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Safety and effectiveness of butorphanol in epidural labor analgesia:A protocol for a systematic review and meta-analysis

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World Journal of Clinical Cases 2024年第8期12卷 1416-1421页

作者： Guan-Cheng Tang Man He Zhen-Zhao Huang Yan Cheng department of anesthesiology Yongkang Hospital of Traditional Chinese MedicineJinhua 321301Zhejiang ProvinceChina department of Gynecology and Obstetrics Yongkang Hospital of Traditional Chinese MedicineJinhua 321301Zhejiang ProvinceChina department of anesthesiology Hangzhou United Liger Sixth Medical Beauty HospitalHangzhou 311215Zhejiang ProvinceChina department of Ultrasound Hangzhou Women’s HospitalHangzhou 310008Zhejiang ProvinceChina

BACKGROUND Epidural analgesia is the most effective analgesic method during *** administered epidurally has been shown to be a successful analgesic method during ***,no comprehensive study has examined the safety and efficacy of using butorphanol as an epidural analgesic during *** To assess butorphanol's safety and efficacy for epidural labor *** The PubMed,Cochrane Library,EMBASE,Web of Science,China National Knowledge Infrastructure,and Google Scholar databases will be searched from *** types of literature,such as conference abstracts and references to pertinent reviews,will also be *** will include randomized controlled trials comparing butorphanol with other opioids combined with local anesthetics for epidural analgesia during *** will be no language *** primary outcomes will include the visual analog scale score for the first stage of labor,fetal effects,and Apgar *** independent reviewers will evaluate the full texts,extract data,and assess the risk of *** bias will be evaluated using Egger's or Begg's tests as well as visual analysis of a funnel plot,and heterogeneity will be evaluated using the Cochran Q test,P values,and I2 ***-analysis,subgroup analysis,and sensitivity analysis will be performed using RevMan software version *** protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)Protocols statement,and the PRISMA statement will be used for the systematic *** This study provides reliable information regarding the safety and efficacy of using butorphanol as an epidural analgesic during *** To support clinical practice and development,this study provides evidence-based findings regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.

关键词： Epidural analgesia during labor Butorphanol Safety Protocol Meta-analysis

High success rate of fiberscope-monitored intubation via a supraglottic airway device BlockBuster^(TM)in good device positioning:A prospective observational study

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Chinese Medical Journal 2024年第7期137卷 871-873页

作者： Zhenfa Hu Kai Su Huihui Miao Xue Gao Fushan Xue Ming Tian department of anesthesiology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China department of anesthesiology Beijing Shijitan HospitalCapital Medical UniversityBeijing 100038China

Airway management is closely related to the safety and quality of *** 2015,the Difcult Airway Society suggested that endotracheal intubation should beberoptic bronchoscope(FOB)-guided and blind intubation should be *** supraglottic airway device(SAD)BlockBuster^(TM)with matched tracheal tube(Block-Buster^(TM)tracheal tube,BTT;Tuoren Medical Instrument Co.,Ltd.,Changyuan,Henan,China)is an improved second-generation SAD with intubation function.[1,2]Theberscope-monitored intubation via SAD BlockBuster^(TM)can make the whole process ***,we investigated the feasibility,success rate,and complications of the new intubation technique in a well-positioned SAD BlockBuster^(TM)by sequential case observation.

关键词： intubation airway supra

Astrocytic pyruvate dehydrogenase kinase-lactic acid axis involvement in glia-neuron crosstalk contributes to morphine-induced hyperalgesia in mice

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Fundamental Research 2024年第4期4卷 820-828页

作者： Xiaqing Ma Qi Qi Wenying Wang Min Huang Haiyan Wang Limin Luo Xiaotao Xu Tifei Yuan Haibo Shi Wei Jiang Tao Xu department of anesthesiology Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200233China department of anesthesiology Suzhou Hospital of Anhui Medical UniversitySuzhou 234000China department of anesthesiology Affliated Hospital of Nantong UniversityMedical School of Nantong UniversityNantong 226001China Shanghai Key Laboratory of Psychotic Disorders Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghai 200030China Shanghai Key Laboratory of Sleep Disordered Breathing Shanghai 200233China

