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Efficacy of ketamine, propofol, and dexmedetomidine for anesthesia in electroconvulsive therapy in treatment-resistant major depressive disorder patients: a double-blind randomized clinical trial. 氯胺酮、异丙酚和右美托咪定对耐药重度抑郁症患者电休克疗法的麻醉效果:一项双盲随机临床试验。
IF 3 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-07-01 DOI: 10.4103/2045-9912.350860
Hesameddin Modir, Behnam Mahmoodiyeh, Mehran Shayganfard, Ayda Abdus, Amir Almasi-Hashiani

Electroconvulsive therapy (ECT) is one of the therapeutic opportunities for patients with psychological disorders when they may decline to take medication. We sought to systematically compare the anesthetic efficacy of ketamine, propofol, and dexmedetomidine for electroconvulsive therapy in treatment-resistant major depressive disorder patients. This double-blind trial enrolled treatment-resistant major depressive disorder patients (n = 85) who had been hospitalized for ECT in the Amir Kabir Hospital's psychiatric ward (Arak, Iran). The ketamine, propofol, and dexmedetomidine groups received a dose of 0.2 μg/kg ketamine, 1.5 mg/kg propofol, and 0.8 mg/kg dexmedetomidine, respectively. In all intervention groups, 10 mL of interventional drugs was injected intravenously for 10 minutes, and in the placebo group, 10 mL of normal saline was given over the same period. The dexmedetomidine group's blood pressure was revealed comparatively lower at all times. Dexmedetomidine-treated patients showed their marked satisfaction, while those treated with propofol had shorter recovery time, shorter seizure duration, and shorter time to achieve an Aldrete score of 9-10 and increased relaxation, and next dexmedetomidine produced deeper relaxation. Propofol could shorten recovery time and seizure duration, and enhance relaxation, while dexmedetomidine was associated with higher patient satisfaction. Considering that any anesthetic which does not shorten seizure duration may serve efficiently for ECT and that ketamine-treated patients had more prolonged seizure duration, the preferred drug can hence be considered from various angles, thereby offering anesthetic agents with highly favorable efficacy in treatment-resistant major depressive disorder patients needing ECT. The drug choice thus depends on physical conditions, underlying diseases, and psychiatrist consultation.

电休克疗法(ECT)是心理障碍患者在拒绝服药时的治疗机会之一。我们试图系统地比较氯胺酮、异丙酚和右美托咪定对耐药重度抑郁症患者电休克疗法的麻醉效果。这项双盲试验招募了曾在阿米尔-卡比尔医院(伊朗阿拉克)精神科病房住院接受电休克治疗的重度抑郁障碍耐药患者(n = 85)。氯胺酮组、异丙酚组和右美托咪定组分别使用 0.2 μg/kg 氯胺酮、1.5 mg/kg 异丙酚和 0.8 mg/kg 右美托咪定。所有干预组均在 10 分钟内静脉注射 10 毫升干预药物,安慰剂组则在同一时间内注射 10 毫升生理盐水。结果显示,右美托咪定组的血压在任何时候都相对较低。右美托咪定治疗的患者表现出明显的满意度,而使用异丙酚治疗的患者恢复时间更短,发作持续时间更短,达到 Aldrete 评分 9-10 分的时间更短,放松程度更高,接下来右美托咪定产生的放松程度更深。丙泊酚可缩短恢复时间和癫痫发作持续时间,并增强松弛度,而右美托咪定可提高患者满意度。考虑到任何不会缩短发作持续时间的麻醉剂都可以有效地用于电痉挛疗法,而氯胺酮治疗的患者发作持续时间更长,因此可以从多个角度考虑首选药物,从而为需要电痉挛疗法的耐药重度抑郁症患者提供疗效更佳的麻醉剂。因此,药物的选择取决于身体状况、潜在疾病和精神科医生的咨询。
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引用次数: 0
Hydrogen applications: advances in the field of medical therapy. 氢的应用:医学治疗领域的进展。
IF 2.9 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-07-01 DOI: 10.4103/2045-9912.344978
Tao Yuan, Jian-Ning Zhao, Ni-Rong Bao

