Influence of propofol or etomidate combined with remifentanil in painless gastroscopy on inflammatory stress response

Objective:To study the influence of propofol or etomidate combined with remifentanil in painless gastroscopy on inflammatory stress response.Methods: 117 patients with suspected gastritis who underwent painless gastroscopy in our hospital between July 2015 and August 2016 were divided into propofol group (n=67) and etomidate group (n=50) according to the anesthesia schemes. Propofol group received propofol combined with remifentanil anesthesia, and etomidate group received etomidate combined with remifentanil anesthesia. The differences in serum levels of inflammatory factors, stress hormones and oxidative stress indicators were compared between the two groups before the examination (T0), immediately after the examination (T1) and 15 min after the examination (T2).Results: At T0, there were no significant differences in serum levels of inflammatory factors, stress hormones or oxidative stress indexes between the two groups (P>0.05). At T1 and T2, serum inflammatory factors IL-1, IL-6 and CRP levels of etomidate group were lower than those of propofol group;serum stress hormones Cor, NE and E levels were lower than those of propofol group;serum oxidation indexes AOPPs and LHP levels were lower than those of propofol group while anti-oxidation indexes CAT and SOD levels were higher than those of propofol group (P<0.05). Conclusion: Etomidate for painless gastroscopy is better than propofol in maintaining depth of anesthesia and reducing operation trauma.

Regulating effects of mangiferin on oxidative stress response and mitochondrial pathway apoptosis in spinal cord injury model

Objective:To study the regulating effects of mangiferin on oxidative stress response and mitochondrial pathway apoptosis in spinal cord injury model.Methods: SD rats were selected as the experimental animals and divided into the control group that underwent sham operation, the injury group that were made into spinal cord injury models and the mangiferin group that were made into spinal cord injury models and given mangiferin intervention. 30 d after the intervention, spinal cord tissue was collected, radioimmunoprecipitation kit was used to determine the contents of oxidative stress indexes ROS, H2O2, SOD, GSH-Px and CAT, and enzyme-linked immunosorbent assay kit was used to determine the contents of apoptosis indexes SKIP, ASK1, Fas, tBid, APAF-1 and Caspase-3.Results:ROS, H2O2, SKIP, ASK1, Fas, tBid, APAF-1 and caspase-3 contents in spinal cord tissue of injury group were significantly higher than those of control group whereas SOD, GSH-Px and CAT contents were significantly lower than those of control group;ROS, H2O2, SKIP, ASK1, Fas, tBid, APAF-1 and caspase-3 contents in spinal cord tissue of mangiferin group were significantly lower than those of injury group whereas SOD, GSH-Px and CAT contents were significantly higher than those of injury group.Conclusion:Mangiferin has inhibitory effect on oxidative stress response and mitochondrial pathway apoptosis in spinal cord injury model.

Optimization of percutaneous coronary intervention through lower frame rates angiogram

Background Coronary artery disease(CAD)is a leading cause of mortality worldwide.Percutaneous coronary intervention(PCI)is a standard treatment for CAD,yet the radiation exposure associated with this procedure can pose significant risks to both patients and healthcare professionals.With the aim to optimize this procedure,we studied the effects of different exposure rates on radiation dose,fluoroscopy time,and procedural complications.Methods A total of 441 consecutive patients who underwent coronary angiography and subsequent PCI treatment from January 2020 to December 2021 were included in this study.Baseon the fluoroscopy frame rates used during the procedure,patients were divided into two groups,which included a standard dose protocol(SDP)group that used15 frames per second(FPS)and a low dose protocol(LDP)group that used 7.5 FPS.Then the impact of different fluoroscopy frame rates on total air kerma(AK),procedure time,fluoroscopy times(FT),and procedural complications in patients undergoing PCI were evaluated.Results Our data indicated that LDP group had a significantly lower AK,indicative of a reduced radiation dose,in comparison to SDP group.Although the procedure time and FT were slightly longer in the LDP group,this increase was not statistically significant.Moreover,the rate of intraoperative complications in the LDP group was not higher than that in the SDP group.In a subgroup of patients who underwent intravascular ultrasound(IVUS)within the LDP group,we observed further reductions in radiation exposure and FT.Conclusions The use of reduced fluoroscopy frame rates and adjunctive IVUS during PCI procedures can be a viable approach to minimizing radiation exposure without compromising procedure success or patient safety.

Twin Reversed Arterial Perfusion Sequence:Prenatal Diagnosis and Treatment

Twin reversed arterial perfusion sequence,a severe and unique complication of monochorionic multiple pregnancy,is characterized by vascular anastomosis and abnormal or absent cardiac development in the twins.This article reviewed its pathogenesis,prenatal ultrasound diagnosis,and management.The pump twin’s chances for survival can be maximized by proper management.The optimal timing of the interventions remains a debate,although the latest studies encourage early intervention,i.e.,in the first trimester.The most preferred approach is to interrupt the vascular supply to the acardius,such as through ultrasound-guided laser coagulation and radiofrequency ablation of the intrafetal vessels.