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Possible role of high calcium concentrations in rat neocortical neurons in inducing hyper excitatory behavior during emergence from sevoflurane: a proposed pathophysiology 高钙浓度的大鼠新皮质神经元在七氟醚苏醒过程中诱导过度兴奋行为的可能作用:一种提出的病理生理学
Q1 Medicine Pub Date : 2023-01-01 DOI: 10.4103/2045-9912.385942
AndiAde Wijaya Ramlan, AmirS Madjid, Elizeus Hanindito, Irawan Mangunatmaja, Nurhadi Ibrahim
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引用次数: 0
Clinical utility of ozone therapy and hyperbaric oxygen therapy in degenerative disc disease. 臭氧与高压氧治疗退行性椎间盘病的临床应用。
IF 2.9 Q1 Medicine Pub Date : 2023-01-01 DOI: 10.4103/2045-9912.351890
Kaitlyn Re, Jason Gandhi, Raymond Liang, Shrey Patel, Gunjan Joshi, Noel L Smith, Inefta Reid, Sardar Ali Khan

Ozone can be medically useful concerning healing wounds and relieving pain in various conditions, such as disc disease. The aspects of human blood ozonation have been reviewed, as well as potential complications that may arise. The mechanisms of ozone therapy are discussed in detail. It is imperative to recognize ozone as a useful proxy in oxidative-stress related diseases, consolidating other medical gases recognized for their therapeutic importance. The utility of hyperbaric oxygen therapy is also discussed. Disc herniation is very common, as more than 3 million cases are treated per year. Herein we review the medical, surgical, and gene-based therapies that ozone therapy can provide regarding disc disease.

臭氧在医学上对愈合伤口和缓解各种情况下的疼痛都很有用,比如椎间盘疾病。已经审查了人体血液臭氧化的各个方面,以及可能出现的潜在并发症。详细讨论了臭氧治疗的机理。必须认识到臭氧是氧化应激相关疾病的一个有用的代理,巩固其他被认为具有治疗重要性的医疗气体。高压氧治疗的应用也进行了讨论。椎间盘突出是非常常见的,每年治疗的病例超过300万例。在此,我们回顾了臭氧治疗椎间盘疾病的医学、外科和基因治疗方法。
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引用次数: 1
The effects of nitric oxide in Alzheimer's disease 一氧化氮对阿尔茨海默病的影响
Q1 Medicine Pub Date : 2023-01-01 DOI: 10.4103/2045-9912.385939
Zongqi Wang, Wen Li, Lingling Wang, Dengfeng Lu, Xiaodong Wang, Gang Chen
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引用次数: 0
Current research progress of isoflurane in cerebral ischemia/reperfusion injury: a narrative review. 异氟醚在脑缺血再灌注损伤中的研究进展
IF 2.9 Q1 Medicine Pub Date : 2022-07-01 DOI: 10.4103/2045-9912.330689
Shu-Jun Chen, Xia-Qing Yuan, Qun Xue, Hai-Feng Lu, Gang Chen

Cerebral ischemia/reperfusion injury is an important factor leading to poor prognosis in ischemic stroke patients. Therefore, it is particularly important to find effective remedial measures to promote the health of patients to return to society. Isoflurane is a safe and reliable anesthetic gas with a long history of clinical application. In recent years, its protection function to human body has been widely recognized, and nowadays isoflurane for cerebral protection has been widely studied, and the stable effect of isoflurane has satisfied many researchers. Basic studies have shown that isoflurane's protection of brain tissue after ischemia/reperfusion involves a variety of signaling pathways and effector molecules. Even though many signaling pathways have been described, more and more studies focus on exploring their mechanisms of action, in order to provide strong evidence for clinical application. This could prompt the introduction of isoflurane therapy to clinical patients as soon as possible. In this paper, several confirmed signaling pathways will be reviewed to find possible strategies for clinical treatment.