Hydrogen (H2) has been widely used in the chemical industry as a reducing agent. As the researches move along, increasing attention has been paid to its biological functions. The selective antioxidant effect of hydrogen is considered to be the main reason for medical applications. So far, many studies have confirmed its potential protective effects on ischemia/reperfusion injury of multiple organs, neurodegenerative diseases, bone and joint diseases, and respiratory diseases, opening a new era in the medical research and application of H2. Increasing studies have focused on its biological effects and molecular mechanisms in the treatment of different diseases. In this paper, we review the biological effects, molecular mechanisms and methods of H2 supply. We do hope that the advances in materials science can be better translated into medical applications and solve clinical problems. The medical application of H2 is promising, and how to prepare an H2 sustained-release system to achieve a sustained and stable H2 supply in the body and ultimately improve the therapeutic effect of H2 is a problem worthy of further investigation.

氢(H2)作为还原剂在化学工业中得到了广泛的应用。随着研究的深入,其生物学功能越来越受到人们的关注。氢的选择性抗氧化作用被认为是其在医学上应用的主要原因。迄今为止,许多研究证实了其对多器官缺血再灌注损伤、神经退行性疾病、骨关节疾病、呼吸系统疾病的潜在保护作用,开启了H2的医学研究和应用的新时代。越来越多的研究集中在其治疗不同疾病的生物学效应和分子机制上。本文就植物供氢的生物学效应、分子机制和方法作一综述。我们希望材料科学的进步能够更好地转化为医学应用,解决临床问题。H2的医学应用前景广阔,如何制备H2缓释体系,实现体内持续稳定的H2供应,最终提高H2的治疗效果是一个值得进一步研究的问题。
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引用次数: 2
Molecular hydrogen therapy for neurological diseases: a review of current evidence. 神经系统疾病的分子氢疗法:当前证据综述。
IF 2.9 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-07-01 DOI: 10.4103/2045-9912.359677
Dinesh Ramanathan, Lei Huang, Taylor Wilson, Warren Boling

Reactive oxygen species and other free radicals cause oxidative stress which is the underlying pathogenesis of cellular injury in various neurological diseases. Molecular hydrogen therapy with its unique biological property of selectively scavenging pathological free radicals has demonstrated therapeutic potential in innumerable animal studies and some clinical trials. These studies have implicated several cellular pathways affected by hydrogen therapy in explaining its anti-inflammatory and antioxidative effects. This article reviews relevant animal and clinical studies that demonstrate neuroprotective effects of hydrogen therapy in stroke, neurodegenerative diseases, neurotrauma, and global brain injury.

活性氧等自由基引起的氧化应激是多种神经系统疾病中细胞损伤的潜在发病机制。分子氢疗法以其独特的选择性清除病理自由基的生物学特性,在无数的动物研究和一些临床试验中显示出治疗潜力。这些研究暗示了氢疗法影响的几种细胞途径,以解释其抗炎和抗氧化作用。本文综述了氢疗法在脑卒中、神经退行性疾病、神经创伤和全脑损伤中的神经保护作用的相关动物和临床研究。
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引用次数: 3
H2-induced transient upregulation of phospholipids with suppression of energy metabolism. h2诱导的瞬时磷脂上调与能量代谢的抑制。
IF 2.9 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-07-01 DOI: 10.4103/2045-9912.344973
Masumi Iketani, Iwao Sakane, Yasunori Fujita, Masafumi Ito, Ikuroh Ohsawa