The activation of spinal astrocytes accounts for opioid-induced hyperalgesia(OIH),but the underlying mechanisms remain *** presence of astrocyte-neuron lactate shuttle(ANLS)makes astrocytes necessary for some neural function and *** aim of this study was to explore the role of ANLS in the occurrence and maintenance of *** 7 days consecutive morphine injection,a mice OIH model was established and astrocytic pyruvate dehydrogenase kinase 4(PDK4),phosphorylated pyruvate dehydrogenase(p-PDH)and accumulation of L-lactate was elevated in the spinal dorsal *** administration of inhibitors of PDK,lactate dehydrogenase 5 and monocarboxylate transporters to decrease the supply of L-lactate on neurons was observed to attenuate hypersensitivity behaviors induced by repeated morphine administration and downregulate the expression of markers of central sensitization in the spinal dorsal *** astrocyte line and the neuronal line were co-cultured to investigate the mechanisms in *** this study,we demonstrated that morphine-induced hyperalgesia was sustained by lactate overload consequent upon aberrant function of spinal *** this process,PDK-p-PDH-lactate axis serves a pivotal role,which might therefore be a new target to improve long-term opioid treatment strategy in clinical practice.

关键词： Pyruvate dehydrogenase kinase 4 Phosphorylated pyruvate dehydrogenase Astrocyte-neuron lactate shuttle Opioid-induced hyperalgesia Lactate

Anesthetic dilemmas in an achondroplastic patient undergoing elective cesarean section

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Journal of Biomedical Research 2024年第5期38卷 512-515页

作者： Aaron Brown Hong Liu Cristina Chandler department of anesthesiology and Pain Medicine University of California Davis HealthSacramentoCA 95817USA

Achondroplasia is a genetic condition characterized by skeletal dysplasia that results in characteristic craniofacial and spinal *** is the most common form of short-limbed skeletal dysplasia.A morbidly obese pregnant patient warrants specific anatomical and physiological considerations,such as a difficult airway with potential hypoxia,full stomach precautions,and a reduced functional residual *** increases the risks of maternal and fetal *** neuraxial techniques are generally preferred for cesarean sections,there is no consensus among patients with *** aimed to discuss the anesthetic challenges in an achondroplastic patient and report our regional anesthesia approach for an elective cesarean section.

关键词： achondroplasia skeletal dysplasia combined spinal-epidural anesthesia cesarean delivery

A Comparative Study between Landmark Based and Real Time Ultrasound Guided Sub Arachnoid Block

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Open Journal of anesthesiology 2024年第4期14卷 118-125页

作者： Kunal Tewari Om Bahadur Thapa Deepak Mishra Manjot Multani Jyotsna Sharma Akash Ray Mohapatra Sandhya Khwaunju department of anesthesiology and Critical Care Armed Forces Medical College Pune India department of anesthesiology and Critical Care AFMC Pune India

Background: Sub arachnoid block (SAB) performed by traditional landmark palpation technique can be inaccurate. This problem is exacerbated by altered patient anatomy due to obesity and age-related changes. A pre-procedural ultrasound scan of the lumbar spine has been shown to be of benefit in guiding lumbar epidural insertion in obstetric patients. Information on the use of real-time ultrasound (RUS) guided SAB, to date, been limited. This study compared RUS guided SAB to traditional landmark guided technique in patients undergoing spinal anesthesia for different surgical procedures. Methods: This was a prospective, single center, comparative observational study conducted in the department of anesthesiology at our center. 560 patients who underwent spinal anesthesia either by landmark based technique or real-time ultrasound-guided methods. The primary outcome was the first attempt success rate of dural puncture when employing the two methods. Results: Baseline characteristics were similar in the two study groups. The first attempt success rate of dural puncture in landmark guided group was 64.3% compared to 72.6% in the ultrasound guided group. This difference was not statistically significant. The procedure performance time was significantly shorter with landmark palpation compared to use of real-time ultrasound guided method. Conclusion: Use of RUS-guided technique does not significantly improve the first attempt success rate of SAB dural puncture during spinal anesthesia compared to the traditional landmark-guided technique.

