effects on the nicotinic acetylcholine receptors. The poly A m RNA from muscle by isolation were microinjected into Xenopus oocytes for receptor expression. Concentration-effect curves for the inhibition of Ach-induced currents were established for vecuronium, rocuranium, and isoflurane. Subsequently, inhibitory effects of NDMRs were studied in the presence of the isoflurane at a concentration equivalent to half the concentration producing a 50 % inhibition alone. All tested drugs produced rapid and readily reversible concentration-dependent inhibition. The 50 % inhibitory concentration values were 889 μmol/L (95 % CI: 711-1214 μmol), 33.4 μmol (95 % CI: 27.1-41.7 nmol) and 9.2 nmol (95 % CI: 7.9-12.3 nmol) for isoflurane, rocuranium and vecuronium, respectively. Coapplication of isoflurane significantly enhanced the inhibitory effects of rocuranium and vecuronium, and it was especially so at low concentration of NMDRs. Isoflurane increases the potency of NDMRs, possibly by enhancing antagonist affinity at the receptor site.

Progressive Muscle Relaxation Effectiveness of the Blood Sugar Patients with Type 2 Diabetes

Background: Diabetes Melilltus (DM) is one serious chronic illness. The proportion of incident type 2 diabetes is 95% of the population of DM in the world. The prevalence of DM in Indonesia showed an increase of 1.1% in 2007 to 2.1% of the population of DM in 2013, and the most cases are Type 2 Diabetes Mellitus. Management of blood sugar levels can be conducted of pharmacologic and nonpharmacologic. One of nonpharmacologic therapy is a complementary therapy. Progressive muscle relaxation is part of a of complementary therapy which is a mindbody therapy. Objective: This study aimed to measure the effectiveness of progressive muscle relaxation of the blood sugar levels of patients with type 2 diabetes. Materials and Methods: Quasi experiment with pre- and posttest randomized control group design, consisting of 48 samples, 24 samples 24 samples of the treatment group and the control group. Subjects treated group guided progressive muscle relaxation exercises 2 times a day for 3 consecutive days with a duration of 25 - 30 minutes in one workout. Subjects of the control group gave breathing exercises. Results: There were significant differences between the average blood sugar levels type 2 diabetes patients in the the treatment group and the control group, with p value = 0.000 (p < 0.05). Conclusion: The progressive muscle relaxation is effective to reduce blood sugar levels of patients with type 2 diabetes at Dr. Salamun Hospital and Advent Hospital in Bandung.

Effect of Psychological Education Combined with Progressive Muscle Relaxation Training on the Symptom Cluster and Rehospitalization Rate of Elderly Patients with Coronary Heart Disease

Objective:To investigate the effect of psychological education combined with progressive muscle relaxation training on the symptom cluster and rehospitalization of elderly patients with coronary heart disease.Methods:This study is a longitudinal randomized controlled study involving 140 elderly patients with coronary heart disease.The patients were divided into two groups:an intervention group and a control group,with 70 cases in each group,via random number table.The patients in the control group received routine nursing,whereas those in the intervention group received psychological education combined with progressive muscle relaxation training for 4 weeks on the basis of routine nursing.The effect of the intervention was evaluated before intervention,at the end of 1 month,3 months,and 6 months after intervention.Results:At the end of 1 month,3 months,and 6 months,the sleep,fatigue,anxiety,and functional status of the patients in the intervention group were significantly better than those of the control group,with statistical significance difference(P<0.05).The rehospitalization rate of the intervention group was lower than that of the control group,and the difference was statistically significant(X2=10.685,P=0.001).Conclusion:Psychological education combined with progressive muscle relaxation training is effective in alleviating the symptom cluster of elderly patients with coronary heart disease and reducing their rehospitalization rate;thus,it should be popularized.