脑缺血再灌注损伤是导致缺血性脑卒中患者预后不良的重要因素。因此,寻找有效的治疗措施,促进患者健康回归社会就显得尤为重要。异氟醚是一种安全可靠的麻醉气体,具有悠久的临床应用历史。近年来,异氟醚对人体的保护作用得到了广泛的认识,如今异氟醚对脑保护的研究也得到了广泛的开展,异氟醚稳定的作用也让很多研究者感到满意。基础研究表明,异氟醚对脑组织缺血再灌注后的保护作用涉及多种信号通路和效应分子。尽管已经描述了许多信号通路,但越来越多的研究集中在探索它们的作用机制,为临床应用提供有力的证据。这可能会促使异氟醚疗法尽快引入临床患者。本文将回顾几种已确认的信号通路,以寻找可能的临床治疗策略。
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引用次数: 3
Comparative analgesic, hemodynamic, pain and duration of sensory and motor block effects of dexmedetomidine, granisetron, and nitroglycerin added to ropivacaine in intravenous anesthesia for forearm surgeries: a randomized clinical study. 右美托咪定、格拉司琼和硝酸甘油加入罗哌卡因静脉麻醉用于前臂手术的镇痛、血流动力学、疼痛和感觉和运动阻滞效应持续时间的比较:一项随机临床研究。
IF 2.9 Q1 Medicine Pub Date : 2022-07-01 DOI: 10.4103/2045-9912.330690
Esmail Moshiri, Hesameddin Modir, Alireza Kamali, Mehran Azami, Morteza Molouk

This trial-based paper strives to address the comparative efficacy of some ropivacaine adjuvant options, comprising dexmedetomidine, granisetron, and nitroglycerin, on pain and hemodynamic changes in intravenous anesthesia for forearm surgeries. This double-blind, placebo-controlled study enrolled four block-randomized eligible groups with patients (overall, n=128) undergoing orthopedic forearm surgeries in the dexmedetomidine, nitroglycerin, granisetron, and placebo groups. Intra- and post-operative vital signs (mean arterial pressure/heart rate/ oxygen saturation) were monitored at baseline and captured every 10 minutes until the end of the surgery, as well as the onset of sensory and motor block and length and duration of the block and mean opioid use within 24 hours. Lastly, pain was noted after tourniquet inflation (at 15, 30, and 45 minutes every 15 minutes until the end of surgery) and after deflation (every 30 minutes to 2 hours at 30, 60, 90, and 120 minutes), as well as 6, 12, and 24 hours after the tourniquet was deflated. The dexmedetomidine-sedated subjects appeared to demonstrate quicker onset and longer length and duration of sensory and motor block, plus less pain and opioid use at all scheduled times (both P = 0.0001). Dexmedetomidine is recommended as an adjuvant to regional anesthesia (Bier's block), while being coupled with the rapid onset and prolonged length and duration of sensory and motor blocks, in addition to soothed pain and diminished opioid use within postoperative 24 hours. The study was approved by Ethics Committee of Arak University of Medical Sciences (approval No. IR.ARAKMU.REC.1398.112) on July 21, 2019, and registered at Iranian Registry of Clinical Trials (registration number IRCT20141209020258N123) on November 2, 2019.