关键词： Sub Arachnoid Block (SAB) Real Time Ultrasound (RUS)

The gasdermin family:emerging therapeutic targets in diseases

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Signal Transduction and Targeted Therapy 2024年第5期9卷 1905-1937页

作者： Chenglong Zhu Sheng Xu Ruoyu Jiang Yizhi Yu Jinjun Bian Zui Zou Faculty of anesthesiology Changhai HospitalNaval Medical UniversityShanghai 200433China School of anesthesiology Naval Medical UniversityShanghai 200433China National Key Laboratory of Immunity&Inflammation Naval Medical UniversityShanghai 200433China d 4 department of Biochemistry and Molecular Biology College of Basic Medical SciencesNaval Medical UniversityShanghai 200433China

The gasdermin(GSDM)family has garnered significant attention for its pivotal role in immunity and disease as a key player in *** recently characterized class of pore-forming effector proteins is pivotal in orchestrating processes such as membrane permeabilization,pyroptosis,and the follow-up inflammatory response,which are crucial self-defense mechanisms against irritants and *** have been implicated in a range of diseases including,but not limited to,sepsis,viral infections,and cancer,either through involvement in pyroptosis or independently of this *** regulation of GSDM-mediated pyroptosis is gaining recognition as a promising therapeutic strategy for the treatment of various *** strategies for inhibiting GSDMD primarily involve binding to GSDMD,blocking GSDMD cleavage or inhibiting GSDMD-N-terminal(NT)oligomerization,albeit with some off-target *** this review,we delve into the cutting-edge understanding of the interplay between GSDMs and pyroptosis,elucidate the activation mechanisms of GSDMs,explore their associations with a range of diseases,and discuss recent advancements and potential strategies for developing GSDMD inhibitors.

关键词： diseases therapeutic immunity

The action mechanism by which C1q/tumor necrosis factor-related protein-6 alleviates cerebral ischemia/reperfusion injury in diabetic mice

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Neural Regeneration Research 2024年第9期19卷 2019-2026页

作者： Bo Zhao Mei Li Bingyu Li Yanan Li Qianni Shen Jiabao Hou Yang Wu Lijuan Gu Wenwei Gao department of anesthesiology Renmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina Central Laboratory Renmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina department of Critical Care Medicine Renmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina

Studies have shown that C1q/tumor necrosis factor-related protein-6 (CTRP6) can alleviate renal ischemia/reperfusion injury in mice. However, its role in the brain remains poorly understood. To investigate the role of CTRP6 in cerebral ischemia/reperfusion injury associated with diabetes mellitus, a diabetes mellitus mouse model of cerebral ischemia/reperfusion injury was established by occlusion of the middle cerebral artery. To overexpress CTRP6 in the brain, an adeno-associated virus carrying CTRP6 was injected into the lateral ventricle. The result was that oxygen injury and inflammation in brain tissue were clearly attenuated, and the number of neurons was greatly reduced. In vitro experiments showed that CTRP6 knockout exacerbated oxidative damage, inflammatory reaction, and apoptosis in cerebral cortical neurons in high glucose hypoxia-simulated diabetic cerebral ischemia/reperfusion injury. CTRP6 overexpression enhanced the sirtuin-1 signaling pathway in diabetic brains after ischemia/reperfusion injury. To investigate the mechanism underlying these effects, we examined mice with depletion of brain tissue-specific sirtuin-1. CTRP6-like protection was achieved by activating the sirtuin-1 signaling pathway. Taken together, these results indicate that CTRP6 likely attenuates cerebral ischemia/reperfusion injury through activation of the sirtuin-1 signaling pathway.