Randomized trial estimating effects of hypnosis versus progressive muscle relaxation on medical students’test anxiety and attentional bias

BACKGROUND Test anxiety is prevalent among medical students and leads to impaired academic performance.Test-related attentional bias has been identified as an important maintaining factor in test-anxious individuals.AIM To evaluate whether hypnosis and progressive muscle relaxation(PMR)could modify medical college students’test anxiety and attentional bias.METHODS A total of 598 medical students were screened.The participants were divided into higher and lower test anxiety groups according to their scores on the test anxiety scale(TAS).Ninety medical college students with high TAS score were randomly assigned to a hypnosis or PMR group.Another 45 students with low TAS score were included,forming a baseline control group.The intervention was conducted weekly for 6 wk,and each session lasted approximately 30 min.The total intervention time and the number of intervention sessions for the hypnosis and PMR groups were equal.Data were collected at the pretest,posttest,and 2-mo follow-up.RESULTS Hypnosis group participants had a significantly lower TAS score at posttest(t=-21.827,P<0.001)and at follow-up(t=-14.824,P<0.001),compared to that at pretest.PMR group participants also had a significantly lower TAS score at posttest(t=-10.777,P<0.001)and at follow-up(t=-7.444,P<0.001),compared to that at pretest.At the posttest level,the hypnosis group had a significantly lower TAS score than the PMR group(t=-3.664,P<0.001).At the follow-up level,the hypnosis group also had a significantly lower TAS score than the PMR group(t=-2.943,P=0.004).Clinically significant improvement was found in both the hypnosis and PMR groups(hypnosis=64.0%;PMR=62.22%).Hypnosis was more effective than PMR in reducing test anxiety among medical college students.Hypnosis could modify attentional bias toward threatening stimuli,but PMR could not.CONCLUSION These results suggest that attentional bias plays an important role in test anxiety treatment.

Effects of progressive muscle relaxation therapy on Maintenance hemodialysis patients:a systematic review and meta-analysis

Objective:This study aimed to evaluate the effects of progressive relaxation therapy on patients with maintenance hemodialysis.Methods:A literature search was performed using PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure,and Wanfang Data from inception to July 2020.Randomized controlled trials on the use of progressive muscle relaxation therapy in maintenance hemodialysis patients were selected.The primary outcomes were the depression and anxiety.Secondary outcomes included fatigue and sleep.Two reviewers proceeded study selection and quality assessment of included trials and performed heterogeneity of included studies before meta-analysis.Results:A total of 8 studies,which comprised a total of 668 participants were included in the final meta-analysis.The results showed that progressive muscle relaxation therapy could reduce the depression of patients(MD=-5.11,95%CI:-6.74 to-3.48,P<0.001),reduce the anxiety(SMD=-1.27,95%CI:-1.73 to-0.82,P<0.001),relieve fatigue symptoms(MD=-0.87,95%CI:-1.20 to-0.53,P<0.001),improve the sleep quality(MD=-1.69,95%CI:-1.95 to-1.42,P<0.001).Conclusion:Progressive muscle relaxation therapy has positive effects on depression,anxiety,fatigue and sleep quality in patients with maintenance hemodialysis.While concurrent evidence is insufficient,and further studies of high quality are needed to strengthen the conclusion.

Difficult airway due to cervical haemorrhage caused by spontaneous rupture of a parathyroid adenoma: A case report

BACKGROUND Cervical haemorrhage due to spontaneous rupture of a parathyroid adenoma is a rare complication that may cause life-threatening acute airway compromise.CASE SUMMARY A 64-year-old woman was admitted to the hospital 1 day after the onset of right neck enlargement, local tenderness, head-turning difficulty, pharyngeal pain, and mild dyspnoea. Repeat routine blood testing showed a rapid decrease in the haemoglobin concentration, indicating active bleeding. Enhanced computed tomography images showed neck haemorrhage and a ruptured right parathyroid adenoma. The plan was to perform emergency neck exploration, haemorrhage removal, and right inferior parathyroidectomy under general anaesthesia. The patient was administered 50 mg of intravenous propofol, and the glottis was successfully visualised on video laryngoscopy. However, after the administration of a muscle relaxant, the glottis was no longer visible and the patient had a difficult airway that prevented mask ventilation and endotracheal intubation. Fortunately, an experienced anaesthesiologist successfully intubated the patient under video laryngoscopy after an emergency laryngeal mask placement. Postoperative pathology showed a parathyroid adenoma with marked bleeding and cystic changes. The patient recovered well without complications.CONCLUSION Airway management is very important in patients with cervical haemorrhage. After the administration of muscle relaxants, the loss of oropharyngeal support can cause acute airway obstruction.Therefore, muscle relaxants should be administered with caution. Anaesthesiologists should pay careful attention to airway management and have alternative airway devices and tracheotomy equipment available.