这篇以试验为基础的论文致力于探讨一些罗哌卡因辅助选择的比较疗效,包括右美托咪定、格拉司琼和硝化甘油,对前臂手术静脉麻醉疼痛和血流动力学变化的影响。这项双盲、安慰剂对照研究纳入了4组符合条件的随机分组患者(总共128人),他们分别接受右美托咪定、硝化甘油、格拉司琼和安慰剂组的前臂骨科手术。在基线时监测术中和术后生命体征(平均动脉压/心率/血氧饱和度),每10分钟捕捉一次,直到手术结束,以及24小时内感觉和运动阻滞的发生、阻滞的长度和持续时间以及平均阿片类药物的使用。最后,止血带充气后(15、30和45分钟,每15分钟一次,直到手术结束)和放气后(30、60、90和120分钟,每30分钟至2小时一次)以及止血带放气后6、12和24小时记录疼痛。右美托咪定镇静的受试者似乎表现出更快的发作,感觉和运动阻滞的长度和持续时间更长,并且在所有预定时间疼痛和阿片类药物的使用更少(P = 0.0001)。右美托咪定被推荐作为区域麻醉(Bier’s阻滞)的辅助药物,同时与快速起效和延长感觉和运动阻滞的长度和持续时间相结合,除了缓解疼痛和减少术后24小时内阿片类药物的使用。本研究已获得阿拉克医科大学伦理委员会批准(批准号:ir . arakmuu . rec .1398.112)于2019年7月21日注册,并于2019年11月2日在伊朗临床试验注册中心注册(注册号IRCT20141209020258N123)。
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引用次数: 3
Spuriously low end tidal carbon dioxide in capnometry: Nafion tube malfunction in end tidal carbon dioxide module blamed for near mishap! 在二氧化碳测量中出现了虚假的低端潮汐二氧化碳:国家石油公司在终端潮汐二氧化碳模块中出现了故障,导致了近乎不幸的事故!
IF 2.9 Q1 Medicine Pub Date : 2022-07-01 DOI: 10.4103/2045-9912.330695
Suma Rabab Ahmad, Chitta Ranjan Mohanty, Snigdha Bellapukonda, Bishu Prasad Patro
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引用次数: 0
Effects of different fresh gas flows and different anesthetics on airway temperature and humidity in surgical patients: a prospective observational study. 不同新鲜气体流量和不同麻醉剂对手术患者气道温度和湿度的影响:一项前瞻性观察研究。
IF 2.9 Q1 Medicine Pub Date : 2022-07-01 DOI: 10.4103/2045-9912.330691
Irem Gumus Ozcan, Ozkan Onal, Aysun Ozdemirkan, Ali Saltali, Mehmet Sari

This study was aimed to investigate the effects of different fresh gas (oxygen + air) flow rates and different anesthetics on airway temperature and humidity when using the same anesthesia machine in patients undergoing general anesthesia. In this prospective, observational study, 240 patients with American Society of Anesthesiologists (ASA) I-II between the age of 18-65 years to be operated under general anesthesia were enrolled and divided into two groups according to the fresh gas flow rate (3-6 L/min). Each of the two main groups was further divided into three subgroups according to the administered anesthetic gases and drugs. The resulting six groups were further divided into two subgroups according to whether the heat and humidity exchanger filter (HME) was attached to the breathing circuit, and the study was carried out on a total of 12 groups. The temperature and humidity of the inspired air were recorded every 10 minutes using an electronic thermo-hygrometer. The inspired temperature and humidity were greater in patients ventilated at 3 L/min compared to the 6 L/min group and in HME (+) patients compared to HME (-), regardless of the type of anesthetics. HME application makes the air more physiological for the respiratory tract by increasing the temperature and humidity of the air regardless of the anesthetic agent. This study was approved by Ethics Committee Review of Selcuk University Faculty of Medicine (No. 2017/261) in September 2017, and was registered in the Clinical Trial Registry (identifier No. NCT04204746) on December 19, 2019.

本研究旨在探讨不同新鲜气体(氧气+空气)流速及不同麻醉药物对全麻患者使用同一麻醉机时气道温度和湿度的影响。在这项前瞻性观察性研究中,选取240例年龄在18-65岁之间的美国麻醉学会(ASA) I-II级全麻手术患者,根据新鲜气体流速(3-6 L/min)分为两组。根据麻醉气体和麻醉药物的不同,两组又分为三组。根据是否在呼吸回路上附加了热湿交换器过滤器(HME),将得到的6组进一步分为2个亚组,共对12组进行了研究。每10分钟用电子温湿计记录吸入空气的温度和湿度。无论麻醉药类型如何,3l /min通气的患者吸入温度和湿度高于6l /min通气组,HME(+)患者吸入温度和湿度高于HME(-)。HME的应用通过提高空气的温度和湿度,使空气对呼吸道更加生理性,而不管麻醉剂是什么。本研究于2017年9月获得Selcuk大学医学院伦理委员会审查(No. 2017/261)批准,并在临床试验登记处注册(标识符No. 2017/261)。NCT04204746)于2019年12月19日生效。
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引用次数: 1
Hydrogen-rich bath with nano-sized bubbles improves antioxidant capacity based on oxygen radical absorbing and inflammation levels in human serum. 富氢浴与纳米尺寸的气泡提高抗氧化能力的基础上,氧自由基吸收和炎症水平在人类血清。
IF 2.9 Q1 Medicine Pub Date : 2022-07-01 DOI: 10.4103/2045-9912.330692
Yoshiharu Tanaka, Li Xiao, Nobuhiko Miwa