Molecular hydrogen (H2) is an antioxidant and anti-inflammatory agent; however, the molecular mechanisms underlying its biological effects are largely unknown. Similar to other gaseous molecules such as inhalation anesthetics, H2 is more soluble in lipids than in water. A recent study demonstrated that H2 reduces radical polymerization-induced cellular damage by suppressing fatty acid peroxidation and membrane permeability. Thus, we sought to examine the effects of short exposure to H2 on lipid composition and associated physiological changes in SH-SY5Y neuroblastoma cells. We analyzed cells by liquid chromatography-high-resolution mass spectrometry to define changes in lipid components. Lipid class analysis of cells exposed to H2 for 1 hour revealed transient increases in glycerophospholipids including phosphatidylethanolamine, phosphatidylinositol, and cardiolipin. Metabolomic analysis also showed that H2 exposure for 1 hour transiently suppressed overall energy metabolism accompanied by a decrease in glutathione. We further observed alterations to endosomal morphology by staining with specific antibodies. Endosomal transport of cholera toxin B to recycling endosomes localized around the Golgi body was delayed in H2-exposed cells. We speculate that H2-induced modification of lipid composition depresses energy production and endosomal transport concomitant with enhancement of oxidative stress, which transiently stimulates stress response pathways to protect cells.

分子氢(H2)是一种抗氧化剂和抗炎剂;然而,其生物学作用的分子机制在很大程度上是未知的。与其他气体分子(如吸入性麻醉剂)类似,H2在脂质中比在水中更易溶解。最近的一项研究表明,H2通过抑制脂肪酸过氧化和膜通透性来减少自由基聚合引起的细胞损伤。因此,我们试图研究短时间暴露于H2对SH-SY5Y神经母细胞瘤细胞脂质组成和相关生理变化的影响。我们通过液相色谱-高分辨率质谱分析细胞来确定脂质成分的变化。对暴露于H2 1小时的细胞进行脂质分类分析,发现甘油磷脂(包括磷脂酰乙醇胺、磷脂酰肌醇和心磷脂)瞬间升高。代谢组学分析还表明,H2暴露1小时会短暂抑制总能量代谢,并伴有谷胱甘肽的减少。我们通过特异性抗体染色进一步观察到内体形态的改变。在h2暴露的细胞中,霍乱毒素B向高尔基体周围的再循环内体的内体运输被延迟。我们推测,h2诱导的脂质成分修饰抑制了能量产生和内体运输,同时增强了氧化应激,从而短暂地刺激应激反应途径以保护细胞。
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引用次数: 1
Quantitative risk assessment of respiratory exposure to acrylonitrile vapor in petrochemical industry by U.S. Environmental Protection Agency method: a cross-sectional study. 美国环境保护署方法对石化工业中丙烯腈蒸气呼吸暴露的定量风险评估:一项横断面研究。
IF 2.9 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-07-01 DOI: 10.4103/2045-9912.350859
Ali Asghar Sajedian, Ali Karimi, Mohsen Sadeghi Yarandi, Vahid Ahmadi Moshiran, Aysa Ghasemi Koozekonan, Farideh Golbabaei

Acrylonitrile is a potential carcinogen for humans, and exposure to this substance can cause adverse effects for workers. This study aimed to carcinogenic and health risk assessment of acrylonitrile vapor exposure in exposed personnel of a petrochemical complex. This crosssectional study was performed in 2019 in a petrochemical complex. In this study, to sample and determine acrylonitrile's respiratory exposure, the method provided by the National Institute of Occupational Safety and Health (NIOSH 1601) was used, and a total of 45 inhaled air samples were sampled from men workers, aged 39.43 ± 9.37 years. All subjects' mean exposure to acrylonitrile vapors was 71.1 ± 122.8 μg/m3. Also, the mean exposure index among all subjects was 0.02 ± 0.034. The non-carcinogenic risk assessment results showed that the mean Hazard quotient index was 4.04 ± 6.93. The mean lifetime cancer risk index was also 2.1 × 10-3 ± 3.5 × 10-3 and was in the definite risk range. Considering that both carcinogenicity and health indicators of exposure to acrylonitrile in the studied petrochemical complex are more than the recommended limits, the necessary engineering and management measures to control and manage the risk to an acceptable level are essential to improving the worker's health.