Effectiveness of aromatherapy with lavender compared to progressive muscle relaxation on anxiety and vital signs in patients under spinal anesthesia:A randomized clinical trial

Objective:This study aimed to determine the effectiveness of aromatherapy with lavender essential oil compared to progressive muscle relaxation(PMR)on anxiety and vital signs of patients under spinal anesthesia.Materials and Methods:This clinical trial was conducted on 120 spinal anesthesia candidates who were randomly assigned into three groups of 40 including control,PMR(Jacobsen group),and aromatherapy.The state-trait anxiety inventory was completed on surgery day and 15 min after the end of the intervention by the samples of all three groups,and at the same time as completing the questionnaire,vital signs were also measured and recorded.Results:The mean score of anxiety after intervention was lower than that before the intervention in the aromatherapy group(P<0.001).The mean score of anxiety in the aromatherapy group was significantly lower than that in the Jacobsen group(P<0.001).Moreover,data analysis showed a significant decrease in the mean arterial blood pressure scores of the PMR(P=008)and aromatherapy(P<0.001)groups and a statistically significant increase in the mean heart rate scores in the control group(P=0.002).Conclusion:The use of aromatherapy with lavender is more effective than PMR therapy in reducing the anxiety level of patients undergoing spinal anesthesia.Due to the high level of anxiety and its serious effects on the patient’s hemodynamics,aromatherapy with lavender can be used as an easy and cheap method to reduce anxiety in operation rooms.

Effects of Progressive Muscle Relaxation Training on Anxiety, Depression, and Quality of Life in Patients with Cerebral Small Vessel Disease

Objective:To explore the effects of progressive muscle relaxation training on anxiety,depression,and quality of life in patients with cerebral small vessel disease(CSVD).Methods:Sixty-one patients with CSVD in the Department of Neurology of a tertiary hospital were divided into an observation group(28 patients)and a control group(33 patients)by lottery method.The control group received conventional nursing care,while the observation group received progressive muscle relaxation training interventions in addition to the conventional care.The Hamilton Anxiety Scale(HAMA),the Hamilton Depression Scale(HAMD),and the Stroke-Specific Quality of Life Scale(SS-QOL)were used to compare the effects before the intervention,7 days after the intervention,and 30 days after the intervention.Results:Over time,at different time points after the intervention,the anxiety and depression scores of patients with CSVD in the observation group were significantly lower than those in the control group(P<0.05).The quality of life scores were significantly higher in the observation group compared to the control group(P<0.05),and these differences were statistically significant.Conclusion:Progressive muscle relaxation training can improve anxiety and depression in patients with cerebral small vessel disease and can effectively enhance their quality of life.

A Bibliometric Study on The Application of Progressive Muscle Relaxation Training in The Nursing Field in China

Objective:To systematically analyze the research status and application of progressive muscle relaxation training(PMRT)in the nursing field in China,and provide a reference basis for scientific research in this field.Methods:The bibliometric method was adopted in“progressive muscle relaxation training”or“PMRT,”and“nursing.”The established database was included in the China National Knowledge Infrastructure(CNKI)and the Wanfang Medical Network.The relevant articles in the Chinese Science and Technology Periodical Database(VIP)were analyzed.Results:A total of 169 literatures were included.The journals,years,and regions of literature publication were uneven,mainly originating from the eastern region(43.19%),and listed the application of progressive muscle relaxation training in the field of nursing in China.Intervention literature information was mainly dominated by experimental studies(97%).Conclusion:The related research and application of progressive muscle relaxation training in nursing in China is increasing,but there is a lack of objective evaluation of outcome indicators and a short intervention period.Further research should be conducted in the future to effectively guide the development of PMRT in the field of nursing in China.