This study compared the effects of hydrogen-water (HW) bath on the oxygen radical absorption-based antioxidant capacity and the inflammatory indicator, C-reactive protein (CRP), in serum between healthy volunteers and inflammatory/collagen disease-patients. The HW bath apparatus supplied nano-bubbles with a diameter of 110 ± 10 nm and 338-682 μg/L of dissolved hydrogen after 120 minutes electrolysis, and nano-bubbles increased to 9.91 × 107/mL along with the increase of correlative dissolved hydrogen. Ten-minute HW bath increased the oxygen radical absorption-based antioxidant capacity to 110.9 ± 9.2% at post-bathing 120 minutes, although unaltered with 10-minute normal water bath at 40°C in healthy subjects. The CRP level was repressed to 70.2 ± 12.1% at 120 minutes after HW bath, although rather increased for normal water bath. In the patients with connective tissue diseases, the CRP level was repressed to 3-24% upon 9 days to 4 months of HW bathing. In another six patients with diverse autoimmune-related diseases, upon daily HW bathing as long as 2-25 months, the pre-bathing CRP level of 5.31 mg/dL decreased to 0.24 mg/dL being within the standard-range, with relief of visible inflammatory symptoms for some cases. Thus, the HW bath with high-density nano-bubbles has beneficial effects on serum antioxidant capacity, inflammation, and the skin appearance. The study was approved by the Committee of Ethics, Japanese Center of Anti-Aging Medical Sciences (Authorization No. H-15-03-2, on January 15, 2019), which was a non-profitable organization officially authenticated by the Hiroshima Prefecture Government of Japan.

本研究比较了氢水(HW)浴对健康志愿者和炎症/胶原蛋白疾病患者血清中基于氧自由基吸收的抗氧化能力和炎症指标c反应蛋白(CRP)的影响。电解120 min后,HW浴装置提供直径为110±10 nm的纳米气泡和338 ~ 682 μg/L的溶解氢,随着相关溶解氢的增加,纳米气泡增加到9.91 × 107/mL。10分钟的HW水浴使健康受试者的抗氧化能力在沐浴120分钟后提高到110.9%±9.2%,而在40°C的正常水浴中,10分钟的HW水浴没有变化。在HW水浴后120分钟,CRP水平被抑制到70.2±12.1%,而在正常水浴时则有所升高。结缔组织疾病患者,在HW沐浴9天至4个月时,CRP水平被抑制至3-24%。另外6例患有多种自身免疫相关疾病的患者,每日沐浴2-25个月后,沐浴前的CRP水平从5.31 mg/dL降至0.24 mg/dL,在标准范围内,部分患者可见炎症症状有所缓解。因此,含有高密度纳米气泡的HW浴液对血清抗氧化能力、炎症和皮肤外观有有益的影响。本研究已获得日本抗衰老医学科学中心伦理委员会批准(授权号:H-15-03-2(2019年1月15日),是日本广岛市政府正式认证的非营利性组织。
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引用次数: 2
In vivo microelectrode monitoring of real-time hydrogen concentration in different tissues of rats after inhaling hydrogen gas. 大鼠吸入氢气后不同组织内氢浓度实时微电极监测。
IF 2.9 Q1 Medicine Pub Date : 2022-07-01 DOI: 10.4103/2045-9912.330694
Bo-Yan Liu, Jun-Li Xue, Qian-Qian Gu, Min Zhao, Meng-Yu Zhang, Ming-Yue Wang, Yun Wang, Shu-Cun Qin

Medical effects of hydrogen have been reported in many studies. Due to difficulties in measuring hydrogen concentration in vivo after intake and high explosive risks of hydrogen, studies about dose-response relationships and tissue concentrations of hydrogen are few. Here, for the first time, we monitored real-time hydrogen concentrations in different tissues in rats including brain, liver, spleen, kidney, thigh muscle, inguinal white adipose tissue, and gonadal white adipose tissue after inhaling different concentrations of hydrogen (4%, 42%, and 67%) using an electrochemical sensor. Hydrogen concentrations in the same tissue showed a dose-dependent response. The equilibrium concentration values were highest in the brain and lowest in the thigh muscle. The saturation and desaturation curves changed more slowly in the thigh muscle and white adipose tissues than in other tissues. These results provide fundamental information for the selection of hydrogen dose applications in basic research and clinical trials. The experiments were approved by the Laboratory Animal Ethics Committee of Shandong First Medical University & Shandong Academy of Medical Sciences (No. 2020-1028) on March 18, 2020.