丙烯腈是一种潜在的人类致癌物,接触这种物质会对工人造成不良影响。本研究旨在对某石化企业作业人员接触丙烯腈蒸气的致癌性和健康风险进行评价。这项横断面研究于2019年在一家石化综合企业进行。本研究采用美国国家职业安全卫生研究所(NIOSH 1601)提供的方法,采集了45份男性工人吸入空气样本,年龄39.43±9.37岁。所有受试者的丙烯腈蒸气平均暴露量为71.1±122.8 μg/m3。所有受试者的平均暴露指数为0.02±0.034。非致癌风险评价结果显示,平均危害商指数为4.04±6.93。平均终生癌症危险指数为2.1 × 10-3±3.5 × 10-3,处于明确的危险范围。考虑到所研究的石化企业丙烯腈暴露的致癌性和健康指标均超过建议限值,采取必要的工程和管理措施,将风险控制和管理到可接受的水平,对改善工人的健康至关重要。
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引用次数: 0
Nitric oxide therapy is beneficial to rehabilitation in professional soccer players: clinical and experimental studies. 一氧化氮治疗对职业足球运动员康复有益:临床和实验研究。
IF 2.9 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-07-01 DOI: 10.4103/2045-9912.344983
Victoria A Zaborova, Alexandra V Butenko, Anatoly B Shekhter, Alexey L Fayzullin, Alexander V Pekshev, Natalia B Serejnikova, Ol'ga V Chigirintseva, Kira Yu Kryuchkova, Konstantin G Gurevich

Nitric oxide can activate neutrophils and macrophages, facilitate the synthesis of collagen, which allows significantly accelerating the regeneration of traumatized tissues. We studied the effects of nitric oxide-containing gas flow generated by plasma-chemical device "Plason" in a rat model of full-thickness wounds. Histological and morphometric analyses revealed that Plason treated wounds expressed significantly fewer signs of inflammation and contained a more mature granulation tissue on day 4 after the operation. Considering the results of the experimental study, we applied the Plason device in sports medicine for the treatment of lower limb bruises of 34 professional soccer players. Athletes were asked to assess the intensity of pain with the Visual Analogue Scale. Girths of their lower limbs were measured over the course of rehabilitation. Nitric oxide therapy of full-thickness wounds inhibited inflammation and accelerated the regeneration of skin and muscle tissues. Compared with the control, we observed a significant reduction in pain syndrome on days 2-7 after injuries, edema, and hematoma, and shortened treatment duration. This pilot study indicates that the use of nitric oxide is a promising treatment method for sports injuries.

一氧化氮可以激活中性粒细胞和巨噬细胞,促进胶原蛋白的合成,从而显著加速创伤组织的再生。我们研究了等离子体化学装置“等离子体”产生的含一氧化氮气体流对大鼠全层伤口模型的影响。组织学和形态计量学分析显示,等离子体治疗的伤口在手术后第4天炎症症状明显减少,肉芽组织更成熟。结合实验研究结果,我们将等离子体装置应用于运动医学,对34名职业足球运动员下肢擦伤进行治疗。运动员被要求用视觉模拟量表评估疼痛的强度。在康复过程中测量了他们的下肢周长。一氧化氮治疗全层创面能抑制炎症,促进皮肤和肌肉组织的再生。与对照组相比,我们观察到损伤后2-7天疼痛综合征、水肿和血肿明显减轻,治疗时间缩短。这项初步研究表明,使用一氧化氮是一种很有前途的治疗运动损伤的方法。
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引用次数: 1
Hydrogen exerts neuroprotective effects by inhibiting oxidative stress in experimental diabetic peripheral neuropathy rats. 氢通过抑制实验性糖尿病周围神经病变大鼠氧化应激发挥神经保护作用。
IF 2.9 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-04-01 DOI: 10.4103/2045-9912.345171
Xiao-Chen Han, Zhou-Heng Ye, Hui-Jun Hu, Qiang Sun, Dan-Feng Fan