Complementary of Nursing Care for an Elderly Family:Management of Hypertension and Smoking Behaviour

Background:An elderly was closed to some medical problem,especially hypertension.Problems that occur in elderly patients with hypertension not only involve the patient itself but also involve the family as the closest person to the patient.One important aspect of family nursing is the family itself.To achieve good treatment outcomes,implementation of evidence-based nursing is needed.The purpose of this study is to present the implementation of evidence-based nursing to an eldelry in a family bu using coconut water to reduce high blood pressure and progressive muscle relaxation therapy to reduce pain intensity in hypertensive patients,as well as acupressure therapy in stopping smoking that is applied 1 week each other.Method:In the implementation,complementary therapy is applied to hypertensive patients by given young coconut water and progressive muscle relaxation therapy,and acupressure therapy in an effort to stop smoking.Results:showed significant results in the reduction of high blood pressure before being given an intervention was TD:200/100 mmHg and after being given the intervention obtained TD:140/80 mmHg and decreased pain intensity in hypertensive patients using relaxation therapy,as well as a decrease in the number of cigarettes smoked with acupressure therapy for 1 week.Conclusion:The application of complementary therapy carried out showed improvement in elderly patients suffering from hypertension and smoking behaviour,therefore,the application of evidence based nursing in providing nursing care is recommended.Suggestion:Complementary Nursing Case Study this is expended to be a reference material to improve health services and provide an overview in carrying out complementary nursing care to families,especially an elderly with comprehensive cases of hypertension(bio,psycho,social and spiritual).

Synthesis of silver and gold nanoparticles from leaf of Litchi chinensis and its biological activities

Objective: To synthesize and isolate silver and gold nanoparticles from Litchi chinensis leaf methanolic extract, and to evaluate its comparative biological activities including muscles relaxant, analgesic, anti-inflammatory and antidiarrheal. Methods: The gold and silver nanoparticles were synthesized by dissolving methanolic extract in gold chloride and silver nitrate solution separately which were confirmed by colour change and UV-Vis spectroscopy, and pellets were collected through centrifugation. Biological activities of the extract were conducted on BALB/c mice through various standard methods and the data were subjected to One-way ANOVA. Results: The colorless gold chloride solution changed to purple soon after the addition of plant extract, demonstrating that the reaction took place and gold ions were reduced to gold nanoparticles, while colorless silver nitrate solution changed to light and dark brown that was indicative of silver nanoparticles. The muscles relaxant activity showed that silver nanoparticles were more effective than gold nanoparticles and methanolic extract in traction test. The analgesic activity showed that silver and gold nanoparticles showed highest percentage decrease in acetic acid induced writhing at the doses of 50, 100 and 150 mg/kg b.w. The highest anti-inflammatory activity was produced by gold nanoparticles followed by silver nanoparticles, while low activity was observed in methanolic leaf extract. Only the crude methanolic extract showed significant antidiarrheal activity as compared to the standard drug atropine sulphate, while antidiarrheal activities of gold and silver nanoparticles were non-significant. Conclusions: The present work concludes that isolated silver and gold nanoparticles from leaf methanolic extract shows strong muscles relaxant, analgesic and anti-inflammatory activities while crude methanolic extract possesses good antidiarrheal activity.

Progressive Muscle Relaxation Combined with Chinese Medicine Five-Element Music on Depression for Cancer Patients: A Randomized Controlled Trial

Objectives： To evaluate the effects of progressive muscle relaxation training （PMRT） combined with five elements music therapy of Chinese medicine （CM） for improving anxiety and depression of cancer patients. Methods： From June 2015 to March 2016, 60 cancer patients were included into the study. The patients were randomly assigned to a control group and a treatment group by envelope randomization, receiving PMRT and PMRT plus CM five elements music therapy, respectively, for 8 weeks. Hospital Anxiety and Depression Scale （HADS）, Benefit Finding Scales （BFS）, Functional Assessment of Chronic Illness Therapy-Spiritual （FACIT-Sp）, and Intervention Expectations Questionnaire （IEQU） were adopted to assess the depression of the two groups before and after the treatment. Results： Four cases dropped out during the study, and 29 cases in the treatment group and 27 in the control group were included in the final analysis. Prior to the treatments, the baselines of the 4 questionnaires in the two groups showed no difference. After the 8-week treatment, the treatment group presented better levels of HADS, BFS and FACIT-Sp scores compared with the control group （P〈0.05）. Among the single items of HADS, 4 items involving vexation, feeling fidgeted, pleasure and prospecting the future in the treatment group were improved compared with the control group （P〈0.05）. Conclusions： As a simple and reliable and effective intervention, PMRT combined with five elements music therapy mitigated anxiety and depression of cancer patients. Cancer patients have been found to respond well to psychological intervention in areas regarding stabilisation of emotions, disease awareness, and therapeutic compliance. This brings about a great difference in improving their quality of life and psychological state, offers an effective approach to better self-management in cancer treatment.