许多研究报告了氢的医学作用。由于摄入氢气后体内氢气浓度难以测量,且氢气具有较高的爆炸危险性,因此关于氢气的剂量-反应关系和组织浓度的研究很少。在这里,我们首次使用电化学传感器实时监测大鼠吸入不同浓度的氢(4%、42%和67%)后,脑、肝、脾、肾、大腿肌肉、腹股沟白色脂肪组织和性腺白色脂肪组织中的氢浓度。同一组织中的氢浓度表现出剂量依赖性反应。平衡浓度在大脑中最高,在大腿肌肉中最低。大腿肌肉和白色脂肪组织的饱和和去饱和曲线变化较其他组织慢。这些结果为基础研究和临床试验中氢剂量的选择提供了依据。本实验于2020年3月18日经山东第一医科大学、山东省医学科学院实验动物伦理委员会(No. 2020-1028)批准。
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引用次数: 7
Anesthesiologists and burnout: what are we missing? 麻醉师和倦怠:我们错过了什么?
IF 2.9 Q1 Medicine Pub Date : 2022-07-01 DOI: 10.4103/2045-9912.330696
Priyanka Bansal, Kunal Bansal
Dear Editor, As we find ourselves in the middle of a roller coaster ride of a pernicious pandemic, bearing the wrath of a deadly virus, I wish to bring forth a terminology which almost forgotten but may itself turnout to be a future pandemic especially among anesthesiologists – “Burnout.” Hyman1 in the article “Burnout: the ‘other’ pandemic” elucidated the definition and impact that burnout has on anesthesiologists. It is a common psychological disorder described first by Herbert J. Freudenberger2 that involves complete emotional detachment from oneself and surroundings or complete denial from reality.3 There are important risk factors that exhibited by a burnout patient emotional detachment, dissociation from reality (existentialism) or depersonalization, or a sense of dissatisfaction from personal accomplishments. A more explicit description of these risk factors has been mentioned by Afonso et al.’s recent study.4 The Facebook, Twitter and the so called oceans of information are flooded with zillions of research on incidence, risk factors, but the true need of the hour is therapy rather than problem because many unfortunates are already showing symptoms. The coronavirus disease 2019 (COVID-19) pandemic has deprived us of love, laugh attachment, physical touch, hugs, gigs over tea and all little human needs that we enjoy as a social being. Human mind already exists in a state of complete denial – we make future plans and deny death, the ultimate solace of all living beings. Humans are humane. We have become selfish as all social animals normally behave when confronted with a danger. Future research needs to be focused not only on the incidence but also on a solid reliable thorough solution to this menace. The syndrome is important to debate because it is directly linked to professionalism, quality of care to both colleagues and patients and efficiency of working. The major factor according to a study is workplace situation rather than personal factors. Lack of adequate workplace support, too many wee hours of working (a major factor for trainees, > 40 hours per week), and lack of a supportive mentor are some of very crucial factors responsible for burnout.4,5 Going not with the flow, we would like to focus more on the actions that can contribute to destress our much needed population. A feeling of support, good leadership at workplace, good mentor and also a healthy home environment bestow positive vibes. One pertinent point that really needs to be emphasized is that workplace environment is directly related to team leader. True leadership roles include being empathetic, passionate, resolute and having a true sympathetic nature towards colleagues harboring a culture of support.5 The anesthesiologists being at greater risk demand attention because we are “Swiss army knives” contributing truly to mankind and catering to a wide arena of services in our institute. We bequest patient care in most hostile circumstances (critical care, triage areas) a
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引用次数: 0
期刊
Medical Gas Research
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