Diabetic peripheral neuropathy (DPN) is a complex disorder caused by long-standing diabetes. Oxidative stress was considered the critical creed in this DPN pathophysiology. Hydrogen has antioxidative effects on diabetes mellitus and related complications. However, there is still no concern on the beneficial effects of hydrogen in DPN. This paper aimed to evaluate the effects of exogenous hydrogen to reduce the severity of DPN in streptozotocin-induced diabetic rats. Compared with hydrogen-rich saline treatment, hydrogen inhalation significantly reduced blood glucose levels in diabetic rats in the 4th and 8th weeks. With regard to nerve function, hydrogen administration significantly attenuated the decrease in the velocity of motor nerve conduction in diabetic animals. In addition, hydrogen significantly attenuated oxidative stress by reducing the level of malondialdehyde, reactive oxygen species, and 8-hydroxy-2-deoxyguanosine and meaningfully enhanced the antioxidant capability by partially restoring the activities of superoxide dismutase. Further studies showed that hydrogen significantly upregulated the expression of nuclear factor erythroid-2-related factor 2 and downstream proteins such as catalase and hemeoxygenase-1 in the nerves of diabetic animals. Our paper showed that hydrogen exerts significant protective effects in DPN by downregulating oxidative stress via the pathway of nuclear factor erythroid-2-related factor 2, which suggests its potential value in clinical applications.

糖尿病周围神经病变(DPN)是一种由长期糖尿病引起的复杂疾病。氧化应激被认为是DPN病理生理学的关键因素。氢对糖尿病及其相关并发症具有抗氧化作用。然而,氢在DPN中的有益作用仍然没有得到关注。本文旨在评价外源性氢对链脲佐菌素诱导的糖尿病大鼠DPN严重程度的影响。与富氢盐水治疗相比,吸入氢在第4周和第8周显著降低糖尿病大鼠的血糖水平。在神经功能方面,给氢显著减轻了糖尿病动物运动神经传导速度的下降。此外,氢通过降低丙二醛、活性氧和8-羟基-2-脱氧鸟苷的水平显著减轻氧化应激,并通过部分恢复超氧化物歧化酶的活性显著增强抗氧化能力。进一步研究表明,氢显著上调糖尿病动物神经中核因子-红细胞-2相关因子-2及下游蛋白过氧化氢酶、血红素加氧酶-1的表达。我们的研究表明,氢通过核因子-红细胞-2相关因子2通路下调氧化应激,对DPN具有显著的保护作用,提示其临床应用价值。
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引用次数: 2
New scientific definitions: hyperbaric therapy and hyperbaric oxygen therapy. 新的科学定义:高压氧治疗和高压氧治疗。
IF 2.9 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-04-01 DOI: 10.4103/2045-9912.356475
Paul G Harch
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引用次数: 2
Realizing brain therapy with “smart medicine”: Mechanism and case report of molecular hydrogen inhalation for Parkinson's disease 用“智慧医学”实现脑治疗:分子氢吸入治疗帕金森病的机理及病例报告
Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.4103/2045-9912.385949
Yusuke Ichikawa, Bunpei Sato, Shin-ichi Hirano, Yoshiyasu Takefuji, Fumitake Satoh
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引用次数: 0
Use of vedolizumab combined with hyperbaric oxygen therapy to treat enteric fistula in Crohn's disease 使用vedolizumab联合高压氧治疗克罗恩病肠瘘
Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.4103/2045-9912.385948
EnioChaves Oliveira, Mauro Bafutto, AlexandreAugusto Ferreira Bafutto, CarlosAlberto Ximenes Filho
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引用次数: 0
期刊
Medical Gas Research
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