Sepsis Strengthens Antagonistic Actions of Neostigmine on Flocuronium in a Rat Model of Cecal Ligation and Puncture

Background： The antagonistic actions of anticholinesterase drugs on non-depolarizing muscle relaxants are theoretically related to the activity of acetylcholinesterase （ACHE） in the neuromuscular junction （NMJ）. However, till date the changes of AChE activity in the NMJ during sepsis have not been directly investigated. We aimed to investigate the effects of sepsis on the antagonistic actions ofneostigmine on rocuronium （Roc） and the underlying changes of AChE activity in the NMJ in a rat model of cecal ligation and puncture （CLP）. Methods： A total of 28 male adult Sprague-Dawley rats were randomized to undergo a sham surgery （the sham group, n = 12） or CLP （the septic group, n = 16）. After 24 h, the time-response curves of the antagonistic actions of 0.1 or 0.5μmol/L of neostigmine on Roc （10 μmol/L）-depressed diaphragm twitch tension were measured. Meanwhile, the activity of AChE in the NMJ was detected using a modified Karnovsky and Roots method. The mRNA levels of the primary transcript and the type T transcript of AChE （AChET） in the diaphragm were determined by real-time reverse transcription-polymerase chain reaction. Results： Four of 16 rats in the septic group died within 24 h. The time-response curves of both two concentrations ofneostigmine in the septic group showed significant upward shifts from those in the sham group （P 〈 0.001 for 0.1 μmol/L; P = 0.009 for 0.5 μmol/L）. Meanwhile, the average optical density of AChE in the NMJ in the septic group was significantly lower than that in the sham group （0.517± 0.045 vs. 1.047 ±0.087, P 〈 0.001）. The AChE and AChET mRNA expression levels in the septic group were significantly lower than those in the sham group （P 0.002 for ACHE; P = 0.001 for AChEv）. Conclusions： Sepsis strengthened the antagonistic actions ofneostigmine on Roc-depressed twitch tension of the diaphragm by inhibiting the activity of AChE in the NMJ. The reduced content of AChE might be one of the possible causes of the decreased AChE activity in the NMJ.

Total intravenous anesthesia for cesarean section in a pregnant woman with spinal muscular atrophy

Spinal muscular atrophy （SMA） is a genetic neuromuscular disorder characterized by progressive degeneration of the anterior horn cell leading to a lower motor neuron lesion. It is characterized by degeneration of alpha neurons in the anterior horn cells of the spinal cord leading to progressive muscle atrophy and premature death, usually from respiratory failure.1 There are four types according to the symptoms （Table 1）.

Trichosanthes dioica根的神经药理特点(英文)

AIM: Trichosanthes dioica Roxb. (Cucurbitaceae), commonly known as pointed gourd in English, is a dioecious climber grown widely in the Indian subcontinent. Traditionally, this plant has been used in India for several medicinal purposes. The present study aimed to evaluate certain neuropharmacological properties of the hydroalcoholic extract of T. dioica root (TDA) in experimental animal models. METHODS: TDA (at 100 and 200 mg·kg-1 body weight, p.o.) was evaluated for anti-nociceptive activity by the acetic acid-induced writhing and tail flick methods. Locomotor depressant activity was measured by means of an actophotometer. Skeletal muscle relaxant effects were evaluated by using a rota-rod apparatus, and the sedative potentiating property by a phenobar-bitone-induced sleep potentiation study. RESULTS: The results of the present study revealed significant (P<0.001) and dose dependent anti-nociceptive, locomotor depressant, muscle relaxant, and sedative potentiating effects of TDA, demonstrating its depressant action on the central nervous system (CNS). CONCLUSION: From the present study, it can be concluded that T. dioica root possessed prominent anti-nociceptive, as well as depressant, action on the CNS, as manifested by these important neuropharmacological properties in mice.