关键词： brain C1q/tumor necrosis factor-related protein-6 cerebral apoptosis diabetes inflammation ischemia/reperfusion injury neuron neuroprotection oxidative damage Sirt1

Comparison of efficacy of lung ultrasound and chest X-ray in diagnosing pulmonary edema and pleural effusion in ICU patients: A single centre, prospective, observational study

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Open Journal of anesthesiology 2024年第3期14卷 41-50页

作者： Kunal Tewari Sumanth Pelluru Deepak Mishra Nitin Pahuja Akash Ray Mohapatra Jyotsna Sharma Om Bahadur Thapa Manjot Multani department of anesthesiology and Critical Care Armed Forces Medical College Pune India department of anesthesiology and Critical Care Military Hospital Bhopal India

Background and Aims While chest X-ray (CXR) has been a conventional tool in intensive care units (ICUs) to identify lung pathologies, computed tomography (CT) scan remains the gold standard. Use of lung ultrasound (LUS) in resource-rich ICUs is still under investigation. The present study compares the utility of LUS to that of CXR in identifying pulmonary edema and pleural effusion in ICU patients. In addition, consolidation and pneumothorax were analyzed as secondary outcome measures. Material and Methods This is a prospective, single centric, observational study. Patients admitted in ICU were examined for lung pathologies, using LUS by a trained intensivist;and CXR done within 4 hours of each other. The final diagnosis was ascertained by an independent senior radiologist, based on the complete medical chart including clinical findings and the results of thoracic CT, if available. The results were compared and analyzed. Results Sensitivity, specificity and diagnostic accuracy of LUS was 95%, 94.4%, 94.67% for pleural effusion;and 98.33%, 97.78%, 98.00% for pulmonary edema respectively. Corresponding values with CXR were 48.33%, 76.67%, 65.33% for pleural effusion;and 36.67%, 82.22% and 64.00% for pulmonary edema respectively. Sensitivity, specificity and diagnostic accuracy of LUS was 91.30%, 96.85%, 96.00% for consolidation;and 100.00%, 79.02%, 80.00% for pneumothorax respectively. Corresponding values with CXR were 60.87%, 81.10%, 78.00% for consolidation;and 71.3%, 97.20%, 96.00% for pneumothorax respectively. Conclusion LUS has better diagnostic accuracy in diagnosis of pleural effusion and pulmonary edema when compared with CXR and is thus recommended as an effective alternative for diagnosis of these conditions in acute care settings. Our study recommends that a thoracic CT scan can be avoided in most of such cases.

关键词： Chest X ray (CXR) Consolidation Pulmonary edema Pleural effusion Lung ultrasound (LUS) Pneumothorax

Ultrasound-guided paravertebral nerve block anesthesia for percutaneous endoscopic laser unroofing treatment of symptomatic simple renal cysts—An innovative ambulatory surgery mode

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Asian Journal of Urology 2024年第1期11卷 65-71页

作者： Jia Hu Yuan Zhang Yong Liu Xiao Yu Shaogang Wang department of Urology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina department of anesthesiology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina

Objective:This study was designed to evaluate the feasibility,efficacy,and safety of percutaneous ureteroscopy laser unroofing as an ambulatory surgery for symptomatic simple renal cysts under multilevel paravertebral nerve block ***:From December 2015 to September 2017,33 simple renal cyst patients who had surgical indications were *** ultrasound guidance,the T10/T11,T11/T12,and T12/L1 paravertebral spaces were identified,and 7-10 mL 0.5%ropivacaine was injected at each *** a puncture needle was placed inside the cyst cavity under ultrasonic monitoring.A guidewire was introduced followed by sequential dilation up to 28/30 *** extra parenchymal portion of the cyst wall was dissociated and incised using a thulium laser,and a pathological examination was ***:Sensory loss to pinprick from T8 to L1 and sensory loss to ice from T6 to L2 were observed in all *** of the patients complained of pain during *** serious complications occurred *** the surgery,all patients recovered their lower limb muscle strength quickly,got out of bed,resumed oral feeding,and left the hospital within 24 h of *** pathologic diagnosis of all cyst walls was a simple renal *** mean follow-up was 35.8 *** the end of follow-up,the cyst units were reduced in size by more than 50%compared to the preoperative size,and no patient experienced a ***:Multi-level paravertebral nerve block for percutaneous ureteroscopy laser unroofing as an ambulatory surgery mode is feasible,safe,and effective for the treatment of simple renal cysts in selected patients.

关键词： Paravertebralnerve blockanesthesia Percutaneous puncture Simplerenalcyst Unroofing Ambulatorysurgery